Cabergoline- Injectable Alternative to Pergolide for Cushing's & PPID

Our 26 year old warmblood gelding was diagnosed with Cushing’s disease two years ago. He was prescribed one daily tablet of Pergolide, which at first we could hide in an apple to administer. After about a year on Pergolide he would detect and refuse to eat Pergolide in an apple, in a drilled-out carrot or hidden in grain, in addition to spitting out any tablet that you managed to sneak into his mouth. Once he stopped eating Pergolide his Cushing’s-related frequent urination problems escalated. We looked for an alternative and found that BET Pharm was producing the Cushing’s medication Cabergoline in a slow-release intramuscular injectable form. Each injection is small, only 1 ml, and lasts our horse for 14 days. We alternate his intramuscular shots from one side of his neck to the other and have seen no signs of irritation at the injection site. We have been using BET Pharm’s injectable BioRelease Cabergoline for 9 months and have found that it has controlled our horse’s Cushing’s symptoms equally as well as Pergolide, while only needing to be administered twice a month, rather than daily. Most importantly our senior horse can enjoy his food and the time we spend with him without the daily battle to administer pills. We had a hard time finding an alternative to Pergolide and wanted to post this information to help other horse owners facing the same problem. Cabergoline is currently more expensive than Pergolide, but perhaps the price will decrease as more horse owners use it.

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That’s brilliant. Thanks for that. I have 32 year old who an detect a pill in just about anything. I have been dreading the day when we have to tussle over pergolide.

What is the dose of the injection? My horse was up to 8mg of Pergolide, now on 2 Prascends during the seasonal rise.

Dose is 1 ml Intramuscular Injection - Lasts 14 Days

Each dose is a 1 ml intramuscular injection, a very small amount, and it lasts for 14 days. It is sold in a small bottle that contains enough medication for 10 injections in total, which together last almost 5 months.

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Not all horses respond adequately to 1 ml dose. My mare is now moving to 1.25 ml every 10 days. She was on 3 tabs of Prascend, that had to be dissolved and syringed to her to assure she got them. She was constantly off feed with daily medication, so we moved to the shot. 1 ml got her ACTH numbers down to 50. Being lethargic and off feed is called “veil”.

If you notice a “veil” after giving medication (either prascend or cabergoline) you might try adding up to 10 ml daily of a product called APF. Advanced Performance Formula helps with this. The label says 8 ml for metabolic horses, but my delicate flower does better with 10 ml and still has 2 off days after every injection. Per Kellon’s advice, I give the APF two days before her shot and continue for two days following. Kellon feels this gives the same benefit as continuous dosing of this supplement. Becca hates this too, so I syringe 5 ml morning and night, which seems to be more acceptable for her. The struggle is real. And costly with regular blood work to Cornell for monitoring. But she’s worth it!

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Thank you for this. Any updates?

I was the first to post on this forum about the use of Cabergoline as an alternative to Pergolide. My horse was on it for over 4 years. The main reason I stopped administering it was that my horse found the shot to be painful and would avoid me for a few days after each injection. He will be 32 this March and looks and acts the same as when he was on Cabergoline. He is now at greater risk of laminitis/founder without the Cabergoline, but we are both happier not having to face the injection every two weeks. One warning to humans: The owner of the ranch who where my horse is retired once administered the injection when I was away and a mishap caused some of the Cabergoline to go in her eyes. She told me it was a very painful experience, but it did not cause long term problems.

i’ve been sticking my mare with Cabergoline for a year now and she is Normal. Perfectly normal. I alternate sides of her neck. I walk right up, no halter needed, stick her and we’re done for the next two weeks. She does hold-it-against-me for a day or two and won’t even eat a piece of carrot! But she gets over it and i go back into the friend-zone in a day or two.

Hi! Can you describe normal? As in shedding properly, ACTH normal???

Yes, shedding properly. She has a normal haircoat. No huge neck crest. Body weight and muscling looking like she did years ago. And mobility…she gets around easily and WANTS to. Haven’t run her blood though.

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