3/2 Dimmu AMPS 344 (?), Increased from 1U to 1,5U, SNAP fPLI result: positive

Yesterday
Good morning!

Dimmu's AMPS was 241, first yellow we've seen in 5 days. He's due for an increase today, so I waited and retested 5 mins later and it became 344. I took the average, and considering his history and meter variance, he's probably still in (or close to) pink. I went ahead and increased him to 1.5U from 1U.

If I had done another BG test during the night before his increase, I'd know if he actually had a drop. Making a decision based on guess work and at his cost doesn't feel nice. I hope I made the right call increasing by .5U instead of .25U....

I woke up to the sound of him pawing the litterbox. As I walked to his toilet to check, there was this familiar stink, and I thought "ah, what a beautiful Saturday morning". He's cleared his constipation!

 

Good luck with the increase, does look like Dimmu needs some more juice.

 

Thank you, Bronx's dad. Dimmu is doing good so far.

I noticed you also use CBD oil, I gave Dimmu 2mg bid for his arthritis, and increased it to 3mg after he started insulin. It's on the high side, but he seems to adopt well. I read that it might also help with pancreatitis. How much do you give Bronx, and what for?
Bronx is a tough little trooper, isn't he?

 

Dimmu's SNAP fPLI result came back, it's abnormal (positive). We also did a GDDR-lipase on 20 Jan, his level was 40ui/L (normal range: <26 ui/L). I know that both tests only have a sensitivity of 67% or lower at diagnosing pancreatitis, but I think these results pretty much confirm he has some degree of pancreatic inflammation (correct me if I'm wrong), although he's not showing much of the clinical signs other then lethargy. The vet that did the SNAP, like our vet, also suggested doing an ultrasound.

If I understand right from what I have read, US is even less accurate at diagnosing pancreatitis, so my question is: is it worth putting Dimmu through yet another stressful vet visit knowing that we might not know more about what we already knew, or is there something else we can gain from the ultrasound?

 

Lipase isn’t accurate for diagnosing pancreatitis in cats. The SNAPP test that you ran isn’t as good as the Spec fPL if in the gray area but if positive is. There’s no reason for an ultrasound unless your vet is concerned about something else. What are tge symptoms? For Max he became inappetent and that’s a sign of nausea. Kidney disease and diabetes can effect the tests we have for pancreatitis but vets aren’t sure to what extent.

I’m not sure why you increased by .5 instead of the usual .25 but not familiar with your cat’s history. The larger increases are usually reserved for high dose kitties. I just went back to yesterday and saw that Wendy suggested the increase so good luck.

 

The increase was suggested per TR Protocol guidelines: "However, if the cat is producing continuously high BGs (nadir always >=300 mg/dl), only hold the dose for 2-3 days before increasing it by 0.5 IU." http://www.tillydiabetes.net/en_6_protocol2.htm
There's a 295 thrown in there, but close enough.

@Dimmu & KL
Good luck with the increased dose!

 

Thank you guys for the kind wishes. Dimmu had a good day (3/2) and seemed to respond better to the increased dose, but his BG went up again today, could this be a bounce again?

Dimmu doesn't have symptoms that would really make us suspect pancreatitis, he has healthy appetite, drinks good, pees good, makes pretty (?) poops when he goes, and is an a good mood most of the time when he's not too tired. The tiredness is the only visible cue, still the tests suggested otherwise.

I think it's the general practice here to do an ultrasound when the fPLI/Lipase is elevated, both vets suggested doing an US to check the "anatomic state of his pancreas", not because they suspect something else.