Cushing’s Disease/ Pituitary Pars Intermedia Dysfunction (PPID) is considered a disease of ageing, where the control of several hormones, e.g. Adrenocorticotrophic hormone (ACTH), produced by the pituitary gland, is lost. This leads to excessive hormone secretion from a certain part of the gland (the pars intermedia, as in PPID), testing the levels of ACTH is one way of diagnosing PPID. Thirty-two percent of horses with PPID also have insulin resistance (IR), leaving them very vulnerable to developing laminitis. Although, the exact link between PPID and IR is not yet fully understood, but we do know that having both conditions will significantly increase the risk of laminitis.