10/26/18 Olive AMPS 207; +3.5=175; +5=146; +9=118; PMPS 198; +4=245

Olive & Paula

Olive & Paula

Very Active Member
Yesterday Cabergoline Day 21

If she stays to pattern, she should drop today earning reducie. Question is tomorrow we will not be home 10+ hrs. Will leave right after t/f/s which will be 30 minutes early. She will be set up in room for free feed and feeder.

Was thinking minus 2 units tonight and minus 2 units tomorrow morning so she gets some insulin but won't drop to low with the higher depot still active.

Don't know if I want to chance just skipping AM with 6 units on board and no one home. If I do skip AM will she be safe with the 6 units from PM, no chance of dropping to low?

Can't take her, not right to keep her in carrier in car 10+ hrs. Is not like I can run out of the service to test her.
 
Hey Olive.

Are you asking if you should do 4 units instead of 6? I've looked at your spreadsheet. She got even higher than my Emmett. Emmett got up to 7 units (he's now nursing 0.5 units).

If you're not comfortable leaving her for 10+ hours with a 6 unit dose I guess you could reduce. However, I think consistency is key for these things. Steady, increases and decreases. If the dose keeps on changing kitteh's body doesn't know how to react and I think the BG levels get outta wack.

I dunno really. If you look at my spreadsheet, I don't believe I ever skipped a dose...I was a little uncomfortable in the beginning at times and reduced like your asking, but as time went on and I learned about Emmett and how he reacts when dose is reduced or skipped I just never did it again. I am away every day of the week from about 7am-4:30pm. And yes, I was constantly worried but came home to a happy, relaxed cat. :)

She's at 207, and over the last few days 94 @ 6 units and 73 @ 6.5 units. Are you doing SLGS? I'm thinking yes. But at any rate, if it were my cat I'd probably do full dose. But do what you're comfy with.


R
 
Rob W. & Emmett said:
Hey Olive.

Are you asking if you should do 4 units instead of 6? I've looked at your spreadsheet. She got even higher than my Emmett. Emmett got up to 7 units (he's now nursing 0.5 units).

If you're not comfortable leaving her for 10+ hours with a 6 unit dose I guess you could reduce. However, I think consistency is key for these things. Steady, increases and decreases. If the dose keeps on changing kitteh's body doesn't know how to react and I think the BG levels get outta wack.

I dunno really. If you look at my spreadsheet, I don't believe I ever skipped a dose...I was a little uncomfortable in the beginning at times and reduced like your asking, but as time went on and I learned about Emmett and how he reacts when dose is reduced or skipped I just never did it again. I am away every day of the week from about 7am-4:30pm. And yes, I was constantly worried but came home to a happy, relaxed cat. :)

She's at 207, and over the last few days 94 @ 6 units and 73 @ 6.5 units. Are you doing SLGS? I'm thinking yes. But at any rate, if it were my cat I'd probably do full dose. But do what you're comfy with.


R
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Rob, she is getting cabergoline for the acro. AND it's working despite what previous vet said. We are not following any protocol now because of the treatment. Even before cabergoline we had to modify TR. We were somewhat lucky that she never got super high doses.

I guess you can say we are following cabergoline protocol. Which there are no instructions for.

My reduction point is 60 to give us a cushion. On 6.5 u she hit 55. It seems every 3rd cycle now she hits a reduction. So that means today or tomorrow AM she would hit 60 or less.
 
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Oh ic. I'm sure you covered this in other posts, but does the cabergoline not play well with the Lantus? I've heard it's hard to regulate a cat that has acro. So could she just all of a sudden dip today if you give her the dose, because of the acro/cabergoline?

Hmm, tricky.


R
 
Rob W. & Emmett said:
Oh ic. I'm sure you covered this in other posts, but does the cabergoline not play well with the Lantus? I've heard it's hard to regulate a cat that has acro. So could she just all of a sudden dip today if you give her the dose, because of the acro/cabergoline?

Hmm, tricky.


R
Click to expand...

The cabergoline is to possibly block the pituitary tumor from secreting the growth hormone which is causing the acro which in turn caused the diabetes. @Wendy&Neko did I get that right?

Preferred treatment is radiation or another medicine that is just unaffordable. Some opt for removal of pituitary gland, I couldn't put her through that. A lot of vets are told cabergoline doesn't work. For some it doesn't. There are only like 2-3 studies on it. It's a 50/50 shot it will work. I believe it's a lot safer and Olive has had no side effects. We had nothing to lose in trying. It just took 4 months of finding a vet willing to help her and give It a try.
 
Rob W. & Emmett said:
So could she just all of a sudden dip today if you give her the dose, because of the acro/cabergoline?

R
Click to expand...

She doesn't dip because of the cabergoline. She dips because the cabergoline isn't allowing the pituitary tumor to produce its insulin (which is different than a straight diabetic with no tumor). Wendy could explain it much better. It's how it makes sense to me.

Because the cabergoline does this, less outside (exogenous) insulin is needed. So at this time Olive isn't requiring the 8.5 units of levemir she was getting and still have high glucoses because the tumor isn't pumping its insulin into her (again it how it makes sense to me).
 
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With diabetic acrocats, you need exogenous insulin to combat the effects of insulin resistance caused by the growth hormone being put out by the pituitary tumour. Slowing the growth hormone output means less insulin resistance, therefore a lower dose is needed.

Paula, I like your idea of taking a couple units off the dose tonight and tomorrow morning. I used to do a smaller decrease but three cycles before as it would take that long in Neko to interupt the depot. But you are doing a larger reducie, so should be OK.
 
Wendy&Neko said:
With diabetic acrocats, you need exogenous insulin to combat the effects of insulin resistance caused by the growth hormone being put out by the pituitary tumour. Slowing the growth hormone output means less insulin resistance, therefore a lower dose is needed.
Click to expand...

Ahhh, as always, Wendy explains very well :)


R
 
Thanks Wendy, maybe I'm getting the hang of this. Ah who we kidding. I don't get it at all. I let the meter do the talking.

Ok so down 2 u tonight and tomorrow AM. I do think it will be okay. And tomorrow PM if home in reasonable shot time range it's right back to current dose.
 
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