Thank you all for the terrific tips, I am going to try them all and see which one works.  I will let you know!  Yes janet, I was aware of the dex/cortef differences, and let me say, If I had to wake up ten times a night to give her a dose of medicine I would.  After her next bloodwork, I am going to bring up circadian dosing and see if we can’t go a step further with scheduling/dosing.

Blessings to all who responded,

K