Pituitary pars intermedia dysfunction

Let me, because I found this out by accident.

You know what PPID is, Cushing syndrome.

Right, right.

Okay.

So in dogs, one of the common things that happens when dogs get older is that they will develop restlessness, sleep restlessness.

So a dog that you used to bring to bed all the time now just paces and just can't fall asleep, et cetera, okay? And it's part of their senility.

So now what I have found, and I found this out totally by accident, is that some of these older horses, like 16 or 18, that aren't showing any signs of PPID yet but have some sleep deprivation behavior, I will try a course of Persend on them.

Even before they're showing the other more classic signs of PPID, I think some of these behavioral changes occur well before they get to that hairy thin horse syndrome.

Um, I think those are probably the two primary areas.

Endocrinology has advanced too some, in terms of, uh, testing for PPID or pituitary pars intermedia dysfunction, um, which is commonly called equine Cushing's.

Mm.

Um, so it's, uh, there's some diagnostics that have advanced as far as that goes.

We are supporting the foundation underneath it.

And today, again, we're talking about Cushing's disease in horses more accurately called PPID, but most people I talk to call it Cushing's.

So we're going to talk about what is happening, what owners that I talk to tend to notice first, how to think about ACTH and where feeding and mineral balance fit into that picture.

We're also going to touch on medication.

And that's important, but it's a whole horse picture.

I want you to finish this episode with a clear way to look at your own horse and a more useful conversation that you can have with the people that help you care for your horse, your entire care team.

So let's talk about what PPID actually means.

It stands for pituitary pars intermediate dysfunction.

And we meet every year and we alternate.

We give recommendations for equine metabolic syndrome, insulin dysregulation, in even years, and we do PPID in odd years.

And it's really to try to give a reduced digest of the research and try to make it accessible to practitioners and owners to understand what is responsible for the endocrine disorders that we see, how to diagnose them, how to manage them, and It's also a way that we have our name out there for people to contact us.

If there are any questions or anything like that with difficult cases, we are always happy to take those questions and help.

But we need to think about what that very horse needs at that time, rather than trying to find a one-size-fits-all, because I don't think we are successful with that.

That's a really good point.

I think that there is a temptation, especially in those older PPID horses, to, you know, they really need help with the protein and maintaining lean muscle mass, and people sort of get very sort of knee-jerk, start feeding them, you know, as if they're insulin-disregulated, and they're not always.

I agree.

Next on October 2nd, we'll be talking about Cushing's disease.

also called PPID, in our 2026 update.

Give your horse some scritches for me, and I'll see you then.

Thanks for listening to the Equine Energy Medicine Podcast.

thank you for joining us and we hope you enjoy the following episode.

In episode 83, we discussed PPID and at the end, Jill, you shared that you were realizing that you should probably get your horse tested and see where his ACTH and incident levels are.

What was it about that episode that made you think you should do that?

Well, my new horse is 18 years old and he's Spanish bred.

So you had a ACTH of 60.6 and an insulin of 45.23.

So both your values fell outside of those reference ranges.

However, as we discussed in our PPID episode, ACTH does rise naturally at this time of year.

And that reference range is not seasonally adjusted.

And, uh, most of my work has focused on the endocrine or hormonal, uh, factors that are involved in the development of laminitis, and especially trying to understand why high concentrations of insulin are going to trigger laminitis.

Uh, we also work on some other, uh, disorders like PPID or what we used to call Cushing's disease, and that's going to really increase the risk of laminitis in those, uh, in those horses.

And we really want to understand the biology of all that to really see, um, why horses do develop laminitis.

What can we do to detect it sooner? Uh, what can we do to treat it? And this is really the, the vision that we have behind the Nancy Fairing Laminitis Research Center at Mississippi State.

Yeah.

Unless you're me and you have a horse and you're always worried about it getting fat and you're like, "Oh my gosh, it's fall and I have an eighteen-year-old and he always looks fat." And I mean, I'm always worried about it, but that's just me.

Um, we did have a listener mention that she had a horse that was diagnosed with PPID because of a late summer fall laminitis episode.

Yes.

What that means is about 90% of laminitis cases have a metabolic cause.

This is due to hormones and diet issues affecting insulin or a disease such as PPID leading to an overproduction of ACTH in the body.

So these are the two main triggers for an endocrinopathic case of laminitis.

And these make up almost every case of laminitis.

And this is normal.

This hormone helps to trigger the horse to grow winter coat and prepare them for winter.

The problem is for some horses that have PPID, this ACTH rises unchecked and it rises too much.

It's unregulated.