Pergolide Veil/Loss of Appetite

[Pico_Banana]

My 22 year old was recently diagnosed with Cushing’s/PPID. We started him on 1/2 tab Prascend for two weeks, then bumped him up to a full tab. That was Tuesday last week. After a couple of days on the full tab, he lost his appetite for grain. After about five days of this, I dropped him back to half a tab, so that’s been another five days back on half a tab. Still won’t eat his grain. Before we started the meds, he was happily eating 9 lbs of Triple Crown Senior split across three meals daily.

I’ve offered him a couple of different grain options. He did eat a pound of the Nutrena Senior the first time I offered it, but then no more. Same with Purina Senior Active. Last night I offered him hay pellets my trainer gave me to try (not sure what brand yet) and he did eat a pound of those.

He’s never been a great hay eater, but I do think he’s eating more hay than before the meds (he gets free choice 24/7) and also drinking more water.

I also had him on Equioxx daily, which I started a couple days before starting the Pergolide. I started wondering if maybe that was bothering him, so I stopped that a few days ago.
In the last six weeks, he also had his first injection of Osphos and some joint injections. The joint injections occurred the day before I bumped him up to a full tab of Pergolide.

My vet is coming on Monday to do the first round of spring shots.

So lots going on, but I think it must be the Pergolide that is causing the loss of appetite. He otherwise seems completely normal.

But I’m a bit confused because I thought Pergolide generally caused an overall loss of appetite, not just grain. Has anyone else seen this?

He is at a decent weight but he does NOT need to lose any weight. I’ve only had him since May and it was a struggle to get weight on him so I don’t want to lose any of that progress.

[cilla1]

I recently started my older gelding on Pergolide, he’s a small horse and we bagan with 1/4 of tablet and then skipped to 1/2 tablet. Vet told me to give him a psyllum supplement daily (a small dose) for the first month because Pergolide tends to give mild constipations at first

[skipollo]

When our older gelding got his Cushings dx, we started him on Pergolide. It did help with his weight/crestiness/fat deposits, but he seemed like he was in a fog. Not lethargic like he was sick, but he was just kind of fuzzy and dull. This was a long time ago, but I’m pretty sure it affected his appetite as well. He was always a food hound, so for him to not be an enthusiastic piggy was very out of character for him.

We eventually ended up weaning him off the Pergolide and managing him medication-free, and he brightened up after coming off the medication.

[NaturallyHappy]

APF is said to help w the Prascend veil.

[Pico_Banana]

I should have mentioned I have ordered APF and it should arrive tomorrow.

[JB]

In addition to the APF, you might have to just stop the Prascend altogether until his appetite comes back. Then, since he did well on the 1/2 tab to start, start there again, but when you increase, try 1/2 tab twice a day instead of 1, once a day. Or, as much as a pain it is, add 1/4 to that 1/2 for a week or so (2nd feeding, not 3/4 at once) and then add the last 1/4 a week or so later

[horsepoor]

What I discovered with my Cushings guy is that I have to give the Prascend separately and after his evening grain. Not that he really gets much grain but a bit of senior with ration balancer and supplements. He gets his hay first, has time to eat just a small amount, then his grain, then I give him the prascend in a small piece of carrot. If he gets the Prascend prior to the grain, even though it isn’t IN the grain, he won’t eat it. But always goes for hay, no matter what the timing of the Prascend is. So I think maybe it makes the grain taste or smell funny, not sure.

My vet would prefer he get the Prascend on a close to empty stomach (or maybe he meant earlier in day, I can’t remember) as he says it is more effective that way, but we’ve done this routine for three years or so now and his ACTH remains good so I have his blessing to continue.

[RedHorses]

Yes. Mine went off grain when I started him on half a pill. I took him off the drug entirely, got him eating again, and then started the drug back about two weeks later. I did half tabs on alternate days for a couple of weeks before going back to daily dosing. I didn’t have to use full tabs until the following spring.

According to BI, you can dose alternate days when you want 1/4 tabs. If your horse was initially fine with the half tab, you could try doing a full tab every two days, with half tabs on the other days, and let him settle before going to full doses daily.

[Pico_Banana]

Thanks, everyone, for these suggestions. I think you may be right that I need to take him off it altogether to get his appetite back, and then taper up again more slowly, and do it AM/PM and/or alternating days. I am also willing to do the pill after he eats, if that helps. Since he’s been off his grain, I have been giving it to him in a pill camo so it’s not like it’s any harder to wait until he’s done.

For those that have given APF, how do you administer it? I assume it has a dropper and then I put the contents of that in a syringe to get the right dose. What do you think I should start him at? The dosage range is all over the place.

From the SmartPak website:
Sales preparation and moderate levels of athletic training: 1.5 – 2 ml per 250 lbs. body weight (6 - 8 ml per 1,000 lbs.)
Intense athletic training and competition: 2.5 – 3 ml per 250 lbs. body weight (10 – 12 ml per 1,000 lbs.)

He’s probably around 1200 lbs so it could be between 7 and 15 mls. Right now we’re still ramping back up from a couple of months off in the winter, so he’s in work 3 days a week mostly at the walk (albeit a brisk, marching walk).

[JB]

@horsepoor

My vet would prefer he get the Prascend on a close to empty stomach (or maybe he meant earlier in day, I can’t remember) as he says it is more effective that way,

A science-based PPID group on FB says the time of day or stomach content doesn’t matter

@Pico_Banana

For those that have given APF, how do you administer it?

yes, fill the dropper to the dose, then put in a small syringe. I asked that same PPID group and they recommended starting at a middle-ish dose, so I went with 2.5mL/250lb

[GreyDes]

@skipollo - What did you find worked as an alternative?

[sparkygrace]

My miniature horse is also on Prascend and is now refusing his pelleted feed. He eats his hay with gusto and grazes for a few hours with a muzzle. He has been on Thyro-L for years, but now I can’t get him to eat it because I was mixing it with his pellets.

He has gained some weight, so I am looking for another way to give him Thyro-L. I may have to mix it in a syringe.

I will note he became very frisky after starting Prascend.

[Pico_Banana]

My guy FINALLY started eating again yesterday, even before the APF arrived. Thank goodness. Will give him some time on this and then resume increasing the dosage, using some of the timing suggestions above.

[beowulf]

Glad to hear he is back to eating.

My trick for getting APF in a horse is to dose it on a gingersnap or fig newton - don’t try to dose it in their food if you can. Give him a “blank” one a few times first before dosing.

[avjudge]

@Pico_Banana

I have been giving it to him in a pill camo

If you continue doing this, be aware that sometimes it (that is, the carrier) just stops working. We used to give our Cushing’s horse his Prascend in treats – carrots, fig newtons, fruit-flavored gum drops – and at some point he just started refusing to eat the treat in question. I have read this same thing from other people on this board and others. Fortunately, after moving from one treat to another for a few rounds, we now just drop it in his grain and he eats it fine. I have no experience with APF & so can’t help with feeding that.

(Also, dogs like fig newtons. Fortunately, one Prascend does not appear to have noticeable effects on a 70 pound dog.)

[victoriakent]

I tried APF last month for my picky eater who had gotten ill and I wanted to boost her immune system and was hoping it would increase her lack luster appetite. She does not have cushings. I can’t say it helped her appetite but she was thrilled with the ginger snaps I put the liquid in. I stacked three ginger snaps per dose on a cookie sheet and smothered the middle cookie with the dose, allowing the outside cookies to absorb excess. I didnt have good luck with the fig newton - it got mushy and fell apart. I did have to warn my family not to eat them, who then grumbled about why I make cookies for horses but not them.

[skipollo]

@GreyDes we managed him med-free. At the time of his dx, his bloodwork was borderline Cushings, not a full blown severe case, but we opted to treat with Pergolide just to be safe.

He had a small field that was pretty grazed down, enough to nibble and be busy but not cause any metabolic issues. His hay was very nice hay but not SUPER rich. He would get some senior feed for additional calories/vitamins/minerals, and we’d bodyclip him a few times per year.

That’s basically it, he lived for many years in that set up. We eventually lost him at 32 to a strangulating lipoma.

[ladipus]

IT’s recommended to start at 1/4 tablet prascend and increase by 1/4 tab every 4 days if appetite is good …APF Pro …a liquid adaptogen dosed orally by mouth helps a lot with the Pergolide veil and it’s side effects…I do have a horse however that couldn’t tolerate being on more than 1 tab prascend so we had to switch him to the compounded Pergolide liquid …he’s been on 2mls for 6+ months now and doing great