PPID Long-term Management

Management of pituitary pars intermedia dysfunction (PPID) in equids consists of improved husbandry, including adequate nutrition and limiting competition for feed, body-clipping, dentistry, and appropriate treatment of concurrent medical problems. In addition, specific treatment with the dopamine agonist pergolide can improve quality of life and reverse many clinical signs of the disease in PPID-affected equids. For patients with chronic laminitis, appropriate trimming or shoeing and judicious use of analgesic medications is also necessary. Although many nutritional supplements and nutraceuticals have been advocated for use in equids with PPID, none have established data to support their claimed benefits. Finally, due to the expense of lifelong medication, a decision of whether or not to treat affected horses with pergolide should be made on a case-by-case basis in consideration of the client’s goals for the patient. Husbandry and nutritional considerations: Management of equids with PPID initially involves attention to general health care along with a variety of management changes to improve the condition of older animals. In the earlier stages of PPID, when hair coat changes may be the primary complaint, body-clipping to remove the long hair may be the only treatment required. Next, since many affected animals are aged, routine oral care and correction of dental abnormalities cannot be overemphasized. In addition, assessment of diet and incorporation of feeds specifically developed for older equids (e.g., senior diets) should be considered. Also, affected equids may need to be separated from the herd if they are not getting adequate access to feed. Unfortunately, because the abdomen may become pendulous, weight loss and muscle wasting in more severely affected animals may not be well recognized by owners. In these instances, measurement of body weight, or estimation with a weight tape or body condition score, are important parameters to monitor during treatment.