Managing The Horse With Cushing’s

The vet has diagnosed it and the reality begins to sink in – your horse has Cushing’s disease. Now what?  Cushing’s is an endocrine disease caused by a tumor on the pituitary gland that is most often seen in older horses and ponies. This tumor results in high cortisol and is most often exhibited by  hyperglycemia (high glucose), excessive thirst, excessive eating, excess urination and a shaggy haircoat.  At this time there is no cure for Cushing’s but by keeping a close eye on nutrition and management, we can improve the quality and possibly lengthen the life span of a Cushing’s horse.

Routine is important to the Cushing’s horse because changes in diet, medication, etc. can have negative effects on health.  Cushing’s horses have a compromised immune system and for that reason, seemingly small or mundane parts of their care become very important.  There are a few management practices that are particularly important: 

  • Deworming – Cushing’s horses can be more susceptible to parasites because of their weakened immune system.  Work closely with your vet to develop a deworming schedule and program that is catered to your horse. Your vet should also be seen regularly for dental care and wellness exams.
  • Farrier Care– Regular farrier visits are important because certain types of leg and foot conditions are more likely with a Cushing’s horse, such as abcesses of the hoof and laminitis. Signs of laminitis can be a tender footed stance and the horse acting like he is “walking on egg shells”. 
  • Grooming – Hair coat and temperature regulation are problems in Cushing’s horses so you will want to help your horse as much as you can by preventative grooming practices. Consider body clipping in hot/humid weather and be mindful of temperature and weather changes. When blanketing, make sure the hair coat is dry and clean to help reduce the incidence of skin issues. Prompt treatment of any wounds or infections is essential.
  • Feeding– One of the main goals in feeding the Cushing’s horse is to control the starch + sugar (NSC) content per meal. This helps to regulate the blood glucose and insulin levels.  The NSC content of the concentrates fed to the horse is important, but even more so is the content of the hay /forage and the combination of the two together. Some guidelines have suggested an NSC maximum value of 10-13% based on the total diet (forage + concentrate). Testing your hay will give you a good idea of the NSC values.
  • Consider a feed that is fortified with lysine, methionine, biotin, vitamin E and complexed trace minerals (copper, zinc, manganese and selenium) to help maintain muscle mass, support hoof growth and support the immune system.

Following these tips will help improve the quality and possibly length of life for the horse diagnosed with Cushing’s.  If you have specific questions regarding your horse, please work with a qualified nutrition consultant or your veterinarian.

7 thoughts on “Managing The Horse With Cushing’s

  1. Pingback: Managing The Horse With Cushing's | The Feed Room | Texas Horse Report

  2. I am looking for ideas on feeding the dentally challenged geriatric horse during winter months. My 30 yr old pony is on soaked Tim/Alf pellets and does very well weight wise but he finishes them in about an hour and then has nothing to eat until supper. I work during the day and can’t split up his feedings so he goes about 12 hrs in between. The teeth he has left are glass smooth and I won’t give him hay due to impaction concerns which I had with another horse with the same issues. Any ideas?

    • Hi Karen, Here are a couple ideas to ponder, others may comment with more! You might try adding a very large smooth stone to his feeding pan, this would at least slow him down some more as he eats. Also, if you provided him some hay in a small hole hay net, he would just eat the fine pieces that fell through and it would reduce his boredom (you’d just have to empty the stems every so often and feed to other horses).

      There are a few companies selling “timed release feeders”. Our SafeChoice Senior is designed with a softer pellet that is easy for horses with poor dentition to chew so you could get away without soaking it and it would flow through the feeder. I had a gelding that lived on dry SafeChoice Senior till 37, had no teeth and never choked; however each horse is an individual. This would be ideal; however the timed release feeders are certainly an investment.

      Thank you ~ Gina T.

  3. Has there been research with cushing’s and magnesium deficiency? I started care for a clients aged gelding with cushing’s in January. He did not shed out in the spring like the other horses and was being supplemented with pergalide(sp?) and chromium. When I began care I supplemented with cattle mineral that was formulated for fescue pasture, in other words, this mineral has a higher level of magnesium. Over the next winter I began to eliminate the other supplements and in the spring for the first time in 5 years this horse shed out just like all the others. I have this idea minerals are very deficient I all of our diets, human and critters alike.

    • Hello Susan, Thank you for the question. Low circulating levels of serum magnesium have been reported in some horses with Cushing’s Disease, and this deficiency may contribute to decreased insulin secretion. Supplementation with Mg and Chromium is thought to help improve insulin sensitivity or counteract insulin insensitivity, but does not have an impact on (elevated) cortisol secretion, therefore does not correct the root cause. Typical daily Mg requirements are around 10 – 15 g/day and it has been suggested that supplementation up to the max daily requirement and that achieves a target calcium:magnesium ratio of 2:1, can be beneficial. Supplementation of chromium picolinate (2.5 – 5 mg/d) may also be helpful to support improved insulin sensitivity if your horse is IR as a result of the Cushings disease.

      Although controlled research to verify efficacy in horses is lacking, these nutrients are helpful in the management of type 2 diabetes and insulin resistance in humans, and may be beneficial in equine cases complicated by insulin resistance and hyperglycemia. Additionally, ensuring that the entire diet (hay, pasture, concentrate, treats) is balanced (energy, amino acids, vitamins and minerals) is also important to ensure some of the symptoms are not nutritionally induced due to other imbalances or deficiencies. Before adjusting or adding anything to the diet, it is recommended to consult with a trusted equine veterinarian and equine nutritionist.
      Thank you ~ Emily L.

  4. I have a horse at my stable that has been diagnosed with Cushing’s. He is on Prascend 1 pill/day for the past year, but he is still extremely difficult to put weight on. The pill does help control his excessive urination and thirst, but he is ravenous all the time. He’s a 25 yr old retired paint gelding, 1100lb. He gets 6lbs of Senior feed along with free choice hay each day, and he easily consumes a bale per day. (Alfalfa/grass mix that we custom bale for our farm). I’ve had the vet recommend in the past for another horse at our barn with Cushing’s to possibly double the pill dosage if the horse’s condition is getting worse, but wanted to know if the feeding was appropriate?

    • Hello Victoria, Thanks for reaching out with your question. A couple things to consider, how is his dentition, is he having any difficulties chewing the hay, any quidding going on? Is he in a paddock with any other horses who might be challenging him? You might think about having your hay analyzed so you know the actual caloric content of the hay as well as the Non Structural Carbohydrate content. This way you would know for sure the calories going in.

      If his ideal weight is 1100#, 6# of senior feed is likely the bare minimum amount he needs per day to balance basic requirements missing in his hay. You would need to check the specific feeding recommendations on the tag of the senior feed you’ve chosen as they are not all formulated the same. We would recommend increasing this amount by 0.5#/day until you get him up to 11#/day to increase the calories and nutrients he is receiving. You might also consider adding a high fat extruded supplement at 2#/day to add more calories in a condensed form.

      Please consult with your Equine Veterinarian regarding his medications to support his condition.

      Thank you ~ Gina T.

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