Opinions on prascend

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equineofallshapesandsizes

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I'm curious what everyone thinks about prascend. I've read horror stories and seen nothing but bad come of it. I know of several horses, owned by different people, that have been on it and now look awful. Their levels are where they should be but their body conditions have dropped significantly. This is horses and ponies both ranging from 7hh to 17hh, younger and old.

I've watched some go from 5-7 on the body score scale to 2-3. Right now I know 3 that went on it looking great and now I can feel every bone from their withers back. The only change was the meds. Is their levels being good worth the negative effects?

A friend of a friend has a previously severely neglected pony. I'm talking spirals for feet (almost 10in taken off each foot specialty shoes, surgery on all 4 feet, etc), BS of 8, an absolute mess. Feet are taken care of now, his weight was getting under control, then they started him on prascend and frankly he looks worse now than he ever has. Poor coat, if negative was possible he'd have a negative topline, a massive low hanging gut, and that doesn't even talk about his mood. I suggested they take him off prascend and find an alternative to managing his levels in hopes his body condition could return. They adamantly denied coming off a possibility stating it would like sky rocket his levels and kill him. At what point would him passing be more humane than living like this?
 
I have one on it and have had zero issues or side effects.
i think some horses do better on much lower doses than the levels require.
Some horses do much better on no prascend and strict management. It really is trial and error.

I do also see it from the other side, quite a few people that i know have oldies that are very poor conditioned, no topline, dropped bellies, depressed etc.. but point blank refuse to blood test for cushings because the horses are ‘old and retired’.
Or the classic ‘he doesn’t have cushings cause he doesn’t have a curly coat’ 🙄
 
I've had 3 with it. First one, made a massive difference. An old girl but gained topline and so, so much more energy. Lost her depression and gave her another 5 years of good quality life.

Second one was late teens. Didn't really see much change with pergolide and her levels stayed high.

3rd and current is only 9. It has made a huge difference to her topline and she is holding weight like never before. I'm actually restricting hay and feed now, in the middle of winter, whereas before it was a struggle to keep weight on. Her coat was really scurfy and awful prior to pergolide and she had near permanent hives despite various supplements. It's now clear and shiny, and this winter I have only clipped twice whereas it was 5 times last year. Her ACHT came down dramatically though, and we halved the dose (so shes now on half a tablet) after 3 months.

I think there's a lot we don't understand about PPID. We measure ACTH but it affects a whole range of hormones and processes. So there's probably a whole host of reasons why some respond better than others. One thing I do know is that I'd always give it a try, having seen the dramatic and very positive difference it can make. If it doesn't work then stop, but I'd never deny one of mine the chance if they needed it.
 
It gave my old pony another 10+ years and even when she was PTS aged 30, she looked more like a 12 year old. She was on 3 tablets in the end, but worth every penny imo (1 tablet a day is only about the same cost as a decent supplement, so not excessive).

I think it's important to make your own mind up. I tried it, fully prepared to take my pony off it if it didn't suit, but she regressed to a youngster within a few weeks and had no problems with it.
 
Zoeypxo said:
I have one on it and have had zero issues or side effects.
i think some horses do better on much lower doses than the levels require.
Some horses do much better on no prascend and strict management. It really is trial and error.

I do also see it from the other side, quite a few people that i know have oldies that are very poor conditioned, no topline, dropped bellies, depressed etc.. but point blank refuse to blood test for cushings because the horses are ‘old and retired’.
Or the classic ‘he doesn’t have cushings cause he doesn’t have a curly coat’ 🙄
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I've seen that side too and it's equally infuriating. I've had many seniors over the years and as soon as there are weight/coat/personality changes i always test. Ive had a few with high levels and i was luckily able to manage them with a change of diet and never needed to do drug intervention. I'm glad it has worked for you and it's nice to hear of a positive impact versus what I've personally seen and heard prior.

I think what bothers me is so many who do have negative results aside from good ACTH levels, refuse or are told there are no alternatives. Again, this is all in my opinion. From what they have said, the vet denies any other possible management for his ACTH levels so they are keeping him looking awful and I can't imagine he feels very well.
 
Nudibranch said:
I've had 3 with it. First one, made a massive difference. An old girl but gained topline and so, so much more energy. Lost her depression and gave her another 5 years of good quality life.

Second one was late teens. Didn't really see much change with pergolide and her levels stayed high.

3rd and current is only 9. It has made a huge difference to her topline and she is holding weight like never before. I'm actually restricting hay and feed now, in the middle of winter, whereas before it was a struggle to keep weight on. Her coat was really scurfy and awful prior to pergolide and she had near permanent hives despite various supplements. It's now clear and shiny, and this winter I have only clipped twice whereas it was 5 times last year. Her ACHT came down dramatically though, and we halved the dose (so shes now on half a tablet) after 3 months.

I think there's a lot we don't understand about PPID. We measure ACTH but it affects a whole range of hormones and processes. So there's probably a whole host of reasons why some respond better than others. One thing I do know is that I'd always give it a try, having seen the dramatic and very positive difference it can make. If it doesn't work then stop, but I'd never deny one of mine the chance if they needed it.
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I'm happy to hear you've had good results. I agree trying is always better than refusing them the chance to improve on it. Maybe the people I know just aren't good horsemen.. which is sad in itself.

I agree, there is a lot we do not understand and I wish more vets and owners would understand its not a 1 solution kind of problem. Unfortunately in my experience, it's treated as such.
 
meleeka said:
It gave my old pony another 10+ years and even when she was PTS aged 30, she looked more like a 12 year old. She was on 3 tablets in the end, but worth every penny imo (1 tablet a day is only about the same cost as a decent supplement, so not excessive).

I think it's important to make your own mind up. I tried it, fully prepared to take my pony off it if it didn't suit, but she regressed to a youngster within a few weeks and had no problems with it
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meleeka said:
It gave my old pony another 10+ years and even when she was PTS aged 30, she looked more like a 12 year old. She was on 3 tablets in the end, but worth every penny imo (1 tablet a day is only about the same cost as a decent supplement, so not excessive).

I think it's important to make your own mind up. I tried it, fully prepared to take my pony off it if it didn't suit, but she regressed to a youngster within a few weeks and had no problems with it.
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It's nice hearing good results through the comments already. Ill be honest, with my experience so far, id be very hesitant to use it if it was needed. I would obviously try but i think it would take the recommendations of multiple vets before i would.

It seems the problems I see with it are more owner/vet recommendation error..
 
There is one on our yard that was diagnosed cushings, put on Prascend and would not drink at all, so has come off it and is just treated like any other horse other than rugging.
Not my circus not my monkeys so I won't comment much further, but other than the sway back, dropped belly and no muscle to speak of (retired) and a thick coat, he seems fine outwardly.
 
Kia was older and his levels were massive when I started him on it and he couldn’t tolerate the dose needed to control his levels.

I had to start at 1/4 of a tablet per day then up it every week until he reached 2.5 tabs a day but he couldn’t tolerate anymore than 1.5tabs a day it just turned him into a doped out zombie and he wasn’t himself.

I had about two years but eventually his body just couldn’t stop infections and I had him PTS.
 
I've a rising 18 year old Welsh A on it. He's been taking 1/4 tablet a day since he was 4 years old after a several minor laminitic episodes despite very tight management. Was raised to 1/2 tab 2 years ago having had laminitis again. I have never managed to get him to test positive for Cushings or EMS despite having all the blood tests on multiple occasions over the years.

Various vets over the years have grumbled about prescribing it due to the lack of evidence via bloods that it is required (originally begged it as a trial which was successful). One vet refused to prescribe it, pony came down with lami around 3-4 months after coming off it, despite very tight management. Went back on it and never got lami again until the time when his dosage needed increased.

I believe it's saved his life and doubt he would have seen 6 years old without it. He has a glossy coat and great topline.
 
I've had two on it, on the first one it brought his levels down to the right levels and he still looked good on it but it only made a slight difference to symptoms that initially led to getting him tested, but then who knows if the symptoms would have been even worse if he wasn't on it! He was on it for about 8 years.

The second one started on it and was on it for about a year, he lost condition and seemed depressed and just looked like a frail old man, which I had been putting down to him getting older and losing his lifelong friends of over 20 years. Then I accidentally ran out of prascend and by the time I got more a few days later he'd started looking more perky and like his old self so I held off giving him any and he just kept getting better so he's never had it again. That was 5 years ago and apart from having thick long coat in winter that is easily managed with a clip, he's looking fantastic and is zooming about the place bucking and just like his fiesty younger self. He's 27 now so we're going for quality over quantity of life, what's the point in me giving him something that might help extend his life but will also make him miserable, I'd rather he just enjoyed whatever time he has left.
 
I have 3 on it and have had another in the past. Out of 4 horses, all managed by me, I have had nothing but good.

However I wonder if this poster is a wind up for some reason. Joined yesterday. no intro just straight in with a bit of a controversial post. Quite a lot who replied seem to have had success. OP last looked in at 7.20pm yesterday so hasn't even seen the last 4 replies or given the posters, who made an effort to reply, the courtesy of a comment or a like.

I would have thought someone wanting to discuss such a specific topic would have looked in frequently.
It reminded me a bit of SV who I understand doesn't believe in prascend. Probably just me, :D:D
 
paddy555 said:
I have 3 on it and have had another in the past. Out of 4 horses, all managed by me, I have had nothing but good.

However I wonder if this poster is a wind up for some reason. Joined yesterday. no intro just straight in with a bit of a controversial post. Quite a lot who replied seem to have had success. OP last looked in at 7.20pm yesterday so hasn't even seen the last 4 replies or given the posters, who made an effort to reply, the courtesy of a comment or a like.

I would have thought someone wanting to discuss such a specific topic would have looked in frequently.
It reminded me a bit of SV who I understand doesn't believe in prascend. Probably just me, :D:D
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You are probably making a valid assumption, and what a shame I’d already taken time to write a thorough reply (as indeed others have). On the basis I don’t really want my personal experiences to be associated with anyone not being genuine I’ve chosen to edit my post. .
 
Assuming it's not a wind up, I've got nothing but good to say about the very low dose mine is on.

He only ever tested equivocal for PPID/EMS and wasn't showing classic symptoms but vet recognised a few odd one's as lesser known symptoms and he was showing low grade laminitis at the time, vet thought it was worth a try at a low level. Never had so much as a warm hoof since (although he's fairly strictly managed and in as much work as I can throw his way too - but he was before prascend).

Regularly get asked by my saddle fitter 'Have I definitely recorded his age right? My record's say he's late teen's but he looks better and brighter than a lot of 9 year olds I see ...' 🤣 So no complaints and only hope it lasts.

It doesn't work for all but nothing ever does.
 
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Of the 4 I’ve personally known that have been on it all did much better in terms of keeping weight on (& other things) when on prascend BUT all did still need feeding with the fact they had a chronic disease that affected their nutritional needs in mind. (Ie hay and grass alone doesn’t cut it)

Both PPID itself and Prascend can affect appetite especially during dose changes (usually referred to as the pergolide veil) and so it’s usually recommended that dose changes (including starting the medication) are done gradually to try and minimise this, although not all vets seem to have got that memo.

Obviously it’s not the answer for every single horse but then nothing is
 
I’ve had 3 on it , first started on it age 12 , was pts age 28 . Then had one on it for about 5 years , lost him aged 32 . Remaining pony will be 37 this year , been on prascend 5 years , no one can believe her age . Had to juggle doses a bit but it definitely worked for all 3.
 
I do wonder if horses have "flare ups" of symptoms and this is when the prascend is needed, at other times maybe the dose is actually overdosing them and that's when you see the negative effects some people report? I've mainly only seen good responses, including with my own. She was over 350 when tested and couldn't stop the weight loss. Vet thought she would need more than 1 tablet per day to get it under control but having heard side effect stories I asked to try 1 per day first. 4 weeks later her bloods came in at 22 and her turnaround was astonishing. She's now on half tablet and doing great, I actually wonder if she needs it all now but I'm not sure I'm brave enough to go against vet advice and stop it altother.
 
I have had two on it. One had side effects, went off her food, passing watery poo, and just looked depressed, so I stopped it. The other was on it for a least five years, at 1/2 tablet and diet control and no side effect what so ever, and stayed on the small dose. He had to be PTS for a field injury

I think there is no harm in a trial, IME the side effects came on quickly and left just as quickly and the pony was mangled by diet but honestly I would rather have quality not quantity of life, so not having it may have shortened her life.
 
I'm currently in a dilemma about prascend. Our pony failed the cushings blood test but the vet was as convinced as us that he had it (many classic symptoms). He definitely perked up once on it and thankfully gained some weight, but his coat, while shinier than it was, is still a bit dull and there is no doubt that he is much more lethargic than he was before he got ill in the first place. And don't get me started on his appetite - thankfully happy to eat grass & hay but we're down to desperate measures to get his prascend down him, and he's only on a low dose.

Basically while I can see improvements in some areas, I'm not 100% convinced that we've got this right. A few chats with the vet needed of course, but would appreciate any additional advice or own experiences as we mull over what to do.
 
I have an old pony on it, when she was 29yrs old she got very lethargic, dropped weight and her coat was ridiculous and she failed to shed it come spring. I assumed cushings, got the vet, and her levels were over 350, she was put on one tablet a day and perked up very quickly, gained weight, lost her coat and was her usual bright, bossy self again, and her levels dropped to about 25.

When we tested her again last year, I expected her levels to be great, as they had been at every testing since she started on Pergoquin, but her levels were high again, so the vet suggested going to one and a half tablets, which I did. After about a month on the raised dose she stopped eating, and became very lethargic again, so I dropped her back to just one tablet and within a couple of weeks she was back to her happy, bossy, greedy self. So I'm not bothered about testing her again unless she becomes clinically unwell, so I can see how easy it could be to overdose on it.

This is the pony last autumn aged 31, she looks equally well now, just a lot muddier!
 

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Made a big difference to mine . Two weeks on it and he had stopped drinking all the time and peeing on rides and the strange sweating that had developed. He was still happy eating hay and grass but not eating most hard feed unless it was molasses. He was on it for about 5 years until it's at 30 for unrelated reason.

I do think that some who aren't too far advanced can do OK if they are only medicated during the parts of the year the levels are highest, or give a lower dose at the other times and that can help reduce side effects.
 
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Saved the life of a Sec A I knew. Came down with laminitis in a cold February when on hay only around 2018. Still going strong!

There was a post on FB yesterday (BD dressage page or something like that) trying to discredit the drug so it looks like the trolls are out
 
I had about 7 extra happy years with my darling old boy thanks to Prascend - he had laminitis while off grass and Prascend stopped it in its tracks. On Prascend, he regained his former bounce and sass which he kept until he was PTS at the age of 29 due to colic.
 
paddy555 said:
However I wonder if this poster is a wind up for some reason. Joined yesterday. no intro just straight in with a bit of a controversial post.
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That was my first thought Paddy.

I've never seen anything but good come of Prascend, though I know some won't eat when on it and have to come off it. It's saved many lives to live happy for many years.
 
equineofallshapesandsizes said:
I would obviously try but i think it would take the recommendations of multiple vets before i would.
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That wouldn't be difficult to find in the UK if you really want to pay several times over for the same advice. The vast majority of vets in the UK would prescribe it, we've probably got tens of thousands of horses on it around the country.
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You don’t really need the recommendations of multiple vets.
It’s a very cut and clear blood test result that comes from the same place which ever vet you use.
You then get to make the decision.
It’s not like one vet looking at a slightly lame horse and disagreeing with another.

My two ponies are on it, as Is the little mare I look after for my neighbour. I have gone through periods when I’ve wondered if it was causing certain issues but in hindsight I don’t think it was.
I also had issues getting one to eat it at first. He started refusing all food. Years on he gets it in a bit of speedibeet each morning and looks wonderful- he’s mid 30’s
 
poiuytrewq said:
You don’t really need the recommendations of multiple vets.
It’s a very cut and clear blood test result that comes from the same place which ever vet you use.
You then get to make the decision.
It’s not like one vet looking at a slightly lame horse and disagreeing with another.
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I'm sorry to disagree with you but it is far from a very cut and clear blood test ie the ACTH test. It is a lousy test IMHO. My first horse tested neg. c 17. That was clearly ridiculous. I retested a week later as I didn't believe it and the result was 11.
What a joke. The horse had EVERY symptom of cushings possible. Hives on ski, abscesses like they were going out of fashion, muscle loss, needed tons of AB's rather than the normal dose, endless infections. Lethargy, he needed carrying sometimes riding, just everything possible. Weeing, tripping.

Vet told me he didn't need prascend he was negative as that was what Liphook put on the results. Insisted on prascend. Very quick reaction to it and 6 months later a totally different horse. No more abscesses, skin hives went forever, lethargy went, tripping stopped. Everything went.

It is to my mind very much a case of looking at the horse and trying to decide if the clinical signs support PPID and are tnen supported by the ACTH test.

If I was stuck I wouldn't rely on the ACTH test alone. I would TRH test if that is possible ATM.
 
paddy555 said:
I'm sorry to disagree with you but it is far from a very cut and clear blood test ie the ACTH test. It is a lousy test IMHO. My first horse tested neg. c 17. That was clearly ridiculous. I retested a week later as I didn't believe it and the result was 11.
What a joke. The horse had EVERY symptom of cushings possible. Hives on ski, abscesses like they were going out of fashion, muscle loss, needed tons of AB's rather than the normal dose, endless infections. Lethargy, he needed carrying sometimes riding, just everything possible. Weeing, tripping.

Vet told me he didn't need prascend he was negative as that was what Liphook put on the results. Insisted on prascend. Very quick reaction to it and 6 months later a totally different horse. No more abscesses, skin hives went forever, lethargy went, tripping stopped. Everything went.

It is to my mind very much a case of looking at the horse and trying to decide if the clinical signs support PPID and are tnen supported by the ACTH test.

If I was stuck I wouldn't rely on the ACTH test alone. I would TRH test if that is possible ATM.
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Yeah you’re right actually in that way. I was thinking more like mine tested 211 so it was a very easy choice.
Mine have always been definite yes tests but you’re right I have heard of horses testing negative when they are definitely not.

That’s still not actually the vet though it’s the test which is still being done by the company rather than the vets.
 
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