Amanda & Shmee
Very Active Member
Previous condo
Hi everyone,
Sorry I have been away for a few days, I have had an overwhelming week. I knew this post would take a while and having to read over my vets emails too, so I have not found time to post. Thank you all who leant their support on my last condo. I have went back and re-read everything a few times and I appreciate it immensely.
I am trying to wrap my head around how to handle the situation with my vet. I attached her email to me after our last conversation, and the article she mentions.
She has been great so far but as of our last conversation (see last condo) she thinks I am going to kill Shmee because he is Somagyi-ing (I plan on giving her that Room & Rand paper, thank you Sienne), and she is no longer on board with TR. She didn’t even want me to increase him to 6 when I talked to her (he is now about to be at 6.5…). She wanted to talk to an internist to see if Shmee really needed the 12 hour fast for the IAA test (I wasn’t going to do it regardless, per Dr. Janine I would do like 6-8 hours), and the endocrinologist came back saying the IAA test is not needed and basically worthless. She said the IGF-1 test would be good to get, but said the IAA is unnecessary. I read over the sticky “acro and other high dose conditions: what we know”, and I am still not really understanding what the IAA test will tell me and how it can help. The links under the IAA section do not work except the petwiki page. Can someone please explain what the IAA test will tell me, and what use the information is? The article she gave me is from 2012. To my understanding, it is basically saying research has found that there are no good studies to prove what can get a cat into remission. I find it ironic that the research the endocrinologist provided shows nothing more than … there is no good research? I found it a little confusing. I have given her the medical journal in the past and the study to support TR, maybe I will have to just give those to her again when I tell her I will still continue to follow it. I also plan on telling her that Somagyi would mean that I am not catching him going low, when I know that I would catch it. So even if it does exist (it doesn't) I would catch the low number.
She also wants me to get pancreatic tests done (TLI and PLI). Thoughts? I am already about to spend $300 on the full panel bloodwork, IAA and IF tests, so wondering if this is also worth it?
(Background - if you look at his past bloodwork, his liver levels were very high. After a few weeks of Denamarin they came back down. Was about to go back for the new bloodwork to see his new levels, and this is when this whole thing started with her because I said I wanted the IGF and IAA tests done at the same time per Wendy’s suggestion.)
Lastly, Sienne said I need to follow TR more rigorously, but I still do not fully understand what I have done wrong. I have the TR sticky printed out in my binder and have read it multiple times so I thought I understood it. The only times he went over three days were when we saw greens, and I was told to wait 2-3 days after the greens to see if they come back from their bounce. The only thing I can think of is that you said if the nadirs are not mostly greens, then you want to increase. So if there is only one nadir on the dose that is green, then maybe I should be increasing and not waiting for the bounce to stop? I just want to be sure I have this down-pat.
Any advice or thoughts about her email/article would be appreciated, and I am going to tag a few people since it is late in the day and I want to be sure I get some of your advice.
@Sienne and Gabby (GA) @Wendy&Neko @Stacy & Asia @Olive & Paula @Tracey&Jones @Janine & Floyd @Carol in Chicago
My vets office is open late on Mondays, so in theory I can fast him for 6-8 hours before a late appointment and get some of these tests done then. I’m mostly worried about when I talk to her next, I want to be prepared with all the information I can be. Thank you all.
Hi everyone,
Sorry I have been away for a few days, I have had an overwhelming week. I knew this post would take a while and having to read over my vets emails too, so I have not found time to post. Thank you all who leant their support on my last condo. I have went back and re-read everything a few times and I appreciate it immensely.
I am trying to wrap my head around how to handle the situation with my vet. I attached her email to me after our last conversation, and the article she mentions.
She has been great so far but as of our last conversation (see last condo) she thinks I am going to kill Shmee because he is Somagyi-ing (I plan on giving her that Room & Rand paper, thank you Sienne), and she is no longer on board with TR. She didn’t even want me to increase him to 6 when I talked to her (he is now about to be at 6.5…). She wanted to talk to an internist to see if Shmee really needed the 12 hour fast for the IAA test (I wasn’t going to do it regardless, per Dr. Janine I would do like 6-8 hours), and the endocrinologist came back saying the IAA test is not needed and basically worthless. She said the IGF-1 test would be good to get, but said the IAA is unnecessary. I read over the sticky “acro and other high dose conditions: what we know”, and I am still not really understanding what the IAA test will tell me and how it can help. The links under the IAA section do not work except the petwiki page. Can someone please explain what the IAA test will tell me, and what use the information is? The article she gave me is from 2012. To my understanding, it is basically saying research has found that there are no good studies to prove what can get a cat into remission. I find it ironic that the research the endocrinologist provided shows nothing more than … there is no good research? I found it a little confusing. I have given her the medical journal in the past and the study to support TR, maybe I will have to just give those to her again when I tell her I will still continue to follow it. I also plan on telling her that Somagyi would mean that I am not catching him going low, when I know that I would catch it. So even if it does exist (it doesn't) I would catch the low number.
She also wants me to get pancreatic tests done (TLI and PLI). Thoughts? I am already about to spend $300 on the full panel bloodwork, IAA and IF tests, so wondering if this is also worth it?
(Background - if you look at his past bloodwork, his liver levels were very high. After a few weeks of Denamarin they came back down. Was about to go back for the new bloodwork to see his new levels, and this is when this whole thing started with her because I said I wanted the IGF and IAA tests done at the same time per Wendy’s suggestion.)
Lastly, Sienne said I need to follow TR more rigorously, but I still do not fully understand what I have done wrong. I have the TR sticky printed out in my binder and have read it multiple times so I thought I understood it. The only times he went over three days were when we saw greens, and I was told to wait 2-3 days after the greens to see if they come back from their bounce. The only thing I can think of is that you said if the nadirs are not mostly greens, then you want to increase. So if there is only one nadir on the dose that is green, then maybe I should be increasing and not waiting for the bounce to stop? I just want to be sure I have this down-pat.
Any advice or thoughts about her email/article would be appreciated, and I am going to tag a few people since it is late in the day and I want to be sure I get some of your advice.
@Sienne and Gabby (GA) @Wendy&Neko @Stacy & Asia @Olive & Paula @Tracey&Jones @Janine & Floyd @Carol in Chicago
My vets office is open late on Mondays, so in theory I can fast him for 6-8 hours before a late appointment and get some of these tests done then. I’m mostly worried about when I talk to her next, I want to be prepared with all the information I can be. Thank you all.
