You’re spoiling me with all this great information. I had looked into a couple FB groups, but hadn’t joined any yet as I was still going through tons of information. I just joined the Equine PPID group and have bookmarked the other sites you posted. I have a lot more good reading to do in my future!
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What has me alarmed is damn, a 10 year old. What is going on with our horses? Is this horse in regular work and galloping?
What were his signs?
I’m curious to hear the numbers too.
I have a PPID mare and my old Arab was PPID too. They both had a history of being air ferns, even muzzled.
Be sure you don’t have long toes on your horse so they are mechanically better built in the event of lami incidences you don’t even know are happening.
This is a great group for support and I too have been a ECIR devotee and Dr. Kellon’s help too over the years.
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And I will add I DO ACTH and insulin test my 10yo mustang and it’s stories like this. Ugh.
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It’s good that you’re building your knowledge with all these great resources people have shared. As you go down this road, you’ll also start to see where the “typical” ways things unfold do and don’t apply to your own horse. My example…my mare was on 0.5 pills for years and years, and maintained very well that way. She never had the “veil,” she was never fussy about eating the pill, and never had any fussiness with her feed. I’ve come to see that was pretty atypical, but it did make it easier to treat her!
Since I have Morgans, I feed them all as if they are insulin resistant, and am fortunate to be able to get a full year’s worth of tested hay that is “safe” for even EMS horses. Right now, none of the horses I have have PPID or EMS/IR, but this is the first time in years that’s been the case for me (sadly I lost the my oldest, who was living with PPID, at 30 years old last December). Once you get in the routine of orienting their diet around the best practices for a metabolic horse, it’s not too hard to keep it up even when horses are in work (I do baby endurance stuff with mine). And I do a full metabolic panel 2x year on all of them that are in their teens to monitor where ACTH and insulin are, just making sure I don’t need to take any additional steps (e.g., add a grazing muzzle). But they are all individuals, and some are easier than others!
Good luck with figuring out what works best for your guy.
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I guess with how much more research and what not they are doing on this subject, they are able to start seeing the red flags sooner. His biggest red flag was his inability to heal in a normal span of time. I’ve been dealing with a persistent bacterial skin issue on his hind (white) legs that heals excruciatingly slowly. He also will have superficial cuts that take 3 - 4 weeks to heal and every small cut he gets has an extreme inflammatory response. We were just going to test his vitamin E levels to see if it was a deficit that was causing the immune system issues, and my vet asked if we could try the TRH test to check for PPID to rule that out too. I guess this flagged it in her mind as potentially early stage and she wanted to rule it out. We thought the test was a longshot and then lo and behold, here we are. He will be back in regular work shortly (training to become an eventer). He’s currently on a break after spraining his ankle in the field. Which I try not to read into too much, as I can’t know for sure, but it sounds like ligament/tendon issues can also be PPID symptoms.
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I’ll leave answering the more specific questions about your situation to this group and all the great resources they’ve shared but I can share a little anecdotal information with you. My horse is a Thoroughbred (foaled in 1996) and he was diagnosed PPID in 2021. He’s pictured below at age 28 in June 2024. He hit the metabolic lottery 
and he’s IR due to the PPID so I have been working on feeding a not-easy keeper under 10% NSC for a few years now. He had one minor laminitic episode (no discernible rotation) during the first year but now that his meds are controlling the PPID better, his insulin is also under better control. Insulin was 13.7 when we tested him recently. I read that Hallway Fibrenergy is 10% NSC and it’s more caloric than most low-NSC feeds so I thought it might be an option for my guy. I was concerned because it smells great and they only list starch on the bag and not sugar so I paid for a sample to be tested by Equi-Analytical and the NSC was indeed 10.6% in the sample I submitted. So that’s a feed to put on your back-up list if it’s appropriate for your horse. My guy gets picky at this time of year so it’s handy to have a few options. Fibrenergy is very palatable to him so it’s a good “treat” for adding more calories.
Good luck with your horse. There are a lot of great learning resources out there. It takes time to get things figured out and sometimes it all feels like a house of cards on a bad day. But the diagnosis of PPID isn’t what it was even 10 years ago. There’s a lot out there to help our horses stay comfortable.
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I think we are catching it earlier before the hair coat is 3 inches long in the summer and the horse has laminitis. My guy was diagnosed at 13. His only symptom was ouchy feet after pulling his shoes one winter. Several people said to just put his shoes back on. My vet tech suggested we run a metabolic panel. He’s 26 now, on 2.5 mg pergolide, sheds out in the spring, eats a normal diet including pasture and is sound.
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As with a lot of things, I think more and more vets and owners are starting to piece together the issues that arise with the more typical PPID horse, and consider maybe this “he’s too young” horse might be in the early stages. 10 years ago, a horse who didn’t heal well would just be “the horse whose immune system sucks” and PPID wouldn’t even be a blip on the radar
I think we’ve also learned a lot more about recognizing earlier PPID in the older horse. Now, it’s considered useful to start testing at 15 if there’s something weird going on, but even as a baseline in the hopes of catching it early. 10 years ago I’m not sure that was the case, and I think 15 was considered young for PPID at that point
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That’s why I tested my guy years ago - tendon issues, infections and he was sluggish. Getting him on Prascend really helped improve his health. He was also 20 or so.
These youngers horses getting it tell me something is wrong. Too little movement? Too overweight? I don’t know but it’s something.
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And right, my old guy and my mare did not have long hair coats. I also know someone locally who had a horse become very overweight, cresty, long toe, fat pads and young. 10. He had a sky high ACTH and then had laminitis set in and he was euthanized after 5 months. This stuff is nothing to fool around with.
I can’t say for sure, but it’s hard to say if things are getting worse, or we are just catching it sooner because we know more these days. My guy was a racehorse until he was 7 years old. He lived the typical racehorse life and was retired for a little under a year before I picked him up a year and a half ago. Since I’ve had him he’s been riding 6 days a week and living half in half out (I can’t turn out 24/7 with my setup), so he’s fairly active. I don’t know how much is caused by genetics and/or environmental factors as well.
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This x 1000. I know of one vet who believes clinical symptoms show up long before the ACTH levels in the blood do. He starts Prascend if clinical signs present regardless of the blood test results. I have a horse in my barn who fits the clinical profile to a T, and had for years. Her ACTH now reflects PPID and she is on Prascend.
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My TB has PPID (20 this year, diagnosed at 18?) but is not IR. I still find it helpful to feed her like she’s IR because she may be sensitive to NSC without being IR (she’s complicated) and it isn’t too hard to find a low NSC ~12% feed to give.
If you need a fat/ calorie supplement that is low NSC, I recommend Coolstance Copra. It puts a lovely shine and extra weight on the horses that need it. It is not very palatable by itself.
For low NSC fortified feed, I like the Tribute Wholesome blends line. It smells great and the horses I’ve given it to eat it like it’s candy (it’s not!).
My horse definitely went through the “veil” and we struggled to get her to eat her grain for weeks. Eventually we dropped down to every other day at 1/4 pill, then every day 1/4 pill and eventually 1/2 pill (as intended). APF Pro was helpful but I had a difficult time getting it in her as I needed to syringe it in since she wasn’t eating food and she’s terrible (for good reason) with orally syringed meds.
Alfalfa has been incredibly helpful in keeping weight and muscle on as well. She has always tolerated it well/ preferred Alf.
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It doesn’t mean something is wrong it means our understanding of the disease is improving. We know to look for it sooner or not rule it out due to age anymore.
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OK, I had theories and I am wrong. Huh. Just seems so odd - like working against evolution.
https://thehorse.com/164356/ppid-not-just-for-domestic-horses/#:~:text=If%20you%20think%20pituitary%20pars,develop%20the%20debilitating%20metabolic%20disorder.
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My Tb gelding is 21yrs old has had PPID for about 5 years now .we:.I give him compounded Pergolide liquid instead of the Prascend pill because he stopped eating and refused to take the pill after he had been on it awhile . I feed him a combo of Triple Crown Senior Gold with 1 cup per day of Triple Crown 30% RB along with soaked Pink Mash and a little bit of Cavalor Fiberforce…he gets a nice second cutting grass hay and a bucket of Triple Crown Stress Free Forage …ideally low sugar & starch feed …12% or below 10% is more ideal
