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From AAEP’s Ask the Vet: Feeding the Cushing’s horse

Hello, I have a Cushing’s mare who is really sweet, she isn’t too bad yet but definitely has it. She isn’t on Pergolide yet, I will probably put her on it in a few years, depending on her condition. I don’t know what to feed her, she is slightly overweight, but it’s more of the muscle wasting so she looks like she is overweight. I don’t know if I should feed her a high protein/low fat or a high fat/ low protein diet. – Olivia

Dear Olivia,

I’m going to take the liberty of providing medical advice as well as nutritional advice in your situation. My recommendation (with the support of your veterinarian) is to start your mare on Pergolide now for her Cushing’s Disease since she’s already showing external signs of the condition, meaning it’s progressed beyond the early stages. By the time you observe hirsutism (long, curly hair), the disease is in the later stages and treatment may not be as effective. Starting her on medication sooner rather than later may slow the progression of the disease and improve her quality of life so I encourage you to rethink your decision to wait.

Now for the nutrition aspect of Cushing’s Disease. From your description, I’m guessing that your mare has developed a pot-bellied appearance that at first glance makes her look overweight but upon closer scrutiny is due to (as you suspect) muscle wasting. As horses lose muscle mass due to the constantly circulating levels of cortisol (stress hormone) that mark this disease, they appear to “sink” in their topline and in their abdomens. Therefore it is not uncommon for a Cushing’s horse to appear be swaybacked and have a “hay-belly.”

The next time your veterinarian pulls blood to recheck your mare’s hormone levels associated with the Cushing’s Disease, ask if a serum chemistry can be run at the same time to see how well her kidneys, liver and other systems are working. If everything seems to be in order, then I would not hesitate to put your mare on a high protein/high fat/high fiber diet. Notice that the only category that should NOT be high is sugars and starches, or simple carbohydrates. While horses with Cushing’s Disease may have altered glucose (sugar) metabolism and even insulin resistance, they should have no difficulty digesting and absorbing protein, fat and fiber. Sources for these additional nutrients include alfalfa hay, soybeans or an amino acid supplement; powdered fats or oils with a healthy omega 3 to omega 6 ratio; and complex carbohydrates from high fiber feedstuffs like beet pulp.

I encourage you to body condition score (and weigh) your mare before gradually adding one of these products at a time to her current diet. Then every two to four weeks rescore and reweigh her to make sure you’re on track.

Lydia F. Gray, DVM, MA SmartPak Staff Veterinarian and Medical Director Dr. Lydia Gray has earned a Bachelor of Science in agriculture, a Doctor of Veterinary Medicine (DVM), and a Master of Arts focusing on interpersonal and organizational communication. After “retiring” from private practice, she put her experience and education to work as the American Association of Equine Practitioner’s first-ever Director of Owner Education. Dr. Gray continues to provide health and nutrition information to horse owners through her position at SmartPak, through publication in more than a dozen general and trade publications, and through presentations around the country. She is the very proud owner of a Trakehner named Newman that she actively competes with in dressage and combined driving. In addition to memberships in the USDF and USEF, Dr. Gray is also a member of the Illinois Dressage and Combined Training Association (IDCTA). She is a USDF “L” Program Graduate and is currently working on her Bronze Medal. Find Dr. Gray on Google+

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9 comments on “From AAEP’s Ask the Vet: Feeding the Cushing’s horse
  1. Judi McNeil says:

    My horse has been diagnosed as pre-cushings (his blood tests show borderline results). In addition to his high protein diet, I had been giving him rice bran and corn oil to put weight on him (he is a rescue and was 250 lbs. under weight when I got him. He is beginning to show decline in his top line, particularly at his hind quarters. Should I continue with the rice bran and oil? Should I be concerned about over working him or even riding him at all?

  2. kathryn mckaig says:

    My 30-year-old horse has mild cushings. The first thing my vet had me do was put him on pergolide even though it is a mild case. This was about three years ago, we recently tested him again and discovered that his cushings has not progressed. He continues to have a good top line as well as good muscle development. I ride him two to three times a week. I strongly recommend listening to the vet, a horse should be put on pergolide once it is determined that he/she has cushings.

    • sherry says:

      I have a mare that has it and she takes pergolide and she does great. She keeps her weight to a great level and there is no extra hair and she looks great

    • Georgia Stokes says:

      I have been leasing a thorougbred for 5 years. She’s a rescue horse and the trainers said she has cushings. Other that drinking a log (in 90 degree Florida) I don’t see any other signs. Should I pay for a Dr to come out and test her blood. Is there another test that should be considered also? She does suffer with rain rot especially on her legs – always has. I really baby her. We only ride 2 times a week and most of the time we don’t cantor. How does excercise affect cushings? Looking for to your answers. Thank you,

      • SmartPak SmartPak says:

        Hi Georgia, thanks for your question! If you and your trainer suspect the horse you’re leasing may have Cushing’s Disease, I would absolutely encourage you (or the horse’s owner) to consult with the veterinarian. The veterinarian should be able to evaluate the horse and determine if additional testing is appropriate to make a diagnosis. If the horse is diagnosed with Cushing’s, it’s possible the vet may prescribe prescription medications to slow the progression of the disease, which can affect the horse’s immune system and cause them to be more susceptible to infections of the skin and other organs. As a resource I’ve also included a link to the Cushing’s section of our Equine Health Library: I hope that’s helpful. – Dr. Lydia Gray

  3. Jenn says:

    I would like to know if you know anything about Chastetree Berry and what you think it does to help cushings horses?

  4. Sheila says:

    I have a 26 yr old mare that thinks she is a two year old. She also is an easy keeper so I really watch her diet so she maintains good weight. She doesn’t have the typical fat deposits but foes grow a thick coat and starts growing early. It isn’t the long curly or wavy coat but thick, I clip her and she grows it back in quickly. She drinks about 2 buckets of water a day which I don’t think is excessive. I have a few years ago had her thyroid tested and it was fine. I’ve owned her 22 yrs and she really hasn’t changed much, always been an easy keeper and grows a thick coat.
    It has been mentioned to me several times that she could be pre cushings. Other than having her blood tested are there other signs I should be looking for?

  5. Gwen says:

    I have a 30 year old gelding who has cushings and has been on pergolide, and was not showing any improvement, so we added metaboleeze (smart pak is the only place I found that carries it). That has helped him the most, took away the swelling, but we are still loosing muscle and weight. I have been warned to stay away from alfalfa hay, because of the sugars… is it Ok to feed? Currently feeding grass hay, beet pulp and timothy grass pellets. Any suggestions would be great!

  6. Robyn Nichols says:

    We are 9 weeks into a nightmare situation. I have an 18 year old retired show horse that is truly one of our valued family members. Cisco is 7/8ths Arabian and 1/8th Saddlebred. Cisco started having leg and/or shoulder issues a couple of years ago and has become my riding horse because of it. Over the summer he got progressively worse. I had our vet test him for navicular. She didn’t find any. We were waiting for an appointment with one of the local hospitals that do radiographs and MRIs on the horses when he suddenly worsened. I found him down one morning, in complete distress and unable to get up. After a lot of urging, he rose but would only move backwards with his hindquarters drawn under him. His pulse, heart rate, heat in his coronary band, etc. were all extremely elevated. After securing the vet from the hospital we underwent radiographs on his feet, tested him for Insulin Resistance, etc. It was a horrible, horrible thing to see my partner in pain like this.

    As it turned out, we were very lucky. Cisco has since been diagnosed with Cushings, Insulin Resistance and Laminitus. The good news: We caught it in time to prevent any rotation in his coffin bone. We are working with the radiographs and our farrier to treat the foot and leg issues, have tested him twice for Cushings to make sure that the Pergolide is the correct dosage, put him thru the whole series of treatment for the Insulin issue and are using bute to treat the pain/inflammation issues. He has been taken off alfalfa and has lost over 100 lbs. We have also had issues with his refusal to eat grass hay but are working to find a suitable solution. I am now appx. 9 weeks and $3,300.00 into this treatment. I have an amazing vet and farrier who both care about this horse as much as I do.


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