Cushings-Like and Other Endocrine Pathologies Revisited

I hear from customers frequently struggling in transition from shoes to barefoot, for years without success. Why? Might there be an underlying endocrine based metabolic issue? The horse is one large hormone producing machine.

Are we open to a different question? Or are we only interested in redefining the problem?

For instance: Can Cushings or Cushings-like signs and symptoms negatively impact functional hooves? What about the same question with Equine Metabolic Syndrome, Insulin  Resistance, hyperglycemia, hypo-thyroid, hypo-pituitary? The answer to all these questions is YES!

How long must an endocrine dysfunction exist before it is apparent to all to see or notice? How much organ reserve or metabolic threshold does a horse have? How old does a horse need to be to be overwhelmed by endocrine dysfunction? The hooves are the eyes of the horse. If you are struggling with chronic hoof problems, be it thrush, WLD, laminitis, re-occurring founder, unable to successfully transition to barefoot for YEARS and more, you might want to read on and think outside the box.

It would appear that so many horses seem to contract a pathology which to date is very difficult to confirm a positive diagnosis by objective means such as an MRI or CT scan, as is used to diagnose human pituitary tumors, much less Diffuse Tensor Imagery (DTI) for horses. It is not my intention, nor the intention of this article, to incite anyone or any group, horse owner or DVM, but merely to give a differing view which may shed a different light on this overwhelming disease process, which is difficult to prove beyond a shadow of a doubt.

The incidence of Cushings in the human population is very, very rare; in fact, it is suggested that the incidence of Cushings is 10 in 1,000,000 across the USA. That being said, why are so many horses assumed or diagnosed with Cushings or Pre-Cushings? Given the rarity of this disease, I wonder if any GP would recognize or even have witnessed this pathology called Cushings in humans?Equine Pituitary, Thyroid, Hypothalamus

I recognize that human and equine Cushings are related yet different disease processes.  What if the origin of this disease process can be shared in varying degrees, that of being Repetitive Traumatic Brain Injury? Should we not consider Cushings-like signs and symptoms caused by neurogenic endocrine dysfunction from the pituitary, thyroid, thalamus, rather than merely adrenal crisis?

My curiosity in this regard was the observation of my Morgan mare, Shiloh. Shiloh has been with me for 8 years and, given the level of my stewardship with her, I do not miss much given her day to day status. Shiloh is very sweet and very easy to get along with. Approximately 18 months ago, Shiloh began to be more and more irritable or annoyed and prone to nastiness with about everything that used to be pleasurable to her, grooming, touching, brushing. Her right eye began to weep incessantly to the point that the fur below the orbit began to shed. Being an easy keeper with the “thrift” gene, keeping her at an acceptable weight became an extra challenge.

Initially, I thought she may be suffering from endocrine dysfunction, and elected to try a major brand Chasteberry extract to see if this would help to balance her endocrine system. I followed the instructions to the letter. After 4 months of using this Chasteberry extract with very little positive changes in Shiloh, I made a change.

Being a retired Doctor of Chiropractic, I adjust my Morgans frequently. I use a new adjusting instrument which was designed with my input, the Innate Intel. With the sophistication of this instrument, I was able to adjust the cranials or the skull of Shiloh. The first time I adjusted Shiloh’s cranials, she dropped her head and began to moan and groan. I needed help to keep her head from actually resting on the ground as I completed the adjustment.

I adjusted her cranials three times over the course of 5 days, and at the end, the right eye ceased to weep. Slowly her attitude began to change. Most owners who have a weeping eye are told that a tear duct is blocked, and the DVM can push a small tube up thru the tear duct via the nostril. Sometimes this works; most times it does not.  Many an equine dentist will explain that a proper dental adjustment will correct a weeping eye; sometimes it does, most times it does not. If you have tried a procedure or two to stop the weeping eye or eyes, then you have not addressed the cause of incessant eye weeping.

I am now of the opinion that most of the incessant weeping of the eyes is a prolonged increase in cranial pressure—essentially your horse has an unending pressure headache. Each horse I have adjusted the cranial bones, which demonstrated incessant eye weeping, has recovered within 1-3 adjustments.

Back to Shiloh, insofar as Shiloh was on Chasteberry extract and after the cranial adjustment she began to feel better, I needed to know what it was, the cranial adjustment or finally the Chasteberry extract. Shiloh was removed from her daily regimen of chasteberry. Within 8 weeks Shiloh was back to her old self—after 3 instrument adjustments to her cranial bones. I, of course, am thinking about this 24/7, and began to draw on my 18 plus years of solo human chiropractic practice experience.

We have all had a sinus infection so severe that our teeth ache, perhaps some of us have actually seen a dentist to ensure you do not have a tooth going bad, only to be told that the prolonged nasal pressure is causing your teeth to ache. For those who get migraine headaches, you will understand cranial pressure. Your head throbs, pain that causes you to vomit, your eyes hurt horribly, light and noise increase your pain disproportionately and if you are like me, your brain is not the same for 36 hours after the pain has subsided.

I know if I am not feeling well, I can relate to my wife or a professional my problems, be it my back or my gut, but I do not have to tell her my head hurts—Kathy knows by looking at me. If the barometric pressure drops, as is the case with a storm, my head will begin to hurt… how does my horse tell me what the problem is?

Given the location of the equine pituitary gland (which is the Master Gland of the horse which regulates all the other glands of the Endocrine system), just under the base of the brain in the horse, just under the halter and bridle, and given the mild to violent repetitive physical energy delivered to the horse in training and in physical correction, are we inadvertently the cause of Cushing like signs and symptoms? We have all seen the bridling up of the horse and the heavy handed reining of the horse, the riders who ride on the face with extraordinary pressure applied to the mouth, face and head of the horse—all of this may cause mild to moderate to severe repetitive brain injury. Bone tissue is an excellent medium in which to transfer energy or force and the transference of that energy is almost instantaneous.

Given the U.S. military’s involvement in the Middle East for the past few years, the use of Improvished Explosive Devices (IEDs), there have been a great deal of concussive brain injuries and a great deal of research in this area coming to the forefront. The increasing trend of mental and coping problems with professional athletes is increasing as we speak. The number of Traumatic Brain Injuries (TBI) in school athletics is staggering and so much of it goes unnoticed until many years later.

I have talked to a few people about my observations, and in each case I am told that Cushings is an “old horse problem.” My response is the same each time, “lung cancer is a old person problem, also, one must smoke for 30-40 years before cigarette smoke overwhelms their system.” Each time, they look at me like a hog looking at a Rolex.

If you take an honest look at the conditions that many times overwhelm us, they are most times self-induced. Over eating, alcohol consumption, smoking, drug use, etc. There have been many changes in human footwear to decrease ankle, knee, hip, and low back pain and dysfunction. The changes in the manufacturing of automobiles are endless, to make them more safe and more passenger safe in case of impact or accident aka Crash Testing.

Foot ball helmets have changed a great deal to decrease the possibility of brain injury because we recognize that impact injuries can and will have a profound impact of soft tissues to include the brain, pituitary, thyroid, adrenal and the nervous system which makes communication possible, be it via nerve impulses to humeral affect via hormones, neurotransmitters and such.

Horses are moved via their heads and necks with a rope made of nylon, leather, hemp, steel, you name it. Just how long would your wrist last if you were moved about with leather or nylon wrapped around your wrist, during the day—not long! The level of nerve and vascular trauma would be extensive. The dislocation or subluxation to the wrist bones would be horrible.

People are generally bound and moved as criminals via their wrist—not the neck and head. Not so with the horse!

Sadly, the study of Traumatic Brain Injury is in its infancy, and there is so much we do not know, and, of course, this research is not ongoing with the horse in mind. But we can, in my opinion, reasonably make a case for the same signs and symptoms in the horse.

Please keep an open heart and mind. Most horse owners have no idea of the history of their horse insofar as most of us have not raised our horses from foals to present. The selling of horses is a slippery slope, and of course, there is no history of rank behavior or attitude; the horses are all dreams until you get them home. The ACE wears off, then the work begins. Next you have the Equine Chiro out to fix the back, the Equine Dentist out to adjust the teeth and you are told the teeth have never been done or have been done very poorly. The feet are in worst shape that you thought and we have all heard the same old story… why do we think the horses training and use is consistent with a Walt Disney movie?

Imagine if you will, your horse is 6 months old and transported across the country; it arrives stressed and frightened. The horse is started at 2 years, the training is very rough, and it is trained 20 minutes every other day. The horse has an immature index, and therefore the training is more rough, because someone is paying for results. 30-90 days are put on the horse, all the tricks and gimmicks are used rather than time, because time is money.

The horse is tarped, checked for 20 minutes at a time unsupervised, it is hit in the head and face to get its mind right. The neck and head have been jerked left, right, up and down to gets its attention.  Heaven forbid the horse bucks and kicks with the saddling process—more roughness, jerking, and such, to get the horses mind right.

Right now, you are saying to yourself, not my horse, it was trained by “so and so trainer” and he or she is the best. Did you ever go over unannounced to watch the training of your horse? Most just want a bomb proof horse with a great mind. How many people have owned your horse before you?

Given the mild to violent repetitive physical energy delivered to the horse in training and in physical correction,

are we inadvertently the cause of Cushing-like signs and symptoms?

Now that the horse is started, now the training starts: side passing, dropping the head, taking the bit, trotting, jogging, cantering, working cows, futurity work, etc… It never ends! Why do we never think the horse has been traumatized physically from the head, brain, neck, wither? Why do we never consider the possibility that our horses have neurological problems, be they very small, but in time begin to get worse?

How long does it take before unaddressed, unrecognized injury will manifest itself in more obvious signs and symptoms? If horses are like humans with respect to Repetitive Brain injury, it will takes years!

Is this why there are so many horses out there with Cushing-like signs and symptoms? Is this a possibility? Is this just another Coulda, Woulda, Shoulda moment? If we do nothing other than what we are currently doing, I feel confident in saying, Nothing will change!

In much of the study of mild-severe Traumatic Brain Injury (TBI), there is the same trend over and over: Hypo-Pituitary dysfunction (4,6,8,18), Hypo-Thyroid Dysfunction (4,6,8), Hypo-thalamic Dysfunction (3,4), Adrenal Dysfunction (18), Hyper-Glycemia (2,7), Glucose Varibility (9), Excessive weight gain (1), Hypo-Gonadism/low testosterone (4), Intercranial pressure (6,10), Neuro-degeneration (14,18), Isolated Growth hormone deficiency (18), sodium dysregulation and adrenal crisis (6).

The behavioral changes expressed due to repetitive and mild to severe Traumatic Brain Injury runs the gambit: fatigue as opposed to sleepiness both mental and physical16, irritability/annoyance (17), cognitive difficulties6, behavioral changes (6), depression (6), and more.

Does any of this sound familiar where your horse is concerned?

There does not seem to be an end to this documentation/research/suggestions of study in the area of Repetitive Traumatic Brain Injury, be it mild, moderate or severe. What is sad is that there is almost no treatment and more times than not, Traumatic Brain Injury, unless it is very evident goes unnoticed, undiagnosed and untreated, but the consequences of this injury continue for a lifetime and up until recently, few are putting 2 and 2 together, historically.

There is no consistent measure of the energy input necessary to cause TBI, in fact it would appear from the reading, the younger the brain, the more predisposed to injury, and far too many times these injuries go unrealized and lead to an unacceptable level of poor outcomes and morbidity across the population in the years to come (2,7,8,10,12,13,15,17,18).

Given the hopelessness that many face with repetitive mild to severe TBI, assuming that it is recognized in this case—your horse—what, if anything can be done? How long must the unrecognized inter-cranial pressure or axonial injury (12), or neuro-degeneration (14), or neuro endocrine dysfunction (17), begin to manifest overt signs and symptoms which can be observed?

As an example, how much pressure can you place on your eye before damage is sustained? How much pressure can be sustained on one’s testicle before certain damage is caused? 70 mm of Hg pressure placed on the Dorsal Nerve root will cause nerve dysfunction, but only 5 mm Hg will cause changes to the vascular supply to the nerve, so the nerve will begin to degenerate due to lack arterial and venous support.

How much is 70mm Hg of pressure, you ask? The weight of a typical pencil unsharpened is not much, and 5mm Hg is a great deal less. It is no surprise that the vast majority of Traumatic Brain Injury goes unnoticed, and when it does, the correlation of the history of TBI is missed and is not held responsible for the overall dysfunction of the human, and in my opinion, same with the horse.

Just how must energy will breech the physical threshold of the nerves, vascular structures, and the physical components of the brain, given the shearing affect of very soft tissue which causes neuro-degenerative dysfunction, ischemia, hypoxia, tissue infarct and such to the pituitary, thyroid, adrenals, the thalamus? It truly is a cascading phenomenon leaving no part of the horse untouched (3,10,12,13,14,18, 25).

If you have observed a baby being born or a few days after a vaginal delivery, you will see a misshaped skull, and that is called skull modeling, which means the skull has the ability to move. My point is we all know cranial bones will move to some degree, and less as the skull ages. Back to the horse…

If you jerk your horse with the halter attached to a 12 foot lead rope to get his attention, I assure you, given the mass of the horse and the lever of the rope and the applied acceleration you impart to the lead rope, you are putting a great deal of energy into the horse’s skull and neck. The Physics equation for that is “Mass times Acceleration equals Energy or Force.”

Just how much force could our skulls and brains take if we did the very same thing to each other? I assure you, you would suffer a Traumatic Brain Injury and perhaps a broken neck, fractured larynx, and a whole host of injuries to include death. So we assume a great deal when we assume that the horse is uninjured when a great deal of energy or force is absorbed by the horse’s head repetitively at our hands, or at the hands of others, via a halter and rope.

Most horses are “broke” or “started” when they are young, and younger brains are far more susceptible to Traumatic Brain Injury (12,13,14,18).  If you can cause an injury with a non-specific random energy/force, it is possible to correct that problem with a specific non-random energy or force. As an example, if your suffer a compound fracture of your forearm, that would represent a non-specific random energy force absorbed by your forearm after a fall from the your bucking horse. If you expect functional healing, you will present at the local hospital and the Orthopedic surgeon will apply a very specific non-random energy or force to your forearm as he sets it, and probably attach a titanium plate. If this is not done, and you do not get an infection which kills you, and you just push the bone back under the skin, if it gets close enough to heal it will—but you will not have functional healing; the arm will probably be somewhat disfigured.

If your horse suffers some level of mechanical Traumatic Brain Injury at the hand of a lead rope, halter, bridle, stick, bite, heavy handed riding, pulling back when tied, etc., until you do something mechanical to change that, it will be there forever. If this happens, we will SAY, “Wow, my horse is getting nasty and grumpy!”

There is very little that is offered to treat humans, much less the horse, of repetitive Traumatic Brain injury allopathically. The drugs which are available are not very effective, and there is hope that something will be forthcoming (22). Therefore, assuming repetitive Traumatic Brain Injury (BTI) is suspected, one will need to take a more naturopathic approach, which will include chiropractic with attention toward cranial work, SOT cranial work, nutrition19, viable probiotic11,21, increased protein and calorie consideration19, and very little stall rest—rather, exercise (21,24).

In writing this article I have included a bibliography. I would encourage anyone who struggles endlessly with the diagnosis of Cushings or Cushings-like to Google “Traumatic Brain Injury and Repetitive Traumatic Brain Injury” and read as much as you care. See if you can draw any conclusions which may help your challenged horse, that you to date may not have considered (26).

In closing, I hope that if you have a horse that is currently diagnosed as Cushings-like, Pre-Cushings, hyper-thyroid, hyper-glycemic, IR, Equine Metabolic Syndrome and such, you will consider the use of an equine professional or equine paraprofessional to address and or rule out Repetitive Traumatic Brain Injury. If your horse is seemingly fine, and you wish to be pro-active in this area, seek out someone who is competent in cranial adjustments and or cranial work to evaluate your horse.

Please keep in mind, the longer this neuro-degeneration or neurogenic dysfunction condition has existed, the longer one would allow for recovery, assuming some level of recovery is possible. If the horse is older with less organ reserve, the outcome will be commensurate with the level of pre-existing chronicity.

The best treatment is prevention. With a recognition that your horse has suffered Traumatic Brain Injury, do what you can (given the options available) to hopefully restore to pre-injury as best as is possible, but waiting and watching will guarantee nothing will change, other than the slowly progressing cascading of Neuro-Endocrine Dysfunction.

Given the prevalence of Insulin Resistance (IR) in horses, could some of the origins of that condition be repetitive Brain Injury and the ensuing Neuro-Endocrine Dysfunction (1,2,7,9)? It is certainly worthy of consideration. Perhaps if we all consider this possibility, we and our horses will forgo the Neuro-Endocrine Dysfunction which originates from ongoing repetitive Traumatic Brain Injury. In my opinion it is not a case of “IF” but rather “WHEN.”

Copyright Mackie K. Hartwig, D.C. (ret)

All right Reserved.

About the author: Dr. Hartwig is the President and CEO of Equine Challenge Supplements, which manufactures Forage Specific nutritional products for horses. Dr. Hartwig was a licensed Doctor of Chiropractic in the state of California from 1986-2011. Dr. Hartwig retired in 2005 to concentrate on the stewardship of horses, and resides in Central California with his wife Kathy and their 6 Morgan mares. For more info, visit

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in children with severe traumatic brain injury Smith, Rebecca L. MD;
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FCCM; Fink, Ericka L. MD; Wisniewski, Stephen R. PhD; Bayir, Hülya
MD; Tyler-Kabara, Elizabeth C. MD, PhD; Clark, Robert S. B. MD;
Brown, S. Danielle RN, MS; Bell, Michael J. MD Pediatric Critical Care
Medicine: January 2012 – Volume 13 – Issue 1 – p 85¬91
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Simon Beaulieu-Bonneau, Charles M. Morin
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Physician; Writer; Associate Professor, Georgetown University Posted:
25. Hypopituitarism following traumatic brain injury: determining factors
for diagnosis Eva Fernandez-Rodriguez1, Ignacio Bernabeu1, Ana
Isabel Castro1, Fahrettin Kelestimur2 and Felipe F. Casanueva1,3* 1
Endocrinology Division, Complejo Hospitalario Universitario de
Santiago de Compostela, SERGAS, Departamento de Medicina,
Universidad de Santiago de Compostela, Santiago de Compostela, Spain
2 Department of Endocrinology, Erciyes University Medical School,
Kayseri, Turkey 3 Centro de Investigación Biomédica en Red de
Fisiopatología Obesidad y Nutrición, Instituto Salud Carlos III, Santiago
de Compostela, Spain
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Unluhizarci K, Kelestimur F. Department of Endocrinology, Erciyes
University Medical School, 38039 Kayseri, Turkey