He has suggested that fat horses and ponies may be suffering from a syndrome which has been well recognised in humans, that of Omental Cushing's disease. In humans, the omentum, a fatty sheet which covers the intestines, becomes an abnormal site for the production of the hormone cortisol. The omentum in these individuals contains an aberrant set of enzymes which convert the person's own inactive cortisone into the active form cortisol. This increased amount of circulating cortisol has an adverse effect on the horse's carbohydrate metabolism causing an increased blood glucose and insulin.
In general, the first postoperative follow-up visit will be scheduled a few weeks after surgery. If problems develop prior to your appointment, you will be asked to return to your neurosurgeon as soon as possible. Your return appointments will be scheduled according to your needs. Lifelong follow-up is necessary. You should ensure that you receive appropriate follow-up by physicians knowledgeable in diagnosing and managing pituitary disorders.
For patients who continue to have excess pituitary production of ACTH following surgery, medications can be helpful along with other therapies. Although there is no medication to control Cushing’s disease, a few drugs can be used in reducing the levels of cortisol. Drugs such as ketoconazole, metyrapone, and mitotane, trilostane, and aminoglutethimide have been used with varying success. These drugs may be given after surgery (sometimes along with radiation treatments).