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When it comes to treating PPID, the earlier the better. Although some early signs can be managed (eg, extra clipping and grooming will control hirsutism), a case can be made in support of starting medical treatment when clinical signs are initially recognized.1 Early treatment can minimize progression of PPID and prolong the life of the older horse.1 When caught early, PPID treatment is very successful in reducing common signs and allowing affected horses to live normal lives.3 Even when a horse has advanced disease, treatment usually gives him a longer, healthier life.3 Some owners even report that their horses act 10 years younger after starting treatment with pergolide. Until PRASCEND became available, there's been no drug specifically approved by the FDA for treating horses with PPID. So, for the past few years, compounded pergolide mesylate has been the only product available for veterinarians to treat PPID in horses.4,5 Unfortunately, many compounded pergolide mesylate formulations, created from a bulk active ingredient, have been shown to be inconsistent in strength and stability, making it challenging to dose correctly.