Increase in Insulin Dosing After Steady Decrease :(

pablo'smom

pablo'smom

Member Since 2024
Hi everyone, it's been a little while, but I need some input on what to do. Pablo has been doing well and we were down to one unit of Lantus twice a day for the past few months or so until about a week ago. I haven't been keeping up to date with his spreadsheet, but he almost always shoots in the 80s-90s then starting last week I noticed he was sitting in 110s-120s. I kept at one unit for a few days but he wasn't breaking below 110s so I decided to give him 1.5 units and test throughout to make sure he doesn't go hypo. Its Day 3 of 1.5 units and he is sitting in 100s pre-shot and gets down to 80s at nadir but I'm just not sure what is causing this sudden shift. I know its not a big deal as he is still controlled, but I'm worried his adenoma could be growing back or he could be sick. He is acting completely normal. Bathroom habits the same, appetite the same, energy level the same, weight the same, etc, and I haven't noticed any signs of infection. I switched from Churu treats to Tiki Cat a few weeks ago so I thought that could do it even though Tiki Cat is less carbs, but switching back to Churu hasn't made a difference. He goes for his followup at MedVet end of August so I'm trying to hold out until then, but any advice or ideas is greatly appreciated. I'm hoping its just a weird bounce because acromegaly is unpredictable and that he will go back down soon.
 
Also, his vial of insulin is from April and should still be good, but I'm considering getting a new one to see if that could be the issue.
 
Without any test data on the spreadsheet, even the recent numbers you've gotten, I'd just be guessing. Not sure what you mean by "weird bounce"? Bouces happen because they go into lower numbers they are used to, or drop quickly.

Have you been to the vet lately, gotten recent bloodwork, had his teeth looked at?

It took almost three years after SRT before Neko's tumour started growing again. Seems a little early for that to be happening.
 
Wendy&Neko said:
Without any test data on the spreadsheet, even the recent numbers you've gotten, I'd just be guessing. Not sure what you mean by "weird bounce"? Bouces happen because they go into lower numbers they are used to, or drop quickly.

Have you been to the vet lately, gotten recent bloodwork, had his teeth looked at?

It took almost three years after SRT before Neko's tumour started growing again. Seems a little early for that to be happening.
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I still test everyday, I just don't have the time to keep up with the sheet, but I could go back and log if need be. And my apologies, I guess its not a bounce then.

Last vet visit was in April and all his labs came back normal and steady with his CKD. He does need a teeth cleaning, but with all the acromegaly, diabetes, and CKD stuff going on the vet recommended waiting until we got him stable. I will bring it up to her at the appointment in August because that could definitely be a factor and he should be able to go under anesthesia safely.
 
Can you put in the last week of data?

I'd call his numbers more than stable enough for a dental. Dentals are one of the prime culprits for insulin resistance. If you are worried about anesthesia - fair concern with an acrocat - you can get an echocardiogram, or an least a CardioPet ProBNP blood test done.
 
I just added some data.

And his breath usually smells very bad especially with having only wet food, so I assume he needs some work done for periodontal disease. I know his regular vet does dental cleanings, but his specialist might want me to take him to the dentist for more specialized care. As long as he stays stable and acts fine, I'll wait until end of August to discuss my concerns with her and get set up with a cleaning.
 
Stinky breath could mean infection/inflammation that can raise numbers. I took Neko to a dental specialist vet. They are used to working with older more complicated pets. Your regular dentist could refer you. Neko had a couple issues related to her acromegaly, which the dental specialist had familiarity with. They were definitely more than just cleaning.
 
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