Cushings / Laminitis / Peroglide PLEASE please help

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aladdin

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Please please does anyone have experience of a horse with cushings and v bad laminitis, and how the laminitis was succesfully resolved, particularly if Peroglide was prescribed? My friend's warmblood is having alot of trouble, he still has laminitis now despite being off grass since mid Sept and having his feet seriously cut back during xray. He has definate pedal rotation. Bute is not helping much and he's not progressing. The vet is against prescribing Peroglide despite Cushings clearly being evident, saying that it won't help his feet? Poor handsome horse is running out of time to show improvement and is clearly in discomfort. My friend is obviously absolutely distraught and wants to be sure they have tried everything to help, but the longer it goes on the more discomfort the horse has to tolerate. Please does anyone have experience of Peroglide in this sort of situation? It would probably mean a change of vet to get it prescribed, and this guy is v v highly regarded, advice please?? Thanku+++
 
I am sorry your friend is having problems, but surely the attending vet is the best person to make clinical decisions about medication because he knows all the details. Although there is nothing to stop your friend getting a second opinion.

I have a friend who's horse got cushings aged only 9 years old. She was on pergolide and she still got laminitis and still had to be PTS as a result of the laminitis and they didn't take that decision lightly.

As far as I am aware Pergolide is not a miracle cure for laminitis. It is a treatment to help keep the effects of Cushings at bay, it is not a cure for Cushings either. My friends other pony has cushings and that is on pergolide too, it has had a couple of very mild laminitic attacks and when she asked the vet about increasing the dose they said there was no point, it won't make any difference to the liklihood of more attacks.
 
Hi, I am doing my research project on Cushing's disease in horses at hte moment.
I am confused as to why the vet won't prescribe pergolide as it is the best drug available at the moment, and helps many of the clinical symptoms resolve. If he is definetly against pergolide cyproheptadine is another drug, no where near as effective but ask been thought to help with the laminitis of cushings. Due to the pedal rotation I am afraid the horse will never be totally comfortable (I don;'t think) but maybe bute plus pergolide would make him more comfortable!

I would ask for a valid reason why the Pergolide is not prescribed, especially for a horse in such a situation, I would have thought that it would be the best thing available!

PM if you want to chat!

Hope this helps a bit
 
Vet is right, pergolide won't help his feet BUT it will help prevent the horse from getting laminitis in the first place! Sack the vet immediately, the horse is suffering needlessly. I have used trilostane as opposed to pergolide and had really good results.
 
just as extra points that i am sure she will have already tried, but altering feed as well is important for the laminitis. Removing sugary feeds, really low quality hay soaked, so any sugar is a minimum. The laminitis can occur due to gut problems and it releasing toxins into the system that degrade/damage the laminae in the hoof. Sugary feeds increase the bacterial growth in teh gut resulting in more toxins, so the less energy you provide them, the better!!!
I know he has had his feet cut back as you said, but has she altered the food aswell?

sorry if this is not much help
 
I look after a pony who got laminitis and over three months just kept getting worse. He went from tottery to lying down all the time and absolutely crippled, in spite of being on the standard box rest, bute and ACP since first having the attack. He only showed any improvement when he went on pergolide. It still took months for the feet to recover and for him to come sound, but the pergolide seemed to stop the laminitis attacking, so he could start to get better.

This pony actually tests negative for cushings but he is the typical grey welsh b mid-teens hairy fatty pony. There was never any bone rotation in his feet though, the damage was all laminal, it may be that the vet thinks this horse's foot x-rays show he is unlikely to recover even if they got the attack under control.

If the vet thinks that the horse's feet have not gone beyond repair please push to give the medication a go before it is too late.
 
If it is Cushing's, the pituitary dysfunction is triggering the onset/persistence of laminitis. I'm really loathe to question a vet but wonder why they are so against using Pergolide (trilostane etc.,) in this case.

The Pergolide to some extent and in some cases can reduce the problem-causing chemicals in the blood, then the laminitis itself can be tackled. I think eventually the Pergolide ceases to affect the pituitary sufficiently to keep the lamitis at bay, and then the laminitis 'gets' them
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It might be due to his size and pedal bone rotation that maybe your vet thinks you are there already. I would ask for a second opinion if you really think all avenues have not been explored, but it's a tricky one. Pergolide takes a while to kick in as well, so it's a race against time in that respect.

Good luck with this, and I can empathize as I think am almost exactly in this 'Cushing's beats you in the end' position
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Oh how awfull....I know exactly what your friend is going through. my Lacey was put to sleep 28 Sept due to Laminitis and Cushings.

As said Pergolide will not help now as the horse has laminitis, it prevents the onset of laminitis in the first instance.

Has your friend tried 'Imprint' shoes?

PM me if you like x
 
Just to add there that the pergolide will potentially help with the laminitis if it is Cushings induced which the OP believes it is. Cushingoid horses can recover from laminitis if they are treated appropriately, the textbook bute and acp/strict laminitis diet alone will not have any effect if the stimulus remains, and that seems to be what has happened here. Once my mare was on treatment she never went down with laminitis again and she had a great two years; grazing everyday. In the end it was her breathing that started to fail, and a general old age slowdown that happened over the course of 4 months.
Good luck Aladdin.
 
Bubbles is right, although the diet changes etc will all HELP! they won't solve the problem if it is due to the excessive hormone production, only the medication can do that!
and pergolide is the best going!

Keep your chin up Aladdin!
 
I had a pony with cushings and laminitis he was on pergolide. I would advise your friend to speak to professor eustace at the laminitis clinic he was wonderful with me and my pony. I know what your friend is going through and it is heartbreaking pm me if you want to good luck
 
<font color="blue"> the textbook bute and acp/strict laminitis diet alone will not have any effect if the stimulus remains, and that seems to be what has happened here </font>

Which is what I was trying to say! Get rid of/lessen the cause and you can treat the symptoms. Your headache won't be cured with aspirin while you are still banging you head on the wall!

Hope we are making some sense.
 
right does any one know if pergolide contains any forms of steriods..??

Have had a quick read up on it.. it looks to be a seriously harmfull drug which should be used as a pretty fair gone solution.

With respect to your vet, he is, at this moment in time more concerned about the acute effects of the laminitis as apposed to the chronic condition of the cushings.

Cushings in itsself does not help laminitis, with fast hoof growth rate and extra pressure on the laminae from this extorsionate rate of growth.

Lou x
 
All I know is that Pergolide is a dopamine and that without the use of it my boy would now be dead .... 3 years on and with the correct treatment of the Laminitis induced by Cushings I still have him with me .....

I would seek another Vet's advice as I was very lucky and mine got it spot on .... it took 5 months of box rest and my love and determination, together with the Vet and Farrier's advice to get there though
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It is a long and painful road, but I can tell you from the bottom of my heart that it was worth it
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My siggie proves it and that was 2 years on
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...he had 10 degrees of rotation of the Pedal Bone
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Ok pergolide is a dopamine agonist, it does the same job that dopamine would do on the pituitary gland. However with Cushing's dopamines inhibtory effect on the pars intermedia of the pituitary gland is reduced, hence the pars intermedia goes into overdrive and produces LOADS of hormones. By giving pergolide it continues the inhibitory effect and so normalises the hormone release.

This is why it is so useful to help reduce/minimise the symptoms. It does not contain any steroids, it is not a last straw to grasp, it should really be one of the first options.

If you give pergolide early enough in the disease it can seriously reduce the number of symptoms you can be exposing the horse to including hirsutism (which he already has, which pergolide will reduce), the extreme laminitis will be minimised, it will reduce his chances of getting secondary infections, improve his wound healing which will be reduced due to the disease, it can minimise muscle wasting/weight loss, can keep appetite, drinking and weeing normal!
I am not saying it is a miracle drug, it does not TREAT the disease. This disease is, at present, not treatable. but this drug allows control as best we can of the symptoms and the effects that htey have on the animal and can give it the best standard of life with the disease.

Hope this helps clear things up a bit?

side effects of pergolide can include anorexia and diarrhoea, but often the pergolide is given at a dose for about 3 days, removed for a day or two then given again at half the first dose and this generally minimises these effects!

Pergolide will no exacerbate the symptoms in any way! (or none has been documented to happen!)
 
Hi there
Im so sorry to hear your friend is going through such a terrible thing. I would ask for a second opinion or contact the Laminitis Clinic - they were helpful about my gelding.
good luck...
Cassandra
 
Hello - I was in a similar position with a big 16.3 hh irish gelding back in June 2004. He was suspect Cushings but as the laminitis attack occured in mid June it was treated for the first week as though diet induced. When he failed to respond the vet gave me the option of pts or pergolide. We chose the pergolide route and though it was a rocky road for him in the initial first few months and there were times we thought he was slipping beyond reach he did turn around but it took a good 6 weeks and ironically the major improvement came after he was booked in to be pts for another problem and turned out into a small pen for a last day of freedom ! He had a reprieve and four years on is still here . I found pergolide, a good farrier and strict management to be the key steps. I can send you a potted history by pm if it helps.
 
Hello,

Well my 32year old pony was diagnosed with Cushings 5yrs ago.
The farrier notices she had changes in her feet so i had her tested as there were other signs as well.
They suggested pergolide which i promptly put her on but i have to say she seemed to become very depressed and just not herself, she is normally a happy bright eyed pony so i was a bit concerned.

Given her age i made the decision to take her off the drug and what will be will be. I have to say she bounced back to her normal self so i decided pergolide wasnt an option for her.
The other problem is her teeth as they are more or less non-existent so to keep weight on she needs grass and soft feed as she can't chew hay very well.
So she has a high fibre diet with as low a sugar content as possible and so far so good, she is holding weight really well.
There have been no bouts of Laminitis in the last 5yrs, she has natural balance farriery in front and is clipped through the summer. I just manage things as best i can for her so that she is happy and comfortable.
 
Thank you all so much for your advice and for sharing experiences, it's been really enlightening and the information and positive vibes are much appreciated. I've forwarded all the replies onto horse's owner, she can't directly join in as only has internet at work which is heavily monitered, so she can't take up offers of PMs but thanks++ to all.

Any more posts would still be fab, all of your inputs are very carefully considered. Thanks againxx
 
I am sorry to hear of your friends gelding and the trouble he is in. My friends horse was diagnosed with cushings but as he is 22 and has lived a smashing life she has made the somewhat difficult decision to call it a day should he get laminitis. I respect my friends wishes, not only would treatment be prohibitive as he wouldn't be covered on insurance her most pressing reasoning is that she would not want to inflict unnecessary suffering on her old friend. Sometimes the hardest decision becomes the easiest in such a situation as your friends warmblood and she probably knows deep down that the time has come. I feel for her with all my heart having lost four of my own horses in a short period of time, and I know of the heartbreak this will bring. But ultimately she has to think of her horse and his quality of life. I wish her well whatever her decision. x
 
I am absolutely shocked and horrified with what this vet has said.

Laminitis due to cushings is caused by increased cortisol. Pergolide IS the drug of choice because it causes the level of cortisol to be reduced.

Without giving Pergolide (or Trilostane etc) the cortisol will not be reduced and the laminitis is unikely to go and may get worse.

As somebody who has had a cushings horse on Pergolide for 6 1/2 years I can assure you that in his case nothing else makes a difference once he has laminitis.

Please get a second opinion from a reputable Equine vet such as Willesley.
 
hi

my pony got really really bad lami last year it took april to oct for her to get over it we started with one vet and ended with another with second vet we had these changes which seemed to help!

plastic white shoes cant remember the name but she was so much more comfy with them.

acp's as it help with circulation

and pernamax (its ment for joint) but it aids with inflammation to me this is what i think helped the most she defently got /felt better when i started giving her these they are green lipped mussels!

my vet had used them in 5 cases as a last resort of being pts and they worked in all 5 cases well now 6 as it helped my mare! i now keep a spare pot around and put her on it if she gets another eposode!

my pony is now on pergolide she had a funny reaction to it at the begging as we gave her to much she is only 12.1 so hard to find how much she needed! she has had a bout of lami since she has been on it and since last april hasnt eaten a blade of grass she goes out in a bark paddock that i have made she has cushing and is IR

i really hope it turns out well lamintis has got to be one of the worst things ever talking from experience i dont ever want to go threw again with any other horse!

my friends horse dies of it just before my pony got it but he got it from steriods! and pedal bone went threw his foot!

Good luck and a hug for your friend and her horse!
 
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