# How long into giving Prascend



## JillA (8 July 2015)

My horse is on a Prascend trial due to laminitis and suspected false negative ACTH test - he has a crest and fat pads although he has been on a low sugar/minimal grass & soaked hay diet for the spring/summer. We have started on 1mg Prascend a day about two weeks ago and he has been living in the manege ever since. As you might remember from my previous thread I am not getting much support from my vet, and will change and get a new test done once I think we might be on the road to recovery or the dose isn't enough. So my question is how long to leave it before considering upping the dose, and getting a new ACTH test (with a different vet)? (I did post this question on the FB group but they never gave me an answer)


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## be positive (8 July 2015)

The fat pads and crest could be due to him being IR rather than cushings so prascend may not be helping, one of my ponies lost his crest and fat pads after a short course, 1 month, of metformin and they have not come back several years later.
I think you need a vet that is more interested in getting to the bottom of the issue rather than waste time and money on what may well be inappropriate treatment.


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## ihatework (8 July 2015)

What did the horses original ACTH come back at?
I'm not sure I'd be upping the prascend dose at all at this stage tbh.
I agree with be positive - it is probably more likely to be insulin resistance from horses obesity. 

In your shoes is retest ACTH after 4 weeks (which is debatable how accurate a reading you will get anyway given horse was negative initially) and then explore other metabolic issues.


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## paddy555 (8 July 2015)

my horse also tested negative twice but had sufficient symptoms to justify a prascend trial . This worked for him and I judged success purely by his physical symptoms. There seemed little point in retesting. I would think 2 weeks is far too short a time to be considering increasing prascend. I would wait at least 3 months to give him time to adjust possibly testing in the Autumn if to want to retest. 
What results are you looking for to judge if the prascend is working? If your horse may have PPID are you giving him sufficient support with a decent supplement and vit E supplementation. This was very important for mine.


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## brucea (8 July 2015)

Prascend helps. But maybe also think about a mineral supplement with adequate magnesium in it. (FP or  PE)


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## JillA (8 July 2015)

brucea said:



			Prascend helps. But maybe also think about a mineral supplement with adequate magnesium in it. (FP or  PE)
		
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He's been on magox for years, and is also on Equifeast calcium, selenium and vit E, as well as a selection of supplements for his skin - I have done all I think I can with his diet and it maybe held it at bay for a few years, but now, at the age of 18 he is displaying more of the symptoms despite it all. I'll give it a couple more weeks at 1mg and then get him tested - meanwhile I will have no surface left in the school, thanks to poo picking daily


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## paddy555 (8 July 2015)

JillA said:



			He's been on magox for years, and is also on Equifeast calcium, selenium and vit E, as well as a selection of supplements for his skin - I have done all I think I can with his diet and it maybe held it at bay for a few years, but now, at the age of 18 he is displaying more of the symptoms despite it all. I'll give it a couple more weeks at 1mg and then get him tested - meanwhile I will have no surface left in the school, thanks to poo picking daily 

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my lad had very bad skin problems to the extent I was wondering how much longer it could go on on welfare grounds. The prascend needed around 3 months to work to produce visible results. The normal vit e dose is 5000iu per day for PPID. Mine needs all of that and the resullts from it have been remarkable. I believe they also need a good all round supplement to incl Cu and Zn etc or at least mine did to enable him to grow good feet. 
He has moved from a life off grass to being able to run around a grass track all day so it can work. He was only 13 when diagnosed.


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## Stacy_W (8 July 2015)

Mine has been on Prascend for two weeks now - 28 year old mare with reading of 48.  I didn't realise I should be giving a vit E supplement.


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## MardyMare (9 July 2015)

Stacy_W said:



			Mine has been on Prascend for two weeks now - 28 year old mare with reading of 48.  I didn't realise I should be giving a vit E supplement.
		
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Neither did I.  One of mine (now semi retired at 16) tested with reading of 59 - started 1mg prascend yesterday.  She has a little fast fibre with a TS of salt, scoop of PRO HOOF and a scoop of TEN daily balancer - should there be extra Vit E? 

ps:  Sorry if I am hijacking your post OP.


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## paddy555 (9 July 2015)

I believe the usual recommendations are around 5000iu of vit E for an average horse with cushings/PPID. There is considerably less in most supplements, probably around only 1000iu. Bear in mind of course only to supplement vit E and not a vit E and selenium mix as you would overdose the selenium. 

I found a lot of difference with mine as he had really suffered in the muscle department due to cushings. 
I also recently read that elderly horses should have vit E supplementation as due to their degenerating teeth they may well not be able to intake sufficient grass. A cushings horse would be struggling with lack of vit E as many will have their grazing restricted due to the disease and fear of laminitis and many will be old and could well have teeth that were less than perfect. Plus of course they are ill with a disease. 


If you google "vitamin e for cushings horse" there are a lot of results which may give you some ideas.


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## Pinkvboots (9 July 2015)

My horse was put on pracend as she tested positive for cushings,  vet told me to re test in 6 weeks to see if levels had gone down, I would also test for ems as my horse has both and it is more common than people think.


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## JillA (9 July 2015)

I'm no scientist and confused by the term iu - how does that relate to volume or weight of whatever form you have available, could someone explain please


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## paddy555 (9 July 2015)

JillA said:



			I'm no scientist and confused by the term iu - how does that relate to volume or weight of whatever form you have available, could someone explain please
		
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iu's are international units and a measure of vit e.

eg endurance horse probably needs 5000iu, pasture pet say 1000iu (as an example) 


equimins oil, 1 litre bottles, supplies 1000 international units per gram weight. So for say a PPID horse you may give 5 grams a day. 

I weigh mine but I think that it is 1ml of equimins oil also equals 1000 international units.

The forage plus vit e comes in powdered form and if you look on their site I expect it tells you the weight to give per iu.


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## Micky (10 July 2015)

If you look on thelaminitissite, it will tell you what feed and supplements are suitable for laminitics, PPID and EMS horses...


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## Pebble101 (10 July 2015)

I have had a look at thelaminitissite but have a few concerns - their advice about frog supports and pads contradicts my vets advice, and also that on thelaminitisclinic.


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## Roasted Chestnuts (10 July 2015)

So how much selenium is toxic? For instance the gold label vit e doesn't say until you read the back bit that it has selenium in it. So if you are feeding a scoop per feed over two feeds are you over dosing the selenium?


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## JillA (10 July 2015)

Black Beastie said:



			So how much selenium is toxic? For instance the gold label vit e doesn't say until you read the back bit that it has selenium in it. So if you are feeding a scoop per feed over two feeds are you over dosing the selenium?
		
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I had a blood test to determine that my horse was lacking in selenium, so when it came I fed according to the instructions on the pack - but I bought it primarily for the selenium, I have ordered some vit E from Progressive Earth, hope it doesn't have selenium because I have no idea if the other horse needs it. I don't think it is toxic but it gives the same symptoms as too little. ??


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## Roasted Chestnuts (10 July 2015)

JillA said:



			I had a blood test to determine that my horse was lacking in selenium, so when it came I fed according to the instructions on the pack - but I bought it primarily for the selenium, I have ordered some vit E from Progressive Earth, hope it doesn't have selenium because I have no idea if the other horse needs it. I don't think it is toxic but it gives the same symptoms as too little. ??
		
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It's a hard one as many things just have selenium and vit e in them. My boy hasn't popped a positive test but been looking at various things along side and this popped up.

I'll maybe ask for a vits level from the next blood test  thanks


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## Nudibranch (10 July 2015)

I would look into changing vet now and getting another test straight away. The first PPID horse I had was tested twice a year. The second the same, but towards the end her ACTH levels shot up despite increasing the Prascend (525 last reading) so we were testing every 2 months to see whether they were coming down. There can be variability between seasons, and they can react differently to the Prascend; some respond much better and sometimes it just levels off for no obvious reason (other than natural disease progression I guess). Timescales are a bit like the proverbial piece of string unfortunately.


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## OldNag (11 July 2015)

JillA said:



			My horse is on a Prascend trial due to laminitis and suspected false negative ACTH test - he has a crest and fat pads although he has been on a low sugar/minimal grass & soaked hay diet for the spring/summer. We have started on 1mg Prascend a day about two weeks ago and he has been living in the manege ever since. As you might remember from my previous thread I am not getting much support from my vet, and will change and get a new test done once I think we might be on the road to recovery or the dose isn't enough. So my question is how long to leave it before considering upping the dose, and getting a new ACTH test (with a different vet)? (I did post this question on the FB group but they never gave me an answer)
		
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My (limited) experience  is that the ACTH test is not that accurate.  I have a Cushings pony who had a negative ACTH test but then a very positive TRH one. My vet would not prescribe Prascend without  having an accurate figure on which to base dosage, hence doing another test.  I was annoyed but appreciated his reasons.

We will retest in the autumn but will go for the TRH. Pony has responded well to Prascend thankfully (1 tab per day) so happy to wait until then.

The painful thing about the TRH test is the cost.  

ETS mine also has fat pads despite being trim, so we are working on the basis of EMS  too - so muzzled , and on soaked hay.


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## BlackRider (11 July 2015)

If it helps, it was about 4 - 6 weeks after starting prascend, before I really started to see a difference, after about 2 weeks she started to get a little more energy, and then gradually started to gain weight and get her mojo back.


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