Pituitary pars intermedia dysfunction, commonly called equine Cushings, requires lifelong management that substantially improves welfare when well-executed.
Untreated PPID causes progressive deterioration including severe laminitis, muscle wasting, immune suppression, and dental disease. Welfare in well-treated horses can be excellent, with return to near-normal activity in many cases. Treatment compliance and monitoring are the primary welfare challenges — owners who find pergolide expensive or difficult to administer may under-treat. Laminitis prevention through diet management, footcare, and seasonal ACTH monitoring during the autumn rise period is the most important welfare intervention in PPID horses.