Remission is one of the craftable items in the game. Users in the Pharmaceutical Sciences stream can craft it using levothyroxine, metformin and pergolide.

Course Article

Metabolic Treatments

Horses over the age of 15 years are susceptible to getting metabolic disease, which is when the hormones in the body fail to respond normally to the body's environment. There are two main metabolic conditions in horses, Equine Metabolic Syndrome (EMS) and Pituitary Pars Intermedia Dysfunction (PPID). Both of these diseases are represented on Oxer to Oxer.

PPID is a condition where the hypothalamus in the horse's brain does not produce enough dopamine (a pituitary inhibitor) to prevent the pituitary gland from producing hormones. This causes the pituitary gland to become enlarged and have hyperactive cells, leading to excessive production of adrenocorticotropic hormone (ACTH). ACTH stimulates the adrenal glands to produce cortisol, the stress hormone. The excessive cortisol causes dysfunction in several areas of the body. The most classic signs of PPID are a long, curly haircoat, loss of muscle mass and repeated laminitis episodes. PPID is typically treated through the use of pergolide, which stimulates more dopamine release from the hypothalamus, thus decreasing the amount of ACTH and cortisol. This drug is quite effective with minimal side effects, and allows horses to have a good quality of life despite their PPID.

EMS is the other main metabolic disease that we see in older horses. This condition is somewhat like diabetes, where the horse's body fails to respond to insulin properly. Normally, insulin allows sugar to move into cells from the blood, but when horses have EMS, the cells become desensitized to insulin, so sugar stays in the blood stream. This causes them to have high blood sugar, leading to laminitis and excess fat deposition on the neck and around the base of the tail. Typically horses with EMS are best treated with management changes, like feeding a low-sugar diet. However, there are a couple drugs that can help with EMS treatment. Levothyroxine can help EMS horses lose weight and increase sugar use, to help prevent future laminitic episodes. Metformin can help lower blood sugar in people, and has been used with some success in horses as well.

The above drugs are combined into one product called Remission in Oxer to Oxer. It can be used on horses who are in a recovery period after being diagnosed with metabolic disease, and it will reduce their recovery time by half!

1. Graves, E.A. Equine Endocrine Diseases: The Basics. American Association of Equine Practitioners. https://aaep.org/horsehealth/equine-endocrine-diseases-basics