hoke Cushing’s Disease (PPiD)
a relatively common condition seen in horses es and is typically caused by obstruction of the gus (food pipe) with food; occasionally a foreign be involved e.g. wood or plastic. Fortunately ses of choke resolve quickly and spontaneously cases in which the Cushing’s obstructionislasts longer Equine nowfor termed minutes are PPID likely (Pars to require veterinary assistance. Pituitary Intermedia ortant to note that this is not themeans same that as the Dysfunction). This an area atening condition in humans, where the of the pituitary gland at the term base of the refers to blockage of the windpipe ratherhormones. than the brain overproduces several 1 agus. This difference means that unlike humans, This results in raised ACTH which with choke can still breathe. circulates in the blood to the adrenal glands and causes excess cortisol (a steroid hormone) to be produced.
It is a gradual age-related change so primarily affects ponies and horses over 15 years of age but recent studies have shown it to be evident in some 10-15 year olds. A significant proportion of horses with laminitis have PPID.
CliniCal SignS: laminitis - occurring acutely or as recurrent bouts and often unresponsive to treatment until the DENTAL PPID is controlled; REGULAR EXAMINATIONS AND TREATMENT CAN REDUCE THE RISK OFcan CHOKE a hairy coat (hirsutism) which become thick ● and curly often be preceded by patchy or late shedding of the hair coat; KEY POINTS drinking excessively and producing large ● of rarely urine (polydipsia andand polyuria); • Don’t panic!volumes Choke is life-threatening lethargy - thisspontaneously. can be perceived by owners to ● many cases will resolve be just a normal age-related change and the • Seek veterinary advice the choke lasts morefollowing than problem mayif only be appreciated 30 minutesimprovement and while waiting for the vet remove all after treatment; food to prevent your horse eating and worsening loss of muscle with a dipped back and pot● the obstruction bellied appearance; • Following an episode choke it is above worth monitoring bulging fat of pads visible the eyes; ● your horse’s respiratory rate (normal <16 breaths/ weight loss; ● min) and rectal temperature for several days. excess sweating; ● • Arrange● regular dental check-ups for your horse therisk immune system compromised making to reduce the of choke as aisresult of a painful affected horses more prone to skin, respiratory, mouth. dental infections and parasite infestation. ●
1Adrenocorticotropic hormone (ACTH)
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Key points •
PPID mainly affects ponies and horses over 15 years of age but it should be considered in younger age groups too, especially if laminitis is present.
A wavy hairy coat is the classic sign but often signs may be more subtle
Diagnosis and treatment to manage the disease can result in a greatly improved quality of life and are crucial in cases of laminitis if PPID is the suspected cause.
a horSe DeveloPing an abnormal Coat that iS Curly anD overgrown iS a CliniCal Sign oF CuShing’S DiSeaSe.
XLEquine Cushing’s Disease (PPiD)
Blood tests can be performed to help diagnose PPID. Choke is a relatively common condition seen in horses There are several tests available but the most commonly and ponies and is typically caused by obstruction of the performed ones are: oesophagus (food pipe) with food; occasionally a foreign
body can be involved e.g. wood or plastic. Fortunately
The ACTH test - this is thecases of choke resolve quickly and spontaneously many most commonly used test, and only cases in which the obstruction lasts for longer affected horses usually than 30 minutes are likely to require veterinary assistance. show a high level when It is important to note that this is not the same as the compared to the seasonal reference range. life-threatening condition in humans, where the term The overnight ● “choke” refers to blockage of the windpipe rather than the dexamethasone oesophagus. This difference means that unlike humans, suppression test - this horses with choke can still breathe. involves collecting a blood sample at about 5pm just prior to an injection of dexamethasone and a second blood sample the following morning. Horses with PPID show a continued high level of cortisol on the second sample compared to normal horses. The test may be unreliable July to your vet m ay want t culty/repeated attempts at o take one SamPleS Fr October. or more b om your h looD orSe;to Fi lowing PreSenCe o 2 rStly teSt The TRH stimulation test ● F CuShing Fo r the ’S D iSeaSe (PPiD monitor yo ) anD then ching/arching of –the ur horSe’S thisneck measures ACTH levels to reSPonSe t o treatmen before and 30 minutes after t. ghing an injection of TRH. This & saliva discharging from the to nose can be useful identify cases with a borderline There is no cure for PPID but the disease can be well controlled with daily oling result on the ACTH test. The tablet medication. nterest in food test may be unreliable July REGULAR AND it acts to control the over Pergolide isDENTAL the drugEXAMINATIONS of choice for treatment; to October. TREATMENT REDUCE THE RISK CHOKE asionally a lump may be seen or felt productionCAN of ACTH and cortisol andOF should be continued for life. Follow ponies and horses with the he left side of Even the neck. up blood samples will help to find and maintain the correct dose for each classic clinical signs of sweating individual. KEY POINTS uspect your horse is suffering from and a curly coat should be Good management is also very important: is important to prevent your horse tested so that the correct s this will make the blockage worse clipping hair is can improve comfort levels; • Don’t● panic! Choke rarely life-threatening and treatment can be started and e difficult to clear. frequent checks for early identification of wounds and infection; ● many cases will resolve spontaneously. the dosage can be monitored. struction doesn’t clear quickly of its regular farriery, and lasts worming checks. • Seek● veterinary advicedentistry if the choke more than 2 Thyrotropin-releasing ord then veterinary assistance must 30 minutes and while waiting for the vet remove all hormone (TRH) ht. There are a number of steps food to prevent your horse eating and worsening can take to help to confirm and treat the obstruction lem. further information contact your local XLEquine practice: • Following an episodeFor of choke it is worth monitoring and ponies with dental problems your horse’s respiratory rate (normal <16 breaths/ vent them grinding their food min) and rectal temperature for several days. ), individuals that bolt their food too • Arrange regular dental check-ups for your horse and those fed XLEquine dry pelleted or cubed is a novel and exciting initiative conceived from within to reduce the risk of choke as a result of a painful e all at increased risk. profession made up of independently owned, the veterinary progressive veterinary practices located throughout themouth. United ●
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