8-11 Gizmo AMPS=315; +4=208; +7.5=134; +8.5=131; PMPS=136

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Chubba (GA)

Chubba (GA)

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Condo - http://www.felinediabetes.com/FDMB/...272-2-363-5-258-pmps-335-2-75-302-386.182025/

PMPS = 335
+2.75 = 302 & 386

AMPS = 315

Increased to 8 units this morning. Morning shot was still old insulin vial. Appears to be very little left (I have a heard time judging this), so pm shot will more than likely be new insulin.

I think I am calling the vet to pursue hyperthyroidism testing. The more I read about it, the more signs I see with Gizmo. Gizmo has a great appetite, but is still losing weight. One of the reasons, I'm not convinced about him having acro. I have increased his food over the past several weeks, but his weight is holding steady or slightly less. He has random bursts of "crazy" activity. He will just bolt through the house at very fast speeds for 30 seconds to a minute. He sometimes yowls at night. Thankfully this doesn't happen often yet. When he first started, there was nights it was so bad I didn't know what was going on. But it sounded horrible ... I thought he was dying. But when I checked on him, he would be fine and start purring. Hoping this might be the reason he seems to be resistant to insulin. Going to start here and if the vet will tack on the IAA and IGF-1 testing, I'll consider that a bonus.

Something's gotta give with these numbers. Other thing in the back of my mind is the fact that his good numbers all occurred when he was on antibiotics. I wish he could talk ... would make things so much easier.
 
Good morn to Gizmo, my question is have you always had high(higher) numbers? Our Titan was diagnosed on 6/11, started out at about 450 at the vet office. We started at 2 units of Lantus 2x a day, at two weeks did a BG curve at the vet office and was a steady 400+ all day. Increased to 6 units then 8 units over several days still holding in the high 300-400 range. Panicked a bit then decided to slowly decrease back to 2 units, 1 x twice a day, have been there for 4 days now but his BG is still holding at 300+. Titan dies not show any signs of Agro or hyperadreno, just wondering if anyone has dealt with possible inability yo absorb/use Lantus???
 
So upon further reading, I am discovering that fish based foods can contribute to thyroid problems. :banghead: When I switched to can, I choose friskies ocean whitefish and tuna. Guess I'm in search of a new food. :mad::arghh: Any suggestions ... I have thinking about switching anyways because the phosphorus is higher than I would like.
 
MyTitan said:
Good morn to Gizmo, my question is have you always had high(higher) numbers? Our Titan was diagnosed on 6/11, started out at about 450 at the vet office. We started at 2 units of Lantus 2x a day, at two weeks did a BG curve at the vet office and was a steady 400+ all day. Increased to 6 units then 8 units over several days still holding in the high 300-400 range. Panicked a bit then decided to slowly decrease back to 2 units, 1 x twice a day, have been there for 4 days now but his BG is still holding at 300+. Titan dies not show any signs of Agro or hyperadreno, just wondering if anyone has dealt with possible inability yo absorb/use Lantus???
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Yes, Gizmo's numbers have always been higher until we hit 7.5 units. Then we had a slight breakthrough, but he seems to be drifting back to more pinks again. Insulin resistance is also something that can happen. When Gizmo hit 5 units, members mentioned testing for insulin resistance and acro, but my vet hasn't agreed yet.
 
We have a vet appt on Tuesday, going to check for resistance. Wondering if a change in insulin may help or if resistant, is a cat resistant to all insulin types ? 15 years ago we regulated two brothers with only diastix's and beef/pork insulin , that was a workload !!!
 
MyTitan said:
We have a vet appt on Tuesday, going to check for resistance. Wondering if a change in insulin may help or if resistant, is a cat resistant to all insulin types ? 15 years ago we regulated two brothers with only diastix's and beef/pork insulin , that was a workload !!!
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I'm really not sure. To new to all of this myself. Good luck at the vets. Hope you get some answers.
 
I think getting the tests done and starting with Hyper-T is a good idea. If it were me I'd want to find out or rule out all known reasons for higher doses. Also, some kitties get right back to business after a FS and some don't. If I shot late or gave a FS (which sometimes happened more then one time in a row) it took an increase or two to get Doodles back on track. He was IAA only with heart issues but very sensitive to even minor changes in schedule. Hope Gizmo slides down a bit and be sure to do something nice for yourself.

Lots of food choices on this list. http://catinfo.org/docs/CatFoodProteinFatCarbPhosphorusChart.pdf It was updated March of this year and also lists the phosphorus levels.
 
So I called the vet and they just want to start him on meds for hyperthyroidism?! I don't know what to do anymore. I questioned about further testing and the lady on the phone said no more testing, just wants him started on meds.
 
I don't understand why they aren't willing to make sure he has hyperthyroidism before prescribing meds. I'm willing to pay for tests and they are saying no. :banghead: I'm beyond frustrated right now.
 
Chubba said:
So I called the vet and they just want to start him on meds for hyperthyroidism?! I don't know what to do anymore. I questioned about further testing and the lady on the phone said no more testing, just wants him started on meds.
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Please speak to your vet about proper testing. They can do a snap T4 test at the clinic and have results within about 20-30 minutes. If you give meds for hyper T without testing and your kitty does not need them it can cause more problems. Also dosing is dependent on how high the readings are:

"Initial Methimazole Dose
The initial methimazole doses used vary depending on the cat’s pretreatment serum T4 value and the size of the thyroid tumor. In general, however, most cats are started on 1.25 mg to 2.5 mg of methimazole, administered twice daily (4-7). This dose is adjusted according to T4 measurements (see below), as well as the cat's clinical response. "

As well you kitty would need to be checked regularly once starting the meds...more often in the beginning and having a starting base is necessary:

"During long-term treatment, it is also important to avoid inducing hypothyroidism, which may be deleterious to the cat’s kidney function (25,26). If hypothyroidism is suspected, a complete thyroid panel is recommended, including determination of the serum concentrations of total T4, free T4, T3, and TSH (see my previous blog posts on diagnostic testing for more information about these tests). The findings of low serum free T4 with high TSH concentrations is diagnostic for iatrogenic hypothyroidism; in those cats, the daily dose of methimazole should be decreased."

https://animalendocrine.blogspot.ca/2012/08/how-to-dose-and-monitor-hyperthyroid.html''

Starting your kitty on Hyper T meds without a definite diagnosis is WRONG!! In many cases people who have a higher T4 reading will often opt for the full thyroid panel which needs to be sent to an outside lab. You are in control and can demand that this testing be done...if you are willing to pay for it then they should follow your wishes.
 
:bighug::bighug::bighug:

What!! Why in the world would the vet gives meds before doing a simple blood test?!?! That is absolutely ridiculous. I would insist the vet do the blood draw. Even if they don't want to it will just be extra money for them right?

I've had two cats with hyperthyroid. Neither of them were diabetic, but they both displayed the same symptoms. They had a ravenous appetite and were still losing weight. They would gobble up their food and then throw up. Before diagnosis I had to give tiny meals to stop the vomiting. They were both extremely vocal, meowing and howling. They both would chase and zoom around the house.

My daughter has hyperthyroid. Before diagnosis she could eat and eat and eat. She would barely sleep and would get up in the middle of the night to eat. She was also an emotional mess. She would go from calm to a rage for no reason.

I hope you can get the test done for Chubba. :bighug:
 
My number ranges will be different than yours ( I am in Canada) but here is some information on T4 readings: in nmol/L
<10 Subnormal
10-60 Normal
30-60 Grey zone in old or symptomatic cats
>60 Hyperthyroidism

Even if a number falls within the normal range the age and symptoms need to be taken into account. Since Gizmo's T4 on your labs (not sure when this one was done) is in the high normal range and he does show some of the signs a full thyroid panel would be advisable before starting any meds. The snap T4 is a good indicator but is not always 100% accurate
 
Chubba said:
He had t4 bloodwork done 3 weeks ago. But I thought he should have additional testing?
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T4 =. 3.4
3 weeks ago, was running a fever during this visit. Started on antibiotics. Said would look further into hyperthyroidism after 2 weeks of antibiotics.
 
Yum had high thyroid readings in her blood work a few years ago. The vet wanted to immediately start her on the meds. She had lost weight but she had also not been happy with a diet change implemented for another cat. She seemed perfectly healthy to me. I couldn't bear the thought of putting her on meds if I wasn't positive she needed them. Also I decided I would do radiation and not meds if she had a thyroid tumor. I dithered around for a few months researching the expensive test for thyroid tumors. When I had her blood retested, her numbers were normal. Just my story.
 
I agree with the others - it's crazy to start thyroid meds without confirming HyperT, especially since his t4 was in the normal range a month ago. Insist on further testing before starting meds!

Also, nighttime howling can be a sign of high BP, so that could be something else to have checked.
 
Thank you to everyone who has responsed. I have an appointment scheduled for a second option at a different vet next wed. Although, over the phone this vet doesn't sound like they support home testing and wouldn't give me a definite answer as to whether I could just email Gizmo's charts instead of weekly visits. I don't know whether to try calling my vet back and asking for more testing, but at this point I have already requested that. We only have 3 vets within my area and the one is 20-25 minutes away and Gizmo doesn't travel well. So I didn't call them.

ETA - this shouldn't be so difficult!:(
 
With regards to home-testing...in the grand scheme, it doesn't matter if the vet supports it. Gizmo is your cat and the vet can't control whether or not you test. Yes, it certainly helps to have them be on board with treatment, but home testing is your decision (and obviously a wise one!) With that said...many vets don't support it...so sad, but true. Maybe this can be an opportunity for you to educate this vet about the importance of home testing, and how it is a bonding experience and doesn't stress the cat out like they seem to believe!
 
+7.5 = 134

At least Gizmo knows how to brighten my day. :cool:
Plus he had more food than he should have at +6. We went out to eat and I watched him eat both his food and Daisy's food. I'm going to retest soon to see whether he is going up or down.
 
Amy&TrixieCat said:
With regards to home-testing...in the grand scheme, it doesn't matter if the vet supports it. Gizmo is your cat and the vet can't control whether or not you test. Yes, it certainly helps to have them be on board with treatment, but home testing is your decision (and obviously a wise one!) With that said...many vets don't support it...so sad, but true. Maybe this can be an opportunity for you to educate this vet about the importance of home testing, and how it is a bonding experience and doesn't stress the cat out like they seem to believe!
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My concern is that they want weekly visits to check blood glucose. That isn't going to happen because they are more expensive then his normal vet (at least they used to be) and there is no need for that when Gizmo doesn't travel well. But at this point, I think I am just looking for a second option. More so, someone to do the testing I want.
 
PMPS = 136
Still :cool: ... awesome. I can tell he feels so much better when in these blue numbers! :smuggrin:
I'm sure the bounce will come, especially if we get to greens tonight, but loving this while it lasts.
 
Chubba said:
When Gizmo hit 5 units, members mentioned testing for insulin resistance and acro, but my vet hasn't agreed yet.
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My vet thought we had to get to 10 units before testing - never did get that high yet tested positive for both IAA and acromegaly. The RVC study that found 1 in 4 diabetic cats has acromegaly, found some on as little as 1 unit. I had to ask my vet to humour me and get the tests done. I would try that tact with your current vet. You are the client paying the bills. Get a thyroid panel and the IAA and IGF-1 tests done. Better to rule them out than always wonder. If you do decide on a new vet, just tell them no on the weekly tests, you are managing the diabetes with blood testing at home. If they reject that, then you don't want to go to that vet.

It's not surprising if an acrocat also has some thyroid issues. One of the roles of the pituitary (where the benign tumour is that causes acromegaly) is to also produce the thyroid stimulating hormone.

Nice blues! :cool:
 
Wendy&Neko said:
If you do decide on a new vet, just tell them no on the weekly tests, you are managing the diabetes with blood testing at home. If they reject that, then you don't want to go to that vet.
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So true. We are going to go next week for the second opinion. Maybe even IAA and IFG-1 tests ... fingers crossed. If things go well, we might switch. Haven't been all that happy with our vet lately. Another doctor at same practice, just gave our drooler several different meds for an ear infection. He only glanced at the ear for a matter of a minute or two and started rattling off all the meds he wanted her on. It was the second bizarre appointment we have had there in a matter of weeks. We had another dog who had chronic ear infections and never was prescribed this much meds. They used to be so good and never rushed, but lately things have been different.
Wendy&Neko said:
It's not surprising if an acrocat also has some thyroid issues. One of the roles of the pituitary (where the benign tumour is that causes acromegaly) is to also produce the thyroid stimulating hormone.
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That's good to know. You always have such valuable advice and information. Thanks for looking out for us.
 
There have even been (though rare) cases of kitties with acromegaly and Cushings, which can also be caused by a pituitary tumour. The hormone system is definitely complex. I admire vets who specialize in the endocrine system.
 
Why do you suspect hyper-t?

You can look at my Gizmo's SS under the food tab for suggestions.

Nice run of blues this afternoon. :cool:
 
LizzieInTexas said:
Or start one. :p
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Looks more like it was a nice way to end the cycle. Gizmo bounced already at +2 (281).
LizzieInTexas said:
Why do you suspect hyper-t?

You can look at my Gizmo's SS under the food tab for suggestions.
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Vet mentioned it at the last blood work because of his high normal T4 test. After looking into and searching the symptoms, he does display some symptoms. He doesn't have the unkempt coat. He is very OCD about staying clean. Lol. I've already looked and relooked at your food tab. I'm trying to find something I can get locally that isn't going to cost an arm and a leg to feed to both cats (plus low carbs and phosphorus) ... I know very unrealistic expectations. :p I'm defiantly going to try to switch away from seafood immediately. I might have to wait a bit to lower the phosphorus.
 
Chubba said:
I'm trying to find something I can get locally that isn't going to cost an arm and a leg to feed to both cats
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I understand. This is what Amanda feeds @Osha. It is higher in phos but not the worst out there.

71Uoh2ePsOL._SX522_-1.jpg


Protein-31
Fat=66
Carb=3
Phos=295 (s/b 200 or less)
Calories=111/3oz

You can also "dilute" phosphorus by mixing egg white in to give protein and stretch food. If you want more info send me a PM (so I will remember tomorrow :p) and I will hunt down the info on this and one of my old condos where we were discussing this. Too tired tonight, headed to bed shortly.
 
Chubba said:
@Marje and Gracie
Do you see enough proof in gizmos lab results to treat for hyperthyroidism without additional testing?
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I certainly don't want to undermine your vet; however, while Gizmo might be hyperT, without more definitive tests, I would be uncomfortable starting meds. I don't think Methimazole/Felimazole is anything to mess around with and vets often overdose the cats with the starting dose.

Even the labs suggest that if the tT4 is in the gray zone, that a fT4 should be done and your vet hasn't even suggested that to my knowledge. The bottom line is that he's your cat and if you are willing to pay for services, I'm surprised your vet would refuse.

If he were mine, I'd ask my vet if he/she would draw the blood required so you can send it to Hemopet to have the analysis. That is their specialty and their tests are cheaper. You'll have to pay your vet to draw the blood and put it in the correct tubes but then you can mail it. On this form, page 2 tells what your vet needs to draw for Thyroid Profile 4 which is $92.00. Dr. Dodds is the leading authority on Thyroid testing and I've used her numerous times (I had a cat that my previous vet thought had hyperT based on fT4 and tT4 but...long story....she ended up not being hyperT and Dr. Dodds called me and explained why.
 
Marje and Gracie said:
I certainly don't want to undermine your vet; however, while Gizmo might be hyperT, without more definitive tests, I would be uncomfortable starting meds. I don't think Methimazole/Felimazole is anything to mess around with and vets often overdose the cats with the starting dose.
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We have decided to go to another vet on wed for a second opinion. I am also uncomfortable with starting methinazole without knowing for sure that he even has hyperthyroidism. I feel he does, but I want proof.
Even the labs suggest that if the tT4 is in the gray zone, that a fT4 should be done and your vet hasn't even suggested that to my knowledge. The bottom line is that he's your cat and if you are willing to pay for services, I'm surprised your vet would refuse.
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I saw and read this same thing on the lab report last night and thought hmmm....why aren't they following the lab protocol.
If he were mine, I'd ask my vet if he/she would draw the blood required so you can send it to Hemopet to have the analysis. That is their specialty and their tests are cheaper. You'll have to pay your vet to draw the blood and put it in the correct tubes but then you can mail it. On this form, page 2 tells what your vet needs to draw for Thyroid Profile 4 which is $92.00. Dr. Dodds is the leading authority on Thyroid testing and I've used her numerous times (I had a cat that my previous vet thought had hyperT based on fT4 and tT4 but...long story....she ended up not being hyperT and Dr. Dodds called me and explained why.
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I am printing this form and taking with me. Hopefully I won't need to send in myself, but I'm willing to if I have to. Do I need to contact Hemopet at all or just package the samples and send to them with this form?
 
Chubba said:
We have decided to go to another vet on wed for a second opinion. I am also uncomfortable with starting methinazole without knowing for sure that he even has hyperthyroidism. I feel he does, but I want proof.

I saw and read this same thing on the lab report last night and thought hmmm....why aren't they following the lab protocol.

I am printing this form and taking with me. Hopefully I won't need to send in myself, but I'm willing to if I have to. Do I need to contact Hemopet at all or just package the samples and send to them with this form?
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You don't need to contact them. Just have the samples...correct amount in the correct tubes....the form, and your payment.

I'm sure my vet would have mailed it but we get a huge discount on FEDEX and I was :nailbiting::nailbiting: so we took it and fedexed it. Got the results back quickly but that was several years ago and I know her business is booming.
 
Marje and Gracie said:
You don't need to contact them. Just have the samples...correct amount in the correct tubes....the form, and your payment.

I'm sure my vet would have mailed it but we get a huge discount on FEDEX and I was :nailbiting::nailbiting: so we took it and fedexed it. Got the results back quickly but that was several years ago and I know her business is booming.
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Great. Thanks. I've printed the IAA and IGf-1 also.
 
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