Stormy - need advice on perg. dose, please


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 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

IN 2012

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