How is equine metabolic syndrome/cushings diagnosed?

Montyforever

Montyforever

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I know obviously cushings has the curly/long coat but in a young pony (8) would that be a symptom yet?
I just get the feeling that something's not quite right with her, and it's been since the lami last year :(
If anyone's had their horse tested could you tell me how much it cost? Pm if you prefer :)
 
it is done through a blood test, but a pony on our yard got diagnosed with it late last year (sure his owner won't mind me sharing) basically, he became very overweight and no amount of dieting appeared to be shifting the weight, his a black horse andhe got white patches around his eyes (as firstly it was thought he had a copper deficiency) and he just became just generally very lethargic and everything was a bit of an effort. His only 8 too!
 
Thanks miss bean, she's not overweight (opposite infact!) but she keeps getting footy, keeps showing signs of lami but not actually getting it and just being generally grumpy :( she's been very overweight in the past though. Im going to keep her off the grass for a few days and see if she feels a bit happier and if she's not will probably have her tested
 
With my cushings pony her coat got thicker than usual so had blood test done. Cost £25 for lab test. Vet was doing routine visit so no extra for visit.
 
My mums horse was diagnosed with cushings last september-its just a simple blood test-it cost about£25-£30 and we had the results in just a few dyas. It would be a good idea to rule it out i'd say. He was 14 at the time, which the vet said was still quite early for cushings, but it has been known to appear in horses as young as 6/7 apparently.
Mums horse is fine now-he's on medication daily and we managed to catch it before any laminitis. his only symtoms were that he didnt lose his winter coat last year and was all patchy, and he just seemed a bit down and lethargic and was drinking quite a lot for a smallish horse!
 
Please be aware that laminitis can be triggered by a number of different things such as emerging encysted small red worms (not detected in a worm count), stress, an infection, concussion etc. Also check your horses digital pulse each day - you vet will be only to pleased to show you how to do it. A pounding pulse indicates the onset of Laminitis.
 
Peternatt- she had acute laminitis last year so I'm being over cautious if anything!!! :p I'm checking her feet and digital pulse am and pm. I could feel it slightly today and this has been the first time this year so she's going to stay in for a few days until I can figure out a way to superglue a muzzle to her face and find a pony to eat down the grass in her pen :)
 
Blood tests are really the key to diagnosis; there are some clinical signs that are suggestive, but are not always present.

Cushings - Most simple screening test is to measure resting ACTH (Adreno-Cortico-Trophic Hormone). Horses with Cushings Disease usually have a high resting ACTH level. It is moderately sensitive (i.e. not many horses with Cushings will test normal) and moderately specific (i.e. not many normal horses will test positive). In the case of equivocal resting ACTH levels then other tests are appropriate. The TRH (Thyrotropin Releasing Hormone) response test involves measuring response to TRH, and the Dexamethasone Suppression Test (DST), which measures response to exogenous steroid administration. The TRH test is more sensitive (will pick up more affected horses), whereas the DST is more specific (will rule out disease in more normal horses). They are often performed as a combined test over 24 hours. In an 8 year old horse, Cushings is possible but unlikely, so these more accurate tests are probably appropriate, although a very high resting ACTH level is also probably diagnostic.

Metabolic Syndrome/Insulin Resistance - Again there is a simple screening test, which involves measuring blood insulin levels after an overnight starvation. This is a pretty specific test, so a high insulin level means there is almost certainly an issue of insulin resistance. It is not very sensitive though, so a normal value does not mean a normal horse. If the simple test is normal, then it is appropriate to perform glucose response tests, which are more sensitive. The easiest of these is to starve overnight, then feed a set amount of glucose, followed by measuring insulin 2 hours later. The only issue with this test is its reliance on normal intestinal glucose absorption. If there are any concerns in this regard then IV glucose response tests are more appropriate.


The short answer is that measuring ACTH and insulin is the best first step. These can be measured at the same time, and is best done first thing in a morning after starving overnight. Just be aware that normal blood results do not necessarily mean a normal horse.
 
Friends pony at the age of 22 was diagnosed with EMS through blood tests. He wasn't hugely fat or even hairy.. just not quite right.. bloods showed the EMS.
 
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