Re: New to Cushings


Hi "K",

Welcome to the group!  We have a strong group of people in Australia who may be of help to your for sourcing products/support, so tell us your general location and I'm sure they will be chiming in!  We need more details about Teshan to help answer your questions better.  To get those details, we ask that all members fill out a case history on their horse.  To do that, you need to join one of our sister sites, ECH8, where we store the CH's.  Here's a link to that site.  It shouldn't take long to get approved and then just follow the instructions to fill out a CH on Teshan.   We follow a philosophy here called DDT/E, which stands for Diagnosis, Diet, Trim and Exercise.  So I'll break it down into each category and give you some more details and links to important information.

Diagnosis:   We do need to know exactly what test you had done and the results as well as the labs normal reference ranges.  There is a place in the CH form for you to enter that information.  Cushing's (PPID) and insulin resistance (IR)  have some similar and overlapping symptoms, and a horse can have just PPID or just IR, but it's also common for a PPID horse to also be IR.  Because of this, we recommend these 4 tests to get a complete diagnosis--eACTH, insulin, glucose and leptin levels on a NON-fasting horse.  Gribbles is the lab to use in Australia.  They do the leptin level.  Here is  a link to our "Australia" file with lab information and lots of other information you may find helpful:   The blood does require special treatment.  Please refer to our website for the details: 

 It's important to get a full diagnosis because the diagnosis dictates the treatment.  PPID is treated with medicine (pergolide) and IR is treated with diet.  If a horse has both PPID and IR then the horse would need both medicine and a carefully managed diet for the rest of it's life.  The chastetree berry can help to control the symptoms of PPID, but it does not control the growth of the tumor.  It can be used in conjuction with the pergolide to help with the symptoms, most notably the long coat.  There is lots of information in this file about pergolide and also CTB:   

Please follow this thread for information from Dr. Kellon about the study that you linked to:   I know when funds are tight for meds and testing it can be very difficult.  Lots of people use this "list of symptoms" in combination with testing to help see if the dose of pergolide is controlling the ACTH level:   Also want to mention that the liquid form of pergolide is the least stable form.  We recommend the powered form in capsules. There is a link to a compounding pharmacy in the Aussie file and more stability information in the "pergolide 101" file.

OK, on to Diet: The IR diet is low sugar starch grass hay (tested to be under 10% sugar + starch), and low fat (under 4%) with minerals to balance the excesses and deficiencies in the hay.  And to replace the fragile ingredients that are lost in the hay curing process we add Vitamin E and ground flax seed.  Details about amounts can be found on the Diet part of our website here:  Until you can have your hay tested we recommend that you start the emergency diet, which involves soaking you hay for an hour in cold water or 30 minutes in hot water which removes up to ~30% of the sugar content. Make sure you dump the water where the horse(s) cannot get it.   Also, as important as what you DO feed is what you DON'T feed!  No pasture, grain, molasses, sugary treats, including apples and carrots, no brown/red salt blocks.  You should be feeding 1.5-2% of your horse's BW in grass hay, divided into several small portions/day.  We like to use small mesh hay nets to slow down the sometimes voracious appetite of some of these IR horses and they are also great for soaking hay!  There is a link to a source for small mesh hay nets in that Australian file I linked to.  The diet recommendations for an IR horse are extremely beneficial to a Cushing's horse's more fragile system and if the Cushing's has caused IR, then it's an essential part of the treatment.  All PPID horses should be fed as though they are IR until proven otherwise!

Trim:  Toes backed and heels lowered so that the hoof capsule closely hugs and supports the internal structures of the foot.  You are welcome to take and post pictures of Teshan's feet for one of our hoof specials to review to see if your trim is optimal.  Please follow the instructions on this site for taking proper hoof photos:   If you do choose to post hoof pictures, please put them in the PHOTOS section of ECH8, the group you join to fill out a CH.   

Exercise:  The best IR buster there is!  But a laminitic horse should never be forced to move!  It's great that Teshan has never had laminitis!!  Unfortunately, fall laminitis is often the first symptom of PPID, due to a naturally occurring seasonal rise in ACTH that all horse experience, but PPID horses have an often exaggerated and prolonged rise in theri ACTH putting at risk for laminitis.  Since you are entering this very fragile time of year in Australia, it's extremely important to get Teshan under adequate control.  There's some great information on our website about the seasonal rise:   In fact, please take the time to read and study all the parts of our website.  There is so much great information there!  It's also a great place to send your vet since many of them are not quite up to date with the latest info on PPID and IR.

So "K", that about sums it up!  I know it's a LOT of information!!  But please do read the files and website!  Any question you might have has probably been answered at least once in the past, so use the archives messages to search for answers to your questions too.  But don't ever hesitate to ask any question that you have!  We ask all members to sign their first name, date of joining and general location each time they post.  Once you get Teshan's CH done, please add a link to it in your signature as well.  It really helps us to find it faster and thus answer your questions faster.  Thanks!

Maggie, Chancey and Spiral in VA
March 2011
EC Primary Response

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