Update on Mitsy's Ultrasound

Discussion in 'Acromegaly / IAA / Cushings Cats' started by Rardito, Aug 8, 2018.

  1. Rardito

    Rardito Member

    Joined:
    Jul 20, 2018
    Mitsy had her Cushing's Disease abdomen ultrasound on Monday. The good news is that her adrenals and organs looked fine. The bad news of course is that it means her tumor is located in the pituitary (which I've suspected for years due to her uneven pupils).

    Had a long chat with the vet about Vetoryl. At this time, he wants to hold off on treating the Cushing's because her sugar levels aren't erratic. He is afraid the medication will be too harsh on her and stated that pituitary tumors are slow growing. Once her sugar levels become erratic, he will reconsider the medication.

    So basically I'm just continuing to monitor her. I'm wondering how long she has since her pupils first became uneven in 2015. I should have asked how slow "slow growing" meant but I was overwhelmed at the time so I forgot to ask.

    At least she looks super cute with shaved udders :)
     

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  2. Ana & Frosty (GA)

    Ana & Frosty (GA) Well-Known Member

    Joined:
    Jan 19, 2018
    Hugs to you and little Mitsy
    :bighug:
    Slow growing usually mean it can take years for it to get bigger. How many years is a little individual, but based on what you’re saying, she probably had it since at least 2015, or possibly even earlier, but now it is starting to act up and secrete cortisol, which is what causes the Cushing’s and diabetes.

    Have you decided what protocol you are going to use for her insulin - I see you go between 1.5 and 2 units. The Lantus forum has two protocols - Tight Regularion (TR) and “Start Low, Go Slow” (SLGS). Tight regulation requires more frequent testing to make sure the kitty isn’t going too low.

    I have Frosty on the SGLS due to my schedule (unable to test during the day due to work), and now that he’s on a Vetoryl, his insulin needs can drop quickly and I want to avoid hypoglycemia.

    Keep us posted on how she’s doing!! :cat: She’s so cute I wanna pet her little belly.
     
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  3. Rardito

    Rardito Member

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    Jul 20, 2018
    Well the vet originally started her on 5 units twice daily (yikes!) of Vetsulin and then I started home testing and she definitely didn't need that much so I've been decreasing it. I am gone from 7am to 4:30pm Monday through Friday so unable to test during the day on weekdays. I need to do a curve this weekend because I'm stuck between 1.5 and 2... she seems to peak early so that's why I was sticking with 2 for awhile but then she was going lower so I got nervous with that much, haha. She's never been in the 300 or higher range since I've tested which is good. I am open to suggestions for anyone who looks at her spreadsheet as well!
     
  4. Ana & Frosty (GA)

    Ana & Frosty (GA) Well-Known Member

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    Jan 19, 2018
    Oh, my apologies, she is on vetsuin, not Lantus, I got confused. :) disregard what I said. There is a forum for vetsulin if you have questions about dosing, etc, I am not familiar with that type of insulin.
     
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  5. Olive & Paula

    Olive & Paula Well-Known Member

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    Sep 6, 2015
    You are doing .5 unit changes. Have you thought about doing .25 unit changes?
     
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  6. Ana & Frosty (GA)

    Ana & Frosty (GA) Well-Known Member

    Joined:
    Jan 19, 2018
    Wow I’m so confused I thought this was meant for me. Please disregard.

    Is there a similar protocol for Vetsulin that we use for Lantus? I skimmed the site and it looks like it’s kind of different. In fact they say not to give insulin if pre shot is under 200.
     
  7. Rardito

    Rardito Member

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    Jul 20, 2018
    I hadn't mainly because the syringes don't have those markings, but I could try that!
     
  8. Rardito

    Rardito Member

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    Jul 20, 2018
    Yeah I believe it says at first not to do that until you're familiar with the numbers, but I haven't read it since the beginning. I'll go review it again :)
     
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  9. JeffJ

    JeffJ Well-Known Member

    Joined:
    Jul 7, 2016
    None of the syringes (that we know of) have 0.25 markings. We estimate as best we can between the lines. Some people use micrometers. In general you are doing a great job with Mitsy.

    Vetsulin is an in and out insulin. Lantus and Levemir form depots. Vetsulin does not. In general, Vetsulin gets utilized in 12 hours and has no lasting effects.
    http://www.felinediabetes.com/FDMB/threads/beginners-guide-to-caninsulin-vetsulin.186099/

    You are lucky Mitsy did not overdose (hypo) with those 5 unit doses. Kudos to you for BG testing and maintaining the spreadsheet. In general her numbers look good. I would urge you to post on the Vetsulin subforum semi-regularly for dosing advice. Also you would be interacting with other Vetsulin users.

    ---------------

    If you stay on Vetsulin, you can alternatively (AND VERY CAREFULLY) use U100 syringes to dose.
    http://www.felinediabetes.com/insulin-conversions-printer.htm
    This would allow you to more accurately estimate 0.25 increments. For example
    1.0 unit of vetsulin
    is 1.0 on a U40 syringe
    and is 2.5 on a U100 syringe - just multiply the intended dose by 2.5

    Therefore if I wanted to deliver
    1.25 units of vetsulin
    it would be 1.25 (estimated) on a U40 syringe
    but it would be 3.12 (1.25 x 2.5) on a U100 syringe, which would be easier to see. At least for me.

    If you use U100 syringes for Vetsulin, please be VERY CAREFUL. I did it for a brief period, and I triple checked each dose before injection. I'm not kidding.

    I didn't like the U40 syringes because the needles were huge.
     
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  10. Rardito

    Rardito Member

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    Jul 20, 2018
    Thanks for the advice!
     
  11. JeffJ

    JeffJ Well-Known Member

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    Jul 7, 2016
    You bet. The nice thing about year 2018 and (2005 onwards) are all the choices we have for diabetes testing and treatment. Most of this technology was not generally available until the mid 1990s.
     
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  12. Olive & Paula

    Olive & Paula Well-Known Member

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    Sep 6, 2015
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  13. Rardito

    Rardito Member

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