AAEP Convention Topics Preview: General Medicine

The latest information on scores of topics is presented at the AAEP convention; we can't report on them all, but we do try to bring you a representative sampling. This year, many of the topics can be grouped into five categories: fighting infection, reproduction, lameness/ injury, medicine, and predicting performance. In-depth coverage following the convention will be in our AAEP Wrap-Up (mailing with the February 2002 issue) and online at www.thehorse.com/aaep2001 after Nov. 24.

Treatment of Cushing's Syndrome

More horses are living into their 20s and 30s, and keeping these older horses healthy can require special management. However, sometimes despite the best care, an older horse might become afflicted with Cushing's syndrome. A result of pituitary pars intermedia (intermediate lobe of the pituitary) dysfunction, Cushing's syndrome is generally characterized by a heavy, coarse, wavy coat that fails to shed in the summer, excessive thirst and urination, a swaybacked or potbellied appearance, increased appetite, loss of muscle over the topline, and a compromised immune system. Blood tests sometimes detect high blood sugar and fats, anemia, reduced lymphocyte counts, and electrolyte problems.

In his presentation during the General Medicine Program on Nov. 25, Harold Schott, DVM, PhD, will present "The Michigan Cushing's Project." He will discuss the subtleties of the disease and recent research completed by Michigan State University comparing two current treatments.

Michigan State University began a study in 1997 involving Schott, Cindy Coursen, DVM, a private practitioner in Pottersville, Mich., other Michigan private practitioners, and Michigan State staff. Their goal was to determine whether cyproheptadine or pergolide is the most effective treatment for Cushing's. Cyproheptadine is a serotonin blocker in tablet form used for years to treat Cushing's, while pergolide mesylate is a dopamine agonist (activator) that also has been a well-accepted treatment option for Cushing's for many years. Previously there was no information available about which treatment was the most effective.

The results of the study give veterinarians and horse owners more information needed to choose treatment options for the horse with Cushing's.

Recurrent Uveitis

A veterinarian's diagnosis of recurrent uveitis, or "moon blindness," is often perplexing and frustrating news for the horse owner. Besides causing recurrent episodes of ocular (eye) irritation in the horse, the condition can eventually cause blindness.

Brian C. Gilger, DVM, MS, Dipl. ACVO, Associate Professor of Ophthalmology at North Carolina State University, has focused on the treatment and prevention of recurrent uveitis for five years. He will present "A Review of Recent Advancements in the Surgical Treatment of Equine Recurrent Uveitis" as a part of the Dolly Green Lecture Series on Nov. 25.

"We've developed some fairly unique methods to deliver medication to the eye of the horse," he explains. Gilger speaks of the cyclosporine implant, which is a device that releases low levels of Cyclosporine A, an immunosuppressant drug. The device is designed to prevent the recurrence of ocular inflammation, which is caused by an overreaction of the horse's immune system after initial ocular injury or infection. Gilger says that these implants can be effective for up to five or six years.

"We've probably placed implants in 25 to 30 clinical patients, and have had reasonably good luck in preventing recurring episodes," he says.

"This presentation is comparing how we treat uveitis to another major treatment (developed in Europe) where people have removed the vitreous from the eye," he adds. (The vitreous is the soft, jelly-like tissue that fills the space between the posterior part of the lens and the posterior surface of the eye.) "We've not been able to repeat success with that method at NC State. We've had horrendous results, and have probably blinded a few horses with it. It's probably useful for horses that are very chronic and very far along in their (recurrent uveitis)."

More about the implant research can be found at www.cvm.ncsu.edu/docs/opthal specialservicescyclo.htm.

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