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Case History Updated; Need advice on managing rising ACTH
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I have just updated Summer's Case History with her newest labs. Her ACTH has climbed even higher after starting her Pergolide in the spring and increasing it twice to 2mg/day at the beginning of the rise last summer at Dr. Kellon's suggestion. My vet wants to try Platinum Performance Metabolic Support without increasing her Pergolide. Since it is basically Magnesium and Chromium and I am already balancing minerals to my hay and from what I read here there is not support for Chromium as being helpful, my inclination is to think it is unlikely to be helpful so that I need to go up on the Pergolide. If that is your recommendations, how much do you recommend. Also, if I'm going to be going higher, I would like to begin compounding. I though I had seen messages regarding how to calculate converting from the Pergolide dosage in Prescend to compounded and how to write the script but couldn't find them if you could send me in the right direction for that.
Thanks so much for this group and your help! -- Mary Gills 2010 Steamboat Springs, CO Summer's Case History: https://ecir.groups.io/g/CaseHistory/files/Summer%20Blush%20Case%20History.pdf |
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I agree with you, Mary. The only thing that's going to help is more pergolide. Magnesium and chromium have nothing to do with the pituitary.
One Prascend tablet contains 1 mg of pergolide from pergolide mesylate. Just remember that the prescription should read X mgs of pergolide from pergolide mesylate. -- Eleanor in PA www.drkellon.com |
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Thanks for confirming my thoughts Dr. Kellon. After much digging in old messages, I found one that said I should multiply her current Prescend dosage of 2 mg x 1.3 for an equivalent compounded dosage of pergolide mesylate. So her current dosage of pergolide mesylate is 2.6 mg. With her current ACTH at 82, how much would you recommend I go up before retesting? My vet is concerned that she is a non-responder to pergolide and we might need to try the other medication options; ? cabergoline. I'm thinking it might be too soon to say that she is a non-responder.
Thanks -- Mary Gills 2010 Steamboat Springs, CO Summer's Case History: https://ecir.groups.io/g/CaseHistory/files/Summer%20Blush%20Case%20History.pdf |
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Sherry Morse
Hi Mary, If she were mine I'd plan on doubling the dose and retesting once she's been on 4mg for 3 weeks.
Thanks, Sherry and Scutch (and Scarlet over the bridge) EC Primary Response PA 2014 https://ecir.groups.io/g/CaseHistory/files/Sherry%20and%20Scutch_Scarlet https://ecir.groups.io/g/CaseHistory/album?id=78891 |
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Mary,
Again, Prascend vs compounded is going to depend on how the prescription was written and what the policy of the pharmacy is. I agree it's too soon to say she's a nonresponder if you are sure she is actually getting her dose (?). I would take her to 3.5 mg pergolide. -- Eleanor in PA www.drkellon.com |
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Thanks so much for the guidance. I will search the archives for information on Chromium. Is there a particular article(s) that you would recommend sharing with my vet.
Mary -- Mary Gills 2010 Steamboat Springs, CO Summer's Case History: https://ecir.groups.io/g/CaseHistory/files/Mary%20and%20Summer%20Blush |
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Hi Mary
Try this https://drkhorsesense.wordpress.com/2021/10/28/chromium-and-insulin/ -- Nancy C in NH ECIR Moderator 2003 ECIR Group Inc. President 2023-2024 Skip and Sonny New Site CH links: Skip: https://ch.ecirhorse.org/case-history.php?id=1 Sonny: https://ch.ecirhorse.org/case-history.php?id=4 Beau groups.io CH links: https://ecir.groups.io/g/CaseHistory/files/Nancy%20and%20Beau ECIR Group NEW Case History site is now open Bookmark and save this link somewhere on your device(s). https://ch.ecirhorse.org/ |
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Thanks so much, Sherry. I'm also working on tightening up her diet. I've found a source for TC Natural Balance Cubes and ordering Stabul 1 online.
-- Mary Gills 2010 Steamboat Springs, CO Summer's Case History: https://ecir.groups.io/g/CaseHistory/files/Mary%20and%20Summer%20Blush |
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