Insulin Resistance — enough insulin for a horse?

Hi everyone,

Newbie here – my 7 year old cat (Thor, male, neutered) has been diagnosed with Acromegaly and insulin resistant Diabetes. Just moved him up to 9 units of Lantus twice a day, and blood glucose is still 500+.

Anyone here have a similar experience? I'd love some advice – my vet is great, but there are times when I feel the insulin isn't doing a damn thing!

we do have a board for acromegaly, that you may find helpful. In the meantime, I will see if some of the folks who have high dose kittehs can come help you.

viewforum.php?f=12

Thank you! Checking out the Acromegaly board now!

A couple of questions for you:

1) are you feeding dry food? Most dry foods are 30-40% calories from carbohydrate and just feed the diabetes fire. Even the Rx dry is greater than 10% calories from carbohydrates. Evo Cat & Kittne, Wellness Core Original in the tan and gold bag, and Young Again 0 Carb (internet only for this one) are the 3 lowest carb dry out there. But ... we'd suggest you don't feed dry. Pop over to Cat Info for information why, plus a food list with nutritional information.

2) Are you hometesting the blood glucose? If yes, great - its much safer for your cat if you do this. If not, you have no way to identify how low he is going, nor what, if any, patterns may be occuring in how he handles the insulin. We encourage testing like this to ensure your cat is safe.

3) How were dose adjustments made? After a curve at the vet office? A curve at home? How big were the dose increases each time?

My boy Grayson is an insulin resistant Acro. He was dx about a year ago. It will help to have as much info about your kitty as possible. BJ already summed up some, but here's a simple list (you can "quote" and then fill in the responses if you'd like.

1. Are you hometesting?
2. Was the 500 something you saw, or was that at the vet?
3. How long after eating was the 500?
4. When was kitty diagnosed with diabetes?
5. How long have you been on Lantus?
6. What dose did you start at and how much/how quickly did you increase?
7. Do you have an IGF-1 number? IAA number?
8. What kind of meter are you using?
9. Are you able to test between shots?
10. What are you feeding the kitty and how much is he/she eating per day? (Grayson ate as much as 12-3 oz cans of Fancy Feast until his numbers started coming down (and his dose was reached).

And please tell us you & your kitty's names and what part of the country you're in. I had someone in town that helped me when I first got Grayson's diagnosis - helped keep me sane!

That's probably enough to get you started. Please check back regularly, as others will be stopping by to check in as well.

Lu-Ann

Hello from another member with a cat diagnosed with acromegaly and IAA last year. Neko got up to 8.75 units of Lantus twice a day before starting back down. We welcome your questions and look forward to hearing more about your cat. Talking to others who've been through the experience were a great help to me when I got Neko's diagnosis. The acromegaly board here isn't as active as the others, but does have a lot of information on it.

Hello from another acro kitty- Sneakers is on 13u of Levemir lately, down from 33u at the most.

If you have any questions for us send us a PM. Also- make sure the last box is checked in the list just below this writing box- Notify me when a reply is posted. That way you get an email when someone comments on your post.

I, too, ditto all the other questions :lol: :lol: :lol:

Hi everyone! Overwhelmed by the response and everyone's willingness to help.

I'm Amy and my Acro kitty is Thor. He's 7 years old, all black, except a small half-circle on his tummy and about 6 hairs in each armpit. (pic attached, if I did it correctly) We are in the Washington, DC metro area.

Basics on Thor:
Thor was diagnosed with diabetes in late January. We noticed the standard signs - thirst and heavy urination. Started at 3 units for 2 weeks, then 5 units for 2-3 weeks, and so on until we were at 7 units with no effect. At that point, we noticed he had lost a LOT of weight (from 22.5 lbs to 14.5 lbs – he's black so it's hard to tell sometimes) and wasn't eating we took him into the vet. He stayed there for 36 hours, but refused to eat and was throwing off tons of ketones. At that point, they put in an esophageal feeding tube and I started tube feeds six to eight times a day. (3am feeding was tough!)

That was almost four weeks ago, and his appetite is back to normal and he's gained about 1.5 lbs back (baby scale from Amazon arrives tomorrow so I can weigh him at home). He is eating about 300 calories a day (four 3oz cans), Fancy Feast wet food. (another cat has Mega-Colon and can't eat dry, so none of our four cats get it.) Over the last couple days his appetite is voracious, so no tube feeds needed to get him the vet-recommended 300 calories/day. Will probably leave the e-tube in while we're figuring out the optimal dose of Lantus – just in case his appetite goes or he crashes and needs food fast. It's also a very handy way to get meds in. Dissolve pills in water and voilá, easy-peasy.

Second vet we saw in April is fantastic – she immediately suspected Acro and recommended we see a specialist and get the test. His score was 270 (with 90 being normal). Guess he is an overachiever, huh?

Answers to questions:
1. Home testing glucose – yes. Average of once a day. Did a curve on Sunday when we went from 8 units to 9 – readings were mostly in the 600's, with one of 530. The 530 was 2 hours after dosing with Lantus.
Meter is an Aplha Trak – have had it calibrated at the vet's office and use the control fluid to check about once a week. It is always in the low 100's. Also tested another cat, who's reading was 108. (Yes, Thor was jealous)

2. Thor eats all the time, best guess on the 530 is it was 90-120 minutes after eating.

3. On weekends I can test more frequently, but can only do twice a day max. Even on the days where curves have been done, his numbers are stuck on 'high'.

4. Vet did a 12-hour curve on 4/27 at 8 units, and he was consistently in the 500-600's. Might do 24-hour curve when we get to the 10 unit mark... any advice on a 24-curve? Is it worth the $200 given he's an easy guy to test at home?

Many thanks for the responses and everyone's willingness to help. Much appreciated!!

-Amy & Thor

any advice on a 24-curve? Is it worth the $200 given he's an easy guy to test at home?

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Are you willing to get up every couple of hours? Instead of $200 dollars at the vet, a curve at home would only cost you the tests strips plus your time, usually less than $5 for the 6-12 tests.

I wouldn't think a 24 hour curve would be any different that a 12 hour curve.

And changing to a human meter would be cheaper in the long run. I'll post here on my saving between alpha track and and the Relion micro:
I look at it this way-
Upfront expenses:
Alpha track meter- $100+ to buy
strips- I think they are $2 EACH
vs
Relion Micro- $15 (Prime is only not that much more and the strips are even cheaper)
strips- store- 100/$36 ($.36 EACH) and auto shipped from ADW 250/$72 ($.29 EACH)

I test, on average, 5 times a day.
Alpha- 5*2.00=10.00/day, 70.00/wk, 280.00/4 wk month.
Relion- 5*.29= 1.45/day, 10.15/wk, 40.60/4 wk month.

I save $239.40 a month by using a human meter, on average. Sure, every 45 days my auto-ship order comes from ADW ($73 because of the auto ship discount covers most of the shipping cost) but I've built that into my budget.

But lets say you only test 3 times a day because of time constraints (both PS shots and one mid-cycle)-
Alpha- 3*2.00=6.00/day, 42.00/wk, 168.00/4 wk month.
Relion- 3*.29= .87/day, 6.09/wk, 24.36/4 wk month.

Comes to a $143.64 savings. That's a lot of cat food (or people food, utility bill, car payment...)

Did you also get a test for IAA as well? Cats can have both or only one and not the other. Each have their own special peculiarities to deal with.

FD cats will be hungry all the time until close to regulation numbers- mainly because they cannot get the nutrients out of the food without insulin. Now, an acro cat actually HAS insulin but the GH-1 hormone excreted by the pituitary gland overwhelms what the cat makes so the result is... you guessed it- FD. Now- acro cats also have this little tumor in the pituitary gland sending out the growth hormone so you now have a full blown teenager living with you and they are known to have hollow legs :lol: :roll: . So another reason they are hungry...
My Sneakers ate 15-20 oz per day until regulation. Currently she eats 6-8 oz per day- a BIG drop.

For an acro cat the numbers will be high until the insulin level is enough to not be knocked out by the GH-1 level. How does Thor react to his shots? Lantus is said to have a bit of a sting at high doses as it is PH positive. Levemir is PH neutral and has no sting. It might be something to look into later on if the Lantus doesn't seem to be working. I think all of the acro cats are currently on Lev on the FB board save one.

As you get the numbers down it will be helpful to look at them in two week increments rather than day to day.

Good luck!

Hi Amy and welcome! :YMHUG: How are things going with you two?