I could use some advice. 
My 22 year old PPID gelding Fhinland has been on 5.5 mg of compounded pergolide. He is in full work 5-6 days/week and going well under saddle. However, he has been displaying stallion type behavior in his stall and while being led to his paddock. People and another gelding have been hurt (not seriously, thank heavens) and I have been asked to find him another boarding facility.

Fhin is scheduled for hCG stimulation hormone testing next week at New Bolton's reproductive center. Meanwhile, having learned that pergolide is in a class of drugs that can cause hypersexuality and aggression, I stopped all his medication.

My question is, what do I need to watch out for while Fhin is off his medication?  Should I put him back on a minimum dose of pergolide, say, 2 mg? He is not IR, at least as far as our last test shows.

My vet contacted BI about another PPID horse that was still showing symptoms after being on 2 mg of Prascend. They told her to stop the medication and restart it as it would restart the receptors. Not sure what that means. 

Karen

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Karen and Fhinland in Maryland

Case Study:   https://ecir.groups.io/g/CaseHistory/files/Karen%20and%20Fhinland

Hi Karen,

Its hard to say what effects stopping pergolide can have because it really depends on the horse.  I looked at your Case History (which is, ahem, 2 years out of date now...), and he does not have a history of high insulin or laminitis, so laminitis is less likely.  You might see a flareup of his inflammatory airway issues, or other allergy type reactions.  At the level of work he's in, I'd be especially concerned about soft tissue injuries and loss of topline muscling, another common effect of PPID.  After 3 weeks off pergolide, I would retest insulin, glucose and baseline ACTH, to see where he stands.  At least this time of year is the safest time to stop pergolide and try to figure this out.

You might find he is safe at a lower pergolide dose, so you could slowly work him back up to whatever that happens to be.  But another option to explore are Cabergoline injections.  They may not produce the same aggressive effect in Fhin.  I would search our message archives to learn more about it, just type Cabergoline in the search box.  A few people have used it very successfully to control ACTH when their horses weren't responding to pergolide anymore.

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Kirsten and Shaku (EMS + PPID) and Snickers (EMS) - 2019
Kitimat, BC, Canada
ECIR Group Moderator
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Karen,

I agree the stop and restart is fiction. It's also totally irrelevant to your issue.

If you stop, he will eventually develop full PPID symptoms. He won't become IR and laminitic overnight but it may happen. Immune compromise, trouble with temperature regulation, abnormal shedding, muscle loss and laxity, tendon/ligament breakdown are possible. There are no herbal alternatives to stop the worst of these signs, only the alternative drugs I mentioned to you privately.
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Eleanor in PA

www.drkellon.com  BOGO 2 for 1 Course Sale Through End of January
EC Owner 2001
The first step to wisdom is "I don't know."