Re: suggestions in getting insulin down
Whichever you decide to do, whether it's increasing Prascend or trying Metformin, I would do only 1 thing at a time so you can see which one helped.
How do we know what to increase it to?Your vet's suggestion to 2 mg Prascend is reasonable.
You are looking for lower insulin, better appetite, reduction in crest/goopy eyes/insulin, etc.
No way to know if it will help with lameness.
Yes, keep retesting insulin and watch for a drop.
There is no harm in giving too much Prascend, except to your pocketbook or if you have a horse that really struggles with the veil it can be hard on both of you increasing the dose. See this post by Sherry about an accidental overdose (100x!!) case study:
Kirsten and Shaku (IR) - 2019
Kitimat, BC, Canada
ECIR Group Moderator
Shaku's Photo Album