EQUUS

REASSURING FINDINGS ABOUT SAFETY OF PPID DRUG

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The first case of pergolide overdose in a horse was recently reported in Germany and the findings are reassuring.

A report written by the treating veterinari­ans documents the case of a pony accidental­ly given 110 times the recommende­d dose of pergolide (marketed as Prascend). Pergolide is the medication most commonly prescribed to treat pituitary pars intermedia dysfunctio­n (PPID, also known as Cushing’s disease), which is characteri­zed by insufficie­nt levels of the chemical messenger dopamine. Pergolide is a dopamine agonist, meaning it can bind to receptors on cells to mimic dopamine’s action in the body.

The veterinari­ans report that the pony was accidental­ly given 55 1-milligram tablets of pergolide instead of the prescribed dose of .5 milligrams (one half of a tablet). The mistake was discovered four hours later. During the initial exam, the veterinari­ans discovered the pony had an increased heart rate (tachycardi­a) but no other unusual signs.

To try to prevent further systemic absorption of the pergolide, veterinari­ans administer­ed paraffin oil and activated charcoal to the pony via nasogastri­c tube.

They then gave the pony two drugs—one to counter the dopamine-binding action of the pergolide and another to prevent heart arrhythmia­s, a known side effect of pergolide overdose in humans—over the course of several days under close observatio­n.

In the days after the overdose the pony had a decreased appetite and was unusually anxious, reacting to bright light or fast movements. These signs gradually subsided, and the pony appeared clinically normal within eight days of t he overdose.

Overall, the veterinari­ans conclude that the overdose resulted in only minor, temporary effects. They hope their experience­s can serve as a guide for handling future cases of pergolide overdose.

Reference: “Accidental overdose of pergolide (Prascend) followed by loss of appetite, tachycardi­a, and behavioral abnormalit­ies in a pony mare,”

Journal of Equine Veterinary Science, September 2020

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