? Dec. 2/19- Freckles-AMPS 14.2 - staying flat in yellows since starting insulin

Condo from 11/30

From @Marje and Gracie

I don’t see a condo for today so I’ll post here.

"Has anyone ever mentioned IAA to you? IAA or Insulin Auto Antibodies is where the immune system sees the insulin as a foreign substance and so attempts to destroy it as it would a virus. That means it’s likely that most of the insulin given isn’t available for the body to use so numbers stay high and flat even as the dose rises. I’m not saying she has IAA but she has “some” insulin resistance.

The only way to know if a kitty has IAA is to test for it which we recommend doing, along with the test for acromegaly when the dose gets to 6u bid. The good thing about IAA is it’s self limiting after a year but there are also other ways to break through it.

My hope is that she’s just developed a little insulin resistance, not IAA, because SLGS has meant she stayed at higher numbers longer. That’s just the nature of the beast quite often. It is what it is. Switching to TR will let you raise the dose faster.

Paws crossed."

Thanks Marje! Freckles did have some blood work done upon the initial diagnosis of FD. Although nothing was said to me by the vet, would any of those results point to IAA or acromegaly? Her test results are on my SS if it helps at all.

 

No, they wouldn’t. These are special tests that have to go to the Univ of Michigan, but again, we wouldn’t do suggest you them until she reaches 6u bid because she just might have run-of-the- mill resistance that a lot of cats have when it takes a bit to get to the right dose.

 

Just FYI, Loudogg has IAA, and only ever got as high as 3 something units. He’s now solid green and in the home stretch. IAA is said to be a self limiting condition, about a year. There have also been acromegalic cats on 1 unit, heck, Neko was below1 unit for quite a while and she had both IAA and acromegaly. The six unit marker for getting the secondary endocrine condition tests done is not a magic number, not all cats with those conditions get to that high a dose, though some get much higher. However, we have had just regular type 2 diabetic cats get to 5.5 units and turn it around. At 6.0, the chances are really good something else is present. Some people get tests done sooner, if there are other possible symptoms present.

So, I am really glad you are starting on TR. hopefully this is just some glucose toxicity and you can get her over the resistance hump soon with faster increases.

 

Thanks Marje. So I can infer that Freckles' flat line of yellows is not that unusual? I've been looking at a lot of SS and Freckle's really doesn't look like anyone else's.

 

Thanks Wendy. So we just keep doing what we are doing? I think I should likely get up during the night so I can hit the @+6 and +8 because Freckles' nadir time isn't really established with her having a flat curve? Thoughts?

I think if I have to increase doses, I will be doing it at PM shot time so I am home and able to check during the night.

 

Flat does make it hard to spot nadir times. It will be more obvious when her numbers start to move. You might also be able to strategically get this middle of the night tests. See if the before bed test is quite a bit lower than preshot (relatively speaking for Freckles of course), then use that indicator to tell you if you need to set a later alarm.

Some cats go lower the first cycle of an increase, some wait to cycle 4-5.

Out of wild curiosity, is yours a new Freestyle meter? The old ones had an issue, since fixed. I started out with Freestyle and got mostly yellows.

 

Ok. Thanks for the tip and I will do that.

I just purchased it at the drugstore at the beginning of November 2019, so I'm assuming it's new. I'll have a look tonight to see if there is a manufacturing date. What would be considered an "old one"?

 

You’re good on the meter. Old is back in my day starting out.

 

It’s not unusual. Wendy and I both are in agreement that, while it could be IAA, it could as likely be glucose toxicity (insulin resistance) as I discussed before. Time will tell. Let’s hope TR gets her moving.

 

Thanks Marje

Yes... movement would be good. I had a little chat with Ms. Freckles tonight about getting her numbers lower!