We just rechecked the insulin on my pony, and it came back at 1200 pmol/L (normal is 28-390). She's been on metformin since the beginning of the year, and while it did work to bring her insulin levels down into the normal range at first, her insulin has just been getting steadily worse now. I know that this is a common phenomenon with metformin. 

I unfortunately can't do the other drug (invokana) as it's too expensive.

My vet is thinking that we should just take my pony off of the metformin since it's no longer working. 

Right now, my pony is the best/ most comfortable she's been since being diagnosed with laminitis in December. But since her insulin is so high, is it likely that she'll have another relapse? 

Her diet is as "tight" as it can be (the hay we're using has the analysis up in her photo album, and I still soak it before feeding). Is there nothing else that can be done to keep the insulin down?

At this point I just really want to get her through the spring and summer without having another relapse, and think about putting her down at the end of the summer so she doesn't have to go through another flare up in the fall/ winter.
--
Helene A. in BC 2021
Photo album:
https://ecir.groups.io/g/CaseHistory/album?id=271068
Case history:
https://ecir.groups.io/g/CaseHistory/files/Helene%20and%20Rosie