Need Advice - High Dose / Levemir?

Maybe I should have posted on Levemir page -- ? Few things going on here in regard to next steps for Bryce. Any thoughts you have would be greatly appreciated!

We've been working with Dr. Lisa for two+ months and wouldn't know what to do without her! We were up to 10U of Lantus before taking Bryce to local vet for testing (earlier this week). Note that our local vet is not "on board" with protocol/testing, and does not specialize in feline diabetes. :sad: Test results all negative other than a question about the x-ray of her heart (from Dr. Lisa). Will probably get 2nd opinion from a specialist.

We've dropped to 5U because local vet talked to another vet who was concerned about rebound and wanted us to go to 2U. The rest of us are not in that "camp" (and have data to support it) since we went down that road in March, therefore, we're meeting in the middle until both vets can discuss. Appears that next steps are to 1) test for Acro and 2) consider switching to Levemir.

Just read Stickies, etc. on Levemir and Acro. Wonder what your thoughts are? Thank you!

 

Hi Debbie,

You said you took Bryce to a local vet for "testing"...do you mean a curve? Do you know how to hometest? If not, there might be somebody nearby that would teach you. Also, it would be very, very helpful if you could create a spreadsheet. It's very easy; there are directions in the Tech forum.

I personally think that any kitty that goes up to 10 u be tested for resistance. Acro "might" actually occur in up to 1/3 of all diabetics, so it's not as uncommon as vets think. You'll want to get the blood drawn on a Monday and then overnight it to MSU - they do the testing on Thursdays. You might as well do both IGF-1 and IAA (the IAA is a very cheap add-on). Could you describe how Bryce looks (besides a beautiful calico!)? Does she snore or breath heavy?

You said you reduced the dose by half...are you testing for ketones?

You can get daily dosing advice in the Lantus forum (even if you switch to Lev) - there are several high dose cats over there.

Last, but not least, welcome. Dr. Lisa is wonderful; she referred me to this board for all dosing advice. The people here actually know much more than most vets about diabetes.

 

Thank you for your reply. Just on the phone with Dr. Lisa (Dr. P)......she mentioned you and Boo! I actually went to CSU, so it's funny that's where the radiation is done. Cool!

Full spreadsheet for Bryce in my profile. We test multiple times a day and do curves on weekends. Bryce has lost energy since being diagnosed ~15 months ago, however, her clinical signs are pretty good. She does have occ. heavy breathing...occ. snore...guess we're just now realizing that we should have recognized / communicated it more to Dr. Lisa. However, Dr. Lisa has been asking us about Acro (and getting testing) for a few weeks. Yes, test for ketones regularly. Have a special meter (.01 reading tonight), and use the strips in the urine. Bryce seems fine except her coat is a bit "off" (not as smooth) as it was. Not sure if that makes sense. She does not have the energy she did, but seems to being fine.

Truly appreciate you responding. We will be having more tests done this week...wondering whether we should switch to Levemir (from Lantus), or wait....will post to Levemir board tonight.

 

Debbie - be sure to post to the Lantus board rather than the Levemir one. The Lantus board is more used to high-dose cats (there are several acro cats over there); the Lev board is more used to lower-dose cats (even though most of the high-dose cats do eventually use Levemir). There's no hurry to switch though. I would just use up your Lantus supply and have the Lev ready. You can order both from Canada much cheaper (but you need a prescription now...used to didn't need it).

 

Hi Debbie -- it would be good to get the IGF-1 and IAA tests done.

My Norton had acromegaly and my vet didn't believe until the IGF-1 test results came back -- this after he had been on a high dose for over a year and had a neurologist confirm presence of a brain tumor. Unfortunately we found it very late -- but he ended up with an aggressive unrelated cancer.

We used Humulin N and PZI for Norton.

After Norton left us, we adopted Tiggy last year thru FDMB and two months ago, adopted Rusty thru FDMB / DCIN.

Both of these guys are "traditional" diabetics (low dose) and we are using Levemir. We like Levemir a lot - it is similar in action to Lantus, but less fragile - we can use a cartridge to the last drop without it going bad.

 

Lots of good advice was given on the LL thread. I'm copying the link here so it's easier to find in case others are looking for the same info:

viewtopic.php?f=9&t=14578