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Prascend Dosage Increase
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I'm curious what the best way is to increase Prascend dosages.
I'm fostering a 29 yr old thoroughbred who is so bonded to a 28 yr old that they become almost manic in their behaviors. They have to be walked together in and out of the barn, and the 29yr old is on 1tablet of Prascend and still has a ACTH of 228.0 pg/mL. My vet is suggesting doubling the Prascend and I'm concerned the mare may not be able to handle it mentally. She couldn't go outside due to an ice storm and she was totally soaked with sweat from weaving. Are there alternatives or better ways to work with this? -- Sherry L., SE Wisconsin, 2009 https://ecir.groups.io/g/CaseHistory/files/Sherry%20LCassie |
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Hi Sherry,
I’m wondering if you saw our responses to your earlier post? Maybe you just need more details but I thought I should check to make sure you are finding your messages and replies. It seems to me that Cassie was on pergolide before she came to you. Is that correct? I would definitely double her dose and she’ll most likely need even more. If you’re concerned about her response, start her on APF for a few days and then start with 1/4 tab of Prascend. They aren’t scored for four so just do your best. Add another 1/4 tablet to her dose every three days, continuing with the APF, until you have her up to 2 tablets. If anything, it should make her appeared depressed, which we refer to as a pergolide veil. If one appears, you can wait until it lifts before making another increase. If you have concerns while doing this, don’t hesitate to check in. Was her insulin checked? As she is a TB, if it is high, it will most likely normalize as her PPID comes under control. -- Martha in Vermont
ECIR Group Primary Response July 2012
Logo (dec. 7/20/19), Tobit(EC) and Pumpkin, Handy and Silver (EC/IR)
Martha and Logo |
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Sherry Morse
Hi Sherry, How long was she on the 1mg dose before the test was done and when was the test done? If she's been on 1mg for a while it's not doing enough and I would bump her up to 2mg now and retest after 3 weeks on that dose but keep in mind that she will probably need more to get her ACTH to where it should be. As far as her diet I would make sure she's eating at least 16.5 lbs. of the Timothy Balance Cubes a day (2% of her ideal weight adjusted for the cubes being fed at a 3:4 ratio to hay) and cut out the Coolstance and the Cryto-Aero which are not suitable for an IR/PPID horse. You can up her Speedibeet and the cubes if you think she needs more than the minimum for her ideal weight (more on this on the website: DDT +E – Diet | ECIR Group, Inc. (ecirhorse.org). If the majority of her diet is the cubes you don't need any other minerals but you do need to add vitamin E in addition to the salt and chia. Her issues with being herdbound and not wanting to be stalled wouldn't stop me from trying to get her ACTH controlled but I also wouldn't expect either of those to magically improve once her ACTH is normalized either. I would suggest treating her for ulcers and consider adding Mg even though there isn't usually a need for extra with the cubes. It may or may not help but can't hurt to try it to see if it helps with her nervous behavior.
Thanks, Sherry and Scutch (and Scarlet over the bridge) EC Primary Response PA 2014 https://ecir.groups.io/g/CaseHistory/files/Sherry%20and%20Scutch_Scarlet https://ecir.groups.io/g/CaseHistory/album?id=78891 |
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Behavioral changes from pergolide are actually rare. Do the increase.
-- Eleanor in PA www.drkellon.com |
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