Hi all, Hope everyone and their sugar babies are well. Nothing too exciting has been happening with Yoshi except I’m shooting some lower than normal preshot numbers and he seems to be higher after the shot sometimes. Going to the new vet Saturday am to talk about Levimir and any other insulin thoughts she may have. Lantus is definitely stinging him at this dose and I read a thread about those that switched with good results. I know this is backwards, but I would like her thoughts on prozinc as well as it worked for him before. He does seem to be getting a bit better, but I’m not sure why we lost those pretty blues Anyway if anyone wants to take a look at his spreadsheet and can interpret anything, feel free. Yoshi sends hugs x
It looks to me like he's responding a little more to the insulin. I would keep increasing. I would see some blues at lower doses, but they would never stick. They started sticking once the preshot values started lowering, so I would think that it's a good indication things are improving. Slowly but surely, look at us!
Hope you have good luck with new vet. Ollie started getting aggressive on lantus starting at 6 units.
Your last increase was too small. Over 5 units, it’s best to increase by 0.5 units unless you are tweaking a dose that is already seeing some green. Given the size of Yoshi’s dose, I would say it’s safe to assume something is causing some insulin resistance. A couple of those conditions, IAA and acromegaly, benefit by not lingering on a dose and taking appropriate sized increases. Good luck with the new vet. I think talking to her about Levemir and testing for high dose conditions is a good idea. Remember, one in four diabetic kitties has acromegaly, so it's relatively common. If Yoshi does have one of these secondary conditions, a depot insulin will be better for him. Prozinc will not benefit him at higher doses. Not the least of the reasons being that there is not the body of knowledge about getting higher dose cats regulated without a depot insulin. Lots of people can help you with Levemir.
I’m not sure I want to test for acro. I can’t go to New York to get his pituitary glad removed and I can’t afford radiation. I’m not sure what the point would be in testing if I can’t afford the treatment. I felt safe with this increase. I started a new pen and wasn’t able to monitor much.
You would know why the dose is increasing. Know why you might be seeing certain symptoms. If it's IAA you will know there will be a breakthrough as it's self limiting.I I couldn't afford radition, and I wouldn't put Ollie through the removal. But I do give the cabergoline, as I can afford that monthly. I say it has helped her. She is more comfortable, for now insulin has dropped 3 units. She certainly doesn't act like our 7 yr old but she isn't suffering at all. She has her moments of play and zoomies although rare. Purrs even if you look at her. Today is not a feel good day for her, but we are use to these days now, and let her do what she needs to do, rest. For me my whole mindset changed. Instead of cringing every time the dose went up and questioning why, it's now we know and the goal is to keep the symptoms at bay and keep her comfortable regardless how much insulin it takes.
I agree with above...time to try to get those numbers down - another increase - and at these levels he needs a real push. Best of luck to you....
I agree with Paula. To me it was a relief to know the reason behind the doses I was dealing with. It did also modify my approach to dosing somewhat. My goal changed from remission, to under renal threshold. That took some pressure off. And with knowing there was acromegaly, I knew to look for certain side effects of the growth hormone. And so did my vets. Those side effects can be managed, for the most part, and bring greater quality of life. Paula also brought an important point. If you know you are dealing with acromegaly, cabergoline is an affordable treatment. While not always a cure, it has helped a lot of cats. And we have seen three cats go OTJ using cabergoline. If you know you are dealing with IAA, then that also has an impact on dosing decisions, and can potentially go away.
If you received an answer to why Yoshi's numbers are still so high, you may feel better about it, less stressed, because you'd have an explanation, and with it comes acceptance (and less guilt)... I think... and if Yoshi does not have any condition, then you know you have to increase the dose to reach the right one, and/or change insulin to Levemir (I would not go back to Prozinc, it would give me heart attacks ^^). Good luck with the new vet!!