New Acro Diagnosis

Discussion in 'Acromegaly / IAA / Cushings Cats' started by LuvinThisPig, Jan 5, 2018.

  1. LuvinThisPig

    LuvinThisPig Well-Known Member

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    Dec 8, 2017
    I am not really sure where to start. Pig has been struggling with unregulated diabetes for about 4 months now and is at a dose of 12u 2x daily. After we reached 7u I decided it was time to test for Acro / IAA. I just received Pig's results and his IGF-1 was >500. I feel like we are starting all over again. I have been increasing his Lantus by 1u every 5 days if his lowest curve number is above 250. They have been. I was increasing the dose by .5u until we reached 10u and after that it has been by full unit raises.

    My vet will be contacting an endocrinologist and internist to see where we need to go. However, I wanted to do my own research and speak to the 'experts' before hand! Please. I appreciate any and all help!

    -Sarah
     
  2. Wendy&Neko

    Wendy&Neko Well-Known Member

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  3. Bronx's dad

    Bronx's dad Well-Known Member

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    You are not alone Sarah, many of us here are dealing with acrocats. Welcome :bighug:
     
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  4. LuvinThisPig

    LuvinThisPig Well-Known Member

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    Thank you guys! I am worried, but realize that Pig is in good hand here! I cannot say how much it means!
     
  5. JeffJ

    JeffJ Well-Known Member

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    Jul 7, 2016
    Hi Sarah. Sorry to hear the results. Leo had Acro too. At one point he was getting 18 units/dose. We opted for SRT, and the details are in Leo's thread in my signature. Lemme know if you have questions.

    A lot of people on this forum helped me, including Wendy. After a bunch of reading (and help), I ended up actually knowing more about Acro than both my cat-only veterinarian and the internist we used. There is some good info in the FAQ.
     
  6. LuvinThisPig

    LuvinThisPig Well-Known Member

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    That is encouraging to hear and what I am hoping for. I have been researching several treatments, but am afraid the SRT would be out of my budget. However, I will do whatever it takes and miracles happen everyday! After all, I was lucky enough to have this guy in my life and that is a giant miracle for me! I really appreciate your kind words.
     
  7. JeffJ

    JeffJ Well-Known Member

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    If you read thru some of the Acromegaly sub-forum threads, you will see there are other treatments. Summary:
    - Cabergoline (drug)
    - Hypophysectomy (surgical removal, probably expensive)

    or continue increasing insulin dose to flood out the excess IGF-1 hormone being produced by the pituitary tumor. There have been cats getting as much as 50 units/dose, with owners posting on the forum.

    B12 (Zobaline) is an important supplement for unregulated cats. Without B12, neuropathy occurs. If Pig is not getting Zobaline, I highly recommend you start providing it daily. Search this subforum, as it is a common discussion point.
     
  8. Wendy&Neko

    Wendy&Neko Well-Known Member

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    Zobaline is only needed if Pig has neuropathy. Not all diabetic cats get neuropathy. Neko didn't. Nor did she get supplemental B12.

    Sarah - you haven't asked here about dosing, but I'm going to offer. ;) Since you've been seeing yellows, I would hold each dose six cycles before increasing, for safety's sake. Give the depot time to build and for Pig to show you want each dose can do.
     
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  9. LuvinThisPig

    LuvinThisPig Well-Known Member

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    Thank you! Yes, Pig has had some neuropathy and I had initially purchased the Zobaline to counter this, however I opted with the injectable forms of cyanocobalamin. I did this considering the fact that the zobaline is an oral and not fully bio-available to him, especially if his numbers remained unregulated. With the cyanocobalamin you are using a full spectrum b12 which not only bypasses the destruction found in the digestive tract, but it also converts the necessary parts over to methylcobalamin. Cyano is good for IBD support as well as other benefits and the methyl is largely better for neurological support. I figured, if your going to dose you better dose the good stuff and reap all the benefits!! At least, this is what all of my research tells me. I could be wrong. I am by far the expert. However, the Zobaline is wonderful advice and I greatly appreciate it! Thank you so much!
     
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  10. LuvinThisPig

    LuvinThisPig Well-Known Member

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    @Wendy&Neko Yes, I have been trying to study the TR protocol before moving forward. Not to mention, I had been told that once you pass the 10u mark your raises should be made in full unit amounts and every 5-6 shots. However, based off his reactions I am entirely in agreement with you. It appears that he does not like full unit raises and I have seen some pretty nasty bounce effects. At least, that is what I assume I am seeing. I am going to let him coast this dose out and see if he settles a bit better after a couple of days. I also am thinking that he might do better with .5u raises, rather than the full unit. However, I am curious if this is just the Acro going a little wonky.

    I recently received my syringes with the .5u marker on the barrel, so now that that is in order I want to start the R. I have a very healthy respect for any medication and especially this R beast. Maybe this is a good time to start if I am letting him settle into the 13u, that way I can get a good idea of how he is going to react to this R. Additionally, I am curious about how you make the dual raises if needed? Do you raise both at the same time or alternate the raises?

    Another question, I recently received a script for Gabapentin 50mg 2x a day and Cisapride 10mg 2x a day. I have read that the Gabapentin was a common thing used to help with Acro pains, however I am a little leery about the cesapride. What do you know about these medications? I had planned on dosing half the dose of the cisapride or both just to see how he responds. I always move slowly with Pig on things like that. He has always reacted funny to some and this has proved beneficial at times.

    I have been reading up on the TR, but am still a little fuzzy on it. I will continue to study. I am assuming that you follow the same protocol with the R as you do with the Lantus?

    Thank you for all your help! I really do appreciate it and I know Pig does!

    -Sarah
     
  11. Wendy&Neko

    Wendy&Neko Well-Known Member

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    With R, you never raise both the L and R insulins at the same time. When you first start R, you need to know what the Lantus cycle to be mostly predictable, so you can see what the effects or R will be. Do you know when the onset and nadir are for Lantus in Pig? When you start R, you want to be able to determine those as well. Those are key to safely using R. The most important thing about using R is learning when NOT to use it. We recommend getting an experienced R person to "sit" with you the first couple of times, so you get an idea of what to expect. You start with testing every hour after you use R, for 4-5 hours. If you are interested in trying R, let me know when and I'll see if I can find an experienced member. Also what time your shot time is, so we can have someone on here with you. Please keep the spreadsheet up to date.

    And no, you do not follow the TR protocol with R. Over time and experimenting slowly, you will build an R table that works for that point. Here are an example of R scales that Sandy used with Black kitty. Note that these are scales that worked for her cat only, and varied over time. Neko's R scales also changed as she went down in dose. You will have to determine your own R scale.

    As for meds, I tried gabapentin for Neko, and it wasn't much help. Just made her sleepy. I had much more success with buprenorphine. Does Pig have arthritis? That was Neko's primary source of pain. Acupuncture also worked really well for her.

    I never had to use cisapride. Does Pig have megacolon? If not and he just some constipation issues, off the counter medications like Miralax in the US can help. Since Neko was on raw food, her poops were narrower and for the longest time all I had to do was add a little pumpkin to her food, as well as plenty of water.
     
  12. LuvinThisPig

    LuvinThisPig Well-Known Member

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    To be honest, I have not really been able to clearly define a nadir on him. However, he is typically lowest around the +5-+6 mark with a decent dip around +10-+11. His onset is typically around the +2-+3, but he drops fast around the +1-+2 and I attributed this to the overlap. I wish I was better with numbers and patterns, then I could read and predict better. Also, because I was following vet advice and now trying to transition to the TR, there is some discrepancy in numbers. For example, Pig now eats whenever he is hungry, whereas he was origionally on 1/2 can of DM 2x a day. That is until he was losing a tremendous amount of weight and his hunger drive was becoming dangerous. I made the decision to open feed low carb wet. Typically, he is fed around the +3-+4 mark with meals every 3-4 hours. I do know his spike is typically around 60-75pnts and lasts around 45-1hr.

    Yes, he has megacolon. However, digestion is something that we have struggled with his whole life. He is a Manx and missing his last two vertebrae. He was born with a malformed hind leg and has struggled with stool consistency. Recent radiographs showed him full from 'stem to stern' and miralax is just not cutting it. He can expel the soft and watery stuff around the hard, but he is still blocked and this blocks his bladder form emptying properly. Not a good thing. The gabapentin is to help with the arthritis in his hind quarters, because as he has aged that malformed back leg is a little wonky. I give .30ml Adequan for joint support and now gaba for pain.

    Okay. That makes sense on the R. I did have Pig in a good coast on his BGs as in he stayed somewhere in the 300. However, the full unit raises have thrown that all off. I had hoped to start tonight, but can wait. I always give shots at the 11:00a and 11:00p mark. The sooner I can start the better, he needs to see lower numbers. However, I do not want to rush it and mess things up. Pig is my main priority and I want him healthy and happy! Not hurting at the hands of my impulsiveness.

    -Sarah
     
  13. LuvinThisPig

    LuvinThisPig Well-Known Member

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    Also, it is important to note that I am over an hour away from any vet care with only the slight possibility of an on call house vet. I am also without personal transportation, but have people willing to help. I order everything online. His vet is over 2hr away. Needless to say, I am always careful.
     
  14. Wendy&Neko

    Wendy&Neko Well-Known Member

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    Glad to hear you are a cautious person. Rather err on the side of not giving R than giving it if you have any doubts for any cycle. I hope you do have a full stock of high carb food, karo/honey/syrup and plenty of test strips. A few other cautions for you:

    - Aim for an R dose that lowers the BG about 100 points, no more. Any more and you'll likely set off a bounce. Typically we'd start with a 0.25U dose of R for the first trial. It will be trial after trial to learn about how R works in Pig and what is a good R scale for you.
    - You want to time giving R so that the nadirs of R and L are not at the same time. Typically people start by giving it at L shot time. The "typical" R cycle onsets and +2 and lasts 4-5 hours. My Neko was not "typical". :rolleyes: But rather later. Know Thy Cat. With experience and data, people might shoot R a second time in the cycle, after nadir, and when the blood sugar is rising.
    - Don't give R on a cycle where a bounce will break. That causes a drop and the R drop on top can cause yet another bounce.
    - Don't give R on the cycle you increase Lantus.
    - Monitor the initial few times for 4-5 hours after the R shot to learn it's onset, nadir, duration. Over time you can reduce the amount of testing to the key times.
    - Develop a double check system when you are giving R and Lantus at the same time. We've had people accidentally give the Lantus dose worth of R. :eek: I used L cartridges (pens refills) and R from a vial, so it was easy to see which was which. I've heard of some putting an elastic band on the R vial, using sticky notes. Whatever works for you.
    - Be patient if you don't see R action in any given cycle. Sometimes just keeping the BG from going up is a positive. Some cats see action in the cycle following giving R.
    - Learning what the R cycle looks like, and layering that on top of the Lantus cycle, will help you know when it's safe to give R.
    - With acrocats, there can be times when the tumour is slowing down and the use of R counterindicated.

    I know you don't know if Pig is IAA yet, but the antibodies can delay the action of the insulin. Similarly, they can release stored up insulin at random times - usually when it's most inconvenient to you.

    Back to dosing on Lantus. When you are seeing yellow nadirs, it's good to wait 6 cycles before increasing. That gives the depot time to develop to that dose and give you a good idea what the dose can do. Once you do the 6 cycles wait, you can still do 1 unit increases. A phenomenon you can see shortly after a dose increase is something we call New Dose Wonkiness. It can explain why numbers can temporarily go higher after the increase.
     
  15. JeffJ

    JeffJ Well-Known Member

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    When Leo was in the peak of Acro, I was graphing his numbers to get some direction. It made me feel good to graph the numbers, but he bounced around a lot and I'm afraid the graphs were not real helpful. Just a suggestion that you could try it and see if there is a trend.
     
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  16. LuvinThisPig

    LuvinThisPig Well-Known Member

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    Yes, that was what I was thinking with the higher BGs with the raise to 13u. I held it for 8 cycles, which I know is far to long. However, I wanted to see if he would settle in better, but that is not happening. That means that the Acro is to blame, correct? He had very little dip last night at all. I raised him to 14u this morning at 11:00a. I have the ability to start the R either tonight or anytime Saturday. I want to make sure I am home to monitor him closely.

    With that being said, I have had an entire 'hypo' kit at the ready since we started insulin. I am new to diabetes and certainly to Acro, but have been in and out of vet clinics my whole life. I had seen hypo several times and it is never any fun. My kit contains the following: 10 cans of FF Gravy Lovers, Honey, Corn Syrup, and Agave Nectar, Thermometer, Oral Syringe, and Bulb Syringe for rectal application if need be. I always keep an extra container of 50cnt test strips and plenty of lancets. Those stay in my 'diabetic' kit, which has all of my testing supplies including urine strips that test for everything, including Ketones. I keep a handwritten notebook of BG numbers, meal times, and injection times along with the SSs. I also keep track of every medication and dose raise on a large desk calendar on the wall since I have help from my brother sometime. I do feel marginally prepared. :)

    As far as keeping the insulins straight, I dose L out of a pen and the R I bought by the vial. I have had it about two weeks, anxiously waiting its use. It has not been poked as of yet. I also have u100 syringes with the half unit markers on the barrel. I assume I will simply have to eyeball the .25u dose? I had planned on dosing with the L and testing every single hour until about +6. I also will not be dosing the R before I go to work until I am more comfortable and know how he will react. I do have my brother check in periodically, but he is restricted by work just as I am. I will start another page in his SS just for R dose numbers and record in both places.

    I think I am prepared. I hope I am prepared. Am I ready to start this? :nailbiting:;):)
     
  17. Wendy&Neko

    Wendy&Neko Well-Known Member

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    What time is your shot time? And what time zone are you in? I'll try to see if someone (maybe me) is available to sit with you the first time. In the mean time, try practising getting a consistent 0.25 unit dose.
     
  18. LuvinThisPig

    LuvinThisPig Well-Known Member

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    I always shoot at 11a and 11p. I am central standard time zone. I will not have much time to practice. I work at 3 today and will not be home until 10:30... But I will give it a few tries! As many as I can!
     
  19. Tricia Cinco(GA) & Harvey

    Tricia Cinco(GA) & Harvey Well-Known Member

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    Jul 18, 2011
    Hi Sarah,

    Just wanted to introduce myself. Wendy asked for someone to help keep an eye on you tonight after she has to go to bed. I'm a night owl, and I live in California, so I volunteered.


    Once you find what you think is good .25 dose, fill a syringe with a colored liquid and keep that on hand to compare to each time - that will help with consistency.

     
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  20. Wendy&Neko

    Wendy&Neko Well-Known Member

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    Hi Sarah,

    I can be around for your preshot time through +3 tests. Tricia, who is a night owl, can be up for the next one. Take the preshot test when you get it, and post it here. Wait for my reply before you shoot the R, so I can see if it's a bounce breaking cycle, which would not be a good time for an R experiment. I can't be around Saturday AM cycle for you, but someone else may be.
     
    Last edited: Jan 11, 2018
    Reason for edit: clarity
  21. JeffJ

    JeffJ Well-Known Member

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    You are 100% prepped for hypos. That is real good to hear.

    Some Acros bounce around. That has been Leo's case. Bouncy before the SRT, and still bouncy 15 months later. I think the pituitary tumor waxes and wanes.
     
  22. LuvinThisPig

    LuvinThisPig Well-Known Member

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    @Wendy
    Thank you! I just walked in the door and he seems to be doing really well tonight. I am just about to take his ps and I will post it before I shoot... I will be hooked here until we figure this out. I cannot express my gratitude for the support!
     
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  23. LuvinThisPig

    LuvinThisPig Well-Known Member

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    Thank you so much! I am a night owl as well, so this will work out great!
     
  24. LuvinThisPig

    LuvinThisPig Well-Known Member

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    @Wendy&Neko .. So, Pig's ps shot was at 400. I took another to be sure and it read @ 428. I also raised his dose this morning to 14u.
     
  25. Wendy&Neko

    Wendy&Neko Well-Known Member

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    Go ahead with the R. He's probably seeing New Dose Wonkiness with the increase to the Lantus.

    See you in an hour after the R shot.
     
  26. Wendy&Neko

    Wendy&Neko Well-Known Member

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    Not sure if I mentioned it, but R shot to the scruff, away from where the Lantus went in.
     
  27. LuvinThisPig

    LuvinThisPig Well-Known Member

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    I just updated his SS. Numbers should be current.
    I am going to prepare food and check back.
     
  28. LuvinThisPig

    LuvinThisPig Well-Known Member

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    Okay... I am really nervous about getting the correct .25u. I think I got it close, but it is really hard to see on the syringe.
     
  29. Wendy&Neko

    Wendy&Neko Well-Known Member

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    You can put the R dose in the units column of the SS. Just right it as 14L; 0.25R.

    Don't worry so much about an exact 0.25 as a repeatable one.
     
  30. LuvinThisPig

    LuvinThisPig Well-Known Member

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    Okay.. I will do that. I hope not. That almost gave me a panic attack. I do not envy the poor soles who have to give drops everyday!! Its very nerve wracking! It is done. Now we wait. Thank you again so very much for all your support with this!
     
  31. Wendy&Neko

    Wendy&Neko Well-Known Member

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    Do we have a +1 yet?
     
  32. LuvinThisPig

    LuvinThisPig Well-Known Member

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    Yes ma'am.. He is sitting @ 412
     
  33. Wendy&Neko

    Wendy&Neko Well-Known Member

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    Pretty flat. Here's hoping we see mire movement in an hour.
     
  34. LuvinThisPig

    LuvinThisPig Well-Known Member

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    I agree. On another note, while we wait... For how long do I hold the doses on the R? How do I decide dosing amounts and when to raise, especially alongside the L? Do we always raise by .25 or .5? I am hesitant to dose the R when I have to go to work. I have it set up so that I can get at least a +3 test before I leave for work, but I am always cautious and worried.
     
  35. Wendy&Neko

    Wendy&Neko Well-Known Member

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    Use R just when you think it's safe to do so. If you are worried, don't use it.

    As for what dose of R tomuse, it's learn by experiment. You build an R scale. Did you look at Black Kitty's one I linked in post 11? You learn, with experience, what dose of R to give at a particular Blood sugar value at a point in the cycle. Once you find an R dose that works, you stick with it.
     
  36. LuvinThisPig

    LuvinThisPig Well-Known Member

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    Another question while I am thinking about it... I was about 30 minutes late in giving him his shot tonight, because I was struggling with the .25u dose and wanted to make sure everything was all set up. I do not like to miss shots even by a few minutes. I can shoot in the AM @ 11:15 and then tomorrow's PM @ 11:00? This will even it out and realign things, correct? I know that with the L consistency is best. Sorry to be such a bother... My mind runs all the time with this and I want to make sure I learn everything I can so that I am prepared in all situations.
     
  37. LuvinThisPig

    LuvinThisPig Well-Known Member

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    I did look at it, but I have a problem with numbers and patterns. I am stupid smart with Literature and Language, but numbers are not my thing.. smh. I was trying to figure it all out. I just need more time to really study them better.

    I am trying my best to absorb all of this. I work full-time and go to school full-time. I am a straight A 3rd year college student and the VP of my school's National English Honors Society, Sigma Tau Delta. It is hard to balance it all out. However, Pig is my priority. I guess I am just asking for patience... :cat:
     
  38. Wendy&Neko

    Wendy&Neko Well-Known Member

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    There is no rush to use R. We can help you learn to use R as a tool, when you have the time to use it. When I first got Neko's acro diagnosis, there was no experienced high dose user with the time to help me. I didn't learn it until a couple years later. For a long time, I didn't need to use it either.

    +2 yet?
     
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  39. LuvinThisPig

    LuvinThisPig Well-Known Member

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    Okay. I want to use this because his numbers need to be lower. He has been above the renal threshold far longer than I would like. However, I also want to be slow and steady with its use. Hypo situations scare me and then adding in the erratic nature of the Acro and I feel like stroking out sometimes! :nailbiting:

    +2 @ 371

    He does typically see a slight drop around +2, even with just the L. Now, he will be asking for food around +2-+3. I always feed when he is hungry. He is not overweight by any means. Actually, he is at a very healthy weight for his frame... lol. I want to keep that going.. :)
     
  40. LuvinThisPig

    LuvinThisPig Well-Known Member

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    I know you may hear this a lot, but I will still say it a million times. Thank you. I cannot believe that someone I never met before is willing to stay up late and help me with my best friend. It is amazing and astounding. I cannot be more grateful.
     
  41. Wendy&Neko

    Wendy&Neko Well-Known Member

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    Yes, you can move the Lantus shot time back by 15 minutes a cycle (so two times a day) or one time by 1/2 hour. You are absolutely not a bother. Everyone asks that question. Someone answered that question for me when I was new. Just paying it back. :bighug:
     
  42. LuvinThisPig

    LuvinThisPig Well-Known Member

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    Something I hope to be able to do one day as well. Many people question my devotion to Pig and some just simply do not understand it. However, my love for him and my civie boy Tail is incomparable. I love them as I love my daughter, as my family. I know most would not understand the dedication or devotion because he is just a cat after all, right? Wrong! He is my very best friend and the things he has done for me far surpass any that i can do for him. He is the love of my life! Your help in this means far more than you will ever know! :)
     
  43. Wendy&Neko

    Wendy&Neko Well-Known Member

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    One of the things that may help you, is to look at spreadsheets of other acrocats when they are first starting out. I know it helped me, but one of my majors was in Math. ;) As long as he's only seeing numbers above 200, you should be fine increasing the Lantus dose every six cycles, provided you can test like you have been. You can slow down when you start to see blues numbers. And that's what the protocol has you do for safety. Hypo situations should scare you, but also know that since you are testing and have high carb food, you can control Pig's numbers.
    If you could, keep the spreadsheet up to date with the numbers. +2 is normally the time R onsets, but like I said, my Neko didn't like to be normal and onset later. The other possibility is that 0.25 R is not enough, either ever, or when he starts above 400. My R scale was really simple for Neko when she was in higher Lev doses - 250-350, give 0.25U, 350 and above, give 0.5 units.

    You are in the right place if you want to talk to cat lovers. :) Even my vet used to joke how much I spent on Neko. But she was worth every penny.
     
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  44. Wendy&Neko

    Wendy&Neko Well-Known Member

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    One more thing if you are killing time, could you drag the 2018 tab on the spreadsheet to the left. Then it'll be the first tab opened and I won't have to tab over every time. Thanks.
     
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  45. Tricia Cinco(GA) & Harvey

    Tricia Cinco(GA) & Harvey Well-Known Member

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    OMG, is this ever the truth! All four of my senior cats were diagnosed with cancer in 2015. Over the course of the following 18 months we spent around $40,000 taking care of them. Not only did they have cancer, but two were diabetic, one was blind, one lost a leg due to her cancer, two were hyperthyroid, two had kidney disease. And then there were things like pancreatitis, herpes etc., etc., etc. I know people who thought we were completely out of our minds. I don't care. We don't have kids. They were our babies. I would do it all again.
     
  46. LuvinThisPig

    LuvinThisPig Well-Known Member

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    Absolutely! I just had it that way because my brain is oddly sequential. lol.

    +3 @ 333
     
  47. LuvinThisPig

    LuvinThisPig Well-Known Member

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    They most certainly are! I live in a very rural area where pets, let alone cats, are not exactly as much of a priority as they are in other areas of the country. Here most animals are for work or purpose. There are a few people who spoil their animals like I do with my cats, but not many. The area is relatively poor. I do know there is one diabetic cat in town because my pharmacist was telling me her friend buys L for her. It is funny, when I go in to purchase his insulin, the ladies at the counter always tell me how crazy I am and even asked me if it was contagious one time.. Like my cat was going to infect them with is dangerous diabetes from all the way across town.. :joyful: One even said she would simply throw the thing out or worse! :eek: I cannot understand that. Then again, these cats they got me all obsessive! Best thing I ever did, though!
     
  48. LuvinThisPig

    LuvinThisPig Well-Known Member

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    Haha... I clicker train all my kitties.. So, Pig knows when he is hungry he goes to his step stool and waits. He is there now, so he is hungry. It is okay to feed, correct? I do not want to mess the numbers up, but he would be eating regardless.

    Just double checking.
     
  49. Tricia Cinco(GA) & Harvey

    Tricia Cinco(GA) & Harvey Well-Known Member

    Joined:
    Jul 18, 2011
    Yes, it is okay to feed. It's still early in the cycle, and that's when you want to give them most of their food.
     
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  50. Wendy&Neko

    Wendy&Neko Well-Known Member

    Joined:
    Feb 28, 2012
    So far this looks a lot like his cycle a couple nights ago. The good thing is that it's a steady drop, but not too much. I'm curious to see if he flattens out like he did then or keeps going down. But I'll have to save that for tomorrow morning when I get up. I would get that +4 test for sure. If you are up, or if he drops a decent amount to +4, I would get a +5.

    After this, I think you said you don't have time to use R until Saturday. Your next Lantus increase wouldn't be until Sunday, so Saturday would still be a good day to try R. We'll see how the rest of tonight goes before deciding if it's the same experiment, or different dose.

    Yes, feed as you normally would.
     
  51. LuvinThisPig

    LuvinThisPig Well-Known Member

    Joined:
    Dec 8, 2017
    Testing as I have been should not be an issue. I like to get a minimum of 4 a day with two each cycle. I always do more, but that is my lowest.

    So, let us say tomorrow morning he preshoots for <300. I stick with the .25u and see where he goes?
     
  52. Wendy&Neko

    Wendy&Neko Well-Known Member

    Joined:
    Feb 28, 2012
    Are you around to monitor tomorrow morning like you did today? I would try 0.25 if between 300 and 400. (provided he doesn't go crazy down in the next hour).
     
  53. LuvinThisPig

    LuvinThisPig Well-Known Member

    Joined:
    Dec 8, 2017
    Yes, Saturday would be the better bet. I am home tomorrow, but will not be able to monitor quite like I would like. So Saturday at 11:00a would be best. Thank you for your help! Rest well!
     
  54. LuvinThisPig

    LuvinThisPig Well-Known Member

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    Dec 8, 2017
    I will be home, but so will my 5 year old daughter. I can test every hour, but it will be hard to keep a close eye on him..
     
  55. Tricia Cinco(GA) & Harvey

    Tricia Cinco(GA) & Harvey Well-Known Member

    Joined:
    Jul 18, 2011
    Checking every hour is keeping a fairly close eye on him, but maybe not quite enough for an R experiment.

    I'll check back to see where he is at +4. I'll be swinging by periodically until then, just in case you need anything.
     
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  56. Wendy&Neko

    Wendy&Neko Well-Known Member

    Joined:
    Feb 28, 2012
    I have a meeting Saturday morning, so I won't be able to pop in. You could just try the same dose if over 300, and see what happens. Keep up the testing every hour. As you gather more data, you will be able to reduce the number of tests.
     
  57. LuvinThisPig

    LuvinThisPig Well-Known Member

    Joined:
    Dec 8, 2017
    Yes. This sounds like a good plan. After this weekend I can dose R more regularly, but typically in the PM. I work and do school overnight, so I know this makes it difficult. I will also have a few days that I can dose during the day and am sure once I know more will be able to do so everyday. However, until then I will err on the side of caution. I will keep testing and updating!
    Thank you again!
     
  58. LuvinThisPig

    LuvinThisPig Well-Known Member

    Joined:
    Dec 8, 2017
    It is... But I am a bit nutso.. lol. I like to watch his breathing patterns and the like. Just to see if there is any pain or repression. Plus, if something were to happen, it would be next to impossible to coral both my daughter and Tail while trying to take care of Pig.

    I will say the same to you as I said to Wendy, thank you so much for your time. I am sure it is as precious as mine and I cannot appreciate it more!
     
  59. Tricia Cinco(GA) & Harvey

    Tricia Cinco(GA) & Harvey Well-Known Member

    Joined:
    Jul 18, 2011
    Around here we like to pay it forward. Someone helped us when we were new, and we want to do the same. I can say without a doubt my Cinco would have died if not for the the people on this Board. Thanks to the help I got here, we had him for another five years. It's something I can never repay. Don't even get me started about all the help with other, including Harvey. That's why we stick around, even after our sugar cats have Gone Ahead.
     
  60. Gill & George

    Gill & George Well-Known Member

    Joined:
    Oct 27, 2015
    Well done with the R experiment.

    You shoot at 11am CST right? That's 6pm for me (i'm in Europe/Spain), I can be around and check in on you if you decide to try R again on Saturday, just so you have some support. Just let me know and feel free to tag me.
     
  61. LuvinThisPig

    LuvinThisPig Well-Known Member

    Joined:
    Dec 8, 2017
    Honestly, it is just so amazing to me! I like to give appreciation where it is due and it is due!

    Pigs +4 was @ 337 - That is a good number for him, especially after eating!
     
  62. LuvinThisPig

    LuvinThisPig Well-Known Member

    Joined:
    Dec 8, 2017
    Wonderful! Thank you so much! I will heed Wendy's advice and only shoot the .25u if he is >300. Yes, at 11am CST.
     
  63. Tricia Cinco(GA) & Harvey

    Tricia Cinco(GA) & Harvey Well-Known Member

    Joined:
    Jul 18, 2011
    It doesn't look like Pig is going to do anything terribly exciting tonight. We'll just chalk this down to a learning experience. There is no such thing as too much data.
     
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  64. LuvinThisPig

    LuvinThisPig Well-Known Member

    Joined:
    Dec 8, 2017
    Yes.. I agree. I will say that he does seem to be feeling better either way. Even as 300#s are not super exciting, they are when you have been hovering in the 400's for the past day or so. With that being said, I say success for tonight!
     
  65. Tricia Cinco(GA) & Harvey

    Tricia Cinco(GA) & Harvey Well-Known Member

    Joined:
    Jul 18, 2011
    This very important. Don't get so lost in the numbers that you lose sight of the whole cat - I got that from a noted endocrinologist at UC Davis Veterinary Teaching Hospital.
     
  66. LuvinThisPig

    LuvinThisPig Well-Known Member

    Joined:
    Dec 8, 2017
    Precisely. I think that is the hardest part, balancing out what you know to be right and the opinion of others.
     
  67. Tricia Cinco(GA) & Harvey

    Tricia Cinco(GA) & Harvey Well-Known Member

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    Jul 18, 2011
    You know what they say about opinions.... :joyful:
     
  68. LuvinThisPig

    LuvinThisPig Well-Known Member

    Joined:
    Dec 8, 2017
    Entirely to true!!
     
  69. LuvinThisPig

    LuvinThisPig Well-Known Member

    Joined:
    Dec 8, 2017
    No. Not anything overly exciting with a +5 @ 327. However, he did roll his belly up on the carpet and that is always a good sign! lol
     
  70. Gill & George

    Gill & George Well-Known Member

    Joined:
    Oct 27, 2015
    Give him a tickle from all of us.
    :bighug::bighug::bighug:
     
  71. LuvinThisPig

    LuvinThisPig Well-Known Member

    Joined:
    Dec 8, 2017
    But of course! He is feeling much better tonight, so I foresee a good cuddle!
     
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  72. Wendy&Neko

    Wendy&Neko Well-Known Member

    Joined:
    Feb 28, 2012
    Looks like the new Lantus dose may be starting to bring him down a little. :) Either that, or what some people see is some action on the cycle following the use of R. Knowing whether Pig is one of those types of cats will be useful as you plan ahead when to use R.
     
  73. LuvinThisPig

    LuvinThisPig Well-Known Member

    Joined:
    Dec 8, 2017
    Yes, I think a lot of it is the L. He responds a bit whenever we increase. We saw BGs almost as low as last night, but not quite. I am glad I did not dose the R today, it has been too busy to properly test. I got a +3 and +5, but not enough. His appetite is good. I will be starting new medications tonight (cisapride), but will only be giving half the dose until I know how he reacts. His Gaba will be here very soon and I will do the same with it. Is it alright to increase or dose R when starting new meds? Or should I do what my gut says and introduce it all very slowly and one at a time?
     
  74. Wendy&Neko

    Wendy&Neko Well-Known Member

    Joined:
    Feb 28, 2012
    If you want to see the impact of an individual med, I would start them one at a time. And without R which might mask if it increases Pig's BG.
     
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  75. LuvinThisPig

    LuvinThisPig Well-Known Member

    Joined:
    Dec 8, 2017
    That sounds like a good plan. It will be hard to test tonight, but not impossible.
     
  76. LuvinThisPig

    LuvinThisPig Well-Known Member

    Joined:
    Dec 8, 2017
    Tonight we start the Cisapride. I got it from Wedgewood veterinary pharmacy. It is compounded with almond oil. This should be fine? It will not raise the BGs?
    Tomorrow we dose with R again, assuming his amps is @ >300.
     
  77. LuvinThisPig

    LuvinThisPig Well-Known Member

    Joined:
    Dec 8, 2017
    I am assuming it is the bitter almond that is only poisonous? If the vet pharmacy compounded it with almond oil, it should be alright, yes? The carbohydrates are at 0% with no sugars either.
     
  78. Tricia Cinco(GA) & Harvey

    Tricia Cinco(GA) & Harvey Well-Known Member

    Joined:
    Jul 18, 2011
    From what I was able to find on the web, plain almond oil is okay. Just not the bitter variety. I also would assume that if Wedgewood used it, it's safe, but one should always double check!
     
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  79. LuvinThisPig

    LuvinThisPig Well-Known Member

    Joined:
    Dec 8, 2017
    @Tricia Cinco(GA) & Harvey ... Have you used Wedgewood before? I am a fan of their services.. However, as you said, I ALWAYS double check! lol... Do you have experience with Cisapride?
     
  80. LuvinThisPig

    LuvinThisPig Well-Known Member

    Joined:
    Dec 8, 2017
    I will be dosing the R this morning @ 11:00 am. He saw a BG spike around the +6 hour last night and I am not sure why. He did not have food around that time, but it might be due to stress. There has been a lot of foot traffic in my home the past day and his numbers almost always reflect this. His numbers never dropped after the spike last night. I will be giving the .25u as recommended. He did receive a half dose of cisapride last night, but the numbers did not jump until much later. I do not know or think that the cisapride is to blame. However, I am no expert.

    I just weighed him and he has put on a whole pound in just over a month.
     
  81. Gill & George

    Gill & George Well-Known Member

    Joined:
    Oct 27, 2015
    Bitter almonds have a high content of cyanide that's what makes them poisonous. (eating 40 bitter almonds could be enough to kill an adult, though you would struggle to eat one, they taste disgusting)
    Sweet almonds only have trace amounts, and the oil made from them is certainly safe for human consumption.

    (we live on a small almond farm in Spain:))
     
  82. Gill & George

    Gill & George Well-Known Member

    Joined:
    Oct 27, 2015
    Could you update last nights numbers on the ss.
     
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  83. JeffJ

    JeffJ Well-Known Member

    Joined:
    Jul 7, 2016
    That is great to hear that Pig has gained a healthy pound since you started insulin treatments. He is probably feeling better as a result.
     
  84. Gill & George

    Gill & George Well-Known Member

    Joined:
    Oct 27, 2015
    How are those tests?
    Any reaction tot he R dose?
     
  85. LuvinThisPig

    LuvinThisPig Well-Known Member

    Joined:
    Dec 8, 2017
    Yes... I was just able to do this. I am about to take a pmps number.
     
  86. LuvinThisPig

    LuvinThisPig Well-Known Member

    Joined:
    Dec 8, 2017
    Today will be only his second dose of R. I am a little concerned about how high he went last night. Wendy said not to give on a bounce breaking cycle and I am hoping that his higher BGs is due to the stress of foot traffic in the house.

    What do you think? I will have the amps here soon...
     
  87. LuvinThisPig

    LuvinThisPig Well-Known Member

    Joined:
    Dec 8, 2017
    Okay... His amps was @ 383, so I do not think it is a bounce. I think he has a normal cycle showing. I feel R would be a good call.

    Now, I work @ 6:00 in the am. Am I safe to dose R tonight?
     
  88. LuvinThisPig

    LuvinThisPig Well-Known Member

    Joined:
    Dec 8, 2017
    Second dose is in... lol. Here's to better numbers!
     
  89. LuvinThisPig

    LuvinThisPig Well-Known Member

    Joined:
    Dec 8, 2017
    Actually, he started off about 14lbs and only lost the weight under the instruction to feed 3oz 2x a day.. That was an awful time. He was sooooo hungry and he dropped fast. I quickly took matters into my own hands and started feeding him when he wanted it. He gained a pound back really quick! Either way... It is a really good thing. He feels better for it!
     
  90. Gill & George

    Gill & George Well-Known Member

    Joined:
    Oct 27, 2015
    Sorry just nipped out to walk the dogs. I got confused about your shot time.

    Paws crossed at this end that we see some movement with r.

    Are you working tomorrow/Sunday at 6am.
     
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  91. LuvinThisPig

    LuvinThisPig Well-Known Member

    Joined:
    Dec 8, 2017
    No worries! It is all good! I just appreciate the support.

    Yes, I am hoping for some movement. I want to at least see some yellow today!

    Yes, I am working at 6am Sunday morning and then @ 7am on Monday. I normally work the nightshift, but we are down a tremendous amount of people right now and I just lost one of my management personnel. This leaves me and my Assistant Manager covering all the hours!

    I am hoping for a more normalized schedule at the end of the week.
     
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  92. LuvinThisPig

    LuvinThisPig Well-Known Member

    Joined:
    Dec 8, 2017
    Okay.. Maybe some movement. I like that.

    +1 @ 343
     
  93. Gill & George

    Gill & George Well-Known Member

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    Oct 27, 2015
    See you at +2.

    Does look like a little drop.
     
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  94. LuvinThisPig

    LuvinThisPig Well-Known Member

    Joined:
    Dec 8, 2017
    Well... What can I say? Pig has always been stubborn and in a league of his own... *sigh*

    +2 @ 346

    Wrong way, buddy... Wrong way... :banghead:
     
  95. Gill & George

    Gill & George Well-Known Member

    Joined:
    Oct 27, 2015
    See you at +3,
    Come on Pig, a little movement please.
     
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  96. LuvinThisPig

    LuvinThisPig Well-Known Member

    Joined:
    Dec 8, 2017
    He gave a little with a minuet drop...
    +3 @ 335

    As of now, this cycle with R is looking remarkably like the last run. Perhaps a move to .5u on the next try is warranted? I am not sure...

    I technically can dose R on his pm schedule tonight, but will need to get up every hour to test. I do not mind. However, I would not increase the R dose if I were to dose it tonight. What if I didn't wake up? Yikes!!

    Thoughts?
     
  97. Gill & George

    Gill & George Well-Known Member

    Joined:
    Oct 27, 2015
    I'm not sure about taking the dose up. I'd rather @Wendy&Neko took a look and offer you a suggestion on that.

    The most important thing with R, particularly in this early phase, is that you monitor closely, so if you even think that there is a chance that you might fall asleep, it might be safest to leave it for another day.

    This cycle is starting to look like the earlier one, but it's not over yet.
    He is looking pretty flat to me.
     
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  98. JeffJ

    JeffJ Well-Known Member

    Joined:
    Jul 7, 2016
    "This leaves me and my Assistant Manager covering all the hours!"
    I hope there is extra compensation as a result of you effectively running the business.
     
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  99. LuvinThisPig

    LuvinThisPig Well-Known Member

    Joined:
    Dec 8, 2017
    Well.. Still in the wrong direction, but that's because he ate.

    Food @ +3.5
    +4 @ 353
     
  100. Gill & George

    Gill & George Well-Known Member

    Joined:
    Oct 27, 2015
    She's looked pretty flat. She may well need a little more R to see some movement. I'm sure Wendy will stop by when she gets a mo.

    Is she on Lev or Lantus??
    I can't see it anywhere on the ss or sig block???
    I'm assuming Lev, and I think I remember reading that somewhere in one of your posts:confused:
     

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