New to this group, Case History posted


Hello. I am new to this group and just posted my horses Case History form and pics of her X-rays. I’m not sure what to do from there. 
The vet we saw didn’t want to put a name on her diagnosis, although from everything I’ve read on here so far it sounds very much like IR. She’s a 9 year old gypsy/Friesian cross that had her first bout of laminitis this spring/summer. She has a cresty neck that is actually improving. She was first seen in June 9th and X-rays showed some rotation and Insulin level elevated at 67. She was started on pergolide and taken off of pasture. Her cresty neck is improved, she seems to have lost some weight, and she is getting around reasonably well. She never had heat in her feet or bounding pulses. She was never down due to lameness. She just seemed a bit off when I started back with riding lessons. She possibly shifted her weight in the front early on, but it didn’t seem severe, meaning it didn’t seem due to discomfort. After 2 months of pergolide I took her back to have her insulin level checked and it was higher than it originally was, it was 80 the second time on Aug. 1st. But both tests were done in the morning, first test done approximately 3 hours after eating a small amount of grain followed by hay, second test was done approx. 4 hours after eating small amount of grain and hay. She also ran around her dry lot area like crazy for about 10 minutes before I could catch her to load her in the trailer the second time. It was hot and we have an hour+ drive to the vet. Not sure if that significant increase in activity right before we left had any impact on her insulin level. But with the warmer temperatures she had been dripping sweat in the trailer on the way to the vet (and because she got herself all worked up and hot). 
I know have a new vet that is coming to the house this week. I briefly told them the story because I think retesting her insulin level might be appropriate. I’m not sure what to make of the last one because of the surrounding circumstances. I asked about retesting and if I should fast or not and she called back after talking to the vet and said that since it is their first time seeing her, to fast her in case any lab draws are decided on at the time of the appointment. I have read on here not to fast, but not sure if any other testing would require fasting. She will be the first appointment of the day. 
The vet we started with suggested that we increase the pergolide to twice a day, but I’m not sure if I want to do that before this appointment. 
Looking for guidance as we navigate through all of this. 
Case History:
Thank you in advance.
Please let me know if I did anything incorrectly or if you have questions. I provided all of the information that I have at this time on the case history form.
Lori Weber

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