Prascend dosage


Dawn Wagstaff
 

I apologize for not having a case history up for my stallion. I have attempted to do so and for whatever reason, cannot download the completed form into the folder I did manage to get set up.


This question is in reference to Tipperary, my 20 year old stallion that gained a tremendous amount of weight, fat pads, eye pads, crest, etc. within a few months and then developed laminitis appx.one month ago.


I received the ACTH test results my vet pulled last week. Unfortunately, he didn't pull a glucose or insulin...


The testing was done at MSU and the results were 9.0pmol/L(normal 2-10pmol/L). The endocrinologist at MSU recommended treating with pergolide due to his presentation and being at the high end of normal.


I tapered him up on Prascend and he is now on 1mg/day.  He began refusing to eat his timothy pellets that contained the APF. After three or four days of this, I took him off the APF and put him back on Jherb. The J herb seems to be helpful in that in the am, he will eat and is more alert, slightly more mobile, etc. I've been giving him the Prascend at 1pm. When I check on him in the afternoon, he stands with his head down, asleep or stoned, has very little interest in eating. This is including his hay, which is a huge concern. His manure production has dropped off and I am starting to get really concerned with this. 


I am planning tomorrow to reduce his dosage back to .5 mgs.  He seemed reasonable on that dosage, it wasn't until I bumped him up to 1mg. that he began refusing the APF and started really going off his hay.

Has anyone else experienced this situation in a horse that is not fully into a Cushing's diagosis?


Dawn Wagstaff/Tipperary

Saline, MI  2003



janieclougher@...
 

Hi, Dawn - It is possible that too high a dose of pergolide will depress the appetite (I am having a senior moment here about the mechanism; Dr. Kellon has explained it very well, but it is eluding me at the moment)

See how he goes at .5 mg, and then re-test ACTH at Cornell 3 weeks after going back to that dose.

I don't know if you recall, but one of our members had a Morgan mare that showed many of the classical signs of Cushing's, but repeated ACTH tests from MSU were normal.  She then sent duplicate samples off, one to MSU and one to Cornell, each from the same blood draw.  MSU returned a "normal" value; Cornell returned quite a high value, indicating positive for PPID (thank you, Melanie!)

I do realize that since you live in Michigan, and since there are members of the prestigious Equine Endocrine Group at MSU, it might be tough to convince your vet to send the blood to Cornell.I think it would be worth it, though.

Stallions, even of IR-prone breeds, tend not to be IR because of the influence of testosterone. They often are not IR unless they are Cushing's as well, and the sudden appearance of the fat deposits, crest, and laminitis in a stallion certainly has a very high index of suspicion for Cushing's. It could be in Tipperary that if you do need to increase his dose of pergolide, you will have to do it very slowly, by 0.25 mg every week rather than every 3 days; and if the J-herb works better for him than the APF, then go with that.  It also could be that 0.5 mg is the correct dose for him.

The decrease in manure production is always a concern.  Make sure he is getting plenty of salt in his feed to promote water intake.

Never a dull moment with these horses, is there? Or with Neo, for that matter - lots of us are having trouble uploading case histories.




This question is in reference to Tipperary, my 20 year old stallion that gained a tremendous amount of weight, fat pads, eye pads, crest, etc. within a few months and then developed laminitis appx.one month ago.



The testing was done at MSU and the results were 9.0pmol/L(normal 2-10pmol/L). The endocrinologist at MSU recommended treating with pergolide due to his presentation and being at the high end of normal.


I tapered him up on Prascend and he is now on 1mg/day.  He began refusing to eat his timothy pellets that contained the APF. After three or four days of this, I took him off the APF and put him back on Jherb. The J herb seems to be helpful in that in the am, he will eat and is more alert, slightly more mobile, etc. I've been giving him the Prascend at 1pm. When I check on him in the afternoon, he stands with his head down, asleep or stoned, has very little interest in eating. This is including his hay, which is a huge concern. His manure production has dropped off and I am starting to get really concerned with this. 


I am planning tomorrow to reduce his dosage back to .5 mgs.  He seemed reasonable on that dosage, it wasn't until I bumped him up to 1mg. that he began refusing the APF and started really going off his hay.

Has anyone else experienced this situation in a horse that is not fully into a Cushing's diagosis?


Dawn Wagstaff/Tipperary

Saline, MI  2003



Dawn Wagstaff
 

" don't know if you recall, but one of our members had a Morgan mare that showed many of the classical signs of Cushing's, but repeated ACTH tests from MSU were normal.  She then sent duplicate samples off, one to MSU and one to Cornell, each from the same blood draw.  MSU returned a "normal" value; Cornell returned quite a high value, indicating positive for PPID (thank you, Melanie!)"

Thank you Jaini for your reply. 
Yes,one of the moderators posted the post from the member which contained a series of tests from MSU for her horse then the test from Cornell.
My vet has been down this road with me in the past, I had a mare with refractory IR after foaling that Dr.Kellon consulted on and we sent blood work to Cornell and to BET labs in Kentucky. He will do it for me, it's just that I have to be sensitive regarding how I ask. My vet is an adjunct at MSU. I will retest and also get a baseline glucose and insulin.

He has lost a lot of the fat pads, but still has a good bit more to go. Crest is still quite pronounced, although it has lessened. This morning, he was lying down when I went in the barn, but got up on his own and managed to get over to his hay and food bowl and ate. 

Trim is the issue now also, as he wants to put the majority of his weight on his left front. I can get the right front up long enough to rasp toes and pull the heel down , but this morning, I could not get the left front up longer than to get a boot on it. I was able to rasp the toe from the front, but I would like to take more off. He needs his hinds done also, they are getting uncomfortable. I think he is lying down more because the hind legs are carrying more weight and are tiring.

This is to say the least, difficult. I've owned this guy since he was four months old. He's always been active, strong,etc. and to see him barely able to wobble around is tough emotionally.

Dawn Wagstaff/Tipperary
Saline, MI 2003


janieclougher@...
 

Apologies if this shows up twice - Yahoo is acting up again.

I hear you, Dawn - when the horses are well, everything is right with the world. When our horses are hurting, the whole world turns grey.

Hang in there - Tipperary is in the best place he can be, with you as his mum.  Toes can be rasped with the hoof up on a chunk of wood, or standing on a deep bed of shavings with a hole dug under the toe for the rasp to work, or even when they are lying down (with a certain amount of treats and wheedling!)

Lessening of fat pads and crest is a great sign.





janieclougher@...
 

I hear you - when the horses are well, everything is right with the world. When our horses are hurting, the whole world turns grey.

Hang in there - Tipperary is in the best place he can be, with you as his mum.  Toes can be rasped with the hoof up on a chunk of wood, or standing on a deep bed of shavings with a hole dug under the toe for the rasp to work, or even when they are lying down (with a certain amount of treats and wheedling!)

Lessening of fat pads and crest is a great sign.