Paul Wilson

PPID is a common condition in older horses and ponies.  30% of 15 year old horses and 80% of 30 year old horses will be affected.  There will be a wide range of (clinical) signs.

Often the clinical signs of Cushing's disease will be quite obvious but usually further tests will be needed to confirm the diagnosis. Unfortunately simply measuring the levels of Cortisol in the blood is not very reliable as there is quite a large variation in levels in normal horses, and levels fluctuate throughout the day. However there are other blood tests we can carry out :–

Ideally, we would test blood levels of ACTH, glucose, and insulin to give us the best picture of what is going on in each case. ACTH levels are used for monitoring response to treatment.

In laminitics, we will also test for Equine Metabolic Syndrome

NB It is also important to run routine blood tests (haematology and biochemistry) to check other body systems e.g. the liver which may be compromised in older horses or to identify underlying infection. Underlying disease may affect the choice and dose of drugs to be used for treatment.

Siskin after treatment

Unfortunately, due to the nature of the condition, we can not cure horses with PPID, but we can manage them very successfully improving their quality of life (massively in some cases). Management is usually based around administration of drugs that eliminate clinical signs, combined with a healthy diet and regular preventative medicine e.g. worming and dentistry.

The drug of choice is called Pergolide (Prascend), which is a dopamine agonist.  This drug is very effective,with a wide dose range and is licensed for use in horses.  It will need to be given daily for the rest of the horse’s life.  The rate of improvement after starting treatment is variable, depression and lethargy are usually lost first and the horse is brighter and more energetic after a few weeks. Most importantly, there is a reduction in the painful bouts of laminitis. The hairy coat may take a little longer to improve. Treatment can be very successful and returns many horses to normal health for several years. (Our longest patient under treatment currently has been under control for >7 years.) Regular blood testing for ACTH levels are required to monitor the response to treatment and to see if adjustments to drug dosage are required.

Horses suffering with ECD are immunosuppressed so preventative health care is very important and seemingly mild ailments such as a touch of dermatitis or snotty nose should be treated as a matter of urgency. It is important that ECD horses are vaccinated and wormed appropriately.

Successful management of ECD sufferers requires the following;

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