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5/7 biscuits amps 462 increased to 13 units +8 592 pmps High +3 542

Discussion in 'Lantus / Basaglar (glargine) and Levemir (detemir)' started by Mollycat, May 7, 2019.

  1. Mollycat

    Mollycat Member

    Joined:
    Mar 16, 2019
    yesterday
    Should I add the humulin r now? I'll need direction with that. And info on meds available.
    Does anyone know the approximate cost of the radiation? Just researching my options.
    Do I need a prescription for the Novolin R @ Wal-Mart?
    Seems like I saw that you don't.

    Feeling a little better today. It is true that Biscuits does not know he has Acromegaly and is just happy eating all the time!!

    He isn't my cat technically. I inherited him in a breakup of my daughter and ex boyfriend! I was to keep him until the EX moved to Philadelphia and got settled. DM diagnosis and that complicated things and here I am.
    He is involved in his care to a point. He pays for meds and vet visits. He didn't take the news well and doesn't want any heroics. Not a medical person and really does not understand. He thinks we may have to make a hard decision about what to do. This makes it even harder.
    One day at a time and hoping for better numbers!
    My vet is great with me and suggestions. I even have her looking at the Forum posts. She's willing to learn and just came from a seminar on cat diabetes.
     
    Last edited: May 7, 2019
  2. Olive & Paula

    Olive & Paula Well-Known Member

    Joined:
    Sep 6, 2015
    Wonder what the vet learned at the seminar.......

    If your willing to treat do you think the ex would surrender Biscuit to you? Or possibly shared custody where he pays for what he does now but you pay for the extra? It doesn't sound as if he is interested in reclaiming Biscuit and if he did I would worry he finds it to much trouble to care for him and not do anything.
     
  3. Mollycat

    Mollycat Member

    Joined:
    Mar 16, 2019
    She was telling me about the seminar but I don't remember the details.
     
  4. AmandaE

    AmandaE Well-Known Member

    Joined:
    Mar 18, 2019
    I agree, I'm wondering what he means by heroics? Like... is giving insulin twice a day considered heroics for him, or more something like a Hypo event? Not to be alarmist but I think Biscuits would be much better under your care.
     
    Sonia & Leo likes this.
  5. Mollycat

    Mollycat Member

    Joined:
    Mar 16, 2019
     
  6. Mollycat

    Mollycat Member

    Joined:
    Mar 16, 2019
    I've had Biscuits for over a year. EX really doesn't understand what's going on. He thinks Biscuits is suffering and doesn't want to do anything that would be uncomfortable for him. I told him about the insulin and medications available. I keep him in the loop. He agrees that Biscuits is best with me.
     
  7. Olive & Paula

    Olive & Paula Well-Known Member

    Joined:
    Sep 6, 2015
    Glad to hear that. Biscuit is indeed the best place.
     
  8. AmandaE

    AmandaE Well-Known Member

    Joined:
    Mar 18, 2019
    I’m glad he’s with you too!

    I feel bad for Ex that he’s worried that biscuits is suffering and that he doesn’t understand the situation. That definitely must be hard for him.
     
  9. Wendy&Neko

    Wendy&Neko Senior Member Moderator

    Joined:
    Feb 28, 2012
    I believe you don’t need a prescription for Novolin R, but I am not the best to ask as I am in Canada where you do not. If @Marje and Gracie or @Bobbie And Bubba are around, maybe they can answer.

    You would only start R when you have the guidance of a member experienced in it’s use around. There are a few of us here. What time zone are you and what time is your shot time? That’ll help us get someone who can “sit” with you, You would not start it the same cycle as a Lantus increase, and would hold that Lantus dose for six cycles when trying R. You need to monitor closely, which means getting tests every hour for the first four hours after giving R, possibly more. You would start with a 0.25 unit dose of R. There is more, but that is enough for now. It is important to know when you can and should not give R, hence the need for guidance the first few times. Let us know when you have the R and we can go from there.

    Did your vet say anything about the acromegaly diagnosis?
     
    Marje and Gracie likes this.
  10. Bronx's dad (GA)

    Bronx's dad (GA) Well-Known Member

    Joined:
    Nov 30, 2016
    No script is needed for Novalin R at Walmart, they have it in the pharmacy fridge. R is what got Bronx out of the constant reds & blacks.
     
  11. Marje and Gracie

    Marje and Gracie Senior Member Moderator

    Joined:
    May 30, 2010
    And I’ll add to Wendy’s post that when you do have someone help you start with R, it’s important that the R and L nadirs don’t overlap. It might not be as critical as you start out because we try to aim for the R dropping the BG by about 100 mg/dL. But it will be important later as the numbers come down.
     
  12. Mollycat

    Mollycat Member

    Joined:
    Mar 16, 2019
    That's terrifying!!!
    Eastern time zone Ohio
    Shot 7:30 am/ pm
    The vet told me about treatment options
    Radiation, surgery, medication, need for high dose of insulin,risk of a crash.
    Leaving it to me to let her know what I decide to do.
    I wish I knew.
     
  13. Wendy&Neko

    Wendy&Neko Senior Member Moderator

    Joined:
    Feb 28, 2012
    Sorry if I made it sound scary. :bighug: R is a powerful tool, if done right. We want to coach you do be able to use it safely.

    I am not in a position to help with AM shots (west coaster) so either we start on a PM or find an east coaster. Let me know when you have the R in house.

    As for treatments, a lot of it depends on what you can afford. SRT (radiation) is a lot more expensive than when I did it, unless you go to Washington State. Maybe $8000 now elsewhere, prices vary. It can take a couple years to see full effects and not all are 100% cured, but see big improvements. Neko’s dose went down to less than 1 unit, but she stayed on insulin. Surgery is more expensive unless you can get in on the trial. It is a complete cure, but there may be some personality changes. That leaves medications, cabergoline being the only one that is affordable. We have had a couple cats here go off insulin on it. Most others see improvements in dose and side effects. It is relatively new so not much in the way of long term data. Any treatment is better than none. The cost of treatment can offset costs of insulin. Likelihood of a crash is unlikely if you monitor as you do. I do see some high dose cats with people testing only occasionally, not before shots - scary! :nailbiting:
     
  14. Mollycat

    Mollycat Member

    Joined:
    Mar 16, 2019
    Is it possible for him to eventually respond to these higher doses of insulin and have his numbers come down? 423 this morning, it seems like we're making a tiny bit of progress.Or do we have to implement some other treatment. I've been meaning to ask this.
     
  15. Olive & Paula

    Olive & Paula Well-Known Member

    Joined:
    Sep 6, 2015
    You don't have to do other treatments. The insulin doses can and will get higher possibly very high. Adding other insulin into it can help get the glucoses down.

    Should you choose to not treat, you might want to discuss with vet about daily ongoing pain meds you can use.

    Olive's IGF was 382 and well with life getting in the way and lack of Drs willing to treat, it was months before we started the caber. One day I guess the tumor had an active spurt, she was so uncomfortable and seemed to be in pain so I then made it a priority to get on it again and push to find some kind of help. I kick myself for dragging my feet. Olive today is completely different than she was. Before the caber all Olive did was lie in one spot and eat. couldn't even pet her, I can only think it was pain making her react to petting. That was it, nothing more just a furry blob. To me that is not a good life. Now she lets me pick her up, let me give a very very light brushing. She walks with confidence with tail up (tail always hung down) she occasionally sprints or trots in for her food, plays with toys even though she lays down doing it. Jumps up on furniture, likes to be with us. And that's just the behavior that changed, the symptoms have pretty much disappeared, an occasional flare here and there so I know there are still spurts of the tumor, but I think it's so much less now. Of course I have no way of knowing for sure, I only know Ollie is so much better than she was.
     
    Krystina & Nelli likes this.
  16. Mollycat

    Mollycat Member

    Joined:
    Mar 16, 2019
    What pain and symptoms will he have? He's totally normal now. Acting more like a cat than when he came here a year ago.
     
  17. Marje and Gracie

    Marje and Gracie Senior Member Moderator

    Joined:
    May 30, 2010
    I’ll just show you a couple SSs of acro cats that weren’t treated.

    Tommy’s SS Look at 2011 and 2012; possibly his tumor was waning and he got down low in dose and had great numbers. Then it was followed by the acro starting to affect Tommy :(

    Crystal’s SS Suki lives in France and there was no way for her to get SRT for Crystal. When the Levemir dose got really high, Suki decided to just use R more aggressively to combat the acro rather than continuing to raise the L dose. She got Crystal into fairly decent numbers but had to treat for pain. It was before anyone was using cabergoline.

    I believe they vary by cat so it’s best if the acro moms give you their experiences. I know Neko had some mouth issues due to tissue growth. I believe Crystal had pain and discomfort from organ growth.
     
    Last edited: May 8, 2019
  18. Olive & Paula

    Olive & Paula Well-Known Member

    Joined:
    Sep 6, 2015
    I can only comment on Olive's. I'm sure they are probably different for everyone. Olive has always had a raspy, gruntal, gurglely, very noisy breathing usually on expirations, so loud you could hear her from another room over the sound of the TV. Sometimes on inhale its like she is trying to suck in air. This has pretty much stopped. probably from the tissue overgrowth in esophagus and or trachea. Occasionally you can hear her if she is next to you but that's it.

    She use to walk like she was testing each step to make sure the floor wouldn't cave in. As acro has overgrowth of soft tissue and bone which causes the big feet I don't know if it was painful or she just couldn't feel the floor well. Her tail always hung down never up. This has stopped altogether. She now trots and jumps on furniture. Tail is half up at least and occasionally has a wag to it.

    The headaches, she use to sit with head pressed into back or corner of couch. She doesn't do this anymore. Light sensitivity, she used to find the dark corner or go to darkest area in the house and stay there until it's better. She hasn't done this in awhile.

    HCM, grade 2 murmur, I don't think it can be reversed. She is on medication for it now. She couldn't take 4 steps without laying down to rest. She now sprints, rare occasion runs, light play with toys. Sits up more now instead of constantly laying down. Just the other night she played with ball on her own initiation. Her echo in March showed improvement over all. She has more stamina now. Maybe combination of the benazepril and caber helping this or just the benazepril, anyone's guess.

    Anytime you tried to pick her up or touch her below the shoulder she would try to bite. IM a year ago said it was quite painful for her when they did the ultrasound of abdomen. He said to up her gab to 3-4 times a day. she had ascites which is fluid build up in the abdominal cavity, vs congestive heart disease. Made her very bloated. We didn't know about the acro then. You couldn't brush, comb or get the matts out without her crying. Now I can lightly stroke her back and pick her up and do about 4 strokes of a comb on her. Bloat is gone. Vet thinks she has spine and or nerve damage, from what or how is anyone's guess.

    Papers, studies, researchers say to let them eat as much as they want. I'm on the fence with this. Olive is 13-13 1/2 pounds she will just balloon if she can eat whenever. I don't see how overweight is healthy, except that it's muscle weight and not fat. Dr always comments on how solid she is. Acro is lean muscle growth but you can't grow muscles and she certainly isn't working out so I don't quite understand this part of it. I rather not have her gain a bunch of weight though.

    This article has explanation of treatment options:
    http://www.diabeticcatinternational.com/knowledge/feline-acromegaly-treatment/

    this one has Symptoms: Ollie has all of these and secondary symptoms related to the primary ones., however not the wide head that anyone can tell and what most vets rely on as first indication for dx. Can't tell you how many said, no not acro head isn't big and jaw not protruding.

    https://www.cat-world.com.au/acromegaly-in-cats.html#Symptoms:

    https://www.merckvetmanual.com/endocrine-system/the-pituitary-gland/feline-acromegaly

    There is another article that list symptoms better but I can't find it right now. It might be on my desktop pc.

    Sorry this was so long and I probably left a bunch out. As I said I can only comment what Olive portrays.
     

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