She confirmed the numbers above, and said she spent 20 min talking to the endocrinologist at MSU. After reviewing Cody's history they decided to increase his dose 2 full units to 9u BID in hopes of getting more of a drop. I agreed that I would start that tomorrow AM when I could monitor the cycle. They want to hold that dose for 2 weeks I think then do a fructosamine, I think. Getting ahead of his numbers is my main goal right now.
We discussed pain meds and she was fine with Buprinex, and agreed cats hide pain, so it can be hard to tell. She said the main concern with increased aspirin is thinning blood too much (inadequate clotting) and stomach ulcers. (I told her I use enteric coated aspirin). I'm not sure he's in pain now so thats just out there for now. First priority is the BG control. She seemed to think I would notice a drop in his appetite if he's in pain, I can't imagine anything dropping his appetite (he's a maniac for food). Is this one of those areas where the acro cat is different?
We talked about miralax, and she wanted me to change the way I add it to every meal, and only add it to every other meal, and we politely disagreed (she's used to me). In my opinion if he eats any food without miralax or lactulose, it becomes hard and stops up the plumbing. She may be right but I'm gonna wait and see if he snaps out of last weeks dog food "indiscretion". I think he's almost there. I had to increase miralax last week and now I need to back off again.
I made her color copies of his ss and we discussed some of the variables we've been dealing with lately- new meter, questionable insulin (still separating), dog food gorging last week, increasing to 6 meals per 24hrs, his lousy nadir of 50-60 points. She said she'd call pro-zinc again about the separating. Its depressing but I'm trying to make the switch to the maxima glucometer- 30 -70 points higher.
I burned her a CD with the new acromegaly article in Jan 2010 Journal of Feline Medicine and Surgery. (Very good BTW)
I told her about catacromegaly.com. She said the endocrinologist told her about that, or catamegaly?.com. (is there a different one also?)
I asked about his enlarged heart in regards to acromegaly, and she said his heart is enlarged because he has heart disease. (the muscles aren't thicker, just stretched out) She confirmed the dose of enelapril.
Interesting discovery today:
Today in skimming that article they have a picture of a cat's protruded lower jaw and the space between the upper and lower canines increased. I compared this on Cody and Tenderfoot and guess what? Cody's space is definitely larger.
Nancy
