Whole-Horse Approach to PPID

by Boehringer Ingelheim / May 17, 2024

How to Manage PPID With the Whole-Horse Approach

Pituitary pars intermedia dysfunction (PPID), formerly known as equine Cushing’s disease, is one of the most common endocrine diseases in horses. PPID affects approximately 21% of horses 15 years and older, and although rare, it has been diagnosed in horses as young as 5 years old.¹

While there is no cure for the disease, a horse diagnosed with PPID can continue to have a good quality of life following early diagnosis, medical treatment and ongoing management.

Step One: Recognize the Signs

Recognizing the clinical signs of PPID is the first step toward receiving a diagnosis. Initially, owners may identify subtle changes in their horse, such as:

Lethargy
Decreased performance
Abnormal sweating
Loss of topline muscle
Regional hypertrichosis (delayed shedding in a specific region)

Horse owners may notice these additional clinical signs in their horses that have advanced disease¹:

Generalized delayed shedding compared to herd mates
Generalized loss of muscle
Increased urination or thirst

If your horse is showing any of these clinical signs of PPID, contact your veterinarian for a full examination.

Step Two: Diagnosis by a Veterinarian

To arrive at a diagnosis of PPID, the veterinarian will likely follow these three steps²:

1. Collect a thorough history of the horse

Your horse may have historically shown clinical signs associated with PPID that are not present at the time of examination. Your veterinarian will look to gain a full understanding of your horse’s history, to consider signs not able to be identified during the exam.

2. Perform a detailed physical examination

Your veterinarian will look over the horse for further signs of PPID not previously identified in the horse’s history. These signs may include delayed coat shedding, abnormal sweating, and regional or generalized muscle loss.

3. Submit plasma for testing

For horses with clinical signs, a blood test should be taken to evaluate adrenocorticotropic hormone (ACTH), insulin and glucose. For horses with early PPID or those in which ACTH levels were normal, a thyrotropin-releasing hormone (TRH) stimulation test may be recommended.

Overall, the diagnosis of PPID should be made using combined information obtained from the history, physical examination and laboratory results.

Step Three: Manage PPID

After a horse receives a diagnosis of PPID, the next step is to take a whole-horse approach, which often includes pharmaceutical treatment, diet management, regular deworming and farrier care.

Pergolide is the drug of choice when treating PPID, and can greatly improve a horse’s quality of life.³ Talk to your veterinarian about PRASCEND^® (pergolide tablets), the most-proven PPID treatment available.⁴

Work With Your Veterinarian

In addition to PRASCEND treatment, work with your veterinarian to determine a proper diet. You can also support overall good horse health by:

Staying up to date on relevant vaccinations
Continuing routine hoof trims every 4–6 weeks
Completing dental exams as needed
Maintaining a regular deworming schedule
Performing body clipping for horses experiencing delayed shedding

By receiving a diagnosis from your veterinarian, starting medical treatment as soon as the disease is detected, and continuing to practice good horse management, you can give a horse with PPID an improved quality of life. 

REFERENCES 

¹Grubbs, Steven, Dwana Neal, and Thomas Keefe. "Epidemiological Characteristics of Horses with PPID at Initial Diagnosis." Boehringer Ingelheim Vetmedica, Inc., 2010.

²IDPPID Testing Program. How the IDPPID Testing Program works. Available at: https://idppid.com/testing-program. Accessed August 7, 2023. 

³McFarlane D. Equine pituitary pars intermedia dysfunction. Vet Clin North Am Equine Pract. 2011;27(1):93–113. 

⁴PRASCEND [Freedom of Information Summary]. Available at: https://prascend.com/prascend. Boehringer Ingelheim Animal Health USA Inc. 2011.

IMPORTANT SAFETY INFORMATION: PRASCEND is for use in horses only. Not for use in humans. PRASCEND has not been evaluated in breeding, pregnant or lactating horses. Treatment with PRASCEND may cause loss of appetite. Most cases are mild. PRASCEND tablets should not be crushed due to the potential for increased human exposure. PRASCEND is contraindicated in horses with hypersensitivity to pergolide mesylate or other ergot derivatives. Keep PRASCEND in a secure location out of reach of dogs, cats, and other animals to prevent accidental ingestion or overdose. Dogs have eaten PRASCEND tablets that were placed in food intended for horses or dropped during administration of the tablets to the horses. Adverse reactions may occur if animals other than horses ingest PRASCEND tablets. Refer to the package insert for complete product information.