Hi, My vet likes to start the horses on a low dose and then increase if symptoms do not improve. We also do a lot of nutritional support with our mare. Have you done much research on Cushings? There is no cure for it, only means of managing it for as long as possible. It can be difficult to diagnose because there is no clear cut test for it only antidotal evidence. Good luck with it. My mare is doing great and I couldn't be happier!! Chris in CA (BTW I do a full body clip on my girl every June if she hasn't shed enough out)