Pituitary pars intermedia dysfunction (PPID), also referred to as equine Cushing’s disease, is a progressive neurodegenerative disorder in horses. In horses with PPID, the pituitary gland can’t keep bodily functions in a healthy working state, resulting in a variety of clinical signs. PPID is also associated with several serious conditions including laminitis, secondary infections and insulin dysregulation.
Diagnosing PPID requires a comprehensive approach. The three main components are: collecting a comprehensive patient history, conducting a detailed physical examination and submitting plasma samples for testing. Because the illness may initially present through a collection of relatively subtle clinical signs, PPID is easier to diagnose when using all information available.
The veterinarian and the horse owner should talk about the horse’s history, both clinical and behavioral. This can help the veterinarian uncover subtle behaviors that take more time to notice like changes in attitude and lethargy, weight loss, or decreased athletic performance.
TIP: Our checklist of clinical signs can help horse owners prepare to talk to their veterinarian.
As the veterinarian examines the horse, they will look for clinical signs of PPID such as delayed coat shedding, abnormal sweating and regional or generalized muscle loss.
If one or more clinical signs are present, it’s time to test. Your veterinarian will pull blood to measure resting adrenocorticotropic hormone (ACTH) levels (alongside insulin and glucose). During certain months, a thyrotropin releasing hormone (TRH) stimulation test is also recommended for horses with early PPID or advanced horses with a normal resting ACTH.
To properly manage PPID, it is important horse owners work closely with their veterinarians to build a plan. Concurrent illnesses such as insulin dysregulation or concurrent equine metabolic syndrome (EMS) can impact the PPID management plan.
Managing PPID for Horse OwnersBecause PPID is a chronic disease, afflicted horses need daily, lifelong medical treatment. The good news is: There is a solution that can help control the clinical signs associated with PPID. PRASCEND can help control the clinical signs of PPID in horses and decrease the risk of other illnesses that may be associated with PPID.4 Treatment with PRASCEND may cause loss of appetite. Most cases are mild.
The Equine Endocrinology Group (EEG) is a group of clinicians and researchers working to advance our understanding of endocrine disorders in horses. Together, these key opinion leaders advise veterinarians, specialists, research scientists, and the public on equine endocrine disorders—with the mission of improving recognition, diagnosis and management.
IMPORTANT SAFETY INFORMATION: PRASCEND is for use in horses only. PRASCEND has not been evaluated in breeding, pregnant, or lactating horses. Treatment with PRASCEND may cause loss of appetite. Most cases are mild. If severe, a temporary dose reduction may be necessary. Weight loss, lack of energy, and behavioral changes also may be observed. PRASCEND is contraindicated in horses with hypersensitivity to pergolide mesylate or other ergot derivatives. Not for use in humans. Do not ingest the product. PRASCEND tablets should not be crushed due to the potential for increased human exposure. Pergolide, like other ergot derivatives, may cause emesis, dizziness, lethargy or low blood pressure. Pregnant or lactating women should wear gloves when administering this product. Store this product separately away from human medicinal products and handle this product with care to avoid accidental ingestion. 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.