02/19-Freckles/Judy - AMPS 220, 239@+3, PMPS 254

Yesterday's post

Heading in to the city to pick up Levemir script. Seeing as I'm off for a few more days, thought it would be a good time to try switching insulin when I'm around in case things get interesting.

Not sure what the dosing should start out at? @Wendy&Neko any suggestions? We are currently on cycle 5 of 7.5u Lantus.

Thanks!

 

We normally start Lev at 70% of the Lantus dose, if it’s a good dose. But that would mean dropping her to 5.25u and with an acro and IAA cat, starting close to her current Lantus dose is probably a better idea. Wendy will let you know for certain but I would think only dropping back to 7u would be fine since you are there to monitor and I would check her closely the first couple of cycles. We can fast track her back to 7.5u if we need to.

I am sorry for the dx but know we are all here to support you and send you lots of extra hugs when you need them.

 

Thanks Marje. I just picked up the test results at the vets. Vet wasn’t there to speak to but did leave me a script for the Levemir.

Test results for insulin autoantibody were 43%. Reference range is <20%.

Insulin-like Growth Factor is >521. Reference value is 12-92 nmol/L

“I would assign priority to the IGF1 result as the reason for insulin resistance.” From the endocrinology vet at MSU.

@Olive & Paula were asking about the results as well.

 

Sorry for dx. You now know why Freckles needs the higher dose. I personally found Ollie's diagnosis a relief, because now I knew why, although I had no idea what it would actually mean.

My way of thinking changed, yes her "diabetes" is important but it is caused by the tumor. So maybe if the tumor can be managed the diabetes can also be managed. So looking into options started. Each treatment has its pros and cons. You will have to read and decide if any are for you and if available in Canada.

It took 4 months to find a vet willing to try cabergoline. I had to change vets to get it. Vet admits not knowing anything about it. Dr and I are following Ollie's lead.

The only reported side effect is GI upset that resolved itself in 3 days. Ollie didn't have any. I did start probiotic while waiting for it to arrive and kept her on it for 1 week after starting it. Don't know if that made a difference or not.

With the last bottle I received it now has a warning "hazardous drug" it says to wear gloves, I don't, the bottle has a stopper in it, so it doesn't drip or spill.

Just saw the results. The IAA isn't to bad, it does resolve on its own in time and you will break through that. You will be doing some fancy dance steps when it happens.

Breathe, it's okay, it's not so bad. You will decide what is right for you and Freckles.

 

I am glad you can monitor closely the first few day. The thing with IAA kitties, the change in insulin can "trick" them temporarily, until they figure out it's insulin again. Check out Jack's spreadsheet, end of May 2016. He switched from Prozinc, kept the same dose because he's seen nothing less than pink. Surprise! His IAA turned out to be 65% (Neko's was 48% BTW), he was also acro. The antibodies wised up after the initial switch and the dose kept climbing.

Because you did see some green on 7, though the dose was doing as I called it "going stale", I think I'd take a little more off than just 0.5 units. I wouldn't go all the way back to 5.25 units either. Maybe 6 or 6.5 as a happy medium. Make sure you are well stocked with high carb food and syrup/honey just in case. No guarantees of an exciting change, but it can happen. Let me know which day you'll be doing the switch, and I'll try to be around.

Same quote from the post when Jack got his diagnoses. Might be some other interesting reading for you there. Including to some links to SS of cats that switched.

 

Oh, one more thing. You shouldn't need a script for Lev. I got it over the counter. That way you aren't tied down to one place to buy insulin.

 

Thanks Wendy. I think I will start Levemir tomorrow morning’s shot. By the time I drive home tonight it will be Freckles’ shot time and I won’t have time to read up on Lev or figure out how to withdraw from pens. So I will do more reading tonight.

 

Hmmm. I got a script from the vet as Pharmacy (Safeway) said I needed one. Vet’s dosage on the script was 2 u. Vet knows we are up to 7.5 u on Lantus and he knows how much I test.

Better get driving as I’m an hour away from home.

 

Hmmm is right.

 

Does the amount of IGF1 in a cat indicate the rate the tumor is growing and throwing out the IGF1 hormone?

Does a high number have a poorer prognosis than a lower one?

 

That was exactly my problem as well, and I tried multiple pharmacies. The good news is that refills shouldn't be a problem, once the vet's script is on file. My vet wasn't sure about the Lev dose/switch either, I'm her first client trying it.

 

I don't know Judy. I'm sure Wendy will know. Don't forget to put acro and IAA in your signature.

 

When I asked the researchers at CSU, they said that they hadn’t found a correlation between the IGF-1 number and anything else. It’s a number that can change over time. It has nothing to do with tumour size. Three weeks before Neko had her SRT, two other cats here had theirs done, also at CSU. They both had lower IGF-1 and larger tumours. Neko lived longer than either of them. However, she might have had more soft tissue/bony growth, which IGF-1 contributes to. Dunno, just speculation on my part. Her arthritis was pretty bad.

The tumour throws out excess growth hormone, which in turn triggers IGF-1 production, not necessarily a 1-1 relationship.

 

Good to know. Thanks Wendy.