3/8 Doodles AMPS 270 +3.5 248 +6.5 246 PMPS 244 + 3.5 270

[julie & punkin (ga)]

Hi Karen, just wanted to offer you a little extra support. Nothing is harder than feeling like you've tried everything but nothing is working.

Couple of thoughts . . . As Judy pointed out, Doodles did this same dose game in 2015. Was he eating dry food when he was on the 3+ unit dose last year, or was he already on canned food?

Like Wendy, I think it's important to be close to a good L dose before adding R into the mix. You don't sound eager to try it at this point anyway, but I just thought I'd throw it out there.

Every cat has a dose that will move them, it's just a matter of getting to it. It sounds like your vet is controlling your dose increases, but holding a dose too long only means that you get the dreaded glucose toxicity going, and that leads to even larger doses. My guess is that your vet hasn't got experience with higher dose cats and she has the idea that all diabetic cats should be able to be regulated on less than 2u. Am I right on that one? Is she dismayed, disbelieving that Doodles might possibly need more than a small dose?

You've done an awesome job of trying to look at all the potential reasons for his dose to be increasing. I think the next step is considering some different dosing strategies as I've mentioned above and seeing if that makes a difference.

by the way, I always warmed up the syringe for a minute between my fingers as well. Punkin never flinched from the Lantus, even though he got to 15.5u per shot. But cats vary on this.

 

[Wendy&Neko]

I'm assuming this is the link/test I have to give her for testing... https://www.animalhealth.msu.edu/Bin/Catalog.exe?Action=Test&PAGE=11&Id=1401

Yes, that is the correct test for acromegaly. I'm not saying I'm thinking Doodles has acromegaly (though one in four diabetic cats do), but getting the test done for it and IAA would provide peace of mind. Your vet does the blood draw and it's sent to MSU. It's cheaper to do both tests at once.

Here is the link for the test for IAA: insulin auto antibodies.

 

[Doodles & Karen]

Your vet does the blood draw and it's sent to MSU. It's cheaper to do both tests at once.

Thanks Wendy, I have both links. We go back to the vet on Monday and will let her know we want the test done for piece of mind.

 

[Marje and Gracie]

The only other thing I can think to do right now is another ultrasound to see if anything is potentially brewing intestinally but that's also more $$$.

 

[Doodles & Karen]

Was he eating dry food when he was on the 3+ unit dose last year, or was he already on canned food?

He was eating mostly dry, DM, then EVO and ended up with YA but always giving wet too to try and make the transition. He's much better now at eating the wet food than ever.

your vet hasn't got experience with higher dose cats

We just switched to this one a few weeks ago after I told them we were leaving their practice. At least she does know lantus but I mentioned Acro and she admitted she doesn't know anything about it.

You don't sound eager to try it at this point anyway

I'm not, it scares me even realizing many use it successfully. Eventually I may have to bite the bullet but just not there yet.

If I were you, I would increase every 4-6 cycles until you're seeing some green numbers again

I reluctantly held the 3.5 units because of the "what if's" at play. We'll go up to 4 units tomorrow since we held the 3.5 for too long (almost did that last night instead of 3.75) Although he's show 200's on the human meter which is what we use for the protocols we all know he's over 300 on AT.


Thank you for visiting and offering advise.

 

[Doodles & Karen]

do right now is another ultrasound

Thought about it but it doesn't tell you much without the biopsy and I won't do that to him again. His platelets are super low. However, the ultrasound will show signs of HCM. His CPK was highly elevated. Neither vet is concerned about it but it's still in the back of my mind. There is no cure and basically he'll pass of heart failure if he has it. For now we're just going to keep going up in dose.

 

[Marje and Gracie]

Thought about it but it doesn't tell you much without the biopsy and I won't do that to him again. His platelets are super low. However, the ultrasound will show signs of HCM. His CPK was highly elevated. Neither vet is concerned about it but it's still in the back of my mind. There is no cure and basically he'll pass of heart failure if he has it. For now we're just going to keep going up in dose.

I also wouldn't do a biopsy ...I totally agree....but, they could see if there is any additional intestinal thickening or if lymph nodes changing, etc.

There is a lot that can be done for HCM depending on where they are with it but, of course, it usually entails pills...not so good for Doodles. I had a kitty with it and kept him stable for many, many years. He did not pass away from it.

 

[Wendy&Neko]

However, the ultrasound will show signs of HCM. His CPK was highly elevated. Neither vet is concerned about it but it's still in the back of my mind. There is no cure and basically he'll pass of heart failure if he has it.

There are medications that can help with HCM. I had a kitty pass from it - two days before his scheduled echocardiogram. It was actually blood clots, not the enlarged heart. Blood thinners can help. One person here had her kitties heart meds compounded into liquids - tuna flavored, he loved it.