Prascend dosage for 11"3?

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popularfurball

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I know it is titrated by ACTH levels but for various reasons blood testing is not an option really.

What would be a reasonable dose? Or what would you start at?
 
Your vet should advise but I started a 13.2 on 1/2 a day for I think 3 days then 1/2 twice a day for about 2 weeks which stabilised him, he stayed on 1/2 twice a day all last winter then dropped during the summer now on 1/2 a day.
You need to introduce it gradually as I think it can shock the system sometimes. Ours is doing ok and I can adjust as I feel the need, without bloods being done. He is 32 and still in light work.
 
As you say PF, it's dictated by the ACTH levels but beyond that it's anybody's guess. My 15.3hh veteran was started on 1mg of Pergolide per day but it was clear that after 3 days he was still deteriorating. He was upped to 2mg but I don't think we've quite cracked it yet and he may need to go up to 2.5 or even 3mg - he's having a 2nd blood test (1 month from the first) Monday to see if/how far hos ACTH levels have dropped. My local equine vet owned a Section A that needed 6mg of Pergolide a day! Why can't you do a repeat blood test? If you register your horse with the website talkaboutcushings.co.uk you can download a voucher to give to your vet that gives you £15 off the normal lab cost of about £25. This site also has some good info on Cushings, as does the Laminitis Trust. Good luck.
 
Her first blood test was miles from even borderline but she has a lot of symptoms ( footy intermittently, thick coat, eyes gungy, loses muscle tone quickly, pot bellied look, fat deposits above eyes).

It took an hour and five lots of sedation to get a blood aample

So firstly vet and my safety is at risk

Secondly She has auto immune disease and this can be triggered by stress so I would rather avoid it of possible.
 
Without the bloods there is really no way of knowing. Our 11hh is on 2mg a day, far more than many large horses, she has been on pergolide for 6 years and during that time her dosage has fluctuated from 0.5mg up to the current dose. Different horses require different doses, and there is no way of knowing without doing the ACTH levels.


What does your vet say? I know would be reluctant to prescribe pergolide without knowing the ACTH levels. I think I would be looking at giving a heavy sed dose IM then grabbing the blood quickly with a twitch on too. If testing is really not an option then your vet is the best person to advise you.
 
My 36" Shetland has been on Prascend since March/April time. He started on Half a tablet, and I had his bloods taken 6 weeks later, and unfortunately he had to be upped to a while tablet.
His bloods are being re-checked again later this month to recheck the dose and check his liver (his last liver readings weren't perfect so we're monitoring that too) and the vet should be checking liver function when they go onto it.
As other posts have suggested, all horses and ponies are different. The readings change throughout the year (oct/nov is a specific time to test as the darker evenings effect the behaviour of the pituitary gland)
Regards your ponies immune system, that's probably caused by the Cushings... And you are right to try and avoid stress.
Can you talk to the vet about ACPing your pony before they arrive to take the edge off?
 
Yeah last time she had acp prior to treatment, couldn't get the vein so went with two lots of Im sedation followed by iv sedation to top up.

The test results were compared against season fluctuations do took in to account the seasons. Liver function etc is fine (had full bloods work up inc electrophoresis due to allergies).

If the medication causes improvement then we will be blood testing but vet in agreement there is little point causing undue stress to test again when last test was so far off positive (insulin also fine) so to treat symptomatically rather than via bloods initially. If there is an improvement and she doesn't react badly to it she will be blood tested regularly - so this is really just for six to eight weeks as a trial.

I just wanted comparable starting doses as I want to give her as low dose as possible to start with incase of reaction - so I guess half a tablet per day will be where we start.
 
My 14.2 started off with 1 tablet for 3 years, last winter upped to 1.5 and, after bloods taken last week she is now on 2. I'll get her tested again in early Spring when she may be able to go back to 1.5. As milliumoo says, the severity of cushings is affected by the length of days, the danger period being when the days are at their shortest.
 
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