Recent costs of Pergolide

[muff747]

Right, I've been shopping around online, and prices have increased dramatically. I have heard that production is eventually, if not already, going to cease and we will only be able to buy Prascend, so I suppose once the wholesalers run out of stocks, the next lot will be priced higher so the pharmacies will have to pass it on.
My local chemist did used to be the cheapest but her supplier ran out and wasn't going to get any more in. So the hunt is on again.
Anyone got any tips?

 

[Keflavik]

Ah -just realised that previous post was an older post - however 'Platta's' post described a recent diagnosis of Cushings disease and was dated 05/2012 - hopefully it was Prascend rather than pergolide which was prescribed.

My big concern is that several recent posts refer to prescription only medicines which, if the poster (?) is to be believed, have been prescribed or acquired illegally. The VMD (veterinary medicines directive) are getting quite tough about the supply of veterinary medicines in the UK and blatant abuse of prescription only medicines freely discussed in the public domain is only likely to make them toughen up more - potentially clamping down on the supply of veterinary medicines which can be freely dispensed - not a good thing for any of us. Interestingly I work periodically abroad, in a country where horses outnumber people yet veterinary medicines are difficult to source and supply, however horse owners 'play by the rules' because they realise that further restriction of supply of veterinary medicines would be disastrous.

To answer your question - 'the cascade' is the system which allows vets to prescribe human medicines (or generic medicines) to treat animals IF THERE IS NO LICENSED FORM OF THOSE MEDICINES available in the UK, however if a licensed product is available, then a non-licensed product should not be prescribed. Therefore, when your pony was first treated, there was no licensed equine pergolide in the UK and it was appropriate to prescribe human pergolide ( and to continue doing so). Newly diagnosed PPID ( Cushings) cases however should only be prescribed Prascend which, although it IS pergolide - has been trialled and licensed for use in equidae.

Sorry, a bit waffly, and a bit complex, but hopefully makes things clearer?

 

[muff747]

Yes thank you, re the cascade question.
I did already understand the reason for still prescribing Pergolide, I thought that's what I had explained to you? or have I got confused?

 

[Keflavik]

Yes thank you, re the cascade question.
I did already understand the reason for still prescribing Pergolide, I thought that's what I had explained to you? or have I got confused?

No - think I'm getting confused though. Your explanation was spot on. I was referring to a previous post where someone with a newly diagnosed PPID case stated that their vet had prescribed pergolide. In fact, they have now made it clear that they were prescribed pergolide in the licensed preparation, Prascend.

Clear as mud, eh....

 

[Box_Of_Frogs]

My understanding from my vets is that horses or ponies ALREADY ON Pergolide can stay on it forever. But newly diagnosed animals will have to go onto Prascend.

 

[nativepony]

Feeling really fed up, my cushings mare has just had her blood tests come back at 46 (should be <29 this time of year) - she's currently on 3mg Prascend (was on pergolide previously but vet can no longer get hold of it?) and have been advised to increase to 4mg!!! Gutted - not only about the cost which I can ill afford but also the fact that it's not under control

 

[skn0404]

How is your horse in it's self tho? My vets dont even run the cushings test as they said the results can be off sue to all sorts of things so they go by symptoms and tbh it works a treat with our little man. 4mg is quite alot i think depending on the size of your horse. My vet said to be very careful about giving too much as it can have dreadful effects that cannot be recovered from. If your horse seems happy enough i think i would wait it out til the summer gets here. Chin up, you know your horse better than anyone

 

[nativepony]

Thanks SKN0404, she seems really at the moment & vet was surprised at blood results, we spoke about leaving it at 3mg but she said we need to get it fully under control or not at all as side effects ie laminitis could occur at any time. It is just such a big amount of the drug though and I was hoping we'd have years ahead keeping it under control at
a much lower level

 

[nativepony]

Sorry missed out 'well' - ''seems really well at the moment!''

 

[skn0404]

I think if it were me and my horse I would go with my gut instinct. I haven't followed my gut in the past and have put my faith in others only to prove that I was right all along. I think I would stick at the 3 for now and if she gets worse then you can up it a little bit, also jumping up from 3 to 4mg per day is a big rise, if you really feel the need to put her up I'd do 3.25 for a few weeks maybe a month then if you still need to go up only go to 3.5. I'm also not a big fan of pushy vets, like I said before you know your horse better than anyone, the vet will go by lab values but who's to say that your horse wouldn't be on the higher side of normal even if she didn't have cushings! Good luck, Katie

 

[muff747]

How is your horse in it's self tho? My vets dont even run the cushings test as they said the results can be off sue to all sorts of things so they go by symptoms and tbh it works a treat with our little man. 4mg is quite alot i think depending on the size of your horse. My vet said to be very careful about giving too much as it can have dreadful effects that cannot be recovered from. If your horse seems happy enough i think i would wait it out til the summer gets here. Chin up, you know your horse better than anyone

Hi skn0404. It sounds like your vet isn't right up to date with the current advice about doseage and side effects of P. Join the EC/IR yahoo group there is loads of current info on there. In the US there are horses on 10mg for years without any side effects. My horse has been on 6mg for the last two winters, which is the dose that controls his PPID with no side effects. The unfortunate side effects of too low a dose is laminitis - I made the decision to go by other owners experiences.
http://pets.groups.yahoo.com/group/EquineCushings/?yguid=406723810
The ACTH tests are very accurate so they can be relied upon, provided the blood samples are treated in the correct way. Liphook Equine Hospital is used by my vet and they have very detailed advice on how the samples should be treated in order to gain an accurate result so providing your vet has followed this advice, there should be no variation-apart from seasonal of course.
http://www.liphookequinehosp.co.uk/documents/PituitaryParsIntermediaDysfunction.pdf
The dreadful effects your vet may be basing the advice on comes from initial experimentation of using Pergolide to treat PPID and they tried giving the equivalent dose weight for weight as in humans, that's when there were side effects but they quickly found that the horse needs much lower doses to get the desired effect of lowering ACTH levels in the blood.
Hope this helps

 

[Sophstar]

My understanding from my vets is that horses or ponies ALREADY ON Pergolide can stay on it forever. But newly diagnosed animals will have to go onto Prascend.

My pony got diagnosed in October and he was allowed to go onto pergolide rather than prascend. Vet explained that if they need an amount smaller than what prascend is available in, pergolide can be used. My pony is only on 250mcg, the smallest amount pergolide comes in. Prascend starts at 1mg and that would be way too much considering his last blood results showed his levels were 23 against the 'norm' of 29. Now he's on pergolide, he can stay on it.