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cushings or cushingoid horse owners - question for you

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  • cushings or cushingoid horse owners - question for you

    when/how did you decide to put your horse on pergolide?
    were the blood test results definitive? did you have other clinical signs?
    and i guess most important, are you happy w/ your decision?
    TQ(Trail Queen) \"Learn How to Ride or Move Over!!\" Clique

  • #2
    I put Cloud on pergolide after discussing his symptoms with my vet: older horse, long wavy hair coat, non-shedding, excessive urination, and general lethargy. Classic Cushings - he suggested we start him on a low dose of Pergolide and watch for improvements. His condition improved substantially. Five years later, we've increased the dosage a little bit, but he's still doing really well. His evergy level seems to be my best gauge of how he's feeling - it's been great - If you do opt for Pergolide, have it prescribed to Hopewell Pharmacy, a compounding pharmacy in town. Cloud's medication costs me less than $50 per month.


    • #3
      I put my horse on pergolide as soon as the test came back that he was positive. I saw absolutely no reason not to treat him. It is a relatively manageable disease with pergolide. His ACTH levels were not super high but they were certainly outside of the normal range so we started out with a very low dose (.5 mg). It has been about three or four years now and we had to up him to 1mg the next year after he was diagnosed but he has done well on it since. I normally test him twice a year although I forgot to do it this time and now it is the normal seasonal rise so I think I am just going to wait until Jan or Feb.

      My horse didn't exhibit what I would call classic Cushings symptoms. What prompted us to test him was that he grew a coat in June after being body clipped all winter. Certainly not normal.

      The ACTH test is pretty definitive (although this time of year you can have some false positives). The cortisol rhythm and dex suppression tests are not, LOTS of false positives and negatives. Have the ACTH test done if you are unsure.


      • Original Poster

        had acth done at the end of july

        Came out elevated. Vet thought pergolide was in order. I was hesitant bc it was the end of July and I thought results might be skewed. But she developed laminitis again 2 weeks ago without any apparent trigger. Took 10 days to get it under control. That's unusually long for her. Im going to speak to thevet again.
        TQ(Trail Queen) \"Learn How to Ride or Move Over!!\" Clique


        • #5
          I never did put my horse on Pergolide. I carefully controlled his diet, clipped the unbelievable excessive hair he would grow and monitored him daily. He developed and was diagnosed with Cushings at 20. He lived to be 33 and I have to be honest, it was the Cushings that was his downfall at 33, but he lived very happily and was in good shape until the final 3 months before I put him down. I had managed to pull him out of laminitic episodes twice with Bute therapy but it finally became too severe and I knew it was time to let him go. I have another horse that is 19 and he is a true and diagnosed IR horse - again we are controlling it strictly thru diet although I am having to put a grazing muzzle on him. It's not easy but it is definitely possible with some horses to control without going the pergolide or cypro route.
          Susan N.

          Don't get confused between my personality & my attitude. My personality is who I am, my attitude depends on who you are.


          • #6
            Originally posted by marta View Post
            when/how did you decide to put your horse on pergolide?
            I took into account the risks and benefits. Considered the prognosis with pergolide and without pergolide. Took into account the age, physical health and general well-being of my horse and decided not to put on pergolide.

            He had been my WEG HDT horse and was also an intermediate eventer and was not the sort of horse to stand about doing nothing. Mine was always an "upbeat" lively sort of a horse (anglo arab) and an alpha gelding in a herd of 13.

            He remained like that and was just the same when his diagnosis confirmed his illness. Indeed my vets were convinced that I was being a little "neurotic" when I asked them to test him and said they were certain they'd come back negative. I took the decision to maintain my horse until the quality of his life was such that it effected what he did day to day. I very carefully managed his diet and was fortunate in that he never had laminitis or anything significant wrong in the years from illness onset until his ultimate death. I was very careful about keeping his coat clipped and ensuring any minor nicks or cuts were well cared for. He continued to be ridden right up to his death - albeit just a 2 mile hack out each day.

            The day before he died he was turned out and did his normal blast round the field, sorted out the stroppy youngster gelding and took control of the mares and was happily grazing. The next day he didn't come to me when I went to the gate to bring them in (the one and only occasion in his life). He was very subdued and lethargic and it turned out he had acute kidney failure. I had him put down in the field.

            were the blood test results definitive?
            Yes and post mortem confirmed he actually had a tumour on his pituitory

            did you have other clinical signs?
            Yes. Muscle wastage, coat taking longer to shed then ultimately excessive curly coat, reduced immunity (minor infections etc, wounds taking a little longer to heal), excessive urination.

            and i guess most important, are you happy w/ your decision?
            Absolutely. He was my "once in a lifetime horse" and I miss him dearly and in the 5 years since he died there's not a week goes by when someone here doesn't recount a story about him but I don't regret my decision at all.


            • #7
              Originally posted by JanWeber View Post
              I put Cloud on pergolide after discussing his symptoms with my vet: older horse, long wavy hair coat, non-shedding, excessive urination, and general lethargy. Classic Cushings - he suggested we start him on a low dose of Pergolide and watch for improvements. His condition improved substantially. Five years later, we've increased the dosage a little bit, but he's still doing really well. His evergy level seems to be my best gauge of how he's feeling - it's been great - If you do opt for Pergolide, have it prescribed to Hopewell Pharmacy, a compounding pharmacy in town. Cloud's medication costs me less than $50 per month.
              Try www.thrivingpets.com The pergolide for my horse (1mg/day) runs me $15 per month, and yes, it is high quality, and tested.
              When someone shows you who they are, BELIEVE them- Maya Angelou


              • #8
                My horse is 25 and is doing great. He is on Pergolide and a large dose but on it he is doing rreally well. I clip him on a regular basis and he is bright and silly at times. He is still being ridden and looks great. He had wierd hind feet issues which ended up to be laminitic . He did not have Laminitis but was not comfortable in his feet. He always acted like an absess was developing but did not. I finally took him to a vet and farrier and through blocking and x rays it was determined that he had issues behind. An increased digital pulse and soreness. We put special shoes on him and maintain his Pergolide dose and he is great. I have owned him for 19 yeas so he is my buddy.


                • #9
                  We decided when my mare tested positive and excessive urination and heavy coat appeared. My horses are in 1/2 the day and out 1/2 day depending on the weather conditions. I think that I save more in shavings by having her on the Pergolide than I would if I did not because the urination was a major problem.

                  We have had a bout of abcesses but have been lucky with only that so far. She is healthy and happy now and I think the Pergolide has made a real difference. I do body clip her about 3 times a year because the hair is thick, long and difficult to manage.


                  • #10
                    I have a 31 yo TWH. When he first came here about 4 years ago he had just been diagnosed and was on Cipro. He did ok for awhile, then I noticed he seemed to be making a slight decline. I talked to his owner, we had him tested and decided to switch him to Pergo. He is doing much much better on it than the Cipro. We have occasional abcesses and all that, and he got a nasty case of rain rot from TS Fay that we are battling, but other than that he is doing very well.
                    "Perhaps the final test of anybody's love of dogs is their willingness to permit them to make a camping ground of the bed" -Henry T. Merwin


                    • Original Poster

                      thanks for all your thoughts.

                      my mare doesn't really seem to have many clinical symptoms other than these more frequent outbreaks of laminitis. she looks good, her coat isn't curly (although she always does grow in a long and thick winter coat which takes a long time to shed out), she's in good weight. i've been managing her IR so maybe that's why i'm not getting all those other clinical signs? i guess that's i'm so hesitant about starting her on pergolide. she is 18 but i feel like maybe i should wait until she's got more clinical signs. i don't want to start too early. i don't want to run out of options too soon. but this last bout of laminits, set off by i have no idea what and lasting as long as it did, really left me worried.
                      TQ(Trail Queen) \"Learn How to Ride or Move Over!!\" Clique


                      • #12
                        I would start on Pergolide and see what dose she needs. I try to avoid Laminitis at all costs, it is a horrible and painful thing for a horse to go through. Just my point of view.


                        • Original Poster

                          Ride On

                          i know, it was awful to watch her the last 10 days. when she finally improved on saturday, i was elated! my poor pony. i don't want her to go through this. however, how do i know that it was related to cushings and not just IR? can i rely on those july ACTH levels are are they already skewed? why do i have so many questions???

                          sorry! information overload is getting the better of me.
                          i guess you're right, i can try her on it and see what happens.
                          TQ(Trail Queen) \"Learn How to Ride or Move Over!!\" Clique


                          • #14
                            I just put my mare of Pergolide about 4 weeks ago. She had excessive drinking and of course urinating...and I mean excessive. Not heavy in fact the oposite, hard trying to keep weight on and it didn't help that she was in foal. Changed her diet to beet pulp, PN ration balancer & Envision only. Once the foal was weaned, she went on pergolide and I do see her very slowly keeping her weight and the one thing I noticed within a couple of weeks was she wasn't drinking nearly as much.

                            I can sympathize with information over load...I've been reading and reading about IR and cushings horses and quite frankly my brain is fried.
                            Follow us: http://www.facebook.com/#!/pages/Tre...1609022?ref=ts
                            Breeders of Sport Horses & New Forest Sport Ponies


                            • #15
                              my 1st cushings/ir horse was on cypro for 2 years before i switched to pergolide, the next 2 cushings /ir horses got put on pergolide as soon as they were diagnosed
                              none of them have foundered


                              • #16
                                To my knowledge there isn't any evidence indicating that earlier use of pergolide causes it to not work later on down the road.

                                I would almost bet (but I am not the gambling type) his cushings is affecting his insulin resistance. That is what happens when the two go together. Not that I understand this in detail but something to the effect that the tumor causes excess cortisol to be produced which in turn causes the IR. I know that is a huge oversimplification.

                                You absolutely want to avoid laminitis or founder at all possible costs. If his cushings is affecting the insulin resistance, I don't know if the strictest diet would get it under control. I would think that you would be very safe in July. If it is already elevated then, it is going to be much more elevated now which might be why the laminitis flareup.

                                I honestly don't know why anyone wouldn't at least try pergolide for a month or two. I imagine that there might be a few horses out there that react badly to it, but I think those are few and far between. I mean there are loads of horses that have been on it for 10+ years. Without pergolide the life expectancy of a cushings horse was something like three years without it and now there are loads of horses living for years and years. I have known of horses that have lived a very long time with an obvious case of cushings without pergolide, but of all those I believe the vast majority didn't get IR for whatever reason. Either case is pretty rare though.

                                Yes the ACTH test is pretty accurate. If there is some sort of mishandling, then the results tend to be lower so there aren't many false positives, with the exception of the fall season rise which wouldn't start until late august at the earliest.


                                • Original Poster


                                  thank you for your response.
                                  that's exactly what i was concerned about - is the july ACTH skewed or can i rely on it. i had a feeling it might have been too early for the seasonal change to affect it. and i didn't even think about the fact that if july was not skewed then now in september her ACTH is even higher and that the recent laminitis bout may be related to that.

                                  anyway, i'm going to try it. the vet that ran the ACTH returns tomorrow and i believe there is an internal medicine specialist at that clinic that she planned to consult with, so hopefully i can speak to them both and determine what amount she should be started on.

                                  this feels like such a huge step... not sure why.
                                  TQ(Trail Queen) \"Learn How to Ride or Move Over!!\" Clique


                                  • #18
                                    Oh, and I get my pergolide from Pet Health Pharmacy and their number is 1800742 0516. My horse has been on their pergolide for at least two years and my horse is tested at least twice a year. His levels came down from over 100 (normal range 40-60 if I remember off the top of my head) down into the normal range with their pergolide so I have no doubt about their efficiency. I get the capsules which are supposed to stay stable for the longest. The stability of liquid is unknown at this time (as in it hasn't really been tested like the capsules have) so I would stick with capsules. I just throw it in my horses feed and he eats it (and he is VERY picky, normally leaves most supplements), doesn't even notice it is there so it is simple to feed. I just ask the barn staff to check to be sure he ate it. It costs me around $45 for a three month bottle including shipping. When he was first diagnosed it was over $100/month when I bought it directly from the vet.

                                    Please feel free to ask any questions. My horse has never shown any negative side effects from the pergolide.


                                    • #19
                                      when/how did you decide to put your horse on pergolide?
                                      January of this year, as soon as we got ACTH test results back. Had pergolide overnighted so I could start horse on it immediately.

                                      were the blood test results definitive?
                                      Yes, he's results left no doubt that he had Cushing's.

                                      did you have other clinical signs?
                                      Initially, my horse was being problematic during shoeings. Later we figured out he was laminitic, witn the ONLY sign being soreness. Wasn't presenting as sore with hoof testers though. That began in roughly Oct. '07. We started getting hoof rings after that shoeing that correlated with the shoeings, which really puzzled us since this sinker had been doing so well otherwise.

                                      About Dec. to early January I noticed a change in his coat. He had longer hair than normal on the backs of his cannons. THAT'S when I knew it had to be Cushing's. He did not have the classic long curly hair that we're all familiar with. That didn't develop until AFTER starting the pergolide, in which some benign symptoms such as this may become worse after starting pergolide but go away within a few weeks time I understand. In any case, the horse shed out his coat like normal and all other symptoms disappeared. Never had the fish bowl eyes, crests, was never a fat horse (had an enviable metabolism, actually), nothing. I should also mention that the testing I did after starting pergolide to check his dosage indicated he was not IR, just Cushing's.

                                      and i guess most important, are you happy w/ your decision?
                                      Absolutely. If I had to do it all over again, I'd not have changed anything I did. I would also have started with the full dosage, even with anorexia being a side effect, because inflammation in a formerly foundered horse CAN become a death sentence. Especially for sinkers.

                                      I also used Pet Health Pharmacy, only I used the oil suspension. You couldn't syringe many things into this horse's mouth without him getting real pissy about it (to the point where he sees a syringe, he starts running), but I could walk up and grab him by the bridge of his nose and administer it without any kind of negative reaction. It became very routine for him and I guess it doesn't have a taste or he didn't mind it. Since this horse would not finish his meals in one sitting usually, I felt the suspension was the best way for us.

                                      FWIW I understand that vets will often begin pergolide with a horse before or without checking ACTH levels if a horse is laminitic and especially if the horse is foundered. I remember incidences like this being discussed here at this fourm, because I too wondered how safe that might be. Turns out, pergolide itself is supposed to be pretty safe.
                                      RIP Bo, the real Appassionato


                                      • Original Poster

                                        well i spoke to the vet again.

                                        her ACTH in July was 60 which vet admits is not that high above the limit. however, given the clinical signs (her laminitic episodes) she thinks that we should put her on 1 mg per day and retest in 6-8 weeks.

                                        1 mg seems high to me but i guess maybe after initial 6-8 weeks we can retest?
                                        TQ(Trail Queen) \"Learn How to Ride or Move Over!!\" Clique