From yesterday's conversation:
Is there a protocol for starting this type of insulin (like with starting doses and anything else I can read about)? Is this something I could talk to my general vet about or would this be for a specialist?
Unfortunately, not a protocol for how to use R. Basically we find someone(s) experienced with R to "sit" on line with you the first few times to teach you about it. There is lots to learn about when to use R, and when not to use it. Starting dose is pretty small, though with his size of Lantus, I'd probably start at 0.5 units. I've seen one other cat on 30 units of Lantus respond well to just 0.5 unit of R. But also seen cats need quite a bit more. It's really ECID. Start low and work your way up based on data you gather.
As far as general vet or specialist, it depends on your general vet. The general vet probably has experience with using R - it's often used in cased of DKA or other emergencies. It's an in and out insulin so good for short term use that responds quickly. You don't have to wait for a depot to build. Most people here haven't gone to a specialist to start using R.
If your vet is one that needs to see it in paper, here is some information:
Acromegaly in 14 Cats by Mark E Peterson, Deborah S. Greco, John F. Randolph, Scott D. Moroff, Clinton D. Lothrop
Journal of Veterinary Internal Medicine, Volume 4, Issue 4, Feb. 2008
http://onlinelibrary.wiley.com/doi/10.1111/j.1939-1676.1990.tb00897.x/pdf
Although this is an older article, it has a good description of what is happening inside the acromegalic cat, including symptoms and X-rays and CT scans. It also mentions the use of the shorter acting insulin R in managing the cat's diabetes.
What new food did you try with him? Love to hear he's feeling good.
I'm always on the hunt for a non fish food for miss pickypants.