![woman with horse](/sites/default/files/images/06A_mavis-10588-960x500.jpg)
Diagnosis of PPID: More than a blood test.
Diagnosing PPID requires a combination of patient history, observation of clinical signs, and confirmation with laboratory test results.
![horse in stall](/sites/default/files/images/04B_vet-07842%283%29-resized-960x500.jpg)
1. Building a Patient History
In conversations with horse owners and trainers, listen for historical information and clinical signs associated with PPID, such as:
- Changes in attitude
- Lethargy
- Recurrent infections
![vet and horse](/sites/default/files/images/09B_vet_female-16733-960x500.jpg)
2. Perform a Physical Exam
Identify and confirm clinical signs consistent with PPID. Determine if clinical signs are early or advanced.
![test tubes](/sites/default/files/images/shutterstock_1080535673_edit_2.jpg)
3. Laboratory Confirmation
If a horse has a medical history and clinical signs consistent with PPID, at a minimum the following should be evaluated:
- ACTH
- insulin
- glucose