Equine pituitary pars intermedia dysfunction: current perspectives on diagnosis and management

Caroline W Spelta Townsville Vet Clinic, Townsville, QLD, Australia Abstract: Equine pituitary pars intermedia dysfunction (PPID) is a neurodegenerative disease of the hypothalamus, resulting in the loss of dopaminergic inhibition of pars intermedia. An oxidative stress injury of unknown etiology h...

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Autor principal:	Spelta CW
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2015
Materias:	Veterinary medicine SF600-1100
Acceso en línea:	https://doaj.org/article/6358a3a8048f4b6db40fd7826325dd82
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spelling	oai:doaj.org-article:6358a3a8048f4b6db40fd7826325dd822021-12-02T02:34:05ZEquine pituitary pars intermedia dysfunction: current perspectives on diagnosis and management2230-2034https://doaj.org/article/6358a3a8048f4b6db40fd7826325dd822015-08-01T00:00:00Zhttp://www.dovepress.com/equine-pituitary-pars-intermedia-dysfunction-current-perspectives-on-d-peer-reviewed-article-VMRRhttps://doaj.org/toc/2230-2034Caroline W Spelta Townsville Vet Clinic, Townsville, QLD, Australia Abstract: Equine pituitary pars intermedia dysfunction (PPID) is a neurodegenerative disease of the hypothalamus, resulting in the loss of dopaminergic inhibition of pars intermedia. An oxidative stress injury of unknown etiology has been suggested to initiate the neurodegeneration. While hypertrichosis (formerly known as hirsutism) is considered pathognomic for advanced disease, the antemortem diagnosis of subclinical and early disease has continued to prove difficult. Numerous tests have been used with varying sensitivities and specificities. The overnight dexamethasone suppression test, originally documented to have 100% sensitivity and specificity in horses with advanced disease, has proven to be less valuable in identifying early disease. Basal plasma adrenocorticotropin concentrations have improved sensitivity and specificity when sampled during the autumn months, and α-melanocyte-stimulating hormone, while not yet commercially available, shows promise as a sensitive and specific single sample test. Recent advances in our knowledge include the strong association between laminitis and hyperinsulinemia, both common clinical signs associated with PPID. The pathogenesis of hyperinsulinemia, laminitis, and their association with this disease is a focus of current research. The dopamine agonist pergolide mesylate is still the mainstay of medical management, with studies on oral bioavailability, pharmacokinetics, and long-term survival rates now published. Keywords: PPID, ACTH, α-MSH, laminitis, pergolide, hypertrichosis, pars pituitary intermedia dysfunctionSpelta CWDove Medical PressarticleVeterinary medicineSF600-1100ENVeterinary Medicine: Research and Reports, Vol 2015, Iss default, Pp 293-300 (2015)
institution	DOAJ
collection	DOAJ
language	EN
topic	Veterinary medicine SF600-1100
spellingShingle	Veterinary medicine SF600-1100 Spelta CW Equine pituitary pars intermedia dysfunction: current perspectives on diagnosis and management
description	Caroline W Spelta Townsville Vet Clinic, Townsville, QLD, Australia Abstract: Equine pituitary pars intermedia dysfunction (PPID) is a neurodegenerative disease of the hypothalamus, resulting in the loss of dopaminergic inhibition of pars intermedia. An oxidative stress injury of unknown etiology has been suggested to initiate the neurodegeneration. While hypertrichosis (formerly known as hirsutism) is considered pathognomic for advanced disease, the antemortem diagnosis of subclinical and early disease has continued to prove difficult. Numerous tests have been used with varying sensitivities and specificities. The overnight dexamethasone suppression test, originally documented to have 100% sensitivity and specificity in horses with advanced disease, has proven to be less valuable in identifying early disease. Basal plasma adrenocorticotropin concentrations have improved sensitivity and specificity when sampled during the autumn months, and α-melanocyte-stimulating hormone, while not yet commercially available, shows promise as a sensitive and specific single sample test. Recent advances in our knowledge include the strong association between laminitis and hyperinsulinemia, both common clinical signs associated with PPID. The pathogenesis of hyperinsulinemia, laminitis, and their association with this disease is a focus of current research. The dopamine agonist pergolide mesylate is still the mainstay of medical management, with studies on oral bioavailability, pharmacokinetics, and long-term survival rates now published. Keywords: PPID, ACTH, α-MSH, laminitis, pergolide, hypertrichosis, pars pituitary intermedia dysfunction
format	article
author	Spelta CW
author_facet	Spelta CW
author_sort	Spelta CW
title	Equine pituitary pars intermedia dysfunction: current perspectives on diagnosis and management
title_short	Equine pituitary pars intermedia dysfunction: current perspectives on diagnosis and management
title_full	Equine pituitary pars intermedia dysfunction: current perspectives on diagnosis and management
title_fullStr	Equine pituitary pars intermedia dysfunction: current perspectives on diagnosis and management
title_full_unstemmed	Equine pituitary pars intermedia dysfunction: current perspectives on diagnosis and management
title_sort	equine pituitary pars intermedia dysfunction: current perspectives on diagnosis and management
publisher	Dove Medical Press
publishDate	2015
url	https://doaj.org/article/6358a3a8048f4b6db40fd7826325dd82
work_keys_str_mv	AT speltacw equinepituitaryparsintermediadysfunctioncurrentperspectivesondiagnosisandmanagement
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Equine pituitary pars intermedia dysfunction: current perspectives on diagnosis and management

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