The email from my vet this morning: "I spoke with Dr. X at X today, and he would strongly advise reconsidering imaging (MRI) with radiation vs surgical correction of the tumor. He has managed several cats that have had numerous episodes of hypoglycemia and DKA. These episodes have caused a lot of harm and stress, which he feels is worse than the procedure. I would strong advised a consultation with him. If that is still not an option, he advised against switching insulin types (Has a patients that receive 25 units of Glargine twice daily with no ill effects- or stinging) and he advised continuing increasing the Glargine dose. He find no more control with Detemir. I had the pleasure of reading the information you attached, but without a study or a recommendation by a specialists, I can not advise to switch at this time. " As I've already mentioned, I will not be doing an MRI or radiation on Baby, so I will not be taking Baby to see this specialist. I wanted to switch to Levemir as at 9.5 Baby is pulling away with shots other than in the scruff. I had two fur shots in one day. Thoughts?
Many high dose kitties get switched to Levemir as it's less likely to sting. There are also a number of acro kitties here who are "managed" with appropriate dosing, etc. rather than being treated with radiation or surgery. That's the route I'd take if my guy was acro. You need to do what you're comfortable with.
Ravan is a BIG bouncer ,so I switched from Lantus to Levemir on 7/28.I heard it might help with the bounces. I was told to give him 1/2 of the amount of Lantus so he started on .75 units of Levemir. For the first few weeks I was amazed at how good he was doing. He went down to .25 units & of course I was dreaming of remission! But it was not to be( yet) He's still getting less insulin than if he was on Lantus. But little by little he started bouncing again & I also had to increase his dose. I read that a lot of Acro kitties get Levemir because it doesn't sting like the Lantus & they do use less insulin with Levemir. Ravan isn't Acro but I'm glad I switched. I give his shot in about the middle of his side. (I have a problem giving it in the scruff I did a fur shot one time that way so now i always give the shot in his side) .I make sure to spread his fur so I see skin & I insert the needle at an angle ,not straight in. He doesn't seem to notice the shot at all. With Lantus he would jump & it seemed to be getting worse as time went on. You can check Ravan's SS & find other people that have Acro kitties & switched to Levemir If you look at their SS you can get an idea of how much less insulin they use compared to other insulins. Best of Luck to you & Baby. (have you considered getting a second opinion from a different vet?)
If you and your vet do not agree on treatment approaches, it may be time to consider another vet. My vet would not consider himself an expert in FD, but he is a valued member of the team caring for Rosie and I consider him to be part of my family. I have brought him several things to review / discuss and he has been open to trying them. We use Lantus, so I don't know his experience or comfort level with levimir. His office is in St. Charles, IL if you would be interested. It might be worth a phone or email consult. Meanwhile, the only other thing I can think of is to shave an area to make giving shots easier.
We have seen a few cats here on high doses on Lantus. However, the majority do seem to find the Lantus sting uncomfortable to say the least. If you think Baby is reacting to the Lantus, I would use that argument, instead of more level BG's, which may happen as a bonus. We have even heard of cats getting bitey from the Lantus shot. Neko sometimes walked away while I was shooting, but stayed and purred through Levemir. Your vet should be in board with reducing pain/sting for your cat. And I see you got a partial fur shot due to the sting, same thing happened to me. We have one member here who is a vet, and has an acrocat. She switched to Levemir and her kitty is much happier now. Since you are home testing, and hopefully testing regularly for ketones, DKA and hypos should not be as much of a concern. Howeve I would test for ketones a bit more frequently than you have. And try to test her BG at least twice each cycle, preshot plus one other. Looks like she went lower last night, and today she is bouncing. Without that before bed time test, we have no idea how low she went.
