Switch to Levemir and/or add R?

Mary Ann & Baby

Member Since 2018
Baby has been on Lantus since May 22nd this year, approximately 4 1/2 months. We are up to 8.5u of Lantus and numbers are not good. This week had Baby back in the reds. :( Today I got two yellows again, so who knows. Ketone blood number is 1.0 today, so no problems there. My question is, do I ask my vet about switching to Levemir and giving that a chance? Vet already mentioned the possibility of needing to add R. I'd rather not have to give more shots unless absolutely necessary, so is there a possibility that she would react better to Levemir alone? I am still waiting to hear the results of her IGF-1 and IAA tests that were sent to MSU last Monday, 9/24. (How long should this take?) Thanks!
 
Also, should I request to use Cabergoline? Who are my Cabergoline kitties? I know about Amethyst and Gizmo, any others?
 
Well, I can't speak to switching to Levemir, except to say I know quite a few high dose kitties do switch because Lantus can burn at higher doses. Those yellows are a great sign, I'd be interested to see what Baby does with her dose tonight. As far as the IGF-1 and IAA tests, they're sent to MSU and it's my understanding they're only run once a week, Wednesday I believe, and they have both results by Friday. I had my buddy Lou drawn on Wednesday, June 20th, and I got the results on Monday, July 2nd. I believe my vet had the results the Friday before, but they didn't call me (I called them on Monday). If they were physically sent off on Monday the 24th, you'd think you should have had the results. If the vet didn't quite send them right away and the samples didn't get to MSU on time for the Wednesday run, the results should come in this Friday. If you don't hear from your vet by Friday, I'd give them a call to check in.
 
Let's start with a diagnosis first. The IGF-1 test is run on Wednesday at MSU, results should be the end of that week, or worst case the beginning is the following week. Ask your vet if the results are in yet. Some aren't proactive about getting back to their clients. It's also possible a blood draw on a Monday didn't make it in time for last week's blood spin, meaning an extra week wait. That's what happened to me.

I wouldn't ask about cabergoline until you know what you are dealing with, ie, have a diagnosis. The thread on cabergoline on the high dose forum contains post from a number of users. Paula just received hers for Olive and will be starting it soon. Marvin and Tiffany went OTJ on cabergoline, as did Gizmo. Other cats are Floyd, Beenie (GA), Maverick. Paul tried if for a while with Bronx, Adrian and Chino, Been a few others but I can't remember all off the top of my head.

Levemir is a good idea, especially if you think she is reacting to the Lantus. Many have found it seems to have longer duration in a number of higher dose cats.

One other thing, I would make sure you get a second test each and every PM cycle, perhaps just before you go to bed. Many cats go lower at night.
 
Let's start with a diagnosis first. The IGF-1 test is run on Wednesday at MSU, results should be the end of that week, or worst case the beginning is the following week. Ask your vet if the results are in yet. Some aren't proactive about getting back to their clients. It's also possible a blood draw on a Monday didn't make it in time for last week's blood spin, meaning an extra week wait. That's what happened to me.

I wouldn't ask about cabergoline until you know what you are dealing with, ie, have a diagnosis. The thread on cabergoline on the high dose forum contains post from a number of users. Paula just received hers for Olive and will be starting it soon. Marvin and Tiffany went OTJ on cabergoline, as did Gizmo. Other cats are Floyd, Beenie (GA), Maverick. Paul tried if for a while with Bronx, Adrian and Chino, Been a few others but I can't remember all off the top of my head.

Levemir is a good idea, especially if you think she is reacting to the Lantus. Many have found it seems to have longer duration in a number of higher dose cats.

One other thing, I would make sure you get a second test each and every PM cycle, perhaps just before you go to bed. Many cats go lower at night.
Thanks, Wendy. I need to go back and reread the Cabergoline threads. Do I understand correctly that Cabergoline is only for Acro cats specifically? Not for IAA or "just" high-dose kitties?
 
Do I understand correctly that Cabergoline is only for Acro cats specifically? Not for IAA or "just" high-dose kitties?
You are correct. Acro is caused by a tumor on the pituitary gland that sends out excess growth hormone. IAA is the kitties immune system attacking the insulin thinking it is a foreign invader.

I never tried Lantus. I went straight from Prozinc to Levemir. My boy was getting 30+ U 2x a day and never flinched at those doses.

Wendy makes a good point, see what the results from the tests are, then form a gameplan for Baby when you know what you are up against.

Hang in there for those results.... I was fidgeting the whole week waiting for the #'s from my vet. MSU is also very good about chatting with your Vet. Mine didn't believe me about high dose cats until she consulted MSU's vet who was more versed in FD.
 
Switching to Levemir did help with Doodles cycles ( he was IAA only) and Lantus was clearly stinging him. It took about 1.5 weeks for his IGF/IAA results to come back. I did use R for a small period of time and hated the extra needles and testing that came along with it :( Like the others, hang tight until you get the results back.
 
Cabergoline impacts the pituitary gland, so yes, is only used for acromegaly. Note that the resuts of cabergoline have been mixed. The Royal Veterinary College did a study and didn't get great results. I think we've done better on FDMB. RVC did tell one of our members that they've had better results with cabergoline and octreotide together. No one here has tried that combination. RVC recommends pasireotide as it has better results. The problem with pasireotide is the price. :( It's very expensive. We've had a couple peeps here with vets suggest they try pasireotide instead of cabergoline. The price difference is substantial. If your vet suggests pasireotide, get them to price it out.
 
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