Lad has been on a high dose of pergolide for years. (24 mg) He has gone to a new owner who is , like me, wondering whether it is safe to reduce the dose. In an earlier message to me Dr. Kellon commented that ACTH may not be the best indicator of what dosage he needs as other hormones are involved. I would like to ask about a consultation.
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Bonnie,

If ACTH has been elevated in the past and used to titrate his pergolide dose, you should stick with that. Your other option is to consider switching to cabergoline.

 There is never a situation with PPID where a horse can go to a lower dose. The dose either controls the hormones or it doesn't. When you have found an effective dose it may remain effective for a while or, more commonly, may need to be increased over time.

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Eleanor in PA

www.drkellon.com 
EC Owner 2001
The first step to wisdom is "I don't know."