I have posted previously about getting Prascend (pergolide) into horse. We restarted mare at 1/4 pill (0.25 mg) and increased every 5 days to full dose (1mg) syringed so we know she is getting the med. She has been at full dose now for 10 days, and is still feeling miserable. She is refusing her feed (eats fine on pasture) but is lethargic and just “flat”. I understand that this is pretty normal at the start of pergolide treatment, but wonder how long this will last. I had been hoping she would start to perk up by now! I would appreciate hearing your experiences.
At what point did she start feeling bad? That’s where you’d stop, even back down the dose, and ramp up more slowly.
If you aren’t using APF, get that - it does miracles for so many “pergolide veil” horses.
If she doesn’t like the taste in the syringe it can take them awhile to eat afterwards. Does she eat before you syringe her?
Mare lives out but comes in to be fed mornings, feed given in stall then medication syringed before she goes out again. She just stands looking at her breakfast, and doesn’t even bother to protest medication syringing.
She has not been happy since starting medication. If I cut it back again, how slowly should it be increased? We have been trying to get her to therapeutic dose for 6 weeks now.
My mare started Prascend and was doing well. After a few months, we started v-e-r-y slowly switching to ration balancer, which she ate happily. Then, at some point a month or so after she had been on the full ration of the balancer, she decided that it was no longer to her liking.
Grain is apparently the reason for living.
She is fed like OP’s horse - in for feed, then back out for hay and pasture. Rather than racing to her fall at feeding time, she wandered the aisle and looked sad (according to BO, she would sigh and look off to the distance 
) She was still eating pasture and hay
We managed to find something she was happy to eat (at least for now) and she perked back up. It wasn’t that she wasn’t eating b/c she was depressed - she was depressed b/c she wasn’t eating. So indirect effect of Prascend via lack of food lust.
You should follow your vet’s recommendations, but maybe vet would be amenable to staying at the low dose for longer than 5 days b/f upping? We did 3 weeks on the half dose.
I had a large pony that simply couldn’t tolerate it. Just that. Depressed and anorexic. I tried repeatedly to up titrate and could never get him to a therapeutic dose without unmanageable side effects.
TBH, I would stop it altogether until she improves in appetite and how she feels. It’s counterproductive to medicate her if she’s not eating well.
If you’ve increase the dose every 5 days, go 10. When you go from 1/4 dose to 1/2, try 1/4 twice a day instead of 1/2 once.
If that doesn’t work, look into carbergoline Pergolide | ECIR Group, Inc. (ecirhorse.org)
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Two suggestions.
One, as @JB said, run don’t walk to buy APF. It takes about a week and a half for it to make a difference for my horse, but between pergolide and hot weather he won’t eat in the summer without it.
Two, if this isn’t already how you’re giving it, talk to your vet about giving her half a pill twice a day instead of one pill once a day. Sometimes they tolerate this dosing better.
If none of this works, talk to your vet about backing her down to the highest dose she can tolerate, and keeping her on that dose for longer before you try to increase again.
If it is an option for her, you might also try changing up her food to tempt her appetite. My horse did very well on Triple Crown Lite for most of his adult life but when I had to increase his pergolide dose last year, he told me “forget it with the celery.” However, after a lifetime of diet food, two cups of TC Senior was very intriguing and he ate that right up. He only eats grain as a medication vector so it doesn’t really matter what’s in his dish.
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What is APF, and where can you buy it in Canada? I have heard mixed opinions as to whether it makes a difference but no explanation as to how it is supposed to work.
Twice daily dosing isn’t going to work, this a pasture boarding barn and horses are only fed once daily. BO will not do extra feedings but care/ pasture/hay is top notch otherwise so I don’t want to move mare. I cannot get to barn every day.
Will stop the ration balancer and try a different grain to see if that cheers her up!
APF is a liquid adaptogen supplement that purports to do everything under the sun, including boosting your horse’s immune system, improving glucose metabolism, helping to build lean muscle, protecting against ulcers, improving exercise tolerance/delaying fatigue, and probably also making your horse’s tail grow.
I don’t know if it does any of those things. I can tell you I was all kinds of skeptical but I got it because my vacuum of a horse was not eating his grain meals, and he started eating his grain meals again.
When I told my vet I’d started with it, she said “You know, it’s not magic”- hilarious because my vet uses both Western and Eastern medicine techniques and has been known to recommend Sore No More poultice over any other because “it has herbs”- but followed that up by saying “I don’t know why, but it works.”
If changing the dosing interval isn’t an option, I would talk to your vet about backing her back down and titrating her up more slowly. But do try the APF.
Any idea where to buy it in Canada? Buying it from US almost triples the cost with exchange, shipping and duties. They may not let it in either (rules on nutraceuticals). Amazon.ca has it for $237 but doesn’t say what size bottle it is, has a picture of SmartPak cookie and the Auburn Lab bottle in the same ad.
I’m in the US so I’m no help, sorry.
This is really normal. And if she’s eating pasture/hay well, I might wait another day or two and see if it passes before backing down, if you’ve already struggled to get up to the correct dose.
I wouldn’t do that if she’s already under weight, or if you have other concerns that she’s not eating. My pony always ate/eats his hay, so I know he’s getting enough. I agree that a RB will get more essentials into your mare with less consumed, so it’s worth a try.
I seem to recall the 10 day mark being the real turnaround for most things related to Cushings - 10 days on meds to see a real improvement in symptoms, and another 10 days or so to start tolerating the meds (lifting the “veil”.) We still struggle (daily) with getting it in the pony…it must really be vile.
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Thank you for posting the recommendation of APF. My guy’s blood work has not changed on 1 mg of Prascend in five weeks. So we just added another half of pill and while he is still eating, he is depressed. It’s very hard to see.
I just ordered APF from smartpak. I don’t have the time to shop around and I get free shipping. It was $59.99. APF - Advanced Protection Formula (smartpakequine.com)
Is there a boarder you trust, whom you can pay or bribe to do this once, just for a short while?
You suggest APF in addition to pergolide? I’m not sure I understand why?
APF has no action on the endocrine system and does not treat the cause of Cushings, which is uncontrolled ACTH in the body. Pergolide controls the release of ACTH.
I suggest APF in helping to mitigate some of the side effects of pergolide, which include inappetance and changes in affect.
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Thank you. I’m starting my boy on pergolide next week. I’m going out of town this weekend and don’t want the barn to have to observe his reaction. He’s a very quite horse when he colics. depressed. . . not eating. I’m concerned about a similar reaction to pergolide and being able to distinguish. As it stands now, not many people recognize when he’s colicky other than me. So even I have concerns about his reaction to this med.
Well, every horse is different, but there are things you can do to manage side effects, some of which have been talked about upthread. A common recommendation is starting at a very low dose and scaling up gradually to a higher dose. For instance, a slow titrate up might be if you want the horse to have 1 pill per day, give him 1/4 pill for a week, then 1/4 pill twice a day for a week, then 1/2 a pill in the morning and 1/4 at night, then 1/2 and 1/2. Or, start with just half a pill for a week and then add the second half at night the second week. I have personally found half dose BID to be more effective and better tolerated than full dose once a day; your mileage may vary.
For my horse, pergolide-induced depression looks like “standing in the back of his stall napping for hours.” But, he’s responsive to stimuli- if the horse two stalls up gets a treat, he’s up at his door begging. “I don’t feel well” depression in him also features a muted response to stimuli, so the other horse gets a treat and he doesn’t even blink. Unfortunately, “I’m not eating because it’s too hot” and “I’m not eating because pergolide” look exactly the same.
ETA for @demidq - I hadn’t looked at the site in awhile. but the ECIR Group website suggests North American ginseng as an alternative to APF in counteracting pergolide veil - https://www.ecirhorse.org/pergolide.php.
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I just read today that the pill should be used after releasing from the tin foil packaging. Does anyone know what that’s about? For those of us tapering up that means tossing the remaining portion of the pill?
