10/14/2025
“Cushing’s disease,” or more correctly, pars pituitary intermedia dysfunction (PPID), is a metabolic condition that tends to affect middle-aged and older horses. In PPID, the pituitary gland in the brain produces an excessive amount of the hormone ACTH, which stimulates the production of large amounts of cortisol, the stress hormone.
Signs of PPID include weight loss, loss of muscle (especially along the topline), a long hair coat that does not shed out in the summer, chronic infections that seem to recur or linger (e.g., hoof abscesses), and laminitis.
In some cases, a veterinarian can diagnose PPID based on clinical signs alone, while in others, the combination of clinical signs plus a blood test measuring ACTH is needed for diagnosis. ACTH levels vary throughout the year in all horses, which can complicate the interpretation of blood tests for PPID. Most normal horses show an increase in ACTH in the fall; however, the magnitude of this increase is much higher in horses with PPID. Therefore, a veterinarian may choose to test for PPID in the fall.
The main treatment for PPID is the daily administration of a medication known as pergolide. However, there are other management considerations for horses with PPID, including special attention to dentistry, body condition, body weight, nutrition, and parasite control.