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Topic:Pituitary Pars Intermedia Dysfunction
Pituitary Pars Intermedia Dysfunction (PPID) is a condition in horses characterized by a dysfunction of the pituitary gland, specifically the pars intermedia. This dysfunction leads to an overproduction of certain hormones, notably adrenocorticotropic hormone (ACTH), which can affect various physiological processes. PPID is commonly diagnosed in older horses and is associated with clinical signs such as hirsutism, laminitis, and changes in body condition. The condition is also referred to as equine Cushing's disease. This page compiles peer-reviewed research studies and scholarly articles that explore the pathophysiology, diagnosis, and management of Pituitary Pars Intermedia Dysfunction in equine populations.
Evaluation of the effects of age and pituitary pars intermedia dysfunction on corneal sensitivity in horses. To determine effects of age and pituitary pars intermedia dysfunction (PPID) on corneal sensitivity in horses. Methods: 20 adult horses allocated into 3 groups (PPID group, old [> 15 years old] horses with PPID [n = 5]; old group, old [> 15 years old] horses without PPID [9]; and young group, young [≤ 10 years old] horses without PPID [6]). All horses with PPID had hirsutism and abnormal fat deposition or laminitis; none of the old or young horses had hirsutism, abnormal fat deposition, or laminitis. Methods: A Cochet-Bonnet aesthesiometer was used to measure the corneal touch threshold (CTT...
[Equine Cushing’s disease; an update]. Lately there has been a tendency to discuss Equine Cushing's disease and its related phenomena, due to the amount of recently acquired research data. The author has composed a brief overview of the present situation emphasizing relevance for practitioners.
Changes in plasma melanocyte-stimulating hormone, ACTH, prolactin, GH, LH, FSH, and thyroid-stimulating hormone in response to injection of sulpiride, thyrotropin-releasing hormone, or vehicle in insulin-sensitive and -insensitive mares. Six insulin-sensitive and 6 insulin-insensitive mares were used in a replicated 3 by 3 Latin square design to determine the pituitary hormonal responses (compared with vehicle) to sulpiride and thyrotropin-releasing hormone (TRH), 2 compounds commonly used to diagnose pituitary pars intermedia dysfunction (PPID) in horses. Mares were classified as insulin sensitive or insensitive by their previous glucose responses to direct injection of human recombinant insulin. Treatment days were February 25, 2012, and March 10 and 24, 2012. Treatments were sulpiride (racemic mixture, 0.01 mg/kg BW), TRH (...
Comparison of hair follicle histology between horses with pituitary pars intermedia dysfunction and excessive hair growth and normal aged horses. Pituitary pars intermedia dysfunction (PPID) in older equids is commonly recognized by a long hair coat that fails to shed. Objective: The aim of this study was to compare hair follicle stages in PPID-affected horses with excessively long hair coats with the stages of normal aged horses (controls) and to compare hair follicle stages in PPID-affected horses after 6 months of treatment with pergolide mesylate with those of control horses. Methods: Eight PPID-affected horses and four normal, age-matched, control horses. Methods: Skin biopsies were collected from the neck and rump of PPID-affected...
Case series of equine pituitary pars intermedia dysfunction in a tropical climate. The clinical manifestations of equine pituitary pars intermedia dysfunction (PPID) in temperate climates are well described. The classic presentation is that of an older animal with hirsutism, laminitis, poor muscle tone, pendulous abdomen and weight loss. This case series highlights the additional clinical signs of anhidrosis and heat stress with secondary exercise intolerance that were seen as primary presenting problems in equids with PPID in the hot, humid conditions of a tropical climate. The clinical signs resolved with medical treatment for PPID.
Short-term incubation of equine laminar veins with cortisol and insulin alters contractility in vitro: possible implications for the pathogenesis of equine laminitis. This study investigated the effects of cortisol and insulin, hormones that affect both glycaemic status and vascular function, on the in vitro contractility of isolated healthy equine small laminar veins. Small veins (150-500 μm) draining the digital laminae from healthy horses or ponies were investigated by wire myography. Concentration response curves were constructed for noradrenaline (NA), phenylephrine (PE), endothelin-1 (ET-1) and 5-hydroxytryptamine (5-HT) in the presence of either cortisol (10(-6 ) m) or insulin (1000 μIU/mL). Cortisol significantly increased the maximum contractilit...
Seasonal variation in results of diagnostic tests for pituitary pars intermedia dysfunction in older, clinically normal geldings. To determine whether seasonal variations exist in endogenous plasma ACTH, plasma α-melanocyte-stimulating hormone (α-MSH), serum cortisol, and serum insulin concentrations and in the results of a dexamethasone suppression test for older, clinically normal geldings in Alabama. Methods: Cohort study. Methods: 15 healthy mixed-breed geldings (median age, 14 years). Methods: Sample collection was repeated monthly for 12 months. Dexamethasone (0.04 mg/kg [0.02 mg/lb], IM) was administered and cortisol concentrations were determined at 15 and 19 hours. Radioimmunoassays were used to measure ACTH, ...
Circadian and circannual rhythms of cortisol, ACTH, and α-melanocyte-stimulating hormone in healthy horses. Cosinor analysis was used to evaluate whether pituitary and adrenal hormones exhibit circadian rhythmicity in horses. The effect of season and animal age on their respective rhythms was also determined. In addition, the usefulness of evaluating cortisol rhythmicity for the diagnosis of pituitary pars intermedia dysfunction (PPID) was assessed. Serum cortisol concentrations (P < 0.01), but not plasma ACTH or α-melanocyte-stimulating hormone (α-MSH), showed a significant circadian periodicity in horses. An effect of season on hormone concentration was observed with plasma ACTH and α-MSH co...
Prevalence, risk factors and clinical signs predictive for equine pituitary pars intermedia dysfunction in aged horses. Equine pituitary pars intermedia dysfunction (PPID) is an ageing-related neurodegenerative disorder. The prevalence and risk factors for PPID using seasonally adjusted basal adrenocorticotropic hormone (ACTH) concentrations in aged horses have not been previously reported. Objective: To determine the prevalence, risk factors and clinical signs predictive for PPID in a population of horses aged ≥ 15 years in Queensland, Australia. Methods: Owner-reported data was obtained using a postal questionnaire distributed to an equestrian group. A subgroup of surveyed owners were visited and a veterina...
Evaluation of basal plasma α-melanocyte-stimulating hormone and adrenocorticotrophic hormone concentrations for the diagnosis of pituitary pars intermedia dysfunction from a population of aged horses. The sensitivity and specificity of basal plasma α-melanocyte-stimulating hormone (α-MSH) and adrenocorticotrophic hormone (ACTH) for the diagnosis of pituitary pars intermedia dysfunction (PPID) has not been evaluated in a population-based study. Objective: To evaluate basal plasma α-MSH and ACTH concentrations for the diagnosis of PPID in a population of horses aged ≥ 15 years. Methods: Owner-reported data were obtained using a postal questionnaire distributed to an equestrian group. A subgroup of surveyed owners was visited and veterinary examination performed on horses aged ≥ 15 year...
Diagnostic frequency, response to therapy, and long-term prognosis among horses and ponies with pituitary par intermedia dysfunction, 1993-2004. Pituitary pars intermedia dysfunction (PPID) is common in older horses. Objective: To determine diagnosis frequency, prognostic factors, long-term survival, and owner satisfaction with treatment. Methods: Medical records from horses diagnosed with PPID, 1993-2004. Methods: A retrospective cohort design with data collected from the Veterinary Medical Data Base (VMDB) and a cohort of 3 VTHs. Proportional accessions, annual incidence, and demographics were compared for all accessions. During the same period, a subset of medical records (n = 44) was extracted and owners (n = 34) contacted to obtai...
Basal glucose metabolism and peripheral insulin sensitivity in equine pituitary pars intermedia dysfunction. Glucocorticoids are suggested to precipitate laminitis and induce insulin resistance in horses. Objective: To assess insulin sensitivity and the basal amount of glucose metabolized in equine pituitary pars intermedia dysfunction (PPID). Methods: The euglycaemic hyperinsulinaemic clamp (EHC) technique was performed in seven horses with a diagnosis of PPID based on the presence of hypertrichosis and positive dexamethasone suppression-test results comprising one gelding and six mares with a mean age of 21.1 ± 5.8 (SD; range 15-34) years. Results were compared with those from five negative (h...
Comparison of cortisol and ACTH responses after administration of thyrotropin releasing hormone in normal horses and those with pituitary pars intermedia dysfunction. Changes in both adrenocorticotropin (ACTH) and cortisol concentration in response to thyrotropin releasing hormone (TRH) administration have been used to diagnose equine pituitary pars intermedia dysfunction (PPID), but the use of the 2 hormones has not been compared. Objective: Measuring ACTH concentration is superior to measuring cortisol concentration after TRH administration in differentiating between normal horses and those with PPID, and the 2 hormone concentrations are disassociated in PPID horses. Methods: Eleven horses and 2 ponies with PPID and 19 normal horses. Methods: A study eval...
Computed tomographic findings in the pituitary gland and brain of horses with pituitary pars intermedia dysfunction. Pituitary pars intermedia dysfunction (PPID) is the most common endocrinologic disorder of aged horses. Objective: Pituitary glands of PPID-affected horses are larger than those of aged horses without signs of PPID, and the size difference can be detected using computed tomography (CT) imaging. Methods: Eight horses with clinical signs of PPID and supportive endocrinologic test results and 3 aged control (PPID-negative) horses. Methods: Computed tomography examination of the brain and pituitary gland was performed twice in 10 of the 11 horses, approximately 6 months apart. Six PPID-affected ho...
Circannual variation in plasma adrenocorticotropic hormone concentrations in the UK in normal horses and ponies, and those with pituitary pars intermedia dysfunction. Pituitary pars intermedia dysfunction (PPID) is a common endocrinopathy, frequently diagnosed via plasma adrenocorticotropic hormone (ACTH) concentrations. Seasonal variation in plasma ACTH concentrations has been described in normal horses prompting caution in diagnosing PPID at certain times of the year. The aims of this study were to determine appropriate reference intervals for equine plasma ACTH throughout the year; and to examine the circannual variation of plasma ACTH concentrations in PPID cases. Objective: Plasma ACTH can be used as a test for PPID throughout the year with the use of ...
The effect of geographic location, breed, and pituitary dysfunction on seasonal adrenocorticotropin and α-melanocyte-stimulating hormone plasma concentrations in horses. Plasma α-melanocyte-stimulating hormone (α-MSH) and adrenocorticotropin (ACTH) concentrations in horses vary with season, confounding diagnostic testing for pituitary pars intermedia dysfunction (PPID). Objective: The goals of this study were to determine whether seasonal variation in plasma α-MSH and ACTH concentrations in horses is influenced by geographic location, breed, or PPID. Methods: Healthy light breed horses residing in Florida, Massachusetts, and Finland (n = 12 per group); healthy Morgan horses (n = 13); healthy ponies (n = 9) and horses with PPID (n = 8). Methods: Monthly plas...
The prevalence of endocrinopathic laminitis among horses presented for laminitis at a first-opinion/referral equine hospital. Endocrinopathic causes of laminitis may be a common underlying causative pathogenesis in first-opinion or field cases presenting with laminitis, as opposed to laminitis produced in inflammatory research models. This study aimed to determine whether evidence of an underlying endocrinopathy was present in horses presented for laminitis to a first-opinion/referral veterinary teaching hospital. A second aim was to compare the signalment of horses and ponies with laminitis with the equine hospital population during the same period. All horses presenting for laminitis at Helsinki University Equine T...
α-Melanocyte–stimulating hormone and adrenocorticotropin concentrations in response to thyrotropin-releasing hormone and comparison with adrenocorticotropin concentration after domperidone administration in healthy horses and horses with pituitary pars intermedia dysfunction. To compare endogenous ACTH and α-melanocyte-stimulating hormone (α-MSH) concentrations after administration of thyrotropin-releasing hormone (TRH) and to compare ACTH concentrations after TRH administration with those following domperidone administration in healthy horses and horses with pituitary pars intermedia dysfunction (PPID). Methods: Prospective case series. Methods: 69 clinically normal horses and 47 horses with or suspected to have PPID. Methods: ACTH concentrations were measured during 108 TRH stimulation tests in 88 horses, and α-MSH concentrations were measured during 56 TRH st...
Seasonal changes in plasma adrenocorticotropic hormone and α-melanocyte-stimulating hormone in response to thyrotropin-releasing hormone in normal, aged horses. Results of diagnostic tests for equine pituitary pars intermedia dysfunction (PPID), including endogenous ACTH concentration and the overnight dexamethasone suppression test (DST), are affected by season. New and potentially more sensitive diagnostic tests for equine PPID, such as thyrotropin-releasing hormone (TRH)-stimulated ACTH response, have been developed, but have had limited evaluation of seasonality. Objective: Our purpose was to evaluate seasonal changes in plasma ACTH and alpha-melanocyte-stimulating hormone (α-MSH) responses to TRH administration. Methods: Nine, healthy, aged hors...
Equine pituitary pars intermedia dysfunction. Equine pituitary pars intermedia dysfunction (PPID), also known as equine Cushing's syndrome, is a widely recognized disease of aged horses. Over the past two decades, the aged horse population has expanded significantly and in addition, client awareness of PPID has increased. As a result, there has been an increase in both diagnostic testing and treatment of the disease. This review focuses on the pathophysiology and clinical syndrome, as well as advances in diagnostic testing and treatment of PPID, with an emphasis on those findings that are new since the excellent comprehensive review by Sc...
Single-dose oral pharmacokinetics of pergolide mesylate in healthy adult mares. Pituitary pars intermedia dysfunction (PPID) is probably the most common disease of geriatric horses. Affected horses show a variety of clinical signs, including hirsutism, polyuria/polydipsia, immunosuppression, muscle wasting, and laminitis. The most common treatment for PPID is pergolide, a dopamine agonist; however, there are no pharmacokinetic data about the use of this drug in horses. This article describes a study designed to address this complete lack of pharmacokinetic information. The pharmacokinetics of pergolide are described in a small group of relatively young, healthy mares (n =...
Association of season and pasture grazing with blood hormone and metabolite concentrations in horses with presumed pituitary pars intermedia dysfunction. Pituitary pars intermedia dysfunction (PPID) is a risk factor for pasture-associated laminitis, which follows a seasonal pattern. Objective: Hormonal responses to season differ between PPID and unaffected horses. Methods: Seventeen horses aged 8-30 years (14 horses ≥ 20 years of age). Methods: Longitudinal observational study. Blood was collected monthly from August 2007 until July 2008 after pasture grazing and again after overnight stall confinement. Blood hormone and metabolite concentrations were measured and pasture grass samples were analyzed to determine carbohydrate content. Analysis...
The use of adrenocorticotrophic hormone as a potential biomarker of pituitary pars intermedia dysfunction in horses. Elevated concentrations of plasma adrenocorticotrophic hormone (ACTH) in horses with pituitary disturbances are often associated with dysfunction of the pituitary's pars intermedia. The majority of such animals exhibit an increased susceptibility to laminitis, particularly during the autumn. The 24h plasma ACTH profiles of horses with pituitary pars intermedia dysfunction (PPID), and those of matched controls, were determined in March, June, September and December. Differences in ACTH concentrations between the groups were significant (P<0.0001), regardless of photoperiod, and persisted thr...
The pharmacologic basis for the treatment of endocrinopathic laminitis. Although the treatment and management of laminitis in the horse requires a holistic and often multidisciplinary approach from the veterinarian, farrier, and nutritionist, this review focuses on pharmacologic interventions that might have prophylactic benefit, specifically in the horse with laminitis as a result of pituitary pars intermedia dysfunction and equine metabolic syndrome.
Gene expression of proteolytic systems and growth regulators of skeletal muscle in horses with myopathy associated with pituitary pars intermedia dysfunction. To investigate gene expression of the major proteolytic systems and growth regulators in skeletal muscle of horses with myopathy associated with pituitary pars intermedia dysfunction (PPID). Methods: 14 horses with PPID-associated myopathy and 7 healthy control horses. Methods: Horses with PPID and controls were age matched (15 to 28 years old). Muscle biopsy specimens were collected from both groups and processed for RNA and cDNA extraction. Validation of the most stable housekeeping genes for skeletal muscle was performed and used to compare gene expression of the following proteolytic syste...
Fecal egg counts after anthelmintic administration to aged horses and horses with pituitary pars intermedia dysfunction. To determine effects of pituitary pars intermedia dysfunction (Cushing's disease) and age on fecal egg count and time to egg reappearance after anthelmintic treatment in horses residing in similar environments. Methods: Cross-sectional study. Methods: 29 healthy horses (4 to 35 years old) and 13 horses with PPID (13 to 33 years old). Methods: Fecal egg counts were performed by use of a modified Wisconsin flotation method at 2-week intervals before and after ivermectin treatment. Results: Horses with PPID had higher fecal egg counts before and 8, 10, and 12 weeks after ivermectin treatment, com...
Pituitary pars intermedia dysfunction (Equine Cushing’s disease) in an onager (Equus hemionus onager). Pituitary pars intermedia dysfunction (PPID), also known as Equine Cushing's disease, is most often diagnosed in older horses and ponies. To the authors' knowledge, there have been no reports of its diagnosis in captive nondomestic equids. A 13-yr old onager (Equus hemionus onager) at the Zoological Society of London (ZSL) Whipsnade Zoo showed clinical signs suggestive of PPID, including hirsutism, fat redistribution, weight loss, laminitis, and chronic infections. A dexamethasone suppression test was performed to confirm PPID. Subsequently, adenomatous hyperplasia and microadenoma of the pars...
Medical implications of obesity in horses–lessons for human obesity. There is growing recognition that obesity is common and represents a significant detriment to the health of companion animals in a manner similar to that by which it is affecting the human population. As is the case for other species, obesity appears to promote insulin resistance in horses and it is through this pathophysiological process that many of the adverse medical consequences of obesity are being characterized. Equine medical conditions that have been described in the context of obesity and insulin resistance differ from those in humans. Chronic human conditions that have been attribut...
Evaluation of plasma ACTH, alpha-melanocyte-stimulating hormone, and insulin concentrations during various photoperiods in clinically normal horses and ponies and those with pituitary pars intermedia dysfunction. To measure plasma ACTH, alpha-melanocyte-stimulating hormone (aloha-MSH), and insulin concentrations during various photoperiods between February and October in horses and ponies with and without pituitary pars intermedia dysfunction (PPID). Methods: Cohort study. Methods: 13 clinically normal (control) ponies, 14 clinically normal (control) horses, 7 ponies with PPID, and 8 horses with PPID. Methods: Blood samples were collected from February through October during 8 photoperiods: 1, February 13 through March 2; 2, April 4 through 6; 3, June 19 through 22; 4, August 6 through 7; 5, August 14 ...
Stability of pergolide mesylate oral liquid at room temerature. Pergolide mesylate (proprietary name Permax) is used to treat equine Cushing's syndrome. Since pergolide mesylate has been removed from the market, the tablets are no longer available. Therefore, pergolide mesylate preparations have to be compounded for veterinary use. Compounded oral liquid formulations have been given arbitrary beyond-use dates of 14 days (aqueous) to 90 days (oil based). The goal of this study was to determine the stability of a 0.2 mg/mL pergolide oral liquid prepared according to a previousy published formulation and stored at room temperature. The sample preparation and ...
