title: Treatment with pergolide or cyproheptadine of pituitary pars intermedia dysfunction (equine Cushing's disease).
abstract: Medical records of 27 horses (including 13 ponies) treated with pergolide or cyproheptadine for pituitary pars intermedia dysfunction were reviewed to determine the effect of treatment on plasma ACTH, insulin, and glucose concentrations and clinical signs. Prior to treatment, the most common clinical signs were laminitis, hirsutism, and abnormal body fat distribution. The median pergolide dose was 3.0 microg/kg p.o. q24h (range, 1.7-5.5 microg/kg). All horses treated with cyproheptadine were given 0.25 mg/kg p.o. q24h. After pergolide treatment, ACTH concentrations (n = 20; median = 30.4 pg/ml; range, 4.2-173) were significantly lower (P < .01) than those in horses treated with cyproheptadine (n = 7; median = 141.0 pg/ml: range, 10-1,230). Among horses treated with pergolide, there was a correlation between ACTH concentration after treatment and the duration of treatment (P < .001) and pergolide dose (P = .04). Significantly (P = .02) more owners of horses treated with pergolide (85%, 17/20) reported an improvement in clinical signs compared to owners of horses treated with cyproheptadine (28%, 2/7).
authors.affiliation: Department of Clinical Studies-New Bolton Center, School of Veterinary Medicine, University of Pennsylvania, Kennett Square, PA 19348, USA. mtd@vet.upenn.edu
authors.forename: Mark T
authors.initials: MT
authors.lastname: Donaldson
authors.forename: Bernadette H
authors.initials: BH
authors.lastname: LaMonte
authors.forename: Peter
authors.initials: P
authors.lastname: Morresey
authors.forename: Gary
authors.initials: G
authors.lastname: Smith
authors.forename: Jill
authors.initials: J
authors.lastname: Beech
mesh_terms: D000324:Adrenocorticotropic Hormone / Q000097:blood; D000818:Animals; D001786:Blood Glucose; D003480:Cushing Syndrome / Q000188:drug therapy* / Q000662:veterinary*; D003533:Cyproheptadine / Q000008:administration & dosage / Q000494:pharmacology*; D018491:Dopamine Agonists / Q000008:administration & dosage / Q000494:pharmacology*; D005260:Female; D006734:Horse Diseases / Q000188:drug therapy* / Q000473:pathology; D006736:Horses; D007004:Hypoglycemic Agents / Q000097:blood; D007328:Insulin / Q000097:blood; D008297:Male; D010479:Pergolide / Q000008:administration & dosage / Q000494:pharmacology*; D012702:Serotonin Antagonists / Q000008:administration & dosage / Q000494:pharmacology*; D016896:Treatment Outcome
chemical_list: D001786:Blood Glucose; D018491:Dopamine Agonists; D007004:Hypoglycemic Agents; D007328:Insulin; D012702:Serotonin Antagonists; D010479:Pergolide; D003533:Cyproheptadine; D000324:Adrenocorticotropic Hormone