Cushings


Sally Mason <won@...>
 

Hi, I am a new member through the healthy horse list. Following is a
summary o my experience with what I believe is a tendency to
misdiagnose in younger horses:

This insideous diseas, along with diabetes & founder in horses, is
among our worst nightmares.I have learend that in matters of health &
well being-self, family & animals- the responsibility for choices is
mine. I risk being wrong but I must be proactive. Often the choices
are
for what is best, not perfect, as perfection is beyond my grasp.
.

There appears to be much misdiagnosis of Cushings & we really need
to do our own very thorough research... every chance diagnosis
should be ruled out especially with young horses unlikely to be true
Cushings candidates.

My mare's "diagnosis of possible Cushings was based on elevated
cortisol in blood tests following founder. "

Elevated cortisol is the body's natural reaction to address
inflammation. As the mare showed none of the other signs of Cushings
Syndrome I opted to forgo ... the drugs.

Seems to me it is most important to rule out anything that might be
causing inflammation. Could be as simple as "horseshoes". (1 example
only) De-shoe & restore natural hoof mechanism i.e.. Strasser &
Jackson. Remove the cause, allow a reasonable amount of time for
inflammation subsidence and see if the cortisol level drops.... foot
mechanism is restored. Allow time for transition ... new circulation
into the foot & bodywide inflammation-cortisol-response (will
subside).

Just pulled out what's left of last years research. My regular vet
did not discuss this with me. A just out of school vet suggested
using either Permax or Cyproheptadine to test/treat. Put the mare on
one or the other and see if cortisol dropped. If it did, she should
be kept on the drug for life. His reasons might well have been a
result of the controversy on testing efficasy as stated below.

CYPROHEPTADINE/PERIACTIN was recommended as less costly than Permax
-in August of last year- as a treatment. IT IS A PSYCHOTROPIC DRUG, A
BLOCKER OF SERATONIN, USED IN HUMANS TO MANAGE SCHIZOPHRENIA.

PERMAX/PARLODEl are the dopamine agonists used in human Parkisons
Diseae.(with) side effects, & often cause for discontinuance, may
COMMONLY CAUSE HALLUCINATIONS & CONFUSION. Psychotropic action.

Dopamine agonists do have anti-depressant actions and I believe in
the information thrown out there was reference to antidepressant
value.

I have a Journal of Equine Veterinary Science article Volume 19, #11
(Nov. '99), starting pg. 684, by Robert Douglas, PhD, BETS
Laboratories titled "Circadian Cortisol Rhythmicity & Equine
Cushing's-Like Disease" stating: "....Although clinical Equine
Cushing's Disease has been recognised for almost half a century, our
ability to diagnostically confirm that horses have PI dysfunction has
not been very good with the exception of necropsy results...." He
goes on to state the most commonly used hormonal diagnostics are
dexamethasone suppression tests and"....Two problems exist with this
testing protocol. First it is INSENSITIVE and second it is RIGID IN
TERMS OF WHEN IT MUST BE PERFORMED...." Research by BET Laboratories
has determined Equine Cushings Disease must be present for 5 years or
more before the test is useful.

BETS is researching "new" testing & treatment protocols, and
recommends a combination treatment using both Permax & Cyproheptadine
which are referred to at the end of the article as dopamine active.

In lactating mares which are taken off the drugs
3 weeks prior to foaling there is indication that some horses taken
off the treatment somehow reset PI (pars intermedia) of the pituitary
gland & remain normal for several years not requiring the drugs.

Another article on hand is from the Knowledge Bank of the Horse
Interactive dated Feb. 1997 titled "Cushings Syndrome" by Karen
Briggs. She interviews
Frank Andrews, DVM, Assoc. Prof. Equine Med at the Univ. of TN.
Though not as recent research as the above the article covers testing
& drug treatment. The testing info 2 years ago was controversial in
terms of accuracy.

Andrews also concludes that horses suffering from chronic founder &
recurrent infection at best might experience limited benefit.

Todays research:
www4.ncbi.nml.nih.gov/PubMed
Peroglide is assoc with development of retroperitonieal fibrosis
(12.9.99)

Below are 2 sites to quick reference prescription drugs.
www.mdma.net/index
www.planetRx.com
My mare is on ABC Plus & free choice Stress Kit supplements &
intermittent herbls including blends from Meadowsweet Acres..
Jim Helfter, CEO Advanced Biological Systems. Jim is conducting a
research project with Alice Stevens on Cushings and
nutritional approach to management. You can contact Alice direct at:
Bjgulliel@...
This is a labor of love for Alice as she has 2 cushings horses.
Go to ABC's website to see if there is more recent info. published.
www.a-b-c-plus.com. If not email an inquiry off the site.
One of the studies I had last year on prescription drug treatment
offered the hope of MAYBE 2 years improvement in quality of life. For
a 12 y.o. foundered mare otherwise looking beautiful & moving with
apparent soundness-and happy with her life, (the drugs were not my
choice.

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