Horses diagnosed with pituitary pars intermedia dysfunction (PPID), or Cushing's disease, respond well to the medication pergolide. In fact, pergolide remains the only FDA-approved medication for PPID. Unfortunately, pergolide can be costly for some owners and time-consuming to administer, especially for pastured horses.
In lieu of oral pergolide, a pair of veterinary surgeons from the Western College of Veterinary Medicine in Saskatchewan, Canada, recently explored whether surgery could help affected horses.
“Surgical ablation of the benign growth in the pars intermedia portion of the pituitary gland helps both people and dogs with Cushing's disease. In horses, however, brain surgery has only been described in a small number of cases,” reported Laura Petroski, B.V.M.S., a veterinarian from Kentucky Equine Research (KER). “Surgical access to the pituitary gland is fraught with challenges.”
Undertaking the daunting task of reaching the pituitary gland, the researchers explored four different approaches in both live and deceased horses. Three of the four failed to allow the surgeons access to the pars intermedia portion of the pituitary gland, whereas a fourth procedure appeared feasible. That approach was achieved by passing a catheter through the deep facial vein until it reached a sinus housing the pituitary gland.
“The surgeons believed the minimally invasive approach was repeatable, atraumatic and relatively inexpensive, thereby allowing access to growths in the pars intermedia,” said Petroski.
More work clearly must be performed prior to the widespread use of this technique, but certainly offers owners hope for viable alternatives to daily pergolide. In the meantime, consider dietary supplements in addition to pergolide for maximal health and welfare in horses with PPID.
“In addition to Bio•Bloom PS for skin, coat, and hoof support, look to omega-3 fatty acids. Products such as EO•3 exert anti-inflammatory properties that can help reduce the inflammation associated with aging and Cushing's disease. In addition, EO•3 can also help improve insulin sensitivity—a common condition in horses with PPID,” explained Petroski.
*Carmalt, J.L., and B.A. Scansen. Development of two surgical approaches to the pituitary gland in the horse. Veterinary Quarterly. In press.
Article reprinted courtesy of Kentucky Equine Research (KER). Visit equinews.com for the latest in equine nutrition and management, and subscribe to The Weekly Feed to receive these articles directly (equinews.com/newsletters).
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