There Ought To Be A Law

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.

PPID Horse

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

About Dr. Kellon

Graduate of University of Pennsylvania Veterinary School. Owner of Equine Nutritional Solutions, www.drkellon.com, industry and private nutritional consultations, online nutritional courses. Staff Veterinary Expert at Uckele Health and Nutrition.
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3 Responses to There Ought To Be A Law

  1. Tracy Nicewander says:

    I can’t agree more. My comment is my gelding had a slightly larger sheath than others ever since I can remember (got him at 6 months). Vets said oh it’s just that way. When he was 20 his sheath swelled a lot. Keep in mind I always kept his sheath clean using only water and Excalibur. After having 3 vets check him out within a 2 week period (he foundered badly during this time) I finally found information – yes on the net – about the sheath size being one of the first signs of chushings appearing at an early age. I promptly got him on pergolide and whal-la he was on his way to recovery.
    I really think this information should b more available. Had the 3 different vets been more informed or if it had come up sooner online for myself I truly believe Nick would have lived much longer. Sadly the founder though quick in coming on was severe. He lived another happy 3 years of light riding until the founder returned with a vengeance and he had to b put down.
    I would have liked to see this abnormality on your list.

    • uckeleequine says:

      The sheath swelling is actually more a sign of insulin resistance. Insulin resistance may accompany Cushing’s but can also occur on its own. Pergolide helps greatly with controlling the IR in Cushing’s horses but dosages may be need to be adjusted as time goes on and/or in the late summer/fall when their hormone levels have a temporary seasonal rise. Even when taking pergolide the IR is best controlled by also feeding an IR appropriate low sugar/starch diet with mineral balancing.

      • Tracy Nicewander says:

        I can’t agree more. My comment is my gelding had a slightly larger sheath than others ever since I can remember (got him at 6 months). Vets said oh it’s just that way. When he was 20 his sheath swelled a lot. Keep in mind I always kept his sheath clean using only water and Excalibur. After having 3 vets check him out within a 2 week period (he foundered badly during this time) I finally found information – yes on the net – about the sheath size being one of the first signs of chushings appearing at an early age. I promptly got him on pergolide and whal-la he was on his way to recovery.
        I really think this information should b more available. Had the 3 different vets been more informed or if it had come up sooner online for myself I truly believe Nick would have lived much longer. Sadly the founder though quick in coming on was severe. He lived another happy 3 years of light riding until the founder returned with a vengeance and he had to b put down.
        I would have liked to see this abnormality on your list.

        Thank you for your reply. Very interesting! Still surprised the vets didn’t catch that. It may explain why Nick did better when I lowered the dose after the first couple of months. I thought it was just because I had been forced to switch pharmacys due to company buyout. Thank you for the education.

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