I drew Flame’s labs last week & sent them to Cornell. I gave 3mg Pergolide & 225mg of Invokana @ 4am & drew labs @ 8am on 7/19. Flame ate and had hay in front of him from the time the meds were given until the time of the lab draw. Insulin is 88.05 uIU/ml & triglycerides are 447 mg/dL. I’m happy with his insulin (it was >200 prior to starting Invokana). I wish his triglycerides were better. I was hoping they had come down enough to do some light lunging, trail riding, etc.

He is getting 4 pounds of tested, unsoaked hay twice a day (the nitrates are too high), 3.5 pounds of TC Timothy balance cubes twice a day (it was 4 pounds but he recently had not been finishing his RSR BP, so I decreased it) & 4 pounds of RSR BP w/ all his salt & supplements. 

Physically he is sound, perky & has good energy.  He has mild anhydrosis & is kept in a stall w/ the front & back doors opened but stall guarded off (for air flow)  so that he can be under a mist system, have a  swamp cooler & fan during the day. At night the back door is unblocked & he can go into the run attached to his stall. He’s doing much better this year with the heat but is still breathing heavy/fast on our really hot days (110+). He’s getting body clipped once a month to keep his coat short. 

This morning my barn owner declared that he looks too skinny, that I don’t notice because I see him every day & that I need to increase his feed, specifically his hay.  I added body pics to our photo file- please look & let me know what you think. She is aware that I seek help from this group but she thinks I need to “treat the horse instead of the numbers”. As a nurse, I really believe a lot in the numbers. Please advise & thanks in advance! 
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Beth & Flame dx 2013 & Diana dx 2020

NV Oct 2013

Flame Case History

Flame Pictures

Diana Case History: https://ecir.groups.io/g/CaseHistory/files/Beth%20and%20Diana