🩺 Vet’s Guide to Monitoring Equine Cushing’s Disease (PPID) in 2025 🐴

As horses age, they become more susceptible to certain endocrine disorders, notably Equine Cushing’s Disease, medically termed Pituitary Pars Intermedia Dysfunction (PPID). In 2025, advancements in veterinary medicine have enhanced our ability to monitor and manage this condition effectively. This guide, presented by Dr. Duncan Houston, delves into the latest strategies for diagnosing, treating, and caring for horses with PPID.

🔍 Understanding Equine Cushing’s Disease (PPID)

PPID is a progressive neurodegenerative disorder affecting the pituitary gland's pars intermedia. It leads to hormonal imbalances, primarily due to decreased dopamine production, resulting in excessive secretion of adrenocorticotropic hormone (ACTH). This hormonal surge can cause a cascade of clinical signs that impact a horse's quality of life.

📌 Common Clinical Signs:

• 🧥 Long, curly coat (hirsutism) that doesn't shed properly
• 🐾 Laminitis or chronic hoof issues
• 💧 Increased drinking and urination
• 😓 Abnormal sweating patterns
• 🪞 Weight loss despite a good appetite
• 🛌 Lethargy and decreased performance
• 🦷 Recurrent infections and delayed wound healing

🧪 Diagnosing PPID in 2025

Early and accurate diagnosis is crucial for effective management. The following diagnostic tools are commonly employed:

1. Baseline Plasma ACTH Test

This blood test measures the resting level of ACTH. Elevated levels, especially when adjusted for seasonal variations, can indicate PPID. It's essential to consider factors like stress and pain, which can artificially elevate ACTH levels.

2. Thyrotropin-Releasing Hormone (TRH) Stimulation Test

Administering TRH stimulates the pituitary gland, and subsequent ACTH levels are measured. A significant increase post-TRH administration suggests PPID. This test is particularly useful in early or equivocal cases.

3. Combined Testing

In some instances, combining ACTH and insulin tests can provide a comprehensive overview, especially if insulin dysregulation is suspected alongside PPID.

💊 Treatment Protocols: Pergolide (Prascend)

The cornerstone of PPID treatment is the administration of pergolide mesylate, commercially known as Prascend. This dopamine agonist helps restore hormonal balance by inhibiting excessive ACTH production.

📋 Dosage and Administration:

• 💊 Starting dose: 0.002 mg/kg orally once daily
• 📈 Dosage adjustments based on clinical response and ACTH levels
• 🕒 Administer at the same time each day to maintain consistent blood levels

⚠️ Potential Side Effects:

• 🍽️ Decreased appetite
• 😴 Lethargy
• 🌀 Behavioral changes

These side effects are often transient. Starting at a lower dose and gradually increasing can mitigate adverse reactions.

📊 Monitoring Treatment Efficacy

Regular monitoring ensures the treatment's effectiveness and allows for timely adjustments. Here's a recommended schedule:

🗓️ Monitoring Timeline:

• 📅 Initial re-evaluation: 4-6 weeks post-treatment initiation
• 📅 Subsequent assessments: Every 3-6 months
• 🍂 Special attention during autumn due to natural ACTH fluctuations

🔬 Parameters to Monitor:

• 📈 ACTH levels
• 🧥 Improvement in coat condition
• 🐾 Reduction in laminitis episodes
• 💧 Normalization of drinking and urination patterns
• 🛌 Overall energy and behavior

🍽️ Nutritional and Lifestyle Management

Beyond medication, holistic care plays a pivotal role in managing PPID:

🥗 Diet:

• 🥬 Low in non-structural carbohydrates (NSCs)
• 🍎 Rich in fiber
• 💧 Ensure constant access to clean water

🏃 Exercise:

• 🚶 Regular, moderate exercise to maintain muscle mass
• 🩺 Tailored activity plans based on the horse's condition

🧹 Grooming and Care:

• 🧼 Regular grooming to manage coat changes
• 🦷 Routine dental check-ups
• 🐴 Hoof care to prevent laminitis complications

📱 Leveraging Technology: Ask A Vet App

Incorporating technology can enhance disease management. The Ask A Vet app offers:

• 📊 Tracking of medication schedules and dosages
• 📝 Logging of clinical signs and changes
• 📞 Direct communication with veterinary professionals
• 📚 Access to educational resources and updates

Download the Ask A Vet app today to stay proactive in your horse's health journey!

🧠 Conclusion

Managing Equine Cushing’s Disease in 2025 requires a multifaceted approach, combining medical treatment with diligent monitoring and holistic care. With advancements in diagnostics, medications like Prascend, and supportive tools like the Ask A Vet app, horses with PPID can lead comfortable and fulfilling lives.

For personalized advice and support, consult with your equine veterinarian and explore resources available through AskAVet.com.