Starting pergolide before testing ACTH?


Cheryl V.
 

Hello all,
I asked my vet about starting my mare on pergolide right away and he brought up a good point.  That being if she's well controlled on the dosage given and then we test for ACTH won't that come back as a false negative? 

Another thing I asked him was if he'd be willing to write a script for compounded pergolide and he said that he won't do it... short of using a different vet what are my options?

CH was updated with a little info today, just added her weight from weight tape and added the link to her photo album which now has two photos in it.  One of her from May of this year where I thought she looked to be at a good weight and one from last month where she's showing the cresty neck and potbelly typical.  Her top line is also worse now than it was before.   Oh and you can see her eye tearing too.  Only change between two pics is access to pasture. 
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Cheryl and Sahara
Lenhartsville, PA, USA
Sept 2017
Photo Album: https://ecir.groups.io/g/CaseHistory/album?id=9672


Maggie
 

Hi Cheryl,

I hope you Jaini's message to you here, which suggests putting "her on compounded pergolide, starting immediately, until at least February; then wean her off and test her ACTH (plus insulin, glucose, leptin and Lyme multiplex, if funds allow.)"  This should avoid any false negative your vet might be concerned about and meanwhile, hopefully improve Sahara's laminitic symptoms.  You could also do the TRH stim test in the NON-seasonal rise time of year.

You can certainly use Prascend for the trial or maybe you can provide your vet with enough information about how we use compounded pergolide--use a reputable pharmacy, use encapsulated form, order only 30 days at a time, etc (details in the following link) to get him to agree to the compounded form.    https://ecir.groups.io/g/main/files/3%20Cushings%20Disease%20-%20PPID/Cushings%20Disease%20Treatments/Pergolide/Pergolide%20101.pdf 

I looked at your photos.  Sahara sure is a pretty girl!  Need someone with a better eye to comment on her condition.
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Maggie, Chancey and Spiral in VA 
March 2011 
EC moderator/Primary Response


Cheryl V.
 

Thanks so much Maggie!  Yes, I did see that comment on my other post and that's actually what I explained to my vet.. hopefully he'll be more likely to write a script for compounded pergolide once I show him the printouts from the info posted here.  I did share the website with him but I doubt he read it... I get the feeling from him that he's the type of vet that feels superior to his clients and that any info or knowledge that they might attempt to share with him isn't worthy of his attention... let's hope he proves me wrong!  I do wish that my original vet was still around.. he loved it when I questioned him and his approach to treatments.. it made him think and do research.. he was a very good vet and I miss him dearly!

I'll keep trying with my vet but I also don't want to make him regret taking me on as a client lol.

Ttfn
Cheryl V.
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Cheryl and Sahara
Lenhartsville, PA, USA
Sept 2017
Photo Album: https://ecir.groups.io/g/CaseHistory/album?id=9672