Help! Rising ACTH and Insulin

Suzy Berkowitz

On February 4 Scout’s ACTH was 29.7 and his insulin was 152.31. He started metformin that day with the recommended 30mg/kg. On February 25 his insulin had come down to 76.51. He seemed very comfortable. The past week or so walking a bit slower, so rechecked ACTH and insulin. March 31 results- ACTH is 33.9 and insulin is back up to 110.44.He has been on metformin all this time.  He has been on 2mg prascend since December after being on 1.5mg for years. He still has fat pads. My questions are should I increase his prascend now or can I safely wait till July before the start of the seasonal rise? Can I try increasing his metformin, have others tried dosing at higher than the 30mg/kg? Thank you.
Suzy in Fl 2020
Scout Case History:
Scout Photos:

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