Symptoms of Cushing’s disease (PPID) in horses
The signs of PPID can vary greatly between horses and may be subtle in the early stages. As the disease progresses, symptoms become more pronounced.
Most well-known symptoms
- a long, often curly coat that sheds poorly or not at all
- laminitis (almost 25% of horses with PPID develop laminitis)
Other common symptoms
- fat pads above the eyes
- increased appetite
- muscle loss, especially along the topline, resulting in a pot-bellied appearance with a dipped back
- reduced immunity, leading to more frequent infections and inflammation
- poor wound healing
- excessive sweating
- increased drinking and urination
- reduced fertility in mares
- in rare cases, blindness or seizure-like episodes
Early, less specific signs
- reduced willingness to work
- decline in performance
- subtle behavioural changes such as being calmer, sleepier or less alert
The link with laminitis
Horses with PPID have an increased risk of developing laminitis, partly due to disturbances in sugar and insulin regulation. Laminitis is one of the most serious complications associated with PPID.
Read more about laminitis in our blog Laminitis.
Diagnosing PPID
In older horses showing typical symptoms, a vet will often suspect PPID. Diagnosis is usually made through a blood test measuring specific hormones, such as ACTH.
Additional tests may sometimes be required, such as:
- repeating the test after 3 to 6 months
- stimulation tests to assess hormone response
- measuring glucose and insulin levels to detect insulin resistance or diabetes
This is important, as disrupted sugar metabolism further increases the risk of laminitis.
Treatment of Cushing’s disease (PPID)
PPID cannot be cured, but it can be managed effectively.
Medication
The standard treatment consists of medication such as pergolide, a dopamine agonist. This drug suppresses the excessive hormone production by the pituitary gland.
- medication must be given for life
- improvement is often visible within 4 to 6 weeks
- dosage may need adjustment over time
Regular veterinary check-ups remain essential.
Feeding and management for PPID horses
Appropriate management is crucial to limit complications:
- a diet low in sugar and starch
- careful management of rich pasture
- regular hoof care every 8 to 10 weeks
- prompt treatment of wounds and infections
- periodic faecal testing and dental checks
Support for horses with Cushing’s disease
In addition to medication, supportive supplements may help keep horses as comfortable as possible, such as:
These products support horses with PPID but never replace medication prescribed by a vet.
PPID versus EMS: what is the difference?
| PPID (Cushing’s) |
Equine Metabolic Syndrome (EMS) |
| Older horses (>15 years) |
Younger horses |
| Muscle loss (especially topline) |
No muscle loss |
| Increased drinking and urination |
Normal drinking and urination |
| Long, curly coat |
Normal coat |
| Fat pads above the eyes and pot belly |
Fat pads on neck, shoulders and tail head |
| Insulin resistance |
Insulin resistance |
| Laminitis |
Laminitis |
In some cases, PPID and EMS may occur together, making management more complex.
Aftercare and quality of life
Although PPID is a chronic condition, many horses can enjoy a good quality of life for many years with the right treatment and care. Regular monitoring, attention to diet and prompt action when symptoms arise make a significant difference.
Cushing’s disease (PPID) is common in older horses, but with proper management it can be controlled effectively. Early recognition, appropriate medication, tailored nutrition and good aftercare are key to maintaining a comfortable and active life in later years. If you suspect your horse may be showing signs of PPID, always consult your vet.
Would you like more information about PPID in horses? Please contact us at veterinarian@vetsend.co.uk.
