Horse Cushings Disease Management and Welfare

Pituitary pars intermedia dysfunction, commonly called Equine Cushings disease, is highly prevalent in older horses and ponies requiring early diagnosis and ongoing management to maintain welfare.

Key Facts

PPID affects approximately 15-21% of horses over 15 years of age based on prevalence studies
The condition causes hypertrophy of the intermediate lobe of the pituitary gland producing excess hormones
Clinical signs include hypertrichosis with a long curly coat that fails to shed, weight loss, and polydipsia
PPID predisposes to recurrent laminitis through insulin dysregulation
Diagnosis uses resting or dynamic ACTH testing with seasonal reference ranges required for accuracy
Pergolide mesylate is the licensed treatment and significantly improves clinical signs in most horses
Early diagnosis before dramatic clinical signs appear allows treatment to prevent advanced welfare compromise

Welfare Considerations

PPID causes progressive welfare decline through multiple mechanisms including chronic laminitis pain, coat problems causing heat stress and fly irritation, muscle wasting weakening normal function, and immune suppression increasing disease susceptibility. The condition is insidious and early signs including subtle coat changes and mild ACTH elevation may be dismissed as normal aging. Treatment with pergolide is highly effective and dramatically improves quality of life but requires lifelong administration and monitoring. Horses diagnosed and treated early maintain much better welfare than those where treatment begins only after advanced clinical signs have developed. Regular ACTH testing of all horses over 15 enables early identification.

What You Can Do

Schedule ACTH testing for all horses over 15 years of age twice annually including during October when sensitivity is highest
Monitor coat shedding pattern annually as failure to shed summer coat is an early PPID indicator
Begin pergolide treatment promptly on positive ACTH test rather than waiting for obvious clinical signs
Adjust pergolide dose with veterinary guidance based on ACTH response and clinical improvement
Manage laminitis risk through dietary carbohydrate restriction in PPID horses with insulin dysregulation
Monitor body weight and muscle condition monthly as weight changes indicate disease progression or treatment response
Discuss quality of life monitoring with your vet as PPID progresses to ensure treatment remains beneficial