Need advise about shooting high dose kittie....

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Jane & Boo (GA)

Jane & Boo (GA)

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Silverado is up to 8.2 units BID and appears to be responding.... I think. for awhile I was bumping him in .5 increments. At 8.0U we still had lots of pinks and high yeloows. 8.5 was the same. Then I went to 9.0 and started getting an inverted curve, so dropped back to 8.0 for awhile, then bumped to 8.2. I'm now seeing a dramatic change in his numbers and don't know what to do with them. To shoot or not to shoot.... that is the question.

Today his numbers are:
AMPS 280 gave 8.2Units
+12 82 Fed him. Waiting for shootable number.
+13 144 Still not shootable.... especially with 8.2 units.... or is it? He's obviously on the rise.
+14 191 Decided to shoot the 8.2Units.

Have I done the right thing? or should I brew a pot of coffee and plan on monitoring him through the night?

Would these numbers indicate that 8.2 is his magic number?

Any and all input will be appreciated.
 
Hi Jane.

I have a high-dose kitty, too, but we use a different insulin, so I'm really not able to help there other than to ask if you can get some overnight checks in case the higher numbers are a reaction to lows that you're not catching... for instance the low he had tonight might cause a bounce in a future cycle.

I would be inclined to try for a flat curve, then try to lower the whole curve. As for the inversion, perhaps that was just a late nadir (KB's nadir is often somewhere between +10 and +12, so his curves look inverted). Nadirs can shift on you, particularly if a dose need is about to change.
 
Hi there,

I also used Lantus, so can't really help with the dose. However, have you considered getting your kitty tested for IGF-1 and IAA (reasons for insulin resistance). You might want to read this sticky: viewtopic.php?f=12&t=375
 
Your reasoning is sound - I had an acrokitty, but lost him to cancer before we had to do much dose changing -- his tumor was pretty stable, and he was getting ~15u per day split in 2 or 3 shots using a sliding scale (PZI from BCP) (disclaimer -- not a technique for Lantus or Levemir)

Has Silverado been tested for IGF-1 or IAA? A big reason for getting these tests -- a kitty with acromegaly has a functioning pancreas, so we need to treat differently.

Several acro-beans spend more time on Facebook - do you have an account there? (free)
 
Thanks for the replies.

No. I have not had Silverado tested yet. I'm trying to work that into the budget. I understand that a vet will typically charge as much as $200 for the service. Silverado's insulin needs ($$$$) plus 19 other kitties in the family make finances a bit tight, but I have a plan for accomplishing it within the next month or so.

Yes. I do have a Facebook account and would like to know how to friend the acro-folks that you have referred to.

I tested Silverado through the night last night:

PMPS 191
+4 253
+6 255
+9 255
+10 264

I fed him at +10 as that is his usual feeding time. I also gave him his 8.2Units and will monitor him through the day.

Should I consider switching to a different insulin? Or will this be better answered after he has the Acro testing done?

Thanks for the help.
 
The thing I am confused about is that you have some great numbers back in December last year on tiny doses. I did notice in the comment line it says "staying inside". This is probably way too easy. Is there any chance he is outside now and getting high carb food from someone else? If not, is there anything else that was different in December?

It is an interesting spreadsheet and reflects your confusion too. That he was doing fine and then starting going up. You have probably gone through several insulin vials since then so that can't be old insulin? Has he been on PZI all this time?

Just brainstorming.
 
Hi Sue.

Your right.... last December it looked like Silverado was going to be a normal diabetic kitty, but it hasn't turned out that way.

Silverado was actually my neighbor's barn cat. He was given no attention over there, so he spent alot of time at my place and always thought of himself as my little man. He decided to become my indoor/outdoor cat about a year before his diabetes diagnosis. As soon as he was diagnosed, I came here and learned alot... changed his diet to all canned, low carb... and to prevent him from raiding the neighbor's barn cat food he was made a full-time indoor kitty. I have 19 other cats and a few of them insist on kibble, but they are fed in isolation where Silverado can't get to the kibble. Occasionally my DH slips up and leaves the kibble out where Silverado can get to it... but it's rare. So no, these numbers are not diet related.

You are correct that the insulin gets used up way before its expiration.

Even though I have not yet had Silverado tested for Acromegaly/Cushings/IAA, I am certain that he is afflicted with one of these. It seems to be the only reasonable explanation for the ever increasing insulin needs. Hopefully, in the near future, I will be able to get the testing done and know for sure.

Thanks for the feedback.

Jane
 
Regarding insulin --- Prozinc is a decent choice for high dose kitties -- if you do want to try another, Levemir is a good insulin also ---

A human diabetic has told us that Lantus stings when injected cold, so at the higher doses -- we've found Levemir to be better than Lantus for High dose kitties.

on facebook:
http://www.facebook.com/group.php?gid=6 ... 605&ref=ts

Most of the group members have or have had acrocats, so post there and send FR. I am the only Phoebe who is a member of the group.
 
Thank you for all the information listed here. Harley will have the IAA test next week but my vet said she did not know where to send it. I have copied all the information for her. Again, thanks.

Pattie
 
Jane and Pattie,
My vet did not have a clue where to send what and how; I had to get all the info and give it to my vet so you're not alone there!

Here are he sheets with info on both tests:
IAA Test
IGF-1 (Acro) Test

Be sure that your vet sends via FEDEX and it MUST go to the lab and not the mail room.
The costs for the tests are cheap but there will be the FEDEX costs and whatever your vet charges for a blood draw and the packaging for shipping.

It really is worth the cost to know what you have - working pancreas then you want to avoid the low numbers with acro, but with just AA, I think you want to be aggressive - not sure on that but something good to know.

You could very well see low doses and then see the dose increase; that's the nature of the condition.
My Oliver was at 26u awhile ago, then went down to half that amount, but he is now back on the rise.

What you could do is to give your vet all the info for the tests, then say you need an estimate of the total costs so that you can budget it. That way you know ahead what you will be paying for the 2 tests. I say get the two tests at once because that tests are cheap but the shipping and stuff is not ... why pay those parts twice? just do it all at the same time.

I can't help at all with the dosing; I had both mine on Lantus, but switched them to Levemir when they tested positive.
Lantus and Levemir: What’s the Difference?
 
Harley had the GF-1 last year and it was negative. She did say it was not necessary to do it again and finally agreed to do the IAA. It was actually a vet tech who told me "no, we won't do the test." After I told her that I would find a vet and clinic that would run the test - the tune changed.

Pattie
 
Pattie, Do you know the results (number) of your IGF-1 test? Honestly, if you are having the IAA test, I would do the IGF-1 again. That number can fluctuate.
 
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