Date   

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



Re: Pergolide versus Pergolide Mesylate Dosing #pergolidestrength

tara sullivan
 

Ian chime in here please. Ok. Please confirm this for me as I do get my mare's meds from Thriving Pets.  I order the 1.5mg capsule dose...which to me would be like giving her 1.149 tablets of prascend....yes??  Just a little more than 1mg of pergolide.  I thought I had this down and now not so sure.
Thanks all
Tara and Divina
2014 NY


yea sac 1026

lj friedman
 

I posted this message in echousekeeping prevíously. this site prob better.

Dr. Kellon recommended this product for one of my non-Cushing's non-IR horses to avoid digestive upset during a hay feed change. I'm wondering if this product could be given  prophylactically   for Cushing's IR horse just because? The price of this product is very inexpensive at approximately $.25 per day. Lj Friedman san diego



does Inky need higher pergolide dose?

ksherbin@...
 

 His latest Cornell test shows 23.4 pg/mL, in a range of 9-35. The vet said that is fine.

 

Is it? Or should it be lower? He seems okay, a bit lethargic, but don't know if that's the Cushing's or if he is just becoming lazy. He tested negative for Lyme, btw.

 

Karin & Inky

Forest, VA

IR/Cushing's

July 27, 2015

ECHistory8

 


Re: Pergolide versus Pergolide Mesylate Dosing #pergolidestrength

eknox217@...
 

Sadly, I had to have my horse, Oscar, euthanized earlier this week. He was suffering with acute and chronic laminitis. We have been trying to help him for several months, but it was not to be. His coffin bone was sinking, and it became clear that he could not suffer through the winter. I believe it was the right decision. Before the end stage of his illness, we thought that the chronic laminitis may have been caused by Cushings disease, so I started him on Pergolide. I ordered Prascend through Valley Vet. 

The Prascend 1 mg pergolide mesylate tablets came as 60 tablets in six blister packs of 10 tablets each. I used 20 tablets (2 blister packs). If someone is interested in purchasing the remaining 40 tablets in four unopened blister packs, I would be happy to send them to you. I paid $112 for the 60 tabs. Do you think $60 is a fair price for the remaining 40 tablets? Please contact me via eknox217@.... Thank you.


PPID, Inflammatory Bowel Disease, Corticosteroids

Tracy H
 

Hello All,
Am a regular reader at ECIR Horse but have come here in case anyone has had a similar experience. 20 year old warmblood, very healthy and sound until late July of this year. Horse has always been excellent drinker with non stop appetite. Not super easy keeper, but well maintained on primarily pasture/hay and small amount of lowish 15% NSC grain. 

In late July, weight loss, starting to lose topline, slight lethargy, but big problem with thermoregulation. Significant sweating during both exercise and turnout. Water consumption way up but with sweating, probably good. No signs of laminitis inc. x-rays. Full blood chem, tick borne disease and ACTH bloodwork done 1st week August. All normal except ACTH at 99. (Cornell Lab) Run Insulin and Leptin (both come back at very bottom end of normal. Start on Prascend. Horse is know to be hyper sensitive to meds so slow titre over 10 days to 1mg. No adverse effects. Appetite excellent as always, and water consumption is normal. Improvement noted in thermoregulation after four weeks, energy level better, gained back a little weight. At 6 weeks of 1 mg (late Sept), retest ACTH. Result is 49. Plan is stay at 1mg thru December and then retest. 

Late October, horse begins to show odd drinking behavior. "Testing" or "playing with water" before he drinks.Has also stopped dunking hay which he does about 50% of meals. This is new behavior. Check mouth, try bottled water, etc. Nothing. Since consumption amount is fine, will discuss with vet at next visit. 

Three weeks ago, horse is still eating well but a bit more slowly, and water consumption stops overnight. Manure is a little dry. Call vet; to thwart possible impaction, feed and hay pulled, Prascend stopped, and three days of IV fluids and enteral fluids via nasogastric tube. Horse is only allowed small handfuls of wet hay as manure is still coming thru. Third day, oil passes. Horse is STARVING (at least in his mind) and finally at least drinks 1 gallon on his own. Day four restart Prascend at 1/2 dose and small small amount of hay. Horse is drinking on his own. Plan is stay 1/2 dose Prascend for four days and then go back to 1 mg. Two days later horse is exhibiting spasmodic colic during eating. Off to vet hospital. Abdominal ultra sound shows moderate to significant inflammation of small intestine. Scope shows no sign of ulcers, problems with esophagus, etc. but inflammation of of first part of small intestine is visible. Biopsy performed. Result show esinophils, likely caused by immune response to something, diagnosed as Inflammatory Bowel Disease. (explained as similar to what happens to people who have celiac disease if they consume gluten). Hard part is figuring out what the something is? Horse is now eating soaked timothy pellets, still on .50 mg Prascend and drinking at hospital.  Bad news is treatment is Corticosteroids. Obviously contra-indicated for PPID horse, but potential impaction due to inflammation is more dire problem. Decision to go back to 1mg Prascend and start steroids. Three days IV Dexamethasone then switch to oral prednisolone as it has a slightly lower risk for inducing laminitis. Horse comes home  doing okay and drinking, although with 6 soaking wet meals of timothy pellets, not enormous amounts. Then drinking stops. Attending vet is concerned that end of seasonal rise, Prascend dose might be the problem. Stop Prascend for two days. Day two horse drinks a little and is as bright and alert and famished as he's been for whole ordeal, scarfing the pellet soup down.  Restart Prascend at .50 mg. Next day, no drinking and eating slowly again.

FYI - When they were scoping him, I asked for a full check of his teeth, gums, etc. they didn't find anything.

Sorry this is so long but I am wondering....
1. Does anyone have experience with Prascend where drinking is more of a problem than eating? Whatever is going on, the drinking stops and he still eats but not the scarfing it down he usually does? I should say that this horse is as food motivated as they come. Eating is his life.

2. Like causes of the IBD are protein sources in grains or some other thing he ingests in hay or pasture....but could be medication. Has anyone had a horse with inflammation of the bowel related to Prascend dose?

3. Is it possible or likely that at this time of the year, he just needs less Prascend?

Thank you all so much in advance. Any insight is most welcome.


Re: switching to odtb cubes

Nancy C
 

Hi Vicky

Thanks for the link to your case history.  It really helps.

It appears you are switching to ODTB Cubes to use a carrier for your supplements: minerals, vit e, flax, salt, etc., instead of the other grain. If so, use only as much as you need to do the job. I feed my 1100 pound gelding about three-quarters of a pound per meal to do this.

Nancy C in NH
February 2003
ECIR Group Mod


---In EquineCushings@..., <vickymonen@...> wrote :

Hi,

Im Switching pony over to the ODTB cubes from Equilizer feed.   How much of the ODTB cubes should I feed per feeding for an IR 1000lb pony, fed twice a day.   With plain forage hay?


Vicky Monen and Samson

Ga, Aug 2015

https://groups.yahoo.com/neo/groups/echistory8/files/Vicky%20and%20Samson/
https://groups.yahoo.com/neo/groups/ECHoof/photos/albums/1698376942`


Re: Pergolide versus Pergolide Mesylate Dosing #pergolidestrength

Nancy C
 

Hi Sharon

Without getting too far into the weeds, that is what we are trying to sort out.

Nancy C in NH
Feburary 2003
ECIR Group Mod


Re: Pergolide versus Pergolide Mesylate Dosing #pergolidestrength

Lorna Cane
 



>> I have one horse on 21mg and another on 10mg! Not sure how long I can continue this , so if one Pharmancy gives more bang for the buck I sure would like to know!


What does the label say?

Does the label say 21mg pergolide from pergolide mesylate?

Or 21mg pergolide mesylate?





Re: Pergolide versus Pergolide Mesylate Dosing #pergolidestrength

Sharon Manning
 

Well this discussion has been over my ability from the very beginning but I have been following it trying to understand. I do understand the simple math in relation to my pocket book. As Nancy points out... I have one horse on 21mg and another on 10mg! Not sure how long I can continue this , so if one Pharmancy gives more bang for the buck I sure would like to know!
Sharon
E TN
2005

Sent from my iPhone
Please forgive any errors


Re: low sugar/starch hay

Maggie
 

Hi Barbara,

Check your Yahoo email.  I sent you an email with instructions on how set up your signature in your Yahoo email.  

Maggie, Chancey and Spiral in VA
March 2011
EC moderator/Primary Response
https://groups.yahoo.com/neo/groups/ECHistory4/files/maggie%20in%20virginia/ 




Re: Pergolide versus Pergolide Mesylate Dosing #pergolidestrength

Nancy C
 

Hi Cass

I may be splitting haris, but I am interested in what compounders are doing so I may compare.  What is in the final product I am receiving. I hope to learn what questions to ask to determine this.  We have heard from others that compounders are using higher levels of pergoide mesylate. It would be important to not lose that info in the discussion of why one compounder may have a business reason to perform in one way or another.

Again, just my opinion based on the needs of my horse.

Nancy C in NH



---In EquineCushings@..., <cbernstein@...> wrote :

Thanks, Ian. I, for one, care very much why compounding pharmacies do what they do. Consistency of the compounded drug is central to my willingness to substitute a compounded drug for an FDA approved formulation. 

Cass for Satra
Sonoma County, Calif. Oct. '12



Re: Vet explains Cushing's horse getting skinny

ksherbin@...
 

Thank you for your real-life example. So glad to hear that your mare is 30. You must be doing a fantastic job with her, and it inspires me that my guy will do well too.

 

 

Karin & Inky

Forest, VA

IR/Cushing's during seasonal rise

July 27, 2015

ECHistory8

 




Re: Vet explains Cushing's horse getting skinny

ksherbin@...
 


"Aging will not make IR go away. If the IR has been induced by uncontrolled Cushing's (PPID), then the IR will indeed go away when the PPID is under control."

Jaini,

 

Thanks for the details to back up your opening statement. The vet and the farm owner won't be open to the information, but as long as I'm clear on it, that is helpful.

 

I didn't understand this comment: "also, double-check the actual ACTH numbers. PPID horses do better if the ACTH is in the middle range, not at the upper end of normal. "

 

Is 23.4 pg/mL considered in the high range of normal when the range is 9-35? Are you suggesting another test? The last one is from a month ago.The vet said she thought it was a good number and said to keep the pergolide dosage at 1 mg daily.

 

Karin & Inky

Forest, VA

IR/Cushing's during seasonal rise

July 27, 2015

https://groups.yahoo.com/neo/groups/echistory8/files/Inky%20Case%20History/

 


switching to odtb cubes

vicky monen
 

Hi,

Im Switching pony over to the ODTB cubes from Equilizer feed.   How much of the ODTB cubes should I feed per feeding for an IR 1000lb pony, fed twice a day.   With plain forage hay?


Vicky Monen and Samson

Ga, Aug 2015

https://groups.yahoo.com/neo/groups/echistory8/files/Vicky%20and%20Samson/
https://groups.yahoo.com/neo/groups/ECHoof/photos/albums/1698376942`


Re: Need some input please

tara sullivan
 

Thanks for the link.  I tried!  Very interested in having you review Divina's CH and tell me what you think.
I know we need to sign...I cant remember when I joined....2014? 2013?
Tara and Divina
NY 2014  


Re: Calming Product for Daily Administration to Horse on Stall Rest

Larks Tabatha
 

Yes... I have some Rescue Remedy, use it before my rides when I have a wild eyed horse.  I am wondering how you would you dose it for daily use?  This healing process may take weeks ;(

Was hoping for something that I could set up in her pre measured baggies of  pellets and supplements for the days that someone else is feeding for me..

Thanks again,
Sally in AZ
April 2013 


Re: Vet explains Cushing's horse getting skinny

janieclougher@...
 


Hi, Karin-

Aging will not make IR go away.  If the IR has been induced by uncontrolled Cushing's (PPID), then the IR will indeed go away when the PPID is under control.

Reduction in weight definitely helps improve the IR status of the horse, and can sometimes bring it to the compensated or even the status of non-IR.  Not always, however.

Good news that the leptin values are going down - I believe that suggests that some of the metabolism is coming under control. However, since Inky is (by his case history) still fat, that may explain why the insulin and glucose levels aren't yet coming down; also, double-check the actual ACTH numbers.  PPID horses do better if the ACTH is in the middle range, not at the upper end of normal.


It is true that a horse is more prone to Cushings(PPID) as it ages; older horses have had more time for oxidative damage to the neurons, which, over time, will result in PPID.  However, they can still be baseline IR, even when skinny.  Being skinny can aid in control of IR, but it can also be a sign of advanced IR.

There are a lot of factors that contribute to weight loss in an older horse (or the horse who was an easy-keeper becoming a hard-keeper). The obvious ones, such as teeth and parasitism, are usually fairly easy to identify.  However, an older horse whose teeth look just fine may no longer have the muscle mass and muscle strength to chew as thoroughly as a younger horse, and so the hay isn't chewed enough to allow proper release of nutrients.  Also, there is a gradual decrease in stomach acid production with age, which will reduce protein absorption.  In elderly humans, there is reduced production of digestive enzymes, and reduced absorption of nutrients in the intestinal tract.  It is possible that the same is also true for horses in the small intestinal portion of the tract, at any rate.


A short check-list of factors contributing to weight loss or hard-keeping would include:


Uncontrolled PPID

Age-related changes in enzyme production, acid production, and ability to absorb nutrients

Teeth - either worn, or needing floating

Chewing ability - lack of strength

Parasitism

Underlying disease - kidney or liver issues, other disease states

Pain - laminitis, arthritis, other

Uncontrolled, advanced IR


Note that uncontrolled PPID will pack a triple whammy with reduced muscle mass and strength, and suppressed immune system resulting in a greater susceptibility to parasitism.


All of the above weight-loss "strategies" come with a price, however - not only are there fewer calories being absorbed, there are fewer essential nutrients being absorbed, and that is not a good thing.


Clear as mud? Sorry, I meant this to be a simple and short answer, but equine metabolism is anything but simple! There are lots of variables involved. Hope this helps a little.




Re: Pergolide versus Pergolide Mesylate Dosing #pergolidestrength

 

Thanks, Ian. I, for one, care very much why compounding pharmacies do what they do. Consistency of the compounded drug is central to my willingness to substitute a compounded drug for an FDA approved formulation. 

Cass for Satra
Sonoma County, Calif. Oct. '12

---In EquineCushings@..., <ian@...> wrote :

I just got off the phone with Rich Gaffin, R.Ph. of Pet Health Pharmacy. Pet Health supplies compounded Pergolide Mesylate. As previously mentioned, compounding formulas are supplied for Pergolide Mesylate (not Pergolide USP or base). Rich guaranteed me that they dispense Pergolide Mesylate and that they do NOT dispense based on Pergolide base. He mentioned that since Prascend has come along they counsel their clients about the 1.305 Pergolide Mesylate to Pergolide base conversion to try to keep the same dose but they do not compound in Pergolide base doses. The net result is, that ThrivingPets and Pet Health (and most likely the majority of other compounding pharmacie as well) compound Pergolide Mesylate. BI makes Prascend in 1mg Pergolide base tablets (1.305mg of Pergolide Mesylate).

I have reached out to Donald Plumb of Plumb's Veterinary Drug Handbook to see if the dosing his publication provides for Pergolide Mesylate is for Pergolide base of Pergolide Mesylate and will get back to the group when I hear back.

-Ian
ThrivingPets


Hay Analysis

 

I am very sorry to clog up this list with this question, but I suspect that Eleanor is not receiving my email messages. I sent her two different sets of hay analysis before the seminar. She was, of course, swamped, but said she would get back to me. I have heard nothing and thought perhaps I didn't get her messages. I totally understand if I need to ask someone else to do my balancing. I just need to know. 

Linda Headley 2002

Woodrow and Tru

79821 - 79840 of 273830