Cushings Disease is generally a disease of older horses and ponies and affects the animal's metabolism. The disease is triggered by a benign tumor on the pituitary gland in the brain. The pituitary gland is responsible for many vital functions including regulating metabolism. The tumor causes the pituitary gland to stimulate the adrenal gland to excess resulting in the over production of endogenous cortisone (cortisone produced within the body). The following signs characterize the disease:

1. Laminitis - chronic low-level laminitis and/or bouts of acute disease.
2. Curly coat especially on the lower limbs. No loss of winter coat in spring.
3. Increased thirst and subsequent increased urination. High glucose levels will often be found in the urine, when tested.
4. There can be muscle wasting and an appearance of having a "pot belly". The ribs might show even though the horse is reasonably well covered with flesh.
5. Abnormal fat deposits. One area where this is often particularly noticeable is above the eyes.
6. Sweating inappropriately, for example when standing at rest in the stable.
7. Depression and/or lack of energy. The animal is listless and can sometimes be found to be anemic.

It is vital that you consult your veterinary surgeon if your horse or pony has any of these symptoms. Some of these symptoms can occur in other diseases and therefore expert advice in the first instance is very important. In fact the disease is often diagnosed when the veterinary surgeon is called to an old pony with laminitis. Blood samples may show raised levels of cortisone and glucose, there may be glucose in the urine and that combined with examination of the animal for the signs mentioned above will help confirm diagnosis of Cushings Disease. Obviously any acute symptoms must be treated at once but ponies can live for many years after being diagnosed with Cushings disease and correct management will help to prolong their life.

MEDICATIONS: A drug called Pergolide is used most frequently to treat the disease, it limits the production of cortisone in the body by inactivating the part of the adrenal gland responsible for its production. However, for some reason it does not work in some animals. These animals are not considered to have classical Cushings Disease but a variation called Peripheral Cushings Disease.

Research is going on into Cushings Disease and its variations and treatments but until that time, it is worth knowing that some good results have been achieved with herbal treatments, most specifically the herb Vitex Agnus Castus, also known as Chasteberry (Hormonise). This herb has long been used for hormonal problems in humans. It is thought to balance the hormones and restore proper function. Although research is still going on, there is much anecdotal evidence to show the success of this herb in treating animals with Cushings Disease. Garlic is used to stimulate the immune system and to improve circulation. It can also help to guard against secondary bacterial infections. For these reasons it should be added to the diet of every animal with Cushings Disease.

CASE HISTORY: Aston Tinkerbell is a thirty-year-old Welsh Section A Mare. She has had laminitis in her early twenties but not since. However, in 2000 she developed symptoms of excessive thirst and urination and of depression. Blood tests pointed to Cushings Disease at about the same time as swellings appeared above the eyes. Loss of weight began to occur despite treatment with Pergolide. She was deeply depressed and did not want to be ridden. She was drinking up to sixteen gallons of water every day. Her appetite was very poor. In June 2001, the owner stopped all drug treatment and subsequently further treatment with Hormonise. By December 2001, the pony was well enough to attend a show and to try and buck her young rider off! Her weight has been restored and she continues to enjoy life. She is down to drinking approximately four gallons of water per day.

FEEDING: Good quality hay or haylage, fed ad-lib must be the main part of the diet. If the pony has poor teeth, then soaked fibre cubes can be substituted for some of the hay ration. With increased sugar levels being part of the problem, all feeds with added sugar (usually in the form of molasses) should be avoided. Manufacturers are recognizing this problem and producing sugar free cubes. Otherwise, weight can be maintained on a diet of oats and either bran or chaff. A portion of the diet can usefully be supplied by vegetable or soy oil. Horses are able to digest oil quiet efficiently and easily but without the problems associated with overfeeding of grain. Excessive grain consumption can lead directly to laminitis. However there can be difficulty keeping weight on the Cushings animal and thus oil can usefully provide a proportion of the feed. This should not be more than 0.3 litres of oil per day. Oil should be introduced slowly over a number of weeks.

The herb Fenugreek has been found to be helpful for Cushings sufferers. It contains steroidal saponins and for this reason has been used for hormonal problems in humans. It has also been used for depression and for excess sweating in humans - two problems that occur in the Cushings animal. Fenugreek also increases the appetite, which is a useful function for the depressed pony.

A good quality vitamin and mineral supplement should be fed. This should be one, which includes iron, folic acid and B vitamins, to guard against anemia.. For the horse with arthritis or other stiffness arising from old age, it can be beneficial to give a herbal "anti-inflammatory" such as a product containing Devils Claw (NoBute). This will help the pony to move more freely

MANAGEMENT; The long coat can be a big problem and for that reason the pony is best stabled, at least at night and clipped. The temperature can then be regulated by the use of rugs. Sponging down with cool water can be useful during very hot weather. Even if the pony lives out all year round, it is useful to clip him in the summer months. This also reduces the coat before the start of winter.

Care should be taken to avoid laminitis. This means restricting grazing, especially in the spring and autumn. There is often a late flush of grass in autumn, when the weather is still warm but there is more rain. Small paddocks can be made inside a larger paddock, by the use of electric fencing. This enables the pony to still interact with his companions, which is important for the depressive aspect of the illness.

Regular gentle exercise is recommended unless there is evidence of laminitis or other lameness problem or the vet has advised against exercise. However, stress should be avoided and therefore travelling and competition are not advised unless carried out with great care. Other stresses such, as extremes of heat and cold and bullying by companions should be avoided.

Take good care of your horse's skin. Horses with Cushings Disease are often prone to skin and other infections. Frequent urination can lead to sore hind legs. This can be washed with Tea Tree shampoo and treated with a general-purpose lotion. Bedding becomes wet very quickly and should be changed regularly. It can be useful to record your horse's weight using a weigh tape, so you can keep a check on his progress. Regular dental work (teeth rasping) will help to ensure proper mastication and digestion of food. A strict worming program should be carried out. His feet will need to be trimmed regularly by the farrier, even if he is unshod. Peace and quiet and routine are very valuable to a horse with Cushings Disease. All of these precautions will give your horse all the help possible to deal with this disease.