Any Reason NOT to give Pergolide for Cushings Horse? ACTH 127?

[SCM1959]

@Crashing Boar - did you miss the part about ACTH being 127? Normal is 9-35. He does not have mild lameness. His xrays show rotation in both feet, with one foot worse than the other. This horse has had a heavier coat and has not shed out normally for years.

Anyway, he will be started on Prascend tomorrow.

SCM1959

[S1969]

@SCM1959

@Crashing Boar - did you miss the part about ACTH being 127? Normal is 9-35. He does not have mild lameness. His xrays show rotation in both feet, with one foot worse than the other. This horse has had a heavier coat and has not shed out normally for years.

Anyway, he will be started on Prascend tomorrow.

SCM1959

Please give us an update in a couple of weeks. I got my pony without knowing he had Cushings and he had sort of a metabolic meltdown after the move to my farm. Once his test results came back (well over 400), we started him on Prascend. It took about 10 days to see enough results for him to start moving around again voluntarily (he was on deep bedding in his stall and shoes glued on to help). Within a couple of weeks he seemed almost normal. (Of course he wasn’t, it took a lot longer for him to start looking healthy, etc.) but your friend should hopefully see results within a couple of weeks or less, especially for the laminitis.

[JB]

@Crashing Boar

Big Fat Reason: It often works marginally, if at all, and is uncomfortably expensive for the average owner. Your vet is honest; there are also vets out there rubber-stamping scripts for this lately without having even tested the horse for genuine article Cushing’s first. Lameness, losing muscle, winter coat coming in earlier, you name it they’ll Perg first and “see if it helps.”
Gotta wonder what that company is handing out in perks to prescribers.

BTW, at 30 it’s not at all abnormal for a horse to run a heavier than usual coat, and laminitis can result from a winding-down metabolism, sweet late-season grass, or too-rich feed. BTW, on the day y’all find a pill that cures Old Horse Syndrome, tell me 'cause I want to buy some too!

Not every case of Old Horse means he has a pituitary tumor. In fact, if we’re seeing THIS many metabolically-driven tumors, in the interest of PREVENTION (vs. treatment) we need to be looking really hard at what’s in the feed bags. Maybe (like we’re finding out with diabetic humans), all that soy and wheat middlings and molasses as primary ingredients isn’t the positive choice it seemed a few years ago for an animal wired by nature to eat GRASS or grass-based pelleted substitutes.

Don’t know what you’re feeding, but I’d try an alfalfa or grass hay based pellet and see if he does better on that.

Except that "This on call vet also did blood work and ACTH came back at 127. "
and
“This particular horse is 30 years old and has had the outward usual Cushing’s signs for years.”

So why again isn’t Pergolide something valid to do right now?

And “works marginally”? Based on what? The many horses whose ACTH numbers come well under control while on pergolide would beg to differ.

And vets don’t get to decide what an owner chooses to afford or not.

Maybe (like we’re finding out with diabetic humans), all that soy and wheat middlings and molasses as primary ingredients isn’t the positive choice it seemed a few years ago for an animal wired by nature to eat GRASS or grass-based pelleted substitutes.

You cannot talk about things like that without context.

Context is 5lb of a 15% NSC feed vs 20lb of even 12% NSC grass - where do you think more sugar is coming from?

IR issues (ie “diabetes”) is not at all the same as Cushing’s. Don’t imply that diet is causing pituitaries to grow.

Countless horses have consumed some amount of soy on a daily basis for 2-3 decades, and die of things related to simple old age, no Cushing’s, no IR. Horses who have never had a hard feed (so no soy) develop Cushing’s.

[tabula_rashah]

@S1969

Not sure what the post above means by the horse “not tolerating” it means specifically - it can affect the appetite, but most horses can get past that to a significant degree. And/or it’s better than they would be without it - even if they eat less. For my very affected pony - it’s Prascend or dead. There is nothing else I can do.

For my mare not tolerating it meant that she basically turned into a zombie horse. She would do nothing all day but stand and stare, not move with her buddies, barely eat, not drinking enough. Didn’t matter if she was turned out or in the stall. She lost a ton of weight. She changed from a lifelong alpha mare to the bottom of the herd. We tried for 2 years to make it work- it wasn’t at all a matter of cost because I’d do pretty much anything for this mare and her current treatment is more expensive than Pracscend. Between the vet and I, we decided that we would aim for quality of life over quantity of life. I’d rather have a couple months of her regular self than a year of zombie horse.

[quietann]

I knew one who could not tolerate Prascend/pergolide. She was 23 or 24 when diagnosed with Cushings, fully retired at 27, and put down at 33, not from Cushings disease but because she was going deaf and blind and becoming dangerous to handle.

[Gamma]

@SCM1959

@AllHorseMy friend’s horse has no problem keeping weight on … he is at least a body score 8, so if anything he is too heavy.

Wait, what? Are you using a different scale than the Henneke scale? 8 is not a borderline score, 8 is essentially obese, which is a health condition in itself. If this horse has been an 8 for a long time, then that needs to be addressed regardless of other problems. A 30 year old with BCS 8 is going to have mechanical arthritis just from physically hauling weight around! (The scale only goes up to 9, presumably a 10 would simply collapse under own weight and be unable to move.)

[SCM1959]

@Gamma - my friend is aware of how heavy her horse is. He actually looks like a miniature draft horse – everything about him is thick. He has the thickest bones! Having said that, he wears a muzzle already nearly 24/7 and gets three weighed portions of hay each day.

And I may be incorrect – maybe she told me 7. He is a heavy guy, though. In contrast, my horse was rated a 4 and even at that, he had fat pads from Cushings/IR. He has since lost a good bit of weight by design – via meds and feed change. His vet told me on Tuesday that he is now practically perfect weight-wise.

SCM1959