There is no doubt that the Prascend is having an effect. The question is whether you are getting complete control of the ACTH or not. Right now, the seasonal rise is in effect so ACTH is steadily rising. Because Yankee's ACTH was elevated back in Feb but he didn't start his meds until late July, you are "chasing the numbers" as the climbing ACTH keeps exceeding the current pergolide dose's ability to fully control it. That's why you see some improvement in the symptoms but not a steady one. In a PPID horse, the rise will continue into at least Oct before plateauing.
If this was one of my horses, I'd plan to increase the dose to at least 2mg before retesting, and hope that is enough of a jump to "catch up".
ESC+starch is 6% in your hay - which is definitely safe. NSC is an outdated term and doesn't matter.
The Smart metabo-lean and Smart lamina are a waste of your money. Stop the Redmond salt and only use plain white or iodized. Really should have your minerals balanced to your hay analysis as you have deficient copper and zinc; several supplements that are adding magnesium; imbalanced calcium to phosphorus ratios.
Realize you are in a tough spot regarding hay but horses are really sensitive to mold so be very, very careful.
Lavinia and George Too
Nappi, George and Dante Over the Bridge
Jan 05, RI
ECIR Support Team