1/20 Oberon +8 292, AMPS 382 (2.5 R), +4.5 361, +6 344, +11 373, PMPS 360 (2.5 R)

Suzi Adams said:
When I look at oberons ss it looks like you use lantus and regular? I’m curious? I haven’t seen two insulin’s used like that?
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Oberon is an unusual case... he has IAA (insulin autoantibodies), which means that he needs a much higher dose of insulin than most cats, but his insulin needs can change suddenly because the antibodies can change how much they're binding up the insulin. Because Lantus is a depot insulin, it's hard to make quick changes to the dose. Using Lantus + R (short acting insulin) gives me more flexibility to adjust his dose quickly as needed. It's definitely not a typical approach, and I needed a lot of guidance from people with experience using R to get me started.
 
Lisa & Oberon said:
Oberon is an unusual case... he has IAA (insulin autoantibodies), which means that he needs a much higher dose of insulin than most cats, but his insulin needs can change suddenly because the antibodies can change how much they're binding up the insulin. Because Lantus is a depot insulin, it's hard to make quick changes to the dose. Using Lantus + R (short acting insulin) gives me more flexibility to adjust his dose quickly as needed. It's definitely not a typical approach, and I needed a lot of guidance from people with experience using R to get me started.
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When did you discover IAA??
 
He was diagnosed with diabetes last December but went into remission after a diet change. Came out of remission in July and went back on Lantus. In late September when we'd been unable to get his BG to come down and he was developing ketones, we got him tested for IAA and acromegaly. He had IAA but not acromegaly (though I'm thinking we may want to rerun that test now). There's no specific treatment for IAA other than increasing insulin as necessary. You just have to wait it out.
 
Lisa & Oberon said:
He was diagnosed with diabetes last December but went into remission after a diet change. Came out of remission in July and went back on Lantus. In late September when we'd been unable to get his BG to come down and he was developing ketones, we got him tested for IAA and acromegaly. He had IAA but not acromegaly (though I'm thinking we may want to rerun that test now). There's no specific treatment for IAA other than increasing insulin as necessary. You just have to wait it out.
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Thank you for answering my questions, I ask because monkey seems insulin resistant....
No ketones detected my dipstick but she’s not responding to insulin consistently
 
Suzi Adams said:
Thank you for answering my questions, I ask because monkey seems insulin resistant....
No ketones detected my dipstick but she’s not responding to insulin consistently
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You might want to think about getting a ketone blood meter. I can get readings from the same drop of blood I use for the BG test, so it's not a big deal at all to do the test, and the blood test checks for a different form of ketone that's a better indicator of possible DKA than the urine test.

I took a quick look at your SS... looks like monkey is getting 3 U now. I think we generally don't start looking for insulin resistance until the dose gets to about 5 or 6 U. Hang in there; you may just need to get a little higher before getting to a breakthrough dose. But it's good to be aware of possible insulin resistance causes you would check for if you get above that and he's still not responding.
 
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