Prascend - Cushings - Side effects - How long do we ride it out for?

[CalamityJane80]

Hi All,

First time poster here, looking for a bit of moral support -

My 25yo Thoroughbred started Prascend under a month ago. He went off his food and became depressed. About 4 days after starting prascend he developed an elbow abscess. SAA's came back at 2477, septic.. very sick horse. Severely anemic, white blood count terrible, Hemoglobin terrible. (not suggesting this is because of the meds, but 100% because of cushings)
Fast forward to now - nearly a month on IV & IM antibiotics, and immune supplements, weekly blood test etc his blood tests came back today, SAA level is 0 - Hooray!! Still slightly anemic, white blood count a bit low, as is hemoglobin, but all starting to trend the right way - finally victory!

However, When I started prascend I had NO IDEA about the "Pergolide veil" and the loss of appetite & depression. gauging side effects of prascend verses symptoms of being on deaths door has been very difficult because of the overlap in symptoms, but I can say in all honestly that i noticed the prascend had put him off his feed before he was sick - and most certainly made him incredibly depressed, to the point that he stood like a statue in the paddock for 9 hours and didn't move.

Almost a month on, his attitude is pretty good, he's "chatty" and follows people down the fenceline when they walk past the paddock. If he knows I'm coming out with a treat, he comes tearing up the paddock to great me, calling out the entire time. I haven't seen him this enthusiastic in 12 months I'd say, and I really feel like i'm seeing my "young horse", i believe this is the prascend starting to work, and i'm really excited to see his continued improvement.

The only thing that hasn't sorted itself out yet is his appetite.

He's been on a "cushings" diet for the last 12 months, Soaked microbeet & a pellet called "EziSport" which is marketed as a cushings friendly feed, he's eaten every morsel without stopping to breath up until now.
Since he started prascend its taking him all day to eat, he finishes breakfast by noon, and finishes dinner around midnight (I hear him throwing the bucket). He doesn't appear excited about his food at all. I've cut back on teh microbeet and added green chaff in an effort to make it a little more appealing for him, but its made no difference.

We are now concerned that he might have ulcers because of the incredible stress his body has been under for the last month (he was on 10mg of bute for two weeks, and 5mg for another week after that). He's due to be scoped at the end of next month to check for ulcers, but until then, I was hoping to hear from people who have their horses on prascend, and have "come out the otherside" of the experience? I guess I'm not sure how much longer i should blame the medication for his lack of appetite, and start to consider ulcer medication for him.

Can anyone advise time frames? or any tricks / tips you found to help your horses appetite along? My boy does eventually eat it, but I know he's not excited about it.

I'm just in uncharted territory here and am hoping to get support from those who have gone before xx

Thanks so much

(photo of the old boy, because he's cute)

 

[Birker2020]

I'm afraid I don't have any experience but just wanted to wish you all the best, coming from an owner of a horse who has cost me a fortune, thousands of sleepless nights and worry and I'm getting a little fed up of playing nursemaid constantly.

Its a total nightmare. Make sure you look after yourself. It's easy to get depressed and dragged down by it all in what sometimes feels like a never ending pit of despair. x

 

[LeneHorse]

I would suggest that you join the equine PPID (cushings) Facebook group. It is a great source of information and advice.
Hope your horse regains their appetite soon and it's not ulcers.
Cushing's is just a nightmare sometimes and you never know if a health problem is due to the cushing's or completely unrelated.

 

[planete]

You could try giving half the dose of Prascend in the morning and half in the evening, i did that for quite some time and it seemed to help. Loits of help and support on the PPID FB group, do have a look.

 

[meleeka]

Mine only got her appetite back when i stopped putting the tablet in her feed. I syringe it now, last thing before I leave, but it took a good couple of months of doing that before she accepted her bucket feed again.

You could try cutting the dosage back for a few days, or i’ve heard splitting the dose morning and night can help.

 

[zandp]

Do you split the pill ? Does he need feed ?

Mine is very funny with taste now and things that are ok suddenly aren't. New things being introduced are very scary and stop her eating for a while. Is the food (I've never heard of it sorry) under the recommended starch/sugar levels of 10% ? Some recommended for Cushings feeds aren't.

I have split the doses up morning and afternoon and often have to cycle through different feeds and ways of feeding her the tablet.

Mine loves soaked hay cobs with agrobs or thunderbrook muesli, currently I'm dissolving the tablet in water and syringing it into her food, or putting it in bits of cut up apple. Mine is quite old so doesn't really eat chaff well with her teeth and is needle phobic so I can't syringe into her mouth.

 

[Jeni the dragon]

I know you shouldn't change feeds suddenly, but what worked with Rog was having a few different things, feeding him little and often, and regularly changing between different things he liked!
He'd get a little feed, then a bit more, never giving a lot in a bucket.

 

[Casey76]

I believe current advice is to titrate up very slowly to avoid the veil, start at 1/4 tablet and slowly work your way up to 1 tablet.

ECIR (forums.io) have the most up to date info

 

[planete]

You can put the tablet inside a gel capsule which will stop him smelling or tasting it. I used to buy them from eBay.

 

[CalamityJane80]

I would suggest that you join the equine PPID (cushings) Facebook group. It is a great source of information and advice.
Hope your horse regains their appetite soon and it's not ulcers.
Cushing's is just a nightmare sometimes and you never know if a health problem is due to the cushing's or completely unrelated.

I've heard that page is great, do you know if I can view it if i don't have a facebook account? I permanently deleted social media last year and this is probably the only downside... I've lost access to great resources

 

[CalamityJane80]

You could try giving half the dose of Prascend in the morning and half in the evening, i did that for quite some time and it seemed to help. Loits of help and support on the PPID FB group, do have a look.

I think i will start doing this as of tomorrow, as it appears to be a common suggestion thankyou so much

 

[CalamityJane80]

Do you split the pill ? Does he need feed ?

Mine is very funny with taste now and things that are ok suddenly aren't. New things being introduced are very scary and stop her eating for a while. Is the food (I've never heard of it sorry) under the recommended starch/sugar levels of 10% ? Some recommended for Cushings feeds aren't.

I have split the doses up morning and afternoon and often have to cycle through different feeds and ways of feeding her the tablet.

Mine loves soaked hay cobs with agrobs or thunderbrook muesli, currently I'm dissolving the tablet in water and syringing it into her food, or putting it in bits of cut up apple. Mine is quite old so doesn't really eat chaff well with her teeth and is needle phobic so I can't syringe into her mouth.

Currently i'm not splitting hte pill, but i will start doing this tomorrow. I usually come out first thing in the morning, and give him the entire 1mg pill in a quarter of a piece of bread, he takes it without question and happily munches away on it, once i hear the tablet being crunched i give him the rest of the bread so it dilutes the flavour of the tablet. He suspects nothing hahahaha - So in that regard, he's a dream, I don't have any problems actually giving him the medication, but he simply isn't fussed on his food anymore. He's grazing no worries, and when i put his hard feed out, he appears to eat it as long as i'm watching him, and then wanders off. It all eventually gets eaten, but he usually throws the bucket round the paddock after he's finished whereas now he doesn't appear to have the same enthusiasm for eating.

Can confirm the Ezisport pellet is below 10%, and he's been on it for about a year - and loved it. In the last 5 days i've started adding green chaff, simply to try to pique his interest and get his appetite going, but its not really making any difference. i think the first step is to split the tablet

 

[LeneHorse]

I've heard that page is great, do you know if I can view it if i don't have a facebook account? I permanently deleted social media last year and this is probably the only downside... I've lost access to great resources

You have to submit a request to join the group and one of their admins approves it. I think you would need to already be on Facebook to be able to do this. I'm not a big Facebook user and am pretty clueless about how these things work so hopefully someone else on here can confirm this ?

 

[Gloi]

Mine never got his appetite back the way it was but he was still bright for 5 or so years on Prascend. He was still keen on hay and grass but low sugar feeds and any mineral supplements he wouldn't touch. I worked on the basis that the laminitis risk should be controlled by the drug so better for him to be eating things he enjoyed within reason than refusing food that was meant to be good for him. He also got the tablets in a scrap of bread.

 

[splashgirl45]

havent read all of the replies but thought my experience may help. i was told it takes at least 6 weeks for prascend to kick in fully, this was the time frame for mine so i assume that its right, once getting back to her normal nutty self she then went off the feed she had been on for years and wouldnt eat the hay either . she was eating a bit in the field but seemed to spend a long time not eating. she lost so much weight i thought it was the end. what i did was change her morning hay to haylege,a very low calorie one, and replaced half of her nightime hay with it as well. i contacted quite a few feed people telling them she was cushings positive and got samples of different feeds to try. i ended up with baileys light chaff, allen and page fast fibre and baileys lo cal balancer, she was happy to eat that mixture and i never had another problem with her appetite. my theory is that the prascend may change how their taste buds work , may be bonkers but thats what i think as i had owned mine for 7 years before diagnosis and never had a problem....hope you get yours sorted

 

[zandp]

I'd try and get some samples from feed companies so that you can trial him and see if he likes them, but be prepared for them to go off some feeds after a certain amount of time and you having to change again.

If she goes off her food and doesn't show interest again I do feed here things she shouldn't have with PPID, or some fruit or something cut up in the food and that always seems to kickstart appetite. Mine are out on minimal to no grass track though so don't really have grazing to fill themselves up.

Good luck, keep trying different things and you'll find something - I find foods that have to be soaked she loves - so anything like fibre pencils / nuggets / hay cobs etc / speedi beet tends to work well for us.

 

[Gloi]

my theory is that the prascend may change how their taste buds work

That is my feeling too

 

[Britestar]

Mine started on prascend in Feb this year.
Half a tablet a day. Was very cautious, as he's never been a good eater.
Luckily he never had laminitis, completely the opposite. Awful condition, and couldn't get weight on him.

Within 2 days I could see the sparkle back in his eyes. He's never eaten so much his whole life! Haynets scoffed, bowls licked clean, he's put on weight and looks amazing.

I can't believe I have my pony back. Galloping around the field, playing, and throwing in bucks when ridden.

 

[JackFrost]

You are right I think to consider if there are other issues such as ulcers. My cushings horse suffered with the veil, but the focus on cushings masked other problems. Have you had the dentist to him? Worth ruling out any dental problems.

 

[brighteyes]

A lot of the problem might stem from how rubbish he has been feeling with his other issues.

I have had three on Prascend and one really would not eat her feed or any means of disguising the pink pill (back in the days when is was dirt cheap). Neither of these two on it now have had the veil but I suspect that's because I dose at the minimum I can to give them the best chance of feeling OK.
It seems to be advised that very bad symptoms call for the dosage to be dropped back and reintroduced gradually. You are at huge advantage if laminitis is not a consideration (past episodes) and I have managed weight on mine so carefully in their earlier years that I just put them on it anyway as a prophylactic to begin with, untested and based on visual clues. Vet agreed but they have both since tested positive and it's simply pragmatics which will dictate how this pans out.

Join the Facebook group - just make a fake name account up - it's well worth it. Cushing's (PPID) is so much more than hairiness.

Good luck and let us know how you get on.

 

[brighteyes]

I believe current advice is to titrate up very slowly to avoid the veil, start at 1/4 tablet and slowly work your way up to 1 tablet.

ECIR (forums.io) have the most up to date info

Link to which is https://www.ecirhorse.org/

 

[brighteyes]

OP might not be based in the UK.

 

[NOISYGIRL2]

Long story short my horse was on prascend for 4 years contant veil symptoms. Changed to BOVA pergolide paste and took about 3 weeks but had my old horse back pre prascend. Please report this to Boehringer as when I did they just think everything's tickadeeboo unless people report the effects of the drug. The BOVA paste was fantastic for mine and made his last 16 months more comfortable. Sadly lost him in March age 42.

Ask your vet about the paste

 

[Northern Hare]

My TBx was 28 when I lost him last year. He'd been on Prascend for about 6 years. When he first went onto it he straight away went off his feed - he was always a tricky feeder and tbh he didn't need to lose any weight so he quickly dropped more condition and started looking really quite poor ? It's such a worry isn't it? In the end I had loads of part bags of various feeds he would eat for a couple of days then decide he didn't like it any more. I phoned around all the feed companies and tried loads of samples. In the end he decided that he really did like the Topspec Comprehensive Conditioner and their Cool Condition cubes. I was so pleased we found a feed he liked, and he stayed on the conditioner and cubes for his last 6 years and looked really well on them. ?

 

[CalamityJane80]

sorry everyone for the lack of replies, i was waiting to see if my eyes weren't deceiving me so I've delayed posting. I went out the other morning to split the tablet. But when he saw me, he came bolting up the paddock, legs in the air, farts, the whole nine yards and I thought he looked really keen for breakfast.. So, I held on to the tablet and just gave him breakfast.. before finally giving him the tablet once he'd finished.

We've been doing this every morning since, and most mornings he eats breakfast in one go, sometimes he leaves a small amount, but he always finishes every morsel. Dinner isn't a problem, he eats with no problems at all.

In hindsight i'm happy I didn't split the tablet, as I lost sight of how sick he's been, how compromised his system is, and how desperate we are to get him to where the tablet is working at full potency. Theres been other stuff going on behind the scenes with him, and the vet and I are counting down the days until he's at the 6 week mark.

I don't know if he's "through the veil" completely, I don't know if switching the feed before tablet is what is working, or whether he was coming out of it by himself, and i don't think i'll ever know now -

I'm just so glad he's eating again!

 

[NOISYGIRL2]

Yes it can take that long to come through it, mine did initially but seemed to have low grade veil symptoms throughout the time he was on it

 

[Northern Hare]

That's great news, it's such a relief when they start getting their appetite back. My horse had been on a vet trial prior to getting Cushings and part of that had been having six monthly ACTH blood tests. He became very slightly short in his stride when out hacking so we tested him again although it was only a couple of months since his last test which had been fine, and his scores were really high so he went onto Prascend straight away.

I also had to keep an eye on his grazing so he wore a grazing muzzle from early spring onwards, as the grass was really good at the yard he was at.

Ps. You might need to sit tight with you ride - they can feel very well in themselves!!

 

[CalamityJane80]

So he ate everything I put infront of him until about 3 weeks ago, and just - stopped eating. I took his supplements out and just gave him his feed straight and he still wouldn't eat. Was happy to graze, happy to take treats, but was totally disinterested in everything I put infront of him. After talking to the vet, she suggested adding Molasses to his feed. I kinda thought this defeated the point of the medication and the "cushings friendly food", but apparently Cushings and laminitis are two branches of the disease, and just because he has Cushing's doesn't mean he will get laminitis. As he's not shown any signs, the vet was happy for him to enjoy some Molasses in his meal. So he's back to eating as if he's a horse that's never been fed.

About 8 days ago I went out to feed him and he bronced three quarters of the way down the paddock, turned and bronced all the way back up again, and I thought "Ah, someone's ready to be bought back into work" So, after lunging for 5 days, today was our first ride in something like 9 months. I never thought I'd sit in my saddle again. I never thought we'd get back to this place. He was an absolute dream. Didn't put a foot wrong. For a horse thats had around 9 months off, you wouldn't have thought he'd missed a day. He was an absolute gentleman.

 

[paddi22]

I know you shouldn't change feeds suddenly, but what worked with Rog was having a few different things, feeding him little and often, and regularly changing between different things he liked!
He'd get a little feed, then a bit more, never giving a lot in a bucket.

yeah my lad is the same. I have to switch feeds every few weeks. small feeds and vary them.

 

[Pinkvboots]

Lovely outcome