New Member_MAF & Buster_Hello/Help_Post-DKA

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Suzanne & Darcy said:
Yes. Zobaline is excellent. I used it. If you want, you can purchase Methylcobalamin and Folate separately and it will be a little less expensive. Can you give Buster a pill? If so, they’re quite small pills. I just gave them to Darcy straight, but he was so easy. I will look at your spreadsheet.
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Buster is not easy to pill (or even test, for that matter). If we use a thin pill wrap or small amount of pill pocket, we can usually get it in him. Can Zobaline be crushed? Or would the powder from capsules of Methylcobalamin & Folate be an option?
 
Suzanne & Darcy said:
I would have gone straight from 9 to 10 units. He’s at a high enough dose now that you can dispense with half unit doses for the time being. Later if you are fine tuning the dose maybe you will do that. I wouldn’t mess around with fat or skinny doses right now either. He needs more insulin based on his spreadsheet number. Since you were at 9.5 units for more than 6 cycles, how about just doing the increase to 10.5 units now? I would hold it for 6 cycles and unless you see blue numbers, increase again.
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His PM meal is at 6p so I didn't see your post in time to adjust.
We kept at 10 today even though there was no drop last night b/c I thought we are to keep at new dose for 3 cycles. Is that not correct or does his acro allow for deviation?
The next increase will be a full unit to 11. If we don't see any yellow today, when do you suggest that should be?
 
Suzanne & Darcy said:
I thought you were going to try to switch to Lantus? What’s going on with treatment for the Acromegaly?
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Regarding Lantus, I orginally dismissed it b/c I read that it stings at higher doses. But, based on the comment from @Wendy&Neko, that may or may not be the case. Honestly, given Buster is already getting squirrely with longer admin of the higher doses, I'm really concerned how he would do with a large dose that also stings. As I understand it, he would start at the same dose amount. Is that accurate?

To that point, however, does it look like the in/out of ProZinc is not lasting for him so a depot insulin would be better?
(Sorry to need to be spoon fed, I'm still learning all of this.)

Regarding the acro, we have a phone consultation for SRT next week with a local hospital (couldn't get in-person for another 2 weeks). In addition, @Sienne and Gabby (GA) was very helpful with information for another. I'm having some difficulty connecting with the closest CyberKnife facility (8 hrs away).
 
Madm4444 said:
Honestly, given Buster is already getting squirrely with longer admin of the higher doses, I'm really concerned how he would do with a large dose that also stings. As I understand it, he would start at the same dose amount. Is that accurate?
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You use the same number on the syringe. But with Lantus you use U-100 syringes as the insulin is more concentrated. You use U-40 syringes with Prozinc. By volume, if you filled a U-40 syringe to the 10 unit line with Lantus, you'd be giving 25 units of Lantus. So 10 units on a U-100 syringe of Lantus, is the same volume as 4 units of Prozinc. Maybe easier to see in this conversion chart . At least it wouldn't take as long to inject.
 
I know everyone says Lantus stings. I never had a reaction from my boy and we were over 40 units of Lantus at one point. It may be that he was just sweet (well, he was sweet) but every cat is different. I have heard people say it stings.
 
It’s very easy to crush Zobaline. Also the methylcobalamin comes in capsules. Some people do mix these things in food or a bit of a squeeze up treat. Darcy used to like the Tiki Stix. They are low carb.
 
I don’t think the spreadsheet is up to date. ? When you get a chance, please update it. I think you mentioned a yellow last night from the Libre sensor. A 269? And he was in the pink this morning? He has had some similar yellows at night. Since you said you already shot 10 this morning and he was bright and alert— and his ketones are still not bad, I would hold the 10 units for 6 cycles and increase to 11 after that. I think this would be Tuesday evening if I counted correctly. Now, if by chance he dips into blue or his ketones go higher, I might recommend going to 11 units before that.

This would probably be a good time to start a new thread.
 
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