Pergolide is available for horses in the UK as the licensed medicine Prascend, and also as the currently unlicensed Bova pergolide paste.  Although a licensed medicine should be the first choice for treating any medical condition, if another product is more suitable for an individual horse, that product can be used if there is "clinical justification" for doing so, e.g. if not taking the licensed medicine could lead to welfare issues/a decline in a horse's clinical condition.  For example, some horses will not eat Prascend tablets in any form, or may need dosing increments less than the 0.5 mg that Prascend tablets can be split into.  The Bova pergolide paste is dispensed in 0.2 mg increments, and being molasses-flavoured has been found to be readily accepted by horses in trials.

Obtaining Bova pergolide paste in the UK

Under the Cascade, medicines other than licensed medicines can be used if there is a clinical justification for using the unlicensed medicine over a licensed medicine.  Bova paste is not available on prescription - it must be obtained from your vet.

Obtaining Bova pergolide paste in France

To our knowledge, to date (March 2021) the French agency for veterinary medicinal products (ANSES) has not given authorisation for Bova paste to be imported, but we understand there is no reason why this should be the case, and we recommend that owners who feel their horses would benefit from the Bova paste ask their vets to contact ANSES and ask for permission to import the Bova paste, setting out the reasons why Prascend is not suitable and the Bova paste would be more suitable, and emphasizing that it is a welfare issue if this is the case.  Hopefully the more people who request the import of the Bova paste, the more chance there is of a successful outcome.

ANSES can be contacted at:
Agence nationale du médicament vétérinaire
14 Rue Claude Bourgelat
Parc d'Activités de la Grande Marche
CS 70611 - 35306 Fougères France
 www.anses.fr
www.anses.fr/en/content/contact-french-agency-veterinary-medicinal-products

We understand that the person who should be contacted is Aline HANOUET, Regulatory Affairs Officer.
email: aline.hanouet@anses.fr

Once permission is obtained from the French authority, the vet should contact Bova UK with:
Confirmation that it is legal to import the Bova paste into France from the French authority,
Proof of veterinary registration and a link to a website so that Bova can authenticate the vet's registration.

Obtaining Bova pergolide paste in other EU countries

We have been informed that the Bova pergolide paste can be and has been imported into many EU countries - your vet should contact Bova UK to ask about import permissions for your country.  

To order from/contact Bova UK:

Bova Specials UK Ltd
7‑9 Gorst road
London
Park Royal
NW10 6LA
United Kingdom
Phone: +44 20 3034 3100
Fax: +44 20 3784 8754
Email: orders@bova.co.uk
VETS ONLY - order online at bova.co.uk/register

Treating PPID with pergolide:
1.  reduces the clinical signs of PPID, 
2.  may slow progression of the disease,
3.  may help protect against further neuron degeneration.

​PPID currently cannot be cured, but can be treated with daily oral administration of a dopamine agonist, which acts in place of the dopamine that is under-produced by a horse with PPID, signalling the pars intermedia to reduce hormone production, and thereby reducing the clinical signs of PPID.  It isn’t currently known whether treatment with pergolide will prevent or slow the hyperplasia and hypertrophy associated with the excess hormone production of the pars intermedia, but in theory this seems likely.

Pergolide is the dopamine agonist most commonly used and studied for treating horses with PPID.  Pergolide is available as Prascend, as Bova pergolide paste, or as compounded pergolide, depending on your country.

In addition, research by Gille et al. (2002) found that pergolide protects dopamine-producing neurons under conditions of elevated oxidative stress, and Dr McFarlane has theorised that any antioxidant and neuroprotective properties of pergolide could be beneficial in slowing the progression of PPID, suggesting that early treatment with pergolide may be advisable

The initial dose of pergolide recommended is 0.002 mg/kg bodyweight once a day, so 1 mg for a 500 kg horse, but the dose may depend on the stage of the PPID, the season and other factors, and it should be titrated to the lowest effective dose for each individual horse based on response to therapy, whether that is improvement in clinical signs and blood results or signs of intolerance.  Many horses require an increased dose during the seasonal rise, with a subsequent reduction in dose around Christmas.  

Some horses go off their food or become depressed when starting treatment with pergolide, but when introduced gradually, ideally starting with 0.2-0.25 mg and slowly increasing to the recommended dose, side effects are minimised.  Giving pergolide at different times to bucket feeds has helped some horses overcome inappetence.

The Bova pergolide paste is molasses flavoured but does not contain molasses, and comes in a tube with 0.2 mg pergolide increments, making it particularly suitable for ponies on small doses and for gradually increasing the dose when first starting pergolide or making changes e.g. for the seasonal rise.  In the UK Prascend is the only licenced treatment that can be obtained with a vet's prescription from pharmacies, but for horses that won't take Prascend or that would be better suited to smaller increments, the Bova pergolide paste can be obtained from vets under the VMD cascade rules.

The video below shows how to administer the Bova pergolide paste.

Evidence that treatment with pergolide is effective 

Fortin JS, Benskey MJ, Lookingland KJ, Petterson JS, Howey EB, Goudreau JL, Schott II HC
Restoring pars intermedia dopamine concentrations and tyrosine hydroxylase expression levels with pergolide: evidence from horses with pituitary pars intermedia dysfunction. 
BMC Vet Res September 2020 16, 356. https://doi.org/10.1186/s12917-020-02565-3
​Dopamine agonist, Equine, Parkinson disease animal model, Pituitary pars intermedia adenoma

Conclusions: "The results of this study demonstrate that pergolide, a DA agonist, re-establishes DA and TH levels in the PI of PPID-affected horses."
​