Re: New Member - Shetland with acute laminitis and cushings
Fat deposits are usually an indication of IR, not PPID. Since you haven't done any bloodwork yet I would suggest that after 3 weeks of being on the full tab of pergolide (should be 1mg dose?) that you have blood pulled for insulin, glucose and ACTH. That will let you know if you need to increase the dosage of pergolide and if his current diet is controlling the IR or it needs to be tightened up even more. Hopefully at this point he's been totally removed from grass. As Bonnie already mentioned lucerne is an issue for many IR and PPID equines so that needs to be cut out completely and just use grass hay for him.
If this is a laminitis due to IR or PPID you might as well stop the bute using the taper outline here: https://ecir.groups.io/g/main/files/Pain%20Medication%20and%20Alternatives/How%20to%20Taper%20Off%20NSAIDs.pdf. The reason he's probably appearing to go backwards when you ease off it may be related to a rebound effect and not really because his feet are any more sore without it than with it.
As already mentioned, pictures of the current trim and any x-rays you have will help us help you. Also having a case history done so we know how much he weighs, how much he should weigh and how much he's currently eating (not just what he's eating) will all be very helpful as well.