Prascend


lj friedman
 

A vet I was using tells me that of the 100 horses he's treated only one got the peroglide Veil . And it's not something very important. What do others think percentagewise of horses that get the veil? If the veil is not going to be an issue, I would consider using 1 mg prascend to start without using the compounded peroglide. Lj friedman san diego nov 14

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PapBallou@...
 

LJ -

It's only important if it's your horse.  I find it hard to believe the vet has not observed the veil.  In my experiences with my vet and from feedback from my trim clients with PPID horses, all were advised about the horse 'potentially' experiencing the veil, but might not have used that term.  It seems to be unique to this list.  I know of a vet in my area who won't prescribe pergolide because of 'the veil'.  I should probably add that the ability of said vet who doesn't treat PPID is suspect at best.

But the point - the veil is a well known side effect.

Linda and Pap Ballou
Western NV
May 2004


 

Lj, 

We did a poll on our UK/Europe support group (2,600+ members) and owners reported around 30% of horses started on the initially recommended dose (usually 1 mg) had symptoms of the pergolide veil - off food and/or depression.

The FDA NADA for Prascend reported 33% decreased appetite and 10% lethargy as side effects of starting 1 mg (2 mcg/kg BW) Prascend - thelaminitissite.myfastforum.org :: FDA New Animal Drug Application for Prascend Sept 2011

The Equine Endocrinology Group recommends: 
"Some horses show a transient reduction in appetite. It is therefore recommended that Prascend be introduced gradually by giving partial doses for the first four days or by administering half the dose morning and evening" -  http://sites.tufts.edu/equineendogroup/files/2013/11/EEG-recommendations_-downloadable-final.pdf
 
Andrea
France/UK Jan 2010



lj friedman
 

I was looking for actual data and that is very helpful to me. Is there any data on what happens to horses with full-blown Cushing's that remain untreated? Is there any data on what happens to horse was with full-blown Cushing's that have there Feed corrected to low starch low sugar but yet remain off of any meds? Are you giving pergolide or prascend? It seems a vet that I've been using will not write for pergolide but only pracend because of inconsistencies in quality and he doesn't think i pergolide is often effective as well Lj friedman san diego non 14

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Nancy C
 

Hi LJ


Data.....Check out the pergolide dbase in the FILES section for a good review of doses and how horses are treated.

Cushing’s cannot be treated by low ESC and Starch feed.  Neuron’s fail in PPID.  They are gone.    Pergolide replaces the lost neurons.  To not treat PPID means a huge risk for laminitis, increased infections, sensitivities to bugs and worms, loss of muscle, inability to work, generally feeling crappy, more. Many man case history examples here on that. Read more about the physiology, diagnosis and treatment of PPID on www.ecirhorse.org

If the horse is also IR, he needs to be managed with mineral balanced low ESC and Starch diet. Can also read about the physiology, diagnosis and treatment of IR on ecirhorse.org.

Dr Kellon’s proceedings from the 2013 NO Laminitis! Conference go into great detail. Mineral Nutrition and IR may prove helpfu to you

http://ecirhorse.org/index.php/no-laminitis-conference/2013-proceedings-recordings-table-of-contents

Scroll down to:
ECIR 2013 Proceedings Kellon Mineral Nutrition and Insulin Resistance

We have had the following reported by the members of this group:

Prascend did not control their horses ACTH
The ACTH improved when switching pharmacies
The ACTH improved when going onto Prascend
The ACTH improved when increasing dosage beyond what BI recommends as the optimum dose of pergolide (3-5mg)
The ACTH improved when changing dose delivery (ie, AM or PM or split or not split)

Some of these reports have been verified by back-up blood work, others are only based on view of symptoms. There are probably other variations of above that I hope others will add but you may get the idea.  If you want to read more about experiences, we have reports in the files:

https://groups.yahoo.com/neo/groups/EquineCushings/files/%201%20A%20a%20Prascend%20Experiences/

Your vet’s experience will be influenced on the details of the diagnosis, the compounder used, the form of compound used, among other potential confounding factors.

ECIR group has been discussing the best way to address pergolide since 2002. How to address potential side effects (titration, use of adaptogens) has also been addressed since then.

Nancy C in NH
ECIR Moderator 2003

FACT: Insulin resistance (IR) is the failure of insulin sensitive cells to respond to “normal” levels of insulin.  See E. M. Kellon, VMD, Diagnosis of Insulin Resistance and PPID, 2013 NO Laminitis! Proceedings, Equine Cushing's and Insulin Resistance Group Inc.

 




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

I was looking for actual data and that is very helpful to me.
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lj friedman
 

Thank you for the replies. My questions are : am i understanding correctly that peroglide is superior to prascend?And am I also understanding that if my horse does not have IR then low starch low sugar feeding is not indicated and does not help the Cushing horse if there is no IR?Thanks LJ Friedman San Diego November 2014

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PapBallou@...
 

LJ -

Prascend is pergolide mesylate, but is manufactured and packaged differently, and typically has more potency than compounded pergolide which is also pergolide mesylate.  That potency difference between the two may range from a lot to basically just the same.  The stability (shelf life) of Prascend over compounded is superior, but that doesn't mean that you can't thoughtfully use compounded.  Purchase just a month's worth in capsule form, and keep in the fridge door.  Compounded pergolide is mixed and packaged by a compounding pharmacy.  Whether they keep the components on the shelf for a long time, or order in small batches is always a question, too.

An uncontrolled PPID horse is at high risk for IR, so the safe s/s diet is important.  Get the PPID controlled, and many, probably most PPID horses will normalize their insulin.  But, since PPID is a somewhat predictably unpredictable disease, the level of control of the insulin may vary even if the ACTH is well within normal ranges.

So the diet is one of those - well, that depends.  You need to test ACTH, insulin, glucose and leptin, (at least leptin initially) and see how the given horse responds to his PPID treatment. 

Linda and Pap Ballou
Western NV
May 2004


Eleanor Kellon, VMD
 

The Equine Endocrinology Group recommends: 
"Some horses show a transient reduction in appetite. It is therefore recommended that Prascend be introduced gradually by giving partial doses for the first four days or by administering half the dose morning and evening" -  http://sites.tufts.edu/equineendogroup/files/2013/11/EEG-recommendations_-downloadable-final.pdf
 
Would like to mention here that the recommendations of this group, which was put together and funded by the manufacturers of Prascend, are often not rooted in science or even extensive personal experience.

Because of the rapid metabolism of pergolide in horses, splitting a dose into two daily segments may well result in the dose only being half as effective.  In other words, 0.5 mg twice a day is not the same as 1 mg once a day.  We have certainly had members whose experience supports that.

Eleanor in PA
www.drkellon.com
EC Co-owner
Feb 2001