Frankie, as Marje suggested, it might be time to think about testing Jessica for acromegaly and IAA. My Neko has both. There is a very quiet
High Dose Forum here. It doesn't see much traffic, but there is a lot of information there. A couple of good posts to read are
acromegaly basics and
overview of high dose conditions.
On FDMB, we recommend that people get their cat tested for these conditions when they get over 6 units of insulin. The two tests are
IGF-1 test for acromegaly and
IAA test. The tests are only performed at Michigan State University. Your vet will have to get blood samples to be send there. If you talk to your vet about these conditions, be prepared that vets were originally trained that these conditions were very rare and might think it's a waste of time. Recent research has shown it's more common. My vet thought I should wait until Neko got to 10 units before we did the test, we never got that high. Her colleague called them "exotic tests". I knew he though I was wasting my money. They were both more surprised than I was when the tests came back positive. Now my vet has recognized another acromegalic cat in her practice.
If Jessica has one or both of these conditions, the most important thing you can do is to manage her blood glucose like you have been doing. And I agree with the Wendy&Tiggy that it might be time to start thinking about .5 unit increases. At this point a .25 unit increase is a relatively smaller percentage of the dose. If you start seeing a lot of green, then increases can be slowed down to .25 again. Both IAA and acromegaly are resistant to insulin, and you have to be a bit more aggressive to get ahead of that resistance. I wouldn't hold the dose for more than 3-5 days if you aren't seeing progress.
The reason that we suggest getting these tests is because acromegaly has some possible side effects to be aware of. For example, growth of soft tissue in the throat can mean that smaller tubes should be used if the cat is under anesthetic. Acrocats also can have growth in their organs and get a type of hypertrophic cardiomyopathy (HCM). My Neko has a slight heart murmur and we had a echocardiogram (heart ultrasound). It turns out the murmur was not from HCM, but now we have a baseline image should the murmur change and we know to monitor it. HCM is often considered a silent killer because there may be no warning signs. However, once diagnosed, it can be treated with medications. I lost a previous kitty to HCM. He had a severe stroke literally days before his echocardiogram was scheduled.
I realize this is a lot to absorb and there is a lot of material to read. Please feel free to PM me if you have questions. I know I had a ton of questions at this stage.
