when to treat or not treat PPID

Johnson, Cathy

A friend of mine recently had her 21 year old gelding tested for PPID and insulin resistance.  The testing was done because a new vet recommended that all horses over the age of 15 get tested, not because the gelding was experiencing any symptoms.  The test showed elevated ACTH levels (she was not given the test results and does not know the exact level).  Also, she fed the gelding his grain ration right before the vet arrived for the blood draw.  The IR results came back very high (again she was not told the numbers) but the vet said that due to the grain meal the results were OK and that the horse was not IR.  The horse was started on 1 tab of Prascend with no recommendation to retest to determine if one tab was sufficient to drop the ACTH.  This just seems incredibly wrong to me.  I did tell her she should call the vet and say she wants a new blood draw for the IR test because she should have been told to not give a grain meal prior to the blood draw.  But, my ultimate question is why treat a 21 year old horse that is showing no PPID symptoms?  What is the benefit?  The horse is already on a low sugar diet, gets his hooves trimmed every 5 weeks, and is ridden almost every day.  
Cathy Johnson


Roy, WA

October 12, 2016


Eleanor Kellon, VMD

Assuming he is genuinely PPID, the first sign is often an unexpected severe tendon or ligament injury.  Tooth loosening, skin and oral infections are common.  If he is at all prone to IR, IR and laminitis can develop long before the typical long coat and other signs.
Eleanor in PA

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