? 2.15.2017 TiTi. Stabilizing at yellow and blue? Another dosecrease?

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Kathy and TiTi

Kathy and TiTi

Member Since 2016
http://www.felinediabetes.com/FDMB/threads/2-14-titi-yellow-and-blue-again.173180/#post-1896035

At this point I really need to know why TiTIi's system accepts a particular dose, and responds favorably by going to blue or even green. Then, soon after, her BG rises quickly, indicating a need for yet another dosecrease.

This is a pattern I've seen since December 17th.

I assume TiTi has acro, yet this pattern seems to me more suggestive of AA. I realize that this is late in the day for AA to manifest, but her pattern does not seem to tally with a growing tumor. I've have heard that such a growth is pretty slow. A pattern of getting to green after a dosecrease, and then within 24 -48 hours needing yet another dosecrease seems more in keeping with an allergic reaction to the insulin.

As I understand the process, the cat's system at first accepts the insulin, but then identifies it as an antigen, and then releases antibodies to neutralize it. Well, I think I may have the names wrong, but the process is, I think, correct. Since TiTi so quickly changes her insulin needs, while the tumor is described as growing very slowly, I find the tumor concept questionable.

I am very possibly wrong in my interpretations, so any clarification is welcome.
 
Sorry Kathy but I don't have answers for you. Have you thought about getting the tests done? Below is the explanation as to how IAA works.

  • IAA is idiopathic. It just shows up spontaneously for unknown reasons.
  • IAA is self limiting and generally resolves in about a year.
  • The way it works when IAAs are present is that injected insulin first gets bound to the antibodies. Any insulin that does not get bound goes toward metabolizing sugars. How much goes to antibodies and how much goes to metabolizing sugars is anybody’s guess and a moving target
  • IAA can retard the initial rise of available insulin after an injection.
  • IAA can lead to an increase in the half-life of free (unbound) insulin in circulation because some bound insulin gets released into circulation.
  • The increase in half-life can lead to prolongation of action.
  • The release of insulin from the antibodies can happen at inopportune times
 
I'd give Titi a couple more cycles at this dose, she could still be bouncing. But if she doesn't get into anything below the 90's, you can probably increase.

Another explanation for what is happening is the slow tumour growth. You increase and catch up to the tumour output. The output grows a bit more and her insulin needs grow a bit, so you have to increase again. When Neko's acro tumour fired up again in the late summer of 2014, I saw exactly this pattern.
 
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