Treatment_and_montoring_PPID_sdl

What condition is Charlie suspected to have based on his symptoms?

Pituitary pars intermedia dysfunction (PPID).

What lab test was performed to confirm Charlie's condition?

Basal ACTH blood test.

What was Charlie's ACTH result that confirmed PPID?

203 pg/ml.

What is the licensed medication to treat PPID in horses?

Pergolide (Prascend).

What is the mechanism of action of Pergolide?

Dopamine D2 receptor agonist that compensates for impaired dopamine signalling in PPID.

What is a common side effect of Pergolide?

Decreased appetite and seeming dullness.

How can the side effects of Pergolide be managed?

They often resolve as the horse adjusts to new dopamine levels.

What is the initial recommended dosage of Pergolide for Charlie?

Half a tablet once a day.

What is the estimated cost of Pergolide per day?

Approximately 52-56p per day.

How long does Charlie need to be on Pergolide?

Lifelong treatment.

When should Charlie be reassessed after starting treatment?

4-6 weeks after starting medication.

What is the first step in managing Charlie's condition?

Assess baseline ACTH.

List one unlicensed medication option for treating PPID.

Trilostane.

What is another unlicensed option for PPID treatment?

Cyproheptadine.

Name a third unlicensed option for treating PPID in horses.

Bromocriptine.

What is the fourth unlicensed option listed for PPID treatment?

Cabergoline.

What dietary advice can be given to manage Charlie's condition?

Minimize risk for laminitis and soak hay.

What significance does soaking hay have in managing PPID?

It helps reduce carbohydrates that could lead to laminitis.

What additional management advice is recommended for Charlie?

Ensure plenty of exercise.

What might indicate that Charlie's dosage needs adjustment after reassessment?

If the ACTH levels do not improve.

What parameter will be tested during the reassessment of PPID treatment?

Improvement in baseline ACTH levels.

Which group offers recommendations for PPID?

Equine Endocrinology Group.

What is the expected range of costs for tablets of Pergolide?

£1.04 to £1.12 per tablet.

What are side effects due to in patients taking Pergolide?

Adjustment to new dopamine levels.

For how long should a follow-up check be scheduled after starting medication?

4-6 weeks.

A 24-year-old retired gelding is showing signs of which disorder?

PPID.

What should be monitored besides ACTH levels during follow-up?

Clinical signs and overall health.

What is the function of dopamine in relation to PPID?

Normalizes ACTH release.

For laboratory confirmation of PPID, what is essential to obtain?

Basal ACTH levels.

What approach should be taken if side effects from Pergolide occur?

Monitor closely; usually resolve with time.

How should Pergolide be administered to facilitate ingestion?

Hide the tablet in food.

What is the primary focus of any treatment for PPID?

To normalize ACTH levels.

Tests done to assess the effectiveness of treatment should include what method?

Blood tests.

Why is excessive grass a concern for horses with PPID?

It increases the risk of laminitis.

What should be assessed 4-6 weeks after starting treatment for PPID?

The effectiveness of the medication.

Which veterinary professional should be consulted for questions regarding PPID treatment?

Steffi at the University of Nottingham.

How does PPID primarily affect older horses?

Impaired hormonal regulation leading to symptoms like muscle loss and coat changes.

What clinical sign initially alerted Charlie's owners to call the vet?

He hasn't lost his winter coat.

Why is dietary management important in the treatment of PPID?

To help mitigate secondary complications.

What mechanism does Pergolide target to alleviate symptoms of PPID?

Inhibition of excessive ACTH release.

Based on the presentation, which horse is at higher risk for PPID?

A 24-year-old retired gelding like Charlie.

What is an important action upon recognizing potential PPID in a horse?

Perform a blood test for ACTH levels.

What should an owner be aware of regarding the lifelong nature of PPID treatment?

Ongoing management and reassessment will be necessary.

What benefit arises from using licensed medications over unlicensed options for equine health?

Safety and efficacy are generally better established.