Seasonal Rise questions for Bullitt and Kate


Sarah Orlofske
 

Hello All, 

Thank you to everyone who responded this spring when I posted questions about Bullitt and Kate. I am back with a few more questions before we head into the fall rise. 

Bullitt's ACTH was not bad this spring but insulin was high. We made some improvements to diet and have tried to increase exercise since he was not showing any pain or lameness due to insulin. He has been fairly energetic except in hot humid weather and I can't really blame him for that. He has shed out beautifully and is honestly, I believe, in the best shape of his life. I want to thank everyone here and especially Dr. Kellon for help getting him this far! 

Kate has had a few more issues. We were not able to get blood work done on her in spring because she is incredibly needle phobic and despite my best training efforts is still terrified of our vet. It would be extremely difficult for us to get a new vet to pull blood and other wise this vet has been very cooperative with our horses. After going through 4 previous vets, we would like to stay on good terms with this one. Based on hoof changes (angle of new growth) it looks like Kate had some issues this spring that potentially coincided with some mare issues we also observed as well as some sulcus thrush. I am wondering if all three of these things are related? We started soaking all her hay and made some other diet improvements and new hoof growth looks much better. She is wearing boots in fronts regularly in the dry lot for my peace of mind but is not acting like she needs them, but we do put boots on all four when we go for short walks. Farrier comes on Thursday and I will try to take updated photos before and after. 

So, I am looking for advice about the seasonal rise. I am wondering if blood work is absolutely necessary given that Kate is so much trouble and would probably be so stressed by the time we got blood that it would not be accurate. I hate to admit it too but with Bullitt at 1.5 moving up to 2 and Kate at 2 moving up to 2.5 or 3 Prascend = 5 tabs a day starting this fall is really becoming a financial challenge. Saving the money on bloodwork would help pay for a lot of meds. We are still trying to find a solution for compounded pergolide that will help save a little money but still be easy to administer and potent enough to trust. We have just started the liquid in oil for Bullitt and I am hoping that will be effective and help with costs. I guess what I am asking is based on increases we needed last year can we just make the increases without bloodwork? The other question is about scheduling. When is the ideal time to make the increases? Should we start in early July? Last year we had bloodwork done July 25 and got it back early August and then made increases and I think that was almost too late and we were behind if not for Bullitt than certainly for Kate who was over the range before hand when we had to move her up gradually 1 prascend to 2 total. 

Finally, I am still a little confused on the compounded pergolide. If it says on the compounded prescription Pergolide 2 mg (as Mesylate) is this the same as 2 tabs Prascend or not? If not, how do I explain to my vet what we need? I am worried that I have been under dosing them because the compounded is not equivalent to the Prascend. 

I appreciate all your help and patience with all my questions! 

--
Sarah O. 
Rudolph, WI
2020


Eleanor Kellon, VMD
 

Hi Sarah,

Research has shown even extreme agitation won't take ACTH out of the normal range. We can't tell you that blindly increasing the dose is the way to go but in reality many people do it. As for her problems this spring, I would be surprised if they weren't related, except for the thrush but even that may have been related to decreased movement. I'm not sure why you went with the oil compound. Capsules are probably the most potent and no more difficult to give than Prascend. They should be considerably less expensive. I would start the increase mid July. We can't possibly even guess about dose without the numbers. In the future, if their condition is stable I would skip the spring blood work and just go with early July.  If the prescription is written as you described, x  mg of pergolide as pergolide mesylate, they would be equivalent.

Have you considered Vicks in her nostrils and a blindfold to make her more cooperative? Are you using a twitch?
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Sarah Orlofske
 

Hello Dr. Kellon, 

Thank you so much for the quick response! I appreciate it. 

We will skip bloodwork next spring if they are stable, but carefully monitor symptoms and do it if we need to. 

I will schedule bloodwork for both horses. I am traveling July 8-13 and my non-horse person husband is not comfortable with the vet doing blood work while I am gone. Should I try to get vet out here before the 8th or would after the 13th work? In the mean time, I will continue to work on training with Kate with the Vicks and a Blindfold. I have her clicker trained now to accept me doing everything short of stabbing her with an actual needle so I am hoping all those pieces together with the vicks and blindfold will help. Last time vet recommended an oral sedative 45 minutes before she gets here, but I thought that might interfere with the bloodwork. 

I will ask about capsules. Our vet seems unfamiliar with all the compounded options but is willing to work with us on it. Is it a power inside the capsules? I am syringing meds right now and will have to figure out how to get the power into the syringe without loosing any. 

What can I do to help Kate in the spring with her mare issues? We are now soaking all her hay and her diet is now balanced (Thank you again for help with that!) but is there something else I can do in March and April when she seems to do worse than other times of the year even though she should have low ACTH at that time? 

As always I appreciate all the help! 

--
Sarah O. 
Rudolph, WI
2020


Eleanor Kellon, VMD
 

If you can get blood work before the 8th that would be best.

Definitely no oral sedative. Most of them do influence test results. Don't hesitate to allow a twitch. Studies have shown twitching increases beta-endorphine, the feel good hormone and there is an acupuncture point on the nose that would explain that. Horses quiet down quickly with a twitch and are calm after it comes off.

Yes, the capsules contain powder.

I don't have a reproductive hormone profile on Kate so hard to say but these mares typically respond to estradiol supplementation.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Kirsten Rasmussen
 

Hi Sarah, I personally find capsules filled with powder easier to give.  I have to syringe meds in.  Hiding Prascend or capsules in a treat got old really fast for my horse.  When I syringe in capsules, I open the capsule carefully by slowly unscrewing it and tap the powder from each half of the capsule into a 5cc syringe preloaded with 2-3cc baby food.  Some powder sticks in the capsule but it's a minute amount.  Then I top up the syringe with another 1-2cc baby food.  My horse loves it, no more battles.

--
Kirsten and Shaku (IR + PPID) - 2019
Kitimat, BC, Canada
ECIR Group Moderator
 
Shaku's Case History
Shaku's Photo Album


Kirsten Rasmussen
 

I should add that others mix the powder in water or baby food in a tiny cup, then suck it up into the syringe.  Both methods work.

--
Kirsten and Shaku (IR + PPID) - 2019
Kitimat, BC, Canada
ECIR Group Moderator
 
Shaku's Case History
Shaku's Photo Album


Sarah Orlofske
 

Thank you so much Kristen for the help with the syringe ideas. I will try to give it a shot! Because they are minis I probably use a smaller syringe so that may be part of the problem. I have been making a very watery homemade applesauce with no sugar added to load the syringe after dissolving the Prascend inside with a little water first. Anything thick like baby food seems to clogs up the small syringes. I will try experimenting. I am just trying to get a handle on how to get the powder in without powder or applesauce running all over. 

I definitely agree with syringing! I was so scared of it at first but worked on both horses to train them to it and now it is super easy and better than wondering if they will get sick of a treat at some random moment or if they dropped it got it all. Thank you again for your help! 
--
Sarah O. 
Rudolph, WI
2020


ferne fedeli
 

Interesting that some of you think syringing pergolide, etc. in easier than giving in a treat.  My Magic is back to accepting his pergolide in a slice of carrot, so is well at the moment.  We did go through a couple of months of him refusing the carrot, so I tried BeeteBites pill pouches and they were fine for awhile, then various fruits--grapes, strawberries, etc. etc. and then went back to carrots and working well for now.  I think syringing sounds like a horror to me, but just a personal problem, I guess!

Ferne Fedeli  Magic & Jack   2007

Point Arena, Mendocino County, California
Case History

 

 


Sherry Morse
 

Apparently I'm the meanest person out there - when I syringe I used a 3cc syringe and fill it about half full with hot water and drop Prascend tabs or whatever in it to melt.  No special flavors and the minimum amount needed to get the meds in. Two of the horses I farm sit for are on Prascend and I dose both of them because it's much easier than putting in a treat and hoping they eat it.




sunygirl06@...
 

I find the compounded capsules are easier to give them than prascend. Prascend must taste icky.

With the capsules I grab one capsule with a gloved hand ( I use the same RH grippy garden glove every day) hold her jaw with my left hand and poke my RH holding the pill into the side of her mouth and set it as far back on her tongue as I can reach. She doesn't mind (I've been doing it this way for 5 years). Then I let her eat her hay and keep as eye on her for a few seconds to see if she'll fling it out. She usually doesn't. She "chomps her mouth" if she bites into it (then she must get the icky flavor) but it's normally too stuck in there with saliva to fling out. 
I've increased her dose by dissolving the capsule contents in water and syringing in a few cc's over 3 days-she hates that (again- full icky flavor) But me more or less "shoving my hand into her mouth" she doesn't mind at all.

It's an inevitability that happens every single day. And I find it's easier being matter-a-fact than sneaky.  I also know for sure that my monetary investment ended up where its supposed go! 

Just wanted to share an option, but do what works for you! 
--
Amber Lauer
September 2016, Black Creek, WI

Sunny Case History https://ecir.groups.io/g/CaseHistory/files/Amber%20and%20Sunny/Sunny%20Case%20History.pdf


Maxine McArthur
 

I do the same as Sherry. Part of the routine, no dramas. The only annoyance is that because I use compounded capsules for Indy, I have to carefully unscrew the capsule and tip the powder into the syringe. The other option is to offer the capsule in a handful of feed, but that doesn’t work for Prascend.  
--
Maxine and Indy (PPID) and Dangles (PPID)

Canberra, Australia 2010
ECIR Primary Response

https://ecir.groups.io/g/CaseHistory/files/Maxine%20and%20Indy%20and%20Dangles 
https://ecir.groups.io/g/CaseHistory/album?id=933

 


Lorna Cane
 

Maxine,I used to stick an end of the capsule with 18g. needle, and squirt the powder out of the hole. Don't know if you would find that any easier,or just more annoying.

--
Lorna in Eastern Ontario
2002


clbroyles55
 

Maxine,

I don't know if this will help you with the Prascend tablet offered in a handful of feed, but I thought I would mention it.  I put the Prascend tablet in an empty gelatin capsule (size #0).  This prevents the bad taste I think, so it works just as well as compounded pergolide in capsules.  I offer it with a small handful of hay pellets, and it goes right down.

Carol Broyles
Spring Valley, Ohio
August 2007


Kirsten Rasmussen
 

Sarah, I think I was lucky because the syringes I bought work well with baby food.  Plus, nowadays baby food comes in tubes with a tip that fits into the big end of my syringes, so I can easily squirt it in mess-free.  You can buy apple-only no sugar added baby food in these tubes... 

Ferne, I started syringing when my horse stopped taking all treats from my hand because of the hidden pills.  I really didn't want to syringe but now I wish I'd started sooner becayse it's made life easier and he likes it better.  No more pills spit out multiple times in a row!!

Sherry, I use a syringe with water for Prascend too since I'm upping the dose for the rise, then I follow it with the baby food syringe.  I wish I had hot water at the barn!  The Prascend is quite slow to dissolve in cold.  You are NOT the meanest person in the world.  LOL!

--
Kirsten and Shaku (IR + PPID) - 2019
Kitimat, BC, Canada
ECIR Group Moderator
 
Shaku's Case History
Shaku's Photo Album


Trisha DePietro
 

I started dissolving the prascend pills in warm water (about 3 cc of water)  and adding  3 cc's of  Apertif peppermint food flavoring, the six cc's of total volume to syringe is also easy to administer without alot of fussing. I got it from Horsetech and so far, Dolly is very happy to be syringed with it... Now she finishes her supplements in the carrier without issue.  I also did 3 days of dosing with just the peppermint flavoring....no prascend...and then slowly added the prascend back into the peppermint mix...and I think that helped as well...
--
Trisha DePietro
Aug 2018
NH
Dolly and Hope's Case Histories
Dolly's Photos 
Hope's Photos 
Primary Responder


 

On Tue, Jun 28, 2022 at 10:42 AM, Sherry Morse wrote:
Apparently I'm the meanest person out there - when I syringe I used a 3cc syringe and fill it about half full with hot water and drop Prascend tabs or whatever in it to melt.
Not mean at all. Just diluting Prascend in water makes it more palatable. My 1100 pound thug who requires a large man to syringe every other medication accepts pergolide dissolved in less than a teaspoon of carrot puree. 
--
Cass, Sonoma Co., CA 2012
ECIR Group Moderator
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