[jherold]

I have not been able to stablize my mare on her pergolide. In the last 2 years she's gone from needing 0.5mg to almost 3mg with the last 2 increases only 3 months apart. Has anyone else had this issue?

[Sansena]

Can't say I have. I've known 3 who've had very little adjustment needed at 6 mo. intervals of retesting. Usually attributed by the vets to 'seasonal' changes.

Admittedly, I don't know what that means, exactly.

So your horse keeps needing more? Is it possible the tumor is growing so she just continues to need more support?

[Macimage]

Has she ever stabilized?

Perhaps she just needs a larger dose and once you find it she'll be stable.

My Cushing's gelding is stable on 6 mg/day.

[jherold]

Sort of. She's had 6 increases in the last 2 years with the last 2 being only 3 months apart. 2 of the 6 were in August so I attribute those to the seasonal rise. We bumped her in May due to not shedding completely and an increase in thirst and urination. She responds favorably to each increase and her symptoms subside temporarily but they seem to return much more rapidly than other Cushings horses. By the way, she is only 12 yrs.

[touchadream]

Pergiolde is very unstable. The shelf life on it is no more then a month and they have done studies that show after a week it starts to loose it's potency. I am actually surprised that your vet would still prescribe it. My vet refuses to prescribe it anymore because of the lack of shelf life and now that there's a new drug for cushions.

I would suggest speaking to your vet about Prascend - the only FDA approved medicine for cushions. It is expensive if you buy it from the vet but I buy mine online for a fraction of the cost and have seen really good results with it.

[jherold]

I tried Prascend right after I had to increase her and had to use the same dose of the new Prascend as the old compounded Wedgewood pergolide. So it's not that the drug I'm using isn't any good.

[marta]

what does your vet say?
does she have any symptoms, other than elevated ACTH, which are getting worse?

[rcloisonne]

FWIW Prascend is a trade name for pergolide. The human version used to be called Permax.

I am also wondering what you mean by the horse is unstable?

[jherold]

Vet and I are thinking she has a malignant tumor on her pituatary gland. Her first symptoms were extreme reactivity and aggression, some increase in urination and water intake and some increase in coat thickness and length. When all the usual causes of this type of behavior were ruled out (behavioral, hormonal, ulcers etc.) we put her on pergolide as a last ditch effort before euthansia. It worked miracles on her. A subsequent test showed that when on pergolide her ACTH levels were in the normal range. My decisions to increase are usually based on her levels of aggression and reactivity. (She gets irritable and aggressive, trys to bite or kick, I up the pergolide and within a few days, she's back to her normal sweet self). Due to cost considerations, I haven't retested her. The May increase was based on a marked increase in urination and the fact that she completely stopped shedding out her winter coat.

I was just wondering if anyone else had a horse that did not stabilize and how did the disease progress for their horses.

[Katy Watts]

PPID is a progressive disease, so increased dosage of pergolide is commonly needed to keep symptoms at the same reduced level. My mare needed 3 mg at the end. She looked great and had no PPID symptoms. She was euthanized for an arthritic knee that made her miserable during cold weather.