what's next


Darby is going through a laminitic episode, no change in circumstances. Negative for Lymes, ACTH is 28.8 and his last insulin was 50.
Darby started Metformin 3 days ago, still waiting for the Prascend (as per Dr. Kellon's recommendation). How soon should I be seeing an effect from it?, My vet said she wanted to test his insulin again in 7 days after reading on the ECIR site that we should. , but I thought it was not wise to test insulin when the animal is stressed? Which he is from his ongoing bout of laminitis.
 I also bought a glucometer, but am unsure when to test, when is the best time to get the appropriate sugar reading? 
I know it has been  repeatedly said that IR horses will not start feeling better until the insulin is controlled and that NSAID's like bute are useless. BUT, every day for the last week he has been unable to walk out of his stall in the morning until I have given him bute (2 grams) and within an hour or so he is visibly more comfortable, less stressed and happy to walk outside( from a deep bedded stall and he wears boots 24/7). Could this be something else I am dealing with?
Wisconsin, Sept 2018


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