Integrative Treatment of Equine Endocrine Disease – 4 CASE EXAMPLES
In horses, the main endocrine diseases are Cushing’s and Equine Metabolic Syndrome/ Insulin Resistance Syndrome. Equine Cushing’s disease, or pituitary pars intermedia dysfunction, is a common syndrome in older horses that can cause hirsutism, laminitis, polydypsia/polyuria, weight loss and other symptoms. Equine Metabolic Syndrome is insulin resistance with obesity and laminitis.
The following four horses have been treated successfully with homeopathy and veterinary spinal manipulation (“chiropractic”).
CASE 1: DINANT
Dinant, a 31-year-old Dutch Warmblood gelding, presented with a history of vaccination reaction (neck stiff, swollen, head down, lethargy) at a young age. In 2013, due to a history of hirsutism, fat pads with weight loss, front end stiffness especially when worked, and multiple infections, he had baseline cortisol testing; it was elevated and pergolide was begun. However, Dinant became listless, stiff and could barely walk, so the pergolide was discontinued.
In January 2016, he had just finished sulfa antibiotics for respiratory infection, and white nasal discharge was seen again. His manure was occasionally soft, his penis no longer extended with urination, his appetite was finicky and he didn’t want to work. He had refused all supplements for six months. He had many tooth extractions, leaving merely a few teeth.
On integrative exam, Dinant had very shallow feet, a bruised right front medial sole, tight front feet with heat, slight crepitus in the right stifle, a stiff right cervical spine and stiff lumbar spine, white nasal discharge and a long coat, with deep weak pulses.
Laser treatment of his right stifle and veterinary spinal manipulation (chiropractic) was performed. In three weeks, Dinant was no longer stiff while working. Though the limberness continued, he was still finicky, had continued nasal discharge, mild ocular discharge, and a very thick coat. While the stiff lumbar and cervical spine were adjusted, his guardian elected for homeopathic treatment. Based on Dinant’s history and physical symptoms, he was given one dose of homeopathic Sulphur 30C. Immediately after the remedy was given, he began to shed out “half a wheelbarrow every other day”, much better than he had for years. He was no longer sluggish, “had an opinion” like his younger self, and was no longer stiff.
One month after the one dose of Sulphur, Dinant’s neck was a bit stiff on the left; his lumbar spine was less stiff but still needed adjustment. He was now well muscled, his pulses were strong, his tongue was pink and he had no diagnostic points on Chinese medicine scan.
At two months post remedy, he underwent sedation and a dental exam. There was nothing abnormal in his mouth – a first in five years. One tooth needed floating because there was no opposing tooth.
At three months after the dose, Dinant began to relapse a bit, with continued hair growth, a slight clear nasal discharge and some stiffness that needed adjustment. Though his guardian said he felt “strong and vibrant when ridden”, the 30c Sulphur was repeated. There was no improvement, so a stronger dose (200c) of homeopathic Sulphur was administered several months later (four months after initial dose).
Dinant began to shed immediately after this dose, and at six months after the original dose, his well-being is excellent. On rides, he looks better than most of the horses at the barn. His coat is normal, his front coffin joints remain slightly tight but there is no heat in his feet, his lumbar spine needed slight adjustment, and his cervical spine was supple and comfortable.
CASE 2: SIENNA
Sienna is an eight-year-old Rocky Mountain mare. During the summer of 2015, she had pulses in all four feet and was painful. She was treated by the farrier and kept in a dry lot with hay. Her soles were growing but not exfoliating normally since the laminitis. She experienced a severe injury to her right hind fetlock in October of 2015 – down to the bone with a severed nerve – needing IV and oral antibiotics and raw honey. It healed with proud flesh and swelling.
She was not fully weight-bearing on exam in February of 2016 and kicked out when the foot was touched. Her right hind hoof was growing out crooked. She had been “spooky” since the injury, could not be ridden, was cranky when worked, hot to the touch and the underside of her neck had become harder. In the last year, she developed a hard cresty neck, fat pads at the shoulder, elbow and croup. She gained weight very easily.
Sienna had white discharge from her left eye, broken hair at the base of her tail (her owner reported she was nearly always in heat with tail rubbing, presenting, “winking”, squealing), hot proud flesh swollen ½” from above the right hind fetlock to the hoof wall (with golden colored discharge at the caudal aspect), and a frostbitten right ear tip. The right side of her neck and occiput were stiff, and she wouldn’t allow manipulation of her front legs proximal to the elbows or her hind legs. She was diagnostic at BL18 and Dan tian on Chinese exam scan, had a weak left pulse and strong right pulse. She was adjusted at this time.
In April of 2016, Sienna had gained some weight, and continued to have heat on her body, worse on the left. She also didn’t sweat on the left. Her right hind foot was beginning to contract. Her body condition score was 7/9, her thoracolumbar spine and right side of the neck were stiff, and she still didn’t allow her hind legs to be manipulated though did allow her entire thoracic limbs to be manipulated. On further questioning, her guardian said Sienna would shake and twist her head and neck when given a new or challenging task, and had the most trouble in hot and humid weather. She would also boss other horses but never bit or kicked them. At this time, her guardian requested homeopathic treatment, and she was given a single dose of Platina 200C.
Two months post treatment, Sienna’s work ethic had increased, she stopped head and neck twisting when given a task, her body cooled down, she was comfortable and not as sweaty in hot humid weather, her fat pockets at the shoulder, elbow, neck and croup had disappeared, her proud flesh had decreased (and was normal and not painful), and she had only had one brief heat cycle without any squealing. On exam, her left pulse was deep, her feet smelled awful, L1 to L3 were slightly stiff and she now allowed mild manipulation of her right hind foot. With homeopathic treatment, healing happens from the inside out, so discharges are often seen (and smelled!) during this process.
CASE 3: MOONSHINE
Moonshine is an 11-yearold miniature horse gelding. When he was five years old, he developed Lyme disease; the next year he developed Ehrlichia, which turned into severe laminitis with much pain. Initially, his laminitis was much worse in the winter, but by 2015 he was lying down almost all the time. Since he had been on antibiotics he also developed diarrhea, which was worse at the end of summer and the beginning of autumn. Probiotics were not helpful. Moonshine loves to lie in the sun, and is an easy keeper.
On exam, he had some tightness in his lumbar and cervical spine, all his feet were hot, his hooves were long and his BCS was 7/9. His pulses were deep and weak, his tongue was red and his diagnostic scan was positive for his front feet. His coat was extremely long. Moonshine was adjusted, received acupuncture for his Chinese diagnosis of Liver Qi Stagnation with Damp Heat, and received the Chinese herbal formula Hot Hoof 2 from Jing Tang Herbal.
Two months later, Moonshine was significantly improved, standing on the manure pile with his hind end and his front feet on the ground. He was much better with the farrier and was standing most of the time with a “perkier” attitude. On exam, all his hooves were warm, his stifles were stiff, he continued to have lumbar and cervical stiffness, and had developed slight edema in his axillae. He was adjusted and received acupuncture.
He did well until the following fall, when his symptoms (pain, lying down, lethargy, poor appetite and thirst, diarrhea) became worse than previously. He began Hot Hoof 2, but with no improvement prior to his appointment for homeopathy on December 23, when he was given one dose of Hepar sulph 30C.
Two weeks after the dose, Moonshine’s diarrhea was resolved, and he was lying down much less. His lumbar spine was slightly stiff, he was painful on manipulation of his front feet, his coat was good with normal thickness, his left pulse was weak and his BCS was 6/9.
By February 11, 2016, all his manure was normal, he was no longer lying down or standing in the sun – he was now staying by the hay. On exam, only L1 needed adjustment, he allowed full manipulation, his feet were cool with visual bruising on the front soles (he had been trimmed the day before), his coat was normal and BCS 5/9.
On April 14, his guardian started noticing some loose manure mixed with the regular. Moonshine also lay down once, but got up right away when fed. She felt he was 65% better, and said he always developed loose manure when the grass began growing in spring. He no longer appeared “sad” but was his regular “ornery” self with the farrier, and had his spirit back. On exam, his front heel bulbs were warm, his coat was normal and shiny, his right cervical spine was tight and he allowed full manipulation of his limbs. Due to the loose manure and lying down episode, he was given a second dose of Hepar sulph 30C.
On July 2, his diarrhea was resolved, and he was no longer lying down, but his front feet seemed painful during and after a trim. His toes were much too short on the fronts, all feet were warm, he was bearing weight mostly on the hinds, his lumbar spine was tight and his BCS was 6/9. He received one dose of Hepar sulph 200C (a stronger potency), and on follow up communication his guardian reported he is better than ever.
CASE 4: HARLEY
Harley is a 20-year-old Quarter/ Morgan cross gelding. His main issue was squamous cell carcinoma (SCC) of the penis, but he also had Cushing’s, determined by bloodwork. He had multiple masses all over the penis, which received several cryotherapy treatments along with 5-fluorouracil. The SCC continued to recur and worsen until he would no longer drop his penis or allow anyone near his hind end. In 2011, when his SCC was first diagnosed, he also had a body condition score of 9/9 and a painful left front foot, which had calcification around the navicular bursa as shown on radiographs.
In January 2016, Harley had warm limbs distal to carpi and hocks, tight lumbar spine and poll, internal rotation of the left glenohumeral joint, right scapula dorsal, wouldn’t allow the left hind to be manipulated proximal to the hock, and had a toe bruise on that foot. His pulses were strong on the right, weaker on the left, he had a long coat, cresty neck, pot belly and BCS 5/9. He was on pergolide at the time. Harley had occasional diarrhea and coughing. He was adjusted, and homeopathic Thuja 30C was recommended, but his guardian did not give the remedy at that time.
He was moved to a new barn, had one more round of cryotherapy and 5FU, but the pergolide was stopped when it ran out. Then he had a severe reaction to the anesthetic given when cryotherapy was performed; his guardian decided she didn’t want it repeated, and was ready to try homeopathy.
In June 2016, Harley had a BCS 7/9 with a grazing muzzle. His pulses were fast and his tongue was purple. He continued to have lumbar spinal stagnation and would not allow an exam of his penis. He was given Thuja 30C at this appointment.
One month later, his penis was comfortable, he allowed unsedated cleaning of his sheath by his guardian, and had much less smegma with no drainage onto his legs. His belly was firm, he no longer had a cresty neck, his feet had no heat, no diagnostic points were found on scan, his muscle condition score was 3/3 and his coat was beautiful. He is due for another recheck in two weeks, but the owner’s e-mail reports say he is doing very well.