Yankee was positively diagnosed with PPID in Feb but medication was not started until July - which puts you squarely in the position of "chasing the rise" to attempt to gain control of the increasing ACTH. There is no mention in the case history of why there was a delay in starting the meds.
Always need to discuss prescribed medication doses with your vet. No one here can prescribe for another member's horse but those with experience can relate those experiences as examples of what might need to happen. Those who have been on this PPID merry-go-round for a longer time, and have good working relationships and the consent of their vets, may have more leeway in making dosing changes more rapidly as needed.
Lack of consistent symptom control: ongoing flat feet and sensitivity plus lack of energy (possible sub-clinical laminitis), fluctuating PU/PD are red flags for lack of good control of the PPID, which would necessitate an increase in the dose of pergolide to correct. Based on the experiences of members here, it can take double, triple the non-seasonal dose of pergolide to maintain good control of the ACTH thru the seasonal rise period and keep the risk of laminitis to a minimum. That 2mg dose is an example of what it may take to get a handle on the situation with Yankee so that Jodi has information to use in a conversation with her vet.
Lavinia and George Too
Nappi, George and Dante Over the Bridge
Jan 05, RI
ECIR Support Team