Companion Animals

Equine Cushing Disease: Welfare Management of PPID

Pituitary Pars Intermedia Dysfunction (PPID), commonly called Cushing disease, is increasingly recognised in older horses and ponies. Early diagnosis and management protect quality of life.

Key Facts

PPID affects an estimated 15-20% of horses and ponies over 15 years of age
Clinical signs include a curly, long coat that fails to shed, muscle wasting, and increased water consumption
The disease is caused by loss of dopaminergic inhibition of the pituitary, leading to ACTH overproduction
Pergolide mesylate (Prascend) is the licensed treatment, usually required lifelong

Welfare Considerations

Unmanaged PPID significantly impacts welfare through laminitis risk (ACTH directly increases laminitis susceptibility), poor body condition from muscle wasting, and compromised immune function. Effective welfare management requires annual (or biannual in autumn) ACTH testing, prompt adjustment of pergolide dose, and careful dietary management to minimise laminitis triggers. Quality of life assessment should guide treatment decisions in geriatric cases.

What You Can Do

Test horses over 15 years annually for PPID using ACTH blood tests, especially in autumn
Begin treatment promptly if PPID is diagnosed — early intervention prevents laminitis and muscle loss
Work with your vet to adjust pergolide dose seasonally, as autumn ACTH rises require higher doses
Monitor coat shedding, body weight, and water intake as early warning indicators of PPID deterioration