What to do next?

If you recognise one or more of the signs of Equine Cushing’s disease in your horse, there are three simple steps you need to take to find out if they have the condition, and how to best manage the disease so that they continue to live a happy and healthy life.

If you suspect that your horse is showing any signs of Equine Cushing’s disease, excluding laminitis*, it is advisable to book a visit from your veterinary surgeon. They will be able to examine your horse, and advise you on whether it is appropriate to carry out a test to check for this disease.

*If you suspect that your horse is showing signs of laminitis, you should contact your veterinary surgeon immediately.

Severe laminitis is an emergency, and ongoing ‘mild’ or ‘moderate’ disease can result in painful long-term consequences. Prompt attention and treatment as soon as you recognise the signs of laminitis is important not only to relieve the pain, but also reduce the long-term damage.

Whilst you are waiting for your veterinary surgeon to arrive, there are a few steps you can take to help your potentially laminitic horse:

  • Remove your horse from pasture (as long as it is not too painful to walk them - never force a laminitic horse to walk whilst on your own, always wait for your vet)
  • Provide deep bedding in the stable, or in the field if you have not been able to move them. Shavings are ideal as they will conform to your horse’s feet and therefore be more comfortable to stand on. Make sure that they cover the entire stable floor, so that wherever your horse stands they can be as comfortable as possible.
  • Ensure they can reach food (soaked hay) and water easily
  • Make sure you have your horse’s passport to hand, as your vet will need to check it in order to prescribe some pain relief medications.
  • Try to stay calm. Although laminitis can be extremely distressing, your horse will be much calmer if you can stay calm too.

When your veterinary surgeon arrives they will examine your horse. If they confirm a diagnosis of laminitis, they will treat the painful symptoms and make recommendations with respect to trimming, farriery, and management. They may test for underlying hormonal conditions (such as Equine Cushing’s disease) or may advise that testing is not carried out until the acute laminitis episode is stabilised.

Get a free test

The simplest and most common test for Equine Cushing’s disease is the basal ACTH test.

To perform this test your vet will take a blood sample from your horse and send it to a laboratory that will measure the levels of a hormone called ACTH. The results of the test will then be compared to reference ranges (which will change with the seasons) to confirm the presence or absence of Equine Cushing’s disease.

The measurement of serum insulin and glucose is often recommended alongside the basal ACTH test: These tests help to differentiate Equine Cushing’s disease from Equine Metabolic Syndrome (EMS) (another common hormonal cause of laminitis), and also act as an indicator of laminitis risk.

Throughout 2020 we are providing complimentary ACTH tests to horse owners who suspect their horse may have Equine Cushing’s disease. Please ask your veterinary surgeon about this when you book your horse's vet visit.

If you would like more information on understanding your horse’s ACTH test, register as a Care About Cushing’s member and take a look at our section on ‘Understanding the basal ACTH test’. 

Learn about managing the disease

Finding out that your horse has or may have a disease is always a worrying time. Rest assured though that a diagnosis of Equine Cushing’s disease does not mean that your horse’s quality of life is going to suffer. There are many management strategies that you can implement to ensure that your horse remains happy and healthy – these primarily fall into three categories: Medication; nutrition; and preventative healthcare.

Medical Treatment 


The correct nutritional support can help your horse or pony cope better with the consequences of Equine Cushing’s disease.

For most horses and ponies with Cushing’s disease the nutritional requirements are very similar to older animals in general. However, some horses with the disease have clinical signs such as weight loss, obesity, or a predisposition to laminitis. There are important additional factors to consider when planning the nutrition for horses with each of these signs.

If you would like to learn more about the nutrition of horses with Equine Cushing’s disease please register as a Care About Cushing’s member and take a look at our section on ‘Feeding horses with Equine Cushing’s disease’. 

Preventative healthcare

In addition to Equine Cushing’s disease, there are a wide range of common diseases that horses and ponies are at risk of developing as they get older. These include dental, musculoskeletal, respiratory, cardiac and skin disorders. As horses with untreated Equine Cushing’s disease have a reduced immunity, they can be more susceptible to infections such as dental disease, worm infestations, or viral infections.

There are therefore several management and preventative healthcare measures that are important aspects of keeping Equine Cushing’s disease patients in the best possible health, whether or not they are receiving any medication.

These measures involve paying careful attention to hoof care, dental care, vaccination, wormer administration, and nutrition of your horse.

If you would like to read more about these measures, please register as a Care About Cushing’s member and take a look at our section on “Preventative healthcare in horses with Equine Cushing’s disease”. 

Case studies

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