What Is Cushing's Disease In Dogs

sarah: hi, smartpak fans. welcome back to smartpak'sask the vet video series with our staff veterinarianand medical director, dr. lydia gray, andmyself, smartpaker sarah. we're here to ask andanswer the questions

What Is Cushing's Disease In Dogs, that you guyssubmitted and voted on. and if your questionis selected, you will be the winnerof a smartpak gift card. dr lydia gray: nice.

sarah: if you've won a giftcard and haven't redeemed it yet you can, email us atcustomercare@smartpak.com and we'll get you all set up. dr lydia gray: get on it. sarah: i'm very excited aboutthis series of questions. so without further ado, i'dlike to jump into the first one. dr lydia gray: yeah. sarah: question number onewas submitted by valerie on the smartpak blog,which is blog.smartpak.com,

if you're looking tosubmit your question. and valerie's wondering, "asthe spring comes and horses start to shed their winter coat,i thought of this question." i wonder if it's goingto be about chapstick, because that's thebiggest problem i have during shedding season,is when your horse's hair sticks to your lips. it's terrible. she's not wondering that.

she's wondering, "is ithealthy to use a shedding blade to get the wintercoat off faster or is it healthier to leaveit alone and wait until the horse will losehis winter coat by himself?" that's really interesting. i never thought about that. dr lydia gray: i didn't either. it was a veryinteresting question. healthy is one thing, but ithink deshedding, or whatever,

is fun, because you get to buy-- sarah: yeah, i see thatyou brought lots of toys. dr lydia gray: --all of these. my new favorite--have you tried these? sarah: i have not. dr lydia gray: thehandson gloves. sarah: but i've heardall of the riders at smartpak talking about them. dr lydia gray: theycome in fun colors now.

and i think by the time thisgoes up, we might have some. but they have theselittle nubbins on them and different sizesand both hands. so you can useboth hands at once. and horses love them, becauseyou can take your finger and get behind theear and under the jaw and in on theankle, the fetlock. so super fun. sarah: feels like goodfor shedding season,

but also good for likeafter sweaty rides. dr lydia gray: that and bathing. you can soak thesepuppies up and have at it. that's so fun. for shedding though-- solet's answer her question. and then, we'll getback to the toys. but i think it's healthyto help the horse shed out, because your currying the skin. and any time you canmassage the skin,

it's healthy, becauseit releases oils and it gets rid ofdead skin cells that are maybe hanging on. so that's a really good thing. this is fun. have you tried one of these? dr lydia gray: the posture prep? because it not only massages theskin and, because it's plastic, it grabs onto the hairsreally well and releases them.

but it's designedto penetrate deeper and it uses across-hatching mechanism on muscles and ligamentsin the soft tissue. so it gets deeper, even,than skin and hair. and i love this andmy horse loves it. but these plastic ones pullthe hair out really well. so-- sarah: but pull in notlike a painful way. dr lydia gray: no.

sarah: because thehair's already loose. dr lydia gray: the hair's dead. so it's a good idea toget rid of the dead hair. it's going to fallout eventually. so why not get rid of it andstimulate new hair growth, stimulate oils, and sebum,production of healthy things. that's what's going to producea good shine on your coat. so we've talked about-- this one is good forbathing, as well as grooming.

i think it's called arubber grooming mitt. it's got little nubbins. this is fun, the sleekez. it's got this metal edge here. and you want to be carefulwhen you use metal ones-- like this is just aregular shedding blade-- that you don't goacross bony areas. like this is notfor legs, hip bones, like the point of theshoulder, the head.

sarah: well, youdon't want to do that. not comfortable. dr lydia gray: but whereit's just skin over bone. you want to go where there'ssome muscle or ligaments. there's another curry. a lot of people like this slick'n easy horse grooming block, because this pumice stonesort of grabs, in a nice way, grabs onto hair. so just lots of fun things here.

and i would encourage youto help your horse get rid of that loose, already loose,almost falling out dead hair. sarah: yeah. all right. our next question isalso submitted by valerie on the smartpak blog. and valerie is wondering,"when should i start my horses on pasture as the spring comes? i've heard after the winterthe grass in the pastures

gets too much sugarand fructan and are not healthy for horses to graze on. when is the best time to startletting horses out to graze?" dr lydia gray: that's areally useful question, because there are horseswho are, what i would call, carbohydrate intolerant, inthat, there are some horses you can throw on pastureand they do fine. and then, there's othersthat set foot in a pasture and they develop laminitis,which i think is her big worry,

or colic or other things. so it a little bitdepends on where you live. and so we don't knowwhere she lives, so-- sarah: we do not. dr lydia gray: ok so we'lljust answer this for everyone. but the main thing is to knowwhen grasses accumulate sugar, because it's the sugar and thefructans that are the problem. so i forget what grade itwas, like some middle school year, where you learnedabout photosynthesis.

and then, the oppositewould be respiration. so what happens is plants usesunlight and air and water to make sugars during the day. and then, they use thosesugars during the night to grow and reproduce anddo other plant business. i'm not sure what all. sarah: oh, plant business. that feels like agood pixar movie. dr lydia gray: plant business.

so at the end of the day,at the end of sunlight, is when the grassis highest in sugar. it's made the most thatit's going to make, so that it can use-- sarah: and then, it's goingto do it's business all night. and then, at the endof the evening when the sun starts again isthe lowest sugar level. so there's awebsite that i love. it's called safergrass.org.

it's run by katy watts. she's not a veterinarianor a nutritionist. she's some sort ofagricultural scientist. there are actualplant scientists. yeah. that's a thing. and she says sherecommends 3 am-10 am. sarah: so just setyour alarm for 2:30. dr lydia gray: her advice is--

sarah: seems convenient. dr lydia gray: maybesmartpak will do this, is someone needs to invent agate opener on a timer that opens up at 3:00 am and thenherds them back in, i guess, and close the gateat 10 am or whatever. sarah: well, 10:00 am, youcould be out there by then. i mean, even on a sunday, guys. 10 am's not that bad. so and of course the grazingmuzzle is a good idea too.

but-- sarah: and so fashionable. dr lydia gray: oh my gosh. the look, when youpad it up with things. you use different colors. i recommend a neonyellow or green so that if they getit off in the pasture you can just find it. sarah: do you know what ilike imagining, just now,

is when i was kid, iwas in middle school, probably learningabout photosynthesis, and i had braces. and you would getthe rubber bands on your braces changed and you'dlike pink and purple for easter and then you do like redand green for christmas. you should change newman'sfleeces for the season. so you can have like green andorange for st. patrick's day. you could do a lot.

dr lydia gray: well,he does like his beer. so the other rule ofthumb that i will give you is, after the springtransitions and the nights are consistently above40 degrees fahrenheit, then it's safer to be on grass. when you have warm days, intensesunlight, and cool evenings, below 40 degrees,then the plants accumulate sugar during the day,but it's too cold to use it, so they continue to store it.

sarah: they don't do plantbusiness when it's cold. plant business it closed. so they store andstore and store sugar. so that morning and the nextday, it's loaded with sugar. so you want to wait untilthe evenings are consistently above 40 degrees. and then, also, theother rule of thumb. there's so many rules of thumb. sarah: that's why youhave a lot of thumbs.

dr lydia gray: that's why youintroduce grazing gradually. so just because it's nowwarm days and warm nights, you don't just throw them out. you start with 10 minutes,15 minutes, whatever. sarah: if you want to knowwhy the sugars in the grass could be a concernfor laminitis, you should submit that question. and then, we can answer it. you get it voted tothe top, we can answer

that in a future episode. is this right? our third question alsosubmitted by valerie on the smartpak blog? dr lydia gray: shewas busy or bored. sarah: valerie had a lotof really good questions. this one is alsoabout springtime. this is very seasonal. i see what youdid there valerie.

this is a good move. dr lydia gray: it worked. sarah: "how shouldthe feed ration of a horse change in the springand should it change at all? is it recommended, in general,to put a horse on less grain than he was on in the winter? i know each horseis individual--" she's watched you before. "i know each horseis individual,

but i would love to hearabout this in general." dr lydia gray: well,that's something i hadn't thought about. and her direction was shouldthey be on less grain. sarah: i thought the same thing. dr lydia gray: ithink if it is-- not for everyone, butfor most people, winter, at least where it's cold, isa time of not riding as much, you're not workingas hard or as long,

and maybe givingyour horse a break, because you had an intenseshow season or something. and so-- sarah: the holidays get busy. all that kind of stuff. and so you maybe feedless grain in the winter, because they don'tneed as many calories. and then, as you begin to uptheir workload in the spring, you add the grain back in.

but then, it got me thinking,why might you swap that. and it has a lot to do with yourhorse's body condition score. and i hope that's something,valerie, that you're checking. some horses loseweight in the winter. some gain weight in the winter. so you have to knowyour individual horse. and then, how does yourhorse come out of winter? so if it comesout of winter fat, then yes, you'd wantto reduce the grain.

but if it comes outskinny and you're going to increase exercise,then you might want to consider, not always justadding more grain, but adding caloriesor energy maybe through fats, maybe more hay,maybe a weight gain supplement, maybe beet pulp. there's a lot of choicesbesides the grain. the other things thati was thinking of are pasture, because it's aquestion we just answered.

some people, because theyknow their horse is going to get sugar in the pasture,they reduce the grain and feed more hay and sortof try to fill them up so they don't go outand gorge and don't allow them to get sugar fromother sources in their diet. so they cut back thegrains and sugars, because they're adding pasture. so there's a lot of thoughtthat goes into this. but i think it has to start withwhat shape is your horse in?

what body condition score? what are you feeding? and is your workload changing? and is the horse's dietchanging in other ways? sarah: i think body conditionscoring is a really good point. and it kind of brings meback to the first question where we talked about allof our fabulous fun toys. and i think a lot ofpeople, oftentimes, when their horsestarts shedding out,

they're surprised athow thin their horse got over the winter. dr lydia gray: or theykept the blanket on and didn't look frequently. didn't really notice. and so i think that's wherebody condition scoring, rather than just like, "oh, yeah,he looks about the same," really getting yourhands on the horse and really getting a sensefor what kind of shape

that they're in. and you guys can finda very fantastic blog on body condition scoring. dr lydia gray: and videos too. sarah: and videoson how to do it. and so we'll include those inthe description of the video. dr lydia gray: absolutely. sarah: all right. question number four.

you want to guess who it's by? dr lydia gray: well, valerie? sarah: it is. it is. it is indeed by valerie. dr lydia gray: she is buildingup those gift certificates. sarah: she is. she's going to go on alittle shopping spree. valerie, i hope you buy someof the products featured here.

if i were you, i'dgo for these gloves. i think your horsewould appreciate that. and valerie is wondering "doesit make a difference at all if a horse has his or her springshots early or late in spring? does it affect the wayhe is going to respond to the shots or anything else?" dr lydia gray: wow. she's really put some thoughtinto these, because, honestly, in all my years that hadnever occurred to me.

so i made a list ofthe things that i think about when i'mtrying to figure out when to give my spring shots. so now, we have to considerthe us equestrian's six month rule, the vaccinationrule, because you have to give the flu andrhino, or the equine influenza and ehv-1, rhinopneumonitis,within six months of entering a horse show facility. sarah: and us equestrian,new name for usef,

the united statesequestrian foundation. dr lydia gray: and i'mtrying to be very good and use the new name. so i know that my lastshow is october 14th. so i'm not going to give myspring shots until april 14th, if i can help it. so that's one consideration. another one is ami in compliance with colicare guidelines?

there's a lot ofhorses in that program. and it says, work withyour veterinarian. have your veterinarianadminister vaccinations. if it's been a longtime and i'm going to go out of complianceif i wait a few months, i might give themearlier in the season. don't forget though,about half of the vaccines we routinely give,the core vaccines. and some of at the riskare because of insects

that spread diseases, westnile, eastern and western equine encephalomyelitis. so you don't want to give thosein the non-mosquito season. like there'd be no reason in,say, the northern climates, minnesota, massachusetts, togive west nile in january, because there's no mosquitoesjanuary, february, march, maybe april. so i tend to time thosejust before the critters are going to come out.

and when you give a vaccine,it takes about two weeks to effect, if it's abooster and not a primary. which is anotherthing i think about. i want this horse to beprotected at a certain time. if it's a booster, then it'sabout two weeks at a time. but if it's an initialseries and you're giving it a shot every, saythree weeks, it might take a month or twothen to reach peak protection. so then, i want to back up.

sarah: if you don't knowyour horse's history and you don't know if ithad vaccines previously, how long, roughly, cana horse go between-- like, if he missed hisbooster for a couple of years, is there a point where itresets and then he doesn't have that primary anymore? dr lydia gray: wedon't know that. that's an underresearched area. we don't know theanswer to that.

there are a few equine diseases,like rabies, that we have the ability to take a titer on. they don't tell you protectionas much, like functionality. they just tell you,does your horse have antibodies to this at a levelthat should be protected. so it's an area thatneeds more research in it. other things that i think about. oh, this is one i'mthinking about right now. is there a clinic,show, or other event

that i want my horse to beprotected at, yet not sore for? so if i'm giving theseinjections, almost anywhere, the neck, very commonarea, the hips-- i tend to give mine in thepectoral muscles, the chest muscles, becausethey're very low. so if there's aproblem, any swelling goes to the lowestpoint and they're very easy to drain there. but also, the front legs areconstantly moving and working

that area. so it's really a niceplace to give vaccinations. but i've got a cliniccoming up and i don't want to give a vaccinewithin about two weeks before that, in case there'san adverse event or soreness. so that's something. sarah: newman appreciates that. he likes to feel his best. dr lydia gray: to neverget vaccines would be his--

and the thing aboutit is, my horse, one of a special population. like a broodmare, they havevery specific vaccination needs. foals. a horse that's rescued andmaybe not the healthiest. senior horses havespecial needs. so those are thequestions i ask myself. not really the one she did. but i think it'sa good way to get

started in the conversation. and this is a conversationyou should absolutely have with yourveterinarian, because they know what's endemic toyour area of the country. for example, i'venever vaccinated a horse for botulism,because we don't have that where i practice. but in some parts of thecountry it is rampant. so your vet will know that.

sarah: last but not least,question number five. submitted by val-- no. not. submitted by what.eqon instagram. i know. somebody else fought theirway into the top five. dr lydia gray: five forfive would be amazing. sarah: five for five, imean, gauntlet is thrown. the challenge is outthere for you guys.

and what.eq asks "what iscushing's, and what is it caused by? what can i do to manage it?" dr lydia gray: so you'llhelp me make sure you answer each of those questions. so the first one is-- sarah: i can keeptrack of the questions. i will not be doingthe answering. dr lydia gray:what is cushing's?

so the other name for it, thename that your veterinarian might use is pituitary parsintermedia dysfunction, or ppid. so here we go with the acronyms. and it's a collectionof clinical signs that are associated withan endocrine dysfunction. so what happens isyour pituitary gland-- and there's three parts. that's why it's narroweddown to the middle part,

pars intermedia-- is under negativeinhibition, so it's being kept in check by anothersection of the brain called the hypothalamus. and the hypothalamus,one of its many jobs is to send over a signal,a neurotransmitter, dopamine specifically, to thepituitary and say, "calm down. keep calm and carry on. just chill."

and then, everything's fine. but as age, oxidativestress, happens to horses-- so this is a seniorhorse disease-- then, the hypothalamus doesn'tdo as good a job sending over that signal and thepituitary is unchecked and it becomes enlarged andoveractive, dysfunction. and so then, itreleases some hormones. acth is probably thebest known of those. and then, we have thiscollection of clinical signs.

and so it might be along and curly hair coat, which we call hypertrichosis. it could be weight loss,specifically muscle loss. and here, i'm thinking over thetop line and the bottom line, or the underline, the belly. increased susceptibilityto infections, so the immune system is dampened. laminitis is a problem. they might urinate morefrequently and then drink more.

so it is truly a cluster orcollection of clinical signs. and together, you begin tonotice things not quite right with your horse, evenbehavior, attitude changes. and you talk toyour veterinarian. and then, theycome out and test. sarah: so we've got what isit, what is it caused by. what can i do to manage it? dr lydia gray: so well, i guesswe can go on with your vet. so your veterinarian comesout and diagnoses it.

and this is a prettysimple test now. now, it's just an acth test. and it's a one time blood draw. so it's pretty simple. it used to be anovernight and fast and you give somethingand that's all done. so once your veterinarianhas a number, there is anfda-approved medication for it called prascend, whichthe active ingredient is

pergolide. and so you givethat and you retest. and you look for the clinicalsigns, the long curly hair coat. these horses, they don'tshed out in the spring. that's sort of theclassic, what you see. sarah: so if these aren'tworking, might have a problem. dr lydia gray: call your vet. that's right.

so if the blood work comesback, like in 30 days, better and the horsebegins to shed out, then you're on the right track. and if not, then, maybetest the blood again. and maybe the medicationneeds changed. so that's themedication side of it. there are somesupplements, specifically targeting the muscle loss. so you can add backin extra amino acids,

lysine, methionine,and threonine to help build up that top line. you can add in someantioxidants, because we know the hypothalamusis not working properly, because ofoxidant-induced injury. so get those going. some omega-3 fattyacids to help balance the inflammatory andanti-inflammatory side. and there are some other herbs.

adaptogens would be great tosupport the immune system. feeding, you don't knowwhat you'll need to feed or how you'll need to feed,unless your veterinarian does the test for cushing's, aswell as a second test, the test for insulin resistance, becauseyou can have cushing's alone. and that's pretty manageable. you just feed to thebody condition score that the horse should be at. and you feed to theirteeth and whatever

issues they might have. but if they also haveinsulin resistance diagnosed with the oral sugartest, then you need to reduce thesugars and starches. so it's things likesoaking the hay or having them weara muzzle or not feeding early or at leastreducing grain and watching the treats that you give. so no longer abag of peppermints

or a bag of carrots. i know people that do that. but you don't haveto do those things, unless your horse has insulinresistance as well as the ppid. sarah: you talked a coupleof times about a word that i think we'repretty familiar with here at smartpak, or a phrase. but i think some of our fansmight be less familiar with. and it brings me almostback to the same grade

that i was in when i waslearning about photosynthesis, oxidation or oxidative stress. and so the way that i thinkmost people might be familiar with it is, if youthink of oxidizing, you might thinkof rust on metal. and so, hopefully, unless we'retalking about the horse shoes, a horse shouldn't beexperiencing rust. so what kind of oxidativestress are horses exposed to? and how does that happen?

dr lydia gray: so think ofnormal things like sunlight, with the ozone layerand all of that and chemicals and just theenvironment and life itself. i mean, exercise inducesinjury oxidative stress. and so it's when freeradicals are generated and you need antioxidantsin your body to capture them as they are generated. so vitamin e is anexcellent antioxidant. vitamin c, vitamin a,there's some other ones.

i like alpha lipoicacid, because it's both fat and water soluble. so it can go everywhere andgather up these harmful agents that are released. so if you have antioxidantson board through the diet-- selenium is one. it partners with vitamin e-- then, you're in bettershape than if your horse is dealing with this oxidativestress on his own.

sarah: that all horses areexposed to all the time. dr lydia gray: all the time. so if there's moreoxidative stress going on, then they're going to burnthrough their normal amount of antioxidants they have. and so it helps to have more. sarah: so we got throughour five questions. i just have a quicksixth bonus question. if i wrote a script formy movie plant business,

would you read it? sarah: thank you. dr lydia gray: wait. wait. can i be in it? sarah: oh, yes. you can do the voice. would you want to be likethe voice of the grass? or would you want to bethe voice of the sun?

dr lydia gray: the grass. i think so. i mean, you're much moreof a grass personality. you feel like you'rereally springing up. i like it. i hope you guys will watch it. it's going to be great. spring 2018. so that's all we have.

those are all the real questionsand that one bonus question. and thank you guys all forsubmitting the questions. we love reading your questions. we love watchingwhat you vote for. and we're always happy toanswer them, especially if we can bring props and showsome of our favorite things. if you guys have questionsfor the next video, including if you want to askthat question about laminitis-- dr lydia gray: and valerie,can keep asking questions.

sarah: valerie, if you'vegot more questions-- dr lydia gray: bring them on. sarah: i mean, someone could gofive for five and unseat you. you can submit your questionswith #askthevetvideo. and you can submit them ontwitter, instagram, facebook, youtube, in our blog comments. you can emailcustomercare@smartpak.com. or you can comment on youtubevideos, instagram posts. just don't forget to usethe hashtag so that we can

gather all of your questions. and questions will beaccepted for our next video until march 30th. and then, you can vote onyoutube, twitter or our blog to vote for your question. if your question wasanswered in this video or in previous videos, emailus at customercare@smartpak.com and let us know. dr lydia gray: whichmeans you, valerie.

sarah: yes. you, valerie, for yourmultiple gift cards. don't forget to email us. and of course, don't forgetto subscribe so that you never miss a future episode orthe premier of our new film plant business. dr lydia gray: andwe've got to think of--

is that title? sarah: plant businesshas to be the title.

dr lydia gray: it works. well, thanks for watching,and have a great ride.