Management of pituitary pars intermedia dysfunction in practice: A clinical audit

Area of Science:

• Equine Medicine
• Veterinary Endocrinology
• Clinical Audit

Background:

• Pituitary pars intermedia dysfunction (PPID) is a common endocrine disorder in equids.
• Pergolide mesylate is the recommended treatment for PPID, requiring regular monitoring.
• Adherence to treatment and monitoring guidelines in private veterinary practice is not well-documented.

Purpose of the Study:

• To compare the treatment and monitoring of PPID cases in a UK veterinary practice against current recommendations.
• To assess the adherence to pergolide mesylate treatment protocols and follow-up monitoring strategies.

Main Methods:

• A clinical audit of PPID cases diagnosed between 2012 and 2016 at a single UK veterinary practice.
• Review of case records, including basal plasma adrenocorticotropic hormone (ACTH) concentrations.
• Comparison of initiated treatments and monitoring frequency with published guidelines over 2-6 years.

Main Results:

• Of 480 audited equids, 51.7% tested positive for PPID based on ACTH levels.
• Pergolide treatment was initiated in 78.7% of positive cases, but only 77.7% of treated animals had documented monitoring.
• Follow-up ACTH testing within 1-3 months occurred in only 48.1% of monitored cases, indicating suboptimal management.

Conclusions:

• Management of PPID in the audited veterinary practice did not consistently meet recommended treatment and monitoring standards.
• There is a significant gap in the consistent monitoring of PPID cases, particularly regarding timely ACTH re-testing.
• Findings highlight the need for improved adherence to established guidelines for effective PPID management in equine practice.