Cushings - medicate or not?

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diddy

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Hi there,

One of my ponies has just tested positive for Cushings. She has a score of 85 (she was 82 this time last year).

When I had her tested last time, the vet’s advice was to keep an eye on her but not to put her on Prascend unless she started showing more signs of the disease. However, this time the advice is that I should put her on half a tablet a day (different vet).

My question is – should I put her on the medication or not?

She is 15 y.o. & is very fluffy (which is what alerted me in the first place). However, she has not (yet) had laminitis, is fine in herself & is not drinking excessively.

Obviously, if she could be in any kind of discomfort or danger I will put her on the Prascend. However, with any luck she'll be with us for many years to come so I wanted to make sure if it’s really necessary before I go ahead - especially since the last vet said until they go significantly higher there’s no need to medicate. She’s largely a field ornament if that makes any difference!

What do others think?

Thank you!

D. x
 
Yes medicate.

Mine has no obvious symptoms and a lower score (in the 60's), but I couldn't not medicate and leave her to her chances of developing any of the potentially horrible symptoms. As, as far as I know the actual number and relation to what symptoms they could develop are unrelated, so they could have a score of 34 and have every symptom or a score of 300 and have none.

Though if mine couldn't have tolerated the prascend it would be a different story, as it is 2.5 years into medicating and she is blooming (and making me feel bad that she certainly had a couple of mild symptoms for a while before we tested :(), to the extent her retirement is postponed at 23 she's doing great :D.
 
AlexHyde said:
Yes medicate.

Mine has no obvious symptoms and a lower score (in the 60's), but I couldn't not medicate and leave her to her chances of developing any of the potentially horrible symptoms. As, as far as I know the actual number and relation to what symptoms they could develop are unrelated, so they could have a score of 34 and have every symptom or a score of 300 and have none.

Though if mine couldn't have tolerated the prascend it would be a different story, as it is 2.5 years into medicating and she is blooming (and making me feel bad that she certainly had a couple of mild symptoms for a while before we tested :(), to the extent her retirement is postponed at 23 she's doing great :D.
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This. I think i've been medicating my old boy for near on 10 years now, wouldn't dream of not medicating him and risking increased symptoms
 
Why would you not? There are no side effects that I know of (apart from temporary loss of appetite for the first week or two) or if they are, they are very rare and there is no other treatment as effective. I have had one on it for 6 years and another for one and counting - without it there is a real risk of laminitis, and to me that is an unacceptable risk
 
There is another option which is try the herbal alternative. Prascend is very expensive. My vet was very supportive of trying this when we thought my old mare might have cushings but tests showed to be negative. The loaner had made an assumption rather than actually test her..

If the blood tests don't show a drop in the levels, then I would go onto the drugs but wouldn't hurt to try - or use the prascend to get the levels correct, move over to herbal and blood test to ensure the levels remain constant. (which you would probably need to do anyway even if on the drugs)
 
I would medicate in your position.
I have 2 horses and 2 ponies, and both the ponies have Cushings and are on Prascend. One is 22 and retired, and he looks fantastic, happy etc and I just couldn't bare to run the risk of lami etc.
It costs a small fortune having 2 on meds, but worth every penny to keep them healthy.
 
Luci07 said:
There is another option which is try the herbal alternative. Prascend is very expensive. My vet was very supportive of trying this when we thought my old mare might have cushings but tests showed to be negative. The loaner had made an assumption rather than actually test her..

If the blood tests don't show a drop in the levels, then I would go onto the drugs but wouldn't hurt to try - or use the prascend to get the levels correct, move over to herbal and blood test to ensure the levels remain constant. (which you would probably need to do anyway even if on the drugs)
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Can't remember where I saw it but I did read some research a few years ago which concluded that the chasteberry (Vitex) herbal remedy acted to reduce the symptoms rather than treat the underlying cause. Better than nothing if you can't afford the £1 a day for 1mg Prascend if you buy on line rather than from your vet (don't forget the cost of the prescription too)
 
I would definitely medicate to avoid Laminitis. Onew incident of Laminitis will cost you a fortune. in your time and vets fees.
I had a horse on Pergolide/Prascend for about 15 years and she was regularly hacked out until she was 29 years old.
 
definately medicate, if you look on the laminitis site they say that it is almost inevitable that cushings sufferers will get laminitis and why risk it.
jillA, prascend only controls the symptoms, nothing can halt the problem...there is no clinical proof that anything other than prascend will control the symptoms...if the pony is put on half a tablet a day it is just £3.50 per week, not that expensive if pony has an improved quality of life and avoids laminitis,which not only is very painful but would need box rest to treat...
 
splashgirl45 said:
jillA, prascend only controls the symptoms, nothing can halt the problem...there is no clinical proof that anything other than prascend will control the symptoms...if the pony is put on half a tablet a day it is just £3.50 per week, not that expensive if pony has an improved quality of life and avoids laminitis,which not only is very painful but would need box rest to treat...
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Maybe I didn't make it clear. Pergolide (prascend) has the effect of reducing the ACTH levels, while Vitex, if it has any effect at all, simply reduces the hirsutism, the lethargy and maybe some of the fat pads which are clinical signs, giving owners the impression it is actually inhibiting the disease.

http://www.*************update.co.uk/vitex.htm

Sorry, no idea why that corrupts the link - it is equine science update.co.uk (without the spaces)
 
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Definitely. My little horse didn't get fat this summer and he always gets fat! He's 23 so I took advantage of the free test and it came back around 70 something. He has been on one Prascend tablet a day for the last six weeks and I have my old horse back! I reckon it has knocked five years off him so far and I'm over the moon.

My big horse, who is also 23 and has quite a few symptoms, had ACTH levels in the low 60s. We are waiting with him, they both will be re-tested in December before any decisions are made with regards to starting/upping medication.
 
It's about quality of life - prascend is the only thing that can control the effects of cushings, so yes, medicate.
Laminitis is the pits - and there are other effects as the pony's immune system is awry such as cuts not healing.
 
My pony was diagnose with Cushing's about 3 years ago. Vet suggested trying herbal supplement Chasteberry (also sold as Agnus Castus).
It has kept his Cushing's under control and no recurrence of laminitis.
Worth discussing with your vet.
 
CMcC said:
My pony was diagnose with Cushing's about 3 years ago. Vet suggested trying herbal supplement Chasteberry (also sold as Agnus Castus).
It has kept his Cushing's under control and no recurrence of laminitis.
Worth discussing with your vet.
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Out of interest on retesting has his levels come down?
 
splashgirl45 said:
definately medicate, if you look on the laminitis site they say that it is almost inevitable that cushings sufferers will get laminitis and why risk it.
jillA, prascend only controls the symptoms, nothing can halt the problem...there is no clinical proof that anything other than prascend will control the symptoms...if the pony is put on half a tablet a day it is just £3.50 per week, not that expensive if pony has an improved quality of life and avoids laminitis,which not only is very painful but would need box rest to treat...
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Out of interest - how accurate are your pricings for prascend? My vet was estimating it would cost me around £100 per month to keep my 16.3 mare on this and that was over 5 years ago.
 
Luci07 said:
Out of interest - how accurate are your pricings for prascend? My vet was estimating it would cost me around £100 per month to keep my 16.3 mare on this and that was over 5 years ago.
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Prices from vets vary dramatically. Animed online is £1 per tablet, then you add the prescription charge, around £20 for six months. My vet charge £180 for 160 tablets which is roughly the same and the difference isn't worth the hassle of getting a prescription.

If it's about money, 1 tablet per day isn't any more expensive than a good supplement. I knew someone spending more than that on different herbs and things to control the symptoms.

Mine is medicated and I wish I'd done it years ago when I first thought she was just getting old. She has a new lease of life now.
 
meleeka said:
Prices from vets vary dramatically. Animed online is £1 per tablet, then you add the prescription charge, around £20 for six months. My vet charge £180 for 160 tablets which is roughly the same and the difference isn't worth the hassle of getting a prescription.

If it's about money, 1 tablet per day isn't any more expensive than a good supplement. I knew someone spending more than that on different herbs and things to control the symptoms.

Mine is medicated and I wish I'd done it years ago when I first thought she was just getting old. She has a new lease of life now.
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Your pricing is still dramatically different from what I was quoted... its a moot point as mare turned out not to have cushings but I still can't understand the huge price difference!
 
CMcC said:
They were not too high to start with, which is why recommended herbal, on re-testing they had come down but only marginally.
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Ah ok, I was interested as I know other people have had seen no effect on the actual acth levels but results on the symptoms, so good you've seen an improvement on both :). Doodle has so few symptoms I have wondered about herbal, but then as her symptoms are so mild I'd be worried I would miss any early warning signs of it not working iyswim... I'm a worrier so went with the medication, my vet loves me :lol:.

Luci07 said:
Your pricing is still dramatically different from what I was quoted... its a moot point as mare turned out not to have cushings but I still can't understand the huge price difference!
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How many pills per day were you quoted for? As about a £1 a tablet is what I pay too.
 
My horse's obvious symptom was weight loss and, in retrospect, a woolly coat. But since I'd always clipped him before and that was his first year of partial retirement, I hadn't bothered with clipping that autumn so I didn't know what a 'normal' winter coat was like for him.

I had him tested and he was borderline positive (forget the number, but it was low.) I didn't hesitate to medicate him as I wanted to nip any further symptoms in the bud. He was put on 1 x Prascend per day, and has been for 4 years. He never did show any signs of laminitis, but who knows what might have happened if I hadn't gone with the medication?

So that's my positive story, OP. If I were you, I'd medicate. You can shop around online for the best deal, or save prescription charges if you prefer to deal directly with your vet.
 
Luci07 said:
Your pricing is still dramatically different from what I was quoted... its a moot point as mare turned out not to have cushings but I still can't understand the huge price difference!
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I get prascend from animed and paid 97p a tablet(when I bought last month) the vet quoted me £1.69 a tablet so there is a big difference in pricing.I get a prescription for £15 which gives me 100 tablets and 3 repeats 400 tablets in total which is just over a years worth .The vet will only supply another prescription if the horse is blood tested at the end of each year.
 
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Medicate and get it under control as soon as possible. Friend had a mare and got scared about the initial weight loss. Went on to chaseberry instead. Six month later laminitis followed shortly by huge abbesses on her face and bottom. I thought I'd seen the worst way a horse could go when I saw ******* strangles years ago, then a bad grass sickness case. I was wrong, poor mare, I've never been so relieved to see a horse put down.
 
I chose initially to go down the herbal route. Big mistake. Pony ended up with a very nasty virus and skin infections.

Put her on Prascend and had another good 18 months before a field accident finished her off. While on the Prascend her coat went back to normal with a beautiful shine to it, her eyes were bright and she was eating well.

In same position I would ALWAYS medicate, without a doubt. IMO the herby stuff just masks the obvious symptoms, you don't know what's going on inside until they begin to suffer the really nasty symptoms. Not worth the risk.
 
JillA said:
Maybe I didn't make it clear. Pergolide (prascend) has the effect of reducing the ACTH levels, while Vitex, if it has any effect at all, simply reduces the hirsutism, the lethargy and maybe some of the fat pads which are clinical signs, giving owners the impression it is actually inhibiting the disease.

http://www.*************update.co.uk/vitex.htm

Sorry, no idea why that corrupts the link - it is equine science update.co.uk (without the spaces)
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oh right, didnt realise what you meant....its such a horrible disease and my mare's cushings was very aggressive and even on 4 tablets daily her levels were still too high and leahurst said there was no point in increasing the dose...the vet thought she was on the verge of laminitis and at age 25 i decided i couldnt let her suffer so called it a day last month....dont regret the decision but miss her alot...
 
Luci07 said:
Out of interest - how accurate are your pricings for prascend? My vet was estimating it would cost me around £100 per month to keep my 16.3 mare on this and that was over 5 years ago.
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ordering on animed site tablets are 99p each....i last ordered at the end of august and my vet did a prescription lasting 6 months for £12.50....
 
I didn't medicate my retired Welsh mare.
She was arthritic and coliced on box rest so either way if she got laminitis she would have been pts.

A year after her cushings positive that's what happened, laminitis in all four feet, vet came out and she was pts straight away. She would have been a nightmare to medicate as she was a fussy eater and coliced on apples so I couldn't even use them.
 
My pony was tested at 148 six weeks ago. I opted to try chasteberry. Retested last week at 114. Now navigating the prascend route as even half a tablet had a negative impact on appetite. Only symptom was skin issues in the winter.
 
I am waiting for the test results for my 23 yr old Draft horse. She was tested in August and a reading of 49 was found, so have just retested. Should her level have gone up, I will certainly medicate. She is a heavy horse, laminitis would be a very painful end for her, which I want to avoid, if at all possible. I do know someone whose pony is still with us 5 yrs on, even though he refuses to take meds. I won't risk it though.
 
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