Cushings - what happens if you DON'T medicate?

[ihatework]

I know it is daft on paper, but i keep thinking about her poor long coat and trying to 'solve' it. At the same time, desperately trying not to get a vet, as it really does stress the mare out - to the point it gets dangerous for all too.

You need a blood test. But you don't need a blood test under stress as that can impact cortisol and via that pathway can give you a false reading.

Speak to your vet. My suggestion would be domosedan gel prior to vet arrival and then blood test while horse is snoozy

 

[paddy555]

Thanks again all.
I'm going to ask another question,
What might happen if you give a prascend tablet to said horse, (somehow!) who hasn't been seen by a vet?

I am not sure that anything would happen however as they are a prescription medicine I am not sure where you are going to get them. One tablet would not make much difference, you may need to give them for some time (weeks) to establish their effectiveness. Many people introduce them very slowly, say a quarter tablet at a time.

My horse tested negative twice. However he had all the symptoms and we put him on a prascend trial. We diagnosed cushings by his reactions to prascend.

You said the only symptom was the long coat. Usually this is very far down the line for cushings. Have you discounted all other symptoms? excessive drinking and peeing, lethargy, muscle loss, horse looks pot bellied, poor immune system, prone to infections, skin infections?

As for giving prascend I don't have a problem. I have 2 on it. One is a very suspicious hill pony mare. I simply soak a tiny amount of spillers hi fibre nuts and put the tablet in there. It is gone in an instant. They both regard it as a treat. It is only a very small quantity, about half an egg cup full when soaked so that small amount does them no harm.

 

[paddy555]

Speak to your vet. My suggestion would be domosedan gel prior to vet arrival and then blood test while horse is snoozy

are you sure that wouldn't affect the result? I had one difficult to get blood from and was told any form of sedation may affect the results.\

OP, why not present a list of symptoms to your vet and explain the problems with getting blood and how stress may affect the results. Many cushings cases are obvious from the symptoms. Perhaps your vet would let you trial prascend based on the symptoms.

 

[ihatework]

are you sure that wouldn't affect the result? I had one difficult to get blood from and was told any form of sedation may affect the results.\

OP, why not present a list of symptoms to your vet and explain the problems with getting blood and how stress may affect the results. Many cushings cases are obvious from the symptoms. Perhaps your vet would let you trial prascend based on the symptoms.

No I'm not sure hence why I said speak to vet!! But I can say for sure you don't want to be doing ACTH testing under stressed conditions.

 

[JillA]

I think vets regulations don't allow them to prescribe willy nilly, Prascend (or pergolide) is dopamine and could easily be abused. In special cases maybe but as a general rule they can only prescribe a certain amount and with a cast iron diagnosis.
To come back to your original question, my beloved old mare had PPID in the days before pergolide was readily available, and unknown to me or my vet, accompanied it with IR. She had one hell of a year, only had to look at grass to develop laminitis, which caused abscessing and a lot of pain. She drank an enormous amount of water, pee'd for England and what didn't come out as urine came out as sweat, she couldn't regulate her temperature. Her bed was sodden every morning as also were her rugs. At the end she simply refused to get to her feet one morning, pretty much asked me to end her suffering, and yes, I had left it too long but she was on the Vitex trial and I kept hoping for improvement. Never again.
If you can get a diagnosis and medicate then please do - either that or euthenase if you are certain that is what she has, before the suffering begins.

 

[ester]

Your vet may agree to a trial of the drug to see if it alleviates symptoms/if they think enough symptoms are present, particularly in an older horse.

 

[nicelittle]

Our nearly 30 year old mini Shetland has started on this in the last couple of months.
We ummed and ahhed for quite a while before deciding to go ahead, due to her age mainly.
I was very sceptical, and had consulted the vet as last summer she seemed not so good, quiet and just a bit off.
However I have to say I'm amazed by the results. She has half a tablet a day and already her belly is reduced (I always thought it was due to having lots of foals), she is more active ( read escaping from field more!) and the vet that came today to take the next blood thinks her coat is improved.
Hopefully she'll enjoy more years of running round the field over jumps with the children(on foot now too big!), giving small people rides and going on 'hacks'
I don't think you can buy the drug without a prescription however!

 

[Boulty]

Depends on the symptoms and the horse really. Yes eventual progression and deterioration is to be expected but it doesn't necessarily follow logic how quickly that will happen. May just be that gradually her coat gets thicker and she gets harder to keep weight on, is a little bit more lethargic and loses muscle and drinks and wees a bit more. Could be that she's a little more prone to infections and lami. Could be any combination of the above.

In the case of my horse I'd've ended up with continuation of weight loss to even more scary levels, would not have been able to ride him and he'd finally have progressed from being a bit footy occasionally to full blown laminitis. I'm not convinced he would have stuck around for a great number of years if I couldn't have gotten the weight back on him and if we hadn't gotten to the bottom of WHY he is so sensitive to grass.

He isn't always the most reliable eater (I hide other supplements in there for his feet) so he has his prascend by syringe. He used to try and rear when you wormed him... food and time has brought him around to the idea

 

[ILuvCowparsely]

I have a 12hh pony that I aquired nearly 9 years ago who I was told had cushings. I was told that pergolide was no good for her.
Obviously I tried Pergolide again & she had a horrific reaction to the pergolide veil - even the vet was amazed & had not seen anything like it.
We then discussed prascend with a view to trying that, but the vet advised me to see if I could manage the symptoms for a few months - it was horrifically expensive back then as Pergolide was still the primary treatment.

Like I said that was nearly 9 years ago. She is now 25 & as bright as a button. In fact she's the first to jump out of her paddock & have a hooley about if she feels like it [rolls eyes]
She's not lethargic (unless it's very hot) & doesn't drink excessively
She does grow an amazing winter coat but casts it easily (her summer coat is through now!) she is lami prone particularly frost sensitive, but I can manage this all very well & she hasn't had a bout for around 6 years.

All in all she's happy & seems healthy. The vet is fine with her not being on medication & agreed that it wouldn't add to her quality of life anymore.
However I am aware that she is an extreme case & I would have no qualms with medicating her the moment I think it's necessary ��

My late donkey was diagnosed with cushings, I decided that I would try prascend, which I did and within a months of use her bloods came way down. I chose to medicate as I could not sit back and do nothing.

You do what you feel is right for you and your pony, but for me I always think of a well known song
see a chance then take it. That is what I do. good luck

https://www.youtube.com/watch?v=0j6g_uUhH2c

 

[Finlib]

I have an anglo arab aged 22 he was diagnosed with Cushings just over a year ago .He was blood tested with a reading of 220 6 weeks on1 prascend a day his reading was 31.He only needs testing now once year so I can get a prescription for the prascend .It is 98p a tablet from Animed that is the cheapest.The prescription gives me 100 tablets with 3 repeats so 400 tablets,just over a years worth at 1 tablet a day. He had no symptoms other than repeated foot abscesses 6 in 4 months .Lovely coat good muscle tone and no laminitis. On prascend he is back to his old self and being ridden lightly
I hollow out a piece of carrot pop the tablet in and he eats it from my hand it seems to have no taste he never spits it out just crunches the whole lot.I am really glad I had him tested. If you can just manage the test and if put on prascend a test 6 weeks later you can get away with a blood test once a year.

 

[splashgirl45]

I have an anglo arab aged 22 he was diagnosed with Cushings just over a year ago .He was blood tested with a reading of 220 6 weeks on1 prascend a day his reading was 31.He only needs testing now once year so I can get a prescription for the prascend .It is 98p a tablet from Animed that is the cheapest.The prescription gives me 100 tablets with 3 repeats so 400 tablets,just over a years worth at 1 tablet a day. He had no symptoms other than repeated foot abscesses 6 in 4 months .Lovely coat good muscle tone and no laminitis. On prascend he is back to his old self and being ridden lightly
I hollow out a piece of carrot pop the tablet in and he eats it from my hand it seems to have no taste he never spits it out just crunches the whole lot.I am really glad I had him tested. If you can just manage the test and if put on prascend a test 6 weeks later you can get away with a blood test once a year.

mine is also very suspicious and will not touch a feed with any type of medication so I do the same ,cut a slit in the side of a carrot and poke the tablets in(all 4 of them) I give her a normal piece of carrot, then the piece with tablets and immediately another normal piece. this has worked for a long time. when she was on a lower dose I could get away with just the medicated bit but she got wise and started spitting it out. fingers crossed she hasn't done that for a long time

 

[peaceandquiet1]

What a fantastically informative thread, with one pony on 1 tab a day and another just starting on 1/4, it is fascinating to read other views and experiences.

 

[TheresaW]

My mare is on 2 a day at the moment, amd is very suspicious of food now. I usually put the tablets into the side of her mouth and hold her until they've dissolved, or she swallows them.

I have recently changed vets as we moved house, and she's just had her latest blood test. Her count has come back at 18 which I am over the moon with. They were in the high 100's at one point. When the vet took the bloods, we had a long chat about symptoms etc, and she said, as long as there are no real symptoms, the idea of giving more and more tablets for high readings isn't necessarily the right way to go.

Dolly's only real change in herself was because she became quite lethargic to ride. I'd been putting it down to her age, 23 this year. Since being on the prascend, she is back to her lively self. If her next blood test shows a low reading again, the vet suggested cutting her meds down by half a tablet.

 

[Nudibranch]

One of mine was dangerously needle phobic even on Domosedan and the vet agreed to medicate based on symptoms. A stressed horse will produce high ACTH levels. We did manage one test but it did produce a ridiculously high result.
Just to clarify for some; pergolide IS prascend. Same drug, just marketed as Prascend only now due to a change in the drug law. So no point talking about bad old pergolide...it's the same thing

 

[Hetsmum]

OP one on my yard has been prescribed Pergolide/Prascend without a blood test as they failed to get blood from pony after trying for a long time! I lost my old pony to Cushings 7 years ago. She was on pergolide for 3 years and I still lost her to laminitis in the end. There gets to a point when the drug didn't work anymore. I wouldn't put a pony on the drug without a diagnosis though as it did make her quite depressed and it was very difficult to get the tablets down her. I think possibly horses are living longer as the diagnosis is sooner now. 7 years ago I actually told my old vet I suspected my pony had cushings. He poo pooed it but blood tested her anyway and was surprised when she came back negative. On medication she still retained her coat and developed an infection (although we never found where), and weed for England. It just held the laminitis at bay a bit longer..........

 

[pepsimaxrock]

...often the tests are free with the vets, but it does involve a blood test, and you will need to pay for the call out fee.

The tests are free - but are paid for by the drug manufacturer .......

 

[Crackerz]

The tests are free - but are paid for by the drug manufacturer .......

you say that rather suspiciously

I have had a number of friends take advantage of the free tests and have negative results

I take advantage of the free test time slots annually to keep track of my old boy

 

[JillA]

There are two types of test, both involving a blood sample. The straightforward ACTH test can throw up false negatives due to the ACTH fluctuating, even within the seasonal variations, a friend had several negatives with her horse despite presenting with many symptoms but he was a different animal on Prascend. The other is more reliable according to Liphook and involves TRH stimulation. It is all here http://liphookequinehospital.co.uk/wp-content/uploads/2012/03/PituitaryParsIntermediaDysfunction.pdf
The "free" test is normally conducted by Liphook between April and October, but only for horses who have never previously been tested. Bear in mind you still have to pay your vet to visit and take the blood sample. I am waiting for my vet to let me know whether they are doing it again this year - I have another one to check.

 

[lindsay1993]

My first pony had undiagnosed cushings. He died a slow horrible death and it was awful to see. Back then, the vets didn't know what was wrong with him and as he was 'old' it didn't seem to concern them. He had to be PTS. He was so lethargic he could barely get out of his stable to the field, he urinated and drank excessive amounts, his coat looked lank and dull and he had recurring laminitis. He just looked sad. He deteriorated very quickly, probably over about 3 months.

Now almost 15 years on & my own daughters first pony has been diagnosed with it too. We didn't hesitate to start the medication and she is doing amazing now. Her weight is strictly managed and she has had a great 6 months since she started prascend. The only tell tale sign is that she has fatty deposits above the eyes, even though her levels are good. She's was on 1/2 a tablet every other day, which has now increased to 1/2 a tablet every day. Her coat looks amazing and she's back to her hyper, silly self.

Seeing my first pony die in such a awful state meant that for us with my daughters pony, medicating her was the only option to consider.

 

[glamourpuss]

One of mine was dangerously needle phobic even on Domosedan and the vet agreed to medicate based on symptoms. A stressed horse will produce high ACTH levels. We did manage one test but it did produce a ridiculously high result.
Just to clarify for some; pergolide IS prascend. Same drug, just marketed as Prascend only now due to a change in the drug law. So no point talking about bad old pergolide...it's the same thing

I didn't know that & the vet at the time discussed Prascend as if it was an option to Pergolide....makes sense that they were reluctant to try her on it if it's the same drug. As I said her reaction to the Pergolide veil was horrific.

To HGA who suggested taking a chance with medication & wishing me luck with my choice. It wasn't so much a choice at the time, as stated the pony didn't get on with Pergolide. The decision to NOT medicate was suggested by my vet after seeing her reaction to the drug.
I am very lucky that 9 years on her illness hasn't progressed & she doesn't have any of the debilitating symptoms. In fact she is well & very happy.
If she starts showing something bad I will definitely try medication again but if she had the same reaction as last time I would have to PTS.

 

[Roasted Chestnuts]

The prascend doesn't always work best. For some the side effects are worse than the cushings symptoms.

I would speak to the vet, I feed chaste berry to my 25yr old welshxappy as a precaution but he doesn't have any symptoms and his last bloods were very low. I also feed cinnamon and turmeric

 

[Nudibranch]

Please, for the sake of you horse OP, speak to a vet rather than mess about with herbs. Anyone who has seen the effects of PPID first hand would do the same. It is horrible.

 

[Luci07]

Interesting thread but my vet actively suggested looking at herbal alternatives once we had stabilised the ACTH levels. The cost of prascend is a big bug bear of mine (read, greedy company that simply relabels a product, says its for equine use only and quadruples the price). As it turned out, my mare did not have cushings... the loaner had made an assumption and put her on a high dosage. Her "symptoms" of a larger belly, losing muscle were due to being in pain around the pelvic area, so as you can see, I am not a fan of self diagnosis. My mare is also wary of vets and a vet trying to make friends simply winds her up beyond reason. The best way (for her) was... no foreplay.. vet would stay out of sight, I would put a head collar on, turn the mares head away and the vet would come in and jab/take bloods with no preamble. The plan had been, when I got my mare back, blood test, put her on medication till the levels were good again, then switch to a herbal medication and retest 6 months later. We would have done this every 6 months if she had been found to have cushings.

 

[Northern Hare]

Ref the cost of Prascend, the list price at my vets was just under double the best price on the web. I wanted to buy from the vets, so I approached them and asked if we could come to an arrangement. Now, as long as I buy 160 tablets at a time, and pay the prescription charge of £20 that I would have had to pay anyway if I'd bought off the web, then they match the web price.

Also, the practice offer two completely free ACTH tests per year for their Cushings patients - as long as you book them for a zone day when the vets are at your yard or in your area.

It's definitely worth approaching your vets to see what deals are available - they need your business, and it's good to put your business their way even though they might not be making the higher margins from the deal you do with them.

 

[_HP_]

The prascend doesn't always work best. For some the side effects are worse than the cushings symptoms.

I would speak to the vet, I feed chaste berry to my 25yr old welshxappy as a precaution but he doesn't have any symptoms and his last bloods were very low. I also feed cinnamon and turmeric

With the correct dose, introduced gradually there shouldn't be any side effects.
Agnus castus may help some symptoms bit won't be treating the Cushing's....Prascend can slow the disease and is the best treatment

 

[ester]

But there are often side effects reported, particularly of depression/appetite suppression etc so some do struggle with it. Prascend is only treating the symptoms too, not treating the cause.

 

[poiuytrewq]

Thanks again all.
I'm going to ask another question,
What might happen if you give a prascend tablet to said horse, (somehow!) who hasn't been seen by a vet?

Could you maybe try Chaste Berry in her feed instead of the actual prescription medication without the vet!? I used it very successfully for a year or so on a TB I had. Its herbal so not going to do harm but you might see a difference in her and then feel more inclined to vet the bloods done?

 

[honetpot]

But there are often side effects reported, particularly of depression/appetite suppression etc so some do struggle with it. Prascend is only treating the symptoms too, not treating the cause.

My little mare reacted very badly to it. Lost loads of weight and it totally upset her digestion, with constant diarrhoea that I have never seen in a horse. I took her off it, managed to the weight back and on her, so she had a couple of good years no symptoms apart from a thick coat. Can never say she lethargic especially as she would clear the fence to eat the farmers barley

 

[southerncomfort]

My mare had awful side affects the first time I tried her on Prascend. Just would not eat anything at all and lost so much weight.

When I reintroduced it I literally started with just dust...then quarter of a tablet...then half a tablet etc etc. But what really helped was her being prescribed another drug alongside the Prascend which acted as an appetite stimulant. We had absolutely no problems introducing the drug this way at all. I *think* the second drug was called Periactin and she only needed it for a couple of weeks.

 

[Slightlyconfused]

My friends 30 year old tb was tested positive for cushings about four years ago.
She hasn't been treated because she is an extremely poor doer and fussy eater and she didn't want the presend to make that worse. The only symptoms she had was poor coat and weeing alot.

She is on Cush X supplement which has helped her coat etc.


My Welsh mare was boarder line positive. I decided not to medicate as she again was a very fussy eater and I manged her weight also the big one for me was she colics when stabled long term and when in pain so she would not be doing any type of lami recovery.
She was pts two years ago aged 22 after getting lami in all four hooves. She wasn't treated long term. Made her comfy over night with the on call vet as soon as I saw it was lami, my normal vet came out the next morning vet to pts.

It seriously depends on your horse and their situation.