Re: Update on Riosa
No idea if you should increase Prascend, so I'll save that one for someone else.
I would have her insulin, glucose and ACTH tested again. I don't think ACTH adds much cost to the testing, so you might as well run it since you are giving Prascend (even though her ACTH was normal last year).
If her insulin is still high then the foot tenderness could be do to that, or due to abscesses or due to a compromised trim (its definitely better now, but still not ideal...it will be a work in progress). So, its hard to know what the reason is as any of those 3 things could contribute.
No idea how low you can get Rio's insulin from those high numbers, but I would aim for less than 80 (the number above which acute laminitis may occur) and hopefully you will see less hoof pain if you get her there, although really you'd want to be as low as you can get her (I personally would be thrilled with 20 but that might not be attainable for Rio...I don't know).
Sorry I'm not much help but I know some others will chime in, too.
I hope the invocana has helped and am cautiously optimistic you will see a real improvement with her next blood panel. Are you seeing improvement in her comfort since you started invocana, or an improvement in any other IR signs?
Kirsten and Shaku (IR) - 2019
Kitimat, BC, Canada
ECIR Group Moderator
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