Pig 1/23 amps 319; +1 300; +2 302;+3 272; +5 276; +9 296 ; pmps 312; +2 321(?)

Yesterday 1/22
Well, a much better start to the morning. This seems to be his new favorite range. That's fine. I am thinking we will see yellow today! Come on Pigs, lets get you golden!

 

Thinking sunny yellow for Pig.

 

I think, perhaps, the best bit of knowledge that I have tried to absorb as my mantra as of late came from @Myagi and Heidi.... My cat is NOT a number. The less intensely focused I am on getting his numbers down, the more focused I am on what it is that Pig is telling me. It is becoming plain to my eyes that Pig does not like fast tracking the L and that any move from pink to yellow needs to be slow with a firm session of paw holding. Pig needs consistency. Dose jumping and variation seem to really disrupt his system and throw it into a fit. I have not seen a bounce or 'black' in several days with only a very few reds and that tells me that baby steps down the stairs is the best way to go for Pig.

Also, he is becoming more loving and voluntarily coming in to snuggle with me. He is feeling better. That is a good thing.. We are getting there and will be there soon, but the more I rush it the longer it is till we get there. Patience pants @Phoebes!!

Now that we are seeing yellow, I think the next best step is to continue what it is we are doing at the moment and to make an appointment with the internist. The next is praying for funds for treatment. Anyone wanna buy a T.V??

 

Oh yes... I think he is finding that he likes the lower 300's to upper 200's.... baby steps

+1 300

 

thats it!

 

I too am hoping for yellow, but what I really want to see is blue and green on Pig's SS. Once you've had a taste of it, you'll crave it too. These numbers are still all above renal threshold (where the kidneys pee out sugar). That's hard on the kidneys, so is acromegaly. A good goal is to get Pig to a dose where he spends the majority of his time under renal threshold. Yes it'll feel odd for him at first, but he's used to several cups of expresso (high blood sugar) each day. Going to decaf is going to take an adjustment.

Having said that, you are doing what you can to get his numbers down by increasing every 6 cycles and using R where appropriate. The good numbers will follow. The hardest thing I had to learn at this stage was to learn to stop hovering and to enjoying the cat more. Try easing off the pokes a bit. Data is good, but at these high numbers, you don't need those +1's all the time. It's not telling you anything new now, and saving a strip goes into the treatment fund. Can you think of other tests you are doing that aren't helping you make decisions now? I was all about strategic testing.

 

Honestly, I was just remarking about this to my Mother. Personally, and of course I could be wrong, I feel it would be most beneficial to test on an R cycle at the +2 mark because this is typically indicative of how his cycle will go. As in, if it is lower then he will have a good steady coast down. If is it similar to ps then he will stay most likely remain around his ps numbers for the whole cycle, give or take 20pnts either way. The +2 is also indicative of the range he will stick to for that cycle. His +2 usually marks his flat coast as the R pulls the numbers down and the L is just starting to kick in and hold them down.

I also like to get a +5 because that can tell me where the L is going to go for that day, especially following an increase. Again, this seems to mark where he levels out with the addition of both as his later test show, even with the addition of food, a fairly steady flat curve. I am also a fan of the +8 or +9 owing to the fact that Pig likes to do what you call a 'double dip' on the L and I have seen much lower numbers at that point that in the rest of the cycle. It also gives me a fair indication of where he will end up on the ps and allows me to tentatively plan the next coming dose range.

I think anything really outside of those time is relatively a pointless, in that he seems to stay fairly level. However, I do not take that for granted because things can change and dosing an Acro, or so I have heard, is a bit like standing in a boat on choppy water. Now, that does not mean I need to poke him every 30 minutes, but rather be aware of what he is telling me. As in, trust what I know about Pig and his behavior and he will let me know if I need to test more often or in those off times.

Yes, I agree implicitly. However, I also know that we are getting there and WILL get there when the time is right. You are correct, I am doing everything I can to see that happen and I also know that allowing my anxiousness to guide my decisions is not doing any good at all. I think I crave those colors and have not even tasted them yet, but what I have tasted is Pigs increased energy and advances. All of this tells me that the way is right, it is just in the slow lane. Pig is getting back to who he was a few months ago, before the bladder infection, and I suspect that more improvement is to follow. Immediate fixes are not always the best and sometimes the very best things come to those who are willing to work and wait. I have all the willingness.

And seriously the best mentors EVER!

 

Good for you, I'm glad you've been thinking about which are the essential tests. I spent many a night before bed pouring over Neko's SS, seeing if it was safe to go to bed or if I had to set an alarm. My DH called it "reading the tea leaves". One thing to remember is that Pig's patterns can and will likely change, especially as he gets into better numbers. Speaking of better numbers, I love that he's feeling better now. Listening to what he is telling you is an important part of the picture.

 

Yes, and I know this. I should listen to it more often. It is funny, because it took me several months of saying (or what felt like screaming) that he was not feeling good and something was off for people to take note. Actually, it took a bladder infection, that I screamed about for a month, to suddenly show signs and signal the extra glucose in his system. I also found his swollen bladder and his constipation issues. In fact, before all I could see was numbers, I predictively called exactly what was wrong with him a month before it was diagnosed (save for the diabetes, because it never crossed my radar). I think my point is this, I am very good at reading Pig and devote countless hours to research and reading on his behalf. Trusting my judgement and listening to Pig are the very most important things. Not being so absorbed in numbers is another.

I cannot say how grateful I am for all the help and support. This board and you are invaluable resources that I never knew we had. I know that the gratitude is not enough, but the results will pay in plenty. Again, I say thank you, because you, and everyone else here, are truly lifesavers.

 

You're welcome. I had people who did the same for me when I was terrified and new, and had a vet who couldn't help. Just paying it back.

 

Hanging on with a +9 of 296! Doing good today! Maybe the 18uL is finally doing a bit of good... lol. His pmps will tell the rest of the tale, but I suspect he will be just over the 300 line. Progress. Slow, but progress.

Today has been a very busy day. I have a call into an internist in Tulsa and hope to hear back from them very soon. They are reasonably priced. Well, at least the consult is. After that I am not sure. I also have lengthy email into my vet requesting the switch to Levemir with the possibility of Cabergoline. the Cabergoline is not intended to be a permanent solution, but something until I can get him the radiation therapy he needs. I have heard success stories with IMRT and it is far more in my budget. However, all of that is still up in the air.

Not to mention, per the advice of @Phoebes I am getting Pig's Cisapride compounded into a transdermal gel for his ear!! Oh yeah! He will like that much better.
I have ordered the Nordic Naturals fish oils per @Wendy&Neko recommendation.

One more thing... @Mom2Maverick what was your experience with Cabergoline? What do I need to know? Things to expect? I do not have the go on it just yet, but I like to be ahead of the game.

 

I was hoping it would reduce insulin needs but I haven't found that to be the case for Maverick. At some point in the next two months we are going to repeat the IGIF-1. It is my hope that it is doing something to offset the progression of acromegaly. I'm attaching the study that I found useful in deciding to use Cabergoline.

 

I am so sorry to hear that... Perhaps, it is a case where it is working, but takes a little longer to see the results? I am hoping that your IGF-1 numbers come back lower. Maybe he just has more IGF right now or it started shoving it out in response to the drug??

Thank you for this file! I will read it and decide. I am utilizing my school's tremendous library as well... Hopefully I can find more. If I do I will certainly share it with you...

 

I just wanted to get advice. Is it safe to continue the R when I have to leave for work? That way I can keep him as routinely regulated as possible.

 

You will have to take it one shot at a time. The numbers will be your guide.
You can always load the auto feeder with an additional mini meal or 2.

BK was my “shop cat”. I worked from home and my office was in a cottage behind our main house. I went through a period of about 6 weeks where I was shooting R every 6 hours, around the clock. I slept on a small futon in my office so I could keep an eye on him. Needless to say I got pretty strung out.
Then someone recommended the 5 compartment digital programable timed feeder. It was a lifesaver in so many ways, the least of which was being able to leave the cottage at night and sleep in my own bed.

You have developed good instincts. You have embraced the spirit of the dance - our kitties lead and we do our best to closely follow.

 

Okay... Yes, this makes sense. I suppose for now, if he is in a pink then I feel safe to dose that. I do not have enough info on a ps in yellow to comfortably shoot R and walk out the door. When those yellow ps come then I can run some more trials and see what happens, but only when I can monitor.

Yes, of course. I always forget the power of the cat butler... lol. I always put one meal plus a snack in it before I leave, but I can always just throw in a few snacks for added measure. I have to watch him, though. Some say that cats will not over eat, but I beg to differ. He may not eat until his stomach pops, but he will eat until he is miserable. If there is food, he will eat it.

I have been advised by someone not on the board to feed an Acro as much as they want. That 25-30 oz of food a day is what they should be having. I cannot agree with that. At least, not for Pig. He will literally make himself sick. He did not use to do this until it was recommended to only feed 2x a day by the vet. I think he thinks if he doesn't eat it now he will not ever eat again.. That kicked those survival instincts in. So, he gets nothing close to 30 oz, but rather I allow him to eat until he begins to slow down. This typically equates into about 2.6oz at dinner time and 2 1.3oz snacks throughout the day and night..... He seems to do just fine on that. He doesn't beg and his weight is very steady and healthy... But, I digress and ramble. lol

Great ideas! That was much easier to say!

 

Pig always has to have the last say on matters... lol

+2 321

Wrong way, buddy.

 

Exactly.

I’d say you now have the beginnings of your first R scale:
>300 = .5uR

I recommend you do your first
trial using R on yellows with .25u. youll know if you need to do a .25u trial again.

 

Yes... This seems like a good comfortable dose. Not too much, but just enough to give the L a leg up...

 

As far as feeding an acro, I fed enough to maintain a good weight. For Neko, that was 4 oz of raw a day, or one 5.5 oz of canned food. I split into three small meals a cycle, she seemed more satisfied with the more frequent feeds. A lot of acros get arthritis, so you really do want to keep an eye on their weight.