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HorseAdvice.com » Diseases of Horses » Endocrine System » Pituitary Pars Intermedia Dysfunction (PPID): Equine Cushing's »
  Discussion on Early Treatment for PPID?
Author Message
Member:
royd

Posted on Tuesday, Mar 12, 2019 - 8:00 pm:

Dr. O.

I have a 14 year old Missouri Fox Trotter mare that I have owned for eight years. For the first six years she shed on a normal schedule. Last year, she started shedding about two weeks late. This year she has just started to shed a few hair, some six weeks later than her normal schedule. I had her tested for Cushings last week and her ACTH hormone level was 17.4 pg/ml, the middle of the normal range. Her glucose level was 86 mg/dl. No other disease symptoms seem to be present.

My goal is to keep her as healthy as possible now rather than wait for other symptoms to surface. My veterinarian has prescribed a dosage of 0.5mg daily of Prascend. Does this course of action seem like the right way to go? Will there be any negative effects from the Prascend given that her ACTH level tested in the normal range? What, if anything, should we be on the lookout for?

Thanks,

Mary
Moderator:
DrO

Posted on Wednesday, Mar 13, 2019 - 6:28 am:

Hello Mary,
The most important consequence of PPID is the predisposition to chronic founder. We are increasingly aware that in some horses it starts early in the disease and may even go unrecognized with slow changes to the lamella of the hoof. We associate this risk with how out of wack the insulin levels have become. See the article for more on this. Though we don't have a insulin level to make a decision, your normal glucose suggest no to minimal insulin resistance/increase. Because glucose rapidly declines in a blood tube, careful handling is important for accurate results.

Low dose pergolide is fairly safe and you can read about toxicity in the article. I do not have information on giving it to normal horses. We know in horses with PPID that it lowers ACTH. Mary I cannot make decisions for your horse from here but I am unsure what you are treating.
DrO
Member:
royd

Posted on Thursday, Mar 14, 2019 - 9:24 am:

Hi Dr. O,
Thank you for the response. I am an avid trail rider and this mare is an excellent and safe trail horse. The reason I am considering early treatment is that I hope to put off the more debilitating symptoms of PPID -- such as muscle wasting, laminitis, lethargy, anxiety, etc. -- for as long as possible to keep her viable for the trail. My logic is: why make her experience these symptoms before initiating treatment. A side benefit would be help with her delayed shedding and associated temperature control issues. We already follow all of the good husbandry practices you mentioned in the article. So I guess the question is should I initiate treatment now or wait until additional symptoms appear?
Moderator:
DrO

Posted on Thursday, Mar 14, 2019 - 12:50 pm:

Mary I do not know of any work that suggests treatment is beneficial at preventing the primary disease or its progress. It does ameliorate existing symptoms and even secondary endocrinopathies. You could consider monitoring of glucose and insulin as a indicator of increasing severity and laminitis predisposition as an alternative but again these decisions must be made between you and your vet.
DrO
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