4/3 Gumung amps 482

Dkshin89 said:
He looks like he is bouncing today too. @+2.25 412
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Looks like it. Get one more test around +6/+7 and take a break from tests till PMPS. This is cycle 6 of the bounce. Unless you see low blues or green tonight, he is good for an increase to 6U from tomorrow.
 
tiffmaxee said:
Are you following TR?
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Yes, but my vet is confused why he need this much of insulin too. Vet recommended to visit internalist to do ultrasound and see if there is any problem. With his recent blood test nothing really came up though.
 
Bandit's Mom said:
Looks like it. Get one more test around +6/+7 and take a break from tests till PMPS. This is cycle 6 of the bounce. Unless you see low blues or green tonight, he is good for an increase to 6U from tomorrow.
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Yes, it does looks like he need to bump up a little. :(
 
Dkshin89 said:
@+5 385
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Quite flat. Take a break till PMPS.

Dkshin89 said:
Yes, but my vet is confused why he need this much of insulin too. Vet recommended to visit internalist to do ultrasound and see if there is any problem. With his recent blood test nothing really came up though.
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When a cat gets to 6U, we recommend that they test for secondary conditions that can cause insulin resistance like Acromegaly and Insulin Auto Antibodies.
https://www.felinediabetes.com/FDMB...-other-high-dose-conditions-what-we-know.375/

@Wendy&Neko
 
A cat needs as much insulin as it needs. Please add TR to your spreadsheet and signature. We have to see if we can break through insulin resistance or if he has other conditions. Give it a little more time since he only started Lantus in February.
 
I think Gumung needs an increase to 6.0 units tomorrow, unless you see green tonight.
Dkshin89 said:
Yes, but my vet is confused why he need this much of insulin too. Vet recommended to visit internalist to do ultrasound and see if there is any problem. With his recent blood test nothing really came up though.
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There are several cats here on doses higher than Gumung's dose. Just keep following the TR protocol and you will find a dose that works for Gumung. There are some secondary conditions that cats can have that mean they need more insulin that others. First, how are Gumung's teeth? Has the vet ever mentioned that he might need a dental? That is one condition that can make it hard to regulate a cat. After than, I don't think an ultrasound is the best next step.

As Bhooma mentioned, when cats get to six units, we recommend that they get bloodwork done to test for two secondary endocrine conditions. They are called acromegaly (test is IGF-1) and is a result of a benign tumour on the pituitary that secretes excess growth hormone. Often these kitties are extra hungry - think of growing teenagers! Recent studies have shown about 25% of diabetic cats have this condition. The second condition, insulin auto antibodies, or IAA, can be though of like an allergic reaction to the injected insulin. Over time this condition will go away, but does make it harder to regulate the cat. My girl Neko had both of these conditions, so feel free to ask questions about them.

The blood for both of these tests is sent to Michigan State University for diagnosis. However, it is not recommended that you get testing done for acromegaly until at least 73 days after the cat starts on insulin, as there can be some false negatives in up to 1/3 of the cats who ultimately test positive. Since Gumung started insulin on January 25th, that's only 68 days from my count, so I'd hold off a week before contacting the vet to get those tests done.
 
Bandit's Mom said:
Quite flat. Take a break till PMPS.


When a cat gets to 6U, we recommend that they test for secondary conditions that can cause insulin resistance like Acromegaly and Insulin Auto Antibodies.
https://www.felinediabetes.com/FDMB...-other-high-dose-conditions-what-we-know.375/

@Wendy&Neko
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I should talk to vet again if he can do acromegaly test and insulin auto antibodies. I am quite sure current vet will keep suggesting meeting with internalist, but will talk to him and if not, I have to find another vet who is more comfortable with cat diabetes. He have never seen a cat needing more than 2 unit of insulin.
 
tiffmaxee said:
A cat needs as much insulin as it needs. Please add TR to your spreadsheet and signature. We have to see if we can break through insulin resistance or if he has other conditions. Give it a little more time since he only started Lantus in February.
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Can insulin resistance happens if owner and vet didn’t use insulin aggressively? For example, when I was introduced with Lantus @Feb (when vetsulin didn’t work) by current vet, he didn’t mention to do curve nor he did it in the vets office. So for 3 weeks, I was blindly have given two units of insulin without any tests. After three weeks ( continue with same symptoms like drinking a lot of water, excessive urine, hunger) he asked me to bring him to do another fructosamine test, which was high. From then, he kept suggesting me to see internalist (appointment in 4/25th)
 
Wendy&Neko said:
Often these kitties are extra hungry - think of growing teenagers!
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Oh man, he’s better with drinking water, not much so, but he is still hungry. I am now afraid that he might have a tumor.

Vet said that his teeth are fine other than bit yellow, and also gums are bit red, but nothing serious.
Might have to contact vet soon to find out if he does those tests in his office. He doesn’t seem to know well with cat diabetes where he is in shock that Gumung needs more than 2 unit of lantus.
 
Dkshin89 said:
I am now afraid that he might have a tumor.
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It is a benign and slow growing tumour. There are also treatments for it should that be what he has. :bighug::bighug:

Red gums means he at least needs a cleaning if not more. If he hasn't had a dental, you might want to talk to the vet about getting one done. Needing a dental is one of the main reasons we see cats hard to get regulated here.
 
Neko's vet only used Caninsulin (same as Vetsulin) and Neko got up to 5 units of Caninsulin before we switched. She had another cat on higher doses of Vetsulin at the time. Turns out he also had acromegaly. But I had to convince vet to run the tests as she thought it was some rare condition. They she realized the other cat had it too. I just think your vet doesn't have much experience with people treating diabetic cats.
 
Wendy&Neko said:
It is a benign and slow growing tumour. There are also treatments for it should that be what he has. :bighug::bighug:

Red gums means he at least needs a cleaning if not more. If he hasn't had a dental, you might want to talk to the vet about getting one done. Needing a dental is one of the main reasons we see cats hard to get regulated here.
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I see, I will have to talk to vet to get dental done soon. Hopefully that was the reason for him to have insulin resistance. :banghead:
 
tiffmaxee said:
I bet your vet hasn’t used Lantus much and used vetsulin and that’s why he’s never given more than 2 units.
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Actually, he was the second vet who introduced me to lantus. I came to him because other vet suggested vetsulin and didn’t even want to know how he was doing after 3 weeks… Its so hard to find a trustworthy vet…
 
Wendy&Neko said:
Neko's vet only used Caninsulin (same as Vetsulin) and Neko got up to 5 units of Caninsulin before we switched. She had another cat on higher doses of Vetsulin at the time. Turns out he also had acromegaly. But I had to convince vet to run the tests as she thought it was some rare condition. They she realized the other cat had it too. I just think your vet doesn't have much experience with people treating diabetic cats.
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Yes, I also think that he doesn’t have lot of experience with diabetes cats. He also mentioned that cat diabetes should not be this complicated while other he treated when to remission. :arghh:
 
Dkshin89 said:
Actually, he was the second vet who introduced me to lantus. I came to him because other vet suggested vetsulin and didn’t even want to know how he was doing after 3 weeks… Its so hard to find a trustworthy vet…
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So agree. I worry that the vet I trust might retire soon and so far no replacement I trust. The ones that might be ok aren’t taking new clients.
 
tiffmaxee said:
So agree. I worry that the vet I trust might retire soon and so far no replacement I trust. The ones that might be ok aren’t taking new clients.
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Oh no, I feel you, could your current vet referral to other cat vet that he knows?
I have been calling other vets who can be trusted with more familiar with cat diabetes. But seems like I meeting with new vet is another journey. I have to start from the beginning, diagnose, blood test again, and talk to vet…
Just wish to find out what’s holding my cats bg high, no matter how much they asks me to pay.
 
Unfortunately no. I don’t trust the other vets in his practice. One pierced Max’s bladder when he blocked and I nearly lost him. Major surgery. Another missed cancer on one cat and bad calls with Max. :(
 
tiffmaxee said:
Unfortunately no. I don’t trust the other vets in his practice. One pierced Max’s bladder when he blocked and I nearly lost him. Major surgery. Another missed cancer on one cat and bad calls with Max. :(
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Oh no :( thats so sad…..
 
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