10/12 ??Bootsie and Acro - should I continue to increase?

https://www.felinediabetes.com/FDMB/threads/10-11-bootsie-is-so-now-what.254129/

Given her new diagnosis of Acromegaly - should I continue to use TR and increase her dose or hold her at 7U until we decide on a course of medical treatment? I sort of feel the increases will not really do much given the insulin resistance seen in Acro

Thanks. - Jackie

 

In my experience, it is important to follow TR and do the increases. It helped my kitty a lot prior his Acromegaly diagnosis and prior to the time we started Cabergoline. Some people, for various reasons, manage their kitties only with insulin. You can still use the insulin to break through the glucose toxicity. Also, you still need to find the dose that Bootsie needs. It’s not that he cannot respond to insulin at all, bit that it will take a lot more insulin than a non-Acro cat to move his numbers. I know it feels futile, but it is not.

 

P.S. my boy Darcy was up to 41 units before the Cabergoline started to kick in. The two key things for us were starting Cabergoline and switching to Levemir.

 

Ok - thanks. I will be talking to my vet later this week when she is back in the office about the Cabergoline. And I will continue to increase per TR. How expensive in Cabergoline and is there a cheaper way to buy her insulin. I am paying $77 for a 300 unit insulin pen.

 

Suzanne said it perfectly - he needs what he needs. We had run up to 14U before starting cabergoline, and we're fortunate to go OTJ very quickly after... though that's a little rare.

I pay $35 for about a 2 month supply...pretty easy to justify cost if insulin requirement goes down. My vet orders the pills and compounds them for me, charges $10 to do that. Make sure they use sugar free liquid. A lot of people use Wedgewood Pharmacy too.

For insulin, for people in the US, Marks Marine Pharmacy in Vancouver is usually the way to go.

 

Thanks for the info. I am in Wisconsin so I don’t think your pharmacies can help me. But I will check prices here at several places

 

? I'm in Ohio. I ordered insulin from Marks Marine, even though it's Canada they still ship here. And Wedgewood has several locations.

 

mom. Thanks. I can look in my area. Can I find Marks Marine online? And I did not look to see where you are located. I just saw you mentioned Vancouver so thought that area of the country. Sorry

 

Yes you can find their website here. We are having unseasonably warm weather here, I'd suggest the extra cold packs and insulation if you have to order soon. It usually takes about 10-12 days from the time I submit the order to when it's in my doorstep.

 

I would surely increase dose to try to get BGs down. In the 300's all the time is not good.
My Snuffles has been on cabergoline for almost 10 months.

He started Gabergoline on Dec 20, 2020 at a dose of 10mcg/kg. The Cabergloine was from Wedgewood Pharmacy as a suspension in almond oil. I just added it to his food.
When I started his PS' were 150-20 at a dose of 11 units. Over time the PS' came down a little dose going as high as 20 units in May with PS 140-100.
At the end of June I found that he had vomited some time ater his morning meal and he was lethargic and mean so I could not even test him. Hi had no interest in the PM meal so I did not give any insulin. Next morning he was fine and had a PS 146 but I was worried so only gave units. Glad I did since PM PS was only 94. Note I get very very few GB between shots since Snuffles has sent me to the Dr one for a bit and worse yet to the ER once when bit and held on to my arm and ripped my arm up besides blooding my hand and legs from minor mites.

In July dose went down to about 16 units with PS' 100-130. In Aug was about the same.

In Sept dose was about the same with PS BG being a little lower.

Early Oct again I found vomit after morning meal but he allowed me to test him before meal time BG was 228 and he had no interest in food but I did leave most of a meal. I did not give anh insulin. Next morning all food was gone and he was acting normally and had a PS 98. I gave full dose of 14 ½ units. Since then PS' have been 115-90 and dose has been reduced to 12 ½ units.

Overall I am pleased with Snuffles progress. It is much different from my previous aero cat when his dose continued to increase to about 50 units twice daily.

 

Jackie - Definitely keep increasing until you find a better dose for Boots. All that time in high numbers is hard on them. Every cat has a dose that moves them into better numbers. She will feel better once she is spending more time under renal threshold and not having to drink and pee as much. Her appetite will also become more manageable. Cabergoline also does not work immediately, and takes some time to work. That length of time varies by cat.

@Larry and Kitties Oh my, Snuffles is a tough one! Have you ever invested in gardening gloves used for handling roses? They saved me more than once working at the shelter with some "characters".

 

The prices at Mark's Marine Pharmacy in Canada were definitely the best for me. I bought Levemir there.

 

Also, Jackie, you had asked about the cost of Cabergoline and I just looked it up:

I paid $240 for a 60 mL bottle of compounded Cabergoline liquid at a strength of 200 mcg/mL. My Darcy, who was over 15 lbs. was on a dose of .4 mL daily, so there were 150 doses in the bottle, which would last for five months. I got fish flavor, and it never bothered him to receive it via an oral syringe (but he was a gem!) My vet ordered it for me from Wedgewood Pharmacy. Hope this helps!

 

I did increase her dose today to 7.5u. Unfortunately we had to travel today so I did not get many chances to check her BG. We are camping and she is with us. She is eating and drinking although did have a little emesis in the car.
How old are most of your cats when you started treatment? She is 13 but our other cats have been 17-18 when they died of natural causes. We had 6 at one time because we had inherited my sons 2 cats at the time but now we are down to just 2.
I will look into Wedgewood Pharmacy.