Stopping pergolide and low insulin

Karen Anderson

My vet suggests discontinuing all pergolide for a month after the seasonal rise as a way to help my PPID horse's body to "reset." She says this will make the medication more effective when it is restarted. The vet feels that 5.5 mg of compounded pergolide is a massive dose and she wants me to reduce back to 2 mg of Prascend. She is also suggesting cyprohepradine as a treatment.  The vet told the owner/manager of the barn where I board that she was not comfortable with my insisting on compounded medications and such dangerously large doses. 

The vet also told the barn owner that she was concerned because Fhinland's tested insulin levels were too low, coming in at the single digits.  Is there a problem with that?

Any suggestions on finding a vet in the Maryland/VA area that is willing to work with me and follow the recommendations of this group? 
Many thanks, Karen
Karen and Fhinland in Maryland

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Sherry Morse

Well my first reaction is 'time to find a new vet' but really you could ask her to produce scientific based articles showing that stopping pergolide, or reducing the dose, will in fact help your horse 'reset' and make the medication more effective when restarted.  You can do a search in the archives for discussion on Cypro but the short answer is 'it doesn't work'.  5.5 is hardly a 'dangerously large dose' and the fact that that vet felt the need to talk to the barn owner behind your back is another indicator to me that it's time to find a new vet.  

The accepted insulin range from Cornell IS now 10-40 but you might want to have a read on the website here about reference ranges: Fasting Insulin – Lab Ref Ranges | ECIR Group, Inc. (

In the meantime, you may want to share your actual location as there's quite a bit of Maryland and Virginia that share a border. 

Eleanor Kellon, VMD

I agree you need a new vet and virtually everything she is suggesting is totally unsubstantiated. Post again with the message title of "need a new vet in Md/Va area".
Eleanor in PA 
EC Owner 2001
The first step to wisdom is "I don't know."


Hi Karen-

I'm not sure where you are, but I work with Dr. Lisa Wagner (she does travel/is mobile vet). I have had some luck with her working to use compounded meds (Wedgewood Pharmacy) at 4-6mg/day (one of my horses is at 4, the other at 6), and that took some reviewing the results this group sees, resources provided by Dr. K, and some really strong words at times, so she may work for what you need. 

Where are you located? 

Jen McCabe
Laytonsville, Maryland 
Joined 2022
+ Odin (2010 BLM Mustang Gelding - IR, dx 2022), Bella (2008 BLM Mustang Mare - PPID/Cushings dx 2000) + Fiki (2015 Arabian, ok so far!)
Odin and Bella Case Histories

Starshine Ranch

Karen, my horses get 12.5 and 9 mg, respectively, of compounded liquid pergolide and I know some who get even more.  We give what it takes to keep their #'s as low as possible.  Get a new vet!
Linda in Grass Valley, CA  2020  Midnight and Ostara

Karen Anderson

Hi Jen:  My vet has gone along with my insistence on compounded pergolide (from Wedgewood) up to 6 mg but she clearly doesn't support my decisions. 
My horse is boarded at Riverwood,, in Boyds, MD which is in upper Montgomery County. I think your guys were boarded close by,, but you may have moved them..

I will be looking for a new vet. I appreciate any suggestions from the group.


Karen and Fhinland in Maryland

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