Hi Sherry,
I’m wondering if you saw our responses to your earlier post?  Maybe you just need more details but I thought I should check to make sure you are finding your messages and replies.

It seems to me that Cassie was on pergolide before she came to you.  Is that correct?  I would definitely double her dose and she’ll most likely need even more.  If you’re concerned about her response, start her on APF for a few days and then start with 1/4 tab of  Prascend.  They aren’t scored for four so just do your best.  Add another 1/4 tablet to her dose every three days, continuing with the APF, until you have her up to 2 tablets.  If anything, it should make her appeared depressed, which we refer to as a pergolide veil.  If one appears, you can wait until it lifts before making another increase.  If you have concerns while doing this, don’t hesitate to check in.

Was her insulin checked?  As she is a TB, if it is high, it will most likely normalize as her PPID comes under control.
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