Re: Increase Pergolide when?

Kerry Isherwood

Well, this is an interesting coincidence:  i was just thinking of writing to ask this very question, whether you more experienced PPID'ers proactively choose to increase pergolide *before* the rise, or is it more generally advised to wait until signs occur to increase pergolide?  My mare also begins to historically fall apart in June and I'm getting anxious b/c this is my first "educated" year into the seasonal rise (mare was diagnosed last Oct, in the midst of a crisis). Here are her ACTHs (all at Cornell):

9/24/14.....ACTH  36.6 untreated, in full hyperglycemic/hyperinsulinemic crisis.  Start 1mg pergolide
10/25/14.....ACTH  26.2 on 1mg.
early Nov.....had severe insulin spike, PU/PD, etc; increased pergo by 0.5mg to 1.5mg/day
12/3/14.....ACTH  22.1 on 1.5mg/day
early '15.....insulin/glucose well-controlled on 1.5mg
5/17/15.....ACTH  22.1 on 1.5mg./day, still seems well-controlled, feels great under tack.

(kinda weird that her ACTH was exactly the same on last two results...I always considered her to be the most even tempered horse I've ever met, but that's getting a little freaky...)

Anyway, I'm not looking for THE right answer but more of experiences -- good and bad -- on how PPID'ers have dealt with the rise in past years, to proactively raise pergolide dose or wait to chase recurrence of symptoms and play catch up (cringe...)?

Any advice greatly appreaciated,
Kerry in NY

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