This is the third in a three-part podcast series on PPID (pituitary pars intermedia dysfunction, also known as Cushing’s Disease). You can read about and listen to Part 1 here and Part 2 here.

Click on the above player to listen.

In these three podcast episodes, we cover various aspects of PPID with Hal Schott, DVM, PhD, DACVIM. He is a professor of Large Animal Clinical Sciences at the Michigan State University College of Veterinary Medicine.

In the first episode (Part 1), we covered what PPID is and clinical signs. We discussed what equids can get PPID, treatments, and what to do if you suspect PPID in one of your senior equids.

In the second episode (Part 2), we discussed daily management of horses with PPID. That might include nutrition, exercise, clipping, supplements, and observation.

In the third and final episode (Part 3), Schott covers whether horses, ponies, donkeys, and mules with PPID can have a useful life.

Positives of a PPID Animal

The older horse, which is more likely to have PPID, is going to have some experience, said Schott. That older horse is going to be a pretty safe horse to be around.

“When people are looking to purchase a horse or get a horse, what’s the best predictor of what that horse is going to do for them,” Schott questioned. “It’s what that hare has been doing the last two to five years.

“If it’s been successfully going on trails in the mountains for a couple of hours, and it’s been pretty sound, it’s probably going to continue to do so regardless of whether or not it has PPID at the same time,” he said.

“If it has PPID, we can manage that typically with some of the things we talked about in the last podcast,” Schott said. “As well as the medication pergolide (trade name Prascend).”

He said many of these horses are very functional and can be great school horses for lesson programs. They also can be great companions. “They are very trustworthy compared to getting that off the track Thoroughbred that you want to break and make yourself.”

“So again, older horses are just going to be a little bit more easy and a little bit more trustworthy, especially if you are putting your kids on these guys,” he noted.

Questions to Ask

Schott recommended asking the person who has the horse to learn what they have actually been doing with the horse the last couple of years.

“Whenever a person’s going to try to get a new horse, I always strongly recommend that they get that horse for a trial period,” said Schott. You can say, “Hey, can I have this horse for 30 days and see if it fits with my other horses and if it fits in for what I wanted to use him for.”

Schott suggested setting up a lease agreement “before you sign on the dotted line and take on the full responsibility of that horse.”

Treatment Costs and Benefits

He reminded that if the horse is on pergolide, “you’re probably going to be looking at maybe $1,000-$1,500 per year on the medication.”

(Editor’s note: Since I have two equids on Prascend, a veterinarian told me that I can order larger amounts of the tablets at one time and save a little per tablet. That can be a pretty big chunk of money out at one time, but it saves over the long run. Check with your practitioner if you want to consider a prescription for a larger amount of tablets at one time.)

Schott reminded the podcast audience that PPID is not a ‘life-threatening’ disease. “But with PPID, the quality of life certainly can be poorer. So using the medication can improve the quality of life.”

Schott added that, “We did an extended treatment project with PPID horses and followed them over the next 10 years. After 10 years we asked the people that treated the horses ‘If you had another horse with PPID, would you treat it again?’ And the response was nearly unanimous. ‘Yes, I definitely would treat the horse again because they saw positive improvement in quality of life for those older equids when they added the Prascend.”

He said some of those horses continued to be show horses. And some continued as trail horses. And some of them just ‘stuck around as pets.’

Small Group Don’t Like the Taste

Schott said there is a small population of horses that can be difficult to treat with the Prascend type of pergolide. “It seems they must have some taste aversion to it,” he said. “And that also happens when they change the formulation from the FDA-approved Prascend with compounded products.”

One horse Schott had as part of a research project would “smell that Prascend.” He said even with a pound of nice feed with applesauce on there, “he would dump that bucket out and get rid of that Prascend.

“But the vast majority of horses seem to tolerate it quite well,” he stressed.

If you have an issue getting your equid to take the tablet, Schott said you could do like he does for his daughter’s pony. “We just mix this little tablet in a couple of mls of water in a little syringe and squirt it in his mouth every evening,” he explained. “He tolerates it just fine.”

He also said some owners put the tablet in a little piece of apple or piece of carrot, and they do quite well.

(Editor’s note: My Tennessee Walking Horse and miniature donkey both eat their very small portion of supplement with their Prascend daily with no issues.)

Starting Prascend and Loss of Appetite

Schott said sometimes when a horse is started on Prascend it suppresses the appetite, mostly for horses on concentrate feeds.

“This happens to maybe 10-20% of horses, and it’s a very transient phenomenon,” said Schott. “If it does happen, we typically take them back off and start back with a lower dose and increase from that. Nearly all horses we can get to accept the Prascend if we do it that way.”

Feed and Dental Management of a PPID Horse

The cost of using medication was mentioned above. Feed management usually is related to lowering starch and sugars in the forage and concentrate feed. Also, as all horses age, dental issues can make feeding older horses more management intensive.

“Feed management is more related to the loss of the ability to chew the forage as the teeth get older,” said Schott. “If you have to switch over to a diet that’s predominately going to be a senior type of pelleted feed, that’s going to be more expensive.

“There’s nothing less expensive than pasture that’s growing out in your backyard,” he noted. “Hay is certainly going to be less expensive than senior feeds in terms of getting the calories in the horses.”

Hoof Care

“One of the biggest questions I would raise or ask is if there is any evidence of chronic founder,” Schott said of getting an older or PPID horse. “Because, if there’s chronic founder, that could be a real problem down the road. The horse can become painful and not able to be ridden and end up with foot abscesses and problems like that.”

Schott said they did a study looking at founder in older horses with PPID. “What was interesting is when we took radiographs of about 35 PPID horses’ feet. The radiographic evidence of founder was much higher than the client recognized.”

Hair Coat

One clinical sign of PPID is a long haircoat that doesn’t shed. And with the long haircoat, sometimes they’ll sweat a little excessively and maybe get a little dermatitis that you might not recognize because the hair is so long.

“But clipping is easy,” said Schott. “You might get away with clipping them for two, three, or four years before you have to go on the medication Prascend.

Attitude

Schott said he tells clients that one improvement they might notice when they start a horse on Prascend is that the horse “wakes up” a little bit. “Their attitudes have improved, they’re brighter, and they’re more vigorous,” he said.

“And certainly to me, that is an improvement in quality of life,” he added.

Final Words

Schott reminded owners of older horses to take notes during the year of any changes they notice and to ask their veterinarians about those observations. Look for clinical signs of PPID. How are the feet doing? Is there any laminitis to worry about? How’s the horse’s weight. Are we doing okay on nutrition? Let’s take a look in his mouth.

He also wanted to add that based on research, just because you put your horse on pergolide doesn’t mean you have to continuously increase the dose. “That doesn’t mean the cost [of maintaining these horses] is going to go up every year.”

Further Reading

  • Kimberly S. Brown is an award-winning writer and publisher. She is the Editorial Director for My Senior Horse. Brown spent 10 years at Equine Network, parent company of My Senior Horse. Prior to that she worked for three years in equine nutrition after she retired from nearly 30 years working at The Blood-Horse. Brown spent the last 15 years of her time at that organization creating and developing The Horse and TheHorse.com.
    View all posts