HI Anne,

Is your case history up to date? His lab results are still not in an ideal range, and this might be part of the issue. Its best if the ACTH numbers are in the low teens for some horses, and your horse's last test results show it in the 40s on 1mg of pergolide. You might need to increase the pergolide, which might bring down his insulin. When was the last time you had bloodwork done? Can you update your case history?

I see the hay analysis you posted- is this the grass hay you are feeding? I agree with Nancy that you need to be feeding more forage first before anything else. You can get a fish scale for fairly cheap and weigh a hay net empty, and then add hay to get the correct measurement of what your horse is eating. 
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Candice Piraino

Primary Response Team

September 2018, Summerfield, FL

Shark's Case History

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PHCP Barefoot Trimmer @www.arkhavenfarm.com