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What is PPID in horses?
What is PPID? Pituitary pars intermedia dysfunction (PPID; equine Cushing’s disease) is an endocrine disorder that occurs in over 20% of aged horses, ponies, and donkeys. Most animals are over 15 years old when diagnosed, but PPID can occur in younger horses. It is, rare in horses less than 10 years old.
What causes laminitis in horses with PPID?
Insulin dysregulation places horses with PPID at a higher risk of developing laminitis, which can be the most devastating complication of PPID. Laminitis (founder) is a crippling disease caused by weakening of the tissues (laminae) anchoring the hoof wall to the underlying bone.
What is equine pituitary pars intermedia dysfunction?
The clinical signs are associated with abnormally elevated hormone concentrations in the blood and along with other hormones, cortisol, plays an important role in this disease. This syndrome is better defined as Equine Pituitary Pars Intermedia Dysfunction (PPID)because it reflects the location within the brain that is abnormal.
What are the early signs and symptoms of equine PPID?
Early signs and symptoms of equine PPID 1 Change in behaviour: A change in personality can be one of the earliest equine PPID symptoms. 2 Subtle hair coat abnormalities and delayed shedding 3 Delayed shedding of the winter coat may occur in some areas, and the summer coat may look different in these same areas. More ...
How do you prevent Cushing's disease in horses?
Although Cushing's disease cannot always be prevented, there are precautions you can take to lower the risk. “The most important thing is to keep your horse's weight down, providing proper nutrition, which means to feed him only what he really needs,” Langer says. Sugar intake should be minimized.
How does a horse get Cushing's disease?
In horses, PPID is attributed to an adenoma (a benign tumor) in the pars intermedia of the pituitary gland. The cells that make up the tumor produce excessive amounts propriomelanocortin (POMC) and adrenocorticotropic hormone (ACTH).
How long can horses live with PPID?
The average age of a horse or pony with PPID is 20 years, although horses as young as 14 years can be affected. The most striking sign, but one that is not always present, especially in early cases, is an excessively long and curly coat (hirsutism).
What causes high ACTH levels in horses?
Therefore if a horse is stressed when the blood is taken, it could be ACTH from the PD, i.e. a normal stress response, that causes ACTH to be above levels considered normal, or it could be ACTH from the PI indicating PPID, or it could be a bit of both. Some medicines increase ACTH, e.g clenbuterol (Ventipulmin).
Can stress cause Cushings in horses?
Equine Cushing's disease, equine Cushing's syndrome, hyperadrenocorticism, and pituitary pars intermedia dysfunction are all used synonymously to describe horses with an endocrine (hormonal) disorder characterized by elevated “stress” hormones (cortisol and others) and blood glucose levels.
Can PPID be prevented?
There is no cure for PPID. Management through medication, diet, and exercise must be maintained for the life of the animal.
Can horses with Cushings go out on grass?
Pasture grasses can have a high NSC content, especially during the spring and fall seasons, and the risk of colic and laminitis is greater when horses are on pasture. Since laminitis and founder are more common in horses with Cushing's disease, pasture grazing should be severely limited or totally avoided.
What should I feed my horse with PPID?
Horses with PPID should be fed a diet composed primarily of forage, which will promote moderate body condition, sidestep obesity, and reduce the risk of IR. Concentrates should be fed only as needed to maintain moderate body condition.
What are the first signs of Cushing's disease in horses?
Clinical signs include increased coat length and delayed shedding of the winter coat, laminitis, lethargy, increased sweating, weight loss and excessive drinking and urinating. The disease primarily affects those over the age of 10, with 19 being the average age at diagnosis.
How common is PPID in horses?
Pituitary pars intermedia dysfunction (PPID; equine Cushing's disease) is an endocrine disorder that occurs in over 20% of aged horses, ponies, and donkeys. Most animals are over 15 years old when diagnosed, but PPID can occur in younger horses. It is, rare in horses less than 10 years old.
When Should a horse be tested for PPID?
At the time of diagnosis, horses with PPID are >15 years of age, and usually older than 20 years. The typical clinical signs include hirsutism, loss of muscle, and accumulation of fat in the neck.
Can Cushings be cured in horses?
There is no cure for Cushing's disease but the good news is that there are medications available which usually improve the clinical signs. Improvement of clinical signs will most often improve the quality and length of life for your horse.
What are the first signs of Cushing's disease in horses?
Early signs and symptoms of equine PPID (Cushing's Disease)Lethargy or decreased athletic performance. Increased sluggishness compared to normal could be an early sign of PPID. ... Change in behaviour. ... Subtle hair coat abnormalities and delayed shedding. ... Loss of topline. ... Regional adiposity. ... Laminitis. ... Infertility.
How common is Cushing's disease in horses?
Equine Cushing's disease, also known as PPID, is thought to affect 20% of horses over the age of 15, and is the 5th most common disease syndrome recognised in horses and ponies in the UK*.
Can Cushings in horses be cured?
There is no cure for Cushing's disease but the good news is that there are medications available which usually improve the clinical signs. Improvement of clinical signs will most often improve the quality and length of life for your horse.
How do you tell if your horse has Cushings?
Signs of Cushing's syndrome include:Failure or later shedding of the winter coat that may become really long, matted and curly especially around the legs.Excessive sweating.Increased drinking and urination.Lethargy and poor performance.A pot-bellied appearance.Loss of muscle and topline.More items...
What does PPID mean for my horse?
With appropriate treatment and management, signs should improve. Repeat ACTH testing after starting therapy should show a reduction in blood concentration.
How do I know if my horse or pony has PPID?
This is why it’s commonly seen in older or geriatric horses, generally above 15 years. Many horse owners are aware of the typical curly-coated appearance of affected horses and it’s a good sign to look out for. What’s actually going on is that abnormal pituitary gland function causes dysregulation (loss of control) of the normal seasonal hair growth patterns , as a result the hairs are being held on to instead of being shed appropriately.
What happens in PPID?
There is a region called the hypothalamus which can be thought of as a control centre. The hypothalamus regulates many essential processes including endocrine ( hormone) function, it sends signals to its neighbour, the pituitary gland, which then releases the hormones that set in motion these pathways.
What is the first line of testing for a horse?
The first line of testing is often an ACTH (adrenocorticotrophin hormone) test through a blood sample. This may be done with or without a full haematology and biochemistry panel to check your horse’s general state of health. ACTH is one of the hormones secreted by the pituitary gland. In PPID horses and ponies, it is present at blood concentrations higher than normal because of the dysregulated activity of the gland.
Can laminitis be caused by divergent lines?
Recent evidence has shown that in PPID there is often a long phase where laminitis is present but not causing a problem to the horse, although it may be suspected from divergent lines on the hooves. As it is the one sign of PPID that can have a serious impact on the horse or pony’s quality of life it’s important to look out for early warning signs of laminitis. Laminitis is a whole other topic in itself, but the laminitis seen with PPID and equine metabolic syndrome (EMS) is a bit different to that seen with pasture or stress related induced laminitis. Catching PPID before bouts of painful laminitis occur can help prevent the often chronic relentless cycles of laminitis that can occur from other causes.
How to treat PPID in horses?
Affected horses are more susceptible to parasites and infection so regular worming, vaccination and teeth care should be instituted. Any dietary changes will depend on the age and condition of the horse or pony, the available grazing, the presence or absence of laminitis, expectations for work, etc. and should be discussed with your veterinarian. Cases with excessively long coats may sweat excessively or may take a long time to dry off after exercise and they should be clipped over their body and neck to help them dry off more quickly. In cooler weather, clipped horses and ponies may need to be rugged.
Who can diagnose PPID in horses?
Your veterinarian is the best person to discuss this complex problem, to determine whether or not your horse or pony really does have PPID, and if so, what treatment is appropriate.
What is PPID in dogs?
Medical Conditions, Pet Services. Pituitary pars intermedia dysfunction (PPID, previously known as Equine Cushing's Disease) is a complex condition associated with abnormal function of a small, hormone-producing organ, the pituitary gland, that lies at the base of the brain. The cause is not fully known but currently it is thought that as part ...
How to diagnose laminitis in horses?
In other less obvious cases, especially in younger horses that are developing the condition, the diagnosis depends on a combination of clinical signs, blood and urine tests. Due to the complex nature of the condition, it may be necessary to use additional specialized blood tests that look at changes in hormone levels in response to the injection of other hormones, testing hormone system function. Animals with PPID usually respond abnormally to one or more of these tests, but interpretation of results is not always straightforward, as they can sometimes appear contradictory. Your veterinarian will help you with this.
How old is a horse with PPID?
The average age of a horse or pony with PPID is 20 years, although horses as young as 14 years can be affected. The most striking sign, but one that is not always present, especially in early cases, is an excessively long and curly coat (hirsutism).
Why do horses need to be clipped?
In cooler weather, clipped horses and ponies may need to be rugged.
Can you prevent a horse from getting a blood test?
It is not possible to prevent this condition . However, with available blood tests we are now able to recognize and treat more cases earlier and more effectively and many treated horses and ponies go on to live normal lives for many years after diagnosis and treatment.
Why is it important to know the early signs of PPID in horses?
Recognizing the early clinical signs of Equine PPID is important because the sooner you begin treatment, the easier it is to manage the symptoms. The signs and symptoms of PPID can vary depending on the level of progression of the disease and the individual horse.
What is the first sign of PPID in horses?
Change in behaviour: A change in personality can be one of the earliest equine PPID symptoms.
What are the symptoms of PPID in horses?
Classic symptoms of PPID (Cushing’s Disease) in horses. While there are many clinical signs and symptoms of PPID, abnormal hair coat and laminitis are the two most well known. Both of these symptoms can occur at all stages of the disease but tend to be subtle earlier on and increase in severity as the disease progresses.
What is a white line on a horse's hoof?
A pronounced white line between the hoof wall and sole. Shifting weight from hoof to hoof. Reluctance or refusal to move or to pick up the feet. An abnormal stance in which the horse may appear rocked back or forward. Laminitis can also occur in a number of situations other than PPID, including equine metabolic syndrome. ...
How to tell if a horse has laminitis?
Equine laminitis signs, in order of disease progression, include: A strong digital pulse and hooves that feel warm to the touch. A shortened stride or stiff gait.
Where does a horse shed its winter coat?
Your horse may shed his winter coat everywhere except in small patches—usually around the jawline and base of the neck, and along the back of the front and hind legs. The summer coat may grow longer and lighter in colour in these areas. In advanced PPID, hair coat abnormalities are more noticeable and generalized;
Is laminitis a sign of PPID?
Laminitis is considered both an early sign and an advanced sign of PPID. Laminitis has been shown to be associated with abnormal insulin levels. Laminitis can be a devastating disease. It is extremely painful and debilitating for the horse. In severe cases, euthanasia is often the only option.
What happens to horses with PPID?
Horses with PPID lose the natural daily rhythm of the hormone cortisol, which is normally high in the morning and low at night. Loss of cortisol circadian rhythm also occurs in animals secondary to stress, disease and old age.
How to test for PPID in horses?
Other tests have been suggested as useful in screening horses for PPID. A screening test is useful to identify which horses might have the disease, but not accurate enough to diagnosis whether the animal has PPID. For example, measurement of fasting serum insulin concentration is often performed in horses suspected of having PPID. A high fasting insulin suggests the horse has insulin resistance. Insulin resistance can occur in horses with PPID, but it also occurs in horses with equine metabolic syndrome and obese horses. Another screening test for PPID is the cortisol ciracadian rhythm test. In this test, serum cortisol concentration is compared in two samples, one collected in the early morning and one collected in the evening. Horses with PPID lose the natural daily rhythm of the hormone cortisol, which is normally high in the morning and low at night. Loss of cortisol circadian rhythm also occurs in animals secondary to stress, disease and old age. Therefore, a loss of cortisol circadian rhythm may support the diagnosis of PPID but further testing is needed for confirmation.
What is a PPId horse?
The most classic symptom of PPID is a long curly hair coat that does not shed properly. This condition is referred to as hirsuitism .
What is the best indication of PPID?
The best indication of PPID is the clinical sign of hirsuitism in the aged horse. The sensitivity of this clinical sign is better at predicting an abnormal pituitary than any diagnostic test available. Horses that have subtle signs of PPID need to be tested to confirm the disease.
How old are horses with PPID?
The average age of horses diagnosed with PPID is 20 years, with over 85 percent of the horses being greater than 15 years of age. Although most common in aged horses, PPID has been diagnosed in horses as young as seven years of age. All breeds of horses can develop PPID, however ponies and Morgan horses have a higher incidence of the disease.
What tests are used to diagnose PPID?
There are other tests that have been used in research settings to diagnosis PPID. These include TRH (thyrotropin releasing hormone) test and the domperidone test. These tests have not been critically analyzed in a large number of horses and their ability to accurately predict PPID in early or late course of disease has yet to be determined.
What is the most common disease in horses?
Equine Cushing’s disease is one of the most common diseases of horses greater than 15 years of age. The clinical signs are associated with abnormally elevated hormone concentrations in the blood and along with other hormones, cortisol, plays an important role in this disease. This syndrome is better defined as Equine Pituitary Pars Intermedia Dysfunction (PPID)because it reflects the location within the brain that is abnormal. In humans, Cushing’s disease affects a different location within the pituitary gland, thus the reason why veterinarians prefer to call this disease PPID.
Endogenous ACTH Testing
EDTA plasma is specifically needed for ACTH testing. Draw blood into an EDTA collection tube (lavender or purple-top tube). Gently invert the specimen several times to mix blood and anti-coagulant and then chill sample (refrigerator/cooler/etc.).
Insulin Testing
The plasma sample collected for ACTH can also be used for insulin testing or serum can be collected as detailed below.
TRH-Response: ACTH Testing
The TRH-response test is used for diagnosing Cushing’s syndrome in horses. Pituitary adenoma cells seem to lose receptor specificity for hypothalamic-releasing hormones.
Dexamethasone-Suppression Test (DST): Cortisol Testing
Collect a Pre (or baseline) blood specimen into a plain red-top collection tube for serum as in Insulin testing above.
What are the symptoms of PPID?
Clinical signs of PPID that develop secondary to high ACTH levels include hair coat abnormalities, behavioral disorders, lethargy, chronic laminitis, excessive drinking and urination, and neurological signs such as inco ordination.
Do horses age faster than humans?
Like humans, horses age slowly compared to other species. One theory suggests that excessive oxidation occurs as antioxidant function wanes with age. With this in mind, providing horses with antioxidants such as vitamin E could help to protect horses from age-related conditions.
