Freya newly diagnosed as hyper-T but insulin dosage already an issue.

SwedishLiz

SwedishLiz

Member Since 2023
Yesterday (Friday, 16/06) Freya was diagnosed as having hyperthyroidism. Part of me is somewhat relieved as this may explain why she has needed such a high dose of insulin to date, but this has thrown a completely new curve-ball into her current TR regime.
She is currently prescribed 2.5mg, BD of Apelka Vet https://www.fass.se/LIF/product?userType=1&nplId=20150124000012 which seems to have had a massive effect on her insulin resistance. She is currently trending dangerously low, even just 2hrs after her PM injection.
How safe is it to drastically reduce an insulin dose quickly, given ‘reasons’? How fast should we reduce to keep Freya safe?
All of this may be academic if her tumour biopsy shows untreatable malignancy, but until then, her life has to be still worth living…
I will update on Monday with specific test results, but until then, thank you as always for your advice!
 
The link to your last post here: https://www.felinediabetes.com/FDMB/threads/14-06-freya-has-a-vet-visit-advice-needed.278549/

Did you give her insulin this morning? The spreadsheet shows a blank units. If so, that 58 tonight is probably due to the depot of the 7.25 units you have been shooting.

Because Freya is on a larger dose of insulin, you might want to give her a one time lower dose (maybe half dose) to help drain that larger depot. The cycle following that you would go to her new dose. At this point, I would use 0.5 unit reductions, not 0.25 units. Over 5 units total dose we typically make changes by 0.5 units anyway.
 
I would keep testing tonight given your +2. In fact, If you've not already done so, I'd give Freya some medium or even some high carb for to slow the drop.

I would reduce the dose. There's no danger in reducing other than high numbers. I might even drop it to 6.0u depending on what you see tonight.

Are you certain there's a tumor? There are many cats with hyperthyroidism that is very treatable.
 
Apologies; SS now corrected. There was definitely a nasal tumour - it was removed yesterday (Friday, 16/06) but the biopsy results won’t be available until 29/06. Freya is currently enjoying the cat biscuits she always loved but had been denied since her DM diagnosis! I’m planning to get very little/no sleep tonight; alarm already set for 03:45 so I can do a ‘nadir test’ so I can administer more treats or we can adjust tomorrow’s morning dose…
As ever, the difficulty I have is that we have a very short window each week for any dosage adjustments (I’m blind & my husband works away from home for half of the week) so we really only have tomorrow (Sunday, 18/06) to try to wiggle things in Freya’s favour…!
Atm, I’m nudging towards a 6 unit dose tomorrow, but obvs will wait to see how her BGs react overnight. Is this normal though? Freya has only had 3x 2.5mg doses of her thyroid med, but it already seems to have had such a massive impact - is such a swift impact normal or has the vet got things wrong?
Thank you, as ever, for your help!
 
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