I just had Dandy retested (6/8/22) with a Stim test with glocose and insulin. He was originally diagnosed with a Stim test last year (6/22/21), and is currently on pergolide 1.5mg powder. These are the results I am trying to better understand. Both tests were done non fasting, free choice hay avaiable, in the morning.

Is his PPID controlled? Can we tell from these numbers?
 
Insulin                                                                                 6/22/2022 = 39.8
Glucose                                                                              6/22/2022 = 94 mg/l
ACTH baseline                           6/8/2022 = 12                  6/22/21 = 16.9
ACTH post stim                          6/8/2022 = 148.0             6/22/21 = 265

Clinical signs: He is still intermitantly lame, with very sensitive feet - not wanting to move beyond a walk and unrideable. He is still thin and ribby with a pot belly. He has intermitant goopy eyes. All these signs are leading me to the conclusion that he might benefit from a higher dose of Pergolide.

What are your suggestions on changes to his dosage? What sort of nubmers are we aiming for with these tests when a horse is being treatedwith Pergolide? My best guess is that he needs a higher dose, and as such I have moved him up to 2mgs per day (as of two days ago) but am unclear if this is warranted and how much I should be increasing his dosage if it is. 

Vet thinks that part of Dandys soundness issues are related to thin soles and wet conditions. He suggests shoes. 

His case history has just been updated. All the referenced lab results are uploaded. 

Thank you for any suggestions you might have. 
Laura

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Laura C in Montana 2021

https://ecir.groups.io/g/CaseHistory/files/Laura%20and%20Dandy