Re: Stormy - need advice on perg. dose, please


LeeAnn, Tina, Nancy and Bonnie,
First of all thank you all for your thoughtful replies...they were appreciated very much.   It's taken me a while to post a reply.  I've been trying to wrap my mind around this...kinda like when I first found this group.  Plus I wanted to see how Stormy was reacting to her higher doses first.   And, I knew this would be long... sorry! 
Nancy...You asked if I got a 30 days supply of compounded caps and if I store them in the door of the frig.   Yes, I do.    I was surprised and pleased when my vet asked me the same thing!   He IS listening!  YAY! He also asked what is the highest dose on the list.  I plan to send him a copy of the data base.   He said he couldn't believe it when Stormy hit 8 mgs...much less 20!  (But like you said, Lee Ann..he has the lab results to prove that she needs it) When I asked him to come do the ACTH, I told him I was sure by her symptoms that her ACTH was too high.   When he got the results (52,9 Cornell) he said "You were right!"  He couldn't believe it was that high on 20mgs perg. 
LeeAnn and Tina...It was so good to hear from both of you.  Knowing that you've been through the same thing really helps.   I kept hearing Dr. Kellon's advice running through my head...that the correct dose is whatever controls the ACTH...but when Stormy hit 20mgs I started to get scared!    Plus, she's a tiny pony!  (I did review the data base...and LeeAnn...your CH on Dawn is a work of art!  Kudos!!!  I didn't get around to reading Rio's)
Bonnie...sounds like you and Lad are headed for the top of the list, too!   
So here's where we're at.  As of today, I've increased her to 27mgs.   I've been increasing by 1mg about every other day.  I day ..not....and repeat.   After reading your post about increasing Dawn by 3 or even 5 mgs at a time, LeeAnn...I started thinking.  (Dangerous! ha!)   My math skills are horrible so this was very painful for me.  :-)   And the more knowledgeable people out there...please correct me if this thinking or my math is wrong.    If your horse is on 1mg perg.  (which a lot of horses are on at the beginning) and you increase by 1 mg (also common) you are essentially DOUBLING their dose.  So we divide the dose by 1/4 and increase .25 mgs every 3 days.    So...for those at high doses....say 20mgs...if you increased by 1/4 the total amount...that would be 5 mgs.  Right?    Stormy has gotten to the point that inc. by 1 mg, barely makes a difference in her symptoms.    So tonight I bumped it up by 3 mgs.   Gulp! :-)     I still feel like I am chasing the ACTH by adding 1mg at a time...and will never get ahead of the rise unless I bump the dose up more.  I felt the same way last fall when we went from 6.5 mgs in July to 14 mgs in Nov.   I followed my gut feeling as I increased her dose and her ACTH was 17.3 in Nov...her best ever!   (At that point the 1mg  did make a noticeable difference.)    Gosh, I just realized... that means I DID double her dose last fall!    Sure hope I don't need to do that this year!  YIKES! 
I too am very thankful to have a vet who listens to me and to the advice of this group.   He has gone along with the increase in dose with very little fuss...I think because Stormy's lab results prove that she needs it.
I guess I will just keep listening to what Stormy tells me she needs, like I've done before, and then test again if I'm uncertain?   I think I am pretty in tune with her at this point.    Am I on the right track?
Thanks again!
Teri and Stormy
IN 2012
I just tried to add the link to Stormy's CH and Yahoo tells me ECHistory5 is closed to NEW case histories, but her's is NOT new.    ?????   Probably good ole neo again!    I just remembered...I didn't delete her old CH when I updated it...could that be it?  


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