Cushing Candidate?

As my followers (and detractors) will undoubtedly confirm, I am often dismissive of traces of blood in the white line. Such traces are often the result of a trauma at some indeterminate time in the past and now, often between three and eight months later, neither owner, nor horse, nor hoof have any recollection of anything untoward and at the next trim, the traces will probably have disappeared all by themselves.

IMG_0035

(trim incomplete)

Certainly, none of the photos I have ever commented upon, would have given us at Sabots Libres any cause for concern. The traces were small, often relatively vague, and frequently only reported in one foot. But the case I am about to touch on here is definitely a cause for concern and set the alarm bells ringing during a routine 6 weekly trim yesterday.

IMG_0038

The horse in question is a 22 year old mare, shod on the recommendation of the breeder/seller until aged about 20 due to a trauma, resulting in club feet, suffered when young. (This is not a classic case of club foot as described elsewhere on this site but could have been avoided by the same means – however, that is beyond the scope of this article).

More significant is that she was being fed grain and cereal up to the age of about 18. This was stopped due to allergic reactions to cereals and pollen–the latter probably being exacerbated by the inappropriate feed. This cessation of feeding supplements and an altered system of distribution of (ad lib) hay was successful in reducing the allergies to an insignificant level.

But the damage had probably already been long done. The last trim showed traces of red in the white line that do set off alarm bells. As we can see from this first photograph, there are red traces extending from the rear into the front quarters.

The extent of the traces is the main cause for concern; they are particularly concentrated around both sides whereas ‘insignificant’ traumatic damage will usually be seen at the front and medially.

When we examine the other hoof, it is clear that something is not right. In this case, the red traces are visible almost full circle. Clearly something out of the ordinary has been going on in the hoof which cannot be written off as a couple of unhandy manoeuvres in the field.

What is also obvious, is that this is not an ‘ordinary’ laminitis. The horse no longer has access to grains nor cereals, the grass is far from rich in sugars and essentially, there has been–and still is–no sign of discomfort in the hoofs. What is noticeable/notable is the poor moult whereby there is still a lot of thicker hair in patches. This gives rise to immediate thoughts of Cushing or, more correctly, PPID (Pituitary Pars Intermedia Dysfunction). This is an incurable but reasonably treatable hormonal condition whereby the body loses its ability to control certain functions. This can manifest itself in various symptoms, among which a poor moult, excessive disordered hair-growth and chronic laminitis.

IMG_0037

The area top-right is the normal summer coat while bottom-left the coat is clearly a lot thicker

When we add up these factors–a long-term grain diet (which additionally has led to allergic reactions), the poor moult and unusually large traces of blood in the white line–then our suspicions are aroused significantly. Obviously, it is not possible to simply say ‘Cushings’, the need for proper testing is unavoidable. However, this is not the best moment to test. The period of greatest–and most testable–hormonal activity is from August to October with the peak in September; by November, the values have usually receded to insignificant and thus indeterminate levels. For this reason, a blood sample will be taken in a few weeks time and sent off for testing.

The results will be posted here in due course.

Leave a Reply