What is PPID:
PPID is the abbreviation of Pituitary Pars Intermedia Dysfunction, also called Cushing's disease or Equine Cushing Syndrome. It is a disease that occurs in the horse due to damage to the nerves that control the pituitary gland. The pituitary gland is a gland that hangs under the brain. The term "Cushing's disease" refers to a benign tumor on the pituitary gland, which is known in dogs. It turns out that this only occurs in horses at a much later stage, so we now use the new term PPID for horses for this disease.
Does your horse really have PPID?
A lot of our customers have questions such as: Does this horse really have PPID? What does the result of the test mean? Is PPID the only problem with this horse? Did PPID arise from another problem? What is the most important thing to treat now? Is Prascend the right choice for this horse?
First lets take a look at symptoms of PPID
Symptoms of PPID:
Excessive and curly hair growth, with sometimes a different color or structure, and horses that do not shed well
·Excessive drinking and urination
·Excessive sweating
·Reduce of muscle tone and less powerful muscles especially on the top line
·Often an increased appetite
·Bumps in the cavity above the eye
·A round belly
·Laminitis (EMS)
·Reduced resistance
·Difficult-to-heal wounds and recurring infections (such as mud fever and rain scald)
·Decreased fertility and abnormal cycle
At an early stage: decreased work ethic, loss of performance, character changes (calmer, less alert, sleepy)
How common is ppid?
Of all horses between 0.1 and 1% have PPID
Of horses older than 15 years between 10 and 20%
Of horses older than 20 years about 20% and horses older than 30 years 30% have PPID.
So how do you know if your horse has PPID?
You can get the vet to test for ACTH levels.
BUT…the ACTH has nothing to do with cushings basically. This is a hormone that gets released during stress. So when you took a blood sample when the horse had acute laminitis then it had pain and pain always causes high ACTH levels. When you take the sample in spring when the horse has a tick winter coat then you get thermal stress/heat stress so also a high ACTH. When the horse is scared of the vet then you will get high ACTH levels. I get stressed as well when I see a needle. So my ACTH would be high as well.
The ACTH levels have zero diagnostic value in horses. It goes up and down and we do not know what causes stress for the horses. So forget about the ACTH and look at the symptoms. This way you can diagnose it. Losing weight and muscle, weird coat, coat gets thicker and longer and keeps growing or horses that don’t shed. Tendons get brittle. These are real things that show cushings. If we look at the horses that are diagnosed with cushings then only few of them show these severe symptoms.
Yes when the horse is 28 years old the topline wont look great anymore. But you should always look at the age of the horse, diet, the training and so on.
When the horse does look like it has cushings then you can still address the underlying issues. Often the symptoms will reseed. Also look at the feeding. Horses that have been on haylage for 10 years will look like a cushings horse.
You should check for KPU ( cryptopyrroluria ) and also insuline resistance.
There is a study that shows that about 60% of horses with a cushings diagnosis have insuline resistance. And long term insuline resistance can show cushings symptoms like the above mentioned symptoms. So In many cases its not a tumor on the pituitary gland its insuline resistance that the horse has had for 10 years or so and never got treated and now has cushings symptoms….
There is still a lot of uncertainty about the ACTH tests. No wonder, because veterinarians and researchers themselves are not yet completely sure about the test. There is currently no test available that can give 100% clear answer.
The use of Prascend:
Using prascend is a band aid for symptoms but it doesn’t target the underlying cause/issues.
The side effects of using this drug is severe. It was on the market for humans for multi sclerosis, as a long term application, and it had to be taken of the market in 2008 because of the severe side effects. Even when they were taken the recommended dose they started to develop fibrotic scare tissue around their hart wall. They developed hart diseases/hart insufficiency. And no one has ever looked at this in horses. Even though we are treating horses with this since 2009.
In 2008 or 2009 it had to be taken of the market for human beings by force. So by the authorities. At the same time they applied for it for veterinary use. And it succeeded and ever since then its been sold like candy to horse owners. So we have tons of horses that have been taken prascend for 10 years or so but no one ever looked at their hart by cutting the horses open. Since the hart muscle of the horse basically works the same as in humans we can only assume that we will find the same problems with the hart in horses.
Prascend is even given to horses at a young age of only 7 years old. You don’t want to know what their hart looks like when they are 15!
Not a single study has been done about the side effects in horses that have been done in humans.
How can we help?
Diet is an important factor of metabolic issues and raised ACTH levels. We have seen that horses with a high sugar and starch diet will have higher ACTH levels.
For horses with `real`cushings it is important that they get enough antioxidants such as vitamin C and E, proteins, enough and good quality roughage, roughage with a sugar content below 10%, less grass intake.
Depending on whether your horse has insulin resistance or other underlying issues it is also important to look at the mineral intake. Minerals such as magnesium, zinc, copper, selenium can have a positive effect as well.
Herbs can help and support the horse such as Agnus Castus (monk pepper), red clover, fennel seed, hemp seed and many more.
We can help and find out what your horse needs to support itself. And we can provide you with a custom made nutrition plan and herbs, medicinal mushrooms and gemmo`s to support the horse.
Scientific articles;
https://thehorsetherapist.ie/gb/webshop/547-free-download-brochure-ems-cushing-insuline-resistance.html
https://www.thelaminitissite.org/ppid-faq/does-a-high-acth-result-mean-my-horse-has-ppid#:~:text=Therefore%20if%20a%20horse%20is,be%20a%20bit%20of%20both.&text=Some%20medicines%20increase%20ACTH%2C%20e.g%20clenbuterol%20(Ventipulmin)
https://www.pbm.va.gov/PBM/vacenterformedicationsafety/nationalpbmbulletin/NationalPBMBulletinPergolide.pdf
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4263906/#:~:text=Acute%20pain%20is%20a%20stressful,perpetuate%20hypocortisolism%20and%20chronic%2C%20recurrent
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10337268/#:~:text=In%20animal%20studies%2C%20very%20high,events%20(1%2C%202)
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4263906/#:~:text=Acute%20pain%20is%20a%20stressful,perpetuate%20hypocortisolism%20and%20chronic%2C%20recurrent