Cushings and appetite

Kris Lindblom

My 16 y/o SWB gelding was started on Pergolide May 2019 with ACTH 45.4 pg/mL. He was started on 1 mg daily, had a beautiful hair coat and got very dopey from the drug. After 2 weeks we dropped it to 0.5 mg daily. He perked up. He started getting a bit hairy the last couple weeks in July 2019 after being on pergolide for about 6 weeks. Prior to this his coat had been the most beautiful one on the farm.  His hair coat has continued to be dull. His ACTH in November 2019 was 54.6 pg/mL. 
We bumped him back up to 1 mg daily. His hair coat looked a little better over winter. March 2020 ACTH 8.31 pg/mL. Continued on 1 mg daily because his haircoat seemed a bit heavier and dull. He is blanketed over winter, out daytime, in overnight.  He has always been a good eater. 
Now he is not wanting his grain as much, still eats hay which he loves  but even leaves some of that. Appetite ok with treats, and carrots but they have to be very fresh and cold. He has been off of work since Sept 2019 as he had a very serious abscess, first one ever, up in middle of right front hoof. Very hard to diagnose and thank God U of MN has CT scanner and great veterinarians. Surgery was done and very specialized farrier care continues and his hoof is almost completely healed. I've questioned at times is he true Cushing's? The reason he was tested is he would stare off at times and just be frozen like he left us. My instructor and her husband, both trainers, raised him from their mare and stallion so complete history is known. They had another Cushing's horse, no relationship,  that had episodes of staring off and was diagnosed Cushing's.  That is why we tested my guy. He never got the poor coat until he was on pergolide. Long story. Thank you for any input. I just want to do what's best for him. He's still very safe in condition and feeling fine but sometimes seems depressed. I worry about his fussy eating.  He has lost some weight but that is also partially from muscles not being in condition from no riding. Is pergolide helping or hurting him? Is dosage wrong for him? He's really a challenge to make sure he takes his pill. It can be in a carrot or a muffin and sometimes he finds a way to spit it out and you find it on edge of feed box in his stall. We try and be consistent hand feeding it like a treat and sometimes he is wise to that as well. I'm just confused and want to do what's best for him. Would appreciate any info. Thank you so much, Kristen 
Kristen L. in Minnesota 2020

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