Simba curve update -

[Theresa and Simba (GA)]

Yesterday we did a decent curve on Simba. Shared the results with the vet this a.m.. He thinks that the extra food eaten (free feed) interferes with N insulin success, so today, he asked me not to feed Simba 4 hours before his pmps . Sure enough, got a lower pmps # and a ravenous cat. Vet suggests start over with the Levemir 2U (previously, our initial dose of 1U did little for him) or increase N. dosage. Lantus or Levemir is better for free feeding. I asked about the acro testing etc. and he said that we can do that, but no matter why he eats so much, what is important is that the insulin given is the proper dose/type that can handle his food spikes. If he needs food, he has to get it. The decision is mine to make. I can finish my half a bottle of Levemir and save the N for emergency use. I will continue with the Novolin 2U tomorrow until I decide what to do. Your input here is very important to me. ( I work a lot during the weekend but will check in when I can ) cat_pet_icon

 

[Vicky & Gandalf (GA) & Murrlin]

I do not remember if extreme hunger is part of acromegaly or not. I know it is in hyper-T. Has he lost weight recently, despite the hunger? Has vet palpated his neck to see if thyroids are enlarged?

I have no experience with food spikes, as Gandalf doesn't really get them, unless he eats something that's higher carb. Some people have used a bolus insulin such as R to combat food spikes, but if he free feeds, that may not be the answer either.

I'm sorry this is frustrating for you. At least your vet sounds helpful. The food trial was a good idea.

 

[Theresa and Simba (GA)]

Thanks Vicky, I did not take Simba with me. He is average weight and it doesn't change much. Overall, he is in pretty good health.The hunger, lack of ketones ever can be a sign of acro. The way I understood the vet is that the more he eats the harder it is to regulate him. That makes sense. That said, he still needs the food, doesn't seem greedy just hungry more than he should be, this has been this way since his diagnosis. What I have to try to do is control the feedings so the insulin has more time to do its job. The no food test also explains the lower amps #'s because I don't get to feed him snacks through the night. I haven't had a chance to tell the vet about todays results, they were closed by then, but I think he already knew he was right.

 

[Sheila & Beau GA & Jeddie GA]

I am not sure I would say that free-feeding doesn't work with N because with the faster insulins you really need food available at about +2 or 3 as the insulin kicks in, but I always tried to not feed after +6 or +7 when Beau was on vetsulin. I just didn't give him more food, but left down any that was not eaten.

If his weight is stable I sort of doubt that he has acro, usually there is weight gain with that. Also, ravenous appetite can be a sign of low blood sugar, although on this lower dose of N (over the higher lev dose) I don't see any really low numbers. I do still wonder about rebound and if his best dose is less than 2u, or even less than 1u. He had some nice response for a few days, but now his numbers are climbing again - in general. He went from a nadir of low 100s to mid 200s.

If you do a rebound test on N, I would try 1u for 3 days. You have to hold it for at least that long to see if anything will change - and maybe see something at the end of the second day, or morning of 3rd day (4th or 5th cycle). And, of course, test for ketones while doing the rebound check.