2/16 Shadoe pmps 383 cycle 1 8.5u

Yesterday’s Condo

Yesterday's recap:
160 - amps
243 - +2
302 - +6
347 - +9
351 - pmps
344 - +3
310 - +6
358 - today's amps

Well, I gave it a couple more shots and the freaky blue streak did not return.
She tried it; she did not like it, she returned to her comfy pinks.
Unless someone has a good reason to stick with 8u for longer, I will go ahead with an increase tonite.
Do I go to 8.5u or 9u?

Today, there was a spot of foam spit up; I gave Shadoe a piece of pepcid. I am out all day, so there is no point in her spending the day with an upset stomach.
All the LB actions were done when we woke, and a little less stinky today.
Shadoe would not eat her wet food until I made it wetter; I guess she has decided she likes the soupy slop form. I don't mind; it's getting fluids in her.
Shadoe was fine for her test and shot this morn, but forgot to ask for her treat! She just went over to the feeder and proceeded to eat her breakfast.
She is now all sprawled out on a pair of my socks, so she is set for the morning.

I'll stop by the vets on the way home to find out about the test arrangements, if the vet does not call me during the day. By Friday, I better have all that info and also, have the R onhand to start over the weekend.

That's it for now.

Scratches for the kitties today.

 

Re: 2/16 Shadoe amps 358 cycle 8 8u dose up tonite?

Darn!! I really thought she was going down! Well, keep your chin up and keep on truckin'....as I know you will. dancing_cat
Morris likes his food soupy too...I add about 1/2 can water to a can of food.
I hope your vet is more cooperative than mine has been...they don't seem to recognize that we have other things on our plate than waiting for them to get with the program....too bad we need'em sometimes. Oh, that sounded really negative..

 

Re: 2/16 Shadoe amps 358 cycle 8 8u dose up tonite?

ohmygod_smile Enough with the Pinks already Shadoe....

 

Re: 2/16 Shadoe amps 358 cycle 8 8u dose up tonite?

Brenda,
I am fortunate in that I am taking Shadoe to an animal hospital just around the corner from our place where there are about 5 vets or so. There is one who has been there for over a decade, and she is older and nicer and has seen alot more than the other young rug rats there who are passing themselves off as super knowledgeable vets. Oh sure, they know lots, but I have to say, sadly, that not a single one of them knows much about FD.
The young one to whom I will speak later tonite about test arrangements is also treating another FD kitty and apparently food has controlled that kitty, so I was advised to change Shadoe's diet to that crappy W/D they carry and Shadoe would be better and her p-titis would go away too! Never mind that I had just said, about 10min earlier, that Shadoe had not eaten a thing for over 24hrs.
You can call it being negative; I call it exposing weaknesses in knowledge.
By now, you are aware of things that work, that your vet does not like, but who can dispute what works?
Don't like that I home test? Tough, I intend to continue.
Don't think tests are necessary? Tough, it's my cat and my money. Just do them.
Don't like what I feed my cat? Tough, her numbers are better on what I feed than what you claim is awesome.

Always remember:
YOU are the customer. It's YOUR cat and YOUR money and YOUR decisions.
The vet is just there to work with you to get your cat to the best health possible.There must be teamwork to be successful.

I know it's hard sometimes; you may worry that your vet will not work with you, but if you take proof to back up your stand, like ss and articles, you can coax them along.
It's slow going but our cats are so worth the extra push at the professionals.

 

Re: 2/16 Shadoe amps 358 cycle 8 8u dose up tonite?

Hi Gayle,
sorry to see the blue didn't hold-still a nice pattern on the ss.

Unless someone with greater knowledge on the acro/IAA comes on I'd go up in .5u increment for now. (That's me being cautious)
Might be worth getting to know Nina and KB better as she's been dealing with this for quite some time.

Have you got a copy of Jojo's Pancreatitis post? I'm at work at the mo, but if no-one else posts it before I'm home and you don't already have it, I'll link it for you-some good info (maybe even your vet will listen, though mine didn't!)

That is the other thing, giving large dose, need to be sure Shadoe is eating.If you have any specific questions, can always post on health about them, get lot more eyes that way too.

 

Re: 2/16 Shadoe amps 358 cycle 8 8u dose up tonite?

Darn! Maybe it was a blue test run.

Sometimes I accidentally put so much water into Basil's food that I think no way is he going to eat that! But he always does.

 

Re: 2/16 Shadoe amps 358 cycle 8 8u dose up tonite?

Hi Kate,
Yes, I have the pancreatitis info from jojo and lots more.
When Shadoe was sick mid Jan, that one young vet gave me that lousy info, but I am not one to stand by that garbage so I went home, gathered up all my info, and Shadoe and parked in their lobby, fuming and TALKING LOUDLY that I wanted to talk to a real vet who would treat my cat with medicine and not words.
Rest assured, I get what Shadoe needs. That day the nice vet gave Shadoe a shot for nausea and another for pain, and gave me pain meds and nausea meds and fluids. We are lucky that there is one good vet who is willing to work with us. She may not know much about FD but she takes all I bring in and scans it all onto her computer for reference.

I will go with the .5u increase tonite unless someone says I need to increase more. I doubt it because we don't want to jump right over Shadoe's ideal dose. I am good with the .5u till we get her tested and know what's going on with my insulin guzzler.

Thanks for the offer of info.

And Lydia, I love that thought: it was a blue test run :lol:

 

Re: 2/16 Shadoe amps 358 cycle 8 8u dose up tonite?

That's great news.

Not only are you getting helpfor Shadoe, your educating a vet for future FD kitties that may come calling :mrgreen:

I'm a bit paranoid on the P'tis stuff as still feel the lack of action on the part of my vets may have contributed to Lucky's death so always check beans are throwing everything at it, only way that seems to work seeing as there is no known cure.

Insulin guzzler on a blue test run-I likes it :lol:

 

Re: 2/16 Shadoe amps 358 cycle 8 8u dose up tonite?

Terrific attitiude Gayle.
I really need you to come to Mntreal and talk some sense into these vets here.
Oh well.
You are doing whatever you can for Shadoe and she loves you dearly for it.
She hit some blue yesterday so we know she has it in her.
I am sure we will see it back soon.
I have full confidence that you will get to the bottom of this!
:YMHUG: :YMHUG:

 

Re: 2/16 Shadoe amps 358 cycle 8 8u dose up tonite?

Kate,
To be sure, I am with you on p-titis lookout with others.
After you see it first hand, how it can completely incapacitate your kitty and seemingly overnight, you are always watching. It can come on so fast!

Demand treatment if you see the signs. If your vet says the test is not necessary, speak up and say I DON'T CARE WHAT YOU THINK. Just do the test now. Get pain and nausea meds to have on hand. Get food and fluids into your kitty. Give fluids if safe for your kitty. Your kitty will thank you.

Some health issues build up, come on slowly; others come on so fast, you feel like you got hit by a Mac truck from left field.

Education and actions are key.

 

Re: 2/16 Shadoe amps 358 cycle 8 8u dose up tonite?

Gayle, you are such a wonderful Advocate and bean to Shadoe!! You know, one of the many things I adore about this board is the amount of knowledge that is learned from folks who are living the very issues that you have. You can go armed with all the resources you need to the vet and let them know that this is what you want because this has been proven to work. I'm sure a lot of vets don't really like hearing about FDMB because it goes against their beliefs, but hey, if you know it works, you gotta go for it!
It's nice that the older vet is willing to learn and work with you and Shadoe. That helps so much! I have a vet who really listens to me, and if there is an issue that I haven't had much experience with, I let her know that I am going home and discussing it with the folks on the board. She has seen how well Spot is doing in the year and a half since he has been dx'd and she knows that is mostly from everything I have learned on the board.
I agree with increasing the dose by .5 only. Good luck on the dose crease!!

 

Re: 2/16 Shadoe amps 358 cycle 8 8u dose up tonite?

Hi Gayle!

Really, if it turns out she's an acro, that's a typical response. With Leo I would see this really exciting response and then right back to the same ole stuff. Wanna get crazy? LOL I see you have an itchy trigger finger.. I did too! I say go for it, you know what to do if she breaks hard, have HC canned on hand? The only thing that holds me off from saying OF COURSE is that 160. It's showing she's starting to break, but I think you have a while to go before she's fully stable in the blues. If you want to go 1/2u increases for the next two cycles and THEN try 1u increases, that's fine too. This is important data collection, whether you go 1/2 or 1u. It's entirely up to you, you are the mama bean and you have to do what fits into your lifestyle and comfort zone. Either way, we'll be cheering you and Shadoe on!

What to do if she breaks through 100 during a cycle:
If she goes below 100, feed 1/2 a can HC at minimum, just to be safe. 1tsp HC is not gonna stop an acro on the way down and we don't know if she's an acro yet so play it safe on the HC intervention. For comparison purposes: Leo gets 2-3 cans HC (5.5oz) during any cycle he's dropping on. Doesn't mean you will need to give her that much, just don't be surprised if you do. HC will not reverse the progress you have made in the long term, and especially not if she's an acro, only temporarily, so don't worry about how much HC you're giving.

 

On pancreatitis

If she's got it, she needs fluids daily during the flare, pain meds, anti nausea, pancreatic support supplements and you need to have appetite stimulants on hand. Jojo likes mirtazapine. I like cyproheptadine because mirt lasts for 3 days and I'm really bad at remembering what is the 3rd day lol. fPLI is the test you need, and I'd not be overly interested in the ultrasound for confirmation unless for some reason the fPLI came back negative. Vomiting calls for fluids, but you must be careful to make sure she does not have a heart condition, which is common to acrocats. Since you don't know if she's an acro, you've gotta be cautious. You can give fluids to a heart kitty, but only in small amounts. For instance my pancreatitis kitty, Spot, got 100cc BID. Leo has HCM, so he gets only 50cc BID.

Jojo's Pancreatitis post: http://www.felinediabetes.com/phorum5/read.php?8,876722,876722

I'm sure you know not to do an increase in dose if she's sick, and if she's off her food, definitely do not increase. Monitor entire cycle tonight if she's off her food so you can gauge where your dose needs to be. If you need to drop your dose, do it, you can drop as far as you like, but she must have insulin on board, even if she is not eating. You can always get this back, and you can always jump right back to the dose you are at rather than slowly coming back up the ladder.
..C

 

Re: 2/16 Shadoe amps 358 cycle 8 8u dose up tonite?

I think I will follow Shadoe's lead. I will go with the 1/2 increase tonite, going to 8.5u. Then cycle 6 would take us to Friday am, but if I am going to start the R on Friday pm, I think I would like to remain on the 8.5u so that we are not introducing too many changes all at once. Better to stay with a dose she knows and a full shed when introducing R, than increasing to 9u at the same time.
What are your thoughts on that logic?

You are so right that I am so ready to move ahead in larger leaps, but only if needed.
The thing that holds me back is that I really don't want to jump right over 'her dose'. I know it's slim that we will pass it, but you never know.
Shadoe seems to do like Leo; give a little tease of some nice numbers, then scampers back on up the color ladder.

I will run my plan by the young vet tonite, for her input, but mainly just to let her know what I AM going to do. I will be set for the weekend for a 1u increase, only if needed, and only after getting the R in use.
For all I know, a bit of R to get the ball rolling and accompany the Lantus will be just the recipe for more frequent blues. Hey, at this point, I'd take a full day of yellows!

Like you said, all data is of value, at least how it relates to Shadoe. Until we get the tests done, and results back, I don't expect anything from the vets other than what meds or supplies that I may tell them I want.

Shadoe may be their first IAA or acro kitty, and why? Because they don't bother to test for anything of the sort.

 

Re: 2/16 Shadoe amps 358 cycle 8 8u dose up tonite?

I just wanted to add something (which may have been said previously). Acrocats have a fully functioning pancreas; they produce insulin, but their body can't use it properly because it gets "eaten" by the IGF-1 stuff. The reason we do HC at the lower numbers is because any meal will stimulate the pancreas to release insulin; therefore, it's possible that a normal LC meal could cause the numbers to go down rather than up (especially when you're at a dose that allows for "good" numbers).

I've republished my ss in case you want to look at numbers and responses to R. I started using R in May.

Get Carolyn's opinion on this, but I think you could safely up the dose AND use R this weekend. Remember, it will take a bit of time for the new dose to "do" anything; the R can simply bring the numbers down into a nicer range.

Finally, at this point, you're not going to miss the "ideal dose" by going up .5 and 1.0. Once you start getting some good yellows or blues, you might go back to .25 increases.

 

Re: 2/16 Shadoe amps 358 cycle 8 8u dose up tonite?

Yes, sadly it's the same at my vet clinic. They did not believe Leo was acro because it's "too rare". Fortunately my vet ran the test because I asked her to and didn't give me any trouble, but she is really good at listening to the client. Other vets in that office would have given me some trouble over it. Leo was their first Lantus cat, is now their first Levemir cat and also their only acrocat. Baby steps though, my vet told me they are now using Lantus. Of course that's because of the Vetsulin recall, but they are getting there. They knew it was out there because of me and Leo and that pleased me.

I agree with your reasoning and your decision. I also can't say enough about data collection. There is no wrong dose decision as long as you are getting data that you can refer back to at a later date. As Jill says, there's more insulin where that dose came from, so if you want to try the 1u increases later, it will always be there for you.

One thing I will caution you about. I don't see you here yet, but it does happen to us who are using R. R is for breaking high/flats. It will not prevent basal dose increases and can not be used in place of basal dose increases. It's a trap many of us fell into when we started using R.. a mental trap anyway. You get to thinking.. I can skip this increase if I "supplement" R.. and you can't. Once the numbers start moving on their own with the basal increases, you can even drop the R, but it will never replace a good basal dose increase. ;-)

 

Re: 2/16 Shadoe amps 358 cycle 8 8u dose up tonite?

Hi Heather,
Thanks so much for your input as well; I can likely use all I can get on high dose treatment along with the IAA and acro knowledge. Every little bit helps. All these points like knowing when the pancreas does not work, works poorly, or works fine are still beyond my level of knowledge so far, so your data is adding to my education.

Carolyn,
I see R as a front end kick start - something to get the show on the road and down on a safer level.
So if R brings her down to yellow or blue, then the Lantus or Lev can't hold up its end of the deal and fizzles by the next shot, I would continue with a dose increase after 6 cycles, yes? I know that's pretty general but general is all I can grasp right now.

 

Re: 2/16 Shadoe amps 358 cycle 8 8u dose up tonite?

Yep that's pretty much it!

 

I received no call from the vets, so I stopped there on the way home from work.

I spoke with the young vet; it seems someone must have said something because her attitude has improved. I guess she realizes something's actually up with Shadoe.
Dr. Lu (nice vet) left the papers and notes for Dr. Steed (young vet), to call a Dr. Greenwood (lab guy) about the arrangements for the tests. Steed did not understand Lu's notes and waited for lab guy to call. She got no call because she was supposed to call the lab guy, not wait for the lab guy to call. Duh. So, she is going to call tonite or tomorrow if the lab is closed already, then let me know. She does not start till 3pm tomorrow, so I will stop there after that time for info.
I started out by saying here is how it's going now, and here's what is going to happen.

Shadoe is getting 8.5u insulin BID 6 am and pm. On Friday, we go up to 9u plus I will start on 0.1u R followed by a full curve to see how Shadoe reacts to the R and then the Lantus. (She asked if Shadoe was on Caninsulin, to which I replied you kidding me? We stopped that crap months ago and switched to Lantus)
I will be splitting the insulin, half on left side of scruff, the other half on the right, and the R right in the middle, shots 3inches apart.
I want the tests done next week, no delays. We have waited long enough, and I got the info for you when I was told your lab did not do the tests.
Mark down to ask if fasting is needed, because I don't want these two tests screwed up. Ask if there are any other preparations we need to do.
Mark down cushings, and see if you can come up with any other issues that can be contributing to Shadoe's insulin guzzling.
Depending on the results, we can do more - she suggested we could do u/s to see what's up with the pancreas. I replied let's see if the tests are positive and we will know the pancreas is working or not first.
When you talk to the lab guy tomorrow, find out how long each step in the process will take and just tell me when to bring Shadoe in for the blood draw - I am assuming Monday, but maybe Sunday would be better and don't ship to the mail room at MSU; it will rot and the test won't get done. Be sure it's shipped right to the lab.
She pointed out that one of the tests can be done in Guelph; I replied why send one to a Cdn lab and the other to the US lab? Send them both to MSU and we get them done together and results received together.

I think this young vet is now more willing to come along for the ride and learn something more. She agreed with everything I said and seemed much more cooperative. I think my last visit when I said I wanted a referral to VEC because I was not getting service I wanted was the turning point.

uh they don't ask for my pet's name anymore when I show up haha_smiley
I walk in and they say "Shadoe, right?"

Ok I have harrassed the vet enough for one day; on to my report on Shadoe.

Nothing to report haha_smiley
Shadoe ate some of her food, not all of it. I think she just did not like what was put out. Too bad. She ate all her dinner though. LB action was good during the day, and her pmps was, you guessed it, a pink 383.
We increased to 8.5u tonite and we'll see what comes once the shed's filled.
And now it's time for Shadoe's pats time

 

I like your attitude, Gayle. :smile: Good luck with the dosecrease!

 

Cushings is a sucky thing to test for, I'd hold off on that til the Acro/IAA tests come back. Will require a day at the vet, it's a curve test. Best way to decide if your cat is *possibly* a cushings cat is to test urine. Cat can NOT be stressed so you want to do a urine collection at home and race it to the vet. Test is not infallible but it should let you know whether you need to continue to the more invasive testing. http://www.lbah.com/canine/cushings.htm#Felcush

 

Good luck with the dosecrease. It's hard increasing when you've had blue, I just did the same thing with KB.

You're getting some great help from Carolyn and Heather, glad they're following you and Shadoe. Also, Leslie just had the tests done for Bayley (also in Canada), she had a bit of a struggle, too.

With roughly a third of diabetic kitties suspected of also being acro kitties, vets really should get on board with this. Sometimes the younger ones are more inclined to do research for you (though I haven't experienced that yet).

 

Impressive vet report Gayle,,,damn, I want u to come with me the next time I go to the bank and ask for a loan! :lol:

And your attitude rocks too - good for u!! :thumbup

 

I like this condo very much, Gayle. Good for you. I hope the vets are on board now.

 

Gayle - you're great! Ronnie may want you with her to negotiate a loan. I want you with me the next time I need to buy a car!

 

I just want you with me the next time I go to the vet.

 

I want you to come to my house and talk to the telemarketers when they call.
((((GAyle))))