What is Cushing's disease (PPID) in horses?

PPID — pituitary pars intermedia dysfunction, often called equine Cushing's — is a common hormonal disorder of older horses. Age-related degeneration makes part of the pituitary gland overactive, unbalancing hormones that control metabolism and many body functions.

What are the signs of Cushing's in horses?

According to the British Horse Society, common signs include a long and/or curly coat, difficulty shedding the winter coat, unusual sweating, increased drinking and urination, lethargy, muscle wastage, recurring infections such as foot abscesses, and laminitis.

Does Cushing's cause laminitis?

Yes — laminitis can be a sign of PPID. Redwings advises that any horse or pony developing laminitis without an obvious cause should be tested for PPID and Equine Metabolic Syndrome, especially if they are older.

Is there a test for Cushing's in horses?

Yes — your vet takes a blood sample to measure the hormone ACTH, sometimes followed by further tests if results are borderline. In the UK, the Care About Cushings scheme offers free diagnostic and monitoring ACTH tests at participating veterinary practices.

Can Cushing's in horses be cured?

No, but it can be effectively managed. According to the British Horse Society, your vet can prescribe pergolide (usually as Prascend tablets) to regulate hormone production. Treatment is lifelong, with regular re-testing to keep the dose right.

How do I care for a horse with Cushing's?

Give medication consistently, keep up regular testing, clip the coat in warm weather if shedding is poor, rug in cold weather, maintain a healthy fat score to reduce laminitis risk, and stay on top of dental care, worming and farriery.

Horse Health

Horse Cushing's (PPID) in the UK

Published 18 July 2026Last updated 18 July 20265 min read

Quick answer

Cushing's disease (PPID) is a common hormonal disorder of older horses, caused by changes in the pituitary gland. According to the British Horse Society, signs include a long, curly coat that won't shed, unusual sweating and laminitis. Your vet can test for it and prescribe pergolide (Prascend) — treatment is lifelong.

Key takeaways

**Cushing's disease (PPID)** is a common hormonal disorder of **older horses**, caused by changes in the pituitary gland.
According to the British Horse Society, signs include a **long, curly coat that won't shed**, unusual sweating and laminitis.
Your vet can test for it and prescribe **pergolide (Prascend)** — treatment is lifelong.

What is PPID?

Pituitary pars intermedia dysfunction — PPID, widely known as equine Cushing's disease — is a long-term, progressive condition caused by age-related degeneration of the pituitary gland. According to the British Horse Society and the Royal Veterinary College, the gland becomes overactive and unbalances the hormones controlling metabolism and many other body functions.

It is one of the most common disorders of older horses — which is why UK vets and charities encourage routine testing of veterans.

Signs of Cushing's

Sign	What you may notice
Coat changes	Long and/or curly coat; failure to shed the winter coat in spring
Sweating	Sweating that seems unusual for the weather or workload
Thirst and urination	Drinking and passing urine noticeably more
Energy	Lethargy, reduced performance
Body shape	Muscle wastage (especially along the topline), pot-bellied appearance, weight loss
Infections	Recurring problems such as foot abscesses or sinusitis
Laminitis	Recurrent or unexplained bouts — a classic red flag

According to the RVC, excessive coat length, weight loss, increased sweating and excessive drinking and urination are among the hallmark clinical signs.

The laminitis link

This is the connection every owner should know: laminitis can be a sign of PPID. Redwings advises that horses and ponies with laminitis — particularly older animals and recurrent cases — should be tested for PPID and Equine Metabolic Syndrome (EMS), because treating the underlying hormonal disease is essential to stop the cycle of painful episodes.

If your horse has laminitis with no clear dietary cause, ask your vet about PPID testing.

Diagnosis and testing

Your vet takes a blood sample to measure ACTH — the main screening test for PPID
Borderline results may need further dynamic testing; your vet will advise on timing, as hormone levels vary
Free testing — the Care About Cushings scheme offers free diagnostic and monitoring ACTH tests for UK horses at participating veterinary practices; ask your vet about eligibility

Regular re-testing matters after diagnosis too: according to the BHS, horses on treatment need ongoing blood tests to confirm they are on the right dose.

Treatment — pergolide via your vet

PPID cannot be cured, but it can be managed. According to the British Horse Society:

Your vet may prescribe pergolide, most commonly as Prascend tablets, which helps regulate hormone production — many horses respond very well
Tablets can be hidden in feed or a slice of fruit or vegetable; a paste version exists but is not yet licensed in the UK, so it is prescribed only where welfare requires it
Once started, medication is usually needed for the rest of the horse's life, with regular testing and occasional dose adjustment by your vet
Never adjust the dose yourself — and order refills in advance so treatment is not interrupted

Costs add up over a lifetime, so discuss the ongoing commitment honestly with your vet at diagnosis.

Day-to-day management

Clip the coat in warmer months if your horse cannot shed properly; rug up when the weather turns chilly
Keep a healthy fat score to reduce laminitis risk; some PPID horses also develop insulin problems managed like EMS — your vet will guide diet
Maintain regular dental care, a testing-led worming programme and routine farriery
Monitor for infection — PPID horses are more prone; treat wounds, abscesses and eye problems promptly
Watch water intake and appetite as simple daily health barometers

When to call the vet

Book a non-urgent visit for any combination of coat changes, increased drinking, lethargy or muscle loss in an older horse — and treat laminitis as an emergency. Already-diagnosed horses need prompt advice if symptoms break through or appetite drops.

Sources & further reading

Facts in this guide are rewritten in plain English from publicly available UK advice. We name the organisation where a specific point comes from their guidance. Links below go to the original pages — use them to read the source material directly.

PETHEALTH+ is independent. These organisations do not sponsor, approve, or partner with this website. Guidance checked against sources listed below (last updated 2026-07-18).

Frequently Asked Questions

What is Cushing's disease (PPID) in horses?: PPID — pituitary pars intermedia dysfunction, often called equine Cushing's — is a common hormonal disorder of older horses. Age-related degeneration makes part of the pituitary gland overactive, unbalancing hormones that control metabolism and many body functions.
What are the signs of Cushing's in horses?: According to the British Horse Society, common signs include a long and/or curly coat, difficulty shedding the winter coat, unusual sweating, increased drinking and urination, lethargy, muscle wastage, recurring infections such as foot abscesses, and laminitis.
Does Cushing's cause laminitis?: Yes — laminitis can be a sign of PPID. Redwings advises that any horse or pony developing laminitis without an obvious cause should be tested for PPID and Equine Metabolic Syndrome, especially if they are older.
Is there a test for Cushing's in horses?: Yes — your vet takes a blood sample to measure the hormone ACTH, sometimes followed by further tests if results are borderline. In the UK, the Care About Cushings scheme offers free diagnostic and monitoring ACTH tests at participating veterinary practices.
Can Cushing's in horses be cured?: No, but it can be effectively managed. According to the British Horse Society, your vet can prescribe pergolide (usually as Prascend tablets) to regulate hormone production. Treatment is lifelong, with regular re-testing to keep the dose right.
How do I care for a horse with Cushing's?: Give medication consistently, keep up regular testing, clip the coat in warm weather if shedding is poor, rug in cold weather, maintain a healthy fat score to reduce laminitis risk, and stay on top of dental care, worming and farriery.