9/9 Yoda AMPS 319 +3 131 +5 291 +7 250 PMPS 200 +2 105

http://www.felinediabetes.com/FDMB/...ps-529-5-40-6-104-6-5-207-8-272-9-323.219110/
I have no idea what these numbers are...I guess I am up late again tonight to keep an eye on him.
Per a suggestion, I have tried to split his meals so he eats over a 3 hour interval starting at his shot time. Judging by his behavior he seems to prefer that!

 

Oh, gosh Yoda, what are you doing????

 

Hi Sarah and Mr. Yoda!

Another member PMd me and asked if I could help you out. I’ve been gone out of the country since Aug 19 and just got home so I’m catching up on his condos and SS. I’ll be back in just a little bit with some thoughts.

One thing, though, is I did read he’s got a voracious appetite and is very thin, that Sandy asked if you had him tested for hyperT and you said last spring his tT4 was normal but the vet felt a nodule.

So hyperthyroidism is a tricky devil. Sometimes the numbers are “normal” but the cat actually has hyperT and it seems to just be a bit before the number changes. This happened with one of my cats. I also don’t think that a lot of vets do a very good job of screening for hyperT and base it just off the tT4.

Because his symptoms...voracious appetite, weight loss, drinking a lot, yowling, and a nodule all sound like hyperT, perhaps it would be a good idea to have him retested. Certainly things can change in six months.

I prefer to use Hemopet for hyperT testing. Your vet draws the sample based on the instructions given and then you ship the blood to Hemopet and they test it. Dr. Dodds at Hemopet is an expert in hyperthyroidism. I’ve attached the form for the testing HERE and, if you look at the second page, it gives the instructions for your vet. You’ll want Thyroid Profile 4. Her prices are also a lot less than if your vet sends a sample to the lab although your vet will likely charge you for the blood draw.

Again...I’ll be back in a bit after I have a chance to look through all the condos and his SS.

Welcome!

 

I’m back. Let me say you e all done a great job of testing! Super teamwork!!!

First, I’m going to recommend you drop the dose back to 0.25u if you haven’t already done so based on that 40. While I’m pretty sure it’s not going to hold, it’s the safest thing to do. Normally, I would not suggest a reduction so soon after the one he earned on 9/8 because it’s very likely the 40 is due to (1) bounce clearing and (2) depot from the 0.75u. But we have so little data on him and he likely went lower again last night as he was headed down. I would have liked to see his BGs today but the SS isn’t updated.

Second, we need to get this boy stabilized. One thing I’m going to strongly urge you to do is to start dosing with calipers and HERE is a post that tells you how to do it. Normally, I tell members they can try it or not but with three people dosing him added on to how inconsistent insulin syringes are from syringe to syringe in the same box, I really believe this is a must for you all.

Third, if you want to get him more stabilized and flattened out, it’s going to take a little work on your team’s part. Here are the things that will help:

• As suggested, start splitting his food allotment each cycle into 3-4 portions; feed a little more at preshot (PS) and +1 to frontload him for onset at +2. You will have to do this for a bit and see what changes will need to be made because, invariably, you will need to make changes as you get data.
• To the greatest extent possible, always get a +2 test. This test will tell you how potentially active the cycle will be. If it’s the same as or a little else than the PS, it’s going to be an active cycle. If it’s a lot less than the PS, you need to be prepared for a very active cycle (we see this kind of cycle when they are clearing a bounce).
• Since there are three of you, if you see a cycle last night where his +2 is that much lower than PS, one of you should be testing. Generally speaking, going to bed on that much of a dropping number with no other tests is a recipe for really low numbers.
• Keep his SS up-to-date and post every day; that’s the best way to give him the best help.

I know you indicated you wanted to do SLGS but, as long as the dry is completely out of the picture, you are testing enough for TR and that gives him the best chance of remission. Once we get a good dose for him, it will allow him to stay there longer.

He’s in dive/bounce cycles right now which is why he looks like he does and it’s important we get that stopped as they lead to those low numbers. Once we get him a little flatter, we will likely need to raise the dose back up but I’d like to see what he does when he’s more stable.

Please let me know if you have questions.

 

Hi I am at work right now but I will let you know he came back up when I went to bed at +5 and I when I woke up at +7 to check it was in the 200s again (I cant remember exactly.)
I scheduled another ap with the speciality vet I saw last spring for next week. It is just difficult to update the ss on my phone because it is so slow so I usually put it off until I can sit at a computer.
I will read more in detail your posts when I get off!!
One thing I caught, the speciality vet told me he wouldnt go into remission ever since he has been unregulated for so long. Have kitties here gotten into remission after more then a year?

 

While the best chance is the first six months, yes, we’ve had cats go into remission even up to three years and one that i can remember that went into remission after that time period.

 

I've updated my SS for everything up until just now. I feel like he should maybe stay on the 0.5 since he has been high all day now?
I will get calipers soon!

Also; for my vet app: I will ask to recheck for hyperthyroid and what exactly was checked last time (such as just the t4). I am not certain about having them draw it to sent out that lab you recommended. Would they draw it and then mail it or do I need to get a special mailer + ice pack and mail it a specific way? I will see how keen the vet is about it.

I am also a bit worried about doing TR: As the summer closes my sibling's jobs will require them to be gone most of the morning sometimes and I won't have a consistent or reliable person to check his blood from 7 am - 2pm in the worst case scenario.

 

He’s bouncing and a bounce can take up to six cycles to clear. Sometimes, cats will signal a bounce clearing cycle by having a “high before the break” which he might be doing right now. I’d see where he is in the morning before you decide on dose.

Insofar as the test being sent to Hemopet, your vet would draw it and you would pack it and mail it. It doesn’t need to be refrigerated. It seems to me that because you are the client, you have the right to ask your vet to draw blood so you can have a test done. If my vet wasn't “keen” on it, I’d find another vet, IMHO.

No worries on the SLGS. I completely understand why you want to stick with it.

Thanks for updating the SS.