Sorry to hear the results.


. But it did look like something was causing insulin resistance in Marvin and now you have answers. One thing someone told me when I got the diagnosis - Marvin is still the same sweet kitty he was before the diagnosis, he doesn't know there is anything different. But you do, and now you can do something about it.
We've had some caregivers quite happy with the results from Cabergoline. Side note, the first kitty here to try Cabergoline was a kitty named Marvin, and he went off of insulin very quickly. Not many cats do, but it is good to be cautious to start it when you can be home to monitor. For the cats who react well, some react within the first couple weeks, some take longer. I've seen quite the variation. Many people get it compounded (bacon marshmallow flavour is a favourite!) and just mix it in with food. Which would make it easy for others to give too.
For dosing, as long as he's seeing numbers just above 200 on a dose, increase by 0.5 units every 3 days. If he gets over 10 units, move that to 1 unit at a time. Smaller increases are needed if he's seeing some green on a dose.
R is a useful tool for both acro and IAA, but also an advanced tool. We also use it for kitties seeing ketones. But we suggest that someone use R only with an experienced R helper the first few times you use it. There is a lot to learn about using R, and most important, a lot to learn about when not to use R. We think of R as giving the Lantus an assist, a slightly lower number to work with. We don't use it to shoot down high numbers, as that can just set off a round of bouncing. Not all higher dose cats need R. I don't think you want to be using R if you are also giving Cabergoline.