Question of the Day

Measure resting ACTH and insulin for pituitary pars intermedia dysfunction (PPID, a.k.a. equine Cushing’s) and equine metabolic syndrome (EMS), respectively. These hooves show evidence of chronic laminitis (see all those rings) and endocrinopathic laminitis is the most common cause.

Equids can have EMS or PPID or both. If resting ACTH and insulin are normal, the next phase of testing (i.e., have increased sensitivity) for EMS and PPID are: the oral sugar test for EMS and thryrotropin-releasing hormone stimulation test for PPID.

Grazing is typically contraindicated in horse with EMS because the fructans in fresh grass exacerbate the insulin response and laminitis.

Steroids also worsen insulin dysregulation and should be avoided in horses with EMS.

Click here for the 2022 Guidelines on the Diagnosis and Management of EMS and one on PPID, courtesy of the Equine Endocrinology Group.

Photograph courtesy of Dr. Ines Pinto.