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Pergolide is a human drug used to treat Parkinson's Disease. Pergolide is the drug of choice to treat pituitary pars intermedia hyperplasia or equine Cushing's Syndrome (ECS) in horses. Pergolide works by binding with drug receptors in the brain that control the production of dopamine.
Cyproheptadine is another drug that has been used to treat ECS although recent work indicates that it is not very effective and that pergolide is clearly the treatment of choice.
For many years, pituitary pars intermedia hyperplasia was called pituitary adenoma. In most cases, this commonly seen condition of older horses and ponies is caused by hyperplasia or hypertrophy of the pars intermedia rather than tumor. Although the hyperplasia eventually may progress to adenoma formation, that is considerably less common. The average age of horses diagnosed with ECS is 20 (range seven to 42). Ponies may be affected more commonly. Pituitary pars intermedia hyperplasia is a medical problem that is managed, not cured. Animals that are being treated usually are on medication for the rest of their lives.
Clinical signs associated with ECS include hirsutism, polyuria, polydipsia, abnormal fat deposition, abnormal sweating patterns, laminitis, and decreased immune competence. Horses usually are started on a low dose of pergolide (0.5 mg/day) and re-evaluated by six weeks. If there is no improvement, the dose should be increased gradually (by 0.25 mg) until improvement is seen. Recent work reported by J. Beech at the 2003 AAEP suggested that some horses may require higher doses than those that are used commonly.
A possible differential diagnosis for ECS is the recently hypothesized Peripheral Cushing's Syndrome (PCS). PCS is thought to be a different endocrine disturbance although there are some similar symptoms. Horses with PCS are overweight with cresty necks, abnormal fat distribution, and frequently suffer from laminitis. They are not hirsute and do not respond to pergolide.
Phenothiazine tranquilizers such as acepromazine may interfere with the action of pergolide.
Overdose in humans causes gastrointestinal upset and hallucinations.
More Pergolide information
May Be Prescribed by Vets for:
Pituitary pars intermediahyperplasia, "pituitary adenoma."
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Barbara Forney, VMD
Dr. Barbara Forney is a veterinary practitioner in Chester County, Pennsylvania. She has a master's degree in animal science from the University of Delaware and graduated from the University of Pennsylvania School of Veterinary Medicine in 1982.
She began to develop her interest in client education and medical writing in 1997. Recent publications include portions of The Pill Book Guide to Medication for Your Dog and Cat, and most recently Understanding Equine Medications published by the Bloodhorse.
Dr. Forney is an FEI veterinarian and an active member of the AAEP, AVMA, and AMWA.
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