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8/14 Biscuits'amps 348 R-0 25 +3 278 +10 472 R-0.75 pmps 381

Discussion in 'Lantus / Basaglar (glargine) and Levemir (detemir)' started by Mollycat, Aug 14, 2019.

  1. Mollycat

    Mollycat Member

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    Mar 16, 2019
  2. Ti-Mousse

    Ti-Mousse Well-Known Member

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    Dec 2, 2018
    Hope you have a good day with Biscuits ! :bighug:
     
  3. Mollycat

    Mollycat Member

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    Mar 16, 2019
    Thanks, he's happy. That's what matters!
     
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  4. Jerry dutchboy

    Jerry dutchboy Well-Known Member

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    Mar 27, 2019
    Com'on little man you can do it... lower numbers are nice but as long as you're happy we're happy. Have a lovely day.:bighug:
     
  5. Mollycat

    Mollycat Member

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    Mar 16, 2019
    He's been stubborn!
     
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  6. Jerry dutchboy

    Jerry dutchboy Well-Known Member

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    Mar 27, 2019
    That's ok,there's always tomorrow right Biscuits? Big snuggles.
     
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  7. Wendy&Neko

    Wendy&Neko Well-Known Member

    Joined:
    Feb 28, 2012
    Why did you think last night was a fur shot? Dose increase should be by 3 units at this point, 4 when he gets to 40.

    I hope you can get him started on cabergoline soon.
     
  8. Mollycat

    Mollycat Member

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    Mar 16, 2019
    His fur smelled like Lantus, usually no smell. I gave the vet info on cabergoline. I'll check with her.
    I'm going through a bottle every 2 weeks now. Add the cabergoline cost, I'm sure it's high too.
    I know you disagree but the vet said he's not going to go low with the acro , and having bg's in the 200 to 300 is a good range for him. I'm using R often unless I should increase that
     
  9. Wendy&Neko

    Wendy&Neko Well-Known Member

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    Feb 28, 2012
    You are right, I am going to disagree with the vet. Acro is hard on kidneys, pile on spending all his time over renal threshold and it’s not a good combo. Acrocats can and do go low, seen it. Probably more acros than your vet has, plus have seen well regulated acros.

    On the up side, cabergoline costs aren’t bad and are based on cat weight.
     
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  10. Krystina & Nelli

    Krystina & Nelli Well-Known Member

    Joined:
    Jul 4, 2018
    Hi :),
    Ive been thinking- never knowing cost of cabergoline I’ve thought, if cabergoline isn’t ridiculously high, when this drug starts to work at lowering insulin intake, your cost of insulin will decrease- I.e. overall rx cost will go down. :)
    This has been on my mind and as you’ve brought cost up I decided to share my thoughts with you :)
     
  11. Krystina & Nelli

    Krystina & Nelli Well-Known Member

    Joined:
    Jul 4, 2018
    Look at @Bronx's dad SS. See how high Bronx was in 2017? Upper 30’s units. 2018 Bronx dropped down needing < half this amount.
    Look at where Paul has brought him to today :cat: :bighug: 3U.
    I realize Bronx Acro was treated differently- Bronx is only one example (there are enough others ;)) of an Acro cat going low. Acro cats can and do go low :cat:
    I can’t imagine going through what you’ve gone thru with Biscuits. I. Can’t. Imagine. You are a very special person (the world needs more of) to save Biscuts life, early on, once.
    I have been following you all the way (up :nailbiting:), nearly from your first day and I continue to be in awe by your care and dedication :bighug:
     
    Last edited: Aug 15, 2019
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  12. Mollycat

    Mollycat Member

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    Mar 16, 2019
     
  13. Mollycat

    Mollycat Member

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    Mar 16, 2019
    Thanks, how do I open the SS? Not the best at navigating the forum! Can you send dosing guidelines for cabergoline ? I want to send it to my vet but I can't seem to find anything. She isn't familiar with it and I know she is looking for that information.
     
  14. Mollycat

    Mollycat Member

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    Mar 16, 2019
    I gave my vet info on cabergoline but what I find is information on trials from a year or so ago Is it routinely prescribed now for acro cats? She'll need dosing and prescribing info. I totally agree with your having seen more acro than most vets. And when I had biscuits to the new grad vet, he said it's very rare and he was the first he had seen. I'm hoping the cabergoline isn't super expensive and does do the trick because the cost of Lantus is getting prohibitive. I have a discount card from the manufacturer which helps a lot but it's still high . I just looked up Cabergoline. $32 for 8, 0.5 mg tablets. That sounds reasonable but not sure without knowing dosing.
     
    Last edited: Aug 15, 2019
  15. Sonia & Leo

    Sonia & Leo Well-Known Member

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    May 24, 2018
    Hi Sandy, I'm tagging Paul to help you with more info on the Cabergoline. @Bronx's dad
    Also @Olive & Paula but she might have her hands full this morning.
    :bighug::bighug::bighug:
     
  16. Krystina & Nelli

    Krystina & Nelli Well-Known Member

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    Jul 4, 2018
    Paul @Bronx's dad and jeff @JeffJ might be able to better direct you with your questions :bighug: (Paul May be away on business). Have you posted on the Acro subforum?
    To open a SS search the member name, click on avatar, then “information”. You will see in their signature a link to SS.
    Click this and it will open spreadsheet :)
     
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  17. Mollycat

    Mollycat Member

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    Mar 16, 2019
    Sounds great
     
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  18. Bronx's dad

    Bronx's dad Well-Known Member

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    Nov 30, 2016
    Last edited: Aug 15, 2019
  19. Olive & Paula

    Olive & Paula Well-Known Member

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    Sep 6, 2015
    @Mollycat .

    There isn't that much info on cabergoline out there. The studies do say what starting dose is. Your vet will have to read the studies and should talk with compounding pharmacy and together they can determine the dose. It is based on weight. I don't use the pills so I couldn't say but what you said above is only for 8 pills. Cats get it everyday or every other day so keep that in mind. I like the suspension because this way I know she gets it in her. Ollie is hard to pill and I see more being wasted than what she would get in her. It also allows me the flexibility to increase dose when the symptoms increase and persist.

    Only one study mentions increasing dosage. I think that is the one who also followed it for 1 yr. The others only followed up at months 4 and 6 and never tried changing the dose.

    You are on much higher dose of insulin than Ollie. You will have the cost of both cabergoline and a lot of insulin for quite sometime. That is something else to consider. It is a lifetime medication. It's possible should remission occur cabergoline could be given every other day but no studies on it. Parent would have to be willing to risk trying it.

    Really think about your expectations regarding cabergoline. Do you expect full remission? It might not happen, you might get a lower dose of insulin if you stay with it long enough but you don't know how low it will get. Example if 20 units twice a day be the lowest you can achieve, is it enough for you?

    Ollie cabergoline costs $127 a month, the lev is $169 a year at this time. Let's say the SRT is about $6000. Ollie can have her meds for just over 45 months before we reach the cost of SRT.

    Ollie's vet knew nothing about it either. But she researched a little (I think I provided most of the info though), talked with endocrinologist (she says) and talked with compounding pharmacy. As she says it's an unknown and we follow Ollie's lead. We guess, we try different things.

    It is not a common med most vets would know about. My goodness look how many still tell owner when dx with diabetes to put cat down. Don't even offer to treat it. How many are against home testing. Your vet won't find a lot about it out there. You both need to decide if you want to take a leap of faith for the right reasons, keeping Biscuit comfortable and possibility of lessening the tumor activity to make that happen. And working together to make it happen.
     
  20. Krystina & Nelli

    Krystina & Nelli Well-Known Member

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    Jul 4, 2018
    Thanks Paul, @Bronx's dad ;)
     
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  21. JeffJ

    JeffJ Well-Known Member

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    Jul 7, 2016
    Paula did a good post on cabergoline.

    I didn't try cabergoline. My sweet Leo was treated with SRT when he got to 18 units in September 2016. The treatment gave him nearly 3 more years of life. SRT costs are $6,000 or more. There was a sub-$5,000 SRT last year at Washington State University. But, from what we can tell, they no longer offer SRT there.
     
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  22. Krystina & Nelli

    Krystina & Nelli Well-Known Member

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    Jul 4, 2018
    Of course... at that size dose?
    I guess you could tell!!! ;).
    Biscuits (& you) stays in my thoughts and prayers :bighug: :cat: :bighug:
     
  23. Marje and Gracie

    Marje and Gracie Well-Known Member

    Joined:
    May 30, 2010
    One in four diabetic cats has acromegaly. Most vets know little about feline diabetes and even less about acro. I would wager that Wendy knows 100% more about acro than the majority of vets.

    Welll.....I’ve been on this board 9.5 years and I’ve seen a lot of acro cats in blue and green....safely. As Wendy said and I mentioned before, for any diabetic cat, you want their BG below renal threshold which can vary by cat. You might see a number if 250 but that’s on lab equipment so on a human meter, it would be less. We’ve had some CGs here monitor their cat’s urine and found the renal threshold for their cat was much lower than 250.
     
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  24. Mollycat

    Mollycat Member

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    Mar 16, 2019
    Thank you so much for that information that is awesome advice.
     
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