Hi Vicky,

 

Please note that once a horse is positively diagnosed as PPID and is on medication there is no need to do the TRH test. Your pre-level shows that your 2.25 pills are not controlling his PPID at this point.  Were he mine I'd bump him up to 3mg and test him 3 weeks after reaching that dose to see if that's brought his ACTH down to the upper teens/low 20s where we like to see it year round in a positive horse.  If it doesn't you'll need to bump him up again.  As that is cost prohibitive with Prascend for most people you might want to start a discussion with your vet about switching to compounded pergolide to reduce your costs.