7/15 Neko PMPS 150 +2 192 +3.5 161

Yesterday http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=74972 was an almost all blue day. Looks like it might make a repeat appearance today.

7/14 Recap:
AMPS 438 +3 286 +5 198 +7 131
PMPS 112 +2.5 166 +4 187 +5.5 186

I "fattened" Neko's dose up by .25 this morning. Although the last dose had some good numbers, it just wasn't enough green for me. With IAA I'm going to have to find my BOS at some point to do bigger increases, but I couldn't find them this morning. :lol:

Today is cooler with some much needed rainshowers early in the AM. I can delay putting out the sprinkler timers for another few days. Neko had just a brief yard patrol due to the weather, but has had good time on DH's lap and on her nanner.

Re: 7/15 Neko AMPS 318 +3 286 +5 213

Wendy&Neko said:

Yesterday http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=74972 was an almost all blue day. Looks like it might make a repeat appearance today.

7/14 Recap:
AMPS 438 +3 286 +5 198 +7 131
PMPS 112 +2.5 166 +4 187 +5.5 186

I "fattened" Neko's dose up by .25 this morning. Although the last dose had some good numbers, it just wasn't enough green for me. With IAA I'm going to have to find my BOS at some point to do bigger increases, but I couldn't find them this morning.

Click to expand...

Nothing wrong with that to begin with. I had some apprehension with Harley the first time I had to really increase his dose. Now that you know that 1 thing is being IAA positive, doing increases will come easier Wendy.

Will be waiting to hear about the other test.

Pattie

Re: 7/15 Neko AMPS 318 +3 286 +5 213

I want to respond to your question/comment about being aggressive with IAA. With IAA, Neko's body quickly develops a tolerance for insulin -- she's resistant to the effects. So, if you stick at what seems to be an effective dose, resistance can develop. What happens is that there are antibodies that disable the effectiveness of the insulin -- the antibodies bind to the insulin making it much less effective at lowering BG. It's much the same as antibodies that act on a bacteria or a virus -- those helpful antibodies render invading foreign substance (i.e., the bacteria or virus) inert.

The point of being aggressive is to get the dose ahead of the antibodies so you can "squish" them. Essentially, you need to overwhelm the antibodies with insulin. You obviously need to be attentive since at some point you are able to squish the antibodies and numbers can start coming down quite rapidly.

Re: 7/15 Neko AMPS 318 +3 286 +5 213

Hi Wendy - I wish you luck with Neko and the IAA. Somehow I missed that Neko was. I like Sienne's summation - i think it is a good one.

Good luck with the new dose this morning - I hope it does help.

We were a tad bit wet this AM too, now we have a brief break with a bit of sun... strange weather for us for the past few days - I have never heard so much thunder here. Mannie too managed to get some outdoor activity in before he decided enough was enough.

I hope you have had a good day today.

Re: 7/15 Neko AMPS 318 +3 286 +5 213

@Sienne - thanks for the explanation, it's the best I've seen. I have a bunch of questions about what it means to be aggressive:

1) should I always be going up in 1/2 unit steps at this point? If yes to this, should I just go up to 8.5 tonight?
2) does it mean staying no longer than 6 cycles at a dose? Neko sometimes has NDW which can take up to 4 of those cycles
3) do I keep going up until the numbers say we go down?

@Pattie - thanks for the support, it's good to know I'm not alone.

@Michelle - I'm going to be seeing a few more dose increases rapidly in the next while I expect. Hope you got out today. This afternoon is just gray but dry for us. The thundershowers missed us but weren't far away.

Re: 7/15 Neko AMPS 318 +3 286 +5 213

Hoping the new dose squishes those antibodies!!! Looks like Neko is doing well so far!
Hope you have a good evening Wendy

Re: 7/15 Neko AMPS 318 +3 286 +5 213 - Acro cat

Pity party at Wendy's house tonight.

The vet just called, IGF 440. She is now referring me to an IM specialist because she doesn't feel comfortable dealing with Neko any further.

Neko shrugged it off and went over to toss around her sisal ball.

Re: 7/15 Neko AMPS 318 +3 286 +5 213

Wendy&Neko said:

With IAA I'm going to have to find my BOS at some point to do bigger increases, but I couldn't find them this morning. :lol:

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Hi there

I heard about your Neko testing positive for IAA and thought I'd pop in for support.
Since you mentioned you were having difficulty finding your BOS I brought some over. ;-)

In all seriousness, in taking a look at Nekos ss you are doing a great job. It's actually quite colorful for an IAA kitty just using Lantus.
BKs ss was a unrelenting sea of pink for so long - It was 6 mos.before we had a green number.

What Sienne mentioned about IAA is correct.
You have to try and get/stay in front of it. also, attentiveness is indeed required .

Regarding doses and increases, once you receive the Acro results you'll then be able to figure out the best strategy.

Speaking from an IAA perspective only, I think .5u increases are in order.
Regarding number of cycles - there is a part of me that thinks it's very ECID and even can vary from increase to increase.
It's something you have to f eel your way through, to some extent.

Lantus Land is a good place to be

Re: 7/15 Neko AMPS 318 +5 213 +8.5 86 - Acro cat

Wow, Neko, nice green. :mrgreen: :mrgreen: I'm sure glad you have others who have experience with acro cats to help you, Wendy. Nice to get some rain. Weren't y'all just about flooded out last month?
Liz

Re: 7/15 Neko AMPS 318 +5 213 +8.5 86 - Acro cat

YESSSSS!!!! Green for Neko.....she is trying to boost your spirits and say no matter what...she can be :mrgreen: :mrgreen: :mrgreen: :mrgreen:

Wendy..... :YMHUG: :YMHUG: :YMHUG: :YMHUG:

I'm glad Sandy dropped by

Re: 7/15 Neko AMPS 318 +5 213 +8.5 86 - Acro cat

(((((wendy))))

it's ok to have a pity party today. neko won't join you at it, of course, because she's just the same as she was last week - you're her bean and she's your sweet neko! but we understand - it's not good news.

i'm sorry for the baggage you've been given, but know you have company, you're not alone and people will all help you deal with this. don't let it overwhelm you. tomorrow is a new day & we can tackle things then. hugs!

Re: 7/15 Neko AMPS 318 +5 213 +8.5 86 - Acro cat

With the dual diagnosis, you have a different set of options. I'd encourage you to talk to Tracy once she and Leo are back from Colorado. I'd also want you to get in touch with Julie/Punkin and Libby/Lucy. They have/had acro cats and can guide you based on their experience. There are two schools of thought when it comes to managing acro especially when in combination with IAA. This is a thread on acro that Libby started that reflects the approach that she and Julie use.

You also have the option of the SRT (stereotactic radiation therapy) that Leo and Grayson will be receiving shortly at Colorado State.

Wendy/Neko said:

1) should I always be going up in 1/2 unit steps at this point? If yes to this, should I just go up to 8.5 tonight?
2) does it mean staying no longer than 6 cycles at a dose? Neko sometimes has NDW which can take up to 4 of those cycles
3) do I keep going up until the numbers say we go down?

Click to expand...

My initial response to your questions is, "Maybe." Like you've seen tonight, sometimes, you just don't know where a dose will take your cat. Given the dose Neko is at, it makes sense to increase in larger units. If you think about the increase in terms of the percentage of the total dose, when you raise a dose from 1.0u to 1.25u, that 0.25u increase represents 25% of the 1.0u dose. When you raise the dose by 0.25u of an 8.0u dose, it's 3% of the dose. Likewise, if you look at the TR protocol, you can increase after 2 days/4 cycles IF nadirs are in the higher ranges.

If you know that it takes Neko to respond to a dose, you need to use that information. ECID always applies. I also think your observation, that increasing the dose until the numbers tell you otherwise, applies not just to Neko but to all of the cats here.

There is a major difference between acro and IAA. With acro, a cat has a working pancreas. The growth factor hormone that's being released by the pancreas counteracts the effect of insulin. The tumor revs up and down which can make insulin needs vary. The IAA makes it slightly more challenging to get the insulin at a dose that will keep BG levels in a good range. It's a balancing act.

Re: 7/15 Neko PMPS 150 - Acro cat

Hi Wendy- I am sorry for the acro Dx. I know there are, as Sienne mentioned, folks her that have acro cats, and can really help you with Neko. I am sorry too that your vet had referred you to an IM specialist - maybe it's best if she feels she cannot adequately treat Neko. I hope you can find a good one that you and Neko like. Thinking of you guys and wishing you the best. I know that LL is the best, all here will help as best we can.

I love neko's response - he is still the same ole kitty he always is: IAA, acro or not. Hugs to all there tonight.

Re: 7/15 Neko PMPS 150 - Acro cat

+9 85 +10 133 PMPS 150

OK - I am officially feeling overwhelmed. I spend a good part of the later afternoon reading but still have a ton more to do. But in all of this I am so grateful to all of LL. Without you, I'd be on higher and higher doses of insulin with a vet who just though Neko is a "high dose cat". But now I can put together a plan of action - still TBD, and have people I can talk to about what to do. That is very comforting.

I still have questions about when to increase the dose. If there is green do I stay or soldier on regardless? I guess it's a question of when to know it's time to move on.

@Tamara - new dose seems to be working well so far. It was good to see green again.

@Sandy - thanks for stopping by and providing advice. .5 units is what I'll try and now that I know what they look like, maybe I can find those BOS again. :lol: Looking at Black Kitty's spreadsheet reminds me that I've been wondering whether I should be using R at times.

@Liz - it is great to know there are experienced people to talk to instead of being all alone. I want just enough rain so I don't have to use the sprinkler. I'm lazy that way!

@Marje - yes, Neko is showing me what I need to see today.

@Julie - you know you'll be one of the people I'll be talking to, and thank you in advance. Neko is actually doing better numbers this week than last, so in that respect she is different from last week.

@Sienne - thanks for pointing me to Libby's thread. I'll read that one next. I had planned on contacting both Tracy and Lu about their experiences when they are back. I am seriously thinking about SRT - Neko is only 11 and I'd like to do what I can.

Re: 7/15 Neko PMPS 150 - Acro cat

Ive missed the green Neko yesterday! cat_pet_icon
He is still the same ole kitty he always is: IAA, acro or not! And we all love him the same!

Re: 7/15 Neko PMPS 150 - Acro cat

Hi Wendy,
I'm sorry about Neko's dx. and the added complications it brings. I'm sure you will figure out the way to deal with it that's best for him though. What led you to suspect it? I missed the original conversation.

It's been storming here and we're losing power off and on. It's been doing this for days now. We get a little sun than cloudy and then it starts pouring. Today we had outrageous winds again and kept losing power. The winds were really scary. I thought we were having a tornado or hurricane for a few minutes.

Have a good night.

Melanie & Racci

Re: 7/15 Neko PMPS 150 +2 192

+2 192
Looks like we might be having an anxious liver responding to those greens.

@Michelle - I've found someone else in FDMB from my area who has an acro cat so have been trading some local info. Turns out I know a local onco vet (through going to chemo with a friend and her dog) who has dealt with the CSU folks. Small world. I also row with a vet who has experience with Lantus, so there are options for support locally too. And Neko is still herself, up on the kitchen counter where I don't want her to be!

@Helen - yes, Neko is still my love bug and I'm going to do what I can to help her.

Hi Wendy,

I just wanted to drop by to offer a word of support and encouragement.

My Weezer was diagnosed with acro and IAA in Dec. last year. Although I wasn’t really surprised, I was still shocked. I don’t know if that makes sense. Intellectually, I recognized that that high dose meant something more than “just” diabetes and there were clues, like her snoring, slight heart murmur, loss of her girlish figure, etc. So I wasn’t surprised. But actually getting the double dx sent me spiraling. After a few days at my own pity party I sucked it up and reevaluated our situation, options and goals for our girl. Give yourself permission to feel all you need to feel. Be as gentle with yourself as you are with Neko.

You’ve been hearing ECID ever since you found FDMB. Well, it just took on a new meaning. Neko is a member of the exclusive Most Special of the Special Kitties Club, where not only ECID, but ECIDED (every cat is different every day). No matter what vet you end up with, you will be the only expert on Neko in the world. The rules that so effectively light the way to treat FD will become only guidelines as you deal with the special conditions created by the competing acro and IAA.

Take a deep breath, wrap yourself in the love coming your way and get ready for the ride. Best of luck to you and your sweetie.

wow, I go away for a few days and things happen! Sorry about Neko's dx... not that it's going to change the way you love her one bit! and she sounds like SHE doesn't care at all either! nice blue numbers either way! Hang in there!

Hi Wendy --

We're at CSU, they just finished Grayson's scope and he was already done w/ CT... Leo is in CT currently.

Sorry you got positive test results, but glad you know. Take some time to breathe. Stay here and feel the love from your friends' support, or be MIA if you need to (briefly). SLOWLY read all the materials so you don't overload yourself, and don't panic about the IM specialist. It's good your vet recognizes their limitations and is strong enough to know someone else might be better able to help you. They aren't kicking you to the curb, however, just this part of her treatment. And that's okay, as you want to work with people that know and understand what she's going through, and can advise you.

Tracy and I (and all the other folks w/ acro and/or IAA) will be more than happy to help you when you are ready or need our help.

I have to comment on something I learned on ProZinc. Someone referred to a"BAM!" dose, and when I looked into it, it was about the percentage. A .25 unit dose increase, well described above, is a small percentage where you are. I've tried to stay with a 20-25% increase. With large doses, that's huge, but Grayson rarely drops to blue, so I didn't have to be concerned about hypo-ing. You know what Neko does, and there are others that have WAY more experience w/ the L's that I would ever profess to have... so listen to them.

So, have a pity party for a while, and have a "date certain" that the party is over and move forward from there. Knowledge is power. Arm yourself and decide where you want to go. Neko will be better for it, and so will you. Good luck, and let me know how we can help you!

Lu-Ann

Hi Wendy --

We're at CSU, they just finished Grayson's scope and he was already done w/ CT... Leo is in CT currently.

Sorry you got positive test results, but glad you know. Take some time to breathe. Stay here and feel the love from your friends' support, or be MIA if you need to (briefly). SLOWLY read all the materials so you don't overload yourself, and don't panic about the IM specialist. It's good your vet recognizes their limitations and is strong enough to know someone else might be better able to help you. They aren't kicking you to the curb, however, just this part of her treatment. And that's okay, as you want to work with people that know and understand what she's going through, and can advise you.

Tracy and I (and all the other folks w/ acro and/or IAA) will be more than happy to help you when you are ready or need our help.

I have to comment on something I learned on ProZinc. Someone referred to a"BAM!" dose, and when I looked into it, it was about the percentage. A .25 unit dose increase, well described above, is a small percentage where you are. I've tried to stay with a 20-25% increase. With large doses, that's huge, but Grayson rarely drops to blue, so I didn't have to be concerned about hypo-ing. You know what Neko does, and there are others that have WAY more experience w/ the L's that I would ever profess to have... so listen to them.

So, have a pity party for a while, and have a "date certain" that the party is over and move forward from there. Knowledge is power. Arm yourself and decide where you want to go. Neko will be better for it, and so will you. Good luck, and let me know how we can help you!

Lu-Ann