Recognizing Clinical Signs of PPID

by Boehringer Ingelheim/February 16, 2024

Pituitary pars intermedia dysfunction (PPID), formerly known as equine Cushing’s disease, is a serious and progressive neurodegenerative disorder. Found in roughly 21% of horses older than 15 years old, the disorder affects the hormone production pathways in the hypothalamus and the pituitary gland, resulting in increased level of hormones produced by the pituitary gland.¹ Being able to recognize the clinical signs of PPID is important to maintaining your horse’s overall health,² whether your horse is approaching middle age, around 15 years old, or in rare cases, as young as 5.

During the beginning stages of PPID, signs may be subtle and hard to recognize. Early clinical signs may include, but are not limited to, a change in attitude, decreased performance, abnormal sweating, loss of topline muscle and regional adiposity, or a crusty neck with fat around the tailhead and other areas.¹

In advanced cases, clinical signs are more obvious to horse owners. “Delayed shedding compared to herd mates, generalized loss of muscle mass, and increased urination or thirst — those are all clinical signs that would start ringing the alarm bells of PPID,” said Steve Grubbs, DVM, Ph.D., DACVIM, Boehringer Ingelheim Technical Services Veterinarian. “These are all signs of advanced disease, and treatment should begin as soon as possible.” Advanced PPID may also result in immunosuppression, leading to secondary infections such as hoof abscesses, skin infections and sinusitis, as well as a generally weakened immune system.¹

If you suspect your horse may be showing clinical signs of PPID, reference the PPID checklist and contact your veterinarian right away. Your veterinarian will likely review your horse’s medical history, perform a physical exam, and run a blood test, evaluating adrenocorticotropic hormone (ACTH), insulin and glucose levels. In certain months, an additional testing procedure may be utilized for horses with subtle clinical signs, or horses with advanced signs that have normal resting ACTH levels.

While there is no cure for PPID, the disease can be managed by working closely with your veterinarian to build a plan.¹ If your horse has been diagnosed with PPID, talk to your veterinarian about Prascend^® (pergolide tablets) — the most proven treatment available to control the clinical signs of PPID.³ In addition to medication, maintaining the overall health of your horse is important to managing the disorder. “Making sure your horse is up to date on their vaccines, getting their feet trimmed regularly, having their teeth floated, providing an appropriate nutrition program, and sticking to your deworming schedule are all things horse owners can do to keep their horses healthy, whether the horse has PPID or not,” advised Grubbs. “Some horses with PPID may also benefit from body clipping if they are exhibiting signs of delayed shedding and longer coat.”

Early detection of the clinical signs of PPID, working with your veterinarian to get an accurate diagnosis, and managing your horse’s overall health can lead to your horse living comfortably with PPID for many more years.²

IMPORTANT SAFETY INFORMATION: 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. Keep PRASCEND in a secure location, out of reach of dogs, cats and other animals, to prevent accidental ingestion or overdose. Adverse reactions may occur if animals other than horses ingest PRASCEND tablets. Not for human use. Do not ingest the product. Refer to the package insert for complete product information.

¹UC Davis Veterinary Medicine Center for Equine Health, Pituitary Pars Intermedia Dysfunction (PPID). Available at https://ceh.vetmed.ucdavis.edu/health-topics/pituitary-pars-intermedia-dysfunction-ppid. Accessed December 22, 2022.

²McFarlane D. Equine pituitary pars intermedia dysfunction. Vet Clin North Am Equine Pract 2011;27(1):93–113.

³PRASCEND [Freedom of Information Summary]. St Joseph, MO: Boehringer Ingelheim Animal Health USA Inc.; 2024.