2/3 Pants AMPS 174

[Christina&Pants]

Previous Post -- Yes you read that right, switching from Lantus to ProZinc

Hi all, checking in partly just for sanity and to say hello.

Since stopping Lantus insulin, Pants has bounced back to his old self quickly, even though the gabapentin has him a little sluggish. It's the darnedest thing No idea if it was a hypersensitivity reaction or some kind of allergic reaction or what... I feel like it'd be difficult to say given all the immunosuppressants he's on.

Current status of Pants:
-Appetite and demeanor improved after stopping Lantus insulin
-Gabapentin seems sufficient to keep him eating despite hole in his gum down to the canine tooth
-Can't really perform surgery nor reduce steroid dose until bloodwork improves
-I made the right call to start up his Atopica again despite no answer from internist, his RBC is still going down but he's regenerative
-Started him on an itty bitty dose of ProZinc as of last night to try and mitigate worsening of diabetic cataracts+DKA risk
-No GI issues seen so far
-Vet is very iffy on any insulin at all at the moment, it does seem like the Lantus had a weird impact on his bloodwork -- likely due to GI symptoms
-He was okay with the 1 unit doseage for now, at least, if even that
-Adding doxycycline back -- no sign of mycoplasma, but positive experiences reported for IMHA and it should help dental issues
-potential to add darbepoetin injections, but no sourcing in Alabama -- Vet calling around

If anybody has ideas on boosting bloodwork, I'm floating everything I see to my vet and internist at this point. Fingers crossed the doxycycline helps. I'd really like to get Pants dental surgery as soon as possible before that becomes another complication.

Ordering/shipping things has been a nightmare the past few days. The ProZinc arrived on Friday, but the needles did not arrive until last night I could not find stock of U40 needles locally, but my usual pharmacy closed too early to check with them. I'm not certain why Darbepoetin doesn't ship to my state, hopefully my vet is able to find some sort of workaround. Otherwise we may be driving up to the internist or a colleague in TN once a week...

 

[Suzanne & Darcy]

-potential to add darbepoetin injections, but no sourcing in Alabama -- Vet calling around

Hi. I am reading through your message and got to this part about Darbepoetin. I buy mine from the Walmart Specialty Pharmacy. They ship all over. I am in Georgia. $219.00 includes the refrigerated overnight shipping. Their number is (877) 453-4566

 

[Suzanne & Darcy]

And they sell the Darbo as a single vial so you don’t have to buy a box of 4. One vial will contain several doses.

 

[Suzanne & Darcy]

How have his numbers been on the ProZinc today? Is he still wearing a Libre?

 

[Suzanne & Darcy]

And believe it or not, I have had people switch from Lantus to ProZinc before. Some cats don’t do well on Lantus for some reason. We were able to get the last cat who switched from Lantus to ProZinc into remission.

What was your experience with Lantus?

 

[Christina&Pants]

How have his numbers been on the ProZinc today? Is he still wearing a Libre?

Yes, he is still wearing a libre! Unfortunately I am at work and can't check his numbers at the moment, and he just had a new sensor put on this morning, but he did good on his first dose last night. Given the sensor switch and vet trip today, I stuck with the 1 unit dose. I have his reader set to alarm for any readings under 70, rigged up in front of a pet camera that will detect it, but so far so good today. I'll grab exact numbers when I get home.

With Lantus, Pants developed loose stool within a few days. Not explosive diarrhea, but anything other than normal bowel movements makes me anxious about his precarious bloodwork. FDMB recommended S Boullardi, which firmed him up, but towards the end of our second week, Pants started vomiting, began to become lethargic, and stopped wanting to eat. He developed a hole in his gumline around the same time, but I don't believe that's related.

The only thing we changed prior to starting Lantus was discontinuing Atopica 24-36 hours prior, and he had not had any GI issues with the Atopica. All of the above symptoms cleared completely after discontinuing Lantus.

Not sure what the hiccups were with the Darbepoetin, but my vet was able to find a provider to ship it to him through a human doctor he knew So that is fixed! Yippee!

 

[Suzanne & Darcy]

I haven’t had any GI issues with Atopica in my cat who takes it, but I keep it in the freezer and that is supposed to help with that. I have him down to every other day now though, since I read in the studies that is what they did with one group of cats. Another group went to twice a week, but I was not successful in that.

 

[Suzanne & Darcy]

I also have a cat who is FIV+. We hesitated to use Atopica on him because he is already on a steroid for IBD. It was Prednisolone but now is Budesonide. We have been trying to not immunosuppress him too much. He already has problems with catching something each time he goes to the vet. And he then stays ill for a long time.

 

[Christina&Pants]

I also have a cat who is FIV+. We hesitated to use Atopica on him because he is already on a steroid for IBD. It was Prednisolone but now is Budesonide. We have been trying to not immunosuppress him too much. He already has problems with catching something each time he goes to the vet. And he then stays ill for a long time.

We've been fortunate not to have any GI issues with Atopica either, I really think it was the Lantus insulin... that's what my gut is telling me. Nothing else in the timeline lines up properly with the loose stool other than ending Atopica and adding Lantus, unless it was an extremely delayed side effect of Leflunomide.

I'll have to update Pants' sheet still but it looks like he's been above 150 all day. He's at ~250 right now with 30 minutes to his usual shot time, but I expected that -- he's had a stronger appetite for his dry food today than he has for the past week or so, for some reason. Being a new sensor, and given the vet's hesitancy this morning, I'll probably stick to 1 unit for tonight still instead of increasing dose, and maybe look at increasing to 2 (our originally prescribed starting dose) in the morning

With Pants in IMHA right now, we've kind of been piling on the immunosuppressants. Fortunately other than dental issues and allergies, he's been healthy as a horse since I adopted him in Nov 2023. Never caught anything at the vet, knock on wood, but I worry it was the stress of my last kitty passing last July that prompted Pants' sudden FIP diagnosis in Sep He's always seemed like a social little guy, but I don't dare introduce a new cat into the home right now.

I try to track all his meds in their own tab on Pant's spreadsheet since it's gotten a little too difficult to capture them in the main sheet -- his meals are captured there as well.