Dec 7   #229718  

"Yes, I remember we were thinking the abdomen was weakness related to PPID.  There are basically two possibilities. He didn’t respond because the dose is too low, or because it’s not PPID related. The spookiness also may be pergolide related or may not.  I would suggest trying him on the thiamine for a week or two and if that doesn’t obviously change the spooking then try reducing pergolide to 2 mg."

The thiamine didn’t bring about any noticeable change so I gradually brought him down from 3 mg to 2 mg of compounded pergolide.  My boy became himself again [ I don't mean a dead head, he's bright and full of vim and vigor just not "crazy" acting] and he has remained on 2 mg compounded pergolide. 

As a result of what happened last year, I approached the seasonal rise differently this year. We have worked very hard on trim/diet/supplements etc. and Lavinia said there is no reason I can’t ride him for conditioning. I had him examined by an equine chiropractor who said he is doing great. She made one small adjustment to his right pelvis. I also had her do a saddle fit check and she said I have the perfect saddle to accommodate his changing topline. He has Cavallo Trek boots that fit great and he is now used to them. I have also continued to test him.

ACTH in July 2019 was 18.9 pg/mL – the lowest it has ever been

Insulin and Leptin values taken August 2019 were slightly elevated when compared to last year but the IR calculator still shows him as compensated IR

 April 2018

Insulin – 11.52 ulU/mL

Leptin – 12.47 ng/mL

August 2019

Insulin – 18.01 ulU/mL

Leptin – 13.54 ng/mL

Finally, to my question, I do not want to raise his Pergolide dose unless I absolutely have to due to the long bout of scary spookiness he went through and sustained until his dose was lowered. However I want to make the right decision here…is the course of action I’m taking appropriate?

I rode him this Saturday. He is feeling great. I took him into the arena to do a little ground work prior to going on some trails right on the farm. He was prancing. When I tied his reins up and let him off his lead he took off and bucked all the way around the arena – came back to me and nuzzled then took off bucking again boots, saddle and all. When we left the arena it was a windy day. He had a couple normal spooks considering it’s only our 2nd time on the trails in almost a year but did great. He was bright, we went down to the creek, walked up and down in the water. I had to hold him back to do the 15 minute warm up but when I let him out he was something to behold. Really strutting his stuff.

 His case history is current. I posted a side view body shot of him [August 2018] in his album and there are post trim photos of his feet there as well.  Blood work files are complete. I plan to retest his ACTH at the end of September. My vet says he is going to talk to the endocrinologist he’s been consulting with at Cornell tomorrow about the elevated insulin and leptin.  I don’t want to under dose Relevante and jeopardize his health but I also don’t want to “fix” what isn’t broken so wanted to ask the question here on the forum as well.