Cleo- current condition & looking ahead

We have a mtg w/ the vet at VCA Animal Diag Clinic- Dallas tomorrow to discuss treatment. They presented a cost of ~$1800 to do a CT scan. Dumping tons of $$$ into this kind of treatment only to have something else go wrong is what we fear, but we love Cleo and feel bad for her and want to help her. I bumped her up to 8U 2x/day starting Sunday night to try to get some lower #'s, but I've only got night time test #'s. Her appetite is really up as she nips us on the ankles when we're in the kitchen not long after she's fed and wants more. This behavior has come on in the past 2 weeks. Her peeing is down to almost normal amounts. She's fairly active and alert, probably because she's so hungry, but the hind legs are still floppy so she's not very fast, just persistent. She's hard to make sit still enough to prick the ear, so I let her eat, then immediately test, then give her a shot.
I will ask about cabergoline along w/ any other treatments. I just feel like she's going down a dead end and being damaged because of the high #'s for the past 6 months. Getting frustrated.

 

Question: should I feed her when she wants more or keep her on the 1 3/4 can of Purina DM daily? Seems an hour or 2 after feeding she wants more. Should I give her more or make her wait until next ration? Trying to spread out the feeding but not sure she ever gets satisfied. Maybe I let her gorge and then see how long it takes before she wants more?
Frustrated the last few tests she was over 400.

 

I'm so glad to hear that Cleo seems to be feeling better! Best of luck with your meeting tomorrow. As for feeding - there was a time I had to feed Rocket almost every two hours. Now, I feed him a quarter or third of a can (small Fancy Feast size) every 3-ish hours, and I feed him once or twice overnight too. Acro kitties are hungry... I think the general consensus here for diabetics in general is to feed smaller meals throughout the day.

Don't get discouraged -- Rocket was in high numbers for so long before we figured out he had acro (take a peek at the 2019 tab of his spreadsheet if you want to see lots of ugly blacks and reds). Now, he's doing sooo much better -- not only in numbers, even though I can't really stick to the prescribed protocols (freelance work, etc.) -- but he's a super happy and even playful kitty again. His neuropathy has greatly improved too. They really can be resilient little guys. Please keep us updated!

 

I used my scale to weigh Neko and see if she needed more food or not. I also switched to raw food, which seemed to fill her up better than canned. Plus she had about three meals per cycle. I also fed meals after preshot in the autofeeder, so she stared at it instead of bugging me for food.

Can you get preshot tests in addition to the night time tests? It's really important to know it's safe to give insulin, and helps fill in the picture on how she's doing on a dose.

 

This cat is already 4-5 lbs overweight. Actually she's been overweight the past 4 years or so, we just haven't been able to get her to reduce. She's probably been pre-acro since we got her in '14 and her weight just kept creeping up. She's always been a persistent eater. When we tried to reduce her daily food, she drove us crazy w/ the constant crying for more. Now she's nipping our ankles! It could be why her personality is so Type A.
I just tested today 7 a.m. CDT and she was 512 rt after eating and rt before the 8U shot. At least her thirst is down to normal- hope that's a good thing.

Question: would reducing the dose cause #'s to come down, or just go up higher?

 

Had visit w/ Dr. Stiller at VCA clinic in Dallas. She wants me to research dosing and usage of cabergoline on cats in the forum. Can everyone using cabergoline give me some support info on cabergoline & their cats?
Meanwhile, we'll just keep increasing the lantus, at her direction, and hope to get some better #'s. She also said to give her more food if she insists (which she usually does). That's her system telling us she's not getting enough nutrition from the food due to lack of insulin. I guess I won't worry about weight gain or overfeeding.

Thanks!
Chris

 

Recent thread of Judy and Freckles talks about cabergoline.
http://www.felinediabetes.com/FDMB/...udy-pmps-157-191-2-209-5.225857/#post-2529290

@Pamela & Amethyst use Cabergoline for her cat Amethyst
@Stressedcatmom uses Cabergoline for her cat Yoshi
@Olive & Paula use Cabergoline for her cat Olive

 

Chris, what do you want to know? I'd be happy to tell you what vet and I do for Ollie.

As far as feeding, acro can cause cats to gain weight very easily. I feed Ollie based on calories needed for ideal weight. She has maintained 12-13 pounds for over a year now.

Lately because glucoses have been going up she is super hungry the first 3 hrs after shot time.

 

My vet wants me to provide dosing and any supporting info to possibly prescribe for Cleo. She's looking into sourcing the drug in the correct dose. Also, need any info such as other conditions/illnesses or things that would exclude or support using this for Cleo. Maybe provide Ollie's specifics and how the drug affects her and her conditions. Cleo's IGF-1 was 460, no ketones, BG#'s avg in the 400's. See SS.

 

Chris, I will do this from pc later today. I will need my notes. I got up very late today.

 

ok, thanks Paula. I'll be around the computer all weekend. Weather is crappy in N. Texas.

 

I was advised to add water to Freckles' mini meals as it seemed to help fill her up. If I let her eat whatever she wanted, I think she would explode. I don't think the meals are registering in her brain. My concern with feeding her whenever she wants is the increase weight gain. I know obese human diabetics are always encouraged to lose weight and maintain a good weight... I'm thinking it's the same for cats. I also use a kitchen scale to weight out Freckles rations. I use an autofeeder and Freckles gets her 1/2 her morning ration for breakfast and then gets the rest of her food divided into 4 mini meals at +2, +4, +6, +8.

Getting more data is really important since Cleocatra may be going low during a cycle and then bouncing up and the high numbers are what you are recording.

Check out Walter's SS for a bouncy kitty! Look at Feb. 19, 2020 in the pm cycle. If Walter's mom didn't grab the +7 test, she would have never known that Walter hit a green number!
https://docs.google.com/spreadsheet...c5_vXAaYQ_grbn-TL_UB6H5tkQiqDxEq8nP2I/pubhtml

 

WOW!!! That IS a bouncy cat!! I've never hit any low #'s w/ Cleo. I haven't run as many curves, tho, but every random test she's always high or higher. Cleo is not easy to deal w/ sometimes to get blood from the ear. She likes to snap or fidget and a lot of times I can't beat the timer on the Alphatrak. Doc said w/ Lantus we don't need to test but every 4 hrs and only once a week since, according to her, Lantus is slow acting. I've never seen any issues w/ hypo, so I give the same shot at 7 & 7 every day. This cat does not cooperate if she's hungry and I don't have time in the a.m. to mess around- gotta go to work & Mrs doesn't do well handling the cat.
Regarding hunger: Cleo has developed a voracious hunger in the past 7 days. She gobbles and cries for more every 3 hours. We saw the doc on Thursday and talked about all the behaviors and symptoms. She said the 3 hrs after a shot, they have the highest hunger. I know we're way over her rations but dr. said if she's hungry and crying, give her more food until she's satisfied. The past 4 days she's been pigging out and this morning the bomb went off- BIG pile in the litter box, she squatted in it, made a big mess in the utility room, and had to have a butt bath this morning. When I went in the room, it smelled more like food than poop so she's eating so much it's just running through. I hope that's not a bad sign & hope this is just a peaking hunger. Rt now (Sat. 9am CDT) she's only had 1/4 can and not crying out so maybe the big hunger is subsiding... or maybe not. We'll see today since I'm home all weekend. I will do a full curve tomorrow and report to Dr. how 8U 2x is doing.
Oh, dr. said we will just keep increasing dose until the #'s start reducing. She really did not push SRT to us on Thurs. I'm surprised because they would make a lot of $$$'s off that.

 

Sadly, your vet is misinformed. You don't need to test every four hours, but every preshot and if possible at least one other per cycle for a total of 4 per day, when you are able to do so. Lantus is slow acting, but cat's can still drop a lot on it. Cat's cat drop from over 500 to less than 100 then back up to over 400 or 500 at the end of the cycle. If you don't test at the right times, you could be missing what is happening. Look at Neko's spreadsheet her first year. Ignore the first couple weeks of a bad meter. She was very sporadically getting good numbers. If I hadn't tested at the right times, I would have missed it.

I'll admit i tested more than I needed to at first and later got down to usually 5 tests a day, one of those being just data gathering. Once you know your cat's onset, nadir, and duration, you can reduce the number of tests. If you are having a hard time getting the blood in time, scrape it onto your fingernail and test it from there.

Cats don't always show signs of hypo either. I have tested Neko in the 30's (human meter where below 50 is low numbers) and she was just snoozing away. To my eye (and I've looked at probably hundreds of spreadsheets), Cleo is either overdosed or underdosed. I can't tell because there isn't enough data.

To help her hunger, add some water to her food to fill her up. As for the hungriest three hours after the shot, I have never seen that. Did your vet have an explanation for why she thinks that's so? Also, what food is she eating? Sounds like maybe it's not filling her up or possibly not agreeing with her. If cats are having food absorption problems, that will also make them hungrier.

 

I didn't get the meter until a couple wks before Xmas, but she was dx'd back in August but never tested regularly. I kept reporting back to the neighborhood clinic vet every 4 weeks that her peeing & drinking was really bad (while on Purina DM dry). So each time, the vet (an older experienced female vet, but not so w/ DM) just said to bump up an addnl unit 2x. So that went on until we got the alphatrak in Dec when I realized we were going nowhere fast, got more educated on diet etc. and then tried to change to canned food.

So you'll see on the SS when I started testing- the #'s were not good. When we finally went 100% on canned food, the #'s dipped a little and that was promising. That was when we saw the specialist vet, she's young and knows more about DM than the old vet, but I don't think this girl has as much hands-on as you and others in here.

AFA getting blood, I now have to give her some food first thing and then shot, and then blood after she's calmed down to let me mess w/ the ears. When she's hungry, I can't get blood to beat the timer and she's fidgety and very impatient. Tomorrow I will run a good test. Gotta go, she's crying for more food! Thanks!!

 

My vet also knew very little about Feline Diabetes despite him being diabetic himself. The vet admits that he is a generalist as are the majority of vets. He also stated that most cats never go into remission despite the research findings that around 80% of cats go into remission. I don't really blame the vets as they are just stating what they are taught, but I do raise my eyebrows when health professionals do not keep up with the latest research.

It would be nice to be able to take everything that the vets say as absolute but just like everything else, it is buyer beware and it is the care giver and cat who have the most vested interest. At the end of the day, the vet goes home to his/her life. I do lots of my own research of peer reviewed scientific journals whenever I can so I can make the most informed decision I can.

Just my 2 bits.

 

I give Freckles a 'treat' (freeze dried chicken treats) when I'm testing. I give her the insulin as she starts eating her breakfast/supper. She's so focused on eating in all of the instances that she doesn't even notice me doing anything. I test and give her insulin on the bathroom counter where it's small, contained and free from distractions.

 

Hi, I’m just catching up on the board as I have been in coronavirus hell being a college teacher/administrator.

@Cleocatra, I haven’t tried cab yet. It was prescribed to us, but I was fearful of using it because I want to administer it in summer when I’m off. I can’t test much during the day sometimes and my fear would be that yoshi would respond and drop too low. I was debating using it just as yoshi started to earn reductions and normalize (anti jinx), and I decided to wait.

I did change to low phosphorus, low carb werva right when yoshi started to earn reductions. I have no idea if food played a role (I’ve been feeding him low carb for years). But maybe you want to consider changing food. Low phosphorus is also better for acro cats. I also switched to levimir and he seemed to flatten out when I did.

 

she's on Purina DM canned. We got her off of the higher carb DM dry. That crap was making her drink like a fish plus it has alot more carbs & cals than the canned.