Actually, there is. It’s called practicing veterinary medicine without a license.
It is no secret there is bad information/advice on the internet. This is taken to another level when it involves statements that are not only wrong but also put ill and often fragile horses at risk. To top it off, this misinformation is coming from commercial web sites selling illegitimate treatments.
It is being claimed Cushing’s is not an actual disease and there is no justification for using pergolide. Really????
Making the rounds of social media is a blog claiming that hyperinsulinemia (high blood insulin) causes ACTH, a pituitary hormone elevated in horses with Cushing’s/PPID, to rise. A web site article it references claims that pituitary hypertrophy or adenoma (benign tumor) have only been rarely documented in horses and those horses had no symptoms. This is pure science fiction. The take home message offered is that PPID doesn’t exist, it’s just a form of equine diabetes type 2, and pergolide is worthless. What the horses really need is, of course, the miracle herbal cure they are selling.
Some elevation of cortisol has been found with type 2 diabetes/metabolic syndrome in humans and rats (not in horses, even when laminitic) but even they do not have elevated ACTH. Multiple studies have documented hypertrophy or adenoma formation in horses with Cushing’s disease [PPID], even to the point of correlating the degree of change with signs observed.
Abnormalities that may be observed with PPID which are not related to high insulin/IR include some or all of the following:
- muscle loss, especially noticeable on topline
- pot bellied
- slow to shed or failure to shed
- wavy, kinky or wiry coat, long guard hairs
- loose teeth
- infections, especially in the head area
- mild anemia
- low total white blood cell count with low lymphocytes, normal neutrophils
- elevated melanocyte stimulating hormone
- elevated endorphin
There are many horses with hyperinsulinemia that do not have elevated ACTH levels or other signs of PPID. There are also clearly PPID horses with elevated ACTH and classical coat changes that do not have hyperinsulinemia – although untreated elevations of ACTH and cortisol can eventually lead to IR even in breeds not normally at risk.
PPID and equine metabolic syndrome/insulin resistance can be and often are separate disorders. Elevated ACTH in PPID can lead to IR but EMS/IR horses do not have elevated ACTH. EMS is controlled through diet and exercise, which are also useful for the IR that can accompany PPID but the only proven effective treatment for PPID is pergolide.
Drink the Kool-Aid at your horse’s risk.
If anyone would like to see bona fide research studies on the points above, drop me a line.
Eleanor Kellon, VMD