ACTH results Dr Kellon please


Suzy Berkowitz
 

Hi Dr Kellon, Scouts latest ACTH is still way too high. I can no longer afford prascend and would like to switch to compounded pergolide. His case history is up to date. Can you take a look and tell me how much cp to try? He has handled the 1mg increases with no side effects at all. Thank you
--
Suzy in Fl 2020
Scout Case History: https://ecir.groups.io/g/CaseHistory/files/Suzy%20and%20Scout 
Scout Photos:  https://ecir.groups.io/g/CaseHistory/album?id=260915


Sherry Morse
 

Hi Suzy,

You would bump him up 1mg (which would be 6mg total if I'm reading your CH correctly).  You need your vet to write the script as "x mg pergolide as pergolide mesylate", as 1mg of Prascend is equal to 1.3mg of compounded pergolide.




Suzy Berkowitz
 

Hi Sherry, I bumped up Scouts prascend from 4mg to 5mg on May 27 when his results came back at 37.5pg/ml. But his ACTH still increased to 41.3pg/ml. I don’t think increasing the pergolide 1mg is going to be enough.
--
Suzy in Fl 2020
Scout Case History: https://ecir.groups.io/g/CaseHistory/files/Suzy%20and%20Scout 
Scout Photos:  https://ecir.groups.io/g/CaseHistory/album?id=260915


Eleanor Kellon, VMD
 

Suzy,

I agree 1 mg probably isn't going to do it. Go up 2 mg.  This isn't the time of year to be making a change but you may want to consider going to injectable cabergoline since he isn't very responsive to pergolide.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Suzy Berkowitz
 

Thank you. I will try the 2mg increase and retest 3 weeks after I start.  In the meantime can you send me information about the injectable cabergoline so I can learn about it. Thanks
--
Suzy in Fl 2020
Scout Case History: https://ecir.groups.io/g/CaseHistory/files/Suzy%20and%20Scout 
Scout Photos:  https://ecir.groups.io/g/CaseHistory/album?id=260915


Eleanor Kellon, VMD
 

For cabergoline information go to this folder in our files https://ecir.groups.io/g/main/files/3%20Cushings%20Disease%20-%20PPID/Cushings%20Disease%20Treatments/Cabergoline . Start with the intro.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Suzy Berkowitz
 

Thank you. Which option would be the best for Scout? Is he in danger with his ACTH remaining high? Where would I get the injectable cabergoline? Than you so much for your help.
--
Suzy in Fl 2020
Scout Case History: https://ecir.groups.io/g/CaseHistory/files/Suzy%20and%20Scout 
Scout Photos:  https://ecir.groups.io/g/CaseHistory/album?id=260915


Eleanor Kellon, VMD
 

I can't predict whether or not he will respond adequately to the 2 mg increase in pergolide. Also no way to know how he would respond to cabergoline although all those that have tried it had good results. The cabergoline folder tells you where to get it. Only BET Labs in Ky makes this.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Suzy Berkowitz
 

I ordered 7mg cp capsules from mixlab and should be here tomorrow. Scout has had no issues with the 1mg increases in the past, do you think the 2mg increase would cause any? I still have prascend left if you think going to 6mg for a few days would be the way to do the increase. I also ordered apf which should be here Thursday, just in case. Thank you for your help
--
Suzy in Fl 2020
Scout Case History: https://ecir.groups.io/g/CaseHistory/files/Suzy%20and%20Scout 
Scout Photos:  https://ecir.groups.io/g/CaseHistory/album?id=260915


Eleanor Kellon, VMD
 

It's reasonable to go to 6 mg first, at least for 4 or 5 days and definitely use up the Prascend! Too expensive not to.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Suzy Berkowitz