ACTH Level & Pergolide Dosage & Tasty additives


Stephanie Stout
 

HI everyone,


I have been searching the files about Pergolide dosages, and found the files on it but am curious.... My guy was just diagnosed with Cushings and high IR levels(but hoping that it is caused from the uncontrolled Cushings). His ACTH titer is 1,160. Has anyone ever had a level that high? If so, how much Pergolide is your horse on?



I know each horse is different, but my vet(that has very, very little experience with Cushings/IR) only thinks my guy needs 1mg per day of Pergolide and I really don't think that is even close to enough to get this Cushings/Laminitis/IR in control(he has rotation). He's a Dutch Warmblood, was very healthy before all of this, and weighed about 1400-1500 before. He's lost some weight since, so only probably weighs between 1200-1300, I'm trying to get him back to his normal weight/body score but he doesn't like his low sugar hay(or his beet pulp that is now no senior added) so he isn't eating much. Which then brings me to my next topic -  anything to add to his beet pulp that will make it a little tastier that he can have?? He is beyond picky!


Thank you SO much for your thoughts!

Stephanie & King

Oregon

Member since Oct 2014





Lavinia Fiscaletti
 

Hi Stephanie,


One of my boys had an ACTH of 1088 the first time he was tested in Aug. He went from 0 to 6mg in approx. a month's time. ACTH was retested and was at 84 in Sept so because the rise was still in full swing he was upped to 9mg to compensate for further rising and get it even lower. We achieved 46pg/ml the next round of testing, which was acceptable for him.


 There are others here that have also had numbers in the 1000+ category so you are not alone. It is highly unlikely that 1mg of pergolide, in a large boy, during the seasonal rise period will bring the ACTH down into the normal ranges but it is possible. How a horse reacts to the meds is a very individual thing. The only way to know is to test about 2 weeks after he has been on the med to see where you stand. Getting the ACTH under good control is vital to managing the disease process over time as even with good control it is a progressive condition. The longer the ACTH stays uncontrolled the harder it becomes to get it controlled.


Have you had a chance to get King's case history done? I see that you have a file but it's empty. Having all that info will help us help you better.


Look in file #8 Pulling it Together. Check the folders Introducing New Feeds and Supplements and the Picky Eaters Checklist for ideas on how to get your boy to accept his changed rations:


https://groups.yahoo.com/neo/groups/EquineCushings/files/8%20Pulling%20it%20Together/


Lavinia, Dante, George Too and Peanut

Jan 05, RI
EC Support team





Teri
 


Hi Stephanie,

 Which then brings me to my next topic -  anything to add to his beet pulp that will make it a little tastier that he can have?? He is beyond picky!


My pony, Stormy is very, very picky.  I tried everything on the picky eater list with no luck.  And don't even think about giving her anything wet...like beet pulp or wet hay cubes.  But, she does like Stabul 1, if you can get it in your area.  Randy from NuZu feeds will send samples for you to try.   (Also,she really likes Diamond V XP Yeast.  I add about 1/4 C. to her Stabul 1.)  The thing with Stormy is that she even refuses the Stabul 1 if her ACTH is only slightly elevated.  Once her ACTH is solidly in the mid range of normal, she starts eating again.  So that MIGHT be something else to consider.  It's possible that when you get his ACTH down, he could start eating better.  There are so many variables to this disease and it seems no two horses/ponies are the same.   I definitely defer to the advice from the experts on the list.    This is just my experience with my little diva.  :-)


Welcome to the list!   You are in the right place to get help for your boy!   


Teri and Stormy 

Indy 2012






Stephanie Stout
 

@Lavinia,
Thanks for commenting and sharing your horse's level. That makes me feel better that I'm not only one with the a horse over 1,000. How often did you increase your Pergolide in the first month? How did you go about deciding how much to increase? Did your horse ever had/have the puffiness above the eyes? If so, how long did it take for that to come down? Did it come down when you increased the Pergolide?

I have King's case history on my computer filled out. I have to try to see if I can upload it, and he also got new updated xrays today so I will see if I can upload those also.

@Teri, Thanks for sharing that Stormy is picky too! I just downloaded the picky eater file and am going to try some peppermint herbal tea I have. I also think my guy isn't eating when his level is high - I'm upping his Pergolide dosage slowly(my vet doesn't think he needs it, but I don't see how 1mg is going to lower his levels therefore stopping the laminitis).

Thanks so much!
Stephanie 




hinecedark@...
 

Hi Teri,

Could you share please at what TSC store in IN you are buying the Stabul 1? I have been working with the Asst Mngr at my local TSC for two months, he has called Randy when I was there, etc., but no product in the store yet. I am eager to try it for my uber picky gelding, if it's a distance I can manage in a day.

Thank you,

Melinda

IN  2010


Lavinia Fiscaletti
 

Hi Stephanie,


When I was raising his pergolide dose I upped the dose every 4 days as I knew we had a ways to go, the rise was in full swing and he had been untreated for a number of years so we were battling several factors. I also have had several other PPID horses (and the histories of the thousands of horses we have here on the list) so have had experience with dosing, reactions, expected response to doses to base the schedule on. My vet works with me on this as he knows I have more hands-on experience with this than he has. This horse has never experienced any "pergolide veil" symptoms.


Generally, we've found here that a .25mg rise every 4 days works well with most horses when tapering onto pergolide. Once the horse is on a larger dose, many have found that larger increments can be used to achieve the target dose without the undesirable "pergolide veil" symptoms showing up. Some sensitive horses will always experience veil sypmtoms when raising their perg level, others never do and the rest fall somewhere between the two ends of the spectrum. A change of 25% of the current dose for 4 days at a time seems to be a safe starting point. If your horse has issues with the "pergolide veil" - transient appetite loss, general spaciness -  adding APF, an adaptogen manufactured by Auburn Labs, can help get him over the hump.


Dante has not had over-the-eye puffiness, which is more of an IR symptom. One of my previous horses did. The puffiness will generally subside once the IR has been controlled but exactly when is really an individual response. For some it will be the first thing that recedes while in others it is the last to go and first to return each time there is a "bump" in their IR status. It can literally change overnight. Whether the pergolide has an effect or not will depend on whether/how much the PPID is the driving force behind the IR that is causing it. Diet will need to be addressed either way.


The first year of a PPID diagnosis is the hardest because you just don't know what to expect.You will become an expert in reading the signs in your own horse and knowing what needs to be done to tweak his routine to maintain tight control.


If you have any problems getting King's history to upload just send it to me and I'll get it up for you. Ditto for his xrays.


Lavinia, Dante, George Too and Peanut

Jan 05, RI

EC Support Team








Teri
 


Melinda,

>>Could you share please at what TSC store in IN you are buying the Stabul 1?


I have been getting my Stabul 1 at Wanamaker Feed and Seed  https://www.facebook.com/wanamakerfeedandseed.   I don't know what part of IN you live in, but Wanamaker is SE of Indianapolis off of I-74 (just SE of 465).   I tried to work with my local TSC and didn't have much luck either.  Randy (from NuZu) told me about this store.  They don't require a minimum purchase...you can just get 1 bag if you want... and the price is actually less than TSC.   I also get my Diamond V XP Yeast there.  It is kinda hard to get, too.  I use it as a taste tempter.  Stormy loves it!   You might try it for your picky guy if you haven't already.   The feed store usually has Stabul 1 on hand, but I'd call ahead...especially if you're traveling very far.  They don't keep the Diamond V in stock, but it usually only takes a couple of days for them to get it.


Teri and Stormy

Indy 2012