Date   

Re: Cabergoline

LJ Friedman
 

Shouldn’t more focused be given to controlling the insulin? I know that often the correct amount of pergolide medication would  not control over 200 insulin,?
The next time you retest for insulin have your vet write  on the lab report to report the exact number over 200. If it’s not reported you can call up and get it reported.,Best to write it on the report before sending
--
LJ Friedman  Nov 2014 Vista,   Northern  San Diego, CA

Jesse( over the rainbow) and majestic ‘s Case History 
Jesse's Photos

 


Riosa & slight bloody nasal discharge

hdavis
 

I noticed tonight that Riosa has nasal discharge in one nostril that is slightly bloody. Not as thick as a bloody nose but still not normal IMO.  I would normally just monitor her but thought I should perhaps ask about it just in case as she is on Invokana.  She appears to be acting normal except perhaps a bit lazier tonight but it is also terribly hot here right now as going through a heat wave.  Temp is 29 Celsius even at 8:00 CST which is not normal for us.  She is eating well and drinking lots which is good in this weather.  We are still waiting for our last bloods pulled on May 13th. Not sure what is taking so long at Guelph but no results yet:(  Just wanted to mention this just in case. Thanks in advance.
--
Heather
August 5, 2017, Brandon, Manitoba, Canada

Riosa 
https://ecir.groups.io/g/CaseHistory/files/Heather%20and%20Riosa

https://ecir.groups.io/g/CaseHistory/album?id=8819 


Storm

Case History


 




Re: Cabergoline

Erica Reimers <Ereimers90@...>
 

Thank you for the clarification. I definitely read the response wrong. Now all I need to do is convince my vet to prescribe me compounded pergolide. 


On Wed, Jun 2, 2021, 2:41 PM celestinefarm <celestinefarm@...> wrote:
Erica, Sherry was calculating what you are paying per month for Prascend . At his current dose of 2.5mgs, you are using 75 mgs of Prascend a month. Prascend costs $2.12 per 1 mg tablet so 75 mgs, per month is costing you $159 a month. If you switch to Cabergoline and give your horse the same dose, your costs will rise to $300 a month.  For comparison, Tipperary's Rx. from Pet Health Pharmacy of 8 mgs of pergolide as mesylate in 1 ml  in apple flavored oil cost me $285,04 including shipping to Michigan for 90 days supply.. .$39.5 cents per mg.or $3.17 per day./$90.35 per month for 8 mgs. 
--
Dawn Wagstaff and Tipperary   

Saline, MI  2003

Tipperary Case History

Juniper Case history: https://ecir.groups.io/g/CaseHistory/files/Dawn%20and%20Juniper/Case%20history%20Juniper.pdf .


--
Erica H CA 2021


Re: Cabergoline

celestinefarm
 

Erica have your vet write the Rx as Dr.Kellon wrote it in her post below.( Where the x is , insert the amount of pergolide you want. The pharmacy will calculate the amount of pergolide for you, you don't need to write it in.) If you are using capsules, each capsule will have whatever amount you want in it ( however, there is a limit per capsule of what can be fit , the pharmacy will publish what amount of pergolide per capsule they can fill). If you choose oil instead, they will mix according to how much you want per ML.  ECIR does not recommend pergolide mesylate in water or in any other delivery form( Wedgewood has lozenges, etc.) because to the best of our knowledge only the capsules and oil have had independent lab studies for length of time of potency, etc. at the different accredited pharmacies.



Dawn Wagstaff and Tipperary   

Saline, MI  2003

Tipperary Case History

Juniper Case history: https://ecir.groups.io/g/CaseHistory/files/Dawn%20and%20Juniper/Case%20history%20Juniper.pdf .


Re: Cabergoline

celestinefarm
 

Erica, Sherry was calculating what you are paying per month for Prascend . At his current dose of 2.5mgs, you are using 75 mgs of Prascend a month. Prascend costs $2.12 per 1 mg tablet so 75 mgs, per month is costing you $159 a month. If you switch to Cabergoline and give your horse the same dose, your costs will rise to $300 a month.  For comparison, Tipperary's Rx. from Pet Health Pharmacy of 8 mgs of pergolide as mesylate in 1 ml  in apple flavored oil cost me $285,04 including shipping to Michigan for 90 days supply.. .$39.5 cents per mg.or $3.17 per day./$90.35 per month for 8 mgs. 
--
Dawn Wagstaff and Tipperary   

Saline, MI  2003

Tipperary Case History

Juniper Case history: https://ecir.groups.io/g/CaseHistory/files/Dawn%20and%20Juniper/Case%20history%20Juniper.pdf .


Re: Cabergoline

Erica Reimers <Ereimers90@...>
 

Thank you for the additional information Dr Kellon. I'm trying to get my vet to prescribe me compounded as I cannot afford to pay for Prascend at 4 mg per day. The 160 count prascend box would only last me 40 days on 4mg a day and that would run me $330ish per month.
If he was on 4mg of prascend, how many mg of compounded pergolide capsules would he need daily? 

Thank you


On Wed, Jun 2, 2021, 2:05 PM Eleanor Kellon, VMD <drkellon@...> wrote:
Erica,

There is only one source for the cabergoline injections, BET. The 2.5 mg pergolide dose isn't that high and obviously not high enough.  There's no way to predict what the effective dose would be but I would titrate his dose up to 4 or even 5 mg/day and not consider the cabergoline until the cost of pergolide is getting higher than what you would pay for cabergoline.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


--
Erica H CA 2021


Re: Cabergoline

Eleanor Kellon, VMD
 
Edited

The concentration of pergolide in the compounded capsule depends on how the prescription is written. If it is written as:

                                       "X mg of pergolide base from pergolide mesylate"

it will be the same as Prascend - i.e. 1 mg = 1 mg.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Re: Cabergoline

Eleanor Kellon, VMD
 

Erica,

As you pointed out, the cabergoline would cost more and there is no guarantee the 1 mL dose would be any better than your current pergolide - sometimes it is, sometimes not. Compounded is your best avenue for controlling costs.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Re: Cabergoline

Eleanor Kellon, VMD
 

Erica,

There is only one source for the cabergoline injections, BET. The 2.5 mg pergolide dose isn't that high and obviously not high enough.  There's no way to predict what the effective dose would be but I would titrate his dose up to 4 or even 5 mg/day and not consider the cabergoline until the cost of pergolide is getting higher than what you would pay for cabergoline.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Re: CA Trace Plus pellets

Maxine McArthur
 


Re: Cabergoline

Erica Reimers <Ereimers90@...>
 

Also, I'm confused where 75mg of pergolide is coming from. I thought the conversion from prascend to pergolide capsules is 1.305=1. So if I switched him from 2.5 MG of prascend, that would equal 3.26 MG of pergolide. With the elevated Acth it seems he would need 3.5 MG of prascend daily or 4.57mg of compounded pergolide capsules. 


On Wed, Jun 2, 2021, 1:07 PM Erica Reimers via groups.io <Ereimers90=gmail.com@groups.io> wrote:
I'm currently spending $170 per month for the prascend at 2.5mg daily and need a way to lower the cost as the 2.5mg is not managing the cushings.  I'm concerned with his elevated acth and Insulin that he may have another laminitic attack and I just can't do that again. 

On Wed, Jun 2, 2021, 12:59 PM Sherry Morse via groups.io <sherry_morse=yahoo.com@groups.io> wrote:
Hi Erica,

We don't usually recommend cabergoline until horses are not responding to oral pergolide or you've hit a tipping point in pricing (which is usually at a MUCH higher dose than 2.5mg/day.)  As far as pricing you're currently at 75mg of pergolide at an average of $2.12/mg which is $159 per month.  Your vet is now proposing to charge you $75 per dose of cabergoline or $300 a month IF a 1ml dose every 7 days works.  Even at $250 a 5ml vial that's still $50/dose or $200 a month IF your vet is willing to let you purchase from some place else.

Based on that math I'd choose increasing Prascend but to get the most 'bang for your buck' compounded pergolide is the way to go.  That may involve a serious discussion with your vet or looking for another vet who is more willing to work with you. 

Thanks,
Sherry and Scutch (and Scarlet over the bridge)
EC Primary Response 
PA 2014
https://ecir.groups.io/g/CaseHistory/files/Sherry%20and%20Scutch_Scarlet 
https://ecir.groups.io/g/CaseHistory/album?id=78891



--
Erica H CA 2021


--
Erica H CA 2021


Re: Cabergoline

Ereimers90@...
 

I'm currently spending $170 per month for the prascend at 2.5mg daily and need a way to lower the cost as the 2.5mg is not managing the cushings.  I'm concerned with his elevated acth and Insulin that he may have another laminitic attack and I just can't do that again. 


On Wed, Jun 2, 2021, 12:59 PM Sherry Morse via groups.io <sherry_morse=yahoo.com@groups.io> wrote:
Hi Erica,

We don't usually recommend cabergoline until horses are not responding to oral pergolide or you've hit a tipping point in pricing (which is usually at a MUCH higher dose than 2.5mg/day.)  As far as pricing you're currently at 75mg of pergolide at an average of $2.12/mg which is $159 per month.  Your vet is now proposing to charge you $75 per dose of cabergoline or $300 a month IF a 1ml dose every 7 days works.  Even at $250 a 5ml vial that's still $50/dose or $200 a month IF your vet is willing to let you purchase from some place else.

Based on that math I'd choose increasing Prascend but to get the most 'bang for your buck' compounded pergolide is the way to go.  That may involve a serious discussion with your vet or looking for another vet who is more willing to work with you. 

Thanks,
Sherry and Scutch (and Scarlet over the bridge)
EC Primary Response 
PA 2014
https://ecir.groups.io/g/CaseHistory/files/Sherry%20and%20Scutch_Scarlet 
https://ecir.groups.io/g/CaseHistory/album?id=78891



--
Erica H CA 2021


Re: Cabergoline

Sherry Morse
 

Hi Erica,

We don't usually recommend cabergoline until horses are not responding to oral pergolide or you've hit a tipping point in pricing (which is usually at a MUCH higher dose than 2.5mg/day.)  As far as pricing you're currently at 75mg of pergolide at an average of $2.12/mg which is $159 per month.  Your vet is now proposing to charge you $75 per dose of cabergoline or $300 a month IF a 1ml dose every 7 days works.  Even at $250 a 5ml vial that's still $50/dose or $200 a month IF your vet is willing to let you purchase from some place else.

Based on that math I'd choose increasing Prascend but to get the most 'bang for your buck' compounded pergolide is the way to go.  That may involve a serious discussion with your vet or looking for another vet who is more willing to work with you. 




Re: Cabergoline

celestinefarm
 

Erica, many of us here have horses that are on much larger doses of pergolide and manage symptoms well. Tipperary is my 25 year old stallion and is currently on 8 mgs of compounded pergolide in oil from Pet Health Pharmacy in AZ and an additional 1 mg tab of Prascend dissolved in water and syringed in. He will have a blood draw next week for a new ACTH and Insulin review and if he needs more pergolide, a new Rx.  There have been horses on 30-40 mgs of pergolide here who lived into their thirties( I believe one member had a pony in their 40s) . The pharmacies recommended here are accredited veterinary compounding pharmacies with experience in dispensing pergolide for horses. Wedgewood veterinary pharmacy, Pet Health, and in Canada, Island Pharmacy. I would strongly urge you to provide your vet with their links. Pet Health pharmacists will also speak personally to her regarding any concerns she has. I would certainly try increased doses of oral meds at this stage as Cabergoline is normally used when horses become refractory to the oral meds, of which there is no way to know that with your horse since he is getting a beginning dose of prascend currently.
--
Dawn Wagstaff and Tipperary   

Saline, MI  2003

Tipperary Case History

Juniper Case history: https://ecir.groups.io/g/CaseHistory/files/Dawn%20and%20Juniper/Case%20history%20Juniper.pdf .


Cabergoline

Ereimers90@...
 

My vet has now suggested using cabergoline for my horse as 2.5 MG of prascend is not managing the PPID. Current levels are Acth: 159 and Insulin: 200

I'm at a loss as per my vet, his diet is great and he was upped from 1.5 MG of prascend to 2mg over the fall, and then up to 2.5 MG since March. He had a laminitic attack last November and is still recovering. At the age of 25 I know his body can't go through another attack and I'm at my wits end trying to manage the cushings and his overall health and need some help with PPID medication. 
My vet wants to charge $375 for the 5ml bottle of cabergoline and start him off at 1ml every other week. Where are others purchasing this from and how much is it? I found it at Bet pharmacy for $250 but can't seem to enter a California address. I've placed a call into them to see if they can ship to CA. If not I definitely can't afford it through my vet as the $375 is more than what I pay for the prascend. 
She wasn't too confident about compounded pergolide but I feel that may be the best option to go since the 2.5 MG of prascend is not working. Almost seems like he would need to go up to 3.5 or 4mg of prascend daily. 
--
Erica H CA 2021


Re: Bloodwork

Sherry Morse
 

Hi Cheryl,

4 hours after the last meal of concentrates. Having hay in front of them until blood is drawn is fine. 



Re: Lavinia--Cadet is still footsore, not sure why

Eleanor Kellon, VMD
 

Aunna,

It's possible there is pain in the back of the feet from the long term underrun heels. His frogs are still contracted.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Bloodwork

Cheryl Oickle
 

Please I need a reminder. When testing for insulin, how long after a feed is the usual time.  It is impossible to keep food in front of Jewel all the time as she has no shut off valve at all.
She is feed in the a.m. by 0700H
Thanks 
--
Cheryl and Jewel
Oct 2018
Port Alberni BC Canada
https://ecir.groups.io/g/CaseHistory/files/Cheryl%20and%20Jewel
https://ecir.groups.io/g/CaseHistory/album?id=81063


Re: Lavinia--Cadet is still footsore, not sure why

riggslippert@...
 

Sorry, Dr. Kellon.  I forgot to mention that Cadet's last hoof radiographs were taken in November of 2020.  Are you thinking he is lame from a condition other than laminitis?  I'm hoping that Lavinia will comment on his trim.  Thank you again for any input.
--
Aunna
October 2018
Oakland County, Michigan, USA
Cadet Case History:  https://ecir.groups.io/g/CaseHistory/files/Aunna%20and%20Cadet
Ruger Case History:  https://ecir.groups.io/g/CaseHistory/files/Aunna%20and%20Ruger

Cadet Photo Album:  https://ecir.groups.io/g/CaseHistory/album?id=84102




Re: Frustrated with vet on follow-up exam

ibstitchin@...
 

Thank you all very much. I’m talking to my local vet about doing the bloodwork. 
--
Lora Bannan in Eastern Oregon
Vera - 2005 TWH mare
Joined 4/2021
Case History Vera https://ecir.groups.io/g/CaseHistory/files/Lora%20and%20Vera
Photos Vera https://ecir.groups.io/g/CaseHistory/album?id=263692 

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