Diseases of the metabolism equine cushing syndrome dr. Schaette

Metabolic disorders: Equine Cushing's SyndromeStudies indicate that about 80% of all laminitis cases are due to metabolic disorders. Formerly rather rare, Equine Cushing's Syndrome and Equine Metabolic Syndrome are now frequently diagnosed.

Equine Cushing Syndrome (ECS)

ECS is a typical disease of old age. The older the horse, the greater the likelihood that the disease will occur. An estimated 20% of all horses 15 years and older are affected. The English name for ECS is PPID (pituitary pars intermedia dysfunction).

ECS is due to excessive hormone production in the pituitary gland (hypophysis). ACTH (adenocorticotropic hormone) is secreted there unchecked. Upsets the hormonal balance.

This is
Chain reaction, which already starts in the hypothalamus (see figure):

1. With increasing age, the cells of the hypothalamus become tired and produce less dopamine. Dopamine regulates the activity of the pituitary gland. Normally slows down the release of ACTH. 2. When the level of dopamine is low, this brake fails. Large amounts of ACTH are released. 3. ACTH stimulates the production of cortisol in the adrenal cortex. 4. A hormonal imbalance develops. 5. The result is the typical ECS symptoms.

The constant activity of the pituitary gland can cause it to enlarge. In some cases a benign tumor forms.

Symptoms of ECS

Cortisol is a stress hormone that puts the body on alert. As a result, blood glucose levels rise. Decrease the defenses.

The signs of ECS often start insidiously. These include:

– fatigue and even apathy – disturbed moult – unnaturally long and thick coat (hirsutism) – weight loss – susceptibility to disease – increased risk of allergies. Infections and parasites – Impaired wound healing – Insulin resistance

In the further course:

– Muscle atrophy – Laminitis – Kidney dysfunction

Excessive teddy coat is a sign of Cushing's disease.


As a rule, a blood analysis is used to check whether the ACTH level is above a certain limit (note: reference values fluctuate over the seasons).

However, the significance of the ACTH value is debated, as it cannot reflect cortisol production 1:1. The TRH stimulation test, in which the cortisol level is determined directly, is therefore considered the most reliable but more complex method.

diseases of the metabolism equine cushing syndrome dr. schaette

Simplified representation of the equine brain with hypothalamus (red) and pituitary gland (green)

When diagnosing Cushing's, it should be taken into account that persistent pain can also lead to stress and thus to increased cortisol secretion.


Not every horse diagnosed with Cushing's disease is actually a Cushing's patient. In some horses the symptoms can be solved only by optimizing the posture and feeding. In such cases one speaks of a pseudo-Cushing or a Cushing's symptomatology. There is still a need for research here. Cushing's is incurable. About the optimization of the attitude. However, a lot can already be achieved with feeding. About the optimization of the husbandry. However, much can already be achieved with feeding. Medicinal plants offer additional support.


First and foremost is the reduction of stress, as this is an additional stimulus for cortisol release. Plenty of space, sufficient retreat possibilities, quiet feeding places and a stable social/group structure prevent stress.


Cushing's horses are particularly susceptible to laminitis. The increased cortisol level causes the blood vessels to constrict, which can be a problem, especially in the hoof corium. Feeding high in starch and protein should therefore be avoided at all costs. High quality hay supplemented with a mineral feed as well as (limited) grazing provides all important nutrients.


Classical medicine relies on the active ingredient pergolide. This stimulates the release of dopamine. Should restore the hormonal balance. However, side effects such as apathy, inappetence, watery stools and aggressiveness are possible. The aim should therefore be to keep the dosage of the drug as low as possible.

Medicinal plants

Another useful support for ECS are medicinal herbs. Whether alone or in combination with pergolide, must be decided from horse to horse.

Monk's pepper can positively influence the hormone balance. Milk thistle, artichoke, curcuma and Fenugreek support and protect the liver. Ginkgo improves blood circulation in the hoof corium. Ginseng and Fenugreek are herbal adaptogens, which help the organism to adapt to physical and emotional stress situations.

diseases of the metabolism equine cushing syndrome dr. schaette

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diseases of the metabolism equine cushing syndrome dr. schaette

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2 Responses to “Metabolic disorders: equine Cushing's syndrome”

Thanks for the article, but if you don't want to run the risk of laminitis and the horse being constantly unwell (unmotivated, in a bad mood, looking sick,….), you can not do without Pergolide. One could have the impression that it is about the sale of the supplementary food.

Thank you for your suggestion. Whether and in what quantity Pergolide is given, as described, varies from horse to horse. Animals with mild symptoms usually cope well with herbal support. Others againrum, as you write, are strongly limited in the well-being and here one should not renounce of course a medicamentous therapy. Also a combination of phytotherapy. Classical medicine has proven itself in many cases. All the best, your Dr.


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