Considering that 62 on 8/16, I would drop his dose to 8.5U for now. Wendy will stop by later to advice whether a further reduction is needed.
Thank you, I'll remember that going forward.Hi Gabrielle when posting on the Lantus board you would post your title like this
8-21 Max AMPS -127 then whatever you want to say. You can add the rest of his tests if you want to
We do a new post everyday so tomorrow would be 8-22 Max AMPS
If you post tomorrow copy your previous thread which would be today's and paste it on your new thread
Max is a cutie
Thank you so much for the very helpful info! I'll pick up Weruva and/or Soulistic and see how he gets on with it. It has been a challenge finding a diet that works for both kidney disease and diabetes, that's for sure. One of the biggest obstacles with his diet is that he just isn't very keen on wet food, he never has been, so we're working on that.Hi Gabrielle! Welcome to the Lantus forum. I'm so sorry that your kitty has acromegaly, but Wendy is one of the moderators here and she has a lot of experience with it. We have several other members whose cats are acrokitties or whose cats are getting high doses of insulin, so you've found a really good community of kind and generous people.
One of the most important bits of advice given to new members here is to start your cat on low carb wet food. This change alone often helps cats into diabetic remission. My cat also has kidney disease in addition to her diabetes and her kidney disease is now diet controlled without resorting to prescription or commercial high carbohydrate renal diets. Many caregivers here feed their CKD cats foods from Weruva and Soulistic, both of which you can get at Petco, and many of them are low in phosphorus. You can also get phosphorus binders to add to low carb food. My cat also has gastrointestinal disease, so I've opted to feed her a low carb, low phosphorus raw diet that has lowered all of her kidney values dramatically in a matter of 6 months. I know this is not necessarily in the cards for all kitties, especially acrokitties, so it's a question of experimenting to see what works.
Since you're already working with an internal medicine specialist I'm sure you've gone through the options of how to manage Max's diet, but both the diabetes and the kidney disease can be managed with low carb food without privileging one condition over another.
Another important aspect of how we manage insulin dosing and low glucose events is through the feeding of a combination of low carb, medium carb, and high carb foods. Having these different combinations of carb content on hand helps us help you steer Max's glucose levels so that he can get the most insulin in him while also keeping him safe. Once you get a handle on how the forum works, you'll be able to understand a bit better how it all works.
Hang in there, and let us know if you have any questions or need more help.
Hi Wendy. Yes, he has been diagnosed with both Cushing's and Acromegaly, along with hypertrophic cardiomyopathy and kidney disease. Regarding his diet, the Internist vet has advised to lean more towards a diet benefitting his kidneys since we can treat the diabetes with insulin but we can't reverse damage to the kidneys. Unfortunately, Max flat out will not eat wet food that doesn't contain fish. He's never been keen on wet food and the Wellness Chicken & Herring, while higher than ideal in phosphorous, is one of the only wet foods he'll eat without a lot of coaxing (he loves FF, but that's way too high in phosphorous). I'll definitely check out the brands Katherine mentioned and look into a phosphorous binder.
Thank you so much!
You are welcome, take a look at the other list also
Thank you, so is Tyler! I'm a sucker for a ginger tom and have one of my own.Wanted to tell you that Max is a handsome boy , good luck with everything
The specialist did mention hypophysectomy but quickly disregarded it as there isn't anywhere nearby that performs the surgery. We discussed SRT, but after speaking with an oncologist it was deemed too risky due to Max's obstructive HCM and kidney disease. They felt the dye from radiation mapping may be too much for his kidneys. Ultimately, due to his age and other health conditions, and the lack of data on treating a small animal with both Cushing's and Acromegaly, we have decided not to undergo any invasive procedures. The cost for SRT is $8000, and if he was otherwise in good health we would give it a shot. I do plan on asking the vet about cabergoline on Monday. She mentioned a medication previously but said it was very cost prohibitive and there wasn't enough long-term data on it yet.
I don't think there is dye used for SRT radiation mapping - mapping is done via CT Scan. Neko had SRT twice at Colorado State University. The folks at NCSU are also really well regarded for SRT. However, I can see how they might think the repeated anaesthesia would be too much for his heart/kidneys. Neko did have early stage kidney disease for her second SRT. She had an echocardiogram/cardio vet consult and complete blood work first, to see if she could handle it.
Do you know what his phosphorus levels are? It’s usually not a good idea to start a binder until the P is over 6; the best approach is to stick with as low a P diet as you can get that is also, for the diabetes, lower in carbs. Keep in mind that you don’t need a super low carb diet. We’ve found most diabetic cats do better with carbs in the 6-10% range so that might open it up a bit more for you. Unfortunately, most foods with fish are higher in P but I would not recommend feeding a higher P food fish diet and adding binder if his P levels are not over 6. Binders can cause constipation and the best one, aluminum hydroxide, could potentially result in aluminum toxicity if you are giving it for a really long time. Hard to say what that might be for him so best to not use it until you have to.
Hi there!
I just wish the raw wasn't so darn expensive. I'll explore this further, though. Thank you!
The oncologist we spoke with did say she would need to use contrast dye for mapping during the CT scan as the pituitary gland is so small. Yes, we were surprised it took so long for the DM to develop. Max certainly marches to the beat of a different drum, though.
Hello and thanks! He had bloodwork done yesterday and his phosphorus levels were within the normal range, though I don't know the exact number. The specialist he sees said everything looked good (Creatinine and BUN both in the high normal range), CBC, thyroid and cortisol also normal. His Pancreatic level is increased, though, and we suspect he may have pancreatitis as he's not eating quite as much suddenly. The vet said she usually doesn't recommend a binder unless the CKD is in the later stages.
Hi! I had a look for Weruva while at PetSmart today but they don't carry it. I'll have a look at Petco as someone else mentioned they stock it.
Hi Suzanne! I'm so very sorry to hear about the loss of your sweet Darcy. My heart goes out to you.
Yes, unfortunately PetSmart does not carry it. Bums me out because PetSmart is literally a 2 minute drive, and PetCo is 20. But I did like that I could get a bunch of different flavors to test rather than having to buy a whole case from Chewy or PetCo online. I bought so many from PetCo in the last few months I had $10 off in rewards...
It doesn't have to be costly if you can make your own. EZ Complete can be expensive alone, but if you buy supermarket meats (vacuum sealed, not in the styrofoam or plastic trays), stick to inexpensive cuts like chicken, turkey, beef, and pork, and grind it yourself, it doesn't have to be expensive. I buy pre-ground boneless meats from a pet food purveyor and they ship it to me frozen. Even with the shipping I spent about as much as I would on Weruva for two cats each month. It comes out to be more if I buy more "exotic" meats like venison and bison. I wrote a condo about raw feeding in the Think Tank forum that might be good for you to read and think about: https://www.felinediabetes.com/FDMB/threads/raw-feeding-senior-kitties.248460/
Alot to unpack here. First, kittens’ values are also in the normal range which means at, Antech Lab, for example, it goes up to 8. A cat with CKD should not be above 4.5 so her saying it is in the “normal” range could be very problematic. I had a vet tell me this on my first CKD not understanding about the kitten values included and my cat’s P was at 7. No wonder he felt horrible and, consequently, I didn’t know to do anything to get the P under control.
Amen!
