Stormy (26yo mini -x mare. PPID/severe IR) continues to stump and confound me. Needing advice.
Had ACTH drawn on Friday 8/8 because her appetite kept getting worse (her best/most reliable indicator) in spite of being on 20 mg Pergolide (compounded caps). I was afraid to increase her dose any more w/o labs to confirm. I was right...ACTH was 52.9! Appetite got even worse over the weekend, so I am sure it has gone even higher since then! (She does best when ACTH is under 20.)
I gave her an extra 1mg. yesterday and added another 1mg today. ( For new people...I think because her dose is so high, I can increase her dose this quickly w/o her experiencing the veil. ) So she got 22mgs today! YIKES! Her appetite had already improved this evening....not great, but better.
After a real struggle, her ACTH was 17.3 on 14mgs perg last Nov. Instead of going down in the spring, ACTH was 30.3 in May....still on 14mgs. I have been chasing it ever since. Like I said, once we got to 20, I got really nervous, did more labs and here I am...in very uncharted waters ...wanting to make sure I am doing the right thing. Can I safely continue to go by her loss or increase in appetite to judge her increase in dose through the rise? I would be shocked if she stabilizes this early in the season. Is there an upper limit on the perg dose?
I just now quickly updated her CH to include her labs and perg doses from this year. There have been a few other minor changes (like adding Phyto-quench) but I really don't think they would affect her ACTH.
She did show signs of anhydrosis/overheating earlier this summer. She has been fine since I body clipped her, but she still does not seem to tolerate being out in the sun for very long. I body clipped her for the 2nd time this year about a week ago. Her feet continue to be tender in spite of great help/advice form Linda. Trim is the best it has been in ages. She is currently wearing Eponas.
Thanks in advance for your help!
Teri and Stormy