Horse Cushings Disease: Recognition and Management in Senior Horses

Equine Cushings disease (PPID) is the most common endocrine disorder in older horses and a significant source of preventable suffering when undiagnosed.

Key Facts

Pituitary pars intermedia dysfunction (PPID) affects an estimated 15-21% of horses over 15 years
Classic signs include hypertrichosis (abnormal coat retention), weight loss, muscle wasting, and increased drinking
PPID horses have dramatically increased laminitis risk, making early diagnosis critically important
Diagnosis uses ACTH measurement, ideally in autumn when seasonal elevations are most diagnostically useful
Pergolide treatment is effective and well-tolerated, typically improving coat, energy, and laminitis risk within weeks
Annual ACTH monitoring allows dose adjustment as the disease naturally progresses over time

Welfare Considerations

Cushings disease in horses is a quiet welfare crisis because its signs develop gradually and are frequently attributed to normal aging. The abnormal coat retention causes chronic heat stress in summer, the muscle wasting is often visible as hollowed temples and topline loss, and the increased laminitis risk creates potential for severe pain. Horses with undiagnosed PPID suffer all of these consequences unnecessarily — pergolide treatment is effective, affordable, and dramatically improves quality of life within weeks of initiation. The welfare imperative is routine screening of older horses rather than waiting for obvious clinical deterioration that represents preventable suffering.

What You Can Do

Screen all horses over 15 years annually for PPID using ACTH measurement, ideally in autumn
Learn to recognize early PPID signs — abnormal summer coat retention is often the first visible indicator
Begin treatment promptly if PPID is confirmed — the welfare benefit of early intervention is substantial
Clip affected horses in summer to prevent heat stress from abnormal coat retention