Whether Jodi consults with her vet depends on the understanding she had with her vet regarding dosages for Yankee with Prascend was prescribed. There are many vets who understand the physiological reasons for a horse to become affected with PPID and there are some who do not. Members here have had to deal with vets who think because BI advertises that a "tablet' will control their horse's PPID , indicating that is a lifetime dose, that raising dosages higher is somehow out of standard practice, can cause liability issues, and also offends their position as appearing more knowledgeable than their client, since they are the licensed vet.
It's a tough position to be in, and one that requires some finesse to manage. I don't know for certain what category her vet is in.
If I were Jodi, I would report to her vet what symptoms have been improved and what haven't, and that she wants to slowly increase the Prascend to 2mgs, if necessary, to see if the additional symptoms are improved. If the vet balks, then she knows she has a problem and will have to address it accordingly.
I haven't looked at Yankee's ACTH testing to see what lab she used. MSU 's endocrinologists, for the past couple of years, have written in their interpretations of results I've received for my own horses, a lengthy encouragement to provide pergolide at dosages that control symptoms and to NOT simply treat by numbers. I would think they are not the only endocrinologists to encourage vets and clients to do so. If there are such notes, I would use that as backup for my position to increase Prascend.
To answer your question after that lengthy non answer, LOL, yes, those of us who are more experienced with PPID are often quicker to recognize symptoms and get an pergolide increase BEFORE a more serious symptom rears it's ugly head such as laminitis. Unfortunately, that experience often came from missing symptoms early. It's why the group encourages members to keep a journal of symptoms, observations, etc on their horse, including the degree to which the symptoms are expressed, weather, stabling and turnout time, etc. so they are more likely to see something early. Not everything is caused by PPID, but PPID and IR early signs are often assigned to other causes and can be mentally discounted as one off's ,etc. when they really are signs of increasing dysfunction. Those of us with experience are trying to help those with less not make the same mistake.
Dawn Wagstaff and Tipperary
Saline, MI 2003