Does Pain Play A Role In Equine Cushing’s Tests?

Nearly one-third of older horses will become affected by pituitary pars intermedia dysregulation (PPID, also called Cushing’s disease) in their lifetime. Horses with PPID have long, shaggy coats that don’t shed out well in the spring. These horses will also drink water excessively, have abnormal fat deposits, abscesses or laminitis and experience chronic infections.

PPID-affected horses have elevated levels of adrenocorticotropic hormone (ACTH), but pain also elevates ACTH levels. Researchers in Germany used 15 horses to see if pain increased ACTH levels enough that they could lead to false positives for PPID.

The main tests for PPID measure baseline ACTH and include the thyrotropin-releasing hormone (TRH) stimulation test, in which TRH stimulates ACTH secretion. Drs. Heidrun Gehlen, Nina Jaburg, Roswitha Merle and Judith Winter divided 15 horses into laminitic, colic or orthopedic issue groups. A pain scale was used to evaluate the intensity of pain each animal was in. Each horse served as his or her own control when they became pain free.

ACTH and cortisol levels were measured before and after the TRH stimulation test. The scientists found no significant differences in the ACTH concentration levels between painful and pain-free horses. They concluded that measuring the baseline ACTH and conducting the TRH stimulation test on moderately painful horses are appropriate to diagnose PPID. Horses suffering from extreme pain may have skewed results.

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