Cushings and acth levels

MummyEms

MummyEms

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Has anyone had any experience of prascend not working for their pony?

Our 21 year old gelding has been on 1 whole tablet per day now for a year.

Recently showing signs of cushings again so vet took the bloods for him and his ACTH levels are still too high.

My children have nearly outgrown him and he would hate to be sold on or even loaned out. We wouldn't do it to him.

He looks typically Ppid now and does show signs of having had enough.

I don't want to keep giving him higher and higher doses of medication for selfish reasons. He's an experienced school master and has not only won everything for my daughters but also given them the time of their lives.a real pony of a lifetime for them both.

Has anyone put to sleep due to cushings?
 
Uncontrolled Cushing's, yes.

It's up to you, but my vets will recommend to going up to 2 Prascend tablets per day to control PPID. If ACTH levels are still too high on 2 tablets per day, and the horse isn't well, they reckon that something else is going on and it's time to call it day.
 
MummyEms said:
Has anyone had any experience of prascend not working for their pony?

Our 21 year old gelding has been on 1 whole tablet per day now for a year.

Recently showing signs of cushings again so vet took the bloods for him and his ACTH levels are still too high.

My children have nearly outgrown him and he would hate to be sold on or even loaned out. We wouldn't do it to him.

He looks typically Ppid now and does show signs of having had enough.

I don't want to keep giving him higher and higher doses of medication for selfish reasons. He's an experienced school master and has not only won everything for my daughters but also given them the time of their lives.a real pony of a lifetime for them both.

Has anyone put to sleep due to cushings?
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I know there is at least one person on the forum who did not PTS but wishes they had, as the end stage for their horse was very distressing to them all. If it is classic PPID, it is a tumour in and/or swelling of the pituitary gland, pressing on the brain and it can rupture.

There doesn't seem a huge reason not to give your much loved horse a peaceful and dignified end.
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I think your vet would suggest upping the dose by 1/2. That’s another 60p a day or £4.20 per week. Of course it’s up to you what you do going forward. There are worse things than a dignified end at home.

I have one that’s been on 2 tablets for around 3 years now and one just gone up to 1.5. It’s been worth the cost for them, but only because they are still enjoying life if symptoms are under control.
 
That is rather alarmist. Let's just shoot the horse as soon as the diagnosis is made and be done with it.

Cushing's can be well controlled in many, but not all, cases and give horses a pretty normal life. Many PPID horses go on to eventually die of unconnected issues.

It does need careful monitoring, though.

I've got one who has been on 1 tablet a day since she was unexpectedly diagnosed after a routine screening test age 11, she's now 17. She's been grand on it, has no symptoms on it and her ACTH levels are well within the normal range on her 6 monthly tests.
 
Tiddlypom said:
That is rather alarmist. Let's just shoot the horse as soon as the diagnosis is made and be done with it.

Cushing's can be well controlled in many, but not all, cases and give horses a pretty normal life. Many PPID horses go on to eventually die of unconnected issues.

It does need careful monitoring, though.
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That's very reactionary TP. The pony has already been on a Prascend a day for a year. There would be no shame in the OP giving him a dignified death now.
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If you have reasons for not wanting to increase prascend and your pony is beginning to struggle then there are worse things than having him to pts. Having said that I had an 11.2 pony who ended up on 3 tablets a day for several years to keep her Cushings under control, however when she developed laminitis while on that dose she was pts.
 
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I think you can increase the dose and see if it brings levels down they can more than 1 tablet a day.

My friend had an Arab that was on 1 tablet for about 3 years then suddenly the levels went high again and vet said to increase to 2 slowly he was fine for a while, then he went down with laminitis really quite badly he just kept lying down he was only 20, he was pts so prascend doesn't always work on some horses.
 
Tiddlypom said:
That is rather alarmist. Let's just shoot the horse as soon as the diagnosis is made and be done with it.

Cushing's can be well controlled in many, but not all, cases and give horses a pretty normal life. Many PPID horses go on to eventually die of unconnected issues.

It does need careful monitoring, though.

I've got one who has been on 1 tablet a day since she was unexpectedly diagnosed after a routine screening test age 11, she's now 17. She's been grand on it, has no symptoms on it and her ACTH levels are well within the normal range on her 6 monthly tests.
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I had one PTS because of cushings. He tested negative but had all the symptoms so we trialled prascend at age 12 it worked and he went on until 21 by which time he was on 2.5 per day. He had a great life all through that time. I would definitely do it again.

At age 21 I started to see his hind quarters "going" It was clear that his brain and hind end were not communicating well. That was obvious slowly over a few days, then one day I though if he went down in his stable he may not get up (or at least get up easily) called the vet,, he spent a lovely day in the paddock (heaven for an off grass cushings horse) He lay down and got up easily in the space outside. He was PTS that day at 6pm.
Nothing dramatic happened, horse not in stress or worry. Got the timing absolutely perfect and very pleased I continued to up the prascend to give him the maximum good time possible.
I think if you know your horse well you can time it's demise (from cushings) very carefully.
Bearing in mind of course that cushings management is very much more than prascend in potential lami horses.

I currently have a pony on a half tablet. She has been having that for nearly 11 years and is still doing great at 38. I am expecting to have to PTS idc due to lack of incisors or colic. Not convinced it will be the cushings.
MummyEms said:
Our 21 year old gelding has been on 1 whole tablet per day now for a year.

Recently showing signs of cushings again so vet took the bloods for him and his ACTH levels are still too high.



He looks typically Ppid now and does show signs of having had enough.

I don't want to keep giving him higher and higher doses of medication for selfish reasons.
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Not sure I get this. Surely clinical symptoms suggest the dose too low as do the ACTH levels. I am pretty sure my vet would recommend increasing the dose.
Not sure why a higher dose would be selfish. Surely it would be better for him. Why not increase the dose for a few months, see how you progress and possible TRH test to make sure the test results are as accurate as possible. Then you will be in a much better position to make a decision.
 
My 15.2 warm blood cross started on 1 tablet and over 5 years I had to increase it until she was on 4 daily. I used to get her tested twice a year but after a year on 4 tablets her levels were too high and she was beginning to get footy, I got the vet to look at her and she thought she was starting to get laminitis , my vet contacted Leahurst who said it wouldn’t help to increase the dose so I PTS. She was 25
 
I kept my cushings horse for 10 years on Prascend and it was very well controlled, no lami, normal ACTH levels etc. Then one day the tumour gave her stroke/ ataxia and it was probably one of the worst things I've ever seen.

So yes I would be wary if the symptoms can not he controlled or the levels lowered, it can be very distressing .
 
Selfish as in medicating him
shortstuff99 said:
I kept my cushings horse for 10 years on Prascend and it was very well controlled, no lami, normal ACTH levels etc. Then one day the tumour gave her stroke/ ataxia and it was probably one of the worst things I've ever seen.

This is what I fear the most. Him suddenly getting unwell in any way.
The prascend in itself already has side effects in him as he's less interested in his feed and does appear quite tired (lethargy).


So yes I would be wary if the symptoms can not he controlled or the levels lowered, it can be very distressing .
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MummyEms said:
He shows some of these signs even on 1 a day.
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MummyEms said:
He rarely finishes his feed etc and is very cross a lot of the time 😔
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I would not increase the Prascend under those circumstances if he were mine EM. If the vet can't suggest anything else that might help him, I would give him a dignified end.
 
Yes, we have had 2 pts because of Cushings. They had both been on Prascend, which wasn't working to control the symptoms, so we decided that as dignified as possible an ending was the best way forward. They were both highly valued horses who we had done a lot with and got a pleasure from over the years, they both deserved the best we could do for them.
 
He may be getting more cushings symptoms as mine was very depressed and was getting grumpy which was unusual and not really eating but when she was on prascend the depression disappeared and her appetite was back, and she went back to being her usual happy self. If you are not able to increase the dose due to side effects then the kindest thing would be to PTS, as others have said a frank discussion with your vet would be best.. I think I aged years while looking after my cushings mare, worrying about her quality of life all of the time..and quality of life is the most important thing when deciding these things..sorry you are having to go through this, we all understand and empathise
 
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