• Home
    • What we do
    • About TLS
    • TLS Privacy Policy
    • Contact
    • Case Studies
  • Laminitis
    • Emergency Treatment
    • Chronic laminitis
    • Laminitis FAQ
  • EMS/ID
    • Management strategies for EMS/ID
    • EMS/ID FAQ
    • Rosie
  • Diet
    • Diet FAQ
  • PPID
    • PPID FAQ
    • Half Pint
    • Widget
  • Feet
    • Realigning Trim
    • Feet A-Z
    • Chronic laminitis
    • Understanding x-rays
    • Taking hoof photos
    • Feet FAQ & Articles
    • Feet gallery
    • Reading the foot
    • Dorsal rotation/long toes
    • High heels
    • Palmar Angle Calculator
    • Sorrel
    • Monroe
    • Cedar
  • News
  • Articles
  • A-Z
    • A
    • B
    • C
    • D
    • E
    • F
    • G
    • H
    • I
    • J K
    • L
    • M
    • N
    • O
    • P Q
    • R
    • S
    • T
    • U V W X Y Z
  • Case Studies
    • Danae
    • Half Pint
    • Herbie
    • Herbie diary
    • Herbie's TTouch diary
    • Izmir
    • Misty
    • Nero
    • Nutmeg
    • Nutmeg TLS rehab
    • Rosie
    • Sorrel
    • Tex
    • Widget
  • France
    • Articles en francais
  • Research
    • New Research/Research by Date
    • Research papers by subject
    • Research papers by author
    • Research news/comment
    • Research projects >
      • NSC in grass & hay
      • How much do horses eat?
      • Do fructans cause laminitis?
      • Turmeric/Curcumin
      • Insulin response to diet
    • Help with research
  • Help!
    • Join Friends of TLS
    • Donate
    • Appeals
    • Raise funds for TLS
    • In Loving Memory
    • Friends of TLS only
The Laminitis Site

How should pergolide/Prascend be introduced?

6/2/2016

2 Comments

 
Picture
​Your horse has been diagnosed with PPID and you are about to start treating him/her with Prascend or pergolide.  Here are some of the most frequently asked questions regarding Prascend/pergolide.

Important sources of information:
NOAH data sheet for Prascend 
www.ecirhorse.org -pergolide
​Q.  My horse has been prescribed 1 mg of Prascend per day, do I give him the full 1 mg on the first day?

A.  No.  The Equine Endocrinology Group, made up of the leading experts on PPID, now recommends introducing Prascend gradually "by giving partial doses for the first four days or by administering half the dose morning and evening".  EEG Recommendations for the Diagnosis and Treatment of PPID Table 6.  

The ECIR group has been recommending introducing the dose of pergolide slowly for years:
"Whether increasing or decreasing dosage or just starting pergolide for the first time taper at a rate of 0.25 mg every three days."  www.ecirhorse.org -pergolide.

When prescribed for humans with Parkinson's Disease, pergolide is always introduced very gradually - seePergolide Dosage and Administration - Pergolide - www.drugs.com.  Why assume this should be any different for horses?

Generally the initial amount given should be 0.25 mg, slowly built up in 0.25 mg increments to reach the prescribed dose.  The urgency of reaching full dose and the horse's reaction to pergolide will dictate how quickly the prescribed dose is reached - this must be discussed with the prescribing vet.  Splitting this between morning and evening would be next to impossible - good results are usually seen when the dose is given once a day and slowly built up.

Q.  What's the best way to give pergolide/Prascend?

A.  Most owners try hiding the tablet/s in a treat and giving it by hand to ensure the tablet is swallowed.  The tablet/s can be pressed into a slice of soft apple, hidden in a hollowed out carrot, pushed into a prune, grape, date or cherry (with the stone removed, obviously!), enveloped in a small jam sandwich or square of malt loaf.  Whilst some of these treats contain sugar, the amounts are very small compared to the sugar in a horse's daily diet, even when keeping sugar/starch below 10%.  More Tips for Getting Horses to Eat Medications.

Q.  What is the "Pergolide Veil"?

A.  The "Pergolide Veil" is a phrase given to the side effects of inappetence and depression commonly seen when a horse starts on pergolide/Prascend.

Research carried out for the FDA New Animal Drug Application for Prascend in 2011 found that of horses with PPID given a starting dose of 1 mg Prascend, 33% had a decreased appetite at one or more meals, that was usually transient, and 10% of horses that had not previously shown signs of lethargy became lethargic - details here.

Q.  Can the "Pergolide Veil" be avoided?

A.  As above, when pergolide is introduced slowly (in 0.25 mg increments building up over several days), the "Pergolide Veil" seems to be experienced less (anecdotal).

The ECIR group has found that using adaptogens such as APF at the same time as introducing pergolide can also help reduce the incidence of these initial side effects.  APF can be bought in the UK from ForagePlus. 

It can be concerning when horses go off their feed when starting pergolide, particularly if they are already underweight.  One owner reported success when her horse (who was ill with a suspected bacterial infection and had lost a significant amount of weight) was given Periactin (cyproheptadine) as an appetite stimulant for the first couple of weeks while starting on Prascend (the horse had previously been tried on Prascend and had gone off feed).  No side effects of either Prascend or Periactin were seen.

Q.  Does it matter what time of day I give Prascend/pergolide?

A.  No.  There is currently no recommendation for giving Prascend/pergolide at any particular time of day - this was confirmed by Dr Marian Little in The Horse.com's Ask the Vet Live Managing Horses with PPID in February 2014 - see notes.

Q.  Should pergolide/Prascend be given once or twice a day?

A.  Once a day, usually.  The NOAH data sheet for Prascend says "The product should be administered orally, once daily."  This is confirmed by the Equine Endocrinology Group Recommendations for the Diagnosis and Treatment of PPID - Table 6 - Prascend should be given "q24h orally", that is once every 24 hours by mouth. 

Q.  What is the difference between pergolide and Prascend?

A.  Pergolide is the name of the drug, i.e. the active ingredient (pergolide mesylate).
Prascend is the only form of pergolide that is currently licensed for use in horses.  It is made by Boehringer Ingelheim and comes in 1 mg tablets, which can be easily broken in half.
2 Comments

    Articles


    How accurate is blood testing for PPID?

    Obtaining Bova pergolide paste
    Treating PPID
    FDA New Animal Drug Application for Prascend September 2011
    ​Free ACTH Testing
    ​PPID and laminitis ​
    ​
    PPID - findings at post mortem
    PPID and breeding
    ​ACTH interpretation
    ​
    PPID and Parkinson's Disease
    Incidence of PPID
    ​
    Should I seasonally alter the dose of Prascend...?
    ​​How should pergolide /Prascend be introduced?
    ​What is PPID?
    Pituitary stress hormones
    Does a high ACTH result mean my horse has PPID?
    What causes PPID?
    Can any horse get PPID?
    Temperament changes with PPID/pergolide

    Archives

    September 2021
    March 2021
    November 2020
    August 2019
    April 2018
    December 2017
    October 2017
    September 2017
    June 2017
    May 2017
    August 2016
    June 2016
    June 2015
    May 2015
    December 2013

    RSS Feed

Laminitis/EMS/PPID? Start here
Need help/support? Join FoTLS
Donate to help laminitic horses
Disclaimer: The information, suggestions and links (hereafter referred to as “information”) contained in this website are provided for information purposes only and should not be relied upon nor replace professional veterinary advice.  Information is non-veterinary, is based as far as possible on current research, does not constitute advice or diagnosis, and should be discussed in full with all relevant vets and hoofcare or other professionals.  No responsibility is taken for the accuracy or suitability of information contained in this website, and no liability accepted for damages of any kind arising from use, reference to or reliance on any information contained in this website.  If you suspect your horse has laminitis or is ill, please consult your vet. 
The Laminitis Site is a charitable company registered in England & Wales No. 8530292, recognized by HMRC as a charity for Gift Aid.  
Please consider making a donation to support the work of The Laminitis Site.
For more information and membership of the TLS support/discussion group, join Friends of The Laminitis Site.
The Laminitis Site's Privacy Policy.