Date
1 - 15 of 15
Pergolide time of day
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Lesley Bludworth
Is there a best time of day to give pergolide?
I started giving it at night as anxiousness was the predominant symptom my boarders horse had and thought if cortisol is highest in the morning I wanted the full affect to be active in the am but who knows?? Do I have to go up to full 1 mg of pergolide or can a therapeutic dose be .5mg? My horse has abnormal ATCH level now. I'm giving .5 for 4 days then plan to go up to 1mg. -- Lesley Bludworth Phoenix, AZ Sophie Case History 7/2022 https://ecir.groups.io/g/CaseHistory/files/SophieB%20Case%20History https://ecir.groups.io/g/CaseHistory/album?id=277749 |
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Trisha DePietro
Hi Lesley. Prascend Dosing should be at the same time every day or as close to the same time as possible. I could not find any reference here on the site of it best given in the morning or at night. I would get your horse to the 1mg, wait three weeks and re-evaluate the effect with another ACTH level. Could a horse be controlled on 0.5 mg...possibly, but you would have to retest at the 0.5 and see where your numbers are at that point. Again, its a progressive disease so, eventually the 0.5 mg will no longer work and your symptoms will come back. I would opt for the full dose, wait 3 weeks and retest. Your goal is for the ACTH level to be high teens to low 20's, year round. 0.5 might not be enough during the seasonal rise time frame to maintain control of the ACTH.
-- Trisha DePietro Aug 2018 NH Dolly and Hope's Case Histories Dolly's Photos Hope's Photos Primary Responder |
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Hi Lesley
To support Trisha's comments, Dr Kellon has stated 0.5 mg to NOT be therapeutic for a full-sized equine. -- Nancy C in NH ECIR Moderator 2003 ECIR Group Inc. President/Treasurer 2021-2022 |
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Lesley Bludworth
Nancy,
Just to clarify, Dr. Kellon said .5mg is possibly enough and could be considered full dose for 1000 lb horse. But either way, if I dose at.5mg or 1mg I should recheck ATCH in 3 weeks? I don't know what symptoms she has with the elevated ATCH to know if the dosage is enough. Seems the IR/EMS and PPID have quite a few over lapping symptoms. -- Lesley Bludworth Phoenix, AZ Sophie Case History 7/2022 https://ecir.groups.io/g/CaseHistory/files/SophieB%20Case%20History https://ecir.groups.io/g/CaseHistory/album?id=277749 |
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Lesley,
Where did I say 0.5 mg pergolide is enough for a 1000 lb horse? The dose that is "enough" is the one that keep ACTH in normal range. By BI's own data submitted to FDA, 1 mg is not enough for 50%, and 2 mg is not always enough either. -- Eleanor in PA www.drkellon.com |
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Lesley Bludworth
Dr. Kellon,
please read the whole thread. I am asking a question here. I am asking for clarification based on what Nancy wrote to me where she typed "Dr. Kellon has stated 0.5 mg to be therapeutic for a full sized horse." That sounded contrary to what she said as a support to what Tricia wrote so I asked for clarification. and, if I did test 3 weeks after dosing at .5mg and her ATCH was in range, then by definition it would be the correct dose and enough for her at this time. I get this has to be checked in spring and fall know how the disease if advancing. She is a sensitive girl. she stopped eating on 1 mg before even with the APF loading and the 4 days at .5mg. I thought it was the metformin but we stopped the pergolide per new vets recommendation as we didn't have evidence she was PPID just not responsive insulin. -- Lesley Bludworth Phoenix, AZ Sophie Case History 7/2022 https://ecir.groups.io/g/CaseHistory/files/SophieB%20Case%20History https://ecir.groups.io/g/CaseHistory/album?id=277749 |
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In addition Lesley, you really can't use symptoms to know if the PPID disease is controlled.
Or the EMS condition. You may be confusing starting at 0.5 mg to titrate up to a higher dose. Please show where you have seen the 0.5 mg as a full dose because if it does say that, it needs to be corrected. https://www.ecirhorse.org/pergolide.php -- Nancy C in NH ECIR Moderator 2003 ECIR Group Inc. President/Treasurer 2021-2022 |
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Lesley Bludworth
Nancy you said it in your response to me
-- Lesley Bludworth Phoenix, AZ Sophie Case History 7/2022 https://ecir.groups.io/g/CaseHistory/files/SophieB%20Case%20History https://ecir.groups.io/g/CaseHistory/album?id=277749 |
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Thank you. Typo. It is NOT therapeutic, which I will now go edit.
Is there somewhere else? -- Nancy C in NH ECIR Moderator 2003 ECIR Group Inc. President/Treasurer 2021-2022 |
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Lesley Bludworth
I have not seen anything else.
Should I do the .5mg longer than 4 days before going up to 1mg to keep her from losing her appetite? -- Lesley Bludworth Phoenix, AZ Sophie Case History 7/2022 https://ecir.groups.io/g/CaseHistory/files/SophieB%20Case%20History https://ecir.groups.io/g/CaseHistory/album?id=277749 |
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PS. "When to test" info and why, is in the pergolide link I provided.
-- Nancy C in NH ECIR Moderator 2003 ECIR Group Inc. President/Treasurer 2021-2022 |
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Lesley,
Every horse is different in how they react. The best way to prevent initial side effects is to use APF, 8 mL/day for the average size horse. If you are doing titration, 4 days is more than enough to go up to the next level. -- Eleanor in PA www.drkellon.com |
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Hi Lesley, you can titrate by 0.25 mg, too. I use a sharp knife to split the pill into quarters. It's not 100% accurate but it helps. Or, Martha suggests dissolving 1/2 pill in a small amount of water in a syringe, mixing it well, then only giving half the syringe (store the other half in the fridge for the next day). We don't have APF in Canada so just have to titrate at low doses.
-- Kirsten and Shaku (IR + PPID) - 2019 Kitimat, BC, Canada ECIR Group Moderator Shaku's Photo Album |
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Lesley Bludworth
Thank you Kristen,
I will do that starting tonight then. If you want some APF, Im sure I could ship it to you! -- Lesley Bludworth Phoenix, AZ Sophie Case History 7/2022 https://ecir.groups.io/g/CaseHistory/files/SophieB%20Case%20History https://ecir.groups.io/g/CaseHistory/album?id=277749 |
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Lol, thank you, but the slow titration works well. Some horses REALLY need APF, but not mine. Its really more for getting started on the pergolide. As the dose increases over the years, most horses become less sensitive to the 'veil'.
-- Kirsten and Shaku (IR + PPID) - 2019 Kitimat, BC, Canada ECIR Group Moderator Shaku's Photo Album |
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