Cushings treatment

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crystal

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Hi, my pony has suspected Cushings and the vet has recommended treating with periactin or the other one tris something or other. She is calling me tomorrow with the costs of each one so I can choose. Does anyone have any experience of these drugs with Cushings and how much I should expect to pay and how much benefit they give? He is getting laminitis twice a year now and is not responding as quickly to painkillers so it is mainly to try and minimise him getting this again. He is otherwise quite well, has trouble shedding his coat and has the typical fat deposits and sway back.
Any advice would be very much appreciated....
 
hi crystal,

my old mare has cushing syndrome, so the only effect she actually has is a long coat that doesnt particularly shed. i'm fortunate in that she has absolutely nothing else from cushings. despite this, i keep her on pergolide which in my view will hopefully limit the development of the syndrome to the 'disease'.

i pay approximately £1.40 a tablet, and she has one per day. this can tend to vary. i know that you can get these drugs online! you will need a prescription from your vet to do this, and it may well be worth buying in bulk, so get a big prescription. i only recently found out about this when a friends' mare had to be put down after a long struggle with cushings. she would get the same drug exactly for approximately a quarter to a third of the price - very very worth investigating. i've yet to go down this route as i bought her pergolide from her, and this should keep me going til next christmas
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hope this may help
 
Has your vet suggested testing for cushings. A dexamethasone supression test is cheap, simple and quite accurate. Unfortunately they don't work well during the autumn so you'd have to wait a month or two before doing it, but at least then you could be sure of the diagnosis.

As mentioned above pergolide is the treatment of choice in horses, although periactin and triamcinolone may be of some use. Pergolide can have a dramatic effect, even in established cushing's disease.
 
If you get a prescription from your vet you can go to any chemist and buy pergolide at a massively reduced price as they are kept in stock for people with Parkinsons Disease, I told a friend to do this as she was paying £89 a time and she now pays just over £20, so please please do it.
 
my little Sec A had suspect Cushings and was given Pergolide for this. With regard to the dexamethasone supression test, this can actually (apparently) bring on another bout of lami, so have a word with vert prior to testing.

Good luck with everything LB x
 
The dex supression test will not bring on laminitis. Clearly it should not be performed during an episode of laminitis, when stabilising the condition would be a priority. However it is important to obtain a diagnosis in these individuals so appropriate therapy can be given, and this test provides the best means of achieving this.
 
a good herbal supplement is vitex (agnus castus). Does help. I'd go down the pergolide route on a prescription. My friend gets is for her pony and it works out at about 30p per tablet.....a lot cheaper than the vets!
 
Hi Crystal, my pony was diagnosed two years ago in Jan: you don't have to have the dex suppression test, you can have a simple blood test run which a lab near Cambridge (CSLS Labs - http://www.cslabs.co.uk/) will take an accurate reading from. Not all vets will agree with this as an accurate method of testing, but it was quite clear cut in my girl's case and didn't risk another bout of laminitis (and cost approx £90). My pony is currently on 120mg of trilostane (market name of Vetoryl, formerly modrenal) and this has worked brilliantly. Up until recently she has shown no symptoms at all, but now she has gone downhill quite dramatically (really excessive thirst and appetite, patchy sweating, depression, long coat, congested lungs) so we're trying the Vitex Equids on top of the Vetoryl. This has helped with the depression, but I've not seen any other signs of improvement so am thinking seriously about the future. Not sure about the cost of the Vitex but I do know that the Vetoryl is costing just under £2 a day, I've been getting it from Equine Pharmacy on a prescription: much cheaper than my vet! Best of luck with this, pm me if you'd like any more info
 
thanks for all the advice... they tried to test him last year but he is terrified of needles so they couldn't get any blood. Due to his symptoms she said to just assume he has Cushings, which we have been doing anyway. He is loads better this week, is on stronger painkiller and sedative and has frog supports on. Still waiting for vet to confirm costs!! At least then I can do some checks on line and at chemist to see if I can get it cheaper...

When looking into pergolide I have seen some issues with liver function, has anyone heard of this or should I not worry about that?? He did test with impaired liver function a while ago and so is already on milk thistle.
 
shadows been on pergolide for nearly 2 years now and i've not had any side effects. the other horses i've known have had issue's, but i would say that this is likely to having a huge variation of drugs 'nearer the end' than putting it down to pergolide alone. all drugs have a side effect that takes it toll after a long period, such as bute will cause liver damage after prolonged dosage.
 
My horse was diagnosed with Cushings nearly 6 years ago at age 14. His main symptom is laminitis so without treatment he would have had to be PTS.

He has been taking pergolide for nearly 6 years and it prevents him getting laminitis, though I have had to increase the dose over the time. He is now on a high dose and has shown no side effects except that he lost his appetite in the first two weeks of taking it.

The price has dropped recently and I think I now pay about 40p per 1mg tablet from the chemist.

Pergolide is definately worth trying and now that the price has come down it's much more affordable.

Good luck with your horse.
 
Just to add weight to the vote for Pergolide, my pony is now going into her 3rd year on it. She has improved condition wise and has not had laminitis this year at all (fingers crossed!). The last lot of tablets I got were £38 for 100 1mg tablets. My vet happily gives me a prescription (and doesn't charge as I believe some do) as long as he has seen her in the last 6 months.
I hope you see an improvement in your pony.
 
Hi - I have been using pergolide on a daily basis since June 2004. My horse was on a dose of 1mg a day and I initially bought the drug from my local vets at a cost of around £90 a month. About 3 months into the treatment my local vet ran out and I had to get emergency supplies from a vet some 50 miles away - I drove to collect the drug and was amazed at their price which was £20 a month. I purchased through the post from them for a number of years but in recent times the exclusive licence on the drug has expired and other companies are now allowed to make it and this has meant that the price has dropped even furthur. My local vet would now charge around £1 per 1mg tablet ie my horses dose would now be £30 a month from them but as vet's prescriptions should now be issued free of charge I collect a monthly prescription from my vet and order the drug from the local chemist. The chemist charges £12 for x30 1mg tablets. The vet is quite happy for me to do this and says he would be doing this himself if in similar circumstances. If you are stuggling to find a supplier this chemist will happily supply through the post .Their name is Tavisdale Ltd tel 0116 2302147. We originally suspected Cushings due to a change in the type of summer coat that grew and because of the filled in hollows above his eyes. I appreciate that there are several more refined tests available but my vet suggested a simple urine test taken early in the morning - which on analysis showed raised levels.
Good Luck with your pony.
 
My old boy was diagnosed with Cushings 2 years ago at the age of 24, following an attack of Laminitis, which he had never had before. The diagnosis was done on the clinical signs basically, due to age, the dips above his eyes disappearing, his coat going curly and of course the dreaded Laminitis. He had blood tests and his Insulin level was 88 (something or other? can have a look if I get the paperwork out). A dextrose test is not good as I beleive it can affect the cortisone levels and trigger off Laminitis (goodness knows what would happen if he was already suffering!). He was on 5 months box rest under Vets orders and the Farrier was on hand to help out. Pergolide has kept him alive and I am now very fortunate that I can ride him again, but for me it was a very long journey, but I am so glad I took it. He is now on 1.5 mg of Pergolide day, which increased from 1mg following a bout of Laminitis I caught early at the end of July and the Vet felt as he was looking more like a typical Cushings pony it would be best to up it. He is a 14.3 Welsh x Hackney.
If you need any more help and advise please PM me as I know how desolate I was in the early days!
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Good Luck!

PS He is in my siggie ... and the 2nd piccie was him 10 months after he was diagnosed (so taken in August 2006), sporting his BEAUTIFUL summer coat, which the Pergolide not doubt helped produce
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wow, he looks great.. I hope my lad can get back to looking like that, he's only 15 so am hoping for plenty more years yet.
vet has given me cost now, but has recommended avoiding pergolide as we haven't had the test done and due to the potential side effects. Didn't think it was worth argueing as if they don't agree with it they won't give me a prescription.. Have gone for periactin at about 1.50 a day for now (although I did a search and can get it prescription free from the US for about 78p a day) They said to give him the 5 a day dose for now (20mg) and if it works, I can probably reduce the dose over Summer as he usually only gets laminitis in Spring and Autumn.. will see how he goes. He is so much better already this week, is actually pacing round the stable when he sees us arrive now instead of being stuck rooted to the spot as he was last week...
 
Hi Crystal
yes fully agree that you should listen to your Vet and as your boy is only 15 then it is worth being cautious, although appparently the youngest horse known to have Cushings was about 8 years old! All I would tend to suggest here though is to try and ascertain how many cases of Cushings that your particular Vet has dealt with, and if they have not come across alot of cases themselves that you can see if they have spoken to their more experience colleagues .... only say this as the first Vet I saw when I suspected Laminitis, did not diagnose it but my usual Vet diagnosed the Cushings and Laminitis as soon as she set eyes on him .... if you see where I am coming from ......
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I am so glad that he is now moving round his box, as it is so heartbreaking when you see your horse look over his shoulder at his haynet, thinking, how do I get over there without it hurting too much!

Hope all goes well and keep us all posted, as this sort of dilemma helps so many of us .....
 
Crystal - You may have allready found them on your internet search but if not you may like to looks at the Yahoo Cushings Group and the Laminits Clinic sites. They both provide a lot of helpful advice. Can appreciate your concerns regarding pergolide but from his own experience my own vet feels that once the going gets tough it is the pergolide that tends to have the better response. Perhaps best to save this for later times. With my own horse the vet's prefered option was to pts and the pergolide was a second option. We chose the pergolide route and it was a rocky road at first . The drug did take a while to kick in but pleased to say that he is still here and leading quite a 'normal' life some three and a half years later - we have just learnt to keep a wary eye for subtle changes and respond accordingly.
 
Crysal - I cannot agree more with EllieP, my Vets advise was to pts 8 weeks after the initial eposide of Laminitis as he was deteriorating ... and on Christmas Eve (some 11+weeks on) was the worst day, however after that day he started to improve
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I was advised that Pergolide is the drug of choice because Periactin is successful in a lower percentage of cases.

Therefore if your horse does not respond to the periactin don't be afraid to ask for the Pergolide.

Sounds like he is picking up though so hopefully it will be OK.

As I said my horse has been on Pergolide for many years and is still in work - dressage/hacking/some jumping and quite happily unaware that he is ill! I often have many comments on how good he looks and nobody can beleive it when I say he has Cushings.
 
My 25 year old mare is on Pergolide and doing well on it.
It recently came out of patent so other drug companies now maufacture it.
I can buy a box of 100 for £30 now.
 
Hi, My pony is 36 and had a number of bouts of laminitis before we realised it was cushings that was causing it. I now buy Agnus Castus powder from a wholesaler and she has a diet with no sugar (that includes carrots, apples, mollasses) she has Soya bean meal with soya oil, brewers yeast for Vit B, the nearest suitable nuts are Baileys top line but even those contain things that agitate the cushings, I read a lot about it on the web about 4 years ago when she was going really down hill, something to do with the pituitory gland. Have a search on it. I've found complete diet change and agnus castus has given her a new lease of life. Good luck
 
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