The ACTH isn't outside of what might be expected in mid August for a 14 YO horse.  The rise occurs gradually to peak in September usually.  Her insulin wasn't high enough to account for foot pain and she doesn't have a history of problems surfacing in the fall.  Could she be moving toward a point where at least seasonal pergolide is reasonable? Maybe - but I don't think it can explain her current clinical picture.
--
Eleanor in PA

 

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EC Owner 2001