? 2/6/20 Stasiu PMPS 387

[JoannaDV1]

I am about to give up! I was feeling pretty good a few weeks ago when I was giving Stasiu 11U BID and seeing really good numbers. I decided to go to 12U to see if this would be the final push to get our numbers lower....wrong! The numbers went high again, so I decided to go to 11.5U, now back to 11U. I have no idea what to do now- go up again? Stay at 11U for a few more days? And, to top it all off- I gave my first fur shot this evening. We have been enduring this process for 5 months now and feel like our efforts are not working at all- upsetting, to say the least. Suggestions of how to handle this would be great!

Also, my vet talked me out of testing for high dose diseases since I wouldn’t treat him any other way and, at this point, he most likely has “something.”

 

[tiffmaxee]

Have you considered switching to Levimar? That has helped some here.

 

[Wendy&Neko]

I am sorry your vet talked you out of the high dose condition testing. That information also helps with dosing decisions. And if by some chance he has acromegaly, I know you said you wouldn’t treat, but several people here have had good luck with a drug called cabergoline. It’s not expensive, and with many of the cats it helps alleviate side effects, and also reduce the dose. We have even see cats go OTJ on it.

As for your current dose, it would really help if you did a couple things. First, always, and I mean every single time, do a blood test before shooting insulin. High dose cats numbers can be erratic and the preshot test tells you if it’s safe to give insulin. Next, we detemine how to change the dose based mostly on nadirs, we don’t change based on preshot values. With the dosing methods we use here, we find it easier if you consistent dose unless either they earn a reduction, or it’s time for an increase. Changing the dose around can cause wonky numbers as the depot is not stable. You weren't on 12 units long enough for the depot to stabilize. You need to hold the dose at least six cycles, unless a reduction is earned. Your signature says TR, which is a good dosing method for high dose cats, but TR is more aggressive, and with that there is a requirement for a minimum of two tests per cycle.

Stasiu does seem rather bouncy, but it’s hard to say why, as there are so many cycles without data. Sorry to sound so repetitive about testing, but the number one cause of death of high dose cats is a hypo. By the nature of what could be causing the insulin resistance, dose needs can change, both up and down.

 

[JoannaDV1]

I am sorry your vet talked you out of the high dose condition testing. That information also helps with dosing decisions. And if by some chance he has acromegaly, I know you said you wouldn’t treat, but several people here have had good luck with a drug called cabergoline. It’s not expensive, and with many of the cats it helps alleviate side effects, and also reduce the dose. We have even see cats go OTJ on it.

As for your current dose, it would really help if you did a couple things. First, always, and I mean every single time, do a blood test before shooting insulin. High dose cats numbers can be erratic and the preshot test tells you if it’s safe to give insulin. Next, we detemine how to change the dose based mostly on nadirs, we don’t change based on preshot values. With the dosing methods we use here, we find it easier if you consistent dose unless either they earn a reduction, or it’s time for an increase. Changing the dose around can cause wonky numbers as the depot is not stable. You weren't on 12 units long enough for the depot to stabilize. You need to hold the dose at least six cycles, unless a reduction is earned. Your signature says TR, which is a good dosing method for high dose cats, but TR is more aggressive, and with that there is a requirement for a minimum of two tests per cycle.

Stasiu does seem rather bouncy, but it’s hard to say why, as there are so many cycles without data. Sorry to sound so repetitive about testing, but the number one cause of death of high dose cats is a hypo. By the nature of what could be causing the insulin resistance, dose needs can change, both up and down.

I always appreciate feedback. Unfortunately, my husband will not do glucose testing when I work 12 hour shifts prior to Stasiu’s evening dose. In 2 weeks, I start a new job and will always be able to get a preshot value. What that also means is that I will not be getting values post- insulin shot during the day when I work, just a value post evening shot before bed. On the weekends, I can get more numbers.
Stasiu has now had 5 doses of the 12U and numbers barely budge- they are practically the same and high 4 hours after his dose is given. Not sure how to handle this- he seemed to be doing well on 11U....do I go back or keep going up? What’s the max dose of Lantus a cat should be given? We are so incredibly high right now, not sure this is the right thing to do! And he continues to be so ravenous with his appetite- he’s always in my kitchen cabinets and has even learned to open the cabinet where we throw our trash.

 

[Judy and Freckles]

And he continues to be so ravenous with his appetite- he’s always in my kitchen cabinets and has even learned to open the cabinet where we throw our trash.

Hi Joanna. We can relate regarding the ravenous appetite. We have put baby safe latches on all the cupboards that Freckles can open, a baby latch on the garbage and the garbage can is bungee strapped so she can't tip it over. It has been an interesting ride, to try and outsmart a 'starving' cat but with the automatic feeder giving her snacks throughout the day, and getting her numbers lower, her appetite has decreased (let's just say, I'm not worried about waking up to the possibility of her gnawing on my arm now! lol)

I am awaiting acro and IAA results that were done about 1 week ago. My vet did not offer or even suggest these tests, but due to the experienced people on this forum, I learned that knowing a bit more what is or is not going on with Freckles would help us with this sugar dance.

 

[Wendy&Neko]

What’s the max dose of Lantus a cat should be given?

The dose that causes them to go into dangerous low numbers. There is no max number on this, as long as a cat has safely reached that dose. A cat needs however much insulin they need. We have seen cats on 80+ units, but those are cats that we know have a high dose condition.

 

[Wendy&Neko]

Regarding dose, you should be holding each dose at least six consecutive cycles, to fill the depot. Unless a reduction is earned. Reduced doses or furshots deplete the depot and then you cannot see how that dose is doing, I only see four shots in a row at 12 units. Hold the dose a couple more cycles at least, longer if you see blue.