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Implications of equine Cushing's disease

Implications of equine Cushing's disease Implications of equine Cushing's disease This issue of EVE contains an interesting account by Donald Beck (p 119) of using bromocriptine mesylate to treat a pony which exhibited clinical signs typical of Cushing's disease. Some interesting points arise from this paper relating to aspects of the specific case and more general considerations of equine Cushing's disease (hyperadrenocorticism). Regarding the particular case described, circumstantial evidence indicated that monitoring blood glucose levels provided a useful adjunct to clinical assessments under field conditions; the preferred route of bromocriptine administration w s by intramuscular injection; and a prolonged therapy of a Cushingoid pony was feasible. Unfortunately, neither hormonal nor pathological confirmation of the diagnosis of Cushing's disease was made and the cause of death of the pony was not ascertained. This situation presents a clinical dilemma: cases of equine Cushing's disease, a debilitating and sometimes painful condition, may benefit from the treatment reported but the observations were made under uncontrolled and unconfirmed conditions with a drug which is neither assessed nor licensed for use in the horse. Nevertheless, despite increasing recognition of equine Cushing's disease, there are only few data available on features such as chronicity of case progression, indications for treatment and comparisons of efficacy of therapies. Although treatment of equine Cushing's disease is not curative, it offers an improved quality of life and therefore the case report published in this issue provides information of practical value to clinicians. Broader issues relating to equine Cushing's disease covered by Satellite articles within this issue, include the pathogenesis of cutaneous manifestations (p 127) and laminitis (p 123); the diagnosis of hyperadrenocorticism (p 13 1) and the differential diagnosis of hyperglycaemia (p 135). These papers serve not only to provide a composite summary of equine Cushing's disease but also to emphasise the need to study further certain fundamental aspects of equine physiology and endocrinology. It is generally recognised, for example, that changes in beta-cell response to glucose and/or sensitivity of body tissues to insulin are central mechanisms in conditions such as Cushing's disease, laminitis and hyperlipaemia; yet extensive research of these phenomena in the horse has not been performed. Logically, advances in understanding the pathogenesis of such conditions will lead to improved therapies and, ultimately, enhance the welfare of the horse. It is well recognised that equine Cushing's disease is almost invariably associated with abnormal proopiomelanocortin (POMC) peptide production from adenomata of the intermediate lobe of the pituitary gland (Orth and Nicholson 1982; Wilson et al 1982; Millington et d 1988; Heinrichs et al 1990). This observation has possibly important implications to both equine and human medicine. Details of the biological function of POMC peptides other than adrenocorticotrophin (ACT'H)have not been defined clearly for any species and, further, the regulatory mechanisms of their secretion is not known. Extensive endocrinological studies of cases of equine Cushing's disease may therefore provide basic knowledge of pituitary gland function. Although rare, neoplasia of the vestigial human pars intermedia results in prolonged exposure to POMC peptides. Improved knowledge of the effects of such exposure could be derived from equine medicine to the benefit of human patients. S. LOVE Department of Veterinary Medicine, University of Glasgow Veterinary School, Bearsden Road, Bearsden, Glasgow G61 lQH, UK. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Equine Veterinary Education Wiley

Implications of equine Cushing's disease

LOVE, S.
Equine Veterinary Education , Volume 4 (3) – Jun 1, 1992
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References (4)

Publisher
Wiley
Copyright
© 1992 EVJ Ltd
ISSN
0957-7734
eISSN
2042-3292
DOI
10.1111/j.2042-3292.1992.tb01586.x
Publisher site
See Article on Publisher Site

Abstract

Implications of equine Cushing's disease This issue of EVE contains an interesting account by Donald Beck (p 119) of using bromocriptine mesylate to treat a pony which exhibited clinical signs typical of Cushing's disease. Some interesting points arise from this paper relating to aspects of the specific case and more general considerations of equine Cushing's disease (hyperadrenocorticism). Regarding the particular case described, circumstantial evidence indicated that monitoring blood glucose levels provided a useful adjunct to clinical assessments under field conditions; the preferred route of bromocriptine administration w s by intramuscular injection; and a prolonged therapy of a Cushingoid pony was feasible. Unfortunately, neither hormonal nor pathological confirmation of the diagnosis of Cushing's disease was made and the cause of death of the pony was not ascertained. This situation presents a clinical dilemma: cases of equine Cushing's disease, a debilitating and sometimes painful condition, may benefit from the treatment reported but the observations were made under uncontrolled and unconfirmed conditions with a drug which is neither assessed nor licensed for use in the horse. Nevertheless, despite increasing recognition of equine Cushing's disease, there are only few data available on features such as chronicity of case progression, indications for treatment and comparisons of efficacy of therapies. Although treatment of equine Cushing's disease is not curative, it offers an improved quality of life and therefore the case report published in this issue provides information of practical value to clinicians. Broader issues relating to equine Cushing's disease covered by Satellite articles within this issue, include the pathogenesis of cutaneous manifestations (p 127) and laminitis (p 123); the diagnosis of hyperadrenocorticism (p 13 1) and the differential diagnosis of hyperglycaemia (p 135). These papers serve not only to provide a composite summary of equine Cushing's disease but also to emphasise the need to study further certain fundamental aspects of equine physiology and endocrinology. It is generally recognised, for example, that changes in beta-cell response to glucose and/or sensitivity of body tissues to insulin are central mechanisms in conditions such as Cushing's disease, laminitis and hyperlipaemia; yet extensive research of these phenomena in the horse has not been performed. Logically, advances in understanding the pathogenesis of such conditions will lead to improved therapies and, ultimately, enhance the welfare of the horse. It is well recognised that equine Cushing's disease is almost invariably associated with abnormal proopiomelanocortin (POMC) peptide production from adenomata of the intermediate lobe of the pituitary gland (Orth and Nicholson 1982; Wilson et al 1982; Millington et d 1988; Heinrichs et al 1990). This observation has possibly important implications to both equine and human medicine. Details of the biological function of POMC peptides other than adrenocorticotrophin (ACT'H)have not been defined clearly for any species and, further, the regulatory mechanisms of their secretion is not known. Extensive endocrinological studies of cases of equine Cushing's disease may therefore provide basic knowledge of pituitary gland function. Although rare, neoplasia of the vestigial human pars intermedia results in prolonged exposure to POMC peptides. Improved knowledge of the effects of such exposure could be derived from equine medicine to the benefit of human patients. S. LOVE Department of Veterinary Medicine, University of Glasgow Veterinary School, Bearsden Road, Bearsden, Glasgow G61 lQH, UK.

Journal

Equine Veterinary Education – Wiley

Published: Jun 1, 1992

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