New numbers from Cornell University show Blessing's ACTH at 49.4. Last August, it was 17.3. I'm having a lot of trouble getting her to consume the compounded pergo (2.75 mg). She has become suspicious of everything. I'm afraid of the time it takes, but is getting her back on 2.75 mg/day and testing in 2 or 3 weeks the right process, or should I ask for an increase in pergo now? If so, what dosage is appropriate?

I've asked the vet to confirm Blessing's weight from her visit, but I recorded 728 lbs on Aug. 14 when the blood sample was drawn. Dr. Kellon encouraged me to keep Blessing's weight near 850 lbs a year ago (and my vet agrees), so we're lagging there too. I will increase her hay to between 18 and 20 lbs. a day until we can get back near 850 lbs.

My vet recommends using 5 cc's of molasses to dissolve the compounded pergo powder, and syringing it into Blessing's mouth. I don't like this idea because of the sugar load, but I'll do it tonight to get the medicine into her. It would seem that dissolving in water would be okay. Is it? Should I ask my vet to request liquid pergo for the future, or is dissolving the powder at the time of feeding okay?

I'm installing an updated version of her case history now. Thank you for any help and reassurance you can offer.
--
Helen Connor and Blessing (IR/PPID)
Scappoose, OR
Member since May 2017
Case History:  https://ecir.groups.io/g/CaseHistory/files/Helen%20and%20Blessing
Photo Album:  https://ecir.groups.io/g/CaseHistory/album?id=6847

It's difficult to even guess without knowing how much she has been getting. For now I think your plan is reasonable but would try something like watered down baby carrots or baby peas instead of molasses. Water is OK too.  Keep the volume as small as possible. Do not go to liquid pergolide - too unstable.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001

Thank you, Dr Kellon! I'll pick up some baby peas and not use molasses. I just taped her to be sure about that weight. I recorded it incorrectly. She appears to be 835 today. Much more optimistic scenario on that front, anyway. Thanks for the caution about liquid pergo.

Helen
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Helen Connor and Blessing (IR/PPID)
Scappoose, OR
Member since May 2017
Case History:  https://ecir.groups.io/g/CaseHistory/files/Helen%20and%20Blessing
Photo Album:  https://ecir.groups.io/g/CaseHistory/album?id=6847

Very interesting Dr. Kellon about liquid pergolide, which I had been using on Scotty for the past year, before going to Prascend, and then to Wedgewood Medimelts, and now, until testing, back to Prascend.

I wish I could understand all the compounding guidelines, and best to use.

Helen...I hope these guidelines will work for you!!!
--
Deb and Scotty I/R, PPID
Pecatonica Illinois, May 13, 2019
Case History:
 https://ecir.groups.io/g/CaseHistory/files/Deb%20and%20Scotty
Photos:
https://ecir.groups.io/g/CaseHistory/album?id=90619

Hi, Deb and all! 

Dang, I can't find one of the studies on potency of pergolide under various conditions. However, the bottom line is that pergolide potency is degraded by light, moisture, and higher temperatures; these effects occur over time. Liquid pergolide has been shown to degrade significantly after 14 days. Powdered pergolide that is exposed to air every time the container is opened will be more subject to degradation than pergolide in capsules. Prascend is one of the most stable formulations, because it is in blister packs, and so protected from air and moisture; however, if you have the blister packs in a hot environment, and exposed to light, that pergolide will last much less time that the expiry date on the package.

For best stability, use either Prascend or capsules. Store in a cool, dark, and dry environment. (I have my capsules in a yogurt container on the door of the fridge, with rice in the bottom, plus silica packs to prevent moisture buildup).

More information here:  https://ecir.groups.io/g/main/files/3%20Cushings%20Disease%20-%20PPID/Cushings%20Disease%20Treatments/Pergolide  
--
Jaini 
Merlin and Maggie (over the bridge), Gypsy, Ranger
ECIR mod/support, Smithers, BC 09

https://ecir.groups.io/g/CaseHistory/files/Jaini%20and%20Merlin-Maggie-Gypsy .
https://ecir.groups.io/g/CaseHistory/album?id=34193  
https://ecir.groups.io/g/CaseHistory/album?id=39711

Pergolide stability

https://www.ncbi.nlm.nih.gov/pubmed/19210262
https://www.ncbi.nlm.nih.gov/pubmed/23966481
https://www.ncbi.nlm.nih.gov/pubmed/21507864  Note that this one shows that pergolide stored at 35 degrees Celsius = 95 degrees Farenheit will lose 10% of potency (ie, will be only 90% as potent as it was at compounding) after only 3 days. This is significant for storage in hot climates.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001

Hi, Helen,

I have had success with inserting the pergolide into a small pice of hollowed out carrot. Also, Equi Bites work. They are like tiny muffins made from beet pulp. They have a little hole in the top to insert the meds. Good luck. BTDT!


--
Kathy 2017 and Donna

Harrowsmith, Ontario

https://ecir.groups.io/g/CaseHistory/files/Kathy%20and%20Donna

Hi Helen, 

Other members have reported here that dissolving pergolide dissolved into water and using a syringe to dose it, followed by a treat works well for horses that are distrustful of eating it.

--
Kirsten Rasmussen
Kitimat, BC, Canada
January 2019

Shaku's Case History: https://ecir.groups.io/g/CaseHistory/files/Kirsten%20and%20Shaku  
 
Shaku's Photo Album:  https://ecir.groups.io/g/CaseHistory/album?id=82559&p=Name,,,20,1,0,0   

A reminder that when giving pergolide by syringe make sure you have an air bubble behind the water or whatever you are using to force all of it through the tip of the syringe.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001

Thanks, Jaini! I'm moving my powdered pergo to the cupboard now!
Helen
--
Helen Connor and Blessing (IR/PPID)
Scappoose, OR
Member since May 2017
Case History:  https://ecir.groups.io/g/CaseHistory/files/Helen%20and%20Blessing
Photo Album:  https://ecir.groups.io/g/CaseHistory/album?id=6847

Hi Kathy. Thanks for your kind suggestions. Some horses seem to take changes in stride. Not Blessing. I've used hollowed out carrots, cucumber, small chunks of apple; homemade horse cookies; Beet-E-Bites; and even handmade hay and herb wraps to pique her interest and get her to take the medicine. But only for a short time with each one. Once she's discovered the pergo, she won't accept the veggie or cookie again, even if the pergo is not there.

I syringed her last night for the first time using a small amount of baby food peas. It took about three minutes to get her to let me put the syringe in her mouth. Once she could taste the apple-flavored pergo (all I have at the moment), it was all over. I offered her a sprig of Italian parsley, which normally loves. She wouldn't touch it. Today, I'll practice getting her to accept the peas and the syringe. I think the critical thing for her is desensitization. She's lost trust in me when it comes to food treats. Once I can rebuild that, we'll be fine.
--
Helen Connor and Blessing (IR/PPID)
Scappoose, OR
Member since May 2017
Case History:  https://ecir.groups.io/g/CaseHistory/files/Helen%20and%20Blessing
Photo Album:  https://ecir.groups.io/g/CaseHistory/album?id=6847

Jaini - Thank you for that info. I kept the medi-melts in an a/c room in a dark cupboard, but if opening the bottle every day causes them to lose strength that would be significant. I have been keeping the Prascend in a mud-room, not a/c, but based on all of this info I believe I will store it in the dark cupboard mentioned above going forward. I would worry about refrigerated air causing moisture.

Dr. Kellon - That is exceptionally interesting concerning the liquid version, as that is all Scotty got for the first almost 2 years. Have studies been done on the stability of compounded formulas in capsules? I wish I would have known 2 years ago what I am now learning and I would have made different choices from the get go.
--
Deb and Scotty I/R, PPID
Pecatonica Illinois, May 13, 2019
Case History:
 https://ecir.groups.io/g/CaseHistory/files/Deb%20and%20Scotty
Photos:
https://ecir.groups.io/g/CaseHistory/album?id=90619

On Thu, Aug 29, 2019 at 01:08 PM, Deb Walker wrote:

I wish I would have known 2 years ago what I am now learning and I would have made different choices from the get go.

That's why ECIR is here. Below is on compounded pergolide.

http://www.ivis.org/proceedings/aaep/2010/z9100110000274.pdf

This is also a good document to answer many pergolide questions

https://www.ecirhorse.org/pergolide.php

ECIR has also done it's own testing on caps that found 95+% efficacy.
 
--
Nancy C in NH
ECIR Moderator 2003
ECIR Group Inc. President/Treasurer  2019-2020
Join us at the 2020 NO Laminitis! Conference, October 22 - 25, Harrisburg, PA

Helen, some horses don't like flavoured items the way we might. Maybe plain is worth a try?
I bet you've tried that though.
If you're using capsules have you tried removing half the peanut from its shell, and substituting a capsule?
Don't need to answer.Just a thought.

--

Lorna  in Kingston, Ontario, Canada
ECIR Moderator
2002
https://ecir.gro
ups.io/g/main/files/PPID%20and%20IR%20Success%20Stories/Success%20Story%20%233%20-%20Lorna%20and%20Ollies%20Story.pdf

 

Didn't realize I could do that. Instead, I packed a little extra baby food peas behind the mixture with the medicine in it. Like your idea better. Thanks!
--
Helen Connor and Blessing (IR/PPID)
Scappoose, OR
Member since May 2017
Case History:  https://ecir.groups.io/g/CaseHistory/files/Helen%20and%20Blessing
Photo Album:  https://ecir.groups.io/g/CaseHistory/album?id=6847

Helen, do you have flavoring in your CP? I switched to molasses flavoring and then tried Bonnie's suggestion to dissolve in Uckele CocoSoya oil. I dissolve the molasses flavored CP in about a teaspoon of water and then mix it into a tablespoon of CocoSoya. I pour this onto a small pile of softened Stabul1 pellets. Cayuse gobbles it and licks the pan clean. High point of her day.
--
Cass for Cayuse (PPID/IR) and Diamond (IR)
Sonoma County, Calif. Oct. '12
Cayuse Case History                Cayuse Photos
Diamond Case History              Diamond Photos

Hi Lorna,

Yes, I've used both in the past. They worked while they worked, but no longer. This mare is my life mentor, I think. She puts me through a lot but I learn a lot too. 

Thanks for your thoughtful recommendations,
Helen
--
Helen Connor and Blessing (IR/PPID)
Scappoose, OR
Member since May 2017
Case History:  https://ecir.groups.io/g/CaseHistory/files/Helen%20and%20Blessing
Photo Album:  https://ecir.groups.io/g/CaseHistory/album?id=6847

Thanks Sherry, it looks like a winner! I'll order one and try it. Helen
--
Helen Connor and Blessing (IR/PPID)
Scappoose, OR
Member since May 2017
Case History:  https://ecir.groups.io/g/CaseHistory/files/Helen%20and%20Blessing
Photo Album:  https://ecir.groups.io/g/CaseHistory/album?id=6847

Hi Cass, What a smart idea! Blessing loves CocoSoya. This could work (for a while anyway). Ms B won't touch the apple-flavored CP, so PHP is shipping plain (unflavored) pills this next time. Should get here in a couple of days. My guess would be that the CocoSoya and maybe a bit of Omega Fields ground, stabilized flax seed will seem very appetizing to her. Thanks for the idea! Helen
--
Helen Connor and Blessing (IR/PPID)
Scappoose, OR
Member since May 2017
Case History:  https://ecir.groups.io/g/CaseHistory/files/Helen%20and%20Blessing
Photo Album:  https://ecir.groups.io/g/CaseHistory/album?id=6847