Miniature on Prasend


Connie Martley
 

Hi My name is Connie from Kansas City, I have a 15 year old mini that foundered years ago. I have kept up on trimming and a pretty solid diet. She started having trouble moving I called vet he put her on isoprene and previcox. She has been on this for about 6 months and then it stopped working. I also had another vet out a year (my reg vet was on vac) earlier that said she had cushing and gave me prasend. When my reg vet came back he said no, and put her on Previcox. So when she got extremely bad I called the vet out again. He said trim her hooves rounded them and put plastic shoes on her and she should be good. She was not moving at all. So I tried the prasend and she was a completely different horse in 3 days. I give her one flake of brome hay in the morning. She gets 1 hour of grazing time and back on dry lot. I cannot afford 160.00 for 60 days of meds. It worked I'm thrilled but now what. I have 30 days left of Prasend. Please help me save this horse. Hopefully to where she is not in pain and I can afford it. The only other thing I know is to find a rescue that is funded to be able to afford her.

In conclusion this has been an eye opener for me. Never before in 15 years have I spent as much money on my horses as I have in the last 3 months. I am now aware that as they age it could be costly. Thank you for your help!!

Connie from KC  


Maggie
 

Hi Connie,

Good job on posting a new topic!  As promised, here is the note that I wrote to you this morning, edited a bit and with a few additional thoughts.

I'm so sorry to hear about all the problems you are having with your mini.  We can definitely start to answer your questions based on the information that you have given us.  The very short answer to your question is "yes" there is an alternative to Prascend--compounded pergolide.  Prascend is the FDA approved "brand name" for pergolide.  Many of us on the list use compounded pergolide at a much reduced price but with excellent results.  It's the same drug.  

To get the best help, we need you to fill out a case history on your mini.  It gives us the details that we need to really see what's going on and to give you the best advice.  Our case histories are stored in a sister group called ECHistory8.   To fill out a case history (CH), you will need to join that group, just like you did the main ECIR list, and then follow the instructions on the main page for filling out the CH.  Let us know if you have any trouble!  We can help you!  This can all be overwhelming at first!  There's a lot of information not only about Cushing's (PPID) and insulin resistance (IR), but learning how to navigate the yahoo groups can be difficult if you are new to it.  Here's a link for the ECH8 group:  https://groups.yahoo.com/neo/groups/echistory8/info   I see that you've asked to join that group--great!  Will be looking forward to seeing more details in you mini's CH!  

In addition to the medicine (pergolide), there are also lots of other things that you can do to help your mini.  So for a more detailed answer, I'm going to explain our protocol, called DDT/E.  That's short for Diagnosis, Diet, Trim and Exercise.  

Diagnosis:  Did you have lab work done to diagnose your mini, or did your vet just prescribe the Prascend based on symptoms?  It sounds like maybe the vet gave you the Prascend just based on symptoms, but if you have any lab work from when she was diagnosed, it would be helpful for us to know the numbers.  You will see a spot on the CH form to put the lab results if you have them.  Prascend or compounded pergolide is used to treat PPID, but the dose used is dependent on what the ACTH is and also on the symptoms. What is the dose of Prascend that she is getting now, part of a tablet or a full tab?
 
PPID (Cushing's) and IR (insulin resistance) are 2 distinctly different conditions but they share some symptoms and can also exist together.  Many PPID horses are also insulin resistant, so until proven otherwise (through lab work) all PPID horses should be treated as though they are also IR.  It sounds like you have made a pretty good start with that, but we can certainly help you to tighten up the diet for your mini.  The labwork that we recommend is an ACTH, insulin, glucose and leptin. These 4 tests help to give a "complete" diagnosis of just PPID, just IR or both.  Here's a link to our website that will give you  some more information about PPID and IR:  http://ecirhorse.org/index.php/cushing-s-disease 
The details about how to get the labs are on the website here:  http://ecirhorse.org/index.php/ddt-overview/ddt-diagnosis 

When using compounded pergolide we recommend the powdered form in capsules (over the liquid or powder in a jar) for the best stability.  Exposure to air and water decreases the potency of the drug--the encapsulated form helps to preserve the potency.  Everything you need to know about pergolide, including a list of compounding pharmacies, is on this page of our website: http://ecirhorse.org/index.php/cushing-s-disease/pergolide  You just need your vet to write a Rx for pergolide and you can get it filled at a compounding pharmacy.  Let us know if you have any trouble getting your vet to write you a Rx.  We have some helpful suggestions.

Ok, on to Diet:  The diet that we recommend is low sugar starch (less than 10% sugar + starch) low fat (4% or less).  We use grass hay (tested to be under 10% combined sugar+starch) with the minerals balanced to the hay analysis, plus salt and to replace the fragile ingredients that are lost when grass is cured into hay we add ground flax seed and Vitamin E.  This diet is essential for an IR horse and also supports the delicate immune system of a PPID horse.  As important as what you DO feed on the IR diet is what you DON'T feed!  No grain, no pelleted or senior feeds, no pasture, no sugary treats (including carrots and apples), no molasses, no brown/red mineral salt blocks--white ones only.  The dry lot that you have for your mini is great.  Can you confine her to that and stop letting her graze?  The sugar/starch content of grass is just to variable--usually way too high for a PPID/IR horse.  She should eat 1.5 to 2% of her BW in low sugar starch hay. Small mesh hay nets can help to slow down how fast she eats and make her allotted amount last longer.  There are safer alternative to the equine senior as well for administering the medicine.  Lots of us hand feed it in a small amount of safe (under 10% sugar+starch) feed, or a grape, prune, peanut in the shell, lots safer alternatives to the equine senior.  Lots of other ideas if you need some, just ask us!
 
Until you can get your hay tested, we recommend that you use the emergency diet.  Here's a link to the page of our website with the details:  http://ecirhorse.org/index.php/ddt-overview/ddt-diet   It should also be in your welcome packet that you got when you joined.  
 
Trim: Often is the missing piece of the puzzle in getting these foundered guys sound again.  A correct trim is toes backed and heels lowered so that hoof capsule closely hugs and supports the internal structures of the feet.  If you post pictures of your mini's feet we can help you to evaluate if your trim is optimal.  You want post the pictures to the PHOTOS section of ECH8, the group you join to fill out the CH on your mini.  Here's a site that shows how to take good hoof pictures:  http://www.all-natural-horse-care.com/good-hoof-photos.html  Is your mini still foot sore?  Is she still on previcox?  That's an NSAID and we don't recommend NSAID's after the first few days as they interfere with healing.  
 
Exercise:  The best IR buster there is, but a laminitic horse should never be forced to move!  I'm a little confused as to whether she is still foot sore or not.  Is she able to move about in her dry lot fairly comfortable now?  When she able to comfortably, you can hand walk her in long straight lines with no tight turns to give her a little exercise as well as letting her move about in her dry lot as she will.  Is she still in plastic shoes?  You can also use boots and pads to make her comfortable..
 
Have you had a chance to look at the links that I gave you this morning, also included above?  Did you look over the information on our website and the link to the compounding pharmacies?  Many horse owners on this list are in the same position that you are as far as not being able to afford the Prascend, and I'm sure some of them will chime right in here!  Ask your vet for a prescription for pergolide and then send it to one of the compounding pharmacies.  Call around and ask them how much they charge.  Lots of folks on the list use Pet Health Pharmacy:  https://www.pethealthpharmacy.com/index.html   To avoid loss of potency, we recommend that you order only 30 days at a time and keep the medicine in the door of the refrigerator.

Thanks for signing your name and general location.  Just add your date of joining to that as well, and then once you get your CH filled out if you could add a link to that it will make it easier for us to find and respond to you.  Hang in there!  We are here to help you help your little mini!
 
Maggie, Chancey and Spiral in VA
March 2011
EC moderator/Primary Response


From: "cmdmartley@... [EquineCushings]"
To: EquineCushings@...
Sent: Friday, June 5, 2015 12:30:02 PM
Subject: [EquineCushings] Miniature on Prasend

 

Hi My name is Connie from Kansas City, I have a 15 year old mini that foundered years ago. I have kept up on trimming and a pretty solid diet. She started having trouble moving I called vet he put her on isoprene and previcox. She has been on this for about 6 months and then it stopped working. I also had another vet out a year (my reg vet was on vac) earlier that said she had cushing and gave me prasend. When my reg vet came back he said no, and put her on Previcox. So when she got extremely bad I called the vet out again. He said trim her hooves rounded them and put plastic shoes on her and she should be good. She was not moving at all. So I tried the prasend and she was a completely different horse in 3 days. I give her one flake of brome hay in the morning. She gets 1 hour of grazing time and back on dry lot. I cannot afford 160.00 for 60 days of meds. It worked I'm thrilled but now what. I have 30 days left of Prasend. Please help me save this horse. Hopefully to where she is not in pain and I can afford it. The only other thing I know is to find a rescue that is funded to be able to afford her.

In conclusion this has been an eye opener for me. Never before in 15 years have I spent as much money on my horses as I have in the last 3 months. I am now aware that as they age it could be costly. Thank you for your help!!

Connie from KC  



Nancy C
 

Hang in Connie.

ECIR Group is built on finding the best way forward for the welfare of the horse.

Glad you found us!

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.

 




fionn@...
 

I just wanted to second what Maggie said.  I’m in the same boat with the cost because we are up to 2.5 mg.  I get mine through Thriving Pets and it is TONS cheaper!  Even at that dose it is only about $45 per month.  If you are only on 1 mg then it will be lots cheaper than that.  The advice from this group has definitely kept him alive and kept me sane.  DDT/E really does work.

My horse also recently got diagnosed with arthritis so we have him on Previcox as well.  I’m not sure yet how well that is going to work.  

It’s hard as they are getting older (mine is 19).  I think Fionn is probably going to have to retire from hard dressage work soon and I’m starting to look for an easier job for him.  You want to do everything you can for them, but some things just cost too much.  

Hang in there and just remember you are trying—and that’s the most important thing.
 
Michelle Peck Williams & Fionn
Lexington, Kentucky USA
Joined June 2012
fionn@...

Case history:  https://groups.yahoo.com/neo/groups/ECHistory5/files/Michelle%20Peck%20Williams/

Photo album: http://groups.yahoo.com/group/ECHistory5/photos/album/867903845/pic/list

Foot Photo album: http://groups.yahoo.com/group/ECHoof/photos/album/1767999070/pic/list

On Jun 5, 2015, at 1:18 PM, spiral1957@... [EquineCushings] <EquineCushings@...> wrote:


Hi Connie,

Good job on posting a new topic!  As promised, here is the note that I wrote to you this morning, edited a bit and with a few additional thoughts.

I'm so sorry to hear about all the problems you are having with your mini.  We can definitely start to answer your questions based on the information that you have given us.  The very short answer to your question is "yes" there is an alternative to Prascend--compounded pergolide.  Prascend is the FDA approved "brand name" for pergolide.  Many of us on the list use compounded pergolide at a much reduced price but with excellent results.  It's the same drug.  


Chanda
 

Connie,

   Hopefully, you can get your vet on board with using compounded pergolide.   It can not be prescribed at 1mg, the dosage in the Prascend, but any other amount can't (I've seen compounded capsules in .95 and 1.05mg).  My mini gelding was diagnosed a couple years ago with Cushing's we started him on 1/2 mg of compounded pergolide, worked great the first year, the second year he needed .75 mg during the fall rise, then back to 1/2 for rest of year, this past fall, it was about 1mg that worked for him, this spring I backed him down to 1/2, but it was too low, now he's on .75mg and that seems to be what he needs  now.   Since Cushing's is progressive, you'll likely need periodic increases in medication; but if you can get your vet on board with compounded it can be much more affordable, his new prescription is like 75 cents a day, so only $25/month with shipping.  [Come winter it'll be closer to $30/month; but that beats the cost of Prascend for my budget.]

Chanda

MT 9/04




lj friedman
 

Remember the prevacox dosage is 57mg MAXIMUM  .  usually it is less., but many give 57 mg,  Because prevacox has such a long half life. many that use it.. give it every other day.. some do mon wed fri.  lj friedman san diego nov 2014. 


Lavinia Fiscaletti
 

Hi Connie,

In addition to all of Maggie's great info, could you please tell us what dose of Previcox your mini is on?

Thanks.

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


Lorna Cane
 


 >Please help me save this horse. Hopefully to where she is not in pain and I can afford it. 


Keep breathing,Connie.

You've come to the right place.

It's overwhelming here at first,on top of how overwhelmed you already feel.

Baby steps will get you there.


Save Maggie's message from yesterday,keep asking questions,and we'll help you get the details sorted out.



Lorna in Ontario,Canada
ECIR Moderator 2002


*See What Works in Equine Nutrition*
http://www.ecirhorse.com/images/stories/Success_Story_3_-Ollies_Story__updated.pdf


https://www.facebook.com/ECIRGroup





Maggie
 

Hi LJ,

Maybe you missed the part about this being a miniature horse.  57 mg of previcox would be a very inappropriate dose for Connie's or any other mini!  Please review Jaini's very informative note to you on the appropriate dosing and side effects of Previcox:  https://groups.yahoo.com/neo/groups/EquineCushings/conversations/messages/192568 

Connie, the dose of previcox is weight dependent.  We've had many discussions on this list about about appropriate and not appropriate doses of previcox, a medicine that is not to be used without caution.  Please give us some more details about your mini's weight, the dose of previcox she is on and the reason you are giving it.  Thanks!

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




Connie Martley
 

Miniature on Prasend
Connie KC June 1, 2015
Not sure I am responding correctly. Lilly is on 1 mg Prasend once a day. She is having her hooves trimmed today by the vet recommended farrier.
Forgive me if this is a incorrect way of responding. Lots of information to take in.



On Saturday, June 6, 2015 4:57 AM, "spiral1957@... [EquineCushings]" <EquineCushings@...> wrote:


 
Hi LJ,

Maybe you missed the part about this being a miniature horse.  57 mg of previcox would be a very inappropriate dose for Connie's or any other mini!  Please review Jaini's very informative note to you on the appropriate dosing and side effects of Previcox:  https://groups.yahoo.com/neo/groups/EquineCushings/conversations/messages/192568 

Connie, the dose of previcox is weight dependent.  We've had many discussions on this list about about appropriate and not appropriate doses of previcox, a medicine that is not to be used without caution.  Please give us some more details about your mini's weight, the dose of previcox she is on and the reason you are giving it.  Thanks!

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






Lavinia Fiscaletti
 

Hi Connie,

You're doing fine. We understand that we throw a lot of new info at you.

Got it on the Prascend dose. That is not a problem.

The concern was about the Previcox dose - how much and why. Vets tend to immensely overdose the Previcox, esp in a mini, as this form of firocoxib is formulated to be administered to dogs. Contrary to how it may seem, dogs require much larger doses of firocoxib to achieve therapeutic blood levels. Correct horse doses are much, much smaller than a canine's would be. Therefore, it is almost impossible to correctly dose Previcox to a mini as you would need to cut a 57mg pill into quarters and the pill is not intended to be divided that way.

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





Lorna Cane
 

>Forgive me if this is a incorrect way of responding. Lots of 

information to take in.

Connie,no need to apologize. There's so much to learn here, it takes time to get comfortable.

Thanks for providing you name, location, date of joining.

Connie KC June 1, 2015

Each time you send a message ,you can just include it at the end of your message,the way I have done after mine below.

If you delete the old message to which you are replying,it is also helpful.

It'll get easier..
No worries!

Lorna in Ontario,Canada
ECIR Moderator 2002

*See What Works in Equine Nutrition*
http://www.ecirhorse.com/images/stories/Success_Story_3_-Ollies_Story__updated.pdf

https://www.facebook.com/ECIRGroup






Connie Martley
 

Agree and it stopped working I was splitting 227mg into half daily. So 113 mg each day. That is why I went to presend another vet gave her. 

Sent from my iPhone

On Jun 8, 2015, at 1:03 PM, shilohmom@... [EquineCushings] <EquineCushings@...> wrote:

 

Hi Connie,

You're doing fine. We understand that we throw a lot of new info at you.

Got it on the Prascend dose. That is not a problem.

The concern was about the Previcox dose - how much and why. Vets tend to immensely overdose the Previcox, esp in a mini, as this form of firocoxib is formulated to be administered to dogs. Contrary to how it may seem, dogs require much larger doses of firocoxib to achieve therapeutic blood levels. Correct horse doses are much, much smaller than a canine's would be. Therefore, it is almost impossible to correctly dose Previcox to a mini as you would need to cut a 57mg pill into quarters and the pill is not intended to be divided that way.

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






Connie Martley
 

My mini is on prasend now not previcox. 

Sent from my iPhone

On Jun 5, 2015, at 10:03 PM, shilohmom@... [EquineCushings] <EquineCushings@...> wrote:

 

Hi Connie,

In addition to all of Maggie's great info, could you please tell us what dose of Previcox your mini is on?

Thanks.

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


janieclougher@...
 

Thanks for the info, Connie!

  Just so you know, the Previcox dose for a 1,000 lb horse is 45 mg, or 3/4 of a 57 mg tablet.

  For a 264 lb/ 120 kg mini the dose of Previcox is 12 mg, or 1/5 of a 57 mg tablet, or 1/20th of a 227 mg tablet.  For pain relief in minis, it is much better to use the firocoxib formulated for horses, Equioxx.  It is much more expensive to use in a full-sized horse, of course, which is why people use the dog formula.  However, the accuracy of dosing is so important that the Equioxx trumps the Previcox for the little guys; and because one is using so little, the cost isn't that huge.




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

My mini is on prasend now not previcox. 

Sent from my iPhone


Connie Martley
 

Wow that is great info so do you think we can back track from now prasend to Equinox?

Sent from my iPhone

On Jun 8, 2015, at 5:56 PM, janieclougher@... [EquineCushings] <EquineCushings@...> wrote:

 

Thanks for the info, Connie!

  Just so you know, the Previcox dose for a 1,000 lb horse is 45 mg, or 3/4 of a 57 mg tablet.

  For a 264 lb/ 120 kg mini the dose of Previcox is 12 mg, or 1/5 of a 57 mg tablet, or 1/20th of a 227 mg tablet.  For pain relief in minis, it is much better to use the firocoxib formulated for horses, Equioxx.  It is much more expensive to use in a full-sized horse, of course, which is why people use the dog formula.  However, the accuracy of dosing is so important that the Equioxx trumps the Previcox for the little guys; and because one is using so little, the cost isn't that huge.




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

My mini is on prasend now not previcox. 

Sent from my iPhone


janieclougher@...
 

"Wow that is great info so do you think we can back track from now prasend to Equinox?"

---------------------------------------------------------------------------------------------------------------------------------------------------------

Hi, Connie - Nope,  Equioxx and Prascend are two totally different drugs.  The /Equioxx is a non-steroidal anti-inflammatory, firocoxib (same drug as in Previcox).  It is a newer pain reliever, similar to phenylbutazone (bute)  It is used to help relieve the pain of laminitis while people are figuring out the actual cause of the laminitis (ie Cushing's disease or insulin resistance or infectious disease)  Long term use of these anti-inflammatories has been linked to gastric ulcers, colonic ulcers, and kidney damage.

Prascend is the drug pergolide, and is used to control Cushing's disease. Getting control of Cushing's disease is often a very important step in allowing the laminitis to stop, along with correct diet and trim.  Once the horse or pony is diagnosed with Cushing's disease, it is important to keep them on Prascend for the rest of their days. So far, there have been no documented adverse side effects with long term use of Prascend (although there can be transient mood changes and appetite loss at the beginning of therapy, and a very few horses can have neurological signs at the beginning of therapy and have to be taken off the drug.  However, I believe that is in the order or 2 horses reported on this list, out of thousands on pergolide)

So.... Previcox = Equioxx = firocoxib = a non-steroidal pain reliever

Prascend = pergolide = the drug used to help control Cushing's disease.

Sorry for the confusion there!





Connie Martley
 

Thank you so much got the info. She is doing very well on prasend had her hooves trimmed he said some rotation in right front but not bad. Any great suggestions to find cheaper presend my vet said 160.00 for $60.00 days 
Mini on prasend
Connie June 1, 2015

Sent from my iPhone

On Jun 11, 2015, at 1:47 AM, janieclougher@... [EquineCushings] <EquineCushings@...> wrote:

 

"Wow that is great info so do you think we can back track from now prasend to Equinox?"

---------------------------------------------------------------------------------------------------------------------------------------------------------

Hi, Connie - Nope,  Equioxx and Prascend are two totally different drugs.  The /Equioxx is a non-steroidal anti-inflammatory, firocoxib (same drug as in Previcox).  It is a newer pain reliever, similar to phenylbutazone (bute)  It is used to help relieve the pain of laminitis while people are figuring out the actual cause of the laminitis (ie Cushing's disease or insulin resistance or infectious disease)  Long term use of these anti-inflammatories has been linked to gastric ulcers, colonic ulcers, and kidney damage.

Prascend is the drug pergolide, and is used to control Cushing's disease. Getting control of Cushing's disease is often a very important step in allowing the laminitis to stop, along with correct diet and trim.  Once the horse or pony is diagnosed with Cushing's disease, it is important to keep them on Prascend for the rest of their days. So far, there have been no documented adverse side effects with long term use of Prascend (although there can be transient mood changes and appetite loss at the beginning of therapy, and a very few horses can have neurological signs at the beginning of therapy and have to be taken off the drug.  However, I believe that is in the order or 2 horses reported on this list, out of thousands on pergolide)

So.... Previcox = Equioxx = firocoxib = a non-steroidal pain reliever

Prascend = pergolide = the drug used to help control Cushing's disease.

Sorry for the confusion there!





Chanda
 

If you can get your vet on board with using compounded pergolide, that is about the only way to get pergolide cheaper.   It's legal to dose in any amount, except 1mg, the amount in Prascend.  

I guess, you can get it a little bit cheaper through a few of the pharmacies, Thriving pets has 60ct Prascend for like $110 (two 30 cts @ $55 each).  Heartland Vet has Prascend at $130 for 60 ct.  Smartpak has it at: 60ct for $120. (there are other pharmacies, but these are on bookmark)     But, check with your vet, some charge a fee for outside prescriptions (my other vet did, so using an outside pharmacy on Prascend didn't work, but was still cheaper for the compounded).  

Chanda

MT 9/04


Connie Martley
 

How do I quit getting emails? Your group is amazing, i want to thank you for all your info!
Connie Martley 

Sent from my iPhone

On Jun 12, 2015, at 2:34 PM, Connie <cmdmartley@...> wrote:

Thank you so much got the info. She is doing very well on prasend had her hooves trimmed he said some rotation in right front but not bad. Any great suggestions to find cheaper presend my vet said 160.00 for $60.00 days 
Mini on prasend
Connie June 1, 2015

Sent from my iPhone

On Jun 11, 2015, at 1:47 AM, janieclougher@... [EquineCushings] <EquineCushings@...> wrote:

 

"Wow that is great info so do you think we can back track from now prasend to Equinox?"

---------------------------------------------------------------------------------------------------------------------------------------------------------

Hi, Connie - Nope,  Equioxx and Prascend are two totally different drugs.  The /Equioxx is a non-steroidal anti-inflammatory, firocoxib (same drug as in Previcox).  It is a newer pain reliever, similar to phenylbutazone (bute)  It is used to help relieve the pain of laminitis while people are figuring out the actual cause of the laminitis (ie Cushing's disease or insulin resistance or infectious disease)  Long term use of these anti-inflammatories has been linked to gastric ulcers, colonic ulcers, and kidney damage.

Prascend is the drug pergolide, and is used to control Cushing's disease. Getting control of Cushing's disease is often a very important step in allowing the laminitis to stop, along with correct diet and trim.  Once the horse or pony is diagnosed with Cushing's disease, it is important to keep them on Prascend for the rest of their days. So far, there have been no documented adverse side effects with long term use of Prascend (although there can be transient mood changes and appetite loss at the beginning of therapy, and a very few horses can have neurological signs at the beginning of therapy and have to be taken off the drug.  However, I believe that is in the order or 2 horses reported on this list, out of thousands on pergolide)

So.... Previcox = Equioxx = firocoxib = a non-steroidal pain reliever

Prascend = pergolide = the drug used to help control Cushing's disease.

Sorry for the confusion there!