PPID in young horses (and the PSSM red herring)

[Nudibranch]

This morning my 9yo Dales mare received a PPID diagnosis. ACTH 109 and definite symptoms. I'm floored tbh. I've had 2 with it before but much older. Vet was really surprised - she was sure it would be EMS.

I can remember discussing it with my old vet when she was about 4 or 5; she's always been super thirsty but he said no way at that age. Anyway a few things have gone on since, and with her age and genetics (P3 and 4 in her bloodlines) I was mainly convinced it was pssm.

I'm relieved it's a diagnosis which is (hopefully) relatively easily treated but my main concern is her age. I'm hoping we've caught it early enough to stall any progression but we could be talking about decades on pergolide. Anyone else with a very young diagnosis - how are they getting on?

I was going to test for pssm variants in the hope that she would be negative and breeding would be an option but I'm pretty sure it's completely off the table now. Apart from the risks to her and of breeding something untoward into any foals, when I think about it I haven't even seen her in season for years. I put it down to not being mareish, although subconsciously I must have added it to the list of flags for PPID. Vet is going to get more info about early onset, but if anyone has experience here I'd be very grateful to hear about it.

 

[Tiddlypom]

Quick reply for now, don’t despair, my PSSM mare was diagnosed with PPID at age 11 at what should have been an uneventful screening test. She went straight on to 1 Prascend a day, and is grand still on the same dose 7 years later.

 

[Pearlsacarolsinger]

This morning my 9yo Dales mare received a PPID diagnosis. ACTH 109 and definite symptoms. I'm floored tbh. I've had 2 with it before but much older. Vet was really surprised - she was sure it would be EMS.

I can remember discussing it with my old vet when she was about 4 or 5; she's always been super thirsty but he said no way at that age. Anyway a few things have gone on since, and with her age and genetics (P3 and 4 in her bloodlines) I was mainly convinced it was pssm.

I'm relieved it's a diagnosis which is (hopefully) relatively easily treated but my main concern is her age. I'm hoping we've caught it early enough to stall any progression but we could be talking about decades on pergolide. Anyone else with a very young diagnosis - how are they getting on?

I was going to test for pssm variants in the hope that she would be negative and breeding would be an option but I'm pretty sure it's completely off the table now. Apart from the risks to her and of breeding something untoward into any foals, when I think about it I haven't even seen her in season for years. I put it down to not being mareish, although subconsciously I must have added it to the list of flags for PPID. Vet is going to get more info about early onset, but if anyone has experience here I'd be very grateful to hear about it.

Just over 20 yrs ago, I lost a 6 yr old Shire mare to what I now believe to be PPID. We had 3 months of vet visits with no diagnosis and the only treatment was bute. She had a recurrent foot abscess, skin issues and was very thin. I had had her less than 12 months. My farrier always said that the vet was to blame for losing her. We had her pts when she foundered, poor girl.
I am so glad that you have a diagnosis and there is an available treatment, even if its not a cure.

 

[Hackback]

My Arab was also diagnosed aged 9. After a very shaky start when he didn't tolerate the Prascend at all, he has done very well. He's 18 now and his.dose has increased from 1/12 to 1 1/2 over 9 years. Last year his ACTH results were high and we increased his dose to 2 tablets, which the vet said was the maximum she would be happy with. As it happened he couldn't tolerate that dose and he's back on 1 1/2.

You wouldn't know he had PPID. He's lived a normal life on the Prascend and was hunting up to last year. I've decided to retire him from energetic duties this year, for a variety of reasons. Not sure if any are related to his condition/medication but he is still very well in himself.

 

[paddy555]

mine was formally diagnosed PPID at 12 with an ACTH count of 17.. I insisted it was wrong due to him having ALL of the symptoms and retested a couple of weeks later at 11. With the benefit of hindsight and a lot more knowledge of PPID I suspected he had it around 6, maybe earlier. His feet went over absolutely anything at speed at 4, then they started not to and at around 6 he was booted and really needed a lot more booting. So I even think now that 5 could have been the start.

He had pracend from 12 to 21. Then his back end went with ataxia and he was PTS.

I suspect mine, a haflinger, also had PSSM. He wasn't tested this was a long time ago but if it was now I would have PSSM1 tested and possibly, (in the absence of a recognised test) work on the basis of PSSM 2 as well as PPID>

Dr K suggests 5000iu of vit e for PPID and that may help with PSSM. All I did was start on pergolide. One of his symptoms was lethargy and on pergo he suddenly became the Duracell Bunny on speed.
It was clear from his improvement that he had cushings. It was so definite, so black and white.

My vet was like we wait until around 15 to test and I know that was widely thought but it seems to be wrong.

 

[paddy555]

Twenty to twenty-five percent of horses over 15 years of age are affected by PPID [2,3,4]. There does not appear to be any sex predilection [3,4] or any breed predisposition to PPID [3]. Previously, despite the high prevalence of PPID in the geriatric equine population, owners were infrequently aware of the disease [4]. In 2012, free basal ACTH testing for PPID was well marketed, improving awareness of PPID in both owners and veterinarians [8]. However, despite recognising clinical signs, owners may be unlikely to seek veterinary advice [4]. Early clinical signs are also easily missed as they can be confused with normal age-related changes [4,47]. It is not recommended to test horses less than 10 years-of-age unless hypertrichosis is present [16] as younger horses are rarely affected by PPID [17]. The youngest horses reported with PPID were 7 years of age. This is considered unusual and early onset familial PPID was suspected [17].

I found the above after googling early onset PPID. Youngest 7 basically but genetic.
Do you know the parents?

 

[paddy555]

Just over 20 yrs ago, I lost a 6 yr old Shire mare to what I now believe to be PPID. We had 3 months of vet visits with no diagnosis and the only treatment was bute. She had a recurrent foot abscess, skin issues and was very thin. I had had her less than 12 months. My farrier always said that the vet was to blame for losing her. We had her pts when she foundered, poor girl.
I am so glad that you have a diagnosis and there is an available treatment, even if its not a cure.

I'm sorry about your mare. I can relate to all of this.

For anyone in this position foot abscesses are a sign. Mine had endless abscesses for absolutely no reason. Before not a single abscess, Once on prascend they stopped. In between time I spent most of my time with nappies/kaolin and soaking. Good barefeet turn bad very quickly and for no apparent reason until you consider PPID.


Mine also had serious skin problems. Hives, lots of them everywhere and I was just about at the stage of PTS for welfare reasons on the skin alone.
He was around 6/7 when this chaos started and I was a lot more ignorant then.

 

[Nudibranch]

Crikey, a lot of similarities. Great bf Dales feet, then we needed boots, now we need boots with pads. Random hives which come and go. Foot abscess back in Feb which really got me thinking - and then I realised the hollows above her eyes had gone. Random nasty virus about 18 months ago which she took ages to recover from. Feeling like the handbrake is on, but no lameness whatsoever. Wierd colicky/tie up type episode as a 3yo which I am convinced was low electrolytes, but that may have nothing to do with it of course. I had her PSSM 1 tested as a 4yo which came back negative. For so long I've been thinking I'm oversensitive to any little thing after a bad run with my previous horse...turns out not.

I know of both parents but not well, and not sure if there's PPID cropping up early in the bloodlines or not. I do wonder how many cases are genuinely early onset, and how many are just diagnosed earlier because of more awareness these days.

 

[shortstuff99]

High iron levels in diet have also been linked to PPID.

Really sorry to hear this though, one of mine lived successfully for 10 years on prascend before the cuchings caught up with her.

 

[paddy555]

Crikey, a lot of similarities. Great bf Dales feet, then we needed boots, now we need boots with pads. Random hives which come and go. Foot abscess back in Feb which really got me thinking - and then I realised the hollows above her eyes had gone. Random nasty virus about 18 months ago which she took ages to recover from. Feeling like the handbrake is on, but no lameness whatsoever. Wierd colicky/tie up type episode as a 3yo which I am convinced was low electrolytes, but that may have nothing to do with it of course. I had her PSSM 1 tested as a 4yo which came back negative. For so long I've been thinking I'm oversensitive to any little thing after a bad run with my previous horse...turns out not.

I know of both parents but not well, and not sure if there's PPID cropping up early in the bloodlines or not. I do wonder how many cases are genuinely early onset, and how many are just diagnosed earlier because of more awareness these days.

Not over sensitive but you are lucky though I doubt you think that ATM. I struggled until he was 12. At least now you can go forward.

Nasty virus. Mine got infections and the like that the others just shrugged off. He needed anti biotics every time and never one course always 2.

Hand brake definitely firmly attached.

However you said something really odd ie the 3yo episode. Happened to mine at 4. No idea what, tests negative. Vet stumped, even tested EHV.

Horse pretty ill but difficult to say why or with what. Looking back that was the start, the trigger.

I would urge you to use vit e. I cannot give you any scientific evidence as to why however mine had been on prascend for a couple of years and was very much under control when one day he couldn’t walk out of the yard gate he had done daily for the previous 12 years. He has gone blind almost overnight. Not ERU,or cataracts type blind just totally blind.

16 months later he started acting oddly and we realized his sight had returned. It did completely. The only thing I had done in the meantime was 5000iu vit e and that was just for PPID per the general recommendation. I hadn’t done that for his sight. Coincidence probably but who knows.

When mine started prascend, which I built up very slowly he went crazy to start with, wrecked every gate ad rails till he settled down and stabilized. Couldn’t ride it would have been dangerous and terrifying but then he settled and was fine.
Good luck.