What is the cutoff dose to be considered HIGH DOSE?

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I wanted to know what is considered a high dose these days.

Someone mentioned that 8u would be high and anything above that amount, so our dose of 6u, started today is getting pretty close.

I have not had IAA or IGF-1 tests done yet; the vet's office I go to said their lab does not have/do those tests, and at the time, we were at a lower dose so I did not push further. I will now if it is something that's needed when at a 6u dose.

Shadoe has no other known health issues, is young, and has just gotten over a bit of p-itis.

I'd appreciate suggestions and comments, along with an idea of the high dose cutoff number.

thx
 
IMO there isn't really a line where high dose begins it's a little relative. For someone who never got above 1U then 3U is HIGH. Dose is different for each cat and many who are on a larger dose aren't nessisarly Acro or IAA or anything there are lots of factors such as weight, insulin resistance, other health conditions (infection, teeth), or simply metabolism. If Someone asked if thier dose was HIGH I would ask is the dose working?, and is it the right dose for the cat? If so it can't be too high although it may be above the average dose. From my observations most cats don't go above twice the recommended starting dose based on ideal weight for Lantus/Levemir.

So a 4kg cat would have a starting dose of 1U (.25U per Kg ideal weight) If this cat were to go above 2 or 2.5U it would indicate an above normal circumstance, but is still not a high dose so to speak.

an 8kg cat (who actually is at ideal weight) would have a dose of 2U starting, if he went over 4 or 5U I would consider that unusual. Being overweight is sometimes associated with greater insulin resistance (not antibodies) just poorer processing of the available insulin.

In circumstances where the dose is double the average dose I would start looking into some possible causes (overweight, wrong food, infections, pooped out insulin etc.) when those are rules out then I would say this cat is perhaps a high dose cat. The time in which to test for acro or IAA's is individual. It depends on the cost, availibility and willingness/desire to know. It is helpful to know if you are possibly dealing with one of these conditions, but it isn't going to determine if a cat is high dose or just above average.

Jan's Buddy has tested positive for IAA's and is getting some greens on 7U Lantus without R. She had just this morning to give a BCS dose because Buddy was lower at PS than he has ever been and she needed to go to work. It is starting to look like Buddy's "high dose" is somewhere under 8U, but his condition makes him a "big gulper" and at 7U it is definately not typical.

I would recommend getting some tests done if it is possible but rather or not you consider being high dose or not, you have worked up to this dose in a systematic way and it is the dose your cat needs, so it is no different than someone who has worked up to 2U. It's not the size of the dose, it's the effect it has on the BG that matters.
I would consider 6U to be an above average dose, if you can get testing done it would be helpful.
 
I agree with Juanita - Michigan State University is the ONLY LAB in North America that runs the Acromegaly test.

It will be cheaper if your vet contacts them directly and ships the blood sample.
 
Thanks so much to all for the replies.

I am still sitting in the pinks at 6u and likely heading to 6.5u tomorrow eve, with just a bit of p-itis in the mix and no other health issues, thus my reason for asking.

I did print out the sheets for bot the IAA and IGF-1 screens from the link you provided and took them down to the vet's yesterday eve. I will pop back in there tonite after work and ask about arranging to have the tests done.

Whatever the outcome, I will continue with the increasing according to the protocol, and in a more aggressive approach. At ~5.3kg, there needs to be some reason for this dose, and if it's she's just a thirsty girl, so be it, but first to eliminate other causes.

Thanks ever so much again for the replies.
 
One of the articles that I read about Acromegaly mentioned >1 unit per pound per day as being "High Dose"

So ... Norton was ~14 pounds and he needed 26 units per day at one point, and 15 units per day after we changed to low carb canned food and removed the dry food.
 
FYI we are passing through 6u now, and this is our happy home :-D

I just had the blood drawn for these tests yesterday and received several good tips because some people have been charged a lot to have it done:

-as already stated, MSU is apparently the main/only place that tests, so have the vet call them directly.
-I was told NOT to use the post office because university mail rooms can be very slow. Send it via next day delivery (Federal Express ?) so it goes straight to the lab
- I provided the vet with my Fed Ex Number, so she couldn't mark up the shipping
-draw it in time to be delivered Tuesday, they test on Wed only. Be sure its packed in an insulated shipper with frozen gel packs
-If the vet thinks you are crazy, (many of us have gotten that) print the veterinary article about the study in which some really high % (30%?) of sugar cats test positive. Its in the stickies where you found the tests.
-some vets only charge for the blood draw & test cost. Consultation isn't really justified unless you plan to do the $$$$ tumor zapping treatment. Others can chime in on that.

Welcome!
 
thanks again for more info.

So based on that 1lb per unit, Shadoe has stepped into high dose zone as she is between 11.2 and 11.9lb with her dose at 6u and going to 6.5u most likely tomorrow.

I dropped off prints of the two tests at my vets yesterday, but won't have a chance to speak with the nice vet since she is in surgery all tomorrow, so I can talk to her on Thursday after work. The cost of the tests is on the printouts, and i will be wanting them to justify any high estimate for the charges to have the 2 tests done. If no decent reply, I guess I will arrange to ship on my own.

I will most definitely print out the article for my vet; I never turn up there without something to go along with my updated ss.
Thank you Phoebe and Nancy for your help.
 
Hi Gayle,

My Boo is a successfully treated acrocat (stereotactic radiation surgery). Personally, I think any cat that hits 5 units without showing much "response" should get the IGF-1 and the IAA tests done. At Boo's peak, she was using 11 units Lantus and up to 4 units R. She weighs about 11.5 lbs.

Everything Nancy said about the tests are correct, except for the consultation part. There is no reason whatsoever for your vet to charge you for "consultation" because I believe the only place that is "zapping" the tumors successfully is Colorado State University. They use something called stereotactic radiation surgery; it takes about a week and costs about $5000. The other type of radiation is costs the same, yet takes about a month (I think they put the cat under 12 - 17 times w/ normal radiation). It's also not near as effective.

February's "Feline Journal" actually has an article on acromegaly, which restates the 30% rate. I'm a little unsure whether the author (Niessen) truly means that 30% of diabetic cats have acromegaly or whether 1/3 of hard to regulate cats have acromegaly. Either way, its much, much more common than vets think.

Heather
 
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