Horse Cushings Disease Management

Pituitary Pars Intermedia Dysfunction (PPID) — equine Cushings disease — affects a significant proportion of horses over 15, causing wide-ranging metabolic and welfare impacts.

Key Facts

PPID affects approximately 20-25% of horses over 15 years — making it one of the most common senior horse conditions
The condition involves dysfunction of the pituitary gland intermediate lobe causing elevated ACTH and cortisol
Classic signs include hypertrichosis (long, curly coat that fails to shed), muscle wasting, pot belly, and laminitis risk
ACTH blood testing in autumn when levels are naturally elevated provides the most sensitive diagnostic window
Pergolide mesylate (Prascend) is the gold standard treatment, normalizing ACTH and resolving clinical signs
Laminitis is the most dangerous consequence of PPID — affected horses require strict dietary carbohydrate management
Early treatment before laminitis develops significantly improves welfare outcomes and long-term prognosis

Welfare Considerations

PPID causes progressive welfare decline across multiple body systems when undiagnosed or untreated. The hypertrichosis itself causes significant discomfort — horses with long, non-shedding coats are unable to thermoregulate effectively, causing overheating and chronic sweat discomfort in warm conditions. Muscle wasting reduces strength and mobility. Laminitis — a preventable consequence of PPID — causes severe hoof pain that can progress to permanent lameness. The welfare case for routine PPID screening in senior horses is compelling: treatment is effective, available, and affordable relative to the welfare cost of progression. Pergolide treatment typically resolves coat abnormalities within months, reduces laminitis risk, and improves energy and behavior as cortisol normalizes. Early diagnosis before clinical signs are advanced achieves the best welfare outcomes.

What You Can Do

Screen horses over 15 for PPID annually using ACTH blood testing — autumn testing provides highest sensitivity
Recognize early PPID signs: delayed coat shedding, subtle muscle loss over the topline, and increased drinking
Initiate pergolide treatment promptly after confirmed diagnosis — do not delay pending symptom severity assessment
Manage PPID horses on low-carbohydrate diets to reduce laminitis risk — test hay NSC content
Clip horses with hypertrichosis in warm weather to prevent heat-related welfare suffering
Monitor for laminitis signs — digital pulses and hoof sensitivity — in all PPID-diagnosed horses throughout the year
Work with an equine veterinarian to establish monitoring protocols and appropriate pergolide dosing adjustments