I’ve been thinking about this a bit and don’t want you to feel ignored. Maybe if I post some thoughts, someone else will come along to correct them, if need be.
I also have an insulin resistant pony with PPID which isn’t able to be monitored with ACTH testing. Because I know I’ve done everything else, he’s at a low weight and not foot sore, I tend to increase his pergolide in the hopes of decreasing his insulin, which is high but not dangerously so. At 35 plus years of age, he’s not getting regular exercise, which might help him more than the pergolide. I have dewormed him with ivermectin.
An increase in hormones precipitated by the fall rise also causes insulin to rise but I’m not sure what portion of that is caused by ACTH or how much of a change to expect in his insulin. We try to keep things in a normal range throughout the year, but try not to make pergolide dosing changes during the rise as it appears to be less effective.
What is Samson’s body condition? Is he still overweight? Do you see inappropriate fat pads? Beet pulp has pretty much had all the sugar extracted but it is overloaded with iron, the reason for all the rinsing. Excess iron is not good, especially for metabolically challenged horses. Are you using the beet pulp as a carrier? If you can find soybean hull pellets, I’ve heard that’s a great easy option. Is he still having issues with lameness? Did those all clear up with the coffin bone injection? What was injected?
Since this is causing you some understandable anxiety, I would increase the Prascend soon and watch carefully for any signs reflecting that the increase was a good idea. As you’ve split the dose, he’s effectively getting less than 2 mg of Prascend, perhaps half. Can you slowly change that by titrating up the morning dose, while titrating down the evening dose? Most people seem to turn to split doses when their horses appear to have issues tolerating a larger dose.
Martha in Vermont
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