2/25 Shadow

[Christina Marie]

Shadow has been bouncing here at his 9.5U. I'm using the SLGS method because of work constraints, so when we initially started him at 9.5 and he hit the low dark greens, he got a dose decrease. I held the 9U a little longer than I should have before bringing him back up to 9.5. Now he's bouncing. I've seen everything from 180s to 450s with this second trial of 9.5. My curve day was originally set for tomorrow to work around my schedule. Does his spreadsheet look like he is possibly in for another increase or should I hold out a little longer to see if his numbers start to settle down?

Waiting to hear back from the internist about getting started on Cabergoline. She had originally given me information for a drug trial, so I had been waiting to hear back from that first. Shadow is not a candidate apparently, so now we move to our next option.

Also, someone from the Facebook group mentioned some acro parents use 2 different types of insulin sometimes to try and get numbers to stabilize? Is it possible we might be at the right dose for the Lantus and just need another faster acting insulin to help kick start the cycle? That whole process and idea elude me completely and I don't even know where to start with it

 

[Larry and Kitties]

Except for the relatively low BG on 2/19, Shadow's BGs have been relatively flat and relatively high.
Is there any explanation for the that low BG?
I use a combination of Levemir and N for my Snuffles (and di for my other aero MurrFee). I started adding N for Snuffles when he was at about 5 units Levemir and I was getting relatively high BGs with little drop. I went to Walmart ang a 10ml vial of N for about $27 and tried adding some of that. This was before Snuffles was diagnosed as aero. The N dropped BG overall and got a curve too. He is now on 5 units Levemir and about 8 units N and I started Cabergoline two month ago. His PS BGs are 100-150 and low >60 (human meter). I very the N dose.
I started the N with one unit and then added as necessary. N also helped with cost since it is cheap compared to Levemir. Most aero cats use Levemir vice Lantus since it is supposed to not stink at high dose.

 

[Wendy&Neko]

She had originally given me information for a drug trial

Do you know the name of the drug? I'm always on the lookout for other possible treatments that can help our kitties. And I wonder what the trial criteria were?

As for dosing, what an acro kitty did 3 weeks ago (last green) isn't related to what what they need now. Insulin needs can change much more quickly than that. Barring you seeing anything below 150 on a curve, it looks like he needs an increase.

As Larry said, many higher dose kitties switch over to Levemir. Not only just the sting (

not stink at high dose

), it seems to often give longer duration. A number of higher dose cats use R (Regular) insulin to supplement the L. About $25 at Walmart for Humulin R. But we recommend you only start that with the help of an experienced user as there are a number of things to learn about when to use, and more important, when not to use it. It also requires extra monitoring, so maybe only something you can do on weekends and nights. And 1 unit is too high a dose to start. I've seen a 30 unit Lantus kitty need no more than 0.5 units R. ECID. Every (high dose) cat is different.

 

[Christina Marie]

Do you know the name of the drug? I'm always on the lookout for other possible treatments that can help our kitties. And I wonder what the trial criteria were?

I am not sure the name of the drug. It is a trial being done with Anivive. We have our prescription sent in for Cabergoline and as soon as they have it for me to pick up, I will have it compounded and we will get started on that journey.

Shadow's primary vet left the office the day after we received his Acro diagnosis, so we've been working with an internist this past month to work on treatment options for that. I will have to call into his primary office and see about speaking with the new vet he's been passed to.

I feel like we're basically starting over from scratch at a pretty pivotal moment in his journey. I also just got a brand new vial of Lantus, so I probably won't switch him over until that is used up. It cost a pretty penny as I'm sure you already know.

Where would I find more information about adding in the other insulin to supplement the Lantus and eventually Levemir?

 

[Wendy&Neko]

There is an Anivive trial where you get genetic testing. Bummer you lost your primary vet. Any idea what clinic he went to?

It cost a pretty penny as I'm sure you already know.

Actually I don't know - I live in Canada where it's much cheaper and OTC. Are you getting insulin from Marks? Buying insulin from Canada, they sell both Lantus and Levemir and their markup isn't too bad.

It's really hard to use R (regular) or even N insulin when following SLGS. You have to ramp up your testing considerably initially, especially the 4 hours after shot time. It's possible you could use it just in the evenings/weekends. The nice thing about using R, is that it's completely optional. If you can't monitor, don't use it. You could see what the internist thinks. If OK, we'd try to line you up with someone experienced with R to help the first few times, until you get the hang of things. It's ECID how each cat reacts, so it's not something that we've documented. With starting carbergoline, hopefully soon, it's hard to say whether R will be a good option or not. I've seen one cat react as quickly as 10 days after starting the drug and OTJ not long after. And others that have taken a few months to start seeing reductions.