Cushing’s or Metabolic Syndrome?

A horse with equine metabolic syndrome (EMS) is typically middle-aged with either generalized or regional adiposity (fat deposits). The horse with Cushing’s or pituitary pars intermedia dysfunction (PPID) is typically older than the horse with EMS; most affected animals are older than 15 years of age.
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Recognizing and treating the horse with endocrine disease was the focus of the lively discussion at the table topic "Cushing's or Metabolic Syndrome?" The session, which was held at the 2008 American Association of Equine Practitioners convention, held Dec. 6-10 in San Diego, Calif., started off with definitions and clinical descriptions of the two endocrine diseases.

A horse with equine metabolic syndrome (EMS) is typically middle-aged with either generalized or regional adiposity (fat deposits). Regional adiposity might manifest as a cresty neck, a fat tailhead, or fat in the sheath region. Horses with EMS are easy keepers and, thus, they are referred to as "thrifty." In addition to having this body type, horses with EMS have insulin resistance and a propensity for laminitis.

The horse with Cushing's or pituitary pars intermedia dysfunction (PPID) is typically older than the horse with EMS; most affected animals are older than 15 years of age. Horses with PPID have abnormal hair coats and muscle wasting, particularly along the topline. The hair coat might be hirsute (long and curly), slow to shed, or shed incompletely. Many horses with PPID have regional fat deposits and laminitis, similar to horses with EMS, and it is suspected that EMS over time leads to the horse developing PPID, although this has not been proven at this time.

If a horse that has had EMS for several years starts to develop muscle wasting and/or an abnormal hair coat, this suggests the horse is developing PPID

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Written by:

Nicholas Frank, DVM, PhD, Dipl. ACVIM, is a professor of large animal internal medicine and associate dean for academic affairs at the Cummings School of Veterinary Medicine at Tufts University, in North Grafton, Massachusetts. Frank grew up in the United Kingdom and then trained in the United States. He received his BSc Honors degree in biology from the University of North Carolina in 1989 and his veterinary degree from Purdue University in 1993. After working for two years in private equine practice in Illinois, he returned to Purdue University in 1995 to complete his residency training and PhD degree. Frank’s research interests include laminitis, metabolic disorders, PPID/equine Cushing’s, and many other internal-medicine related areas.

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