Come to CE with Me- PPID Update

Dechra - pharmaceutical company who manufactures the new Zygolide FDA generic pergolide- hosted an online veterinary continuing education event the other week that I attended to get the scoop on the new FDA approved generic pergolide medication called Zygolide. Most of the meetings was a summary refresher on PPID. I’m going to also include that here for readers who are unfamiliar with the condition:

PPID stands for Pituitary Pars Intermedia Dysfunction, also known as Cushing’s. It is a separate disorder than Cushing’s in dogs or humans. It is fairly common in aged equines - about 1 in 5 are affected. PPID is caused by a benign (non-spreading) tumor at the pituitary gland which causes more of a certain hormone called ACTH to increase. The increased ACTH causes a number of symptoms including: excessive hair, delayed shedding, muscle wasting- especially over the top line, strange sweating patterns OR lack of sweating, increased thirst and urination, dry and brittle hair coat, changes in behavior, milk production or udder development in non-pregnant mares, frequent infections, recurring soft tissue injuries, dental disease, more parasites, and laminitis. Some horses develop a lot of the symptoms and some only show one or two. Personally, I like to see vet testing on horses who show a couple of the symptoms and are over age 15-17, and if it comes back negative, to recheck once a year. The earlier PPID is caught and medicated, the slower the symptoms progress. The medication doesn’t reverse the disease but does almost stop the symptoms from advancing beyond where they are currently, which is why discovering it early and getting them on medication makes such a big difference.

Up until now, the only FDA-approved medication was Prascend, which is the drug pergolide in a patented delivery system. There were some compounded versions but they didn’t test well and didn’t control symptoms well, which meant they were basically a waste of money, Treating PPID is quite expensive compared to many chronic disease drugs, with a cost of $2.75-$3 per day at regular dose amounts, so there was a lot of excitement about the new approved generic drug. Unfortunately, it looks like the savings is only around 40 cents per day. However, for horses on higher doses or farms with multiple horses on Prascend, it may be a bigger impact. The pill also has a peppermint flavor- Prascend is notoriously hard to feed for some horses; elaborate systems for masking the taste are sometimes necessary, and there is the “pergolide veil” where horses go off feed. I’ll do a second post about tips and tricks for feeding Prascend. We will have to see if the peppermint flavoring makes a difference for horses accepting it, and if the veil is still an issue. The new Zygolide pill is conveniently scored to make breaking into halves easier. Stay tuned for updates-