Page 969 - The Veterinary Care of the Horse

MANAGEMENT

The following management changes can significantly improve the horse’s quality of life.
VetBooks.ir • Clipping the coat to reduce the sweating and aid thermoregulation.

•
Providing shelter once it has been clipped.
• Modifying the diet to reduce the occurrence of laminitis while maintaining adequate

protein and micronutrient (vitamin and mineral) levels. The diet should be based on
forage and fibre feeds, avoiding lush pasture and cereals high in starch and sugars.

• Regular worming, vaccination, dental checks and hoof care.

MEDICATION

Treatment is expensive and must be given for the rest of the horse’s life. There are four
different medications currently in use.

• Pergolide is licenced for use in horses and is the drug of choice.

• Bromocriptine.
• Trilostane.

• Cyproheptadine.

The response to treatment is monitored by repeat blood tests. When the clinical signs and

ACTH levels have improved, it is recommended that blood tests are repeated twice a year.

An improvement in the coat and a reduction in drinking and urination are usually seen within
3–6 weeks of starting medication. Treatment does not completely halt the progression of the

disease but it can lessen the clinical signs and improve the animal’s quality of life. Advanced
cases are less likely to respond to treatment. Some horses lose their appetite with pergolide;

in most cases this is temporary. It may be necessary to stop the medicine and then re-
introduce it gradually.

Clinical trials to assess the effects of plant extract of Vitex agnus castus (Chasteberry,
Monk’s Pepper) on horses and ponies with PPID have had disappointing results but seem to

help in individual cases.

Prognosis

The disease cannot be cured. It often develops slowly over a period of several years.

Treatment may extend or improve the horse’s quality of life but medication is expensive and
once started must be maintained. Many affected horses and ponies are able to live
comfortably with good management for several years. Ultimately, recurrent bouts of laminitis