Hi Amy,

I'm not sure I understand your first sentence especially the part about that 10-11 is the target max.

The only thing I would add (besides I'm kind of surprised his insulin has been as close as it has to normal (keeping in mind that 10-11 is the target max) in the past with his ACTH numbers--wow!  those are really high)

The target range for insulin is 10-40. No he is not eating bananas or any treats as far as I know. 
Everyone at the barn knows he is a "no treat" horse. Of course we do get visitors from time to time
so that is an unknown. He does occasionally pull me and others to grass, but that is a momentary
issue. 

You're right  - his ACTH numbers are crazy high. I'm still trying to understand Dr. Kellon's remark
that there are horses with high ACTH that are "biologically inactive". I asked my vet 
He seems to be doing well. I'm back to riding him - he has an issue with right-rear hamstrings,
so we are trying to be careful to work those. He has lots of energy.
I'm looking for some suggestions to replace the InsulinWise. 
 
--

Irene & Logan
NRC 2009
Hudson, NH

https://ecir.groups.io/g/CaseHistory/album?id=9598

https://ecir.groups.io/g/CaseHistory/files/Irene%20&%20Logan