PPID, ID, or Both? Diagnosing Equine Endocrine Disorders

 

While pituitary pars intermedia dysfunction (PPID, formerly known as equine Cushing’s disease) and insulin dysregulation (ID, similar to human prediabetes) are two separate equine endocrine disorders, researchers estimate a 30% average comorbidity rate, meaning horses have both. Erica Macon, MS, PAS, PhD, assistant professor of equine science at Texas A&M University, in College Station, outlined the process of testing a horse for both conditions at the 2024 American Association of Equine Practitioners Convention, held Dec. 7-11, in Orlando, Florida.

What Do PPID and ID Look Like?

The phenotypes, or observable characteristics, of PPID and ID are distinct from one another, Macon said:

• For PPID, veterinarians and horse owners most often notice muscle atrophy (wasting), hypertrichosis (a long, curly coat), patchy shedding, and retained hairs.
• As for ID, they are more likely to note generalized obesity, regional fat deposits (i.e., cresty neck), and chronic or subclinical laminitis as visible—but not pathognomonic (exclusive)—indicators of the condition.

“Appearances can be deceiving, as both lean and fat horses can have neither, either, or both conditions,” Macon explained. “I have seen a morbidly obese—body condition score 9/9 on the Henneke scale—horse with regional fat deposits with insulin levels in the healthy range.” While PPID mainly affects horses 15 or older, the younger equine population is not immune. As for ID, horses of any age, sex, or breed can be affected, although overweight horses and certain breeds (such as Warmbloods and pony breeds) are predisposed.

Equine Endocrine Disorders: Diagnostic Testing for ID in Horses

Macon cautioned horse owners and practitioners against relying on resting insulin levels to diagnose ID because this number can fluctuate based on feeding status (such as a recent grain meal) and seasonality. Additionally, some ID-affected horses have normal resting insulin concentrations, creating a false negative result.

Experts now agree the oral sugar test (OST) is a better alternative. Macon reviewed the proper steps to perform this diagnostic screening:

1. Withhold grain for five to six hours before testing.
2. Administer a 0.15 mL/kg body weight dose of corn syrup (e.g., Karo syrup), which is very rich in sugar. Include an extra 5 mL to account for spillage.
3. Draw blood (in a ethylenediaminetetraacetic acid, EDTA tube, which prevents clotting and preserves cells) 60 minutes after administration.
4. Check results. Blood insulin levels over 45 µIU/mL indicate ID.

Equine Endocrine Disorders: Diagnostic Testing for PPID in Horses

Veterinarians have long considered measuring resting ACTH levels the standard for diagnosing PPID in horses. Because stress, geographical region, and seasonal variations can skew results, practitioners have instead turned to the thyrotropin-releasing hormone (TRH, also called thyroid-releasing hormone) stimulation test, which Macon detailed:

1. Draw blood in an EDTA blood tube.
2. Inject TRH. The dose will depend on body weight. Equids weighing less than 250 kg should receive 0.5 mg TRH, and those weighing more than 250 kg should receive 1.0 mg TRH.
3. After TRH administration wait 10 minutes and take another blood sample.
4. Check results: 100-200npicograms/mL is suspect, and over 200 pg/mL is likely indicative of PPID.

Comorbidities: ID and PPID in Horses

When veterinarians suspect a horse might have both PPID and ID, the tests remain the same as they would for diagnosing either disorder separately. If testing for both endocrine diseases on the same day, Macon suggests performing the TRH test first, followed by the OST. Conducting the OST before the TRH stimulation test could result in a false positive.

Take-Home Message

Diagnosing equine endocrine disorders involves carefully evaluating clinical signs, following test protocols, and considering confounding factors. “Each endocrine case will present and react differently,” Macon said. By keeping these guidelines in mind, veterinarians can accurately diagnose and manage PPID or ID—or both—in their equine patients.

ARE YOU ASKING THESE QUESTIONS ABOUT SELLING YOUR HOME?

 Some homeowners hesitate to sell because they’ve got unanswered questions that hold them back. But a lot of times their concerns are based on misconceptions, not facts. And if they’d just talk to an agent about it, they’d see these doubts aren’t necessarily a hurdle at all.

If uncertainty is keeping you from making a move, it’s time to get the real answers. The ones you deserve. And to take the pressure off, you don’t have to ask the questions, because here’s the data that answers them.

1. Is It Even a Good Idea To Move Right Now? 

If you own a home already, you may be tempted to wait because you don’t want to sell and take on a higher mortgage rate on your next house. But your move may be a lot more feasible than you think, and that’s because of how much your house has likely grown in value.

Think about it. Do you know anyone in your neighborhood who’s sold their house recently? If so, did you hear what it sold for? With how much home values have gone up in recent years, the number may surprise you. According to Lawrence Yun, Chief Economist at the National Association of Realtors (NAR), the typical homeowner has gained $147,000 in housing wealth in the last five years alone.

That’s significant – and when you sell, that can give you what you need to fund your next move.

2. Will I Be Able To Find a Home I Like? 

If this is on your mind, it’s probably because you remember just how hard it was to find a home over the past few years. But in today’s market, it isn’t as challenging.

Data from Realtor.com shows how much inventory has increased – it's up nearly 25% compared to this time last year (see graph below): 

Even though inventory is still below more normal pre-pandemic levels, it’s improved a lot in the past year. And the best part is, experts say it’ll grow another 10 to 15% this year. That means you have more options for your move – and the best chance in years to find a home you love.

3. Are Buyers Still Buying?

And last, if you’re worried no one’s buying with rates and prices where they are right now, here’s some perspective that can help. While there weren’t as many home sales last year as there’d be in a normal market, roughly 4.24 million homes still sold (not including new construction), according to the National Association of Realtors (NAR). And the expectation is that number will rise in 2025. But even if we only match how many homes sold last year, here’s what that looks like.

• 4.24 million homes ÷ 365 days in a year = 11,616 homes sell each day
• 11,616 homes ÷ 24 hours in a day = 484 homes sell per hour
• 484 homes ÷ 60 minutes = 8 homes sell every minute

Think about that. Just in the time it took you to read this, 8 homes sold. Let this reassure you – the market isn’t at a standstill. Every day, thousands of people buy, and they're looking for homes like yours.

Bottom Line

When you’re ready to walk through what’s on your mind, the Rural KC Team has the answers you need. And in the meantime, tell me: what’s holding you back from making your move?

WHY MORE PEOPLE ARE BUYING MULT-GENERATIONAL HOMES TODAY

 

Today, 17% of homebuyers are choosing multi-generational homes — that’s when you buy a house with your parents, adult children, or even distant relatives. What makes that noteworthy is that 17% is actually the highest level ever recorded by the National Association of Realtors (NAR). But what’s driving the recent rise in multi-generational living?

Top Benefits of Choosing a Multi-Generational Home

In the past, homebuyers often opted for multi-generational homes to make it easier to care for their parents. And while that’s still a key reason, it’s not the only one. Right now, there’s another powerful motivator: affordability.

According to the latest data from NAR, cost savings are the main reason more people are choosing to live with family today.

The rising cost of homeownership is making it harder for many people to afford a home on their own. This has led to more families pooling their resources to make buying a home possible.

By combining incomes and sharing expenses like the mortgage, utility bills, and more, multi-generational living offers a way to overcome financial challenges that might otherwise put homeownership out of reach. As Rick Sharga, Founder and CEO at CJ Patrick Company, explains:

“There are a few ways to improve affordability, at least marginally. . . purchase a property with a family member — there are a growing number of multi-generational households across the country today, and affordability is one of the reasons for this.”

You may even find it helps you afford a bigger home than you would have been able to on your own. So, if you need more room, but can’t afford it with today’s rates and prices, this could be an option to still get the space you need.

On top of the financial benefits, it could also bring your family closer together and strengthen your bonds by getting more quality time together.

Bottom Line

Multi-generational homes or properties are a great choice for rural homebuyers, particularly for those intending to establish a hobby farm or raise livestock. If you’re considering a move, buying a multi-generational home might be worth exploring – especially if your budget is stretched too thin on your own. Multi-generational homes/properties make so much sense for rural home buyers.  

Let’s discuss your needs and find a home that fits your family’s unique situation.