Retrospective assessment of the use of extended-release cabergoline in the management of equine pituitary pars intermedia dysfunction.
Abstract: Dopaminergic agonists are accepted as the most effective treatment for pituitary pars intermedia dysfunction. However, some horses are refractory to daily oral pergolide, the recommended registered treatment. Extended-release cabergoline (ERC) injection may offer an alternative. The objective of this retrospective case series was to describe clinical and endocrinological responses to ERC. Unassigned: Medical records of horses treated with weekly intramuscular injections of ERC (5 mg/mL, BOVA Aus) at either 0.01 mg/kg (high dose, HD) ( = 10) or 0.005 mg/kg (low dose, LD) ( = 30) were reviewed. Short-term ACTH responses were assessed at 5-8 days using a Wilcoxon signed ranked test. Longer-term ACTH responses (30 to 365 days) were assessed using generalised estimating equations. Unassigned: Five to eight days after the first dose of LDERC, median adrenocorticotropic hormone (ACTH) concentration was lower ( = 0.001), changing from 153 pg/mL (IQR: 78, 331) to 57 pg/mL (IQR: 30, 102). With HDERC, median ACTH concentration was also 153 pg/mL (IQR: 96, 185) before and then 56 pg/mL (IQR: 29, 86) after 5-8 days of treatment ( = 0.047). Over 12 months of treatment, ACTH concentration ranged from 14 to >1,250 pg/mL (median: 51 pg/mL) in horses treated with LDERC and 20 to 472 pg/mL (median: 50 pg/mL) in horses treated with HDERC. Measurements remained above the seasonal reference range in 39.3 and 52.3% of horses treated with LDERC and HDERC, respectively. Clinical improvement was reported by owners in 78.3 and 100% of horses treated with LDERC and HDERC, respectively. Partial, self-limiting inappetence was reported in 30.0% of LDERC and 60% HDERC cases. Seven horses exhibited lethargy (5 LDERC, 2 HDERC). Insulin concentrations measured 30 days post-ERC treatment were no different from baseline. Unassigned: Clinical and endocrinological responses were consistent with results of previous reports of oral pergolide treatment. Weekly injection of ERC may be an effective alternative to pergolide; the 0.005 mg/kg dose appeared to be as effective, with less risk of inappetence, than the 0.01 mg/kg dose that has been reported previously.
Copyright © 2024 Sundra, Kelty, Rossi and Rendle.
Publication Date: 2024-03-06 PubMed ID: 38511195PubMed Central: PMC10951098DOI: 10.3389/fvets.2024.1332337Google Scholar: Lookup
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- Journal Article
Summary
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The article examines the use of extended-release cabergoline injection as an alternative treatment for horses with pituitary pars intermedia dysfunction (PPID). The study finds that this administration can reduce adrenocorticotropic hormone concentration and improve clinical symptoms, suggesting that it can be a viable alternative to the standard daily oral pergolide treatment, especially for horses unresponsive to the latter.
Background
- Dopaminergic agonists, such as pergolide, are acknowledged as effective treatment for PPID in horses, a hormonal disorder related to the pituitary gland.
- Not all horses react positively to pergolide, requiring an alternative treatment solution. This study focuses on extended-release cabergoline (ERC) as a possible substitute.
Study Methods
- The researchers reviewed medical records of horses treated with weekly ERC injections at two different doses – high dose (HD) and low dose (LD).
- They evaluated the short-term responses (5-8 days) using the Wilcoxon signed rank test and long-term responses (30 to 365 days) with generalized estimating equations.
Results
- Both high and low doses of ERC led to a reduction in median adrenocorticotropic hormone (ACTH) concentration in 5-8 days. This hormone is related to the stress response and is often elevated in PPID.
- Over a period of 12 months, ACTH concentration showed a wide range of fluctuation, with measurements remaining above the seasonal reference range in about 40-52% of the cases, irrespective of the dosage.
- In addition, owners reported clinical improvements in most cases. However, partial, self-limiting inappetence and lethargy were observed in some horses, more regardless of dosage.
- Insulin concentrations remained the same before and 30 days post-ERC treatment, indicating that the treatment didn’t affect the insulin levels.
Conclusion
- The study establishes the clinical and endocrinological responses to ERC as consistent with previous studies on daily oral pergolide treatment.
- This implies that weekly ERC injection might be an effective alternative, with the lower dosage having comparable effectiveness but less risk of side effects.
Cite This Article
APA
Sundra T, Kelty E, Rossi G, Rendle D.
(2024).
Retrospective assessment of the use of extended-release cabergoline in the management of equine pituitary pars intermedia dysfunction.
Front Vet Sci, 11, 1332337.
https://doi.org/10.3389/fvets.2024.1332337 Publication
Researcher Affiliations
- Avon Ridge Equine Veterinary Services, Brigadoon, WA, Australia.
- School of Veterinary Medicine, Murdoch University, Murdoch, WA, Australia.
- School of Population and Global Health, University of Western Australia, Crawley, WA, Australia.
- School of Veterinary Medicine, Murdoch University, Murdoch, WA, Australia.
- EMT Consulting, Tiverton, United Kingdom.
Conflict of Interest Statement
DR provides consultancy services to BOVA Aus, BOVA UK and Luoda Pharma, who have developed and produced the extended release cabergoline preparation that was investigated. TS has received subsidised travel expenses from BOVA Aus for attending CPD events. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
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