Horse Cushings Disease: PPID Welfare Management

Pituitary Pars Intermedia Dysfunction (PPID or Cushings) is the most common endocrine disease in older horses and ponies. Early diagnosis and treatment prevent significant suffering.

Key Facts

PPID affects an estimated 20-25% of horses and ponies over 15 years of age
It is caused by dysfunction of the pituitary gland, resulting in elevated ACTH and cortisol production
Classic signs include a curly, non-shedding coat (hypertrichosis), muscle wasting, lethargy, and increased thirst
PPID significantly increases laminitis risk - many older horses with laminitis have undiagnosed PPID
Diagnosis uses blood ACTH measurement, which varies seasonally requiring time-specific reference ranges
Pergolide (Prascend) is an effective licensed treatment that controls symptoms in most horses when given daily
Early treatment before severe muscle wasting and immunosuppression develops produces much better welfare outcomes

Welfare Considerations

PPID causes progressive welfare deterioration that owners often attribute to normal aging. The muscle wasting causes weakness and reduced ability to engage in normal activity. Chronic hypertrichosis in warm weather causes thermal discomfort requiring clipping. Immunosuppression from elevated cortisol means dental disease, parasitism, and minor infections progress more severely than in healthy horses. The connection between PPID and laminitis means many cases of recurrent laminitis in older horses have an untreated hormonal cause. Pergolide treatment is effective and affordable, making ongoing suffering from undiagnosed PPID a preventable welfare failure in most horses with access to veterinary care.

What You Can Do

Request ACTH testing for any horse or pony over 15 showing clinical signs of PPID
Test at the appropriate seasonal time - autumn sees naturally elevated ACTH requiring season-specific reference ranges
Begin pergolide treatment promptly once diagnosis is confirmed - early treatment prevents progression
Clip hypertrichotic horses in warm weather to prevent thermal stress
Manage laminitis risk proactively in PPID horses through dietary carbohydrate restriction
Follow monitoring recommendations for treatment efficacy - adjust dosing as needed seasonally