Re: Alternate drug to Metformin
Once we have diagnosed pergolide, we have found its best to keep ACTH at or below the middle of the normal range, even through the seasonal rise. PPID horses seem to do better with this really tight control on ACTH. Your bloodwork shows a value of 27 pg/ml in mid-August, which is already above that middle-of-the-range max we recommend. Guaranteed it went higher still into the seasonal rise, unless you increased the pergolide at that time. Insulin was already high then, and it likely climbed higher as well. Did you test in September, too? Your Case History only goes to Aug 29.
You might want to talk to your vet about switching to compounded pergolide. You can justify it because it will be easier to give 1 pill a day (and there are huge cost savings). Island Pharmacy on Vancouver Island is fantastic and highly recommended here. Keep some Prascend on hand for dose increases, if/when it needs to be adjusted.
Kirsten and Shaku (IR + PPID) - 2019
Kitimat, BC, Canada
ECIR Group Moderator
Shaku's Photo Album