Hi Laura,

We as a group have found that the most stable form of pergolide is capsules, not powder so just something to think about as far as 'best bang for your buck'.  What the results tell you is that his PPID is slightly better than last year but still not as controlled as it could be.  So increasing his dosage of pergolide is definitely the right answer, but again, you may want to consider going to capsules vs. loose powder that may lost potency each time it's exposed to air.  

I found you do have a photo album at  https://ecir.groups.io/g/CaseHistory/album?id=269693 - has Dandy's trim improved since those x-rays were taken?  If not, it's not surprising he's still not comfortable as he had no sole and long toes and that alone could lead to soreness.  Are you booting him at all so he'll feel more comfortable?  Were this my horse I would address the trim before trying to put shoes on as that will not fix the underlying issues and may in fact may make him more uncomfortable.