PPID in older horses – is it actually normal?

decision to treat is best made following advice from your veterinary surgeon who knows your horse and their management. If the horse has experienced even a single episode of laminitis then medical treatment is advisable in addition to management to reduce the risk of further incidents.
The downside of treatment is mainly financial
Some horses will show a transient anorexia when on pergolide but this often resolves if the drug is stopped and restarted at a lower dose before increasing the dose slowly. Long term treatment is generally well tolerated without serious side effects.
If you are concerned that your horse may have PPID or would benefit from testing please speak to your veterinary surgeon who will be best placed to advise you on your individual situation.