Laminitis, Cushing’s disease and Equine Metabolic Syndrome

New research shows that nearly 90% of horses and ponies that suffer from laminitis are suffering from either Cushing’s disease (PPID) or Equine Metabolic Disease (EMS).  

By treating the underlying cause you are well on the way to vastly reducing the number of painful laminitic episodes your horse or pony suffers and will go a long way to improving their overall quality of life.

Let’s start with Cushing’s disease

What causes Cushing’s disease?

It’s a complex process but simply put it’s down to two tiny glands deep in the horse’s brain called the hypothalamus and the pituitary. Over time hypothalamus can degenerate and stop producing a hormone called dopamine. Dopamine is needed to control manufacture of other hormones produced by the pituitary.  When that happens abnormally high levers of hormone such as cortisol and ACTH are produced and results in Cushing’s disease Pituitary Pars Intermedia Dysfunction (PPID).  It can’t be cured but it can be effectively controlled or at least the degeneration slowed down.

A horse or pony suffering from Cushing’s can show a variety of clinical signs apart from the usual long curly coat.  Cushing disease is no longer considered a disease just affecting the older horse.  Be on the lookout for excessive sweating, increased appetite, increased drinking and urination, lethargy, loss of muscle tone, a pot-bellied appearance and recurring infections.

Effective Diagnosis

Clinical signs may be obvious but a blood test will accurately determine hormone levels in your horse.  An ACTH blood test is a quick and easy way to determine whether you horse or pony is at risk.


Prascend is the only licensed medicine on the market for the treatment of PPID.  It helps to normalise hormone secretion from the pituitary into the bloodstream.  It is normally taken daily.  After 4-6 weeks treatment it is useful to re-test for ACTH to determine whether the medication is being administered at the correct dose for optimum effectiveness.

For more information on this and laminitis visit

Equine Metaboilc Syndrome (EMS)

EMS has many similarities with Cushing’s in that it is a major contributory factor in laminitic episodes.  It is has very strong links with obesity although any pony can be affected it is usually seen in overweight equines.   Also similar to Cushing’s it is connected to abnormal hormone production.  EMS is primarily insulin resistance and is very similar to type II diabetes in humans. 
Some of the symptoms of EMS are similar to Cushing’s. Look out for laminitis, lethargy and excessive drink and urination.  But you almost sure to also find obesity and experience difficulty in achieving weight loss, abnormal fat deposits above the eyes, in the neck and crest and at the head of the tail.

Effective Diagnosis

Again, blood tests are taken but this time dynamic testing measures the response to glucose.  The horse or pony is starved overnight and given a dose of glucose under controlled conditions.  The vet will advise exactly when and how much glucose should be given. 


The most important and most effective treatment for EMA is diet and exercise. The need for exercise cannot be overlooked.  Exercise has been shown to significantly improve the uptake of glucose and effectively reduces blood sugar levels.  A balanced diet with low levels of carbohydrate is necessary.  A drug called metformin can help until a proper exercise regime can be implemented. It is not seen as a long term treatment though – it is really there to help those unable to exercise due to acute laminitis.  Once recovery from laminitis is achieved then appropriate diet and exercise will offer a good prognosis.  

Bearl Equine ClinicBearl FarmBywellStocksfieldNorthumberlandNE43 7AJ01661 842542find us
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This number is a direct line to our out of hours emergency call centre. The operator will take details and pass information to the vet who will call you back as soon as possible.

Please use this number before 8.30am and after 5pm on week days and before 9am and after 1pm on Saturdays.


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