What you see. The starting point for addressing any equine health related issue is your observation.


Cushing's Disease Suspected Based on Appearance


"Cushing's Disease" (now called Pituitary Pars Intermedia Dysfunction, PPID) is not an observation, it is a diagnosis. The reason I have included it here is that horse owners tend to be on the lookout for this condition and may think they can diagnose it easily.

It is important to know there is still a great deal of confusion about this condition, which commonly occurs in older horses. It is usually still under-diagnosed and is often misdiagnosed and misunderstood.

The classic signs of PPID are weight loss, excessive urination, hair coat changes and lameness. In addition, affected horses may have chronic infection and other health problems. But importantly, the signs can be very subtle.

Many of the signs commonly associated with PPID are confused with those seen in horses with Equine Metabolic Disease, EMS. Overweight, cresty necked horses are actually likely not to have PPID or Cushing's disease but instead have EMS.

  • Code Orange

    Call Your Vet at Their First Available Office Hours
    • If you notice lameness in addition to this sign.
    • If the horse seems stiff, or digital pulse is present.
  • Code Yellow

    Contact Your Vet at Your Convenience for an Appointment
    • If you do not notice any lameness or stiffness.
    • If you do not notice digital pulse or heat in the feet.

your role


What To Do

Instead of jumping to a diagnosis, just observe your horse carefully. Assess the horse's general health using the Whole Horse Exam (WHE), and assess for lameness at the walk, which could indicate low grade laminitis. Try searching again based on words that describe what you actually see - your observations - or call your vet to discuss your hunch.

your vet's role

If your horse has all of the classic signs of PPID, your vet will discuss the ways to diagnose and quantify the severity of the condition. They may also discuss the pros and cons of treating the horse without definitive diagnosis. In this case, an improvement in the horse's condition with treatment (pergolide) would be diagnostic of the condition. It is always best to use lab testing to help provide baseline and improvement.
Questions Your Vet Might Ask:
  • How old is the horse?
  • Why do you think the horse has Cushing's Disease?
  • Have you noticed that the horse is stiff or sore?
  • Does the horse show any signs of lameness or resistance to move?
  • Does the horse seem to have hair coat changes?
  • To your knowledge, does the horse have a history of laminitis?
  • Has the horse lost weight?
  • What are the results of the Whole Horse Exam (WHE)?

Treatments Your Vet May Recommend

A way to resolve the condition or diagnosis. Resolving the underlying cause or treating the signs of disease (symptomatic treatment)

Very Common
more treatments

further reading & resources

Author: Doug Thal DVM Dipl. ABVP