Hi Martha,
Actually surprised our vet took ECIR info so well since I literally handed him printed info at his first visit!  (My dentist recommended him).  I think having worked worked with doctors in human health care for 35+ years helped me know how to present it and my medical knowledge gave me some credibility.  He was a bit leery of ECIR being a "forum" where everyone posts info but I've assured him it's very research/science based info which Dr. Kellon oversees.  When it comes to farriers, I'd say I'd have an easier time finding another good horse vet than a good farrier.  When I asked vet about his farrier, he said he's very aggressive and don't need that.  Asked guy we just bought hay from (his daughter shows horses), described farrier as grumpy guy who had difficulty scheduling appointments because he also shows draft horses.  Tried vet clinics too and did get list but most of them are not close by.  Will keep trying in case current farrier quits. I want to focus on Apollo but would like someone else to trim our other horse, at least for now. On positive side, trimming Apollo myself will save money I can use elsewhere.

The fact that high insulin levels can caused by both uncontrolled IR or uncontrolled PPID or both at same time means at least some periodic testing is necessary for proper management of both.  Could you give me your ideal recommended testing routine (which specific tests and when/how often to do them)?  Then I can figure out a schedule I can manage financially.  Fortunately, my husband's still working and has a good job but he's due to join me in retirement possibly as early as next December.  We've planned well for retirement but didn't anticipate having a horse requiring expensive medical care.  He's concerned we're spending a lot of money on Apollo and just prolonging his inevitable decline.  At this point, the past 9 months do seem like one endless struggle and there's always something else we should be doing.  Since Apollo's PPID was picked up early, I'm hoping there's a good chance he can still live a long and productive life. Maybe even be able to pull the sleigh again this winter.
--
Karen B.
Wisconsin
2022
Apollo Case History: https://ecir.groups.io/g/CaseHistory/files/Karen%20and%20Apollo
Photo album:  https://ecir.groups.io/g/CaseHistory/album?id=275817