? IAA ? Mocha 2/10 amps=572/+4=306/+7=218/+8=192/pmps=431/+3=344 looking 4 blue again 5:00 am

I posted yesterday to the IAA section and then learned it is not actively used anymore. So here is yesterday's post.
http://www.felinediabetes.com/FDMB/threads/looking-to-see-ss-for-iaa.152406/#post-1600829

I am very concerned about the possibility Mocha is IAA, she can't get her footing in good territory long.

I would think I can get her tested at a new vet, if not my own...too many issues to put here.

But, if that testing only tells you a condition and apparently does not have any different treatment avenues, the struggle is where I am now and have been.

Many know of our recent condo move and it is really much more quiet than the plane noise we were under every few minutes but our balcony project starts mid April and goes thru Thanksgiving with about 8 hours of jackhammering 5 days a week. Yes, I have the rescue remedy and it "may" help some but I am uncertain.

I really thought by now she would be better stabilized and the noise factor is not going to help that in my estimation.

I just feel incredibly defeated.

http://www.felinediabetes.com/FDMB/...64-2-454-7-5-113-9-5-245.152225/#post-1598003

 

Hi Kari, I feel like I should know, but what's IAA?

Glad to hear that the everyday noise has reduced, ick on the jackhammering Hope Mocha manages to cope.

 

I'm sorry things are so stressful right now. Someone with experience about IAA should be along soon to help out.

 

Toby is a high dose kitty but, I have never had him tested for Acro or IAA. I couldn't afford the SRT treatment anyway. So I just increased until he started getting good numbers. We got as high as 18 units. Now he seems to want to go down in insulin. We are currently down to 11.5 units. Is the tumor waning or has the IAA broken? I don't know. I am just playing as it goes at this point. We have been at it for over 2 yrs, now. We started with PZI and then went to the Levermir .

 

"IAA" = "nightmare" it means there is insulin resistance....their bodies fight the insulin and don't come down. I am sure someone will give a better answer. Now I see I lost my cheatsheet with the info of what to test and the true definition of IAA.

 

Did not know anyone that went that high, suppose if I could at least see it was helping her into green and even blues, I would "get over" the number of the dose.....I guess this possibility is really setting in. Did Levermir make a difference?

My vet is not well versed in diabetes and he wanted to pull Lantus when she was around 4 units. He would be out of his mind if he knew she was this high. I don't know that switching will really make a difference, unless it is comfort to not burn at the higher dose.....

What is SRT? I did not know there was any different treatment of IAA.

Just so frustrated that I don't feel I have been of any help to her. I suppose she would be far worse w/o insulin....but sure hard when you see no progress. The run away train! My hub is not an animal person and as much I wish I could share my pain over this struggle, he only sees that she gets "too much attention" and tells me often, even though that is primarily feeding, litter box, testing and insulin. If it were not for this forum, I would lose my mind.

 

Will someone please point me back to the info on iaa testing? I cannot find it anymore.

 

So sorry Kari that you can't get Mocha to come down and stay down. You have had a lot going on for some time which no doubt effects Mocha. It was my understanding that if it is IAA, they eventually break through after about one year. I am going to tag @Wendy&Neko as she understands the issue. The only thread I found is :

http://www.felinediabetes.com/FDMB/forums/acromegaly-iaa-cushings-cats.12/

 

Hi Kari, hope this is what you are looking for http://www.felinediabetes.com/FDMB/threads/10u-bid-lantus-acro-levemir.14578/#post-147048

 

I know it's frustrating when you feel like you're fighting an uphill battle We do have several high dose kitties (at one point Suki's Crystal was on 60 units of Lantus PLUS a hefty dose of R insulin at the same time!!) here and a good amount of high-dose experience, so there are people who can help you get Mocha into better numbers if she does end up being either an IAA or Acro kitty.

I'm sorry your husband isn't supportive, but we are here for you

 

These are the two tests you would need to have done to determine whether Mocha has either acromegaly or IAA. If you are in Canada or the US they are only done at Michigan State Diagnostics as far as I know.


Insulin Like Growth Factor-1 (Acromegaly)

https://www.animalhealth.msu.edu/Bin/Catalog.exe?Action=Test&NAME=IGF&Id=1401


Insulin Autoantibody

https://www.animalhealth.msu.edu/Bin/Catalog.exe?Action=Test&PAGE=11&Id=1494


Your vet would do the blood draw and preparation and the samples would be shipped to Michigan State

 

Hello again ☕️

It is a bit daunting, believe me I know. When we took BK in off the streets 8 years ago I never could have imagined what we were in for. FIV, conjunctivitis, upper respiratory infection - along with the recommendation he be euthanized. That was day one.
Day 2 we got the news he was diabetic and taking care of a diabetic cat was a big commitment (boy did that turn out to be an understatement). The vet again offered euthanasia. DBF and I discussed and decided we had to try and do all possible. We knew Black Kitty was special.

We had him neutered. Then came DKA episode 1 followed by DKA episode 2 which brought us to the breaking point. If not for the FDMB that would have been the end for BK. With the support of LL we persevered.

Up and up in dose he went...and still he was drowning in a relentless sea of pink. It had to be acro the wise ones said. So we had him tested. To everyones surprise the results were-negative. Now what??? Talk about hopeless... You know the saying 'no good deed goes unpunished '?

Jojo (a member here who was also a vet tech with extraordinary FD knowledge) the resident guru of our time was mystified. She put her thinking cap on and recommended BK be tested for a condition she had heard about - IAA.
That's exactly what it was. I felt relieved somehow having nailed down the reason for the immovable BG. However there were no precedents.
No ones sleeve to tug on, no ones ss to refer to. We were in uncharted territory-all of us.
These are the highlights of the first 7 months of our journey.

As I mentioned in yesterday's thread IAA is self limiting. It may seem like a nightmare-but you do eventually wake up on the other side. It resolves in a year or so. So get your kitty tested. Then, whatever the outcome, you can proceed in the right direction - for which, in the case of IAA, plenty of road maps are now available

 

If she is IAA, in your experience, is it wise to ditch Lantus at this point about 5 months in?

Go to levimar for 5 months and compare?

How can we determine what insulin is best and for how long?

If I am overwhelmed @ the thought of IAA, I bet my current vet will really be in over his head. He was dumbstruck about dosing issues early on, when she shot higher and he literally could not speak! I am like....what? what?!

It sounds like "time" and "patience" are the rule....but perhaps not so with dosing...maybe the 3-5 day rule is better for IAA under TR?

I was holding if she had a fur shot or if she hit under 200 but I don't even know that this is right for her (the under 200) when the majority of the range is well above 200....maybe she should just go up and up until that entire range is down...and maybe best before the jackhammers come!

I am saddened by the words that were said to you along your journey. You really rose to the challenge. I am hoping to keep doing the same.

Just curious, did you leave that vet who you had on day 1?

Yes, needing someone to lean on who has walked this road.

 

I don't have Lev experience; it had just come onto the scene back then. Jojo suggejsted it and I considered it however I was having a hard enough time getting the vet to give me a Lantus prescription.

You bet I did. Check out the tab on BKs ss 'Prognosis 6-2008'. The vet put his cell phone number there because the prognosis was poor and I would certainly be calling for the final solution. The call I made was to a new vet.

First things first - and that is to get the tests. Then, based on the results and with the help of folks here who have been there, work up a strategy based on your kittys needs.

Perseverance Patience and Persistence.
These will be your best allies.

 

Hi Kari, sorry you are feeling overwhelmed. Believe me, I know that feeling. I will give a longer post later when I am home (been busy with family stuff). Just know that NO vet will really understand IAA, the most experience you will find is here. We can help you do this, whether it be IAA, acromegaly or both. Get both tests done. If IAA is in the picture, it can change our dosing recommendations.

ETA: I stuck with my vet. She knew nothing but was willing to learn and work with me, I like her for everything else.

 

So I only need to get IAA or also acro (even though I doubt it?) I lost my note with the bloodwork names. Sorry.

Focus on your family.....I will gain my footing somehow. Just happy to see blue again frankly.

 

I wouldn't bet against acromegaly. One in four diabetic cats have it. Mary Ann posted the links for both tests above, the IGF-1 test is the one that can identify acromegaly. It is more common for cats to have both conditions than just IAA. Neko, Polly, Hyde have been confirmed as having both.

 

Kari, I'm sorry to hear that you feel so defeated at the moment. We've all been there with the frustration of FD, and some of us have the added misfortune of either IAA or acromegaly or both. Getting your vet to accept high doses can be difficult, mine is horrified at Crystal's dose and tried to tell me to reduce, but the evidence speaks for itself and she now just lets me get on with it. Try not to focus so much on the dose units, one of the first things I was told here repeatedly is that a kitty needs as much insulin as it needs, there is no limit. There are cats here that do very well on tiny microdoses of insulin and others, like Crystal, that just guzzle it. Believe me, I too found it hard to keep on upping the dose but it does work in the end, you just have to perserve to find the magic number that works, whether its 4, 14 or 40. In Crystal's case is was 60 units of Levemir plus 26u of R twice a day at her worse, thankfully she has come down quite a bit from those horrendous figures and I am now trying her with 35u Lev and 10u of R.
I hope your DH comes round to being a bit more supportive in time, but you are not alone, there are lots of kindhearted people here who will help you with advice and support, listen to your worries and share your joy when things get better. Hang in there

 

Yikes! Makes the 7 look docile. I see you have tried at least 3 insulins and switched from Lantus to Levimir around 16 units or so. Did you notice upset with that high of dose being painful (like growling?) I can't imagine how fast you have to release that much fluid and have them be still for it. Not easy on 7 frankly at times. Thanks for encouragement, I drink it in @ the moment.

Who do you know of with IAA currently on the forum other than current posts? Is it a "small family?"

 

Yes, I would advise test for both IAA and acro. The Michigan State University info posted earlier was our source for testing. My vet raised his eyebrows but my girl was at 7 units Lantus and had spent two days hospitalized for a mystery ailment which I now suspect was p'titis. We had really focused on staying ahead of her numbers. Off the bloodwork went. Polly was positive for both IAA and acro. We had the radiation treatment done at Colorado State a little over a year and a half ago. Polly was up to 10 units at that time.

I have used Lantus since Polly's FD diagnosis in April 2014. Once she hit 10 units, she began to flinch at shots. Lantus is more acidic and can sting at higher doses. But then she had radiation (SRT) and she started down the dose scale. I've kept Lantus; it seems to be working for us.

All the wisdom here from those experienced with acro/IAA got us through.

I'm dashing about tonight but want you to know whatever you and your kitty are facing, FDMB is the place to be.

Marilyn and Polly

 

Hang in there Kari. I'm on my way out the door, but want to just give you a little encouragement. There's no reason to feel defeated. You don't yet know what you are dealing with, so no point in imagining things are worse than they may be.

I'd encourage you to make the appointment to get a blood draw done and have BOTH the acromegaly test and the insulin autoantibodies test done. I think that's important. Just because you don't see visible symptoms of acro doesn't mean that she doesn't have it. It helps us to know what strategies are best for you to use with Mocha.

Punkin had acromegaly only and got up to 15.5u per shot before we had the SRT (stereotactic radiation therapy) done. In other words, he got radiated to zap the tumor. High dose cats need doses that vary tremendously. How much a cat is going to need is never known in advance.

We stayed with Lantus because it didn't bother him and because i understood his cycles, how Lantus worked, and I liked the earlier nadir. I don't think it stings in every cat, although I keep seeing that blanket statement being made. Punkin never flinched or was bothered by his shots. However, it does have a slightly acidic ph, and some cats have definitely reacted to it. If you're not seeing a problem now, there probably won't be one later either. However, when you're near the end of the current vial/pen, then you might want to reassess. If you want to make a change, I'd go with Levemir.

Gotta go but will check back in with you. There is a quote that I've shared with my kids:

If you see ten troubles coming down the road, you can be sure that nine will run into the ditch before they reach you.
Calvin Coolidge

Read more at http://www.brainyquote.com/quotes/keywords/down_the_road.html#5ZC6FFHbcd0eKPtl.99 ​

Hang in there! and hang in here. We'll be there for you no matter what comes.

 

What about testing pancreatitis?

 

I changed to Levemir as I thought Crystal wasn't reacting well to the Lantus dose, with hindsight I suppose in her case it didn't matter much as we were going skyward with the dosing anyway. There was the odd flinch and trying to bite me but now she totally sits still and allows me to do anything, including giving her doses over three separate syringes, she is such a good girl. Have you tried shooting while Mocha is actually eating? tends to take their mind off the shot.

I'm not personally aware of any other IAA kitties other than those already mentioned or who have posted. Wendy, Julie and Sandy tend to know everyone, I can't keep up with all the new kitties that arrive here every week.

I have no experience of pancreatitis, luckily my crew have so far avoided it (antijinx) so have no idea how it is diagnosed, but unfortunately it seems very common.

I would reiterate what others have said Kari and stress the importance of getting Mocha tested for both IAA and acromegaly, then you will know exactly what you are dealing with and the appropriate course of action. This forum has literally saved Crystal's life (and my sanity) when I felt abandoned by the lack of veterinary knowledge and advice available to me - have faith, I'm sure it will be a great support for you as well

 

I posted a couple of other links to high dose kitties with acro and IAA over on your post in the High Dose forum. Cobb started on Prozinc, went to Lantus, then switched to Levemir. Shortly after switching to Levemir he started down the dosing scale - very quickly. He was diagnosed with IAA, but Suzanne did not test him for acromegaly, though she suspected it. I started Neko on Caninsulin (vet's choice, not mine), quickly got her over to Lantus and reached her highest dose of 8.75 units. It wasn't until she was on a much smaller dose after SRT that I switched to Levemir as a last ditch attempt to get rid of her habit of only going low at night. I had not thought the Lantus was bothering her, but I noticed a difference on Levemir. On Lantus she would sometimes walk away during the shot. On Levemir, she lies down for it and often purrs through the shot.

Pancreatitis can contribute to higher numbers, but not as high a dose as Mocha is on. A common symptom in not wanting to eat. The other high dose condition is Cushing's, but we don't see it much and hair loss is a common symptom.

 

/
Would you believe one clinic said $300 for the igf-1 but can't do the 2nd. I gave them these links and will see what their new price is. Robbery!

 

I paid far more than the listed price too. That is the price MSU charges the vets. The vets charge for the blood draw and preparation, the shipping and of course their profits.

Any vets office should be able to do theses tests. If they aren't sure about how the blood is to be prepared then they can contact MSU. MSU has been doing these tests a long time and as far as I know it is the go-to place for them

 

peanut butter and jelly sandwiches are on my horizon.

 

I had mine done about 1 year ago. I am in Canada and the total from my vet for both tests was about $290.00 Cdn funds.

 

I paid $179 for the IGF-1 and $98 for IAA testing (CDN). The lab my vet deals with had no idea what the IAA test even was and I had to provide the test codes from MSU so my vet could make the necessary arrangement for shipping through the lab she uses. These costs covered the tests and shipping.

ETA - Testing was done Nov 2015

 

Mary-Ann and Linda, you got a good price from your vet. Mine was over $300 4 years ago, but we had farther to ship.

Kari - most people in the US pay quite a bit less than us Canadians. We have to worry about cross border issues. Some people have arranged shipping themselves to save a bit of $$. MSU will tell you how to ship things.

 

Mine was done Feb 2015, so the pricing is very close. I also took the codes for blood preparation in as well as the contact info for MSU

 

YIKES!! The one problem with shipping it yourself is that you still need to get the blood draw and preparation done at the vet. The shipping for both my tests (done at the same time) was only $25 Cdn..the rest of the cost was the blood draw, test costs and profit for the vet

 

Thanks for the heads up
@Tuxedo Mom
@MrWorfMen's Mom
@Wendy&Neko
I thought the price on the catalog of $17 and $55 was "approximately" an idea. Gee.....wonder how DH will respond when I finally get thru the vet relay to get this done. Have to really get my ducks in a row for that one. If I could work, would sure be less a "discussion."

 

Can anyone tell me how dwarfism plays into diabetes. This I could see. She is very small in bone structure.

 

Dwarfism is when a cat has normal body proportions but has unusually short legs. My Maxie civie is very small. only a little over half the size of my sweet Tuxie (they are brother and sister). A small cat does not mean it has dwarfism unless the legs are proportionately shorter than they should be.

ETA Here is some information on dwarfism:

http://www.peteducation.com/article.cfm?c=1 2139&aid=868

 

I've never heard of any connection between the 2 conditions in either humans or felines. Cats like humans can be of varying sizes without having dwarfism or gigantism being a factor. The connection between diabetes and the high dose condition acromegaly would be more akin to gigantism than dwarfism. Acromegaly results in excess hormone production that ultimately causes tissue overgrowth and can cause striking changes in a cat's appearance once it has advanced enough. That excess hormone disrupts the body's ability to utilize insulin effectively thus causing the diabetes. In dwarfism, there would be no competing hormones to cause a problem with the insulin use. That is not to say that a person with dwarfism would never develop diabetes, it just isn't going to result from the dwarfism.

 

I only asked because on Michigan State is specifies both the diagnosis of acromegaly and dwarfism for the igf-1. She does have short legs but did since adoption and not as dramatic as most pictured in a search. But, this one shown below does look VERY similar to her structure.

 

There is a breed of cat known as a Munchkin and that cat looks like it might be one or a mix. Munchkins happen naturally and someone managed to maintain the mutation and created the breed but some of those cats still produce normal height kitties. I really don't know if the Munchkins and dwarfism in a cat are one in the same. Sure is a cutie though!

The IGF-1 would be used to diagnose either problem but it's the excess that causes the diabetes. A lack of it would cause dwarfism but not diabetes.

 

Well, one throwing me off that I felt good with. The tech was great calling for the info but the "admin" won't permit it, well they don't want to have the extra expense of the special mailers and all this to figure out the quote because the dr may not approve after the exam that you need it. These emotional roller coasters are ridiculous.......oh but bring her in and let the dr see because we never order those tests so probably or likely may not think necessary. (and I would come to you for what?)

the other large frustration is the tech agreed that I could have a first visit and a blood draw and that I would just need to schedule that appt after they have the bag to send away the draw. Now, I hear won't happen and may not at all.


waiting on the door 3, and 4.....the one vet who personally spoke to me said they could send it out but I don't know that I want to go there since he has no real understanding of the test.

 

Her legs are about 6 inches tall to the base of her body and her back standing up is just under 12" so I guess half of her frame is normal for a shortcake.

 

Bingo.
He will get the testing done-and you will have the results, mission accomplished.
After that if he is on board great. If not. ..you still have the results.
That's my $0.02

Did he provide pricing?

 

no. he did not. I may be calling back if the other 2 fall thru. I agree just need to get somewhere. And, to help myself take it in stride I remind myself, I am going to pick up the dosing to only 6 cycles and evaluate so as to not be stuck while I try to get someone to see her and test her. You are right, so far he was the only willing....I may fax the sheets to him and ask for a price tomorrow.

 

Munchkins hind legs are longer than their front. But 6" and 12" sound much longer than a munchie, Sly's front legs were hardly more than elbows and paws.
This is him standing straight up.

This one shows his legs outstretched pretty good

Sly was our munchie diabetic foster. His diabetes just seemed to be bad diet related. Once we got him into foster and dealt with that (the shelter couldn't get him to eat wet food) he came off of insulin in a few months and remains diet controlled last I heard. He was a tough little bugger, but we didn't end up with high doses at all. In fact 0.5 could put him in the 40s where 0.25 wasn't enough.

 

Adorable kitty and that is like what I saw, so it appears that is not her condition. Thanks for the beautiful photos and the info.