# Side effects of prascend



## Polish warmblood (13 September 2013)

Hi,my elderly gelding has been diagnosed with cushings and recommend that I give him prascend. well I did and couldn't understand why my horse wouldn't eat and was deeply depressed until I read the known side effects of the drug and saw how it affected my horse. I guess each horse is an individual and doesn't always react the same.   I took my horse off of the drug and now he is a picture of health, has a hearty appetite and is his old cheeky self again. My horse has no external symptoms i.e. wee, pooh ,eating and coat are all normal.   my vet says his acth levels are high and advised that the horse should go back onto the prascend.  I am struggling with this as I would rather have a happy, horse than a depressed skeletal horse....anyone else experiencing the same problems?any help advice appreciated. cheers.


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## JillA (13 September 2013)

The loss of appetite is only a temporary thing (what they call the pergolide veil) and he will get back to normal in a very few weeks. He needs the Prascend (equine version of pergolide) to compensate for the hormone problems Cushings causes - he may seem well enough now but without it he will eventually get quite ill, with insulin resistance and laminitis, weight loss etc.. Put him back on it and grit your teeth for a week or two - it will be worth it in the long run.


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## Polish warmblood (13 September 2013)

Many thanks for your reply.....I am still not happy.  My horse had the side effects for months and months , most of last year infact.... I hear what you say , you are warning me that he is going to get really ill at some point in the near future....but I am very unhappy with the level of deep depression he went into and he completely stopped eating whilst he was on prascend.

My vet wants me to contact her in one weeks time to discuss further.  I don't know if my vet was guilty of not analysing or getting the dosage correct for my particular horse, but the minimum she would allow me to give my
horse was one tablet per day ....and on this dosage he had the deep depression and complete loss of apPetite..
surely this can not be right???...
 Is there not a milder drug?  
or perhaps a Homeopathic(herbal ) remedy. I know I sound negative, but I am willing to try alternatives.....
WHen my horse is on Prascend.  I can not bear to see how ill and depressed he gets.  What quality of life is this
I would rather he had a shorter albeit happier life....than months and years of being miserable and depressed and not eating when on this drug.
I really do appreciate your reply........but I also ask for any other fellow sufferers who can see it from my point of view
. It wold be good to get the PROs and CONS  and then I can hopefully make the right decision for my horse.
 many thanks.


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## Amymay (13 September 2013)

Contact Wagtail on here for some advice.


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## Polish warmblood (13 September 2013)

wagtail??  ...RIGHT OK thanks
 polish warmblood.


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## Pinkvboots (13 September 2013)

A friend of mine had a similar experience so she just reduced the dosage and I think he has about a quarter of a tablet now and is ok, I think it can be difficult to get the right dosage to start with, I wish you luck with your horse.


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## JillA (13 September 2013)

Or these people on Facebook https://www.facebook.com/groups/475349259169277/?ref=ts&fref=ts or the Yahoo group for owners with horses with PPID/Cushings. 
I'm surprised your vet hasn't taken enough interest to adjust the dose - maybe start with 1/2 tablet, or use pergolide which comes in multiples of 250mgc (1 Prascend is 1000mcg)


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## ihatework (13 September 2013)

Polish Warmblood I completely hear what you are saying.
It sounds like you gave the Prascend a good trial? I would urge you to keep talking to your vet though and make them very aware of how the drug is affecting your horse.

I have 2 horses currently on Prascend.

One is a late teens TB type, on 1 mg a day and doing very very well on it.

My other horse is a 7yo. I am in a bit of a trauma about him at the moment. He has been titrated up 3 times now, and still his ACTH is not under control. He initially had a short period of loss of appetite, but that seems to have resolved (although he still does not like eating the prascend). He is looking to be drug resistant, possibly with a more agressive tumour. He is now showing some behaviour changes that concern me and I don't know if these are tumour linked, drug linked or something else.

I get the whole quality of life rather than quantity of life arguement, and at his next blood test in 2 weeks time I will be having the conversation with the vet about withdrawaing the prascend to see what effect this has on his behaviours.


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## Polish warmblood (13 September 2013)

OOH THAT IS VERY INTERESTING..... ALL info welcome.  I need "ammunition" as vets are way too brainy for me...I am so glad I joined this forum ...as I need to arm myself with lots of info to help me make the right decision for my
own horse.
many thanks.


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## Polish warmblood (13 September 2013)

lOVELY to hear that.   someone with a similar problem to me.... Great....I am making a list so I can be better informed next time I talk to my vet.
many thanks


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## Polish warmblood (13 September 2013)

oOH...SO reassuring to hear from you.  What bad luck two horses suffering YOU poor thing. My very first horse had cushings with all the expected symptoms. This was back in 1990.  He passed away after having a stroke in 1999, but
this was before the drug treatment came into use I guess.
My NOW horse is 28 and has absolutely no symptoms of cushings and is a picture of health. I have to watch his pain control as he has spavin and the cold weather is really bad for him. He is coping on 2 bute per day and regular gentle ridden work and turnout.    As for the prascend....it didn't agree with him at all last  year....I don't think it will be any 
different this year but I would like my vet to listen to me...... I feel strongly that my horse needs a much lower dosage or a different drug ....so I will be collating all information so I can discuss further next week.Thankyou.......


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## Pasha (13 September 2013)

My boy is on 4 prascend per day.... when he first started it, he did lose his appetite (was only on 2 per day then) and the ECIR Yahoo Horse Group suggest I feed him an Adaptogen like Ginseng. 

Honestly within 48 hours of starting Siberian Ginseng, he was back to his old self, wolfing down everything in sight.

I kept him on it for 6 months and then took him off it, although it's fairly cheap and I can only find positive info on it. He hasn't reverted back and is still happy and eating everything in sight


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## YasandCrystal (13 September 2013)

I have heard this time and again about horses being poor and unhappy on Prascend and Pergolide. I am certain my pony has cushings so I feed him chaste berry powder. That is a hormonal balancer (natural) and there was a letter in a recent BHS magazine showing how a pony put on this had a repeat blood test after several months on the chaste berry and his levels were absolutely normal.  Wagtail has had good results with chaste berry and my pony looks very happy and healthy too. It's cheap at around ten pounds for a kg. I feed my 10hh around 10ml a day.


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## Polish warmblood (13 September 2013)

very INTERESTED.....I will certainly look into getting my horse some Adaptogen.....  Ofcourse I want him to be happy and as well as can be expected for his age whilst dealing with various health issues...

but I cant believe prascend is for him if he as such a strong reaction against the drug.  If I follow my vets advice I think a reduction in dosage is the answer.  BUt I definitely welcome alternatives anti drugs....
I give hive NO BUTE at the moment and am amazed how well this works for him

many thanks for your response.polish warmblood.


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## ihatework (13 September 2013)

Polish warmblood said:



			very INTERESTED.....I will certainly look into getting my horse some Adaptogen.....  Ofcourse I want him to be happy and as well as can be expected for his age whilst dealing with various health issues...

but I cant believe prascend is for him if he as such a strong reaction against the drug.  If I follow my vets advice I think a reduction in dosage is the answer.  BUt I definitely welcome alternatives anti drugs....
I give hive NO BUTE at the moment and am amazed how well this works for him

many thanks for your response.polish warmblood.
		
Click to expand...

If the Prascend controlled his ACTH level then my advice would be to try one more time. I'd start at a very low dose and then gradually increase. Try and find the dosage 1 level below where the depression and apetite loss starts. Alongside that, there would be no harm in trying chasteberry (also called Agnus Cactus or Monks Pepper) and an appetite stimulant (such as Ginseng as mentioned), or I just use mint to flavour feed to get mine to eat it.


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## Polish warmblood (13 September 2013)

oK.....I WILL take it one step at a time and try him on a really low dose.....I want to avoid the side effects if at all possible as he is awfully depressed and subdued when on these tablets...and wont eat a thing which is no fun at all
kind regards polish warmblood.


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## Micky (13 September 2013)

See the facebook group 'PPID/Cushings and EMS' and ask/put your concerns to Andrea Jones, she has had years of knowledge dealing with PPID (Cushings) and the treatments/diet/pergolide veil/grass management adn has knowledge of the ACTH levels etc, she will help you more than on here...no offence guys please 
Some horses react a lot to the prascend, I have heard that you take them off the dose for a week or so, then put them back on it at half the dosage. Also ask for an EMS test to be done by your vet to help rule that out too
Enticing them to eat can be helped by adding fizzy apple juice to their low sugar feed ( dont ask, it apparently works).
Don't give up.
If your vet isnt being forthcoming or helpful in the treatment of your horse, GET another vet!
Good luck and keep us posted


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## HashRouge (13 September 2013)

Do you know what his ACTH levels were and have you had him retested recently?
My mare is on 1/2 a tablet per day and never went through the pergolide veil, and her ACTH levels are now under control. So this might be a possibility for you. I would talk to your vet about giving a lower dose, but given the age of your horse I would be inclined to stop the prascend entirely if you have similar trouble on a lower dose. I think you have to look at quality of life versus quantity!


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## serenityjane (14 September 2013)

If you read the leaflet in the box of prascend it says that the depressed state and appetite loss are signs that the dose is not correct, if you get these side effects it is best to stop it for three days and then restart on a lower dose. My mare has just started on half a tablet and will have a blood test shortly to see if it has reduced the hormone levels. She has had no side effects at all. Talk to your vet about reducing his dose to half a tablet. When they first start it is important that the correct dose is given-enough to reduce the hormone levels (shown from blood tests) but not so much that the horse gets noticeable side effects.


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## flame96 (18 September 2013)

hey i had the same problem with my mare but i found out about herbal alternatives many though many people think in the late stages pergolide or prescend is needed at the early stages i have found using chaste berry (from cushy life) solutions as a herbal alternative has worked wonders for my mare she is happy and health blood tests came back great and is back in work again even though 2 years ago the vets told me to put her to sleep the only thing you have to watch with it is which solution you use as some are very poor quality and weak the one i use cushy life is one of if not the strongest one on the market at a 1:2 solution of pure chaste berry and water hope that helps x


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## LCH611 (18 September 2013)

my old Dartmoor is on 1/2 tablet a day and he went through the pergolide veil to begin with and it was terrible to see him so low & depressed and anorexic. However we stuck with it and it has absolutely transformed his life - at 28 he was in it to win it at Pony Club camp and stormed round a 10 mile sponsored ride the other day, having been out for 5 hours the day before and was cheeky enough to buck his jockey off twice!


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## Mrs B (18 September 2013)

Mine was diagnosed in the early stages in February this year. Prescribed half a tablet of Prascend, but became very depressed, although he was still eating. Vet advised to take him off the tablets for 10 days, then restart at a quarter of a tablet and retest him in 3 months.

He perked up, has mostly been ridden 6 days out of 7 since then and his ACTH levels went down from 44 to 29 (ie borderline 'normal').

He was tested again yesterday (to accommodate the natural ACTH peak at this time of year) and I am awaiting the results. Vet has said that if he needs extra she'll prescribe chaste berry as he can't tolerate higher doses of Prascend. I agreed - even if it's not as effective in the long term, rather a shorter life of a better quality than a longer, depressed one ...

Good luck with yours, OP


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## Mrs B (18 September 2013)

Just had the results - top of 'normal' at this time of year is 47 (I think I remembered that right!): he's up to 121.

So - Chasteberry it is. Will be retested in 3 months again, so we shall see ...


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## Rjd84 (20 September 2013)

my experience with Prascend has been a very positive one, so i thought id share. My boy came down very suddenly with laminitis, no previous history. despite acting very quickly in taking him off grass, in box rest, soaked hay etc he foundered in one foot and vet wanted to put him to sleep, he is only just 14. Vet tested for cushings an ATCH was 67, with the help of a good farrier and 1mg prascend a day he is now sound and beginning to get back to living like a horse again (as opposed to stable ornament!). hes been on prascend 6 weeks, ATCH now 27. The first week was rough, he was depressed, off his food etc and it was awful to see him like that but then literally overnight he changed, the sparkle came back to his eye and he has gone from strength to strength. Hes even off bute (was on 4 sachets a day initially!).
So i would say try and half the dose and dont give up, its really not worth letting the ATCH levels climb and risking the associated problems such as laminitis, especially as in my case it progressed very quickly to founder and i could have lost my horse. Saying that, of course what works for one may not work for another, youve obviously got your horses best interests at heart and im sure youl ldo the right thing by him x


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## Gloi (8 October 2013)

We have 3 just started on Prascend this week. If they are going to start with depression and appetite loss how quickly does it tend to come on after starting with the drug. Our 3 are all 24yo and came back with readings of 67, 91 & 220 when they were tested last week although none had very strong symptoms just slow to shed last years winter coat and one drinking a bit more than usual.


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## Fruitcake (21 October 2013)

I had a very similar experience, OP.  My pony reacted very badly to Prascend.  It was awful to watch. He was depressed and had dreadful ataxia, wobbling and shaking all over the place.  We did all the stopping for so many days and restarting on a lower dose.- In the end, he was on a quarter of a tablet a day and still had the dreadful side effects.  We stuck at it for months and there was no improvement.  I had vet out numerous times and in the end, she agreed that it obviously wasn't right for him and quality of life had to be put before quantity.  I understand that, for some, this drug has really helped their ponies but, in my opinion, you have to do what's best for your pony.  It took a couple of weeks after stopping the Prascend for my pony to return to his cheeky little self but now he seems to be doing well.  I have him on Vitex 4Equids (Agnus Castus extract which is chaste berry- made by the Laminitis Clinic) and he seems to be doing well.  His ACTH levels weren't sky high anyway.  I think I've made the best decision for my pony and in the end, that's all we can do.

I really hope you work something out.  At the end of the day, you know your pony and it has to be your decision.

Good luck!


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