How accurate is blood testing for PPID?

3/9/2021

Meyer JC, Hunyadi LM, Ordóñez-Mena JM
The accuracy of ACTH as a biomarker for Pituitary Pars Intermedia Dysfunction in horses: A systematic review and meta-analysis
Equine Vet J. 2021 Aug 24. doi: 10.1111/evj.13500. Epub ahead of print. PMID: 34428330
Conclusions: !"In horses with a high pre-test probability of PPID, ACTH may be a functional "rule-in" test. Baseline ACTH is not recommended for screening purposes or use in horses without clinical signs of PPID."
See also A Systematic Review and Meta-analysis on the diagnosic accuracy of baseline ACTH for the diagnosis of PPID in adult horses and ponies by James Meyer 4th Global Equine Endocrine Symposium 2020 p8
Conclusions: "The overall results and those in the reference standard subgroup of histopathology suggest that the specificity of baseline ACTH for the diagnosis of PPID is good while the sensitivity is marginal (lower CI 57%). This would corroborate the current recommendation that baseline ACTH be used as a triage test for PPID with further diagnostics being recommended in patients that test negative."

Vivian Sherman

9/2/2023 02:01:51 pm

My 25 year old Paso was diagnosed with boarder line Cushings, 3-11-15,
He has clinical signs of Insulin Resistance which are the same as Cushings as far as the fatty deposits.He gets a long winter coat here in Michigan, but sheds it out starting in February and always has. He only foundered once in 2018, when he and my mini got into the hay chaff. Since then he has never had signs of laminitis. In August of last year, he was tested by my vet, ACTH, test, which came back at 66 and he was positive for IR.
He was on Prascend from then until December 1st. He was lethargic and just not himself. He was off it for two months. I started him on herbs and he is doing well. I just had him tested February 3. His ACTH, this time came back at 42. My question to you is,, is 42 still too high for this time of year here in Michigan?

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