Cushings Medication

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Pink Gorilla

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I was wondering if anyone could tell me some info about medication for cushings disease? I suspect my horse may have Cushings and I plan to get him tested. I was wondering, do people generally use medication to prolong life and alleviate the symptoms, or do they generally just practise good management and let the disease run its course until euthanasia would be the kindest option? For those that have medicated, does it generally work quite well, or show little improvement. Also, are there any side effects of the medication? Finally, have any of you tried the photonic therapy?
 
I medicate mine to prolong his life and alleviate the symptoms, untreated I don't think they would last as long, some symptoms are horrible so it depends if yours has these
 
Why would you even consider not using the one tried and tested product (Prascend, formerly known as pergolide) which has been shown to reduce symptoms, lower ACTH levels and prolong life? It really does halt the progress - and you have to manage diet as well, because of the IR which accompanies it. The only side effect generally reported is a temporary reduction in appetite, for a couple of weeks or two, and that might be alleviated if you introduce gradually.
I had a much loved mare who developed the condition before pergolide was readily available. She had a dreadful time - laminitis, abscesses, sweating, soaking rugs and beds, unable to have any grass at all, before she positively asked me to let her go. Since then I have had a rehomed arab mare diagnosed at 29 who lived until 36 with the help of Prascend, and was finally PTS due to cardio/circulatory problems, entirely unrelated.
If you aren't going to administer Prascend, euthanase him now before he gets to that stage, I wish I had.
Chasteberry (Vitex) can help with the symptoms but studies have shown it only does that, it does nothing to affect the underlying condition.
 
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2 of mine are on prascend as I believe it is the only medication shown to work and it does and has given one several more very good years and hopefully more to come.

There can be side effects if you go straight in at 1 tablet a day. Introduce it a quarter of a tablet at a time and work up to 1 after about a month. The only side effect I had was the horse went crazy after the first month. I couldn't have ridden him he was so above himself. It was lovely to see him coming back to life. After a couple of months he settled down again.

What symptoms do you have that makes you suspect cushings?
 
It is absolutely about quality of life, be that short or longer.

Many horses do well on prascend - you need to discuss fully with your vet as each will react slightly differently.

In addition to medication you are likely to need tight management too - low sugar/starch diet, good levels of vits and mins, careful monitoring of whether they are hot or cold as their thermoregulation can go awry, discussion with vets on any other drug treatments including vaccs and wormers, regular blood testing.
 
As everyone has said above really...you really don't want to let ppid take its course, it's really not a nice way for your horse to live it's life, varying symptoms, all uncomfortable/painful for the,...prascend is the only way to alleviate/keep ppid under control with diet correctly aligned feet, basically changing the management of them...my 19 yr old was diagnosed 4/5 years ago now, he was lethargic and had low grade laminitis, after x rays, prascend and all the stuff that goes with it, he was back to his bouncy (actually better than before) self, I'm hacking showing jumping etc with him...it's fab..the laminitis site has lots of info if you want to gem up..
 
One of my horses was diagnosed with this at 13. He had no symptoms, just a dull coat start which made me think he was not quite right and needed a blood test. He has always been on the slow side since I got him so didn't think anything of it. Anyway he came back as positive to Cushings. He is now on 1 prascend a day and his coat is shiny and he is bags more forward. At his age there's no way I wouldn't medicate.
 
Cushings can develop slowly, the symptoms often being put down to old age (lethargy, thick coat etc). The danger is that untreated they are at risk of getting laminitis. I would recommend you get your horse tested (first test should be free of charge). Then, if confirmed, you will be prescribed Prascend. I have had 3 horses with this condition, all of whom took this drug. After about 6 weeks of taking the drug there was a complete transformation - much more energy, coat returning to normal and much happier. I would definitely recommend treating the condition rather than leaving it as the risk of developing laminitis is high.
 
We have had 2 on Prascend for about 3 years now. Both are doing well with all the symptoms we noticed well under control, very pleased with how they are. They are rather more fussy eaters than before medication but have found a diet that works for them.
 
My mare was diagnosed at 14, the only symptoms she showed was slightly longer hair growth and she took longer to shed. I have her on Prascend as she already has problems with her legs and I think if her Cushings worsened to the point that she developed laminitis then it would be the end for her as there is no way she would be able to stay upright. I didn't realise until she had been on the tablets for a few months that she also had the lethargy that some horses get...I only realised as she has now got a second lease of life!
 
Hi. Thank you for your replies. Jilla, I wouldn't ever let a disease go on without medicating unless the medication doesn't work well and has horrid side effects and the vet advised against it, hence why I was asking about the medication. I've had my gelding most my life and I'm in my 30's now,so he's like a child to me. He doesn't have severe symptoms, just a thick (not curly) winter coat which is often late shedding. He also has had hoof abscesses once per year since 2014, when he never had them before. He sometimes looks very sleepy in the field too, but perks up and is back to his bargy self when handled. Finally he is stabled overnight and his bed is absolutely soaking most mornings. He's luckily never had laminitis though. However I am treating him as a risky case for it, so he is fed a low sugar and starch diet with strip grazing, no treats etc. I'm very pleased to hear there is medication that works so well. I've only ever really known one other horse with cushings and he was pts, so I didn't know if that was the recommended route. Thankfully it sounds not!
 
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Sometimes the laminitis is too far gone hence pts...it might be an idea to clip him if he has a thick coat, if he doesn't shed it, they struggle to control their temperature...there's lots of stuff on the laminitis site, also ask the vet re EMS too, the wet bed is more of a symptom of that, and the two diseases can go hand in hand, though not always and after meds, things improve...good luck..
 
Zuzzie said:
(first test should be free of charge).
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The first test is only free if Boehringher (sp), makers of Prascend, have the scheme running, which they usually do but from June to October, when the ACTH is in its seasonal rise. And of course they may decide not to this year - I reckon they should do every year all year, after all it is their means of you deciding to buy their product. Even then you have to pay for your vet to take and despatch the sample.
And the wet bed (and excessive drinking) is symptomatic of Insulin Resistance which often goes with Cushings, not EMS which is a different metabolic disorder altogether.
 
LincsLady22 said:
Hi. He doesn't have severe symptoms, just a thick (not curly) winter coat which is often late shedding. He also has had hoof abscesses once per year since 2014, when he never had them before. He sometimes looks very sleepy in the field too, but perks up and is back to his bargy self when handled. Finally he is stabled overnight and his bed is absolutely soaking most mornings.
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to me the coat symptom is quite far down the cushings line and I would regard it as a severe symptom. Soaking bed is excessive peeing. If he were mine I would test asap and get him onto prascend.
 
My fabulous 23 yr old Draft mare is on 1Prascend a day, which is well below the correct dfosage for her weight. She has responded extremely well. Immediately, she stopped drinking and weeing so much but was still sweating about 6 weeks in. when vet came to do repeat bloods, I really thought that we would need to increase the Prascend but her ACTH level had dropped back to 25, which is excellent. Shortly afterwards, she stopped sweating, except on exceptionally mild winter nights and she is full of energy(!). The farrier recently said that her feet are the best he has ever seen them, which is great as she had an abscess on and off for over 2 months before Christmas.
She is medicated to maximise her quality of life, for as long as possible. She owes us absolutely nothing and I will ensure that she is pts before her QoL is compromised, although, of course, I hope that will be many years hence.
 
I have one who has been on prascend for over 10 years, it has definitely prolonged her life and eased symptoms. Previously she was having several laminitis attacks, plus drinking and peeing a lot. She is 24 now and is doing really well. She never showed any side effects of being on the prascend.
 
Definitely medicate. I started off down the herbal route and her symptoms got gradually worse. Some of the symptoms are very unpleasant and uncomfortable for the horse, plus of course you are at increased risk of serious laminitis attack.

Once we started her on the Prascend she was a different pony and happy and healthy for another couple of years before she was PTS due to a field accident.
 
The drugs have a lot of side effects (such as lethargy and decreased appetite) however they are far outweighed by the benefits.

Most horses dont die of cushings / PPID but they can be affected very seriously by it. The biggest issue is avoiding laminitis - which for a ppid horse is a serious risk - because they cannot control their blood sugar : insulin they can come down with lami without an obvious cause.
obviously the other improvements improve quality of life such as less hair etc.

However i have seen some horses managed without the drugs cope very well - but only if the laminitis risk is emilinated. Hair can be clipped off etc.

So its up to you ... it does work ... and you know your horse best ...
 
LincsLady22 said:
Hi. Thank you for your replies. Jilla, I wouldn't ever let a disease go on without medicating unless the medication doesn't work well and has horrid side effects and the vet advised against it, hence why I was asking about the medication. I've had my gelding most my life and I'm in my 30's now,so he's like a child to me. He doesn't have severe symptoms, just a thick (not curly) winter coat which is often late shedding. He also has had hoof abscesses once per year since 2014, when he never had them before. He sometimes looks very sleepy in the field too, but perks up and is back to his bargy self when handled. Finally he is stabled overnight and his bed is absolutely soaking most mornings. He's luckily never had laminitis though. However I am treating him as a risky case for it, so he is fed a low sugar and starch diet with strip grazing, no treats etc. I'm very pleased to hear there is medication that works so well. I've only ever really known one other horse with cushings and he was pts, so I didn't know if that was the recommended route. Thankfully it sounds not!
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So he has most if not all of the symptoms, I would medicate
 
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