Laminitis/Cushings - How long to get Pergolide dosage right

Lottie7

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Any help from people who have experience of this subject would be very greatly appreciated.

My 20 yr old 16.2 warmblood was diagnosed with cushings in January when he developed an acute bout of laminitis. We have gone down the normal laminitis lock down route - box rest, deep shavings bed, soaked hay, etc. He is on Happy Hoof and Formula 4 Feet. He started Pergolide at 1mg and has been blood tested 3 times now (each time he is sedated for foot trim) and the ACTH levels have steadily dropped as we have increased the dosage. We are just about to increase from 2mg to 2.5mg as his ACTH levels are in the 50s (and need to be below 30, I am advised).

His general well being has improved dramatically as the dosage has increased and we have virtually dropped the bute off as we do not want him to be too active in the stable. He has only set foot on the yard to have his feet trimmed, other than that he is on box rest.

The initial x-rays showed minimal rotation and the farrier has done a brilliant job with restructuring the feet. However, after this latest trim he is showing some "sponginess" to the sole (just below point of frog) in one hoof. We are going to x-ray again at the next trim if this still looks cause for concern.

Any input would be welcome but I would specifically be grateful if anyone has expericene of how long it took to stabalise the laminitis following start of pergolide treatment. I appreciate that the dosage has to be increased gradually and in accordance with the levels of ACTH but I'm concerned that the laminitis is still bubbling away and he is at risk of further rotation until we get on top of it. The fact that he is a large, middle weight horse does not help him in these circumstances. Does anyone else have experience of treating a horse of this size with this problem.

Many thanks.
 
I'm afraid I know nothing about pergolide but my mare has just had laminitis as a result of insulin resistance caused by an operation she had. I read a huge amount about barefoot treatment, mainly because the horse has been barefoot for many years prior to this illness and I wanted to get her back that way as soon as possible. I've never really looked into barefoot as therapy before but in your situation I think you would also find it really interesting - probably the most comprehensive book is Founder by Jaime Jackson.
My mare was tested for cushings when she got lami as she is in her late teens but thankfully she's not showing signs of it. One of the nurses though said that she had a pony that lived happily for a long time (I think it was at least 10 if not 15 years) on pergolide.
Good luck with it all.
 
hi.
i have a small rescue and have 3 ponies with cushings.
we got one pony who was already on pergolide when we took her in
and 2 who we found had it when we got them.
all 3 were put onto hilton herbs cush x.
the pony who was on pergolide had been on it a few years on varying doses depending on bloodtest results.
when put on cush x she was a transformed pony within 2 weeks with losing her long coat and getting proper topline in stead of the odd cushings muscleline.
pergolide has side affects in humans which is why i changed to the herbal version.

i also worm with verm x pellets(not powder or liquid) as it is a liver tonic as well which i find is great for cushings.
 
From experience of exactly the same thing very recently, you are doing everything right. Perhaps one thing I could have tried was hot/cold therapy for the laminitis. Also assuming he is on bute and ACP?
 
Absolutely the best person to advise is Jackie Taylor of The Metabolic Horse (http://www.metabolichorse.co.uk/index.htm)

And she moderates a fantastic discussion group on Yahoo - http://pets.groups.yahoo.com/group/themetabolichorse/

There are many many people on there using pergolide, going through exactly what you're going through and can give huge amounts of been there done that advice. The discussion group also hosts a huge number of articles that you'll find incredibly useful.

I would also recommend Jaime Jackson's Founder: Prevention and Cure the Natural Way. It really is THE book to read on laminitis.

Hope your lad feels better soon.
 
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