Many horse owners are familiar with the stereotypical “Cushing's” horse – one that has a thick haircoat no matter the weather, a cresty neck, and a pendulous pot belly, even if he's dewormed regularly and fed quality feed and forage.
Unfortunately, by the time these signs are easily recognizable, the disease is already quite advanced.
There are early signs that a horse is developing pituitary pars intermedia dysfunction (PPID), but they are often missed, reports a just-published review. Close observation is key to noticing small changes, such as a horse that is drinking and urinating more than usual, or one that is lethargic or has recurrent infections.
The most common test for PPID is the basal adrenocorticotropic hormone (ACTH) concentration, but the most accurate test to identify the disease early is the thyrotropin-releasing hormone (TRH) stimulation test. Both of these tests have their shortcomings; basal ACTH concentrations can lack sensitivity, and TRH is not commercially available in many countries.
Drs. Naomi Kirkwood, Kristopher Hughes, and Allison Stewart note that the sooner a horse begins treatment for the disease, the better his quality of life. Though a horse can be diagnosed with PPID solely on clinical signs, the disease is often severe by this stage.
Horses with PPID require careful management. If the horse has foundered or has been diagnosed with insulin dysregulation, his feeding protocol must be even more regimented, avoiding feeds high in non-structural carbohydrates. This can be complicated by the fact that PPID horses often lose weight.
PPID horses also have a decreased immune function, so preventative health measures are imperative to their health. Treatment with pergolide mesylate is recommended. The authors note that there may be a correlation between low vitamin B12 and PPID, but further research is needed.
The research team stresses that early disease detection is imperative. They recommend that future studies focus on improving the accuracy of diagnosis; long-term response to pergolide should also be studied.
Read more at HorseTalk.
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