PPID (Equine Cushing's) in Horses: Advanced Management

An in-depth guide to pituitary pars intermedia dysfunction in horses and ponies, covering welfare, treatment, and monitoring.

Key Facts

PPID results from progressive neurodegeneration of the pars intermedia of the pituitary gland
It is the most common endocrine disease of horses affecting predominantly older animals
ACTH measurement is the primary diagnostic test with seasonal adjustments needed
Laminitis is the most important welfare complication of unmanaged PPID
Pergolide mesylate is the treatment of choice providing significant welfare improvement
Most horses with PPID live well for many years with appropriate management

Welfare Considerations and Management

Comprehensive PPID management in horses requires diagnosis, pergolide treatment, laminitis prevention, and regular monitoring. Pergolide normalises ACTH levels and resolves clinical signs (hirsuitism, lethargy, polyuria) in most cases. Dietary management reducing non-structural carbohydrate intake prevents laminitis. Regular ACTH measurement (adjusting for autumn insulin resistance elevation) guides dose adjustments. Clinical monitoring includes body condition, coat quality, drinking, and laminitic episodes. Most horses maintain good quality of life with treatment.

What You Can Do

Test for PPID using ACTH measurement in any horse over 15 years with clinical signs
Begin pergolide treatment promptly once diagnosed — welfare improves significantly
Implement dietary management reducing sugar and starch to prevent laminitis
Monitor ACTH levels every 3-6 months and adjust pergolide dose as needed