Cushings Disease (PPID) IS Manageable – Read On!

Cushings Disease (PPID) IS Manageable – Read On!

It’s 2025 and I’m grateful to say my horse, Pie, is fit and healthy at 30 years old.  Through a routine blood test (about) 10 years ago he was diagnosed with Cushings and it’s been managed successfully with no signs of laminitis by:

Medicating with Pergolide mesylate (Prascend) daily.  He started off on half a pill a day and he’s now up to a whole pill a day.

He has regular exercise. He goes on rides usually 3 but up to 5 days a week.

He’s fed a low starch high fibre diet with the addition of Top Spec balancer. He’s fed a good amount of hay and I’m careful about the amount of grass he gets in those ‘dangerous’ times of year which can be anything from March to November it seems (!)

I tried having him barefoot in his younger years but he was never comfortable with it and the boots rubbed him.  I’m sure things have moved on since then but I’m not going to put him through any discomfort at this stage of his life.  He’s shod with light steels, no clips and is perfectly sound.

He’s clipped about 4 times a year, his coat doesn’t get long but it will get very thick and can also get itchy if it’s left too long between clips.

Oh and LOVE, never forget love really does make a difference …

The above is just an example of what’s been working for us.  It’s not suggested as an ideal protocol.  There are many people out there who are convinced their way is the only way. I’m not one of them.  It’s not just horses are different but people’s circumstances and what they can manage must be taken into consideration.

Here’s general sensible information and advice on Cushings:

Cushing’s disease in horses, also known as Pituitary Pars Intermedia Dysfunction (PPID), is a chronic condition caused by an overproduction of hormones from the pituitary gland. This often results in excessive production of cortisol by the adrenal glands, leading to a range of symptoms that can affect the horse’s quality of life. It is most commonly seen in older horses but can occur in middle-aged horses as well.

Symptoms of Cushing’s Disease in Horses

Some common signs include:

• Long, shaggy coat (hirsutism): Failure to shed properly, resulting in a long and often curly coat.
• Lethargy or reduced energy levels.
• Increased thirst and urination.
• Muscle loss and a pot-bellied appearance.
• Recurrent laminitis: One of the most serious complications.
• Prone to infections: Such as skin infections, dental problems, and delayed wound healing.
• Abnormal fat deposits: Particularly around the neck, tailhead, and above the eyes.
• Sweating abnormalities: Excessive sweating or inability to sweat.

Diagnosis

If you suspect Cushing’s in your horse, a veterinarian can confirm the condition through clinical signs and diagnostic tests such as:

1. ACTH blood test: Measures levels of adrenocorticotropic hormone.
2. Dexamethasone suppression test (DST): Evaluates cortisol production.
3. TRH stimulation test: A newer and more sensitive diagnostic method.

Treatment Options

1. Medication:
   1. Pergolide mesylate (Prascend): The most common and effective medication for managing PPID. It helps regulate hormone levels.
   1. Adjustments to the dose may be needed based on follow-up blood tests.
2. Dietary Management:
   1. Feed a low-sugar, low-starch diet to reduce the risk of laminitis.
   1. Provide high-quality forage and consider soaked hay if needed to reduce non-structural carbohydrates (NSCs).
   1. Include a balanced diet with appropriate vitamins and minerals.
3. Regular Farrier Care:
   1. Proper hoof care is essential to manage or prevent laminitis.
4. Exercise:
   1. Maintain regular, gentle exercise if the horse is not affected by laminitis or other mobility issues.
5. Clipping and Grooming:
   1. Clip the horse’s coat during warm weather to prevent overheating.
   1. Provide blankets as needed during colder months if the coat is clipped.
6. General Health Monitoring:
   1. Watch for infections and ensure routine dental and veterinary care.
   1. Monitor for signs of laminitis or other complications.

How You Can Best Help Your Horse

• Regular Vet Checkups: Maintain routine veterinary care to monitor the progression of the disease.
• Adjust Lifestyle: Modify the horse’s environment and diet to meet their changing needs.
• Manage Stress: Keep the horse’s routine consistent to minimize stress, which can exacerbate symptoms.
• Supportive Care: Provide a comfortable living environment, including appropriate bedding and turnout.
• Educate Yourself: Stay informed about the condition and how to recognize signs of worsening symptoms.

With early diagnosis and appropriate management, horses with Cushing’s disease can live comfortable and productive lives for many years.

Must Watch Equine Webinars with Dr Andrew Hemmings

Exclusive Members-Only Video: Log-In To View

Dr Andrew Hemmings answers questions about the wonders of the equine brain. He covers topics such as Dopamine, Blinking, Cushings, Stereotypical Behaviours, Emotional Control and more!

See the Summer and Spring issues of the IH Magazine for background articles on Andrews work on Dopamine and other related topics.

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