? 7/9 Jack AMPS 275, +4 351 - IAA IGF results

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saltycat

saltycat

Member Since 2016
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I finally got the results back from the vet and had a good conversation with her about it. She had to call the vet at MSU to get a primer on IAA and Acro, she was not very familiar with them. Great she is willing to learn, I felt like I was having a vet to vet chat with her after all that I have learned here!

Results:
IGF-1 321
IAA %65

OUCH! So it seems like I have a stubborn cat that will be determined to continue to demand attention. I was hoping for a little better news on the results, but given his dose knew something was up. So now I need to start learning more about what to do with the most recent news.

Watching Doodles thread, this is what freaks me out about IAA and the high dose needed, the dives seem to come out of nowhere. But then again Acro scares me with the changes to their bodies and the heart and other issues that will eventually crop up. Not exactly the news I was hoping for.

Jack threw a yellow during AMPS, but at +4 is still climbing, this cat confuses me to no end sometimes.
He used to maintain weight at 133kcals a meal and is now barely holding his weight at 200kals a day plus freeze dried chicken treats(not sure on kcals in them). He is showing signs of wanting more food, counter surfing, crying, etc. but is holding his weight. He ate the leaves off some corn ears left on the counter.


I could definitely use some advice on what to make of the above numbers. The MSU vet said IAA is very common in Acro cats

Vet findings: The serum concentration of IGF1 is elevated and Acromegaly remains as a differential diagnosis. Are there phyiscal changes consistent with Acromegaly? It is recognized that elevation of this hormone may occur as a metabolic response to diabetes mellitus in some cats, but this result is clearly higher then what would be expected in the later scenario.
There is also an increase of the IAA index result, indicative of the formation of insulin-binding antibodies. With abnormalities on both tests, I would assign priority to the elevation of IGF1 and Acromegaly as the primary reason for insulin resistance.
 
Sorry the results were not what you hoped for, guess you kind of expected something was up given the dose.
I've pm'd some of the HD kitty mums so they can offer you the benefit of their experince
:bighug::bighug::bighug:
 
I am so very sorry but did expect it unfortunately. You are in the best place to help Jack with some very experienced members. @Wendy&Neko has Acro & IAA. @julie & punkin (ga) Acro kitty, @Sandy and Black Kitty extreme IAA that they beat and BK lived happily for 6 years OTJ. @pollydoodle , also Acro and doing fabulous.

They are more than happy to help with the strategy and learning curve. I can only offer support by understanding where you are. Lots of vines and prayers.
 
I'm sorry for the diagnosis, but it's always better to know what you're facing. IAA is self-limiting, meaning that it will resolve itself in about a year on average. Acro is treatable, depending on your budget.

Wendy & I have tried to keep the most recent research on this thread: http://www.felinediabetes.com/FDMB/threads/acromegaly-the-basics-hope-you-will-read-n-like.45324/

It's located on the "Basics: New to the Group? Start Here." sticky. There are other links in the same section that might be helpful to you.
  • 2014 ~ 39th Congress of the World Small Animal Veterinary Association (WSAVA)
    • Which Insulin in Cats - p 156
    • Management and Monitoring of the Diabetic Cat - p 160
    • Feline Diabetes - p 229
    • Diabetes Mellitus and Quality of Life - p 730
    • Acromegaly in Cats – p 733
    • Insulin Resistance – p 737 (description of mechanisms of resistance on p 738 under heading Pet)
    • Medical and Nutritional Management of Diabetes Mellitus – p 739 (description on p 741 of glucose toxicity and lipotoxicity)
There are also some helpful threads in the "Where Can I Find?" post under "my cat is ill/has a special condition"


Read as much as you can and ask us questions. Between us we know most everything there is to know on those two conditions. But the two most important things to remember is that Jack is still the sweet cat he's always been, and that the important numbers are the blood sugar - NOT the size of the dose. Cats need as much as they need and it can vary from a drop to as much as 100u per shot.
That's probably enough for now, but just know that we're with you. You're not alone and there are lots of people here who can help. The most recent research is that 1 in 4 cats have acromegaly - so lots of people posting today have acro cats but just don't know it because the dose hasn't gone high enough yet for them to have their kitty tested.

Hang in there!:bighug::bighug::bighug:
​
 
Thank you all for the support. The knowledge and support of the group has been a HUGE help in learning how best to take care of the furball. I was hoping, but kind of knew that the results were not going to be great news.

I'm going to have to have him get a job soon with all the tests and supplies, insulin, extra litter, the list goes on ... Sheesh, nothing new to the group here though! I will say the group knowledge has saved us a lot between human meters and Marks Marine and other little tricks. Just the savings from home testing versus the torture and cost of vet curves has made Jack and myself happier. He comes when he hears me pull out the meter and is a trooper with all the testing, especially since there is a tasty vittle in it for him.

Thanks for all the info Julie, I read up a little on it, but need to review and re-read again now that we know for sure.

So the first big question is getting him to the right(at least a better) dose, he has been wearing his pink tutu for quite awhile and the .5u increases don't seem to be doing much. Should I continue to climb the ladder .5u every 6 cycles or is it time to start doing larger dosecreases?

Thank you again for all the support, you have no idea how much it helps! It has been such a learning experience absorbing all the info. Just when I thought I was starting to get the hang of it, I now need to relearn some of what I thought I knew with the new test results.
 
I'm so sorry to hear the diagnosis, but I'm glad you know what you're up against. You are fortunate to be in the best possible place for guidance and support as you start this battle. I am not one of the people that can help you, but I just wanted to let you know that we all care and send our best vines to help Jack fight back.
 
Most of the CGs with acro cats have followed TR. Unless Julie or Wendy suggest otherwise, I would continue to increase by 0.5u. I believe once you pass 10u, the increase is by 1.0u.
 
Sienne and Gabby (GA) said:
Most of the CGs with acro cats have followed TR. Unless Julie or Wendy suggest otherwise, I would continue to increase by 0.5u. I believe once you pass 10u, the increase is by 1.0u.
Click to expand...
Thanks Sienne. He is at 9.5u now, so we can continue to follow TR, one more .5u increase then start thinking about full U increases.

Bobbie replied to someone and it has stuck with me "The best place you never wanted to be" in regards to the boards here. The knowledge and help here is amazing, such a great community. I knew when I was explaining things to the vet that I had found a place with a tremendous amount of knowledge which has helped me know I'm giving the best care I can to my cat as well as helping me understand some of the strangeness that is FD especially when high-dose conditions are included in the mix.
 
Hi Wes - sorry about the diagnosis results. :bighug: But you are in good company here. Keep reading and asking questions. I know I had a lot of them at this stage. Interesting the MSU vet said IAA is very common in acro cats. I think a few more acrokitties here have it than not, but most vets no absolutely nothing about IAA.

A couple of us are discussing strategies to try to get Jack into better numbers sooner and will get back to you later. With a diagnosis, it gives us some direction. I know you are worried about the deep dive to greens. Here is Neko's first SS. She started out seeing greens, and then losing them, then going green, then losing it,.... That's very common for IAA as the antibodies fight back. I called it the dose going stale.

Give Jack some scritches from me. I know all too well the counter surfing too.:rolleyes:
 
Thank you Wendy, and to the rest of the committee helping in formulating a plan! That just shows how caring this community is. If i recall the MSU vet mentioned the IAA being common in acro cats was partly because of the high doses needed to out compete the IGF.

Wendy&Neko said:
I know you are worried about the deep dive to greens
Click to expand...
While a concern, I understand it kind of comes with the territory of high dose conditions, kind of like Karen & Doodles experience today. When something changes, the IAA has an off day or some other change, there is a large depot at play which can drop them quick. I think I just need to understand that it can happen and is an unfortunate side effect of the high doses needed to control BG.

He typically only counter surfs when he is very hungry, like when we had him dieting years ago to get to a healthier weight. Recently he has started back up again. I'm having trouble keeping his weight up which is odd since one of the Acro signs is weight gain. I think it was Julie that posted some pics of punkin pre and post acro, and I do see some similarities in the changes in Jack's face, although not as pronounced yet. I had attributed it to him becoming an older man, but I think wonder if it might be some early signs of Acro.
 
So sorry for the diagnosis. Colin was losing weight when first diagnosed too, and he now is holding the same weight, no gain or loss with the same amount of food. The signs come on so slowly, it's hard to see them sometimes. I only see some slight changes when I compare pics from a few years ago to ones taken now. I also know the fear of shooting that low PS! Often I chicken out and reduce his dose, then regret it. I'm getting better at it as I learn how Colin reacts to Lev and that he comes up easy with food. I hope you find the right dose for Jack soon. Wendy, Julie and the others really know their stuff and will give you great advice! Give Jack some chin scritches from me.
 
I understand. Just about two years ago I got the MSU results for Polly. IAA and acro. You have found the place to be. Julie and Wendy lead us through the ups and downs with enormous knowledge and always back-patting encouragement. My vet admittedly knew nothing so FDMB is our guide and my vet respects what I learn here and supports us without reservation.

Step by step; lesson by lesson. Lots to learn, but it will fall into place over time. Jack is lucky to have you.

Marilyn and Polly
 
Not all acro cats look acro. I saw a recent study saying something like one third had notable facial changes on diagnosis. Neko's signs were very subtle at first, eye tearing from soft tissue growth blocking the tear ducts, some aversion to bright light, and that hunger! Several bread products were consumed in the process. :rolleyes:

It looks like you are able to test Jack fairly regularly each day. Are there any exceptions? One technique we'll use with IAA/acro cats is fast tracking where doses are increased every four cycles, until blue appears, then you back off to follow TR more closely. Provided you can get tests in every cycle and try to post every day so we can guide you. Sometimes you have to get more aggressive to battle the IAA. Note to any lurkers, this is a suggestion only for Jack. The other side of the coin as you've seen Karen had to do today, once you see progress and get ahead of the IAA you have to get more cautious. What do you think? As Sienne mentioned earlier, for now you'd stick to .5 unit increases until you hit 10 units, then go to 1 unit increases. You might wait until after the first 1 unit increase to start the fast tracking as sometimes a bigger jump up is a good kickstart.
 
Just wishing the best for Jack and you. Hang in there! You have some fantastically knowledgeable and caring people to help you.
Jack is a lucky kitty to have you for his papabean.
 
Thanks everyone. It has been quite a ride so far. I can't believe how lucky I was to find this site and such a great group of people. I've already have a few friends laugh when I say I have to go shoot my cat, not realizing they aren't on the boards reading about us doing it daily. It has been quite an experience and I hope Jack realizes he has a crazy cat dad who stays up reading about other cats for him and telling him to act more like cats he has never met.:)

Wendy, I like the idea of fast tracking. A little anxiety about it, but his continued high BG is concerning as well. Jack definitely has a lot more "eye goopies", no visible tearing though. I work from home, but visit clients. I manage a couple schools and they keep me busy for the next month or so, late July I'll be out of town for a few 3-4 day stretches. Otherwise, I am around or can adjust my schedule to squeeze in a test. My dad is retired and likes the cat and I have slowly gotten him comfortable with testing, shooting, and texting me #'s which is a big help when I am on the road. He does a great job filling in the gaps and learned more then I expected.

I'll have to do some math and look at the calendar. I might have to stick with TR for a bit due to the schedule. I'd have to be around and when doing the fast track.

Thanks for the support, it is much appreciated as I learn more about FD then most vets.
 
Hi there :cool:

Glad you had your kitty tested - forewarned is forearmed.

Back in late 2008, after tests for Acro and Cushings came back negative, my Black Kitty was the first FDMB kitty to test for IAA. His result was 82% - extreme insulin resistance.

That explained why it took 6 months and some 12u (Lantus and R combined) to get our first green number, which lasted about 3 hours. The next green we saw was about 6 weeks later.
It was 1 year before he had his first taste of HC

Although the test told us why BK was drowning in a sea of pinks and reds, it didn't tell us what to do about it. Being the first meant there was no ones sleeve to tug on.
We were in uncharted territory.

With one foot on the accelerator and the other one on the brakes and with the help of the wise ones of those times we embarked on an intrepid journey, mostly flying by the seat of our pants. Then, after 21 months on insulin, in October of 2009, BK went into remission where he happily remained until he crossed over the bridge on April 4 2016.

These days, whether a kitty tests positive for IAA only, Acro only or like Jack a combination of both, help from experienced caregivers is never far away. :cool:




 
julie & punkin (ga) said:
There are also some helpful threads in the "Where Can I Find?" post under "my cat is ill/has a special condition"
High Dose Kitties
......Acromegaly, Insulin Resistance, Insulin Autoantibodies: research and testing information
......Switching from Lantus to Levemir, JoJo & Dr. Lisa, dvm
......Switching from Lantus to Levemir, Doodles, advice before switching
Click to expand...

I just wanted to point out that in the "Doodles advise before switching" there are about 5/6 kitties SS's who have IAA, Acro, or a combination of both. It helped me to look at them. While we never copy dosing it did show me what it's like and how they handled some situation.
 
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