You can see if you vet can prescribe Cyproheptadine HCI. It is a compounded prescription. My horse is on both Prascend and this compounded medication. The benefit to Cyproheptadine, is they get an appetite. My boy is the poster child for problem horses and needing more than one thing to control his cushings:-([SIZE=1] [/SIZE]
Prascend does not always ‘help’ every equine.
My pony went on prascend about 2 years ago after a bought of laminitis and some behavioral changes. I did a slow taper onto the drug, per my vets instructions. Pony did go off feed, lost weight and it was serious scary for about a month. My vet told me to give it that long before we made a long term decision. At the end of the month he started eating more normally, but I found that we had to switch around his food quite a bit to keep him from going off his grain. About a year after I started him on prascend he started to not eat again and wouldn’t even take treats. He’s 27 years old, is one of my amazing w/t lesson horses (I’ve owned him for almost 20 years) and I want him to have the best life he can have, so I decided to take him off the meds. I didn’t want him on the meds and miserable. Would rather him off the meds and happy.
2 month update. Pony is doing amazing. He’s eating, gaining weight and his attitude is upbeat and perky. I know the inevitable is around the corner somewhere, but we will deal with that when it happens. In the meantime, I am so happy to watch this pony continue to cart around w/t kids and even have the occasional fun lesson over some low jumps.
I was curious about that too so I looked it up and it doesn’t sound all that scary to me…? This is from the manufacturer’s website:
“Not for use in humans. Keep this and all medications out of the reach of children. PRASCEND should not be administered by persons who have had adverse reactions to ergotamine or other ergot derivatives. Pregnant or lactating women should wear gloves when administering this product. It has been reported that pergolide tablets may cause eye irritation, an irritating smell, or headache when PRASCEND Tablets are split or crushed. PRASCEND Tablets should not be crushed due to the potential for increased human exposure and care should be taken to minimize exposure when splitting tablets. Consult a physician in case of accidental ingestion by humans.”
https://www.prascend.com/prescribe.html
I think the stuff about children, pregnant women, and accidental ingestion are pretty much standard.
@Libby2563 Thank you. I completely forgot about this. We forget about the dust from various meds and supplements and their effect on us. A good reminder to use precaution.
You need to start prascend very small and gradually …the package insert recommends starting at 1/4 pill for 4 days, then 1/2 for 4 days, then 3/4 for 4, then 1 full pill…if not then your horse will experience the pergolide veil (loss of appetite/change of demeanor)…that’s what happened with your boy…so back off until he’s back to normal…things to help in the meantime are APF - an adaptogen that really helps get the appetite back in these situations…also don’t put the pill in his grain …hide it in a slice of carrot/apple/ fig newton as the pill is very bitter
The 21 year old horse I’m leasing started on Prascend about six weeks ago and it’s been nothing but great. His energy is back up, he’s less prone to getting winded during work, he’s sweating less - it’s been a big help.
So Prascend and pergolide are the same drug? Good to know because I had an older mare who had pergolide (liquid) tip her over the edge and resulted in possibly a quicker euthanasia than had she been left alone.
We’re having a senior tested this March, he constantly has a swollen sheath but no other symptoms, so probably going to start on a low dose of Prascend. May try the every other day regime.
In what way did you believe the pergolide was the problem? (Versus the Cushings instead?)
She was up and eating, whereas after the pergolide was started, she was down and dropping weight. Probably 100 pounds in a week.
We pay $2.73 per pill in Ontario, when we buy 160 pills at a time, otherwise it does cost more.
My guess would be overdosed?
Was that compounded, from a pharmacy?
Good that you stopped when it was not doing right.
Those drugs don’t have that much of a safety margin, a little goes a long way.
If a horse by test is extremely low, mine was, our vet was concerned, the lowest he had ever seen, he gave him a shot to get him started and then we started him on 1/2 pill, which he was for over 4 years most of the time and that was plenty for a fat heavy made quarter horse gelding.
This last year he has been on a whole pill and it is almost too much for him at times, so we did taper off to half for a bit here and there.
I don’t think it’s possible for a horse to lose 100lbs in a week. Even if they stop eating entirely.
But yes, the most common and significant side effect of Pergolide/Prascend is inappetence. I have to think there was more than just the meds if she went down and couldn’t get up again. Or she had a very unusual reaction, which I suppose is always possible for any drug…or it was compounded incorrectly and an overdose occurred, as Bluey said.
Did you take her off immediately? Did she improve then?
Yes, and no.
I’ve see several horses who were on compounded Pergolide. who were switched over to Prascend when it became available. None of them had a problem.
I think that dropping to 1/4 and slowly building up is a good answer. Prascend is a life saver.
UPDATE to my original post:
I took my horse off prascend for 30 days as suggested by my vet. When I tried to give it to him again, we started at 1/4 pill every other day. After a total of 4 quarter pills he was experiencing most of the same issues lethargy, didn’t seem to know his legs were attached to his body, etc. My vet said he will not tolerate the drug so now what? Any suggestions on alternative medicines, supplements, or whatever? I don’t know what to do!
What was his ACTH? What are his other symptoms?
I think you may need to do a cost/benefit comparison - which is worse, the drug or the disease?
I am not aware of any other medication that treats Cushings. Some herbal products like chasteberry may help with symptoms. And if he is not terribly symptomatic it may be enough.
Ciproheptidine (pretty sure that is spelled incorrectly) can be used for horses who don’t tolerate Prascend or need more help than P offers. I have no experience w it.
There are a few cushings forums on FB. Lots of good info there and quite a few people using alternative measures to treat it. My horse experienced the lethargy for a good 2 months before finally snapping out of it. We’re still battling weight loss, or more likely, inability to gain weight, but he’s tolerating the drug for now.
