Scout

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tara_simpson

Member Since 2012
Just now getting to introducing Scout. Scout is a 10 yr old neutered male. He is a rescue and I have had him since he was a couple of months old. He was diagnosed in late april/early may of this year. He is on Lantus 2x a day and eats Purina DM dry. He has always eaten Science Diet Light dry, until his diagnosis. He was started on 1/2u on Lantus and is now at 12u (I KNOW---a ridiculously high amount). The plan has been to slowly increase not to exceed 12u, then if he wasn't regulated, we would do some more tests to make sure we aren't looking at anything more (Acromegaly, UTI, Ketones, etc). He typically ranges high at b/t 350-475. I test him with an AlphaTrak 2 prior to meals/injections (12 hrs apart). I have started testing before I go to bed; roughly 5 hours after his dinner. My vet has been monitoring my records since diagnosis. I am planning on asking about switching him to Purina DM canned, in addition to running a few tests. He still drinks and urinates more than "normal", but it has improved since receiving injections. His activity level, appetite, coat, and hydration remain normal.
 
Yes, he could have one of the high dose conditions, and it would be wise to check them out. But a big part of your problem could be the dry food. We try to feed less than 8-10% carbs. There is really no need to feed Purina prescription. Lots of the regular foods like Fancy Feast, Friskies, Merrick or Wellness have as good or better ingredients and cost a lot less. If you switch to wet, watch the doses carefully, faithfully testing before each shot because he could come down fast.
 
Hello.
I noticed you haven't had many responses yet so I had to check it out.
It's been hectic around here lately and the website was down for that large window.

Welcome to the board. You will find a very wonderful supportive community here. Always ask questions when you need help.
I tthought you could use this information to learn about why the dry food is so bad and make an informed decision.
Your dosage is high. I wonder about insulin resistance. ( I can't help you on that- no experience)

www.catinfo.org
She explains the food issue and how important it is.

There is also a list of foods with their nutritional values
http://binkyspage.tripod.com/CanFoodNew.html
http://binkyspage.tripod.com/CanFoodOld.html

Most of us choose canned food with carb values lower than 10% . I try for 6 % or less.
The food you are using is high in carbs and none of us really like it at all.
However, IF you decide to suddenly change foods, You will want to immediately reduce the dosage of insulin to 1 unit or less.
The change in diet could have drastic effects and you don't want to risk a hypo situation.
Think of it as a reset.
Post again, and ask questions and you will get responses to help with this. Something like, " Changing food, Need advise."
You would definitely need some experienced eyes before making any changes.

Vets continue to push the special diet dry foods . I think it's because those brands fund so much research that the vets don't question what they are selling.
You have the experiences here as to how Great a difference it makes when you start feeding foods that are more appropriate to your cat.

So remember, ask for help. Reduce the dosage of Lantus when and if you decide to change diet.

Welcome. I think you will find much better results for your sugarbaby as you learn how to manage your cat's diabetes.
 
Hi Tara(?)
Yes, that is a hefty dose of insulin. And as others have said, the dry may be a big contributing factor to needing the high dose and still being unregulated. It is good to hear you are testing before giving insulin, and now starting to add another test in there. Interesting the vet is aware of high dose conditions such as acro.

It is not necessary to switch to a prescription wet food. There are many brand name foods that will be just fine (possibly better quality and less money, too!). When you do decide to switch, it will be very important that you test more frequently as the reduction in carbs may cause a huge drop in blood sugar alone. The link Rhiannon gave you catinfo.org has information on how to fully transition a cat from dry to wet food.

Let us know when you decide to do the switch, so folks can help guide you with a safe(r) dose that is not putting Scout at risk of ketones OR hypoglycemia. It's a tricky balance, but with testing and guidance from knowledgable group members I think it can be done safely.
 
rhiannon and shadow said:
However, IF you decide to suddenly change foods, You will want to immediately reduce the dosage of insulin to 1 unit or less.
The change in diet could have drastic effects and you don't want to risk a hypo situation.

My concern with considering such a large drop of insulin, despite a food change is that we know very little about Scout. There is no data on what kind of BG's he has over a period of time, other than a few curves at the vet. We have no idea if there is an underlying condition, aside from the dry food, causing such high numbers and need for insulin. True, you do not want to risk a hypo situation. You also do not want to risk ketones. If there is a possibility of infection brewing right now, it could become a life threatening matter within hours.

I think the key is going to be testing a lot (at home) and a slow transition to wet food while monitoring. It may make sense to drop a few units or more. More feedback from others on the board + your vet can help you determine how much to drop. Can you give us an idea how much your cat weighs?

The alpha meter is a bit more costly. If you are going to test more during this transition, I might suggest something like the walmart relion meter. The strips are much cheaper and you can go to a walmart any time vs waiting for your vet to open. You will also want to get a box of ketostix to check for ketones in Scout's urine.
 
tara_simpson said:
Just now getting to introducing Scout. Scout is a 10 yr old neutered male. He is a rescue and I have had him since he was a couple of months old. He was diagnosed in late april/early may of this year. He is on Lantus 2x a day and eats Purina DM dry. He has always eaten Science Diet Light dry, until his diagnosis. He was started on 1/2u on Lantus and is now at 12u (I KNOW---a ridiculously high amount). The plan has been to slowly increase not to exceed 12u, then if he wasn't regulated, we would do some more tests to make sure we aren't looking at anything more (Acromegaly, UTI, Ketones, etc). He typically ranges high at b/t 350-475. I test him with an AlphaTrak 2 prior to meals/injections (12 hrs apart). I have started testing before I go to bed; roughly 5 hours after his dinner. My vet has been monitoring my records since diagnosis. I am planning on asking about switching him to Purina DM canned, in addition to running a few tests. He still drinks and urinates more than "normal", but it has improved since receiving injections. His activity level, appetite, coat, and hydration remain normal.

Tara,
Do you have some numbers for Scout, for your testing on the AT? I know that dry food may make a difference but 12units twice a day is alot of Lantus even for a cat eating dry food.

Before dropping a drastic amount of dose, you may want to be testing for ketones now if you are not, you can get KETOSTIX from the pharmacy, and maybe see if he likes the low carb wet food first. If he is already liking wet food now, or takes to it well, see if you can try a gradual change in diet, or if you want to remove the dry all at once, be sure that you have some cans of high carb gravy type food on hand in case you see Scout dip really low in his numbers. I think dropping back by half dose, provided you will be testing frequently could be safe and read how to handle any possible hypo conditions.
List of Hypo symptoms
How to treat HYPOS-They can kill! Print this out!
Jojo’s HYPO TOOLKIT

If you can post some of Scout's numbers and a bit about how you plan to make the transition, others here can help you with some suggestions based on experience. While two of my cats were diagnosed with acromegaly, I did not have to make a food change while at a very high dose as my cats were already switched to wet before getting to high doses.
 
hi tara. someone asked me to take a peek at your thread...

I think dropping back by half dose, provided you will be testing frequently could be safe and read how to handle any possible hypo conditions.

i think carolyn and gayle have given you some excellent advice. like gayle said, please post whatever numbers you have for scout as well as your thoughts on how you plan to make the transition to low carb wet food. this kind of info will help us help you.
 
Since my initial post, Scout has had a few tests come back.

His thyroid is fine.

He has pancreatitis and is being treated for it currently. His lipase came back in the 20's; so far above the normal range. He is on prednisolone and seems to be doing better. He is drinking and urinating less and seems to have more energy. I am taking him back Saturday to retest his lipase as he will have been on prednisolone for 2 weeks. His glucose is still higher than it should be, but it is consistently lower than before. He is now getting DM canned and a little DM dry (weaning him off of it). I am predicting the canned is the reason for the lower glucose readings, but the prednisolone are still keeping it higher as is expected. My vet an I are anxious to see what kind of readings he has once he is no longer taking the steroids.

I received a call from my vet with the results of his IFG1 test. Unfortunately it was sky high. 416 instead of falling within the range of 12-92. This is consistent with Acromegaly. Before we jump on board the Acro train, we are waiting to see what results the second lipase test show. Hopefully, his lipase is down and we will progress from there. Radiation was mentioned; however we are a far ways from considering that treatment.

My vet is consulting several professionals from around the country to gain more knowledge of Acromelagy, so she can provide me with the best treatment options for Scout.

I will report back with any new information.
 
Hi Tara -

Welcome to the IGF-1 "off the chart" club! Grayson is also IAA (insulin resistant), so he too is a high dose kitty. At 4 units he was considered high dose, but when you get beyond that, it's pretty much a guzzler, while you see your friends' cats responding to .25 units - the Sippers!

When they ran the IGF-1, did they also check for resistance? Often they run the two tests together. It was no surprise when Grayson came back positive for IAA - his was a 50 and the normal range goes up to 20. There's some great info on the Acro/IAA forum, so I encourage you to look there and read all you can absorb. But just like w/ the diabetes diagnosis - don't OVERdo. It can be very overwhelming!!!

Grayson and Tracy's Leo (also a regular poster on Lantus TR forum) were at Colorado State at the same time for the SRT Stereotactic Radiation. This is the most widely used treatment in this small group of cats, if you should choose to proceed with treatment. Another poster, I THINK from FDMB, Perry/Cathy took their cat Sooty for the Cyber Knife Radiation in NY. Sooty is now down to about 5 units - not sure what his max was, but when you start aggresively treating the tumor (and resistance is often, though not always, a symptom of Acro), you go through insulin VERY quickly, and the expenses add up. Julie/Punkin crunched numbers for the treatment and concluded that the break-even point was 10 months. Everyones ability to do for their cats varies, so it's often helpful to do an analysis of your cat, his current condition, his insulin needs, your resources, and your interest in treating vs managing. And if you're like me, the IGF-1 results, and the likelihood of Acromegaly was VERY overwhelming! I had to step back and catch my breath before I moved too quickly in ANY direction.

The Acro/IAA/Cushings forum here is not very active, as there's an Acro group on Facebook that most utilize. This is an extremely small number of cats - I was told (or I read) that in 2010 there were 16 cats that were diagnosed with Acromegaly in the US & Canada. SIXTEEN.

It's great that your vet is working with you as a partner. There are vets that are also members of the Acro group, and you may want to share that fact with yours. There's a public group as well as a closed group, so if you're interested in more info, send me a PM and I'll help you get connected.

Please let me know how I can help you best.

Lu-Ann (aka Grayson's mom)
 
Tara --

There are several people who have acro cats who post on the Lantus forum. Lu, along with Tracy/Leo post there as does Julie/Punkin and Wendy/Neko. Wendy is currently at CSU where Neko is undergoing the SRT procedure. You are more than welcome to join us on the Lantus TR forum.

Just a head's up regarding the lipase test and pancreatitis. It's not a reliable test for cats. This is a quote from the Cornell veterinary website describing the lipase test interpretation in cats:
In the cat, lipase is not consistently elevated in pancreatitis. It was hoped that measurement of trypsin-like immunoreactivity (TLI) would be better for diagnosis in cats, as high values are seen in dogs with pancreatitis and are very useful for diagnosis in dogs with normal lipase values. However, recent data suggests that TLI values are not consistently increased in cats with confirmed pancreatitis, limiting the usefulness of this test to cats with exocrine pancreatic insufficiency.
Currently, the best lab test for feline pancreatitis is the spec fPL which has replaced the TLI for diagnosing pancreatitis. With this test, a sample needs to be sent to IDEXX labs. There is an in-office version of the test, the snap fPL. The latter test is kind of like a pregnancy test -- it gives you a positive or a negative reading vs. a number. The spec fPL does give you a numeric value.
 
Welcome Tara and Scout!

It is good that you are getting the dry out of the way- that will help with regulating.

Sneakers was DX with FD in November 2011 and Acro in June 2012- 482 :shock: . She doesn't have IAA though- only 9. We are currently on 22u of Lev and she EATS alot. (Basically Scout is heading through the teen-age years all over again).

The facebook forum is active and there are quite a few that can tell you about the SRT.

Welcome aboard!
 
Is the IAA (insulin resistance) test called anything else? I know my vet did 3 tests this last time. Just want to make sure we are getting all the tests he needs.

One was thyroid, which she got the results before we left from the their clinic. All was normal.

The second was the Pancreatic Lipase (spec fPL) which we got in about 2-3 days. It was a 24 I believe.

The third was the IFG-1 test which was sent to Michigan State and we got those results in about 2 weeks. Came back a massive 416.
 
Heather is right. MSU is the place that does the endocrine testing. Even the vets at Colorado State said that. They rattled off various places across the country and their specialties. MSU was it for these, particularly because they had years and years of numbers to have accurate baselines for cats.

The prep for the blood is much like that for the IGF-1 (Insulin-like Growth Hormone). The IAA is the lesser expensive of the 2 tests, if I recall correctly. IGF-1 is $49, IAA $15 or so, if I remember correctly, but the blood still needs to be drawn by your vet, spun and frozen, then shipped to MSU. One of them required overnight shipping. The other did not. Mine were shipped together in a mailer that MSU sent to my vet. If you go on the Acro/IAA forum, there should be some info about the testing.

Here's the link to the post: viewtopic.php?f=12&t=375
entitled Acromegaly and other High Dose Conditions: What we know.
 
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