Peer-reviewed veterinary case report
Equine pituitary pars intermedia dysfunction: current perspectives on diagnosis and management
- Journal:
- Veterinary Medicine: Research and Reports
- Year:
- 2015
- Authors:
- Spelta CW
- Species:
- horse
Plain-English summary
Equine pituitary pars intermedia dysfunction (PPID) is a condition in horses that affects the brain and leads to problems with hormone regulation. This disease often causes symptoms like excessive hair growth, especially in more advanced cases, but catching it early can be challenging. Various tests have been used to diagnose PPID, but some are better than others, especially during the fall when certain hormone levels can be more telling. The medication pergolide is the primary treatment for managing this condition, and recent studies have provided more information about how it works and its effectiveness over time. Overall, while diagnosing early stages of PPID can be tough, treatment with pergolide has been shown to be beneficial.
Abstract
Caroline W Spelta Townsville Vet Clinic, Townsville, QLD, Australia Abstract: Equine pituitary pars intermedia dysfunction (PPID) is a neurodegenerative disease of the hypothalamus, resulting in the loss of dopaminergic inhibition of pars intermedia. An oxidative stress injury of unknown etiology has been suggested to initiate the neurodegeneration. While hypertrichosis (formerly known as hirsutism) is considered pathognomic for advanced disease, the antemortem diagnosis of subclinical and early disease has continued to prove difficult. Numerous tests have been used with varying sensitivities and specificities. The overnight dexamethasone suppression test, originally documented to have 100% sensitivity and specificity in horses with advanced disease, has proven to be less valuable in identifying early disease. Basal plasma adrenocorticotropin concentrations have improved sensitivity and specificity when sampled during the autumn months, and α-melanocyte-stimulating hormone, while not yet commercially available, shows promise as a sensitive and specific single sample test. Recent advances in our knowledge include the strong association between laminitis and hyperinsulinemia, both common clinical signs associated with PPID. The pathogenesis of hyperinsulinemia, laminitis, and their association with this disease is a focus of current research. The dopamine agonist pergolide mesylate is still the mainstay of medical management, with studies on oral bioavailability, pharmacokinetics, and long-term survival rates now published. Keywords: PPID, ACTH, α-MSH, laminitis, pergolide, hypertrichosis, pars pituitary intermedia dysfunction
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