? 07/06/2022 MICIO: AMPS 176/ 136@ +3.25 Not responding well to insulin, even despite the increase

MISSY + Simone&MICIO (GA)

MISSY + Simone&MICIO (GA)

Member Since 2021
Yesterday: AMPS 168 / 173@ +3.25 / 187@ +5.5 / 199@ +3 / PMPS 195 / 158@ +3.25 / 173@ +5.75
Not quite sure what's going on with Micio but lately his numbers are very instable and, at times,it seems his nadirs moved to a later time.
He doesn't appear to have any infections on his mouth right now, eating and acting his "normal", NO furshots (finally awhile ago my new vet got to educate me on that matter).
What's to blame on his bg's going up rather then down after insulin? Usually his bg's would drop 2-3 hours after shot. Even though I bumbed it up to 9u yesterday, I don't see much expected change...
Could it be something wrong with the insulin or, again, just Acromegaly is to blame? @Wendy&Neko
Should I consider Levemir? I think this glargine insulin started stinging Micio a bit.
Don't know what else to think of...
 
Remind me, was he ever tested for IAA? And yes, if stinging, I would switch to Lev. What behaviour is making you think it’s stinging?
 
Definitely sound like he's feeling the shot. Do you put the syringe between your fingers to warm the liquid a bit before injecting? I might also consider Lev, if the later onset and nadir would work with your schedule.

With acromegaly, the tumour does wax and wane. You could be just in one of those pulsing modes where it's ramping up a bit. And as Elise said, I'd consider the 0.5 unit increases at this point with just high green nadirs.
 
Wendy&Neko said:
Definitely sound like he's feeling the shot. Do you put the syringe between your fingers to warm the liquid a bit before injecting? I might also consider Lev, if the later onset and nadir would work with your schedule.

With acromegaly, the tumour does wax and wane. You could be just in one of those pulsing modes where it's ramping up a bit. And as Elise said, I'd consider the 0.5 unit increases at this point with just high green nadirs.
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Will try to warm up the syringe in my fingers, forgot about that...and will increase by .5u next time. Forgot about Levemir and later onset, wouldn't work well with my schedule (especially with my 4 hours sleep at night) but we'll see what happens with next increases.
 
I would say that, at this high of a dose, it probably is stinging him. He doesn’t seem to be responding the same, does he? He’s quite flat a lot of the time recently. At least his numbers aren’t really bad - that’s something! I hope just a little increase will get him back on track. It’s good to hear that his mouth is still doing fine. Hang in there.
 
MICIO&Simone said:
Forgot about Levemir and later onset, wouldn't work well with my schedule (especially with my 4 hours sleep at night)
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I actually ended up getting better sleep with Levemir than I did with Lantus. It was more predictable, and the flatter cycles meant far fewer unexpected drops and I could space out the tests more. Between my AM+9 (10), PMPS and before bed test, I could figure out if I needed to get up later than night, or rather early morning. Neko also nadired much closer to preshot, meaning longer stretches between testing. Micio is already pretty flat on Lantus, so not sure you'd see that benefit.
 
Wendy&Neko said:
I actually ended up getting better sleep with Levemir than I did with Lantus. It was more predictable, and the flatter cycles meant far fewer unexpected drops and I could space out the tests more. Between my AM+9 (10), PMPS and before bed test, I could figure out if I needed to get up later than night, or rather early morning. Neko also nadired much closer to preshot, meaning longer stretches between testing. Micio is already pretty flat on Lantus, so not sure you'd see that benefit.
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Well, for as crazy as it may sound, I think I'm going to buy another 5 pens carton of Insuline Glargine cause I'm still hoping it is because the insulin is not good; don't know if you remember - I can't find that post right now- but a couple of weeks ago the brand new carton was left on the heat for 15-20 minutes and since I started using the new pen, Micio's numbers are higher and don't seem to respond well even to the recent .5u increase. The insulin doesn't appear cloudy but neither completely clear.
Is insulin suppose to be 100% clear like water or a slightly "tinted" (just enough so you can see it inside the syringe) ? Please remind me, how long unopened insulin can be good if kept on the fridge?
And if it won't work then I'll have to try Levemir.
 
MICIO&Simone said:
Please remind me, how long unopened insulin can be good if kept on the fridge?
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If in the fridge, until the expiry date. Here is the post where you asked the question about pens being left out on the way home. The insulin is supposed to be good for 28 days out of the fridge. People taking insulin keep their in use pen out of the fridge. I don't think the 10-15 minutes extra time to get home would have hurt the insulin that much.
 
MICIO&Simone said:
Well, for as crazy as it may sound, I think I'm going to buy another 5 pens carton of Insuline Glargine cause I'm still hoping it is because the insulin is not good; don't know if you remember - I can't find that post right now- but a couple of weeks ago the brand new carton was left on the heat for 15-20 minutes and since I started using the new pen, Micio's numbers are higher and don't seem to respond well even to the recent .5u increase. The insulin doesn't appear cloudy but neither completely clear.
Is insulin suppose to be 100% clear like water or a slightly "tinted" (just enough so you can see it inside the syringe) ? Please remind me, how long unopened insulin can be good if kept on the fridge?
And if it won't work then I'll have to try Levemir.
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I hope it will make a difference. It may be that he just needs an increase and I see that you have increased to 9.5 so I hope he will do better on that dose. Still, I think his mostly blue numbers are not bad. A lot of people would love to have mostly blues. I think you are doing a great job caring for Micio! Good work.
 
MICIO&Simone said:
Well, for as crazy as it may sound, I think I'm going to buy another 5 pens carton of Insuline Glargine cause I'm still hoping it is because the insulin is not good; don't know if you remember - I can't find that post right now- but a couple of weeks ago the brand new carton was left on the heat for 15-20 minutes and since I started using the new pen, Micio's numbers are higher and don't seem to respond well even to the recent .5u increase. The insulin doesn't appear cloudy but neither completely clear.
Is insulin suppose to be 100% clear like water or a slightly "tinted" (just enough so you can see it inside the syringe) ? Please remind me, how long unopened insulin can be good if kept on the fridge?
And if it won't work then I'll have to try Levemir.
Click to expand...

I hope that its just the pen. I had a pen go bad, even though I followed all rules to prolong. Even the smell began to get lighter. Once I opened up a new pen and 2 cycles later, Ares was back in business.
Good luck!:bighug:
 
Ashleigh & Ares said:
I hope that its just the pen. I had a pen go bad, even though I followed all rules to prolong. Even the smell began to get lighter. Once I opened up a new pen and 2 cycles later, Ares was back in business.
Good luck!:bighug:
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I'm seconding that one. Had to put Whiskey back onto Lantus recently, and even though the insulin I had left over wasn't cloudy, her numbers did not start improving until I got a new vial of. Lantus.

The original was 6 months old and lived in the fridge all that time with the exception of a few minutes at shot times.
 
Well, for as much as I wanted to blame the insulin, I'm afraid mouth infection is coming back... numbers dropped down to the 80's tonight, does this mean the insulin is ok and working? @Wendy&Neko , today I felt the bump on Micio's jaw is changing again and getting bigger, bumpier. Not sure what the dentist would do this time, probably another type of antibiotic but a third surgery will be out of questions.
Lately, I also noticed Micio's multiple skin growths gotten much bigger and are filled with this nasty sebo/oils/blood and are continuously erupting so I have to manually express them but they will quicly fill up again...poor Micio, he's soo tired of me constantly tormenting him :( Vet says surgical removal would be only option.
Also, I noticed his nails are bigger/thicker than what they used to, is that age related or Acromegaly?
 
Looks like the insulin is working.:D

Sorry about the jaw bump, hoping a different antibiotic will help. Thicker nails is a common acro comment, but also just in older cats. I wonder if a vet dermatologist would have any thoughts on the skin bumps. I had an older cat have a couple skin growths removed and they were small enough the vet could do them under sedation, not anaesthesia.
 
Oh Simone, I am so sorry to read this about the jaw and skin lumps. Poor Micio. That’s a good idea about a veterinary dermatologist. Have any of those lumps ever been biopsied or had any cell samples looked at by a pathologist? I know that they biopsied and examined the jaw and found no cancer.
Darcy’s nails had gotten very thick. He was an acro cat but not really old.
 
Suzanne & Darcy said:
Oh Simone, I am so sorry to read this about the jaw and skin lumps. Poor Micio. That’s a good idea about a veterinary dermatologist. Have any of those lumps ever been biopsied or had any cell samples looked at by a pathologist? I know that they biopsied and examined the jaw and found no cancer.
Darcy’s nails had gotten very thick. He was an acro cat but not really old.
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We have been focused on the mouth/jaw infection sice last december that we put aside the skin issues; I brought to my old vet's attention as soon as they started appearing over a year ago but she always said "no worries, they're not a problem and no biopsies needed". The new vet also said they're just sebaceous cysts/growths and could also be removed with local anesthesia but the initial shot would sting/hurt him and Micio has been through a lot lately so I put that aside. But just in the last couple of weeks these skin tags went out of control, I describe them as a "vulcano that erupts and the lava keeps coming out. I may consider a dermatolos
 
MICIO&Simone said:
We have been focused on the mouth/jaw infection sice last december that we put aside the skin issues; I brought to my old vet's attention as soon as they started appearing over a year ago but she always said "no worries, they're not a problem and no biopsies needed". The new vet also said they're just sebaceous cysts/growths and could also be removed with local anesthesia but the initial shot would sting/hurt him and Micio has been through a lot lately so I put that aside. But just in the last couple of weeks these skin tags went out of control, I describe them as a "vulcano that erupts and the lava keeps coming out. I may consider a dermatolos
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:bighug::bighug: Yes, you have had a lot of conditions to juggle with Micio, and you have to prioritize. I understand. You’re such a good mama to Micio.
 
UPDATE: very stressfull day for Micio yesterday: I had to drop him off at the dentist for the day because of the swelling on his left botton side and again but at least he got to be seen by the dentist; still, Dr. doesn't know why this abscess keeps happening, we started Micio on Clindamycin capsules (2x .25mg every 12 hours = 100 mg per day) and hopefully no side effects this time.
Fingers cross this antibiotic will work better.
 
MICIO&Simone said:
UPDATE: very stressfull day for Micio yesterday: I had to drop him off at the dentist for the day because of the swelling on his left botton side and again but at least he got to be seen by the dentist; still, Dr. doesn't know why this abscess keeps happening, we started Micio on Clindamycin capsules (2x .25mg every 12 hours = 100 mg per day) and hopefully no side effects this time.
Fingers cross this antibiotic will work better.
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Oh, I hope so. That poor, sweet boy. Did he not tolerate it well last time? I am trying to remember. I do recall his antibiotic being changed though. Hugs to you. Is he still eating all right?
 
Suzanne & Darcy said:
Oh, I hope so. That poor, sweet boy. Did he not tolerate it well last time? I am trying to remember. I do recall his antibiotic being changed though. Hugs to you. Is he still eating all right?
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Back in December last year he started with mouth infections: a Dr. at the ER had me give him a liquid form od Clindamycin but Micio got so sick from it I had to take him bacl the morning after and give Micio a Convenia shot (which he well tollerated). Then infection occur again and my old vet prescribed another antibiotic (don't recall which one) but it wasn't doing anything and finally, in February I started taking him to a board certified dentist and got the first surgery done and add another antibioti. Then abscess occur again and we tried Veraflox antibiotic twice but didn't work neither and now we're trying with Clandimycin again but in a cpsule form so hopefully, by not tasting it, he won't get sick from it...so far so good!
Micio has been on so many and so much antibiotics since last December I can't even count anymore. Because I've been giving him very good pre+probiotics for long time now, I think it's helping him tremendously to go through all this: despite this, stools are good and his appetite is great, he totally lives for food and all of the attentions I give him:D. He's such a fighter and a very good boy, but he's tired of all of these in and out vet's trips.
 
MICIO&Simone said:
Back in December last year he started with mouth infections: a Dr. at the ER had me give him a liquid form od Clindamycin but Micio got so sick from it I had to take him bacl the morning after and give Micio a Convenia shot (which he well tollerated). Then infection occur again and my old vet prescribed another antibiotic (don't recall which one) but it wasn't doing anything and finally, in February I started taking him to a board certified dentist and got the first surgery done and add another antibioti. Then abscess occur again and we tried Veraflox antibiotic twice but didn't work neither and now we're trying with Clandimycin again but in a cpsule form so hopefully, by not tasting it, he won't get sick from it...so far so good!
Micio has been on so many and so much antibiotics since last December I can't even count anymore. Because I've been giving him very good pre+probiotics for long time now, I think it's helping him tremendously to go through all this: despite this, stools are good and his appetite is great, he totally lives for food and all of the attentions I give him:D. He's such a fighter and a very good boy, but he's tired of all of these in and out vet's trips.
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Yes. Clindamycin is the best antibiotic usually for any oral bacterial infections. But it is horribly bitter and will make them drool and foam at the mouth. I would never do liquid. I recently finished a course of clindamycin in one of my cats and I put the tablets into gelatin capsules just to make sure she would not taste it at all when I pilled her. I hope this will really help Micio now. Will this be a long term course of antibiotics, do you think?
 
MICIO&Simone said:
….stools are good and his appetite is great, he totally lives for food and all of the attentions I give him
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This sounds like he is very happy and has good quality of life. He just doesn’t like the vet visits. I’m glad he’s tolerating the capsules every 12 hours so far! Good news!
 
Suzanne & Darcy said:
Yes. Clindamycin is the best antibiotic usually for any oral bacterial infections. But it is horribly bitter and will make them drool and foam at the mouth. I would never do liquid. I recently finished a course of clindamycin in one of my cats and I put the tablets into gelatin capsules just to make sure she would not taste it at all when I pilled her. I hope this will really help Micio now. Will this be a long term course of antibiotics, do you think?
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I've been given 40 x 25mg caps (Micio has to have 4 caps per day) for the next 10 days for now in order to see if he could tollerate, after that I believe the Dr. said he'll like to continue for a couple of weeks (would talk to the dentistry team on Monday to see how things are going and go from there). So far Micio seems ok, did not altered his great appetite; stools were already a bit softer so I will switch to stronger antibiotics ( "Adored Beast- Gut Soothe" is great in this instance ). His BG's have also been a bit better now, wonder if antibiotic may be playing a role already?! Fingers cross...
 
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