I sent her a bottle of Four Marvels, thinking that whether it was diabetes or Cushings, both indicated SMS. She gave it for a month, with no apparent change, then went back to the local vet who convinced her to try 1.5.units of insulin BID. She did not see any changes in his attitude, but when she took him back, GLU was down to 300 from 400. Vet wanted to increase dose to 2.5, my friend started with 2.0 over the weekend, in case there was trouble, no change in ravenousness. On Monday, increased to 2.5 and all hell broke loose-- he refused to eat, was depressed and had liquid diarrhea. She stopped it all, and after a day he went back to his baseline, albeit with even more hair loss.
Do you think this is a matter of more carefully tweaking the insulin, or are they on the wrong track altogether? Clearly the kitty did not go into a keto-acidotic crisis in the 8 months from when they measured high glucose and when they treated. But he is miserable, and so is the owner. Should we try a higher dose of SMS? Is this more consistent with a tumor than a centrally mediated insulin dyscrasia?