Hi Linda,
I'm sorry you don't have more support "on the ground", but you'll find plenty here.
A "normal" insulin depends on when and what the horse was last fed. An insulin of 40 uIU/mL is normal after a grain meal, but not normal if fasting or not fed grain.
You might want to print out the Va Polytechnic pony study in our files for your vet. It clearly shows that pasture laminitis risk is linked to higher insulin. It also shows that normal ponies on the same pasture that caused laminitis in IR ponies had an insulin no higher than 12 uIU/mL.
You have already done quite a lot in the face of stiff resistance, so don't be so hard on yourself. This could have been much worse without the weight loss, exercise and hoof care.
Eleanor in PA
www.drkellon.com
EC Co-owner
Feb 2001