Fellow cushings owners, what would you do?

[nativepony]

My 21 year old mare was diagnosed 2 years ago and started on 1mg of pergolide. After regular blood tests to get it under control she is now on 3mg(!!!) of Prascend (my vet no longer prescribes pergolide) - anyway her most recent blood tests have come back at 52 (should be <29 for this time of year). My vet has advised we increase the drug to 4mg as she said if it wasn't completely under control there is little point in treating it!

She is currently showing no symptoms and after talking to a number of people one being a very helpful Jackie Taylor at metabolic horse I have been told that 52 is not excessive and as long as she is staying symptom free, but keeping a very close eye on her feet/weight then I should stick to the 3mg - ie. Treat the horse rather than the lab results!

Not only am I feeling that 4mg seems a really hefty dosage but at £1 a tablet is really expensive!!

Wondered what your thoughts are? Sorry for the essay!

 

[LeneHorse]

I'm new to all this - my mare was only diagnosed last week. Her blood test result was 55 so similar to yours and is also not showing symptoms. My vet has started her on 1 tablet per day and she's to be retested after 4 weeks. So yes I would think 4mg seems a high dose - is your test result of 52 showing an increase on previous tests? Hope this doesn't happen to me when mine gets retested. I'm hoping to see a decrease in her score. Hope you get some replies from people who know more about this than me!

 

[goldypops]

Hi, at the last blood test my mare came out high (cant remember the figure). My vets queried it as to how much seasonal adjustment needed to be made (the test was nov/dec). The lab came back and asked if she was showing any other symptoms? - she wasnt, no laminitis, coat slightly thicker but not long, not drinking excessively, no fat pads etc. There advice was to keep her on the 1mg/day she was on until she showed any other signs. In other words go with how she was looking and her symptoms rather than the lab result.

 

[itsonlyme]

I would treat the horse, not the lab results. Just up the dosage as her symptoms progress. Or maybe try chasteberry as well as the 3mg?
Some people don't treat at all with pergolide/pracend until alternative treatments stop working. That's what I've read on the yahoo Cushings group anyway.
Mine is only on 1mg at the mo, but we think it will need upping this autumn to 1.5mg as she has had a few 'depressed days'. I can't imagine paying out for 4mg a day!
Good luck though. I hope she's ok x

 

[be positive]

I have a 33 year old and treat him by adjusting the amount as and when he shows signs that require it, he had 1mg up to 2 initially then over the first 6 months this gradually reduced to 1/2, last summer he went down to 1/2 every other day, back up in the autumn to 1 daily, now down to 1/2 every other day again.

While he is so well and symptom free this suits him, when he was on more he did not eat well and lost weight, he is not laminitic so that helps.

He is not tested now as he is stable and if he goes down I know a day or two of increase and he is back on form.

 

[splashgirl45]

my 21 yr old was diagnosed last august and she is currently on 2 prascend daily and seems fine, (although her summer coat does seem a bit thick to me). i am getting her tested again in about a month to check the levels as my main worry is laminitis and our grass is very good this year. she has never shown any sign of laminitis but i am a worrier and would rather up the prascend rather than wait for symptoms to show. i know what you mean about the cost, i am on a pension and struggled to keep my horse before so now its even worse, still thats what credit cards are for!!!!!

 

[Zorgzion]

Hi, ask your vet for a prescription for pergolide. It seems to work much better than the horse version. I'm told that if your horse was already on the human form hey can keep giving you it? Might be worth asking or check out some other vets.

 

[Oberon]

I've had my old boy on 1mg Prascend for four weeks now - I will get his bloods checked this week (vet originally planned to wait for 8 weeks, but I'd prefer to test earlier).

His ACTH was originally over 200

So I imagine I will need more than 1mg in the future

.

I've heard of horses on the Yahoo group needing up to 10mg in the autumn

.

I'm moving to a cheaper yard at the end of the month to afford the medication

.

 

[skn0404]

Go with your instincts. If your horse is symptom free at the mo go with the old says of if it ain't broke don't try to fix it! Like I said earlier I dose our little man on symptoms only and have never had him tested and it would appear that I am not the only one working from symptoms. If your horse starts to show negative symptoms then up the dose a bit but be aware that too much pergolide can make the horse lethargic, not interested in food and bad on its feet just the same way not enough pergolide can do but whe you're overdosing they tend to be uncoordinated as they walk rather than lame. Good luck :0)

 

[muff747]

Go with your instincts. If your horse is symptom free at the mo go with the old says of if it ain't broke don't try to fix it! Like I said earlier I dose our little man on symptoms only and have never had him tested and it would appear that I am not the only one working from symptoms. If your horse starts to show negative symptoms then up the dose a bit but be aware that too much pergolide can make the horse lethargic, not interested in food and bad on its feet just the same way not enough pergolide can do but whe you're overdosing they tend to be uncoordinated as they walk rather than lame. Good luck :0)

There are some wierd myths about dosing higher than a few mg of Pergolide
You can get some side effects when you begin giving the tablets which includes going off food and being depressed. This can be easily avoided by introducing the drug in small amounts over the first week or two, so a quarter of a tablet for four days then half for four days, then threequarters for four days and also by giving with or after a feed.
See my post here in a recent thread about Pergolide
http://www.horseandhound.co.uk/forums/showthread.php?t=535461

If you decide to go by symptoms alone, you should be aware that some horses do not show any symptoms at all, in fact the first you know about it is the sudden devastating laminitis attack.
Also, some lami attacks happen so suddenly, there is no indication and are not always recoverable.
My horse has very vague symptoms which don't include the thick coat or the filled hollows above his eyes. He looks like a retired, under muscled, field ornament, which at 24 years old, looks like any normal retired horse.