The Equine Cushing Syndrome also known as Pituitary Pars Intermedia Dysfunction (PPID) is a neurodegenerative progressive disease of aged horses and ponies. In the present study a questionnaire was used to collect and analyze data on the Equine Cushing Syndrome. For the clinical part of the study patients were chosen from the questionnaires to be included into the study and fed for six month with a Vitex agnus castus containing product Corticosal®. The clinical symptoms and the ACTH value were used to assess the efficacy of the product. In total 257 questionnaires were evaluated. The proportion of ponies in the population was 51 %. The mean age of first recognition of disease was 19.5 years. The early symptoms were delay in hair shedding and hirsutism, commonly in combination with hyperhidrosis. These symptoms and laminitis were the early signs of disease. In most of the cases diagnosis was established on the basis of clinical symptoms. If further diagnostics were performed the resting adrenocorticotropin hormone (ACTH) concentration was measured. In total, 83 % of the treated animals received pergolide to treat the ECS. The symptoms of most of the treated patients improved in comparison to non-treated horses and ponies. Progression of the disease was retarded through treatment. Adverse events were reported in horses treated with pergolide. In total 38 horses and ponies were enrolled to the clinical study. The inclusion criteria were ACTH concentration ≥ 50 pg/ml and / or clinical score of at least five. The average age of the included animals was 24.2 yearsThe proportion of ponies and warmblood horses was almost equal. According to their treatment with pergolide patients were allocated to different treatment groups. Patients without pergolide treatment received Corticosal® for the whole six month. The horses and ponies already treated with pergolide were divided into two groups: first group received Corticosal® for a six month period, the second group received placebo for the first three month and – after the second visit - treatment was changed to Corticosal® for the last three months. Treatment duration in all three groups was six months. Three visits were performed per patient. A statistically significant difference occurred within the first treatment group T1 from visit 1 to visit 2 (p=0.004) and from visit 2 to visit 3 (p<0.001). At visit 3 there was no difference in the clinical scores between the groups. ACTH concentrations increased in all groups from visit one to visit three. It seems that there was a seasonal influence already in July this year. There was no correlation between increase of ACTH and development of clinical signs. Insulin and glucose measurements were also performed and evaluated. In 40 % of the horses and ponies an insulin resistance was detected at the beginning of the study. The occurrence of insulin resistance was not correlated to the ACTH concentration. A positive effect of Corticosal® in patients with Equine Cushing Syndrome could be detected.
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