Prascend or no Prascend for Cushings????

[res]

Lancer is my soon-to-be-30 yr old Arab gelding. His Cushings symptoms started in 2007, while we were living in Alaska and he was staying in Oklahoma with a friend. When we returned to Oklahoma in the fall of 2010, I started him on compounded Pergolide - literally within days of getting him "home". He was getting .5 mcg per day - never shed out, never regained much muscle tone or topline, and had a crappy appetite. I used a different vet in May 2012 who said Lancer needed to be on 1.5 mcg per day, and encouraged me to start using Prascend instead of Pergolide.

Since May 2012, he has been on 1.5 mcg of Prascend. Every day. Never sheds out. Always droopy and grumpy. Never finishes his feed. Looked like crap. I also never had any bloodwork done, and I don't plan to. He's 30... If he were 15-20 yrs old, I would be more intensely managing his condition, but.... he's 30.

Long story, I know... So this summer was pretty darn expensive for us. We had budgeted for ONE trip to Kansas, but we hadn't expected to have our heat pump quit on us ($6700) or to have to go to TX for 3 weeks (~$5k). When Lancer's Prascend ran out at the very start of September, I simply could not afford the $300 to get another box. And I can't afford it now, either.

But.... since he ran out of Prascend, I started giving him Rascal's SmartCombo Senior supplement (hoof, joint, omega 3 and digestion). He's been on it for 2 months now - and he is FULL of energy, has defined muscles, devours his feed, and is a completely different horse.

Could somebody please tell me I am making the right decision to just keep him "happy" on the new supplement and not worry about the Prascend? The "what-if's" are killing me.... But he really seems *better* since he has been off the Prascend, so I have to wonder if he even needed it in the 1st place?

[donna]

If he is 30 years old and is fiesty and happy without the expensive stuff, why feed it to him? You can't cure old age.

[Trailpal]

I have to agree with Donna!

What is your goal - to keep him perky and happy! This looks like it's doing the job.

Curious, I looked at the Prascend website - looks like what you saw in Lancer can sometimes be expected

Treatment with PRASCEND may cause loss of appetite. Most cases are mild. Weight loss, lack of energy, and behavioral changes also may be observed. If severe, a temporary dose reduction may be necessary.

So, you may want to put him back on it at some point. Was he off Prascend for very long before you started him on the SmartCombo Senior? If not, then what you are observing might simply be the fact that he's off the Prascend.

[Marci]

i remember our friends with their cushings pony putting him on and off of the meds as he needed it. If he feels better then why not listen to his body.
He is 30, let him feel good while he can.

[Mary Ann]

Honestly, I would never treat for Cushing's without the bloodwork to find out exactly how much he needs. Because there's a chance it could be something else, or a lesser dose would do, or a higher dose is necessary.

Did you know that people sometimes use cyproheptadine to treat Cushing's? It's a heck of a lot cheaper.

Have you put him on a low carb diet? Cushing's horses are often insulin resistant, too.

I hear ya on the $$$ hemorrhage. Years like that suck big time.

[Yip]

I also wouldn't have treated for Cushings w/o the bloodwork at the beginning.

I also agree with the others to list your goals for Lancer at 30 and beyond. Medicated horse who won't eat well & looks and feels awful vs. an old horse who feels pretty darn good for his age. I know which I'd choose!

[res]

I know it seems strange to dose without bloodwork. The yahoo Cushings group is almost rabid about bloodwork, testing feeds, testing hays, etc. Some people sink thousands into managing, no, micro-managing their horses. But, Lancer is really a pasture pet at this point, and I have to keep the finances of my family in mind. Lancer has been examined by 5 vets now, in 2 different states. None of them have pushed, required or suggested bloodwork. It was offered by 2, but the other three of them discouraged me from doing it at all - it is far from a perfect process. Stress and season of the year can skew the results. Pergolide is extremely unpredictable in it's efficacy and concentration - Prascend is better, but uber expensive. I actually had a discussion with a graduating-this-year OSU Vet student about Lancer this summer. She said OSU is now teaching to diagnose based solely on coat "history" and forego any bloodwork. (She is a lifelong friend of my farrier and was riding shotgun with him this summer).

I do have him on a "Cushings" diet. He is on Triple Crown Sr. and Triple Crown Timothy Balancer cubes. He has orchard hay and fescue pasture, but very little of either make it to his digestive tract. He quids and drops 90% of it. He is loosing teeth - I am finding them in his feed tub...

I WANT to take more comfort in seeing him wound up to eat, pacing and pawing, and trotting into his stall, than I do in knowing I am medicating him.

The pergolide/prascend "veil" that makes the horses dopey... He definitely had it for the first few weeks I had him on Pergolide back in 2010. I was told it shouldn't be permanent, so I am not sure what his deal is/was. He is super-duper picky about his feed, and I never tasted either Prascend or Pergolide to see if they were bitter like bute. It could have been a taste issue, I guess. I mean, if all you had to look forward to each day was your buckets of slop, and it tasted like crap, you'd probably get pretty grumpy, too. Right?

[Jenni]

It sounds like he's doing fine - or better even without it.

My old Cricket had "cushings" symptoms most of the time I had her. I never knew what it was until she and I were both in our mid 20s, lol. I asked a vet about it once when she was about 30 and he said - "is she laminitic?" -no- "Is she happy and healthy?" - yep- "I wouldn't treat her - just shave her in the heat of the summer and call it good", lol. I never did treat her and she never had problems.

[ride4fun]

I know I'd go for the happy horse even if it might mean a few less months of existence vs prolonging a poor quality of life. When Star was probably cushings our vet just had us test her thyroid function and put her on thryo-L to treat the low thyroid, he said he'd never had good outcomes with the Cushings meds. But she did progress in the disease and developed severe laminitis a few years later.

[res]

Nov 5, 2013 9:20:31 GMT -5 ride4fun said:

I know I'd go for the happy horse even if it might mean a few less months of existence vs prolonging a poor quality of life. When Star was probably cushings our vet just had us test her thyroid function and put her on thryo-L to treat the low thyroid, he said he'd never had good outcomes with the Cushings meds. But she did progress in the disease and developed severe laminitis a few years later.

I think that is what scares me the most... Laminitis. I am afraid that I will blame myself if he develops it and I don't have him on Prascend. I don't want to be blaming myself.

But Dang! It makes my heart so happy to see him running around. He and Khenny have been playing HARD the last few weeks - it is like I have 2 youngsters. The fools keep running into the drylot fence at night because they are goofing off so much - kicking and bucking and running amok. He feels GOOD right now.

I just have to keep repeating - I will be okay with this. I will be okay with this. It is the right decision. It is the right decision.

[Idaho Linda]

It IS the right decision. He is happy and pain free. If he develops laminitis, then it will be time to let him go. All the exercise will help him use those carbs more effectively and help protect him from laminitis.

Put him on Jiaogulan and Chaste Tree berry and let him enjoy the years he has left. www.herbalcom.com/store.php3?list=cats&alpha=yes&lett=i-lI-L&session=138413a66ca9e62d7bd9d0b3a388c7ff

You can't fix or prevent everything. Let him enjoy and play and be a horse. He has had a good life. And if he is too hot in the summer, shave him. If he is cold in the winter because the hair doesn't insulate, put a turnout on him.

[Marci]

But you know if he is happy until he founders...that is better. Got to be Quality of life too. Otherwise why bother?
We never know how long we have, and at age 30 any time is borrowed.
I know I will be losing Shadow in the near future, simply because she is 27. Has the melanomas that greys get and shows some signs of cushings, but still sheds. Just have to watch sugars or her feet get sore. Its such a balancing act isn't it?
I find that the less quality hay is better for her. And no more Sr, she gets alfalfa pellets only. Different sugar. Good thing she loves them.
Its HARD having an older horse. I know when Shadow is gone I am done. Unless I marry a man that has horses I am tired of struggling to care for them. Its too hard.