# Prascend- pros and cons please for those using it



## glinda (6 July 2014)

Hi

My small Shetland cross pony (she weights about 150kg) is 16 years old and has been diagnosed with Cushings (and associated laminitis) She was first diagnosed at christmas and her only symptom at the time was sudden onset laminitis.

She was put onto 1/2 Prascend tablet per day.

Since then her ACTH levels have dropped back to normal range and at the moment she is sound and doing well with her laminitis

BUT

She is a different pony in terms of her behaviour and demeanour&#8230;&#8230; she used to be a greedy pony who would eat anything if you put it it front of her, now I struggle to get her to eat anything- she only has small feeds anyway but I like her to have the correct nutrition from a balancer and her supplements and extra fibre but she is just no longer interested in eating&#8230;.. she calls for food but as soon as you give it to her she takes 1 mouthful and then turns away. She will however eat her soaked hay fine.

She also seems depressed&#8230;. she has just lost her sparkle and her personality.

I have read lots of things about side effects to Prascend&#8230;. and my vet spoke of them too but wanted her to stay on the drug&#8230;&#8230;

What are eveybody's experiences???? Good and bad??
I obviously want to do whats best for her&#8230;. I want to keep her laminitis and cushings free but I am so worried that the tablets are making things worse on a different level

Thoughts please


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## BlackRider (6 July 2014)

They do say that these symptoms are often temporary, but I would have thought if that was the case she would have improved by now.

My horse was quiet for the first couple of weeks, and then really got her mojo back.  She never went off her food though.

Would it be worth discussing with your vet, about giving her a break before the seasonal rise? Also how high was her ACTH levels before and after?


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## paddy555 (6 July 2014)

I would quesry if your dose is too high, or at least too high for the moment.I would definitely stick to the prascend but perhaps try and reduce it to a quarter for a few weeks and maybe increase again and try to get back to a half. (obviously after discussing it with the vet) You may get her lifestyle and eating more stabilised on a lower dose and then be able to work upwards if necessary. It is possible to divide prascend into quarters but you are not supposed to handle it. If your vet agreeed he may let you have pergolide which I believe copes with lower doses. 


I have found the whole cushings thing a balancing act and I suspect what works for one is more difficult for another but prascend has been a lifesaver for mine so I am grateful for it.

There is a thread on "tack room" called something like "mercy for cushings".  It is not a nice thread but there is a lot of info on there going back over a couple of years and it is well worth reading


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## ruth83 (6 July 2014)

A friend had similar issues with her gelding. With agreement from the vet she lowered the dose and gradually built it back up again. This seemed to solve the issue. 

I wonder whether the vet is reluctant to lower the dose due to the reported high number of lammi cases this year?


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## Micky (6 July 2014)

It does sound like she is going through a veil moment, discuss with your vet or go ahead and reduce dose to a quarter tablet ( use a pill splitter from chemists) see if she improves and when she does, up it again to the half tablet. 
In the meantime, make sure she doesnt get too much grass, feed the soaked hay instead if easier ( bare dust paddock with the hay).
Also have a look at the laminitis site for info on PPID ( cushings), prascend, lami, etc. It is a balancing act, but do-able.


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## Mrs B (6 July 2014)

Merlin couldn't tolerate more than a quarter of a tablet of Prascend. He became lethargic and miserable and picked at his food on a half. So we kept it at a quarter and he perked up no end, having a very happy summer. However, I was surprised by just how high his ACTH reading was when it was time for his Autumn blood test.

My vet suggested I try him on chasteberry (I used C-Plus by Feedmark) alongside the quarter Prascend. We retested him 3 months later and his ACTH levels had come down by two thirds 

HHO member mybfg tried her mare on C-Plus after she coliced on Prascend. She came back to post a while later and it had worked for her too.


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## Shay (6 July 2014)

If you have to drop below a 1/2 pill your vet can still prescribe pergolide which is a lower dose -and cheaper.  A friend had the same with small Shetlands and the prascend doses can just be too high for the little ones.  But keep her on it if at all possible - there really is no good long term alternative for cushings management.


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## Silverfire (6 July 2014)

My 21 yr horse has no appetite for his feeds at the moment either but he is happy otherwise. He's on 2.5 prascend and I did recently reduce his dose for two weeks to see if it would help but its made no difference. I give him a feed anyway and sometimes he eats it and other times he doesn't. He eats loads of hay though.


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## Gloi (6 July 2014)

My 25yo has lost his interest in low sugar bucket feeds since he has been on Prascend. He eats them for a while then walks away. He still eats hay & grass as he always has and given the chance would eat mollassed feed, but I don't let him. He looks well though. I'm hoping to find a low starch feed he likes before winter. I do agree with the others that your pony's dose may be too high.


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## lelly (6 July 2014)

I have been through all that you mention with my 23 year old Shetland. It's an absolute nightmare but they do come out of it eventually. It's taken around eighteen months but I finally have my old pony back. There's been many times I thought I should call it a day but I'm so pleased I didn't.


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## Micky (7 July 2014)

Autumn time is peak seasonal rise time for acth levels... keep at it, it is worth it to get your pony back and to help him. Have a look at the laminitis site for any info you're not getting from here.


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## glinda (7 July 2014)

Thanks for all your replies- its helpful to know that i'm not the only one..



lelly said:



			I have been through all that you mention with my 23 year old Shetland. It's an absolute nightmare but they do come out of it eventually. It's taken around eighteen months but I finally have my old pony back. There's been many times I thought I should call it a day but I'm so pleased I didn't.
		
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What did you do with yours, what were the problems etc. be very interested to hear

Just to note- she has turn out on a small bare paddock and always has 8-10 hour soaked hay (always has)  and only gets Topspec Antilam and a small handful of Dengie Happy Hooves molasses free. She already has a chaste berry supplement- this doesn't seem to have made any difference to her.

My vet is coming out again on thursday to do some more bloods- just to make sure nothing else is going on and then he said we could try her at 1/4 tablet daily and see.

My main concern is that her Laminitis doesn't flare up again as I have worked hard to get her sound.. its very annoying as I have always treated her as if she had laminitis anyway.. soaked hay, low sugar diet, grazing muzzle and restricted turnout, daily exercise, regular feet trims every 6 weeks. blooming Cushings its sooooooo frustrating


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## splashgirl45 (7 July 2014)

how and when are you giving her the prascend?   mine will not eat a feed with it in so I hide it in a carrot and hand feed her.  its getting more difficult as she is now on 4 daily.....but this does work and she eats her feed with her supplements in with no problem...unfortunately laminitis is a side effect of cushings so if you can keep the cushings under control and continue with good management hopefully you can keep her laminitis free.  good luck, I know how frustrating it is (and costly!!!!!!)


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## glinda (8 July 2014)

splashgirl45 said:



			how and when are you giving her the prascend?   mine will not eat a feed with it in so I hide it in a carrot and hand feed her.  its getting more difficult as she is now on 4 daily.....but this does work and she eats her feed with her supplements in with no problem...unfortunately laminitis is a side effect of cushings so if you can keep the cushings under control and continue with good management hopefully you can keep her laminitis free.  good luck, I know how frustrating it is (and costly!!!!!!)
		
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Like you I give her the tablet in a small piece if carrot- she eats this fine! and then she has her food which she mostly doesn't eat!


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## ihatework (8 July 2014)

I own 2 cushings horses.

1 was diagnosed young and was very atypical. His ACTH did not respond to prascend (he was gradually titrated up to 3mg a day) but he got such severe depression that I took the decision to withdraw him from the prascend. He has been off the drug for 12 months now and is a much happier horse for it.

My other horse is late teens and had an ACTH of around 350 when he was first diagnosed. He has been well controlled for 3 years on 1mg with no side effects what so ever until recently when I have increased the dose to 1.5mg 

I would think 0.5mg is quite a high starting dose for such a little horse. I'd be inclined to speak with your vet, do a short wash out and restart with 0.25mg, hopefully that will work better for you.

What I would say is that prascend is really unpalatable - both my horses eventually refused to eat carrots-apples for fear of being poisoned  The old boy has recently gone on another bout of food strike in an attempt to avoid the drugs so we just force them down using an old gastroguard syringe every day!


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## glinda (10 July 2014)

ihatework said:



			I own 2 cushings horses.

1 was diagnosed young and was very atypical. His ACTH did not respond to prascend (he was gradually titrated up to 3mg a day) but he got such severe depression that I took the decision to withdraw him from the prascend. He has been off the drug for 12 months now and is a much happier horse for it.

My other horse is late teens and had an ACTH of around 350 when he was first diagnosed. He has been well controlled for 3 years on 1mg with no side effects what so ever until recently when I have increased the dose to 1.5mg 

I would think 0.5mg is quite a high starting dose for such a little horse. I'd be inclined to speak with your vet, do a short wash out and restart with 0.25mg, hopefully that will work better for you.

What I would say is that prascend is really unpalatable - both my horses eventually refused to eat carrots-apples for fear of being poisoned  The old boy has recently gone on another bout of food strike in an attempt to avoid the drugs so we just force them down using an old gastroguard syringe every day!
		
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Very interesting- thanks for that
Vet is coming to se her today and I really want to reduce the dose!
It seems from looking at everyones comments 1/2 tablet is a lot for a small pony- when much bigger horses seem to do well on the same dose!!!!!

The interesting thing is that the only bit she does eat is the carrot with the tablet in it!!!! Its everything else thats a problem lol
Though we did have a problem when she had to have Danilon in her food for a while.. she thought we were totally trying to poison her- silly horses lol- even new buckets etc didn't convince her there wasn't anything nasty in the food.


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## southerncomfort (10 July 2014)

I have a 25 year old welsh pony who cannot tolerate even the smallest amount of prascend.  I tried for several months but when we reached the point where there was thick snow on the ground and she was stood with her head down, refusing to eat her hay, shivering like mad....that was the point I stopped giving it to her and promised never to try again.  She was so depressed I honestly think she'd given up.  She also began to refuse water.  

I changed vets recently and discussed my decision with my new vet who was very supportive and said that sadly some equines simply cannot tolerate it.

My pony has been on chasteberry since she came off the prascend and is a different pony.  She is sparky and happy and her coat is the best it's been for many years.

If you do need to take your pony off it for any reason, don't let anyone make you feel guilty.  I came upon some particularly nasty bullies on FB who accused me of sentencing my pony to death!  Some people are very fundamentalist about it (no-one on HHO I hasten to add!).


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