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  1. #1
    Join Date
    Feb. 8, 2002
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    Default Pergolide questions...does this sound right to you?

    Large pony in barn, body score 7ish (cresty neck, "apple" bum, but no fat pads, etc..), age 9-10. Easy, easy keeper, stays fat on Bermuda hay fed at 1 1/2-2% wgt, NO pasture. 1lb LMF super supplement. Ridden 4-5x/week, in pretty decent shape fitness wise. Vet sees fat pony, thick, somewhat curly coat, asks if she drinks/urinates a lot (moderate). Based on that, without doing blood tests, prescribes 1.5mg Pergolide daily. Does this sound right to you? Said pony has been on (worked up to it after reading a LOT here) 1mg for about a week, 1/2mg the week before. Starting to seem a bit "hazy" after eating pergolide (veil?) and maybe a little hormonal. Nothing bad, but just some observations....can give more info if needed. Thanks for any and all help.



  2. #2
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    Dec. 18, 2002
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    Chesterton, IN US
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    Default

    Sounds like a high initial dose especially without blood tests. Why not run a test to make sure. If the pony was foundering, I could maybe see not waiting, and the pony does have a lot of symptoms, but we started my mare on 0.5mg, not 1.5mg. The Cushings people advise gradually increasing the dosage to avoid the pergolide veil. It's not like that stuff is candy and it sure isn't cheap. I'd ask the vet why he didn't do a blood test.



  3. #3
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    Quote Originally Posted by jherold View Post
    Sounds like a high initial dose especially without blood tests. Why not run a test to make sure. If the pony was foundering, I could maybe see not waiting, and the pony does have a lot of symptoms, but we started my mare on 0.5mg, not 1.5mg. The Cushings people advise gradually increasing the dosage to avoid the pergolide veil. It's not like that stuff is candy and it sure isn't cheap. I'd ask the vet why he didn't do a blood test.

    Hmm, interesting, I thought because some folks were feeding 3/4mg maybe the dosage was kinda low. ??? Said pony won't eat it anyway, she will only "tolerate" about .5 mg in her food before she turns up her nose at it. Frustrating.... The vet's comment about not running the blood test was basically a money saving one, plus he said he likes to just go ahead and put them on it and see if it helps.... I thought it sounded weird, but not the usual vet and I have NO experience with this stuff.



  4. #4
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    Jun. 1, 2005
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    Floral City , Fl.
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    First of all...............they hate the pergolide Do not just put it into their food unless you like just wasting your money. This med is expensive. We put the pergolide powder into a syringe with water ( 6 cc syringe) and put it into their mouth to make sure they get it. One of my mares is on 0.5 dosage. Seems the dosage your vet is prescribing is excessive. JMHO.

    And anyway, does it seems more tests should be done before giving this drug?
    Sandy
    www.sugarbrook.com
    hunter/jumper ponies



  5. #5
    Join Date
    Sep. 8, 2010
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    Default

    You can't run the endogenous ACTH test this time of year, you will get false readings which ends up being a waste of money. That is the most popular test that vets around here run but they won't do it in the fall.

    Expensive? Last I knew it is only about $35 a month for the pergolide.



  6. #6
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    Feb. 28, 2006
    Location
    The rocky part of KY
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    Default

    Quote Originally Posted by davistina67 View Post
    . . .
    Expensive? Last I knew it is only about $35 a month for the pergolide.
    Yes, it can be expensive. I either have to fire my vet and find one that will write me a scrip for Thriving pets, which sells the 1mg powder for $0.55 per dose, or get the suspension through my vet at $1.50 per 1mg/ml. ($1.59 with tax, to be picky.)
    When we started the old guy right around now last year we did 3mg/ml.
    That's what the vet told me to do, though we brought it down to 1mg/ml after about a month and a half. $4.50 per day was a bit difficult-although the joke was on me as I now have a medication I take that the insurance won't cover that costs exactly the same.
    Courageous Weenie Eventer Wannabe
    Incredible Invisible



  7. #7
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    Jul. 14, 2003
    Location
    Rhode Island
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    1,850

    Default

    My girl is on 1mg per day( .5 am/.5pm). I get mine through my vet from Wedgewood Pharmacy in the form of an apple/molasses flavored pill that I break in half and she takes it easily. With shipping it's well under $50.00/month.



  8. #8
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    Sep. 8, 2010
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    Default

    Quote Originally Posted by ReSomething View Post
    Yes, it can be expensive. I either have to fire my vet and find one that will write me a scrip for Thriving pets, which sells the 1mg powder for $0.55 per dose, or get the suspension through my vet at $1.50 per 1mg/ml. ($1.59 with tax, to be picky.)
    When we started the old guy right around now last year we did 3mg/ml.
    That's what the vet told me to do, though we brought it down to 1mg/ml after about a month and a half. $4.50 per day was a bit difficult-although the joke was on me as I now have a medication I take that the insurance won't cover that costs exactly the same.
    Just have your vet write a script for you. I wasn't clear if you were buying it direct from your vet. If you are, by law he must sell it to you at his cost. Compounded drugs can not be marked up by a vet and by law he must write you a script for a prescription if you ask for it to be filled anywhere you like.



  9. #9
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    Dec. 18, 2002
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    Chesterton, IN US
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    Default

    My vet uses a test that measures the rise in cortisol through the day. They take an am and pm blood test and the lab measures a percentage difference. This test is not affected by the seasonal rise in corisol. (This is not the low dose dex supression test. You don't want to do that as it can actually cause founder).

    Currently I'm using my vet's compounding pharmacy, which looks like it is more expensive than who some of you guys are using. I'm thinking of switching now that we have her dose figured out, but I'm concerned about quality and consistancy of the drug. Is Thriving Pets the one everyone is using and has anyone had any problems with them?



  10. #10
    Join Date
    Apr. 22, 2006
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    Default

    That does seem like a very high starting dosage. My gelding started out on .5 and worked up to 1 mg. My vet tests before prescribing. Pergolide can be pricey. It was through my vet, but she wrote a prescription that I get filled with Wedgewood. Much, much cheaper.

    The thing my vet will do is put very fat horses and ponies on Thyro L without blood tests and see if it works. If I was going to guess I'd guess fat, cresty ponies more likely to be IR than Cushings. Cushings isn't necessarily associated with obesity. My gelding dropped a lot of weight fast and was weak and lethargic when he was tested and diagnosed. He was tested in December, just after Christmas.
    "The captive bolt is not a proper tool for slaughter of equids they regain consciousness 30 seconds after being struck fully aware they are being vivisected." Dr Friedlander DVM & frmr Chief USDA Insp



  11. #11
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    Feb. 8, 2002
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    Quote Originally Posted by Sugarbrook View Post
    First of all...............they hate the pergolide Do not just put it into their food unless you like just wasting your money. This med is expensive. We put the pergolide powder into a syringe with water ( 6 cc syringe) and put it into their mouth to make sure they get it. One of my mares is on 0.5 dosage. Seems the dosage your vet is prescribing is excessive. JMHO.

    And anyway, does it seems more tests should be done before giving this drug?
    Well, she *was* eating the .5mg with no problems, so I didn't expect an issue when I gradually increased it. I'll just go back down to what she'll eat in her food for now, because syringing it into her mouth will be a nightmare on a daily basis. She's rotten that way...

    Quote Originally Posted by davistina67 View Post
    You can't run the endogenous ACTH test this time of year, you will get false readings which ends up being a waste of money. That is the most popular test that vets around here run but they won't do it in the fall.

    Expensive? Last I knew it is only about $35 a month for the pergolide.
    That's kinda what I thought on both counts, but wanted to be sure. I just wish he had started with Thyroid L even though her blood tests in the past have been normal. I just hate the thought of such a young pony on such a strong drug.

    Quote Originally Posted by CB/TB View Post
    My girl is on 1mg per day( .5 am/.5pm). I get mine through my vet from Wedgewood Pharmacy in the form of an apple/molasses flavored pill that I break in half and she takes it easily. With shipping it's well under $50.00/month.
    Those sound easy peasy, thanks for the tip...



    Quote Originally Posted by jherold View Post
    My vet uses a test that measures the rise in cortisol through the day. They take an am and pm blood test and the lab measures a percentage difference. This test is not affected by the seasonal rise in corisol. (This is not the low dose dex supression test. You don't want to do that as it can actually cause founder).
    Can you find out the name of your vet's test for me, please?

    Quote Originally Posted by ptownevt View Post
    That does seem like a very high starting dosage. My gelding started out on .5 and worked up to 1 mg. My vet tests before prescribing. Pergolide can be pricey. It was through my vet, but she wrote a prescription that I get filled with Wedgewood. Much, much cheaper.

    The thing my vet will do is put very fat horses and ponies on Thyro L without blood tests and see if it works. If I was going to guess I'd guess fat, cresty ponies more likely to be IR than Cushings. Cushings isn't necessarily associated with obesity. My gelding dropped a lot of weight fast and was weak and lethargic when he was tested and diagnosed. He was tested in December, just after Christmas.
    Yeah, see above, I was hoping to try the Thyroid-L first but he wanted to go straight to Pergolide. I haven't gotten my bill from him yet, now you guys have me scared. LOL I got a tiny bottle and it'll probably cost $300.00!!!



  12. #12

    Default

    Quote Originally Posted by ReSomething View Post
    Yes, it can be expensive. I either have to fire my vet and find one that will write me a scrip for Thriving pets, which sells the 1mg powder for $0.55 per dose, or get the suspension through my vet at $1.50 per 1mg/ml. ($1.59 with tax, to be picky.)
    When we started the old guy right around now last year we did 3mg/ml.
    That's what the vet told me to do, though we brought it down to 1mg/ml after about a month and a half. $4.50 per day was a bit difficult-although the joke was on me as I now have a medication I take that the insurance won't cover that costs exactly the same.
    Your vet is misinformed if they are selling you a suspension of this stuff. Suspensions of pergolide quickly degrade, and usually only last about 2 weeks max. Get the powder, inform your vet!



  13. #13
    Join Date
    Apr. 22, 2006
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    Default

    I think it degrades slower if it is suspended in oil versus water, but even with the oil it may only be good for 30 days.
    "The captive bolt is not a proper tool for slaughter of equids they regain consciousness 30 seconds after being struck fully aware they are being vivisected." Dr Friedlander DVM & frmr Chief USDA Insp



  14. #14
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    Feb. 28, 2006
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    The rocky part of KY
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    Quote Originally Posted by cute_lil_fancy_pants_pony View Post
    . . .Suspensions of pergolide quickly degrade, and usually only last about 2 weeks max. Get the powder, inform your vet!
    Quote Originally Posted by ptownevt View Post
    I think it degrades slower if it is suspended in oil versus water, but even with the oil it may only be good for 30 days.
    Sources, please?
    Courageous Weenie Eventer Wannabe
    Incredible Invisible



  15. #15

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    Which Endocrine Disorder Are We Dealing With? Pituitary Pars Intermedia Dysfunction versus Equine Metabolic Syndrome: Treatment Options
    ACVIM 2010
    Nicholas Frank, DVM, PhD, DACVIM
    University of Tennessee, Knoxville, TN, USA
    20099484

    He quoted: Davis JL, et al. J Am Vet Med Assoc 2009;234:385.
    Davis et al. demonstrated that pergolide lacked stability over a 35-day period when prepared as an aqueous suspension. This group also showed that higher temperatures and exposure to light enhanced degradation, so aqueous preparations should be stored in dark containers and refrigerated. Even under these conditions, a maximum 30-day shelf life should be assumed for aqueous preparations. Pergolide is prescribed on a total dose basis, using a starting dose of 1.0 mg/day for horses and ponies with PPID.



  16. #16

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    J Am Vet Med Assoc. 2009 Feb 1;234(3):385-9.
    Effects of compounding and storage conditions on stability of pergolide mesylate.
    Davis JL, Kirk LM, Davidson GS, Papich MG.

    Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC 27606, USA.
    Comment in:

    J Am Vet Med Assoc. 2009 Apr 1;234(7):873, author reply 873.
    Abstract
    OBJECTIVE: To determine the effects of temperature and light over a 35-day period on stability of pergolide mesylate after compounding in an aqueous vehicle.

    DESIGN: Evaluation study.

    PROCEDURES: Pergolide was compounded into a formulation with a final target concentration of 1 mg/mL. Aliquots of the formulation were then stored at -20 degrees, 8 degrees, 25 degrees, or 37 degrees C without exposure to light or at 25 degrees C with exposure to light for 35 days. Samples were assayed in triplicate by means of high-pressure liquid chromatography immediately after compounding and after 1, 7, 14, 21, and 35 days of storage.

    RESULTS: Mean+/-SD concentration of pergolide in the formulation immediately after compounding was 1.05+/-0.086 mg/mL. Samples exposed to light while stored at 25 degrees C had undergone excessive degradation by day 14, samples stored at 37 degrees C had undergone excessive degradation by day 21, and samples stored at 25 degrees C without exposure to light had undergone excessive degradation by day 35. The decrease in expected concentration corresponded with the appearance of degradation peaks in chromatograms and with a change in color of the formulation.

    CONCLUSIONS AND CLINICAL RELEVANCE: Results indicated that pergolide mesylate was unstable after compounding in an aqueous vehicle and that storage conditions had an effect on stability of the compounded formulation. Compounded pergolide formulations in aqueous vehicles should be stored in a dark container, protected from light, and refrigerated and should not be used >30 days after produced. Formulations that have undergone a color change should be considered unstable and discarded.



  17. #17
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    The rocky part of KY
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    Thank you for the information CLFPP!

    Now the Eagle study available on equine Cushings Yahoo group indicates that Pergolide in liquid showed little to no degradation up to I think 90 days - BUT the liquid substrate was not named. Are there any studies regarding the stabilty in an oil base? The suspension I'm using mixes easily with flaxseed oil, which I use as a carrier so I believe it is oil based. He became more and more difficult to dose directly with the syringe, eventually just spitting it out altogether, figured out cored apples but will eat it as a top dressing - still losing a portion as he is a "dropper" and the dentist says that it is unlikely that he will completely stop losing food when he eats at this point.

    I'd like to take advantage of the lower price, ensure he is getting the entire dose and ensure the pergolide is at full potency by using the encapsulated powder - now I have to approach the vet with real data as opposed to internet anecdotes. This is a great help.
    Courageous Weenie Eventer Wannabe
    Incredible Invisible



  18. #18

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    Quote Originally Posted by ReSomething View Post
    Thank you for the information CLFPP!

    Now the Eagle study available on equine Cushings Yahoo group indicates that Pergolide in liquid showed little to no degradation up to I think 90 days - BUT the liquid substrate was not named. Are there any studies regarding the stabilty in an oil base? The suspension I'm using mixes easily with flaxseed oil, which I use as a carrier so I believe it is oil based. He became more and more difficult to dose directly with the syringe, eventually just spitting it out altogether, figured out cored apples but will eat it as a top dressing - still losing a portion as he is a "dropper" and the dentist says that it is unlikely that he will completely stop losing food when he eats at this point.

    I'd like to take advantage of the lower price, ensure he is getting the entire dose and ensure the pergolide is at full potency by using the encapsulated powder - now I have to approach the vet with real data as opposed to internet anecdotes. This is a great help.
    Try putting the powder capsule in a little bread with peanut butter and/or jelly.



  19. #19

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    I have not found any studies about pergolide in oil.



  20. #20
    Join Date
    Apr. 22, 2006
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    Quote Originally Posted by ReSomething View Post
    Sources, please?
    Source: my vet
    "The captive bolt is not a proper tool for slaughter of equids they regain consciousness 30 seconds after being struck fully aware they are being vivisected." Dr Friedlander DVM & frmr Chief USDA Insp



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