Re: PPID, Inflammatory Bowel Disease, Corticosteroids


Maggie
 

Hi "silversnaffle",

Welcome to the group!  You've sure been through the wringer with your warmblood!  Sorry you are having so much trouble!  Since you are a regular reader at our website, ECIRhorse.org, I won't go into the basics of the DDT/E, since the website covers all of that.  To get the best answers to all of your questions, we need you to fill out a CH on your boy.  To do that, you will need to join our sister group called ECHistory8, a filing cabinet for current CH's.  It should not take long to get approved and then just follow the instruction on the main page to fill out a CH on your boy.  Here's a link to that group:  https://groups.yahoo.com/neo/groups/echistory8/info  In addition to the "fill in the blanks" on the CH form, at the very end is a "comments" section that you may want to use to copy and paste the information you have provided in your post.  This will put all the important facts in one easily accessible place for the volunteers.

Meanwhile, I had a couple of thoughts when I read your post.  I am sure others will chime in with their thoughts as well.  

I do see that you weaned onto the pergolide, but did not see mention if you used APF.  Did you try that?  APF is an adaptogen that can really help with the symptoms related to the "pergolide veil".  You might be able to pick some up at a local tack or feed store.  It's also available in online catalogs, and on their website:  http://www.auburnlabs.com/html/eqProdGen.html   I'm sorry, but I have no experience, nor do I remember reading about any horses on the list where decreased water consumption is a veil symptom, but I haven't been around as long as many of the other members.  You did also mention that he wasn't eating as enthusiastically.   If that in combination with the decreased water consumption your warmblood is experiencing are his veil symptoms, the APF should be very helpful.

I also see that you weaned onto the pergolide, which is good, but it may be that you didn't wean on slowly enough.  We recommend that you start with 0.25mg for 3-4 days, and increase by 0.25mg every 3-4 days until you reach your target dose.  Since Prascend is scored to be broken in half, but not recommended to break into quarters, you can dissolve 1/2 tab (0.5mg) in 10cc water, administer 5cc (0.25mg) and save the other 5cc in the fridge for administration the next day.  May be that your boy needs this slower wean onto the drug.

The other thing that jumped out at me is the ACTH of 49 in late September after 6 weeks on 1mg of Prascend.  Since you mention the "seasonal rise", I'm guessing that you may have already read that section on the ECIRhorse website.  If not, here's a link to that part so that you can read the details:  http://ecirhorse.org/index.php/cushing-s-disease/seasonal-rise   The seasonal rise is period of the year (fall in the northern hemisphere) when all horses have a natural rise in their ACTH, but PPID horses can have an exaggerated rise over an extended period of time.  Many (most) horses need an increase in their pergolide to get them through the seasonal rise.  We like to see their ACTH down in the middle of the normal range (Cornell 9-35, so mid teen's to low 20's).  Since your boy was doing well on 1mg of Prascend in late September, but his ACTH was still high at 49, it makes sense that he would have benefited from an increase in his pergolide at that time.  Many PPID horses don't peak their ACTH until October (or even November), so it's possible that his ACTH continued to rise after the late September ACTH of 49, causing him the problems that started in late October.  Some early PPID horses do need pergolide only during the seasonal rise.  The only way to know is to test again.  We recommend that the horse be on a set dose for 3 weeks before testing to see if that dose is controlling the ACTH.  

Those are my thoughts as I read your post.  Hopefully others will chime in with their knowledge/experience.

We ask members to sign each post with their name (first is fine), date of joining, and general location, which helps us to help you source products.  Also, once you get your CH done, please add a link to it in your signature as well.  It really helps us to find it faster and to answer questions faster.  Thanks for your help with that!  And keep us posted on your boy!

Maggie, Chancey and Spiral in VA


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