Dosing an Acro Cat?

Hi All!

I have surfed the forums for a while now and taken much advice, but this is the first day I have posted. I am posting because we recently received a diagnosis that we did not want! After fighting with steadily higher BG numbers, I insisted that we test for Acro / IAA. Pig's Acro came back at >500!!

We have gone through a cycle. With every raise Pig would marginally respond to the dose, but cycle back up. Initially, his raises were done at .5u (after receiving better advice), but now are done in full unit raises since we passed the 10u mark. Pig is now on 12u 2x a day with food as needed. He eats a low carb / low phosphorus food mix of Sheba Pates and Tiki Cat. He gets food anytime he wants, but typically every 2 hours. I use a blender to blend his food into a smooth sauce of food and water. I was wondering if anyone had any dosing advice or any advice period.

Also, I was told to start an R insulin. I purchased a bottle of Novolin R. My vet wants to wait on dosing this. Is there any reason I should? I see it that these numbers need to come down as soon as possible...
His chart is as follows:

https://docs.google.com/spreadsheet...CLqCt8eHkLntNat15msCD4czcA/edit#gid=343926592

 

Welcome Pig and Pig’s human!

I’m sorry about the acro diagnosis. You are in wonderful company here, there are quite a few acro cats and some very experienced caregivers that I’m sure can help guide you with acro and R. I’m not one of them, but wanted to say hello! Awesome that you got your spreadsheet sheet all set up, that is so helpful to others helping you.

Read as much as you can, read the stickies, read other threads and other cat’s SS, it’s all very helpful and it can take a bit for it all to sink in, but that’s okay.

 

@Wendy&Neko is one of our resident acro experts

She's usually around this time of night so hopefully she'll see the tag.

Sorry you got the acro diagnosis, but remember, Pig's still the same kitty you loved before you knew for sure that he was an acrocat ......nothing has changed for him!! Try not to let your worries spill over to him because he won't understand why his hoomin is so concerned.

 

Welcome to the Lantus and Levemir Insulin Support Group.

I’m sorry you’ve gotten the dx of acro. Does he also have IAA?

When was he dx with diabetes...was it in August or before?

We do use R here and he could likely benefit from it. Several of us are experienced with using R. I’ve tagged @Wendy&Neko because she is our resident high dose expert. I’d like her to give you some thoughts and you can ask her questions but I’m glad you are raising the dose by 1u.

The SS is not the same one we use. We have one formatted for pet meters. We also link our SSs in our signature blocks so other members can easily access. Here are the Spreadsheet Instructions which include how to post it correctly.

 

Welcome Pig (love the name) phoebe is to a high dose kitty. I can't give you dosing info, but can offer a warm welcome and tell you this is the most wonderful place you never wanted to be. She was at 24 units 2x a day now at 16. It was the usage of R that helped her, along with finding her magic dose. Wendy is the bomb diggity.

 

Hi Sarah and Pig and welcome. Angela @Phoebes you are making me blush.

In your post on the high dose forum and message to me, you said you were looking at what sorts of treatments are out there. First things first, I see you live in the US, Oklahoma. Treatments fall into 4 categories. First is just treating with insulin and trying to find a dose that keeps them mostly below renal threshold. If you look at Phoebe's spreadsheet, you can see Angela is doing a great job with that. No matter what other treatments you might pursue, finding good numbers is key. The second and third options require travel and cost that not all can afford. Option 2, which I did, is stereostatic radiation therapy. There are maybe 10 or so places in North America that do this. Option 3 is surgical removal of the pituitary. Only two places in the US have experience doing this, it is risky. Royal veterinary College (RVC) in London is to go-to place for it, they have done many such surgeries successfully. The last option is medical. Ther are two such drugs that RVC has tested with varying degrees of success. Pasireotide (Signifor) has the best success and is very expensive. The last is called cabergoline, very new and cost effective. A few people here started on it this last year. One cat egpven went off insulin in it.

Once we know more about his IAA diagnosis, we will have more to say about dosing. In the mean time, start by reading the Sticky Note on the Tight Regulation Protocol. It is probably your best bet for getting to a good dose as fast and safely as possible, if you can do it.

Keep asking questions.

 

Welcome Sarah! Glad to see you made it to the right place to help Pig get into better numbers. Bronx is also an Acro and using R along with Levemir. If you look at his 2017 SS, you can see how R was the reason we finally got into lower numbers. You are in good hands here, Wendy and Sandy @Sandy and Black Kitty were so helpful in "coaching" me with R at first.

 

Welcome. Gizmo is also an Acro cat. We are using Cabergoline, but have no experience with using R. We are still fairly new in this sugar dance (hard to believe it’s been almost a year already). Ask lots of questions ... everyone here is very helpful.

 

Hi there and welcome

 

You are so very right!! I have been trying to be as positive as possible.. I find it hard not to 'hover' over him out of concern, but force myself to let him still cat... lol

 

As far as I know he is negative for IAA, but that is still pending. His diabetes diagnosis was in early August, but we started Insulin on 8-29-2017. I wanted to see if we could manage with diet alone and that obviously did not work.
I will work on fixing up the ss for the correct format! Thank you for helping me with that! I actually use a Relion Micro, so the numbers I have are from a human meter.
I cannot say how much I appreciate the help here!

 

She is beautiful! I am really anxious to try the R, but have waited at the insistence of my vet. However, I am really wanting to start this and cannot see that it would be any harm. Well, unless I go overboard, but I do not plan to do that... Thank you sooo much!

 

Thank you @Wendy&Neko this is great advice! I will begin at the sticky notes! I do not think I will be able to afford SRT unless I can make a miracle happen (which for Pig is entirely possible), but neither do I just want to treat with Insulin. I would rather attack the source, so to say. However, I worry about the effects of some of the medications. I do agree that better numbers are where we want to be, so I study TR and look at the R first and foremost. Thank you for your kind words!

 

Thank you, we think she is but we are very biased. Lol I was a nervous wreck starting R because of the seriousness of the R. But with the right people @ Wendy @Sandy and Black Kitty they really helped me breathe thru it. It only took a couple of injections to get Phoebe turned around. We are not sure if it was the R or we found the right dose or a combinaton of both. Whatever it was, we were over the moon. Continue to pick our brains for any questions or thoughts we might help you with. This dance is complicated but very doable. Especially with the right music and partners. And we all are here for you and Pig.

 

Thank you! I will be brushing up on TR and then moving forward. I am trying to make a plan to start dosing the R tomorrow or Monday. I sort of want to wait until Monday when I know that the local vets will be open if he does Hypo. However, I doubt that, but you never know with Pig. He has always been the odd ball... lol

btw. she is beautiful. No bias there!

 

What we usually do when a person starts R for the first time, is have an experienced person "sit" with you, ie. be online at the same time. Make sure you have high carb food or karo on hand. You will test every hour for 4-5 hours to get an idea what the R cycle looks like in Pig. And start on a small dose like 0.25 units of R, less if kitty is on a smaller L dose. The experienced R user can tell you if it's a good cycle to use R. You only want the R to lower the BG by about 100 points, or you'll set of a bounce. A bounce breaking cycle is not a good time for R. Learning when not to use R is one of the skills you'll build.

 

We have lots of resources here to help you nd Pig so please don’t hesitate to ask questions.

I’d suggest that when you get the R, you get it from Walmart. The name of it from there is Normalin R. A vial is about $24. If you buy it from a non Walmart Pharmacy, it’s Humilin R and costs +$80.