"Many cases do fine with management changes alone," said Harold Schott, DVM, PhD, Dipl. ACVIM, professor of large animal clinical sciences at Michigan State University, at the 2006 AAEP Convention. "This might include body clipping, regular hoof care, nutrition changes (such as reducing sugars and other rich carbohydrates), and good dental care to ensure proper eating for these older horses.

"Whether a horse needs medication and when that should be started is decided on an individual basis," he added. "When a horse is put on medications, I recommend twice-annual reassessment–clinical examination and glucose/endocrine (hormone) testing. If needed, we adjust medication dosing, then retest the horse in 30-60 days to make sure his (hormone) responses are in the appropriate range."

There’s also the issue of the horse that is a possible PPID case, but it’s between August and November, so testing is of little value (seasonal changes can alter test results). In these cases, "if the owner can afford it, we might treat the horse for a few months just in case, then try to take him off medications and test to see if it’s truly warranted," Schott commented.

For confirmed cases, "Is continuous treatment required?" he asked. "We don’t really know. Epidemiological studies are hard enough, let alone following horses for 10 years (for the research needed to answer this question)