Horses with PPID might have more medical events but have a similar lifespan to those without PPID. | iStockPituitary pars intermedia dysfunction (PPID, formerly known as equine Cushings disease) is one of the most common endocrine diseases in older horses, affecting an estimated 20% of horses over the age of 15. But despite its prevalence, many owners still wonder what a diagnosis means for their horses long-term health and longevity. Researchers recently reviewed nearly three decades of medical records from the Purdue University Equine Field Service, in Lafayette, Indiana, to compare 132 horses diagnosed with PPID with 274 age- and breed-matched controls. Their goal was to understand whether horses with PPID develop different medical problems or have shorter lifespans than horses without the condition.Our goal was to gain a better understanding of the overall clinical picture of PPID in primary care practice, said Emma Stapley, DVM, Dipl. ACVIM, of Purdues College of Veterinary Medicine. After a diagnosis of PPID, what should owners and veterinarians expect in terms of medical needs and overall life expectancy?Medical Events in PPID HorsesOverall, the researchers found horses with PPID experienced more total medical events during their lifetimes than horses without the condition. However, these horses were not euthanized at a younger age. In fact, median euthanasia age was similar between groups26 years old for horses with PPID and 24 for controls.Reasons for euthanasia were also similar between the two groups, with colic, quality-of-life concerns, and being unable to rise among the most common factors. Only a small percentage of horses were euthanized primarily due to PPID.Dental Problems in PPID HorsesAnother notable finding, says Stapley, involved dental health. Horses with PPID were more likely to have dental problems, including missing teeth or equine odontoclastic tooth resorption and hypercementosis (EOTRH). This condition occurs in older horses of at least 15 years of age. The condition develops when one or more teeth are resorbed and the body produces excess cementumthe hard, outer layer of the tooththat replaces the bulk of the normal, healthy tooth.In terms of unexpected outcomes, it was surprising that horses with PPID had more dental issues, said Stapley. A possible link between the two conditions could be quite exciting and opens up a lot of new research questions.The researchers also identified other factors associated with PPID, including hyperinsulinemia-associated laminitis, poor wound healing, and more frequent use of non-steroidal anti-inflammatory drugs (NSAIDs).Managing PPID HorsesWhile the results suggest many horses with PPID can live long lives, they also highlight the importance of comprehensive management. I would hope owners take away that PPID is absolutely worth treating, said Stapley. Horses can live as long and as happy of lives with PPID as without. However, she adds, owners should remain vigilant about potential health issues and maintain consistent, correct management practices, including appropriate diets, regular dental care, hoof care, and parasite control.For veterinarians, the study reinforces that managing PPID goes beyond prescribing medications, said Stapley. The researchers found horses with PPID and insulin dysregulation that develop laminitis were just as likely to experience repeat episodes as laminitic horses without PPID. This finding underscores the importance of diet, hoof care, and metabolic management.Future ResearchStapley and her colleagues are exploring future research directions where they will examine which factors, such as initial clinical signs, treatment approaches, or owner resources, might influence disease progression in horses with PPID.The team is also investigating the possible connection between PPID and dental disease by studying calcium metabolism in affected horses, said Stapley. For now, the researchers emphasize that with appropriate care and monitoring, many horses with PPID can continue to live long and comfortable lives.The study, Horses diagnosed with pituitary pars intermedia dysfunction do not have shorter life expectancies but experience more medical events during their lifetime, was published in the Journal of the American Veterinary Medical Association in March 2026. View this post on Instagram A post shared by The Horse (@thehorsemag)