Cushings and Lethargy - will prascend get his mojo back?

seoirse

seoirse

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Hi,
I'm struggling with my recently diagnosed cushingoid horses energy levels and would be interested to hear from other people with horses with cushings about lethargy.

Last summer my horse was on top form, jumping double clears at shows and charging round our cross country course. August he started to slow down a bit and developed a cough, Sept he was really starting to get lethargic so we tested for cushings, his levels were 192. I was stunned. He'd gone from fab form to hardly able to trot a circle in the school in just a few weeks. We started him on prascend and antibiotics for the cough, sadly he suffered an episode of colic 3 weeks in so we had to temporarily stop the prascend, though the vet is fairly sure it didn't cause the colic, though I'm not convinced but anyway...

So he had 3 weeks of prascend, then 2 weeks off it, and now we've just started it for the second time, we're only onto day 4 though. He is incredibly lethargic when ridden, though he seems bright in himself and his appetite is good. I'm bringing him in at night simply so he can have a good rest in a cosy stable because he has so little energy, though he usually lives out.

I've been reading on the prascend website and cushings obviously can cause lethargy and has in this case, it says going onto prascend can cause temporary lethargy, and too high a dose of prascend (we are on 1 pill a day) can also cause lethargy! :eek:

Has anyone managed to get their horses mojo back with prascend? Right now I'm going to have to consider retiring him if things don't improve as he is so flat. He's only 15.
 
my horse is on a prascend trial. He is 14. He had 2 negative tests but I didn't believe them. He lost muscle along his back and he was too quiet.
I put him on vitex agnus castus at the begining of October and a week later decided to add prascend to see if there was a difference.
I started at a quarter of a tablet (500kg) for 6 days, moved up to a half for another 3 days, up to three quarters and after about 2 weeks working up to it he was finally on 1 per day. I felt a very slight setback when he got onto the 1 per day for a couple of days when he just didn't really want to go for a walk.
He has now been on 1 per day for about 2 weeks. He was a nightmare to keep weight on before and was eating a whole bale of hay per day and still looked thin. (he tested negative for EMS)
He is now on half the quantity of hay and I am starting to think about weightwatchers. He has cheered up a lot and is now back to being a naughtly little pony (haflinger)

mine was just an educated guess at cushings but you have a reasonably definitive test reading and a horse that started getting lethargic when the levels were rising in September. Are you able to just give him a couple of months off to let him sort himself out?

if you are only on day 4 perhaps you could consider cutting the dose down and working up more gradually. My vet said just start him on one a day but I had read a lot about the "pergolide veil" and decided to go very very slowly. I didn't ride mine at all whilst I was getting him onto prascend. I led him in hand for a daily walk and I am only now thinking about getting back on for short distances.
 
It's funny how the test results don't always reflect whats happening to the horse? I've heard of other people who's horses had normal levels but obvious symptoms so they started prascend and had good results. My horses results were clear, but his symptoms were, compared to some others with similar levels not very advanced. He has the fat eye pads, which developed in a matter of weeks, in August he didn't have them at all, he still had hollows over his eyes, but within 5 weeks they had sprung up. I'm a tiny bit worried his cushings it aggresive and advancing really fast but I just need to try and be patient and give the prascend a chance. I read about the 'veil' too but my vet was adamant that I should go straight in with 1mg a day and then only reduce if he didn't tolerate it as she said only some of them struggle. Other than lethargy, which mine had before the prascend anyway, he hasn't shown any of the other veil symptoms and is eating fine, though is is now ultra suspicious of apples so I've had to change to hiding the pill in carrots! Really glad to hear yours is slowly improving though, thanks for reassuring me. I just need to try and be patient and give it a bit of time I think but I need a bit of hand holding while we go through this! :D
 
My horse has just been tested with a count of 67. No obvious signs, (he is 19 years old retired 17.2hh sport horse). He did have an unexplained temperature and 2 septic feet back in August.

He had 7 days on half a pill, followed by 5 days on one pill. He lost his appetite and seemed rather 'distant' in himself. He can't afford to drop much weight so pills were stopped. Just started back on half a pill again and he is eating well and looks OK.
 
a slice of buttered bread made into a sandwich works with mine. He never notices the pill. Mind you I think his brains are in his stomach. :D
 
It took about 5 weeks for the prascend to kick in and get my mare back to her very lively self, her levels were 172 ... she is currently feeling extremely well and i hope i can keep her like that..unfortunately we had to keep upping the prascend and she is on 2 1/2 daily, so pretty expensive...still she seems happy:D
 
Thanks everyone. I think its just all getting to me a bit and I'm in need of some reassurance. Just heard from my friend who brought him in for me tonight that he was a prat to come in and was prancing and squealing, so to me thats good news!!! I've just really got my hopes pinned on this prascend working, he's my dream horse and I've only had him a year and so this has all come as a bit of an unpleasant surprise. If he gets even 50% of his old sparkle back then I'll be happy, but bottom line is, I want him to be happy and he's so up and down at the moment.
It's good to talk to other people with cushings horse though. I know every case is different, but it's just good to know I'm not alone with it!
Many thanks.
Gin and tonics (with lime!) all round. :D
 
splashgirl45 said:
It took about 5 weeks for the prascend to kick in and get my mare back to her very lively self, her levels were 172 ... she is currently feeling extremely well and i hope i can keep her like that..unfortunately we had to keep upping the prascend and she is on 2 1/2 daily, so pretty expensive...still she seems happy:D
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Really good to hear of one getting back to her lively self! Long may it continue. x
 
I'm sure you've read up all you can on Cushings so apologies if you know all this but I thought it might be helpful. Cushings is caused by a tumour on the pituitary gland in the brain that then stimulates the horse's body to produce 24/7 cortisol which is the fight or flight hormone. I can't imagine what it must feel like to live permanently as if there's an axe murderer in an upstairs room in your house, because that's what 24/7 cortisol will feel like to the horse! So what happens is that the body starts to redirect all its energies to being ready to flee and the "normal" stuff gets forgotten - stuff like cuts healing, infestations getting cleared up, heart and lungs working properly, body temperature normal, mind focussed and active etc etc etc. My veteran was displaying such weird symptoms that I was questionning his quality of life. He had weight loss, lethargy, unable to control body temperature, truly awful sweating that smelt bad enough to make you gag, confusion, mild ataxia, forgetting where he lived, loss of appetite, depression... Thank god I had his ACTH levels tested and he came back at 200! You need to persevere with the prascend rather than take him off and on. Also, get him retested after about a month on the dosage level you and your vet think is right. My lad was started on 1 pergolide but it was upped to 2 per day very rapidly and he's now the high end of normal at that dosage. You may have to tinker with it in the spring and autumn as the normal ACTH level changes at those times. Take great care to watch for laminitis which can go hand in glove with cushings.

And finally, remember that pergolide/prascend counteracts the cortisol, it doesn't cure the pituitary tumour so there will come a time, hopefully many years ahead, when prascend will not be able to help your boy.
 
Thanks box of frogs.

He seemed bright going out this morning and his appetite, while a bit weird in that he won't eat the things he normally does, is certainly no less and he is eating both bucket feeds and all his hay, as well as half his blimming bed as well.

I think I might leave him out this week, though I am scared at the prospect! I know I shouldn't be. He wintered out last winter, and this year as yet has not been clipped (he's not got the crazy cushings coat yet!), he has a field shelter, and plenty to eat, so there is no reason why he can't be out and he's only been in for 2 weeks since his colic episode. The vet wants him out because of his breathing but I think I'm just treating him like glass a bit at the moment and liking having him in. I need to toughen up a bit. He will be fine out and it will be better for his airways anyway.
 
cheer up Seoirse, I am now about 2.5 weeks on a full tablet. I have done tiny rides the last couple of days with a lot of leading but today I did a full hour. Only road walking but a lot more bounce and he gave the impression of wanting to trot but I woudn't let him.
Still very early days but it was really nice to ride him for the first time for ages even only at a walk and have him wanting to go. Before I had just about been carrying him.
 
paddy555 said:
cheer up Seoirse, I am now about 2.5 weeks on a full tablet. I have done tiny rides the last couple of days with a lot of leading but today I did a full hour. Only road walking but a lot more bounce and he gave the impression of wanting to trot but I woudn't let him.
Still very early days but it was really nice to ride him for the first time for ages even only at a walk and have him wanting to go. Before I had just about been carrying him.
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oh this is great news, well done, and only 2.5 weeks in as well, thats good, how old is your horse? Really pleased for you and hope the improvement continues and he/she gets all the old sparkle back. I left mine out last night and surprise surprise he didn't dissolve! I'm going to give him until the weekend then get back on and see if there is any improvement though he was larking about in the field last night when I went out with his food which was nice to see. :p
 
seoirse said:
oh this is great news, well done, and only 2.5 weeks in as well, thats good, how old is your horse? Really pleased for you and hope the improvement continues and he/she gets all the old sparkle back. I left mine out last night and surprise surprise he didn't dissolve! I'm going to give him until the weekend then get back on and see if there is any improvement though he was larking about in the field last night when I went out with his food which was nice to see. :p
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mine is only 14. Hope you have success with yours.
 
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