To give Prascend or not?

[paddy555]

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.

good job my horse avoided him then. on that basis he would have been PTS at 12 with just about every symptom of cushings, as it was he had prascend and was PTS at 21 after many more years riding.
I had side effects in that the horse become very high for the first 3 months as he adjusted to the drug. After that not a single side effect but the dreaded abscesses which plagued him constantly were gone. Before prascend he had so much time off with abscessing and I spent so much time treating them. After he had one abscess in nearly 10 years.

I am not sure how a vet would treat cushings supportively. What can you do to treat abscesses, topline muscle loss, constant requirement for anti biotics to deal with the slightest problem which others cope without, hives making the horse unrideable, excessive peeing and drinking, losing weight even with excessive eating, total lethargy when ridden. The list goes on.

I'm not sure why a vet would recommend depriving a horse of possibly many years of useful life.

 

[meleeka]

I'm not sure why a vet would recommend depriving a horse of possibly many years of useful life.

Just in case they are one of the tiny minority who it doesn’t agree with apparently ?

That’s like me saying nobody should ever use a certain cream because I had a bad allergic reaction to it. It was awful for me, but many people use the same cream without trouble.

It seems to me that some people will use any excuse to avoid the cost which is around £31 a month for most horses. That’s about the same as a decent joint supplement or a couple of bottles of fly repellent in the summer.

 

[Not_so_brave_anymore]

I know I'm late to this, I haven't read the full thread, you may not want any more opinions. But. My little mare had tummy issues BEFORE she was diagnosed ppid. She used to have very watery cow pat droppings, and she cribbed badly. This has all stopped since starting the prascend. So my experience is that ppid can actually present as a bit colicky, and not only has the prascend not aggravated it, it's actually massively helped.

But I totally understand that fear of actively doing something that makes the poor horse WORSE. I personally would start with 1/4 a day and see how it went ?‍

 

[ILuvCowparsely]

Hi
One of mine has been diagnosed with Pituitary Pars Intermedia Dysfunction (PPID) or 'Cushings', and I have duly been given Prascend for her.
I do not want to give her Prascend, however, as she doesn't show any of the symptoms of PPID (with the exception of laminitis which I suspect is more due to her EMS).
The laminitis is under control with diet.
I also believe that the side effects of Prascend will hit this horse particularly hard.

So convince me to obey the vet and give her the 1/2 pill she's been prescribed, please.

My donkey developed cushings - she did go off her feed a bit after being on it at the beginning, but I would follow my vets advice on this, if you trust your vet.

 

[MuffettMischief]

An interesting post recently on a vets page re cushings/meds

*just read comments and realise it is referenced above!

 

[Not_so_brave_anymore]

An interesting post recently on a vets page re cushings/meds
View attachment 81240View attachment 81241View attachment 81242

Hhhm, my (very limited) experience does not support this at all. I have a pony with medium ACTH levels, and a number of very low level ppid symptoms. I had real trouble getting the tablets into her over the winter, she didn't seem any worse for not having the full amount every day, so I kind of gave up a bit. (I mean, I was still chucking the 1/2 a tablet into her feed every day, and occasionally trying out new methods to trick her into eating it, but I knew she was avoiding it and/or spitting it out very often)

She got laminitis (despite being VERY carefully managed alongside a previously laminitic Shetland) and despite catching it very early, with no damage shown on xrays, she just wouldn't come *quite* right until I started syringing the prascend to make sure she got the absolute full dose every single day. And she's been right as rain since then. She's even been out on grass for 2 hours a day and been fine, whereas before she was completely grass free and still getting raised pulses even from unsoaked hay.

Just my one personal experience.

 

[Tiddlypom]

Disappointing post from equine vet Natalie McGoldrick.

My vets, who I trust, actually recommend if only testing annually to do the test in the autumn as that is where PPID horses show abnormally high levels.

A higher than expected seasonal autumn rise of ACTH is one of the early signs of PPID. Affected horses may well only need Prascend to assist with the autumn rise, and may be able to do without the rest of the year as the levels drop down again. They still have early Cushing's, and need monitoring. This is not new news.

Wise vets advise treating early. I wouid not stay with a vet with such antipathy to treatment.

 

[paddy555]

What can you do to treat abscesses, topline muscle loss, constant requirement for anti biotics to deal with the slightest problem which others cope without, hives making the horse unrideable, excessive peeing and drinking, losing weight even with excessive eating, total lethargy when ridden.

these are cushings signs. I'm not sure how Natalie Mcgoldrick would treat them without prascend.

Her post is interesting but dangerous. People with little knowledge of cushings are going to read that and think it is Autumn, no point in testing and really is cushings that important anyway. Was for mine. Vet said he didn't have cushings after 2 very neg. ACTH tests. I basically saved his life by insisting on prascend, Without my input he would have been dead long ago. Symptoms were all there and jumping out hitting the vet in the face. Prascend resolved all his symptoms. Fortunately I had done a lot of research. If I had only read Natalie's post I may have just gone along with the vet and signed his death warrant.

. She raises a good point about the inaccuracy of ACTH tests, I don't think it has done any favours posting that. If that is her view, and it may be correct, by all means put those points to her clients when they can ask questions and discuss it don't put it on the internet where it will be taken as gospel by some who have no other knowledge or experience.

ETA at the time mine started prascend, he wasn't diagnosed as his tests were neg. another identical horse of the same breed and same age had the same symptoms. That vet wouldn't prescribe prascend despite laminitis. My horse lived another 9 years. The other one had to be PTS pretty soon afterwards.

 

[meleeka]

Further down the comments, the same
vet also says this, which contradicts her original post somewhat.

This vet has a loyal customer base but many more people who don’t like her. I’ve read that Liphook won’t even deal with her so that speaks volumes for me.

 

[Winters100]

Disappointing post from equine vet Natalie McGoldrick.

My vets, who I trust, actually recommend if only testing annually to do the test in the autumn as that is where PPID horses show abnormally high levels.

A higher than expected seasonal autumn rise of ACTH is one of the early signs of PPID. Affected horses may well only need Prascend to assist with the autumn rise, and may be able to do without the rest of the year as the levels drop down again. They still have early Cushing's, and need monitoring. This is not new news.

Wise vets advise treating early. I wouid not stay with a vet with such antipathy to treatment.

My vet also recommends testing in Autumn, and for last 3 years has been testing my oldie at this time. This year she tested at slightly above normal levels. His opinion is that finding and treating it early gives her the best chance of having more quality years. I am not a vet, but he is a very experienced and well respected professional, so I am happy to follow his recommendations in this regard.

 

[Shilasdair]

I just wanted to thank everyone who has taken time to respond - I have read every post very carefully, and will try to do what I think is best for my horse going forwards.

 

[Shilasdair]

Just in case they are one of the tiny minority who it doesn’t agree with apparently ?

That’s like me saying nobody should ever use a certain cream because I had a bad allergic reaction to it. It was awful for me, but many people use the same cream without trouble.

It seems to me that some people will use any excuse to avoid the cost which is around £31 a month for most horses. That’s about the same as a decent joint supplement or a couple of bottles of fly repellent in the summer.

I'm unsure whether you believe that I am 'using any excuse to avoid the cost' regarding Prascend, or whether it was a more general observation?
I'm in the fortunate position of not having to worry too much about the costs of vet treatment - in fact I already have the Prascend pills.

BUT - for some people, finding £31 a month or even less is not so easy - and we should recognise that, and empathise.

 

[meleeka]

I'm unsure whether you believe that I am 'using any excuse to avoid the cost' regarding Prascend, or whether it was a more general observation?
I'm in the fortunate position of not having to worry too much about the costs of vet treatment - in fact I already have the Prascend pills.

BUT - for some people, finding £31 a month or even less is not so easy - and we should recognise that, and empathise.

No it was a general observation. I do understand why you’re are asking the question. I’d have probably asked the same.

I do think if you are going to own a horse you ought be able to figure that into your monthly outgoings. Horses by their nature like to find ways to cost us money.

 

[Shilasdair]

No it was a general observation. I do understand why you’re are asking the question. I’d have probably asked the same.

I do think if you are going to own a horse you ought be able to figure that into your monthly outgoings. Horses by their nature like to find ways to cost us money.

Maybe - but one of mine cost me £13k in the space of 18 months.
How many people would foresee that and/or be able to pay?

 

[meleeka]

Maybe - but one of mine cost me £13k in the space of 18 months.
How many people would foresee that and/or be able to pay?

Well yes I think most people would struggle with that! ?

 

[Gloi]

Mine stopped eating his normal hard feed when he was on Prascend but would still eat grass and hay. If he went off hay it was usually a diastema problem that could be dealt with. I was careful at first to keep him on a low sugar feed but when he was refusing that gave him a bit of mix which was mollassed and he ate that so mixing that into his other feed kept him eating it. He had never been laminitic but had been drinking and peeing a lot before diagnosis.

 

[meleeka]

Mine stopped eating his normal hard feed when he was on Prascend but would still eat grass and hay. If he went off hay it was usually a diastema problem that could be dealt with. I was careful at first to keep him on a low sugar feed but when he was refusing that gave him a bit of mix which was mollassed and he ate that so mixing that into his other feed kept him eating it. He had never been laminitic but had been drinking and peeing a lot before diagnosis.

Mine still gets teaspoon of Sixteen Plus mix on her tea. I’m not sure why it makes such a difference but it does apparently.

 

[Tarragon]

I gave my pony a general health check when he reached 18 years old as I felt I wanted to know what I might be up against in the future and found, to my and my vet's surprise, that his ACTH levels were up, as at that time he had no symptoms. He has been on Prascend ever since and is now 23 and still shows no symptoms, and I put that down to the fact the Prascend is ensuring that his body is functioning as though he doesn't have cushings. My management of him hasn't changed at all.
What I can't tell you is what he would have been like if I hadn't treated him but my gut reaction is that I would now be having to manage all the typical cushing symptoms, especially laminitis, which would be horrible.