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Equine Insulin Resistance Pergolide/Cushings Disease/Older Horse Information

All Older Horses Eventually Get Insulin Resistance
Liquid Pergolide Problems
Powdered Pergolide Problems
Chasteberry Helps
Parkinsons Drugs
Probiotics Help Cushings Horses
Cushings Alone Does NOT Cause Laminitis
Cabergoline Is Not The Answer
Ginger Helps Equine Cushings

Studies have shown Pergolide alone will not help in Insulin Resistance cases. If your overweight horse is being given Pergolide and does not have Cushings Disease, you are getting the wrong medicine. Pergolide is not cheap and has side effects. It is excellent in treating Cushings Disease but has no place in the treatment of a horse with Insulin Resistance alone. Many horses have Cushings and Horse Insulin Resistance together. These horses that are on Pergolide but continue to get Laminitis need HEIRO™ to help support the body and maintain Insulin control. If you are on Pergolide and are lame or on a dirt lot, you need to add HEIRO to get back on pasture and avoid lameness.

All older horses are found to have Insulin Resistance problems whether horse is a Cushings horse or just older.

  University of Kentucky, College of Agriculture, 2013, found that older horses and older horses with Cushings had a 75% decrease in Insulin sensitivity.  “It seems our average aged horses may be as much for risk for Insulin Resistance as our horses with PPID (Cushings).”  Decreased Insulin sensitivity might occur as a normal part of aging.

Again, the University of Kentucky study clearly proved high fat causes Insulin surges in horses. If your horse has both Cushings and Insulin Resistance, and you do not know yet about the Insulin Resistance, it is a problem. Many Cushings horses will go on to Insulin Resistance and that is why you need to test yearly for Insulin Resistance if you have a Cushings Horse.

 A Michigan State University study (2018) finds that even healthy older horses with no Cushings have insulin problems. This same problem is seen in older humans and now IR is being considered more and more as a “normalcy of aging”. Why is this happening?  Muscle loss is seen in aging – the less muscle, the more IR problems in people and horses.
Click Here to read more about the study on Horsetalk.

 

 

Prascend Tablets are the best form of Pergolide to use in the horse due to being stable. Stable? This means the drug stays in its active form for at least 1 year.  Prascend is the only FDA approved Equine Pergolide due to this fact. You can keep box at room temperature in full light with no problem.

Pergolide exposure to people is a real problem in liquid or powder forms.  FDA withdrew this drug in humans due to cardiac problems, but people had it on their hands skin, or inhaled it when using on horses.  Prascend tablets are encoated so there is no longer a problem.

A.  Problem with liquid Pergolide at room temperature undergoes “extensive degradation by day 14.”  Even if you keep it in the dark, it undergoes  “Excessive degradation by day 35”.  Dr. Davis, University of North Carolina School of Veterinary Medicine. JAVMA 2009.
Conclusion:  Liquid Pergolide, even in a dark container and in the refrigerator “should not be used over 30 days after produced.”

B. Powdered or capsule Pergolide compounded problems:

1.  “Capsulated products degraded more slowly then suspension, but potency variability among capsules made it difficult to access and interpret these products.”  “Many products fell far below labeled potency upon delivery to the test lab.”  Dr. Stanley, University of California, Equine Analytical Lab Report, 2010 AAEP.

C.  The Prascend tablets  come in 1 mg of Pergolide per tablet.

• Retest ACTH levels 30 days after starting.  We find results this fast on blood tests in our practice.
• Retest ACTH yearly in the Spring.
• Pergolide will NOT stop or slow seasonal rise of ACTH in our studies.  This surge in ACTH does not appear to be controlled by this medicine.
• Always test Insulin if testing ACTH.
• Two times a day dosing may be the best with Pergolide.  Pergolide dosing might be wrong for Cushings horses.  Past studies in 2013 (Rendle, EVJ) with oral Pergolide, showed that 1/2 of the drug in horses is eliminated within 5.8 hours on average.   This was using a dosage per pound of the 1 mg per 1000 pound horse.  This is what is used in the Prascend pill (1 mg pill).  Recent (See link below) IV study just this year has it at 5.64 hours and in both studies they said “twice-daily dosing may be more appropriate than once-daily dosing.”  Horses with hairy coats or horses with ACTH numbers still up when testing after on Pergolide already, may not need a bigger dose (and hence a bigger bill to owners).  Instead, try giving 1/2 mg in morning and 1/2 mg in evening.  This is a better way than giving 2mg (doubling the dose).  After 30 days on the 1/2 & 1/2, retest ACTH or see if signs of Cushings is lessened.

Click here for Study Links:
Pharmacokinetics of pergolide after intravenous administration to horses.
Pharmacokinetics of Pergolide Mesylate in horses.
Package insert for Prascend.

D.  Chastetree Berry

 1.  Many clients with Cushing Horses will add this to the diet either as whole berries (available in health food stores and online herbal stores) or teas of Chastetree Berry such as with Evitex.
2.  This herb does help many with shedding out and Chastetree Berry is an adaptogen, so helps with stress.
3.  Chastetree Berry can be given with Pergolide (Prascend).  They will not fight each other.
4.  BUT, Chastetree Berry is NOT an herbal substitute for Pergolide.  Chastetree Berry will not lower ACTH levels like Pergolide can do.  Once your horse’s ACTH levels start climbing and you have been using Chastetree Berry, then it is time to add the Prascend.

Click here to see article on Chastetree Berry not lowering ACTH hormone.

E.  Tasigna in horses and Nilotinib in Horses.

1.  October 2015 study showed this anti-cancer drug could help with Parkinson’s neurodegeneration.   Click here to see the article on Cancer Drug Improved Cognition, Motor Skills in small Parkinson’s Clinical Trial.

2.  Tasigna in horses may be coming!  Or other medications in this category used.

3.  Why would Tasigna in horses be tried?  Parkinson’s is a dopamine receptor losing disease as is horse Cushings Disease.  They are different parts of the brain but very similar.

4.  Dr. Dianne McFarlane at Oklahoma State Veterinary school has been a pioneer in the horse Cushings/Parkinsons Link.  Brilliant Doctor.   Click here to see Heroes in Medicine: Dr. Dianne McFarlane.

F. Probiotics to Help Cushings Disease

Parkinson’s disease in people and Cushings in horses are both dopamine receptor loss diseases of the brain. See a study showing the gut flora can have direct effect on the progress of Parkinson’s disease.

Click here to be brought to the article: http://www.bbc.com/news/health-38173287

G. Cushings alone will NOT cause laminitis – must be Cushings and Horse Insulin Resistance to get laminitis.

a. Horses with only Cushings and no laminitis had normal insulin
b. Horse with Cushings and Laminitis also had high insulin
c. Conclusion: ONLY those with both conditions were associated with laminar pathology

Click here to see Dr. Karinkoski’s 2016 article in Equine Veterinary Journal

d. PPID (Cushings) horses 4 times more likely to get laminitis.
e. PPID horses 2.7 times more likely to also have high insulin (insulin resistance).
Click Here For Dr. McGowan’s 2018 Study

H. Cabergoline Problems in Horses with Cushings

1. Cabergoline is NOT FDA approved in horses.

2. No long-term studies have been done on cabergoline in horses to see side effects.

3. No long-term study has been done on cabergoline in Cushing horses.

4. The form of the medicine on the market is a 1 time a week, intramuscular shot. Prascend is an oral pill – easier, FDA approved and proven to help in long-term studies.

5. The cost of cabergoline is 255% more a week than Prascend pills.

BET Labs price for cabergoline is $375 a bottle with 10 doses = $37.50 a week.

Prascend pills (1mg a day) is $14.70 a week (from Valley Vet’s website).

Cabergoline is $1185.60 more expensive a year to use than Prascend. A year of cabergoline is $1950, a year of Prascend is $764.40.

6. Shots once a week is not easy with cabergoline.

Click here to see a 2017 long-term study of Cabergoline in people with Cushing’s Disease – note that “only 20-25% were good responders” in the end.

7. See Mayo Clinic for a list of Cabergoline side effects.

Rapid weight gain, swelling around the eyes, racing heartbeat, confusion, etc.

 Click here for a full list of side effects from the Mayo Clinic website.

I. Ginger Helps Equine Cushings

Many owners comment their horses with cushings shed out better and feel better when Heiro is added to pergolide – why?

Equine cushings is due to a less of dopamine receptors in the brain and Ginger can help protect these dopamine neurons.

 Click Here to see how Shogaols in Ginger helps the receptors (Dr. Park, 2013)

a. Ginger helped reduce inflammatory markers in the brain
b. Ginger helped reverse cell loss in brain
c. Shogaols exerts Neuroprotective effects on Dopamine Neurons

 Click Here to see how ginger can reduce toxic effects (Dr. Waggas, 2009)

a. Ginger increased Dopamine in the brain
b. Ginger was a Neuroprotective against a toxin

 Click Here to see how Paradol metabolites of Shogaols from ginger have therapeutic potential in brain disorders (Dr. Gaire, 2015)

a. Paradol lowered inflammatory mediators
b. Paradol protects brain after injury

Ginger is in Heiro!

 

Click here to see 26 ways HEIRO is the Best Choice and why the winner over other products.

Proper diet and exercise is essential for horse health. This product is a supplement to help maintain horse health. This product is not intended to diagnose, treat, cure, or prevent disease.