Allie - new acro

MollyG

MollyG

Member
Thought I'd post my spreadsheet and see if anyone has suggestions for Allie. Her sugar's been way too high for too long. Now we have the acro dx, I've been zipping up the ProZinc that we just re-started, as she had done the best on that prior. I realize we'll probably end up back with Lantus, or will want to try Levemir.

I've asked my vet about that, and about getting a cabergoline rx.

Molly
https://docs.google.com/spreadsheet...YUfUDXD-yY7iDwQLXoq0eLZGU/edit#gid=1182885903
 
I had a question about insulin. I have been filling the syringe and leaving it at room temperature for 15 minutes. Does anyone know how long it actually takes for the insulin to reach room temp?
 
It shouldn't take too long. The conventional wisdom is to never leave a syringe longer than 30 minutes. I am sure 15 minutes will bring it to room temp. Does your kitty seem sensitive when you give the shots? Twitching or shying away or anything? Pro Zinc should not sting.
 
MollyG said:
I had a question about insulin. I have been filling the syringe and leaving it at room temperature for 15 minutes. Does anyone know how long it actually takes for the insulin to reach room temp?
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Forgot to say that I doubt it will take a full 15 minutes for that small, slender syringe to warm up to room temp.
 
Thanks! I got in the habit with vetsulin I think. I tried giving a shot right away, then 5 minutes, 10 minutes and 15 minutes later. Did that a few times before coming up with the 15 minutes. She seemed less irritated at 15 than 10. News to me about the 30 minute limit. When she was first dx I had read tons of the answers in this forum and was leaving the syringe overnight so I knew it was warm enough in the morning. I'm sure I based this on info from the web, and my vet's confirmation. I stopped that a long time ago once I saw that I could feed her first, another bit of misinformation I had acquired. I just keep learning.

I can see she's going to be getting up there in the units of whatever insulin she's on. I'm wondering how people actually give so much at once, I've read 30 or 50 units a dose! My current syringes only go to 20, I really hope she doesn't need more than that. She's good about her shots, but she's not patient.

My vet seems overwhelmed by the dx of acro. I guess he hasn't dealt with it before. It's taking him a while to get back to me about the cabergoline. I'd really like to get her on it asap. Again, thanks for responding.
 
I had to use two syringes at one point. After we started Cabergoline and switched to Levemir his insulin requirements went down.
 
There are lots of good papers and info on this Board that you can show your vet if he/she is willing to read. My vet did a lot of research on it on her own. She said that she had never had a client who “opted to treat” before.
 
So I've been winging the increases since I went to 9 on the ProZinc and haven't heard from my vet, but her numbers are getting worse. We had decided to go to the ProZinc just prior to the acro dx, so we stuck with that, but now we know its probably not as much about the insulin type.

Of course I won't hear from my vet now until Monday. Thinking of going back to Lantus for now, to 7 units, where we left off. I know I need to grab more numbers from her, but this trend has to stop. Her hind legs are worse and she's sleeping more and hanging on her water. In between though, she is her loving self and always comes to me for her test or shot before I call. Not sure how to post this to any other thread. Thanks for any suggestions.

I saw that someone in another thread was consulting with an internist at Cornell so I'd like to get that number. I've asked my vet (we've consulted with Cornell on other animals)
 
MollyG said:
So I've been winging the increases since I went to 9 on the ProZinc and haven't heard from my vet, but her numbers are getting worse. We had decided to go to the ProZinc just prior to the acro dx, so we stuck with that, but now we know its probably not as much about the insulin type.

Of course I won't hear from my vet now until Monday. Thinking of going back to Lantus for now, to 7 units, where we left off. I know I need to grab more numbers from her, but this trend has to stop. Her hind legs are worse and she's sleeping more and hanging on her water. In between though, she is her loving self and always comes to me for her test or shot before I call. Not sure how to post this to any other thread. Thanks for any suggestions.

I saw that someone in another thread was consulting with an internist at Cornell so I'd like to get that number. I've asked my vet (we've consulted with Cornell on other animals)
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I feel for you. I’ve been there. When I look at your spreadsheet, I don’t see many tests. There should be a morning test before the insulin injection (AMPS) and the evening pre-shot test as well (PMPS). You need more data to know how to adjust your dose. You need to know what your kitty’s nadir is. Can you get a test before each shot for starters?
 
The hind leg weakness could be diabetic neuropathy which needs to be addressed with a methyl b-12 like Zobaline or a combo of methylcobalamin plus folate. Or, it could be something else. Has Allie had lab work done recently?
 
I held the filled syringe between my fingers for a little bit, to warm the content. Never more than 30 seconds would do it.

Lantus/Levemir syringes can come in 30 or 50 unit amounts, the 50 unit ones don't have the 1/2 unit marks on them.

Here is the post with the links to the dosing methods we use for Lantus and Levemir here: Dosing Methods: Start Low, Go Slow (SLGS) & Tight Regulation (TR)
As others have said, it will require more testing. At a minimum, tests at preshot AM and PM to make sure it's safe to give insulin. Many (most) cats go lower at night, so a test after the PM shot is also valuable. A good long lasting depot insulin, and preferably following Tight Regulation if you can, is the best and fasted way to get your kitty into better numbers.

Don't go with Vetsulin, Levemir would be better as the Lantus acid base can sting at higher doses.

What sort of information are you looking for about cabergoline?
 
MollyG said:
she's on B12. No lab work
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Well if the B12 you are using is methylcobalamin (as opposed to cyanocobalamin) it should help diabetic neuropathy. It could take a few weeks; I don’t know how long you have been giving it.
The reason I mentioned labs is that there are other reasons for hind leg weakness. My kitty, for example, started having hind leg weakness and trouble walking. It turned out to be high blood phosphorus levels. If she hasn’t had bloodwork done, it sounds like it’s time to get some (a senior panel would be good - where they send it out to the lab because you will get more information). Also a urinalysis can tell the vet a lot. Hang in there!
 
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