Shilasdair
Patting her thylacine
Yes, both.
She was in pain/stressed from displacement colic (and she's scared of vets) and also an abscess.
To give Prascend or not?
- Thread starter Shilasdair
- Start date
Yes, both.
She was in pain/stressed from displacement colic (and she's scared of vets) and also an abscess.
MuddyMonster
Well-Known Member
Oh, OK. Thats quite a different scenario to what I first thought - I think that ACTH increases with stress, so if there are genuinely no other symptoms I'd be more inclined to keep a close eye on and re-test.
I assumed the bloods were taken routinely, or at least understand, under investigation when she wasn't colic-ing.
paddy555
Well-Known Member
https://www.thelaminitissite.org/ppid-faq/does-a-high-acth-result-mean-my-horse-has-ppid
I think it is well known that stress may affect the results. People are advised for eg. not to travel their horse to the vet for an ACTH test as it may be stressful or that horse.
and this is from Rossdales
Concurrent disease, stress and travel can also have an impact on ACTH concentration and the presence or absence of these factors should be considered when interpreting any result.
I wouldn't be giving prascend based on what you have said so far.. If I wanted to know if she was PPID I would either retest ACTH when things were calm or more probably TRH test in the hope of getting an accurate results.
ETA if would be really helpful if people gave all the info in their first post. If you had said the horse was trying to die then stress v accuracy of a result would have been the first answer.
I think it is well known that stress may affect the results. People are advised for eg. not to travel their horse to the vet for an ACTH test as it may be stressful or that horse.
and this is from Rossdales
Concurrent disease, stress and travel can also have an impact on ACTH concentration and the presence or absence of these factors should be considered when interpreting any result.
I wouldn't be giving prascend based on what you have said so far.. If I wanted to know if she was PPID I would either retest ACTH when things were calm or more probably TRH test in the hope of getting an accurate results.
ETA if would be really helpful if people gave all the info in their first post. If you had said the horse was trying to die then stress v accuracy of a result would have been the first answer.
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Shilasdair
Patting her thylacine
Yes - I was concerned about the robustness of the results, and for this horse, the risk of colic from Pergolide.
And regarding your last edit - valid point - I should have explained more.
Gloi
Too little time, too much to read.
The prascend really made a big difference to the three oldies we gave it to.
Winters100
Well-Known Member
I started my old girl on it some weeks ago. During the first days she had what I am pretty sure was the early signs of colic, but we saw it early and vet came immediately, so no serious problem. A few days later we reduced the dose to 1/4 tablet on the advice of people here, and with the agreement of our vet, and we are now back up to 1/2 tablet with no recurrence of the colic problem. I can't really advise as I am new to this disease myself, but my understanding from what my vet has told me is that the drug is needed to prevent problems in future. Interestingly with her she has always been a really poor doer, but I have finally been able to reduce the size of her feeds as she is gaining weight, which in her case is good, as she has always needed 5+ feeds a day to keep weight on. We have kept to the same number of feeds for now but cut the quantity by 1/4. I am no expert on this disease, but I can say that so far our experience if the medication is good and my mare looks good and is full of life. Best tip I got from this forum - give the tablet in something dry such as a handful of muesli. I was having no end of problems giving it in apples and carrots, but a small handful of muesli and she accepts it everytime (so far at least!).
meleeka
Well-Known Member
I’d rather give it when not needed than not give it and lose my horse to
laminitis. I’ve just started one on Prascend, my second with it, and I started on 1/4 tablet for a week, then 1/2. We’ve had no problems at all, which is very difference to my first pony who went off feed and was really depressed. I didn’t know about starting slowly then, but she did have laminitis (also her only symptom or so I thought£ so I’d probably do the same for her again. I thought she was just getting old, but Prascend literally took years off her and she’s been great for the last 8 years or so.
The vet’s FB post you read was very misleading. In the comments she also said she always prescribes Prascend when laminitis is present and indeed has one of her own on it for those reasons. She just doesn’t prescribe it when there are no symptoms, based on numbers alone. The post was irresponsible, and your post proves why imo.
laminitis. I’ve just started one on Prascend, my second with it, and I started on 1/4 tablet for a week, then 1/2. We’ve had no problems at all, which is very difference to my first pony who went off feed and was really depressed. I didn’t know about starting slowly then, but she did have laminitis (also her only symptom or so I thought£ so I’d probably do the same for her again. I thought she was just getting old, but Prascend literally took years off her and she’s been great for the last 8 years or so.
The vet’s FB post you read was very misleading. In the comments she also said she always prescribes Prascend when laminitis is present and indeed has one of her own on it for those reasons. She just doesn’t prescribe it when there are no symptoms, based on numbers alone. The post was irresponsible, and your post proves why imo.
Boulty
Well-Known Member
If the blood was taken in a stressful situation & you're wondering about validity then would probably hang fire & retest in a few months then start treatment if still positive. Would get vet permission to start at tiniest dose possible & would look into APF (forage plus sell it in UK I think) as it can help with depression & inappetence (unsure if documented to help with colic)
TwyfordM
Well-Known Member
I’d say given test was done in a highly stressful situation I’d wait and retest (don’t do it for a while as it’s currently the seasonal rise so could be false positive)
But, if you get a positive result you definitely need to give the prascend. There’s a newish version out called BOVA paste, might be worth discussing with vet as can be given in lower doses and may reduce the colic risk?
My mare had no outward signs of cushings and borderline results, meds seemed to make her miserable so I stopped giving - she then went down with laminitis out the blue a while later. Rotations and sinking, now also EMS ??
I honestly wish I’d pushed more with the vets over other options as she’s now on the paste and happy as Larry!
But, if you get a positive result you definitely need to give the prascend. There’s a newish version out called BOVA paste, might be worth discussing with vet as can be given in lower doses and may reduce the colic risk?
My mare had no outward signs of cushings and borderline results, meds seemed to make her miserable so I stopped giving - she then went down with laminitis out the blue a while later. Rotations and sinking, now also EMS ??
I honestly wish I’d pushed more with the vets over other options as she’s now on the paste and happy as Larry!
BronsonNutter
Well-Known Member
Given your further info regarding the bloods being taken at the time of colic, I would repeat the test in a few weeks when your pony has recovered and is back to her normal self. Stress can elevate the levels of ACTH. If they're still high then I would medicate then so that you can get everything is under control prior to spring.
As an aside, I've seen a number of ponies who get grumbly low-grade colics (not displacements, more spasmodics) and have been reported to be much better on prascend. No idea why but it's interesting how owners perceive things differently. Can't say I've seen things colic significantly more often since beginning with prascend - go off their feed maybe, but I start on a very low dose and build up from there gradually to try and avoid this when prescribing it.
As an aside, I've seen a number of ponies who get grumbly low-grade colics (not displacements, more spasmodics) and have been reported to be much better on prascend. No idea why but it's interesting how owners perceive things differently. Can't say I've seen things colic significantly more often since beginning with prascend - go off their feed maybe, but I start on a very low dose and build up from there gradually to try and avoid this when prescribing it.
paddy555
Well-Known Member
good to hear this. I wondered how you were getting along.
Shilasdair
Patting her thylacine
She's very large for a pony (750kg large).
It's possible that she will colic less on Prascend, rather than more - but it is a stated side effect of pergolide.
But yes - I'm thinking about whether to give a small dose, then re-test, or no dose then re-test.
I'm a slow thinker.
Lady Jane
Well-Known Member
My friend has the same dilemma. Blood tests taken in the Autumn are 'correct' but the normal range for Autumn is very wide so they are not as conclusive. Her horse was in the grey area for Cushings, and so another test may be done a couple of months later to see if levels have changed. The vet has just tested for insulin dysfuction following grass and we are waiting for the results. He is also borderline EMS. Unfortunately we have learnt so much recently how complex these cases can be, its rarely just a case of the horse being too fat and you need to find the root cause of the laminitus to be able to manage it properly
paddy555
Well-Known Member
She's very large for a pony (750kg large).
It's possible that she will colic less on Prascend, rather than more - but it is a stated side effect of pergolide.
But yes - I'm thinking about whether to give a small dose, then re-test, or no dose then re-test.
I'm a slow thinker.
if you give a small dose and then re test how will you have anything to compare your retest results with? the levels may have gone up, remained the same or the small dose may have brought them down. You need an accurate base to start from and you haven't got that ATM.
That will of course be more expensive. See I haven't forgotten the word "expensive" after all
Shilasdair
Patting her thylacine
Interestingly, when she first came down with laminitis the vet told me she was unlikely to have EMS as she was not overweight. But she has EMS.
Shilasdair
Patting her thylacine
if you give a small dose and then re test how will you have anything to compare your retest results with? the levels may have gone up, remained the same or the small dose may have brought them down. You need an accurate base to start from and you haven't got that ATM.
That will of course be more expensive. See I haven't forgotten the word "expensive" after all
Well played, Padster.Yes, good point re lack of an accurate base. Also - where can I sell my partner's kidney?
Lady Jane
Well-Known Member
My friend's horse was only a teeny bit over weight. Not being over weight but having laminitus is the indicator that something (like EMS) is causing it
BronsonNutter
Well-Known Member
She's very large for a pony (750kg large).
It's possible that she will colic less on Prascend, rather than more - but it is a stated side effect of pergolide.
But yes - I'm thinking about whether to give a small dose, then re-test, or no dose then re-test.
I'm a slow thinker.
They're all ponies to me - 750kg falls into 'very big pony' category
Just as all dogs are puppies regardless of age!If you're happy that all your laminitis risk factors (weight, diet, grass etc) are all under control currently then I think personally I would go for no dose and re-test, as if you go small dose and re-test you'll not know if the prascend has made the difference or if it was a stray test.
Shilasdair
Patting her thylacine
I do think there's scope for more research into the causes of laminitis - vets are, in my opinion, too quick to pin it on weight alone. I look around my yard - some horses are fat, with/without laminitis, some are thin, with/without laminitis. And mine were respectively fat (without laminitis) and thin (without laminitis) until this year - so what changed, and what triggered the change?
Tiddlypom
Carries on creakily
Along with others I agree that, after your update, I would discount the ACTH results which taken at a time of great stress, which raises ACTH levels anyway.
It's worth getting older (>10 years old) horses tested annually, to pick PPID up early. That's how I found the then 11yo IDx was +ve. She's been on 1 prascend a day for 4 years now, her ACTH levels are stable, and she does very well on it.
It's worth getting older (>10 years old) horses tested annually, to pick PPID up early. That's how I found the then 11yo IDx was +ve. She's been on 1 prascend a day for 4 years now, her ACTH levels are stable, and she does very well on it.
ycbm
Einstein would be proud of my Insanity...
Pearlsacarolsinger
Up in the clouds
My mare had had a few colic episodes, each one slightly worse than the last before she was diagnosed with PPID and, although I didn't link the 2, she didn't have one in the last year of her life, when she was taking Prascend. Digestive issues are often a symptom/effect of the aging process, as is Cushings
southerncomfort
Well-Known Member
Happy to share my 2 experiences of cushings/prascend:
20 year old welsh section B tested due to coat growing longer than normal and pony being a bit flat. ACTH was 135. Started prascend but was given no advice re starting on low dose or avoiding the veil. Pony became depressed, lethargic, refused to eat and was utterly miserable. Took her off prascend completely and put her on cush x instead. For almost a year she did well and seemed much better until suddenly she became very, very poorly with a virus. She lost 15kgs and we very nearly lost her as her compromised immune system struggled to fight it off. Retested and ACTH was off the scale. Started her back on prascend (literally just dust to begin with) and increased it very slowly. All symptoms improved and she was kept healthy until 25 when she started getting repeated skin infections despite being on maximum dose. She was PTS due to a field accident but the cushings was very advanced by this stage. My biggest regret was not persevering with the prascend at the beginning as I'm certain she wouldn't have been so ill with the virus and it may have slowed the progress of the disease more.
And:
20 year old welsh cob X. Very slow to shed coat last year and the coat itself was very scurfy. She was so itchy I ended up giving her a full clip in May.
I'd already decided to have her tested this autumn when she started having intermittent lameness. By which I mean she'd be lame in the morning and perfectly sound a couple of hours later. Vet diagnosed sub clinical laminitis. ACTH was 74 so not overly high but with the intermittent lameness and coat issues it was decided to put her on prascend. Dose was 1 tablet so I started her on half a tablet. Increased to 1 tablet after 10 days and she immediately went on hunger strike. Back to half a tablet and she is fine. She is now up to an hour an a half on grass.
Their is some research to suggest that putting (and keeping) a horse on a low dose of prascend right from when ACTH levels show even a small increase is as beneficial as putting a horse with obvious symptoms and high ACTH on a high dose.
I want to say that I completely understand your reticence and some people do choose to go down the herbal route in the full knowledge that it only improves symptoms and does not slow the progress of the disease, and accept that ultimately the horse won't live as long as one on prascend. I think that's a legitimate approach though not not one I would personally take for the simple reason that when the cushings symptoms finally take hold they are absolutely horrible and it can be quite upsetting.
Hope that helps. ?
20 year old welsh section B tested due to coat growing longer than normal and pony being a bit flat. ACTH was 135. Started prascend but was given no advice re starting on low dose or avoiding the veil. Pony became depressed, lethargic, refused to eat and was utterly miserable. Took her off prascend completely and put her on cush x instead. For almost a year she did well and seemed much better until suddenly she became very, very poorly with a virus. She lost 15kgs and we very nearly lost her as her compromised immune system struggled to fight it off. Retested and ACTH was off the scale. Started her back on prascend (literally just dust to begin with) and increased it very slowly. All symptoms improved and she was kept healthy until 25 when she started getting repeated skin infections despite being on maximum dose. She was PTS due to a field accident but the cushings was very advanced by this stage. My biggest regret was not persevering with the prascend at the beginning as I'm certain she wouldn't have been so ill with the virus and it may have slowed the progress of the disease more.
And:
20 year old welsh cob X. Very slow to shed coat last year and the coat itself was very scurfy. She was so itchy I ended up giving her a full clip in May.
I'd already decided to have her tested this autumn when she started having intermittent lameness. By which I mean she'd be lame in the morning and perfectly sound a couple of hours later. Vet diagnosed sub clinical laminitis. ACTH was 74 so not overly high but with the intermittent lameness and coat issues it was decided to put her on prascend. Dose was 1 tablet so I started her on half a tablet. Increased to 1 tablet after 10 days and she immediately went on hunger strike. Back to half a tablet and she is fine. She is now up to an hour an a half on grass.
Their is some research to suggest that putting (and keeping) a horse on a low dose of prascend right from when ACTH levels show even a small increase is as beneficial as putting a horse with obvious symptoms and high ACTH on a high dose.
I want to say that I completely understand your reticence and some people do choose to go down the herbal route in the full knowledge that it only improves symptoms and does not slow the progress of the disease, and accept that ultimately the horse won't live as long as one on prascend. I think that's a legitimate approach though not not one I would personally take for the simple reason that when the cushings symptoms finally take hold they are absolutely horrible and it can be quite upsetting.
Hope that helps. ?
HollyWoozle
Well-Known Member
My mare tested positive for Cushings last autumn, but only just. Had her tested after she suddenly became footsore (she was 18, now 19). Ended up putting front shoes on to fix the footsoreness and vets gave me the option of Prascend and said I could try her on it or go without and see what happens. Now a year on without any treatment and she has been completely normal for her.
Perhaps a bit different as my mare is retired and a little stiff generally. As other posters have said, Prascend might make all the difference in some cases, but for me I thought I’d just see how we got on without and so far so good.
Pippin and Poppy
Well-Known Member
I was quite surprised a few years ago when the vet taking a blood sample from my husband's horse said she would never give Prascend to her horse.
It wasn't a decision we had to make as the blood test was negative for Cushings.
Advancing age and experience has taught me to take vet advice with a pinch of salt. In the end an owner should be able to make their own (informed) decision. This is one of the reasons we don't insure.
Edited to add - I agreed with her comment and actually she is a very good vet!
It wasn't a decision we had to make as the blood test was negative for Cushings.
Advancing age and experience has taught me to take vet advice with a pinch of salt. In the end an owner should be able to make their own (informed) decision. This is one of the reasons we don't insure.
Edited to add - I agreed with her comment and actually she is a very good vet!
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meleeka
Well-Known Member
What were her reasons?
Pippin and Poppy
Well-Known Member
I thought I might be asked this lol but I didn't ask the vet because it wasn't relevant to us at the time. I knew the mare didn't have Cushings and I also knew I would not give Prascend even if she did.
I was surprised that the vet volunteered the comment 'out of the blue'. The horse was losing weight.
The blood tests found nothing and we kept the mare going for another two years.
She was an old horse with an unconfirmed birth date.
meleeka
Well-Known Member
How odd that you agreed with her without knowing her reasons, but like to take vets advice with a pinch of salt ?
Snowfilly
Well-Known Member
Recently had a pony tested and the vet said that none of his own horses would have Prascend and he’d rather supportively treat any symptoms of long coat etc and PTS when it progressed; he said he’d seen far too many side effects to want to use the drugs.
Another vet from same practice was out for something different and chatted about it; she would recommend dosing from first high test.
So if two vets from the same equine practice have such different views, I think it’s fair to assume there’s a range of ideas on it. Pony was negative so not something we needed to follow up but who’s advice would I have followed?
Another vet from same practice was out for something different and chatted about it; she would recommend dosing from first high test.
So if two vets from the same equine practice have such different views, I think it’s fair to assume there’s a range of ideas on it. Pony was negative so not something we needed to follow up but who’s advice would I have followed?
meleeka
Well-Known Member
The side effects aren’t permanent, so I would always give it a go and reassess if necessary. I had an inkling about one of mine, but apart from being old she had no symptoms. Her coat looked awful so I ended up having her tested and was fully prepared to take her off Prascend if it didn’t suit. She’s ancient and I only took her on out of pity so didn’t think I really owed her anything, but I cannot believe the difference in her. She was semi feral in that you could handle her but she was like a coiled spring, but she’s calm but alert and just seems happier than she’s ever been. I also caught her having a mutual scratch with the shetland the other day which she’s never done before. I can’t really begrudge the £1 a day when it’s made so much of a positive difference.