South African Equine Veterinary Association Congress 2015 Protea Hotel Stellenbosch
reverse many clinical signs of PPID. Combination treatment with both pergolide and
cyproheptadine, in the author‟s experience, may also prove beneficial in more advanced cases.
Assessment for concurrent glucose and insulin dysregulation, especially in patients with laminitis,
is also warranted. Management of these latter conditions requires appropriate feeding and exercise
programs, proper hoof care, judicious use of analgesic medications, and in some cases use of
additional medications (metformin and levothyroxine) may be considered. Finally, due to the
costs of lifelong management and medication(s), the extent of treatment of PPID-affected equids
should be made on a case-by-case basis, in consideration of the client‟s goals.
Husbandry and nutritional considerations: In the earlier stages of PPID, when hypertrichosis may
be the primary complaint, body-clipping may be the only treatment required. Since many affected
animals are aged, routine oral care and correction of dental abnormalities cannot be
overemphasized. In addition, assessment of diet and incorporation of pelleted feeds designed
specifically for older equids (e.g., senior diets) should be considered. Sweet feeds and other
concentrates high in soluble carbohydrate are best avoided (unless that is all that they will eat),
especially with concurrent glucose and insulin dysregulation. Affected equids may also need to be
separated from the herd if they are not getting adequate access to feed. Unfortunately, because the
ventral abdomen may become somewhat pendulous, weight loss and muscle wasting in more
severely affected animals may not be well-recognized by owners. Consequently, regular
measurement of body weight, or estimation with a weight tape, and assessment of body condition
score are important parameters to monitor during treatment.
Whether or not it is “safe” to allow PPID-affected equids to graze pasture remains a controversial
question. Pasture, especially lush spring and fall pasture, should be considered similar to feeding
concentrates high in soluble carbohydrates and many veterinarians recommend that PPID-affected
equids not be turned out on pasture. In this author‟s opinion, it is important to assess the overall
condition of the patient. If the equid is overweight, has abnormal fat deposits, or a history of
laminitis (all supportive of concurrent insulin dysregulation), pasture turn out would not be
recommended. Instead, feeding grass hay at 1.5% of the body weight daily would be the preferred
forage diet and animals that are overweight clearly do not need an additional “low starch”
concent