Questions about Babe on pergolide

Anna Dolly

Good morning,
I have written up a handful of questions and took them to the vet's clinic on Monday. I have not heard anything back, yet. I'd like y'all's input, too, please.
Babe's ACTH was 45 and he was fasting when they drew blood. He also had abscesses in both front hooves. He WAS moving some that day, so it wasn't the worst day, but he was not comfortable.
Would pain affect his ACTH levels?

We've had several mornings in the upper 30s (F) this last week. Babe has come down shivering. This is atypical weather and atypical of him to be chilled in that temp range (me, not so much, and I'm ALWAYS cold!). He is also shedding. I cannot tell if this is his normal shedding from grooming or not- my other horse is also shedding some. Babe's hair is short and glossy- maybe 1/4" long and always has been, in warm months.
Would pergolide be affecting his ability to stay warm? This is going to be a very long hard winter, if that's the case. We get between 10-20 (F) in winter.

What does a TRH test (the vet who is too far away suggested doing that in Jan, my vets haven't mentioned it) tell a vet that ACTH doesn't? All I know is it measures tryptophan levels, but not what role those play.

I've read some about chasteberry (vitex) here and other respected sites and still do not have a comprehensive grasp of what that herb could do for him if the pergolide is going to cause him issues. 

would there be any reason NOT to give him CBD? I know that it can help with pain and inflammation. 

They put him on Hot Hoof 2, but did not say whether this is for long term use or flareups? I took him off of it a few days ago, he's still a little tender, but no heat and not really limping. 
The farrier will be out as soon as he can get this way (we live in a rather remote area) to rasp his toes and I know that will help. If I had a clue what I was doing, I'd do it, but I'm not about to go make anything worse for him.

They never would check for Lyme, just told me that his bloodwork 'didn't indicate the need for it'. We live in the woods and have for 5 years. I'd be amazed if my boys hadn't been exposed. But what in the regular CBC would tell a vet that there's no need for a Lyme test? I'd like to understand.

I've had a hard time accepting that this may be what we're dealing with, unlike his heaves. That I could see for myself. This has had too many questions that I haven't gotten answers to. It may very well BE PPID. But I don't want him looking droopy and doped (I can definitely see a change after a week of pergolide) on meds that can have serious side effects if it's not certain that's what's going on.
He has a 5 year history (since we moved from the Gulf Coast and sandy soil to rocks and mud in the mountains) of occasional abscesses, and then this, a month or so ago, was the first time both fronts were affected. I didn't know about NSAIDS and antibiotics potentially prolonging abscesses and may have done him a disservice, there, as these just drug on for weeks. This is the first I know of laminitis and rotation, but also the first we've done radiographs, so I do not know if he's ever been laminitic before.
I think this is all of my questions for now...
Thanks for your help.
Anna Dolly
Keyser, WV
Sept. 2020
Babe's Case History
Babe's Photo Album

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