When to Euthanize a Horse With Cushing’s? A Scary Decision!

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Last Updated on March 14, 2023

Knowing when to euthanize a horse with Cushing’s disease is a painful decision for a horse owner to make. Thanks to modern-day medicine and treatments, horses are now living longer than ever before, but this unfortunately means more and more horse owners need to decide when to euthanize their horses.

As Cushing’s disease is a slow, progressive disease, it can be hard to notice that your horse’s quality of life has deteriorated to an unacceptable level. Let’s take a look at the facts about Cushing’s disease in horses, and figure out the key signs that euthanasia might be the kindest option.

What is Cushing’s Disease in Horses?

Cushing’s disease in horses is an endocrinopathy – this means it affects the endocrine system, which is responsible for the control of hormones within the body. These hormones are essential for regulating and balancing the various metabolic systems within the body which keep our horses fit and healthy. When this system is disrupted, many different metabolic changes can occur within the body.

Cushing’s disease, more correctly known as Pituitary Pars Intermedia Dysfunction (PPID), is the most common endocrinopathy diagnosed in elderly horses. It normally affects horses in their geriatric years, but it can be diagnosed in horses aged ten and over. On rare occasions, it has been diagnosed in horses far younger than this.

What is the Equine Cushing’s or PPID

Cushing’s disease is caused by changes within the pituitary gland, located at the base of the brain. This gland receives signals from the brain and sends out hormones in response to these, instructing various body systems on how to function. The changes within the pituitary gland in PPID cause the signals to become disrupted, leading to excessive amounts of certain hormones being produced.

Learn more about the Signs & Causes of Cushing’s Disease in Horses

How does Cushing’s disease affect a horse’s quality of life?

The hormonal changes that occur in Cushing’s disease can cause some painful and debilitating symptoms. The two most common signs and symptoms of PPID in horses are hirsutism and laminitis.

Hirsutism occurs when the horse fails to shed its coat, and as a consequence, it grows a long, curly coat. This is the classic sign of Cushing’s disease in horses and, if observed, is taken as a definitive diagnosis. While the shaggy coat of a horse with Cushing’s disease may look cute, it can lead to excessive sweating and skin infections.

A diagnosis of Cushing’s disease frequently occurs when a horse or pony succumbs to laminitis later in life. PPID is a leading cause of laminitis in older horses and can cause painful and irreversible changes within the hoof. This can have life-threatening consequences if not treated correctly.

Other signs of PPID in horses include muscle atrophy and weight loss, despite adequate food intake. Increased thirst – polydipsia – and increased urination – polyuria – are also classic signs of Cushing’s disease in horses. The horse may appear dull and lethargic, and patchy sweating may be observed.

Diagnosis and Treatment of Cushing’s Disease in Horses

If you suspect that your horse has Cushing’s disease, your veterinarian will carry out a full clinical examination. A long, curly coat and laminitis with no apparent cause are often key signs that an older horse has developed PPID.

A definitive diagnosis can be obtained by carrying out laboratory tests. The first and easiest option is an ACTH test, but if this is inconclusive then DST (Dexamethasone Suppression Test) and cortisol measurements are the gold standards. 

Once a definitive diagnosis has been reached, your veterinarian will prescribe a course of medication. At present, the only FDA-approved treatment for Cushing’s disease in horses is a drug called Prascend (pergolide mesylate). This helps to regulate the output of hormones from the pituitary gland, reducing the severity of symptoms of this disease. Your veterinarian will need to carry out regular blood tests to assess the efficacy of the dose of this drug, enabling adjustments to be made as necessary.

Other treatment options for PPID in horses include cyproheptadine, trilostane, bromocriptine, herbal medicine, and acupuncture, but currently, these have little scientific evidence to back them up.

One thing that most veterinarians agree on is that horses with Cushing’s disease benefit from a holistic management approach. So, as well as regulating the disease with medication, the symptoms should be managed and treated as necessary. This may include approaches such as clipping the coat, switching the diet to an energy source that is easier to digest, and providing long-term remedial farriery care for horses with laminitis.

Learn more about How Long Do Horses Live With Cushing’s Disease?

When to Euthanize a Horse With Cushing’s Disease?

Nowadays, due to the increase in horse life expectancy as well as the increasing elderly horse population, it is more common for veterinarians to have several horses with PPID under their care. There is also increased awareness about the link between clinical signs like hirsutism and laminitis and Cushing’s disease, leading to an increase in the diagnosis of this condition at a younger age.

Studies have shown that a horse’s survival rate after being diagnosed with Cushing’s disease is on average 4.6 years. The longevity of a horse with Cushing’s disease will depend on several factors, such as how progressed the disease was at diagnosis and the severity of any secondary conditions such as laminitis.

Cushing’s disease is a chronic disease that cannot be cured, but, with careful management, many horses with this condition will live comfortable and happy life. However, the slow progression of this disease can lead to a gradual decline in the health and well-being of your horse, which can often be easily overlooked during the day to day life. Untreated Cushing’s disease in horses leads to a faster decline and a more rapid need for euthanasia on welfare grounds.

Finally, When To Euthanize A Horse With Cushing’s

To decide when the time is right to euthanize your horse, regular quality of life assessments should be carried out during the late stages of Cushing’s in horses. This will help you to objectively assess how well your horse is coping with various aspects of day-to-day life.

These assessments normally come in the form of a questionnaire and will ask you to consider factors such as:

  • Is your horse in unmanageable pain?
  • Does your horse struggle to eat or drink normally?
  • Can your horse get up and move around comfortably?
  • Does your horse have sufficient body condition to get through the winter without suffering?

It may also be necessary to take into account the effectiveness of the treatment available and the affordability of veterinarian costs, as the treatment costs of this chronic long-term condition can quickly escalate when secondary complications develop.

How much does horse euthanasia cost?

It is a reality of owning a horse that everything comes with a price, and that includes euthanasia. If you own or care for a horse, you should have a realistic expectation of how much euthanasia costs, including any additional expenses that may be incurred.

The cost of euthanasia will vary widely according to a range of different factors, such as the size of the horse and how you plan for it to be euthanized. You also need to consider what you will do with the body of the horse after it has been euthanized.

The cheapest form of euthanasia for a horse is normally by a bullet, as the drugs used for euthanasia by injection tend to be more expensive. Euthanasia by injection can only be carried out by qualified and registered veterinarians, whilst euthanasia by the bullet can be carried out in some regions by other trained professionals. You may hear horror stories about horse euthanasia gone wrong, but the safest way to avoid this is by using a qualified and experienced professional.

So, the lowest cost way to euthanize a horse is by a bullet, using a licensed slaughterman. This method also means that you may be able to take the cheapest option of removal of the body afterward, where it is taken away to the slaughterhouse for processing.

However, many horse owners find the bullet method too distressing and prefer to opt for euthanasia by injection. This can only be carried out by a veterinarian, so you will need to factor in the cost of the vet visit plus the drugs. When a horse is euthanized by lethal injection the body must be cremated afterward, which adds to the costs.

As the costs vary so widely from region to region, it is impossible to give a guide on how much it costs to euthanize a horse. If you own or care for a horse, it is a good idea to speak to your veterinarian to decide on a euthanasia plan and budget for the costs involved.

horse euthanasia gone wrong

Will a vet euthanize a healthy horse?

Nobody likes to hear of a healthy animal being euthanized, but it is a reality of keeping domesticated animals that this sometimes happens. But will a vet euthanize a healthy horse, or are there situations where they may refuse?

This can be a very tricky area for a veterinarian, as there are many grey areas where it may or may not be appropriate to euthanize an animal. For example, if the owner can no longer care for the horse properly but cannot be rehomed, euthanasia may be the best option. There may also be situations where the behavior of the horse means it is no longer safe, meaning euthanasia is the best option.

When it comes to euthanizing a healthy horse, can present an ethical dilemma for a veterinary surgeon. Veterinarians have to abide by a code of conduct that outlines what they can and cannot do, and they have a moral duty to refuse to carry out any treatment that is not in the best interests of the animal. In most situations, the owner and the veterinarian will agree that euthanasia is the best option, normally because the animal is in incurable pain or their quality of life has deteriorated.

For a healthy horse, most veterinarians will advise the owner on other possible courses of action before euthanasia is agreed on. This could be options such as re-homing the horse or signing it over to an equine rescue charity.

Sadly, in many countries, there is a large overpopulation problem when it comes to horses, and it can be very difficult to find a new home for a horse, especially if it cannot be ridden. These situations have led to many healthy horses being euthanized in an attempt to get the population back to more manageable levels.

Summary – When to Euthanize a Horse With Cushing’s Disease

So, as we have learned, Cushing’s disease in horses is an incurable chronic condition that will slowly affect the quality of life of your horse. Carrying out regular quality-of-life assessments is a useful way to judge the extent to which your horse is suffering, helping you to make the difficult decision of when to euthanize a horse with Cushing’s disease. With any long-term condition, it is wise to have a euthanasia plan in place to avoid excessive distress when the time comes.

We would love to hear your thoughts about when to euthanize a horse with Cushing’s disease – is this a dilemma that you dread facing in the future? Or perhaps you’ve got some questions about how to manage a horse with Cushing’s disease? Leave a comment below and we will get back to you!

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