Horse PPID (Cushings): Recognition and Welfare

Pituitary pars intermedia dysfunction (PPID) is extremely common in older horses. Early recognition and treatment prevent painful complications and maintain quality of life.

Key Facts

PPID affects an estimated 15-30% of horses over 15 years of age
Caused by dysfunction of the pituitary gland resulting in excess ACTH and cortisol-like effects
Classic signs include hypertrichosis (failure to shed a curly coat), laminitis, muscle wasting, and increased water intake
Subtle early signs including delayed coat shedding and reduced performance are often missed
Pergolide treatment (Prascend) effectively controls PPID in most horses with regular dose monitoring
Untreated PPID is the most common predisposing cause of laminitis in horses over 15 years

Welfare Considerations

PPID causes significant welfare impacts through its complications, particularly laminitis. A horse with undiagnosed PPID recurrently developing laminitis has a preventable welfare problem — the PPID drives repeated inflammatory episodes that cause severe hoof pain. Treatment is highly effective at controlling PPID and reducing laminitis risk. The welfare imperative is early recognition through routine screening of older horses and prompt treatment, making PPID one of the highest-impact welfare interventions available for geriatric equine care.

What You Can Do

Have any horse over 15 years with delayed coat shedding tested for PPID with an ACTH blood test
Screen all horses known to have recurrent laminitis for underlying PPID regardless of obvious clinical signs
Begin pergolide treatment promptly upon diagnosis and monitor with annual ACTH testing
Adjust testing timing for seasonal variation in ACTH levels — autumn values are normally elevated
Implement appropriate dietary management for PPID horses, particularly restricting dietary sugar and starch
Monitor dental health closely in PPID horses as muscle wasting can affect chewing efficiency