Cushings Horse

Cushing’s Disease & Metabolic Health

By: Dr. Lydia Gray

SmartPak strongly encourages you to consult your veterinarian regarding specific questions about your horse's health. This information is not intended to diagnose or treat any disease, and is purely educational.

Brief Description

Also known as Pituitary Pars Intermedia Dysfunction or PPID, Cushing’s Disease is a dysfunction of the pituitary gland. It is most common in older horses (18 – 23 years). Since it is sometimes associated with Insulin Resistance, Cushing’s can be confused with another condition called Equine Metabolic Syndrome. For more information on Equine Metabolic Syndrome, click here.

Signs of Cushing’s include:
  • Hypertrichosis  (long, curly hair )
  • Delayed haircoat shedding
  • Change in body conformation (muscle wasting and rounded abdomen or “potbelly”)
  • Decreased athletic performance
  • Change in attitude/lethargy
  • Fat deposits, especially along the crest of the neck and over the tail head
  • Laminitis
  • Increased drinking and urination
  • Recurrent infections
  • Abnormal sweating
  • Absent reproductive cycle/infertility
  • Neurologic deficit/blindness

Supplements that May Lend Support

The following ingredients may be helpful in the management of Cushing’s and are often considered beneficial for senior horses in general:
  • Antioxidants and plant adaptogens to fight oxidative stress and provide immune support
  • Chaste berry (Vitex agnus castus) to assist with proper endocrine function
  • Amino acids such as lysinemethionine and threonine to support lean muscle mass
  • Healthy fat (like omega 3 fatty acids) for additional aid in preparing a normal response to inflammation
Products with these and other ingredients that may provide complementary support to prescription medications for this condition can be found on our Equine Cushing’s Medication and Pituitary Health Supplement page.

Possible Diagnostic Tests

After a complete physical examination and routine bloodwork (CBC and serum chemistry), your veterinarian has a few options for specifically diagnosing Cushing’s. These include measuring the resting ACTH level, performing a TRH Stimulation Test, and others.

Prescription Medications Available

Prascend® is the first and only FDA-approved product for the management of Cushing’s in horses. It contains the active ingredient pergolide.

Other Management Suggestions


Because insulin and blood sugar metabolism may not be functioning properly in Cushing’s horses, avoid feeding traditional grains, treats or pasture because these can be high in sugars and starches. Instead, meet the horse’s nutrient requirements with a multi-vitamin/mineral supplement or low-sugar/high-fiber feed made especially for senior horses. Add fat for additional calories, if needed.


An older horse with Cushing’s is truly a “special needs” horse. Cushing’s often compromises the immune system, causing horses with this condition to be more prone to infections and other health problems. Because of this, Cushing’s horses should be seen by a veterinarian at least twice per year with special attention paid to vaccinations, deworming, dental health, hoof care, and other preventive maintenance.

Questions to Ask Your Veterinarian

  • How is Cushing’s Disease different from Equine Metabolic Syndrome and Insulin Resistance?
  • Is Cushing’s Disease the same thing as diabetes?

Additional Resources

Further Reading for You

From the SmartPak Ask the Vet Blog:

Supplementing Chronic Conditions in the Senior Horse

Diet Considerations for Horses with Cushing's

Ask the Vet: Insulin Resistance, Cushing's Disease, & Equine Metabolic Syndrome

Getting to the Root of Laminitis

About Dr. Lydia Gray

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