Equine Endocrine Diseases: PPID and EMS Welfare Management

Key Facts

• PPID (Cushings) affects approximately 21% of horses and ponies over 15 years in the UK
• Clinical signs of PPID include hypertrichosis (abnormal coat retention), muscle wasting, polyuria, and recurrent laminitis
• EMS is characterized by obesity, regional adiposity, and insulin dysregulation — the primary driver of pasture-associated laminitis
• Pergolide (Prascend) is the primary treatment for PPID, providing significant clinical improvement in most horses
• Dietary management — low-sugar, low-starch forage with restricted pasture access — is central to EMS management

Welfare Considerations

PPID and EMS cause chronic welfare suffering, primarily through recurrent laminitis in susceptible animals. The hypertrichosis of PPID — failure to shed the winter coat — causes thermal discomfort in summer and secondary skin infections. Insulin dysregulation in EMS drives pasture-associated laminitis that can be severe and recurrent without dietary management. Both conditions are chronic and progressive, requiring lifelong management commitment. Welfare monitoring for horses with endocrine disease must include regular laminitis risk assessment, body condition scoring, and response evaluation to pergolide therapy.

What You Can Do

• Screen all horses and ponies over 15 with hypertrichosis or recurrent laminitis for PPID using ACTH testing
• Initiate pergolide therapy promptly for confirmed PPID and adjust dose seasonally in autumn when ACTH naturally rises
• Implement strict dietary management for EMS: weigh hay, soak to reduce sugar, restrict pasture access
• Use an Equine Cushing's and Insulin Resistance Network (ECIR) protocol for integrated management
• Monitor body condition score monthly and adjust management to maintain optimal condition