Olive - needs high dose?

Hi all - I'm a cat mom to Olive, a very opinionated 9-lb. 14 y/o. She was diagnosed with diabetes in March 2022. I still have yet to get her BG completely controlled with Lantus and am not having a lot of success with my vet. I am in the process of raising her dose again after we did a dietary switch. I had her on Tiki Cat wet food most of the year and didn't realize it was high-calorie (was only focused on the fact that it was zero carbs, so she was overfed). I switched her to Fancy Feast - I am currently transitioning her from Purely Naturals to the classic pate (after finding the food chart on here and realizing that would be just as effective and far less costly). As of last night, she's at 6 units 2x/day of Lantus. I've been doing glucose curves weekly in addition to spot checks - she averages about 370 and was 386 this morning at feeding (using Alpha Trak). The vet is baffled by how how high of a dose we've had to go and doesn't know what to do given the lack of progress despite the calorie reduction. I just read on here that the scruff is not recommended for injections, so I may try other locations this weekend when I'm able to monitor her closely. Does anyone else on here require high doses? Also, any additional thoughts/guidance would be welcomed. This site is a wonderful resource, but I feel a bit overwhelmed by the sheer amount of information.

 

Welcome tp the FDMB. We ask new members to post an intro on the main forum first. There you will get set up with a spreadsheet and signature. We are very data oriented here and need the spreadsheet to make recommendations.

You can copy and paste this to the thread you will begin on main/health. Once set up you will return here. There are high dose conditions and it sounds like Olive has one.Has your vet ever suggested testing for ACRO? We have several members here with high dose cats. @Wendy&Neko is our pro on this topic.

 

Hello and welcome, her is a post we suggest new people read,
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My girl got to 8,75 units and we have some cats needing even more. She had two secondary conditions that can cause some cats to need higher doses. One is called acromegaly, which is caused by a benign pituitary tumour that sends out excess growth hormone and causes the diabetes. One in four diabetics have this condition, though not all need higher doses. The second condition is IAA or insulin auto antibodies an you can think of it like the bodies reaction to injected insulin. To test for these conditions, the vet would do a blood draw and sent it to Michigan State University lab if you are in the Americas.

Tiki Cat is perfectly fine food. Though you don’t need to feed zero carb, anything under 10% carbs is fine. Nothing wrong with higher calorie, unless kitty needs to lose weight. It does not impact the diabetes or her blood sugars. I never fed Neko Fancy Feast, it is too high in phosphorus, which is no good if kitty ever gets kidney disease.

I shot Neko just below the shoulder blades for five years. She didn’t want me shooting anywhere else. Just rotate around and alternate left and right sides so you aren’t shooting exactly the same place all the time.

 

Thank you both for your responses! My apologies for posting in the wrong forum first. It's ironic that you mentioned acromegaly. The vet left a message today after consulting with an internist and the recommendation was to get her tested for this condition. I'm going to read more about it tonight. I live in WA State - how long does it typically take to get results back? I'm now quite anxious to get this test done!

Thank you also for the information about calories. She's never been an overeater and has lost a significant amount of weight in the past year (her profile pic is from before she got sick). The vet believed the excess calories were contributing to the increased BG, but now that I've switched to a lower calorie food and followed her strict recommendations for several weeks, it's clear that it's not making a difference. I've felt horrible restricting her calories because she was screaming nonstop for food. This has lessened a bit in the past week or so as I've continued to raise her Lantus dose to a point where it's starting to make a difference again.

 

The test for acromegaly is run on Wednesday’s, and overnight. So if you get the blood there by Tuesday, you should get the results end of that week or beginning of the following. If it gets in late in the week, unfortunately like I did, you wait an extra week. Make sure the vet tests for IAA too, some cats have one but not the other.

Lots of work done on treating acromegaly at Washington State University.

For amount of food, a scale is good, to see if she is trending to the weight you want.

 

My vet just shared test results. IAA was negative, but IGF-1 was significantly elevated. Looks like Olive is an acrocat. Feeling pretty devastated for my sweet girl, but I'm going to read as much as I can on the acromegaly forum before the vet calls back to discuss treatment planning.

 

Sorry to hear the news. Most important to remember, Olive doesn't know she has acromegaly, she's the same sweet cat as before.

A lot of us have been in your shoes. If you post on the acro forum Acromegaly / IAA / Cushings Cats you'll get people stopping in an helping who have had experience. We have a current member who went to Washington State Univ for one of the available types of treatment. There are several options.

 

What was the specific value?

 

IGF-1 = 325 nmol/L

I just spoke with the vet and we're going to get her started on cabergoline. I'm pouring over those threads in the acro forum.

 

@Larry and Kitties