Acute laminitis - unable to control pain


My 9 year old Paso Fino mare started an acute laminitis episode 5 days ago.  She is overweight by 200lbs. She currently weighs 1150 and she should be 950 at 14’2 hands.  She has been on Levothyroxin for 2 years and limited pasture, muzzle - all the usual measures.  Since Wednesday she has been in a stall on a mat and 8-10 inches of shavings.  She is wearing easy boot clouds.  She is on bute and gabapentin and just started Prescend today. She is EMS but I strongly suspect she is also PPID. Seems like bloodwork to confirm is pointless right now due to the pain response.  Her rads show very little rotation and I have the farrier and vet booked tomorrow for corrective trim. But the pain just won’t stop.  I’m a nurse and I just can’t deal with not getting her pain under control. Any help would be so appreciated. 
Shannon B in Ontario 2020

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