Hi Paula - I think there is little guidelines on the use of permax and there are many thoughts out there on its use. My first vet had me start at .75gm/day and then I was to decrease to .25gm/day over several months if his symptoms cleared. For various reasons, I switched vets and she said .75gm/day was low and 1 to 1.5gm/day was more common in her experience. We just did the BET lab work which indicated his rhythm was 12% and low thyroid. BET and my vet recommended I first add the thyroid and then re-test his blood before increasing the permax. Karen Brigg's 1977 article on Cushings indicated that one vet was having great results with .75gm/day. She said that in the past vets used it at higher doses (comparable to cyproheptadine which is up there in grams) and it had a vasoconstricting effect which would worsen any ongoing laminitis.
Confession time (I haven't told my vet this yet!): I increased his permax to 1gm/day (from the .75gm) the day we took the blood work since she had mentioned it could be higher. My horse was very lethargic at the time and growing a winter coat. With all the concern about laminitis with these horses, I decided to increase it while we waited for the results. It took a week to get the results and in that week he started to feel better. I increased it to 1.25gm/day (still waiting to get the Eudaemics thyroid supplement - being shipped from Florida) and he is now shedding out his winter coat.
I plan on 'confessing' to my vet when the thyroid gets here. I'm hoping that with the addition of the thyroid I can lower his permax without him growing long hair. It just makes sense to me that these two things are so interrelated and that one out of balance will affect the other. And that once both are in balance the medications can be lowered safely. Time will tell for me.... Has anyone else noticed this? Who else is on thyroid and permax or cyproheptadine?
