As the number of horses with Cushing’s (PPID) continues to rise, we need to keep building on our understanding of the disease, as well as how to recognize and treat it.
If you read the Part 1 of this article in the last issue of Equine Wellness (V12I2), you now have an overall understanding of how to recognize and test for Cushing’s, or PPID. Now we’ll look at how to support and treat Cushing’s horses with supportive nutrition and integrative options.
Holistic medical treatment
The alternative medicine toolbox contains many tools for treating the Cushing’s horse, but each animal is an individual and will respond differently. In treating these complex cases, it is important to proceed one step at a time, and realize that the course of treatment may be long and expensive if the horse has many medical problems. There isn’t one simple answer to Cushing’s. In my practice, I try to look at how severe and longstanding the clinical signs are so I can determine how much to do at one time.
The goal in natural treating Cushing’s or PPID and PPID-based laminitis is to return the horse’s metabolism to proper balance; provide nutritional support to prevent and reverse damage from circulating free radicals; and prevent further damage to and encourage healthy laminar attachments in the feet. Most horses can live a long and functional life, even with laminitis, if the program is good and tailored to their needs.
Repairing the gut
The first step in your program is to repair the gut. Many horses have been given anti-inflammatories and antibiotics frequently throughout their lives. This compromises the health of the digestive tract in many ways.
- Restore gut function with high quality probiotics. This is the most important thing. If the gut is in poor shape, try 20 grams of glutamine per day. Glutamine is an amino acid that serves as a fuel for cells of the gut wall.
- Feed whole foods if possible, unless the horse has poor teeth or poor digestion. Processed grains and hays may lose key ingredients during manufacturing since pellets and extruded feeds are made at high temperatures. Some horses digest their food better when enzymes are added.
- Choose a feed that’s low in sugar! No horse needs any sweet feed. Plain whole grains are effective; if you need to purchase a processed grain, get a low carb feed, preferably one made from non-GMO ingredients. Plain barley and oats make a simple, clean non-GMO mixture, if they are available. Barley is a cooling food from a Chinese medicine perspective, and is useful for inflammation.
- You may need to restrict your horse’s grazing in order to control his weight.
- Grass types, quality and sugar content vary across the country, so you need to learn about your local grasses.
- Time in the pasture is good for reducing stress, but can cause problems as well. Pasture Paradise setups, with a track for horses to walk to reach their hay, water and shelter, can be useful if you own your property.
- Muzzles are a compromise that work well for many horses, though not so well for others.
- Exercise is one of the best things you can do to help control weight, but this won’t work if the horse is in a lot of pain.
- Consider a possible need for higher levels of protein (up to 14%) and calories for Cushing’s horses with weight loss problems. Increased calories can be given as fats (vegetable oils, coconut oil or rice bran) and are well digested by most horses.
- Provide high levels of antioxidants.
- Coenzyme Q10 is very valuable in this respect. The therapeutic dose is 300mg to 600mg per day for the first week or two if the horse is acutely laminitic; the dose can then be slowly decreased to a maintenance dose of about 100mg per day (a good level for the non-laminitic horse).
- Vitamin C is an excellent antioxidant and nutrient for collagen support as well as organ and immune system healing. Doses range from 3g to 8g per day.
- Give the horse access to free choice minerals, with salt fed separately. This is among the most important aspects of any nutritional program for. Several key minerals are needed for glucose metabolism in the Cushing’s horse.
- Magnesium affects insulin secretion and its action in the cells. It also helps cells become more flexible and permeable to insulin.
- Chromium helps make muscle more sensitive to insulin so glucose can be taken into muscle cells more easily. In addition, chromium is related to elevated blood sugar and is effective in reducing fasting blood sugar levels.
- Vanadium or vandyl sulfate has actual insulin-like effects on glucose metabolism, which helps transport glucose into the cells.
- Provide essential fatty acids (EFAs); these are needed to help make cell walls more permeable to insulin. They are anti-inflammatory and improve the health of the immune system. Omega 3 fatty acids are especially deficient in many equine diets. Flax, chia seeds and hemp provide plenty of Omega 3s that are palatable to the equine.
- Consider pituitary glandular support. I often use it for the Cushing’s syndrome horse, along with general glandular support, because the pituitary gland is central to the function of the entire hormonal system. Glandulars are nutritional supplements made from actual glandular tissue, often prepared with supporting nutrients.
Glandulars can be useful in equine nutrition and should be considered instead of synthetic organ replacement, as in thyroid therapy or as support for other organs such as the pituitary gland. Cushing’s horses are about the only ones I will use glandulars for because of the vegetarian nature of the equine. Additional thyroid supplementation may be necessary in some cases.
Treat each Cushing’s horse as an individual and seek quality practitioners to assist as you develop a program to help your equine partner. Use as much whole food nutrition as possible, supplement with specific nutrients as needed, reduce stresses and vaccinations, and support a healthy digestive tract. With some dedicated effort, your Cushing’s horse can lead a long and happy life.
More integrative therapies for Cushing’s
1. Herbs of many types are useful for the Cushing’s horse. Milk thistle, vitex agnus castus, bilberry, fenugreek, and many others have properties that support and correct the hormonal system.
2. Homeopathy is important to the success of treatment in many cases. If homeopathy is used, it is advisable to work with an experienced homeopath to determine the constitutional remedy that best the individual horse.
3. Chinese medicine, with acupuncture and Chinese herbs, can be also used to help Cushing’s horses. Herbal formulas are tailored to address the imbalance in each individual horse, so there are no generalizations. It is best to work with a veterinarian experienced in either Chinese herbs or acupuncture.