Hi guys,

Hope everyone had a great holiday. I haven't written about this guy yet but we had one of our horses, who is retired, bloodwork pulled and it has been confirmed he has Cushings.

Results from Cornell as follows:
ACTH 76
Insulin 57.03
Leptin 6.34

Obviously everything is very high so the vet did recommend starting him on 1 mg of pergolide, exercise, and diet changes.

A little background on him is that he is a 15 hand Walking Horse and I believe he is 19 years old. Like I said he is at this point retired and lives on a dirt lot so grass isn't an issue. His main symptoms are fat pads over the dock of the tail, over the eyes, cresty neck, muscle wasting over the hips, and poor coat quality. He is "ribby" and his hip bones protrude but has what most would call a small "hay belly".

Now with a horse like him is it necessary to start the emergency diet or can changes be made in his diet to something else?

Currently he is receiving costal hay, which is in the process of being tested, and I believe he receives a senior feed.

I'm sorry I don't have more details but he is my mothers horse. I will create a case history for him as soon as I can.

Thank you!
Katie
Charlotte, NC
October 2012

Results from Cornell as follows:
ACTH 76
Insulin 57.03
Leptin 6.34

A little background on him is that he is a 15 hand Walking Horse and I believe he is 19 years old. Like I said he is at this point retired and lives on a dirt lot so grass isn't an issue. His main symptoms are fat pads over the dock of the tail, over the eyes, cresty neck, muscle wasting over the hips, and poor coat quality. He is "ribby" and his hip bones protrude but has what most would call a small "hay belly".

Hi Katie,
The emergency diet is only a temporary, stop-gap measure to use until you can get a correct, balanced, safe diet in place. If you can start a good IR-safe diet now, no need to use the emergency one.
I would definitely remove the senior feed pronto, add vit E gelcaps and salt and soak the hay pending the analysis results. Starting the perg - don't forget to taper the dose up in 1/4mg increments - and adding exercise are great recommendations from the vet. Would plan to retest at least the ACTH after 3 weeks on the full 1mg dose to see if you are controlling adequately or not. We're on the downside of the seasonal rise now so little danger of it continuing to go up.
TWH are known as an IR-prone breed so an older, retired guy on sweet feed showing elevated insulin is no surprise. His visual symptoms are spot-on for a PPID/IR older gelding.

Lavinia, Dante, George Too and Peanut
Jan 05, RI
EC Support Team

Hi!

Thanks for the response! I haven't spoken directly to the vet yet but can you tell me how to go about obtaining pergolide? Will I get it from the vet or a pharmacy?

Also, he isn't on a sweet feed but a pelleted senior feed. However, I'm going to start researching a feed change for him.

Thanks!
Katie
Charlotte, NC
October 2012

I haven't spoken directly to the vet yet but can you tell me how to go about obtaining pergolide? Will I get it from the vet or a pharmacy?
Also, he isn't on a sweet feed but a pelleted senior feed. However, I'm going to start researching a feed change for him.

Katie,
You will need a prescription from the vet for the pergolide. Some vets will want to provide the drug themselves while others will write you a script. From the vet is usually the most expensive route. There is both compounded and the patented product Prascend. The Prascend only comes in 1mg caplets while the compounded is available in any dose(except 1mg) and in any formulation - capsule, powder, liquid. We recommend the capsule form of the compounded as it is simple to administer, retains potency the longest of the compounded varieties and is the most cost efficient (liquid is the worst).
Two pharmacies that many on the list use are Pet Health Pharmacy in Younstown, AZ and Thriving Pets in Denver, CO. You can fax/call/snail mail the prescription to them.

The form of the senior feed is immaterial - senior feeds are NOT appropriate for an IR horse as they contain too much sugar/starch/fat. If you can get Triple Crown products in your area you can get the Ontario Dehy Balanced Timothy Cubes. These could be Jett's entire diet, with vit E gelcaps, salt and ground flax added. Or you could just replace the senior feed with them. Rinsed/soaked/rinsed beet pulp is also safe and has 1.5 times the caloric punch of hay. Most horses like it.

Lavinia, Dante, George Too and Peanut
Jan 05, RI
EC Support Team

Lavinia,

Thanks for the feedback on the pergolide. Goi g the capsule route to most just administer whole or crush it and our it in their horses's feed?

Ok good to know on the feed I figured it wasn't appropriate and will speak to my mother who owns him about discontinuing this ASAP.

We do already have the beet pulp at the barn as my horse is on it until we get the analysis back on the hay so that would be any easy solution in the mean time.

Thanks!
Katie
Charlotte, NC
October 2012

Thanks for the feedback on the pergolide. Goi g the capsule route to most just administer whole or crush it and our it in their horses's feed?

Hi Katie,
I use compounded capsules and feed it whole in a small handful of lo-carb pellets. This way I can make sure he gets it! Another option is to hide it in a prune, then it's disguised as a treat. I used to do that then figured out that Ollie eats it just fine without the prune.
CHeryl and Ollie in MA
Jan. 2004
EC list support

Good to know thanks!

Between my IR horse and now my mother's Cushings horse I'm learning all sorts of new info!

Thanks!
Katie
Charlotte, NC
October 2012

Thanks for the feedback on the pergolide. Goi g the capsule route to most just administer whole or crush it and our it in their horses's feed?

Hi Katie,
I use compounded capsules and feed it whole in a small handful of lo-carb pellets. This way I can make sure he gets it! Another option is to hide it in a prune, then it's disguised as a treat. I used to do that then figured out that Ollie eats it just fine without the prune.
CHeryl and Ollie in MA
Jan. 2004
EC list support