? 9/7 Taco AMPS 218, +4 50

Hi Brandi - hope the the latter part of summer treated you and Taco well. Taco seems to have turned a little corner in his numbers. :) Yes, I'd try the 0.5 unit decrease, and see how it goes. If it doesn't work, next time you might try 0.25 units. With larger dose cat, you really do have to experiment to see what works for them. With Neko, depending on whether she was otherwise stable on her dose, or doing a big down dose slide, I'd chose a smaller or larger decrease.

Can't remember if I've mentioned it to you, but on cats that get over 6 units, we suggest that caregivers think about getting test done for a couple secondary conditions that can mean the cat needs higher doses. Specifically, IAA and acromegaly. My Neko had both conditions. One in four diabetic cats has acromegly, which is caused by a benign pituitary tumour that sends our excess growth hormone which in turn causes the diabetes. IAA is sort of like an allergy to the injected insulin. The tests for both conditions are blood tests that are sent to the same place, Michigan State University. Note, some cats with these conditions have lower doses, which is one of the reasons I hate the term high dose conditions, but typically a cat over 6 units has a secondary condition of some kind causing the need for more insulin.

How is Taco doing overall?
 
Wendy&Neko said:
Hi Brandi - hope the the latter part of summer treated you and Taco well. Taco seems to have turned a little corner in his numbers. :) Yes, I'd try the 0.5 unit decrease, and see how it goes. If it doesn't work, next time you might try 0.25 units. With larger dose cat, you really do have to experiment to see what works for them. With Neko, depending on whether she was otherwise stable on her dose, or doing a big down dose slide, I'd chose a smaller or larger decrease.

Can't remember if I've mentioned it to you, but on cats that get over 6 units, we suggest that caregivers think about getting test done for a couple secondary conditions that can mean the cat needs higher doses. Specifically, IAA and acromegaly. My Neko had both conditions. One in four diabetic cats has acromegly, which is caused by a benign pituitary tumour that sends our excess growth hormone which in turn causes the diabetes. IAA is sort of like an allergy to the injected insulin. The tests for both conditions are blood tests that are sent to the same place, Michigan State University. Note, some cats with these conditions have lower doses, which is one of the reasons I hate the term high dose conditions, but typically a cat over 6 units has a secondary condition of some kind causing the need for more insulin.

How is Taco doing overall?
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Thanks Wendy :) Taco is doing fair. He eats wells, uses the litter box and drinks water throughout the day. He spends all of his time on our dining room table. That's where he eats and sleeps. He has been struggling with neuropathy and I'm giving him Methyl B12 5000mg per day. He has good and bad days. He usually looks like he feels bad though. :(
I have read a little about the acro stuff but not a lot. I really do need to get him tested for those two things. Are there any medications they take for those to help?
And that makes sence about seeing what kind of decrease works for them. I think I'll go down a 1/2 u tonight (7u) and see how he does with that. I gave him 7 yesterday morning because he was so low and I felt panicked and he did good yesterday.
Thanks again for your help.
 
For IAA - there is nothing but time and a good dose of insulin, it is a condition that is supposed to be self limiting after about a year. For acromegaly, there are some really expensive treatments, and a modestly priced daily medication called cabergoline that has helped a fair number of acros here. Neko had SRT or stereotactic radiation therapy, on her pituitary tumour, which really helped. It didn't cure, but really reduced the tumour so she was on less than 3 units for most of her diabetic life. She did get some of the side effects of acromegaly, but other than the arthritis, most of them didn't show up until several years later. So her quality of life was better. However, the price of SRT has soared in the last few years, more than double what we paid.

Another thing to consider at some point - is that many larger dose cats seem to do better on Levemir instead of Lantus. For many cats, the acid base of Lantus stings at higher doses. And I've seen some say they see a personality change for the better after switching. Neko used to occasionally walk away from her Lantus shots - she purred through the Lev ones.
 
Wendy&Neko said:
For IAA - there is nothing but time and a good dose of insulin, it is a condition that is supposed to be self limiting after about a year. For acromegaly, there are some really expensive treatments, and a modestly priced daily medication called cabergoline that has helped a fair number of acros here. Neko had SRT or stereotactic radiation therapy, on her pituitary tumour, which really helped. It didn't cure, but really reduced the tumour so she was on less than 3 units for most of her diabetic life. She did get some of the side effects of acromegaly, but other than the arthritis, most of them didn't show up until several years later. So her quality of life was better. However, the price of SRT has soared in the last few years, more than double what we paid.

Another thing to consider at some point - is that many larger dose cats seem to do better on Levemir instead of Lantus. For many cats, the acid base of Lantus stings at higher doses. And I've seen some say they see a personality change for the better after switching. Neko used to occasionally walk away from her Lantus shots - she purred through the Lev ones.
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I'll look into the Levemir. Is it cheaper than Lantus in the US? I'm currently buying the Lantus pens thru Mark's. In fact I just ordered another five. He doesn't seem to be bothered at all by his shots though. Is that the only upside to Levemir or does it work better than Lantus at higher doses?
Also, I'm not even sure if we'd be able to afford the high cost meds if he does end up testing positive for acro. :( I hate to even say that but it's the reality of my life right now. I can barely afford the Lantus. If it's just something he has to just live with is it even worth getting the testing? Gawd, I hope that doesn't sound awful. I don't mean it to. I love my boy so much.
 
I think the price with Levemir is very similar - a lot of Americans here get it from Marks as well. There is the odd cat who needs less Levemir than Lantus, though most need about the same dose. Maxi just switched this week and is on about 70% of his Lantus dose now and it's looking good.

This post on cabergoline has a good discussion from some people who used it, plus month costs. Seems to range around $70+ per month. Dose is based on cat weight.
 
Wendy&Neko said:
I think the price with Levemir is very similar - a lot of Americans here get it from Marks as well. There is the odd cat who needs less Levemir than Lantus, though most need about the same dose. Maxi just switched this week and is on about 70% of his Lantus dose now and it's looking good.

This post on cabergoline has a good discussion from some people who used it, plus month costs. Seems to range around $70+ per month. Dose is based on cat weight.
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Thank you so much! I really appreciate all the info you share. I will look at that link. That cost seems doable.
 
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