Looking to see SS for IAA

Discussion in 'Acromegaly / IAA / Cushings Cats' started by Mocha aka Cold Play, Feb 9, 2016.

  1. Mocha aka Cold Play

    Mocha aka Cold Play Well-Known Member

    Joined:
    Sep 23, 2015
    I would appreciate any replies to see some history of other IAA cats and if you can tell me when the diagnosis was made. I would like to see what IAA ss look like. A blood test may be on the horizon for my girl but my vet is horrible with blood sticks. I am seeking a 2nd vet out.

    Is there any kind of pattern to help identify one way or the other for iaa?
     
  2. suki & crystal (GA)

    suki & crystal (GA) Well-Known Member

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    May 4, 2014
    Hi Kari, my Crystal is probably IAA but the specific test isn't available here in France. She also has acromegaly, which the experienced members here might suggest you get Mocha tested for. I'll tag the experts for you @Wendy&Neko @julie & punkin (ga) @Grayson & Lu @Sandy and Black Kitty .
    Another IAA kitty is Anne's Hyde - she is currently on vacation but check out her SS also. @Peg and Toby is another high dose kitty with probable IAA as well as Marilyn's Polly (I think?) @pollydoodle

    Good luck with Mocha.
    Suki
     
  3. Mocha aka Cold Play

    Mocha aka Cold Play Well-Known Member

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    Sep 23, 2015
    Thanks, I do have the info for testing and I am just trying to get my understanding around what it might look like on a ss. I will take a peak after a med appt. I would like to see only IAA on a ss, as I do not believe the acro is a concern right now. I see no signs of that.
     
  4. Sandy and Black Kitty

    Sandy and Black Kitty Well-Known Member

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    Dec 31, 2009
    If you are looking for purely IAA check out BKs ss.
    It's a bit crazy. I'm happy to answer any questions you may have.

    He was the first here to be tested and the result was 84% - extreme insulin resistance.

    I want to see your ss on a big screen (I'm on my phone now). BBL
     
  5. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Feb 18, 2015
    Hi Kari. My sugar tested positive for IAA and negative for acromegaly. I have not done any Cushing's testing yet as I think I am starting to see a tiny bit of a break in her numbers. I have a kibble addicted cat so always expected her insulin needs would be higher than the "norm", however switching her from a 29% to 8% carb kibble did absolutely NOTHING and that was my first clue something might be a little off the beaten path with her.

    I had to switch to Levemir from Lantus due to painful injections at around 6u and once she got to 8u Levemir, I had the testing done.

    Please note I test with both a human meter (since July2015) and a pet one so note the names on the tabs at the bottom if you want to have a peak at her sheet. Only the World sheet which is pet meter numbers is being converted into US values. Took a quick look at your spreadsheet and I can understand your concern. I would generally notice some small reaction to an dose increase on the first day and maybe the second, and then Menace would be right back to square one initially but I NEVER saw anything close to blue numbers. Now that she is sometimes getting a few blues now and then (human meter usually), I think she is bouncing on dose increases. I always hold doses for 7 days as it takes that long to really get a feel for how it's working.

    I am now considering switching Menace to Hypurin PZI which is closer to cat insulin but I'm not sure if IAA means resistant to all insulin or just exogenous and even my vet is investigating this further. I'd have to import the Hypurin PZI from the UK and don't know it going through the hassle is worth it if there is little to no chance of it solving the resistance.

    If you have any other questions about my experience, please let me know.:)
     
    Last edited: Feb 9, 2016
    Reason for edit: info added
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  6. Grayson & Lu

    Grayson & Lu Well-Known Member

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    Jan 9, 2012
    Check out Grayson's SS from Jan-May 2012. He had the IGF-1 and IAA tests run in April; results early May. Positive on both. He was switched from ProZinc to Levemir when I returned from a scheduled trip over Memorial Day weekend, then went to Colorado State for SRT in mid July. He was NOWHERE near regulated at that time. We climbed the dosing ladder with Lev, fairly quickly (or so it seemed) to 50u +3uR max when he finally started responding (October/November). He gradually reduced... kind of like a cha cha... three steps forward; one step back. Did we have a breakthrough? Was it the SRT? No way to know for certain, but he came down and was at .5u nearly 3 yrs post-dx, when he was diagnosed with Eosinophilic Leukemia/Hyper-Eosinophilic Syndrome (a cancer in his blood, liver, spleen and an abdominal mass the size of a 12 oz can of soda), and ultimately put to sleep in November 2014. In my eyes, and those of his specialist, Dr. Kathy Lunn at NC State Univ., he had beaten the Acromegaly and the IAA.
     
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  7. Mocha aka Cold Play

    Mocha aka Cold Play Well-Known Member

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    Sep 23, 2015
    Sorry that I feel so much information that sometimes I can't sort thru it. I have chronic pain issues and reading thru mounds of anything is taxing to me mentally and physically, so that is why i am seeking y'all.:cool:

    In what I read, other than the blood test, I was not seeing (or can't recall) any "treatment" other than perhaps ;;;;;;;;;;;-0
    [I left this above because Mocha typed it and it looks like a squinty eye and a scream!]

    changing to different insulin and see what happens.

    What happened to help resolve the iaa, when it could be reversed?

    How long is considered "long enough" to allow a type of insulin to work?

    I have noticed some periodic discomfort with the insulin dose in the last month or so, but not every time. I have plenty of Lantus (a new bottle of 10u) and 5 (3unit) pens to open, but if that really was to be the difference, I could sell off the pens. I just don't know that dropping off Lantus to Levemir is going to make a hill of beans and I am concerned we backtrack even more because of the dose.

    I appreciate keeping track of her numbers going forward and giving any insight. I left her for my appt and I don't know if that spiked her or merely that blue early this am. I wish she would tell me!
    Kari
     
  8. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Feb 18, 2015
    A specialist in Texas consulted on Menace's case before I had the testing done. He indicated that until a cat gets over 8u of insulin, he would not consider testing for IAA or acromegaly. He also suggested switching to PZI if the dose exceeded 8u Lantus. The closest thing to PZI here in Canada is ProZinc or an unreliable supply of compounded pork PZI. I am concerned that the ProZinc is not enough of a change (still human recombinant) to make a big impact. I don't want to risk not being able to get the compounded or worse, deal with concentration/sterility issues that are inherent in the compounded insulin. So I am considering the manufactured bovine PZI (closest to cat insulin) from the UK.

    If you decide to go forward with testing for IAA, I would get the IGF-1 done as well as the IAA. Many cats with acro do not have any classic symptoms in the early stages. The IGF-1 can and does fluctuate so while Menace has no symptoms of acro and her IGF-1 was negative, it is not 100% conclusive and I will have her re-tested if her progress remains static.

    I switched Menace to Levemir simply because my once docile cat slowly began flinching, jumping and crying out with her shots. The only thing I could figure out was that Lantus is acidic and the higher dose was now stinging. She never flinched or cried out until I started pressing the plunger so I knew it wasn't the needle poke bothering her. Admittedly I was super conservative with my switch by following my vet's advice and in hindsight I should have followed the advice given here but hindsight is always 20/20. I hoped that the change would also "break" the resistance but that was not the case.

    Admittedly your pattern looks much different from mine. Mocha seems to have some pretty wild swings whereas Menace just seems to coast along essentially in the same range with a few small dips and rises periodically. I'll bookmark your sheet and watch it but I am by no means an expert with any of this. Have you asked any of the more experienced folks on the Lantus board to provide an opinion of what they think might be going on?
     
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  9. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Feb 18, 2015
    Probably a stupid question but I just looked back at your 2015 sheet and notice you have another cat. Is the other cat on the same diet or could Mocha be pilfering food that is higher in carbs? I have a problem here in that I have a furry vacuum cleaner (Menace's step-brother) who pilfers Menace's portions sometimes making it hard to keep track of her exact intake.
     
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  10. Sandy and Black Kitty

    Sandy and Black Kitty Well-Known Member

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    Dec 31, 2009
    BK was tested for IAA in Sept. 2008 after a negative acro test. It was a last ditch effort to figure out why his BG just would not budge.
    As you can see on his ss, we had been at it for 6 months before we saw green-which lasted about 3 hours and did not return for 6 weeks.

    The good news is that it is self limiting and resolves after a year or so. There is not a treatment or cure, you just want to keep BG under the renal threshold (200 or so) until the IAA breaks. When it does break it can be quite dramatic so you want to be mindful of depot size.

    I recommend you get both the IAA and Acro tests since you cant go by appearances. As Linda stated above, classic symptoms may not be visible in early stages.

    For now I'd be a bit more aggressive with increases - provided you can monitor closely.

    I did notice on your 2015 ss comments about gum inflammation. May be time for another dental.
     
  11. Mocha aka Cold Play

    Mocha aka Cold Play Well-Known Member

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    Sep 23, 2015
    Latte gets some dry kibble but very little. She is eating the juice from the canned of Mocha's.

    At our prior home (pre Jan 6, 2016) Mocha definitely hit the lotto a few times with Latte's kibble. I did not always remove it fast enough but that has not happened here. They eat across from one another (if Latte wants kibble) and Latte is on top of a high file cabinet that Mocha can only reach by a much more difficult path. Mocha has little legs and since Latte is eating kibble right by me and I see her, I have removed her small dish so far. But, you are right, it was a factor a few times that she had more than a few bites. Otherwise, she sometimes got crumbs from the box Latte ate in at the old house because it was on the floor. But, again, I am able to monitor it better now.

    I was following Tilly's TR and looking for overall range to be under 200 but when not, moved up the dose. Maybe she needs to settle in this dose, since it brought her lovely greens not long ago.

    Any info is helpful and needed.
     
  12. Mocha aka Cold Play

    Mocha aka Cold Play Well-Known Member

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    Sep 23, 2015
    I am watching the gums, and they are really holding well. But, I am keeping it on radar. :D
     
  13. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Feb 18, 2015
    @Sandy and Black Kitty I just peeked at BK's SS and noticed you were using R insulin for awhile to bring the numbers down. My vet admits to never having dealt with IAA before and never suggested using R as an option, although I have to admit I have toyed with discussing it with her after seeing a lot of Acro kitty parents using it. I'm wondering if you used the R strictly to keep BK below renal threshold or was this something recommended to you to help break the resistance? We've been at this a year now and I admit I am royally frustrated and getting more desperate by the day to see some improvement.
     
  14. Mocha aka Cold Play

    Mocha aka Cold Play Well-Known Member

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    Sep 23, 2015
    what is "r" insulin?
     
  15. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Feb 18, 2015
    "R" is a fast acting non depot (in and out) insulin that goes to work quickly and brings glucose down sharply unlike Lantus which is a slow acting depot insulin. "R" is not normally used in cats unless there is some reason to need to get levels down quickly e.g DKA or long term numbers above renal threshold. It is not something you would use without some expert guidance and I would want to know what I was dealing with before going that route....not just high numbers.
     
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  16. julie & punkin (ga)

    julie & punkin (ga) Well-Known Member

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    Feb 17, 2011
    Ozy was diagnosed with only iaa (68% high Dec 17, 2013 ss) and his IGF-1 (acromegaly) was negative but high on the negative end. I want to say it was in the 80's. Here is his spreadsheet link. Donaleen switched him from Lantus to Levemir Dec 21, 2013 and was really, really happy with the Lev. Most people now switch high dose cats to Levemir because of its long duration and neutral ph.

    One tell-tale "look" of a spreadsheet of iaa cats - often when the dose is increased, they might have an initial response and their BG might drop into a lower range, but shortly after that it will appear that the dose has stopped working and the blood sugar range rises. Wendy coined the term "going stale" to describe that response, and that's a perfect description of it.

    Acro spreadsheets, on the other hand, can sometimes stay at a dose for a long-ish period of time. The tumor that causes acromegaly is called "pulsative" meaning that it can ramp up or down in its hormonal secretions. Or the dose can go up and go down. Some acro cats can go into remission when the tumor takes a break, then end up back on insulin again in a while. But you don't necessarily see that pattern that the dose initially works, then stops working. By the way, as others have said, I really don't think you can rule out acromegaly without a test. It is more common than iaa - the latest study shows 1 in 4 diabetic cats have acromegaly.

    R is "regular" insulin, either Humulin Regular or Novolin Regular. You can buy it in the US without prescription, just ask at the pharmacy. It can be a great tool when it is needed. Most people with high dose cats choose to use it, but there are people with non-high dose cats that also use it. One has to be careful with it because it has a nadir, just like Lantus or Lev, and you don't want the nadirs of both insulins to occur at the same time. Timing is everything with R. If you are interested in it, let us know and an experienced R user would guide you. In cats with iaa, the action of R can be extended, so it isn't as quickly in and out as it is in non-iaa cats.

    I don't see any advantage in holding the dose longer in any diabetic cat if it's not getting the cat into normal numbers. Holding onto a dose that isn't working causes Glucose Toxicity to develop and the result of that is having to go up in dose.

    High dose kitties have higher/lower IAA percentages and higher/lower IGF-1 results. The result of this is the perhaps more than any cat, the phrase "know thy cat" is critical.

    If you decide to test Mocha, I'd definitely test for both acro and iaa. Cushing's is the 3rd cause of insulin resistance, but it typically includes fragile skin symptoms and I would say is the least seen here. The acro/iaa are relatively common. We usually suggest people get their cat tested if they get to 6u per shot.

    By the way, if you're following the guidelines laid out on the Tilly page, you would be increasing the dose a little faster. You can increase in 2-3days when a cat is all in high numbers. As much as you test, and with Mocha having passed 6u, I wouldn't hold on to a dose longer than those 2-3 days until you are seeing green numbers. But of course, it's up to you.
     
  17. julie & punkin (ga)

    julie & punkin (ga) Well-Known Member

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    Feb 17, 2011
    One more thought about R - in addition to Linda's description here:
    R is also used when one might anticipate the dose needing to be lowered quickly. For example, with Sandy's BK, she used significant amounts of R regularly in addition to the Lantus because if his iaa broke, the depot from a large dose of Lantus would continue giving out at that larger rate and it could've become a problem. Suki does this with Crystal too.

    The strategy that these 2 use has the L insulin providing a baseline control and the R is adjusted to fit the blood sugar tests. It allows a little more flexibility in dosing, without having this giant depot from the L insulin continuing to give out if you need to reduce the dose immediately. That's something one works up to so it's not something you need to worry about, but I wanted to mention it because with iaa, R can be a very important tool.

    I'm sure Wendy will have more to add to the conversation but she's tied up with family issues at the moment.
     
  18. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Feb 18, 2015
    @julie & punkin (ga) Thank you for that explanation and incite. The info re: using the "R" to "compensate" when the need to lower the dose of "L" is anticipated makes perfect sense to me NOW! Quite frankly I've looked at some of those spreadsheets and was just totally confused and mystified as to what folks were doing. I may have to go the "R" route myself in the not too distant future with my IAA girl and you have helped to lower my anxiety of doing so.
     
  19. Mocha aka Cold Play

    Mocha aka Cold Play Well-Known Member

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    Sep 23, 2015
    I am wondering about the dosing mid July 2014....it seems to move very rapid and some times I can't figure it out. I get the reduction of .25 if under 90 but can't really figure out what was going on there.
     
  20. julie & punkin (ga)

    julie & punkin (ga) Well-Known Member

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    Feb 17, 2011
    Ozy died in August. Donaleen didn't reduce for under 90, but may have reduced if he seemed ill. By July he wasn't doing well all the time. Like most kitties, he had other things going on. He had eosinophilic granuloma (hope I have that spelled correctly.) It is also called rodent ulcers, and when it flared up, his blood sugar reflected it. I would look more at the dosing pre-summer 2014.

    @MrWorfMen's Mom Linda, it is just another tool, nothing to be afraid of. But like all tools you want to learn to use it correctly and understand how it works. There are several people who can teach you if you want to learn. I really liked knowing how to use it with punkin and found it helped a great deal.
     
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  21. julie & punkin (ga)

    julie & punkin (ga) Well-Known Member

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    Feb 17, 2011
    I just realized this is posted over on the high dose support group. That group has been inactive for years. They moved to a facebook group in 2011/12.

    Kari, as far as I know, since then, all the high dose kitties on FDMB now post in the Lantus/Lev insulin support group. There are plenty of people there who didn't get tagged, who could be offering you their experience with their own high dose kitties.
     
  22. Sandy and Black Kitty

    Sandy and Black Kitty Well-Known Member

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    Dec 31, 2009
    That's good however what may be going on under the gum line is another story. . .
    @MrWorfMen's Mom -I started using R when BK went DKA for the 2nd time. Keep him under the renal threshold?!? I was happy to see a break in the relentless sea of pink - even if it was 299.
    BKs vet (#3), met BK after he recovered from the 2nd DKA . She was very nice but knew nothing about IAA. Nevertheless after the acro test came back negative she humored me and ordered the IAA test. After the results she was constantly on me to switch him to PZI. She flipped out when she saw my ss- 13.5u Lantus plus up to 15u R per cycle seemed insane to her. It got to the point where she said she was not going to renew his Lantus prescription.
    Fortunately the IAA broke right after that threat and she saw the light.:p She clearly gained respect for my unorthodox (in her eyes) treatment and it was smooth sailing. When he went OTJ she said "he is amazing".
    I cried when she moved back to her home state of Kentucky.

    Julie has provided great info on the use of R.
    I will add that along with knowing when to use R it is equally important to know when not to use R .
    It is a double edged sword and it's power can be seductive.

    Over the years I've seen kitties whose caregivers got trapped on "the R Roller-coaster":
    They see a high number and grab the R to shoot it down. Kittys BG then dives, triggering a bounce to the stratosphere, whereupon the caregiver grabs the R.... You get the picture. Getting out of that endless loop is painful.
    Like Julie said its nothing to be afraid of if used properly. It's power must be understood and respected for safety sake.
     
  23. julie & punkin (ga)

    julie & punkin (ga) Well-Known Member

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    Feb 17, 2011
    yuppers! I agree absolutely. Learn how to use it from experienced users rather than trying it on your own.
     
  24. suki & crystal (GA)

    suki & crystal (GA) Well-Known Member

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    May 4, 2014
    @MrWorfMen's Mom , hi Linda, I would just add my 2 cents worth and recommend that you seriously think about giving the R insulin a try. I too like you was getting totally frustrated with ever increasing high numbers but was gently persuaded to give it a go (under watchful eyes and plenty of hand holding), and Crystal is now in a very good range. It was the best decision I/we ever made for her and now Crystal's dosage is also coming down (signs of the IAA breaking ?) having been at one time the highest dosed cat on the L&L forum. I use the R every day and give it at PS, but that is what suits Crystal, but ECID and you must be aware of the dangers so ask for guidance if you do decide to try it.

    Lots of excellent advice here from experienced members, thanks for picking up my tags ladies.
     
  25. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Feb 18, 2015
    @Mocha aka Cold Play I'm so sorry but it seems I have somewhat hijacked your thread. While this info may be of interest to you, I certainly did not intend to make this thread about my Menace.:oops:

    @julie & punkin (ga) @suki & crystal @Sandy and Black Kitty I cannot thank you enough for all your input and for lessening my fears. I have a week long trip coming up very soon so don't want to start anything new right now (sitter could never handle it nor would I expect her to) but when I return, I am absolutely going to look into adding "R" into my tool kit under your guidance. I am so grateful for the knowledge and hands on experience on this board! :bighug:
     
  26. Mocha aka Cold Play

    Mocha aka Cold Play Well-Known Member

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    Sep 23, 2015
    No worries. It is about "community." I never thought otherwise. You ask the questions that I don't know.
     
  27. Grayson & Lu

    Grayson & Lu Well-Known Member

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    Jan 9, 2012
    A couple thoughts...

    Lantus is a very good insulin - in most cases I would venture to say THE BEST choice for diabetic kitties. However, some kitties, particularly those getting higher doses, appear to experience a sting from shots, similar to human diabetics. Most of our Acro kitties and IAA kitties are on Levemir, as it is pH-neutral and doesn't have the same effect.

    ProZinc does not have the shed that the L insulins have, which is extremely beneficial for IAA kitties. I would discourage you from considering a switch to ProZinc (though I believe I've read that some of the compounded PZI options may have a shed - someone else would have to confirm this).

    If your kitty is getting a good insulin, is eating a low-carb diet, and is STILL not responding to reasonable amounts of insulin, it is likely to be resistant. Grayson was on as much as 6u ProZinc TID (3x/day) with barely a move. Insulin resistance was no surprise. It's worth it to test, and though it's not completely necessary to do both the IGF-1 and IAA tests together, the blood is prepared & shipped together. Grayson's tests were $15 and $49 four years ago, so in the grand scheme of things, not much more to test for both. We have one acro mom that has had a second acro that SHE dx before the test results proved it. Sometimes the first IGF-1 test comes back in the normal range, while some are positive first time around.

    My last thought may not sit well with everyone here... but here you go: TR and SLGS are very good protocols - for regular diabetics. In the case of the IAA kitty, however, they are NOT as effective. Insulin resistance can be VERY powerful, and in order to beat it, you have to use aggressive dosing. We hold a dose for generally 3 days tops - so your 7ths shot is an increase. Unless and until you start seeing consistently low blues and/or greens, I increased by 20-25%. Same philosophy as TR when you're at 1u and go to 1.25u; but when you get to higher doses, say 6u, .25 is about a 4% increase. You have to stay "ahead of the train", and that can only be done by chasing it aggressively.
     
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  28. Wendy&Neko

    Wendy&Neko Well-Known Member

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    Feb 28, 2012
    Sorry to be late to the party. In response to what IAA looks like, Neko had the classic IAA "look" back in the beginning. Here is her 2012 SS. Ignore the first 3 weeks on a bad meter. She started seeing greens at 3.75U but didn't earn her first reduction until 8.75U. It had that typical look of not being able to keep on greens. I called it "the dose going stale". She also has acromegaly but wasn't able to hold onto a dose any length of time until the IAA broke, around the time right after her SRT (stereostatic radiation therapy) treatment. Other IAA plus acro kitties were Cobb (started Prozinc, switched to Lantus then Levemir) and Pepper

    Wrong and wrong! We had one member post here recently with an acrokitty on 4 units of insulin and fairly well regulated. I've seen a paper by Dr. Lunn of NCSU (probably North America's top acro researcher) recommend testing over 5 units. The Royal Veterinary College (probably THE best source of acro research in the world) did a study of 59 acrocats being treated with an average of 7 units BID. Lu-Ann gives a good description of why the longer lasting insulins are a better choice.
     
  29. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Feb 18, 2015
    That so called specialist came up with a few other less than credible reasons why my cat might not be seeing much, if any results from her insulin therapy. Thank you for confirming that I was right to go with my "gut" rather than the specialist's recommendations when I refused to switch to a non-depot insulin and insisted on the IAA and Acro testing. While my vet has always been pretty open to my suggestions, she did try to discourage me from wasting money on the IAA testing given it is thought to be so rare. She was gobsmacked when it came back positive! I felt vindicated! I think those results have made it a little easier for my vet to let me do what I feel needs to be done. I am definitely shelving the PZI idea and will be looking to add some "R" with guidance from those here who have already walked this path.
     
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  30. Wendy&Neko

    Wendy&Neko Well-Known Member

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    Feb 28, 2012
    Neko's vet didn't think I needed to do tests until she got over 10 units (she never did). She consulted the local IM specialist who said the same thing. The senior vet at the clinic called them "exotic tests". Both were "gobsmacked" when both came back positive. And as you said, insisting on the test results and being right gains a lot of respect - now the senior vet admits I know more than him about acromegaly. Admittedly a low bar, but they have since recognized other acros.
     
  31. Dawn and Peek-a-Boo (GA)

    Dawn and Peek-a-Boo (GA) Member

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    Dec 27, 2015
    My Peek-a-Boo is an acromegalic cat that started on Prozinc and we worked up to 6u BID with little to no response after 4 months. The specialty clinic I was then referred to had him changed to Vetsulin, same dose. The Dr. there was Australian and said they had great results with it in Australia. Peek-a-Boo did horribly on it and layed in one spot for hours and was extremely lethargic. Dr. said to hold it for 2 weeks to let it take effect. After 7 days, I took it upon myself to go back to Prozinc and he returned to previous condition. My regular vet recommended we next try Lantus. He said he never had success with Vetsulin. After 4 months of Lantus at 4u and still high BG, I requested that we test IGF-1. That came back a whopping 521. I went back to specialty clinic to see different Dr. and had a CT scan to confirm acromegaly. Around that same time Peeks somehow "settled in" to that 4u Lantus dosing and became regulated. At that point he was on his "wrists" and the backfeet were in a plantigrade stance (walking on the hocks) from diabetic neuropathy . Once regulated, his neuropathy quickly reversed. March will mark the one year anniversary of being on the same dose of Lantus at 4u and being regulated. Our situation is a bit different in that my cat doesn't require the extreme doses of many others here, but still has acromegaly. I agree with others, and in my opinion, would test for IGF-1. I never had the IAA test done.

    Best wishes to you and Mocha.
     
  32. Dawn and Peek-a-Boo (GA)

    Dawn and Peek-a-Boo (GA) Member

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    Dec 27, 2015
    Once Peek-a-Boo achieved regulation in March 2015, I test him for ketones with urine strips regularly and he gets a fructosamine test every 3 months. Fortunately, these have shown good regulation. He has a test coming in a couple weeks so hopefully we are still smooth sailing (knock on wood :cat:).
     
  33. Pumpkin's Mom

    Pumpkin's Mom Member

    Joined:
    Nov 27, 2016
    @Sandy and Black Kitty my Pumpkin just tested positive for IAA (not sure of percentage, didn't know to ask the vet but I will). He is at 9u of Lantus and looking to move up now that we know. I was very excited to see that the IAA will eventually break. I am thinking I will stay with the Lantus right now. The vet said to test in the AM and if in 399 range to go to 10. How long did it take Black Kitty to go from the high dose down? Looking at your SS it looks like the drop was gradual, but some people said it was fast. We are at 6 months on insulin now. Do you think the higher dose just eventually triggers the backing off of the antibodies? Pumpkin is very happy and doing well now even with his high blood sugar.
     

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