Re: Most recent PPID and EMS/IR lab results


Thanks for everyone's help.  I've relayed recommendations for metformin again to my vet.  Also told him need to increase pergolide dose.  Said Dr. Kellon is concerned about Apollo's history of laminitis during last year's seasonal rise and his increased risk of laminitis now because of high insulin.  This time he didn't ignore me but texted back asking for recommended dose for metformin.   In Kristen's reply to me, she said 30 mg/kg 2x/day.  I know it should be mixed with milk of magnesia when given by syringe and his mouth rinsed after to prevent ulcers in his mouth.  How much milk of magnesia should be added?

Also Can metformin be given at same time as any of his other meds?  Gets J-herb in morning and night plus Thyrol-L (being weaned off) and Prascend in evening.  Not positive on Apollo's exact weight so how to figure safe but effective dose?  When should insulin level be retested?  How long does he stay on metformin, until it stops working or when insulin goes down?

Regarding increasing Prascend.   This is in addition to metformin?  Should I increase now?  Start with 1/2 tablet increase and then wait 3-4 days before adding another 1/2 tablet?  He had some difficulty when first started Prascend last year but didn't last very long.  Gave APF a couple of days but he really hated it and didn't make big difference.
Karen B.
Apollo Case History:
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