ACTH question


Trisha DePietro
 

Hi all. Dolly is well controlled on her Prascend at 2 mg/day. Her ACTH is 8.77.
Is it advisable to reduce the amount of the Prascend back to 1 tablet and then increase again to 2 mg prior to seasonal rise? ( Her case history is up to date). 


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Trisha DePietro
Aug 2018
NH
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Primary Responder


Sherry Morse
 

Hi Tricia,

You could try her on 1.5mg but since she was on 1mg and her ACTH was 45 back in 2019 I wouldn't drop back that far.




Eleanor Kellon, VMD
 

It's very difficult to predict whether a dose reduction would be tolerated. I would probably be cautious and take her to 1.5, watch carefully for any signs recurring.
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Eleanor in PA

www.drkellon.com 
EC Owner 2001


Pamela Swartz
 

If it ain’t broke….don’t fix it is the motto I’d use. The price difference for a half tablet over a year is cheap compared to a vet call, a follow up lab from Cornell or additional help from your farrier. 
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Pamela Swartz


 

Hi Trisha,
I’ve wondered about this as well.  If you give more pergolide than needed, will that higher dose protect the horse as it needs more?  Or does the horse adapt to the dose it is given?  I feel like I never am able to express this question adequately so I’m not sure about any responses I’ve received.

But - the next rise technically begins in a month so it may be a moot point.
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Martha in Vermont
ECIR Group Primary Response
July 2012 
 
Logo (dec. 7/20/19), Tobit(EC) and Pumpkin, Handy and Silver (EC/IR)

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Eleanor Kellon, VMD
 

Martha,

I think the answer is we don't know.  We know some horses require continued dosage increase but exactly why that is the case is unclear. It may be that the adenoma continues to grow despite pergolide so takes more to control it. In other cases, it seems to just stop working but a switch to cabergoline is effective. More questions than answers.

I am fairly certain that the lower ACTH is going into the rise, the lower the increase will be. We know horses can be controlled even through the rise with medication - we've seen it.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001