Horse Cushing Disease and Welfare Management

Pituitary pars intermedia dysfunction (PPID), commonly called Equine Cushing Disease, is the most common endocrine disorder in horses over 15 years old. Long-term welfare management is essential for affected horses.

Key Facts

PPID affects an estimated 15-30% of horses over 15 years old
Signs include hypertrichosis (long, curly coat), laminitis, muscle wasting, lethargy, and polyuria/polydipsia
Diagnosis uses ACTH measurement - seasonal adjustment of reference ranges is required for accurate interpretation
Pergolide mesylate (Prascend) is the primary treatment and significantly improves welfare when started early
Untreated PPID leads to progressive immune compromise, laminitis, and reduced quality of life
Regular dental checks and parasite management are particularly important in PPID horses due to immune compromise
Laminitis associated with PPID requires careful dietary management including avoidance of high-sugar grass

Welfare Considerations

PPID welfare management illustrates how early intervention dramatically changes welfare outcomes. Horses treated with pergolide from early clinical signs maintain good quality of life for years; those diagnosed late with advanced laminitis face more complex welfare management. The distinctive clinical signs (particularly the long curly coat retained through summer) should prompt veterinary investigation in any horse over 15 years old. PPID horses require integrated management addressing the endocrine disease, secondary laminitis risk, and the general vulnerability that comes with immune compromise. Quality-of-life assessment should be part of regular veterinary review for horses on long-term pergolide treatment.

What You Can Do

Have horses over 15 years old screened for PPID annually with ACTH blood testing
Treat with pergolide immediately after diagnosis - early treatment preserves welfare
Manage grazing carefully for PPID horses: avoid high-sugar spring and autumn grass
Ensure regular dental care and parasite management as PPID compromises immune function
Monitor laminitis risk continuously - adjust management with seasonal grass sugar changes
Discuss quality-of-life assessment and end-of-life planning with your vet proactively