<Le sigh> Nico, the “rollercoaster” cat

Discussion in 'Feline Health - (Welcome & Main Forum)' started by Emily Tuomey, Nov 21, 2020.

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  1. Emily Tuomey

    Emily Tuomey Member

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    Up down, up down, up down. I mean I know bounces are pretty normal in the beginning, but man alive(!) if we could get outta the black for good that’d be lovely. I guess practicing patience isn’t my strong suit...

    Dose increased to 3.5u this evening, and we will see where that takes us. Thank you, everyone, for your unending support. We are immensely grateful for all of you.

    https://www.felinediabetes.com/FDMB...gnosis-nico-ma-suga-butt.238630/#post-2684332

    https://www.felinediabetes.com/FDMB...mbers-all-over-the-place.238707/#post-2684051
     
  2. JanetNJ

    JanetNJ Well-Known Member

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    That 254 last night was nice to see
     
  3. Emily Tuomey

    Emily Tuomey Member

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    I agree. Was back to his usual pre-shot of 600+ this morning though. Is this normal? I’ll continue to see how he does for the next few days, I guess. He’s due for an official curve this week — probably Wednesday — though that will be called into his vet for review. Just a heads up, in case there’s anything I/we need to be aware of or prepare for prior, especially with the holiday. Be in touch, pretty please.
     
  4. JanetNJ

    JanetNJ Well-Known Member

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    When you are due for new insulin you could consider lantus. Not every insulin work with every cat. Maybe it would be a better fit of this doesn't work out.
     
    Last edited: Nov 22, 2020
  5. Emily Tuomey

    Emily Tuomey Member

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    Okay. I think we are at about 2/3 of the 10mL vial left, so it’ll be a bit. His vet did mention Lantus first, but Prozinc was a little more economical so we opted to try it out first then switch, if needed. He’s 290 at +4. Can I leave him be until PMPS, or would you guys like to see another mid (and if so, which interval would help fill out his spreadsheet for you?)??
     
  6. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

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  7. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

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    I would give Prozinc a few months before switching. It's a good insulin.

    Was there a reason you increased the dose by 0.5u? Typical increases are 0.25u.
     
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  8. Emily Tuomey

    Emily Tuomey Member

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    I believe my vet wants to give it a good go before switching as well. Just trying to remain patient; I know we are still very new to this game. In regards to dosage increase(s) I will defer to
    and
     
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  9. JanetNJ

    JanetNJ Well-Known Member

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    Her cat's nadir are above 200.
     

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  10. Deb & Wink

    Deb & Wink Well-Known Member

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    The problem with Nico seems to be the duration of the Prozinc is so very, very short. Although most cats get 10-14 hours of duration, I don't think that Nico is getting more than about 8 hours duration on his good days. So that gives you the near constant highs at the pre-shot tests. The Prozinc is acting more like an NPH insulin for Nico, with the short duration. NPH insulins often only have a 6-8 hour duration in cats. Kind of what you are seeing with Nico while you are using the Prozinc.

    I'll be home for Turkey Day! As long as you keep posting so we know what is going on, I have my alerts set to let me know when there is a new response to a thread where I have commented before. Might not get around to signing on until later in the evenings, but I do read those posts where I have an alert to follow up on.

    p.s. Thanks for the new thread. My reply here will cause me to continue getting those alerts, but for this new thread.
     
  11. Emily Tuomey

    Emily Tuomey Member

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    I swear these PMPS #’s are the bane of my existence :banghead: I cannot get them down for him! I was so hopeful because he was acting quite the opposite right up until testing— even now he’s bounding through the house, getting into shenanigans with his sister, cuddling nonstop. It’s the absolute BEST I’ve seen him in the evening, probably ever, since our diabetes journey began! I know that he’s more than his number, so I guess despite the 600+HI reading I can still be hopeful that maybe tomorrow will bring change to his actual number. We shall see.. For now, I just love having my boy back :bighug: he’s gained a bit more weight back and is handling his injections like a CHAMP. upload_2020-11-22_19-38-3.png
    He’s keeping his eye on the household tonight; just thought I’d share. Eye on the prize. :cat:
     
  12. Emily Tuomey

    Emily Tuomey Member

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    Thank you for all of this! I will be around as well (we here in Washington are under strict lockdown orders, so no Thanksgiving Day gatherings sadly). We will keep doing what we are doing, and I will keep updating. Fingers crossed for some more decent (nonblack) numbers in the coming days.
     
  13. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

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    @JanetNJ - the issue of the 0.5u increase depends on whether the modified dosing method is being used.
     
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  14. Emily Tuomey

    Emily Tuomey Member

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    HAPPY DANCE — 360 at AMPS!!!!!!!!!!!!!!!!!!
     

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  15. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

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    hahaha you come up with the neatest pics :bighug:
     
  16. JanetNJ

    JanetNJ Well-Known Member

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    Excellent.
     
  17. Emily Tuomey

    Emily Tuomey Member

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    He just read 439 at +5. Is it normal for a cat’s body to have this type of jump over the past two cycles, since beginning his new dose of 3.5u? Or is it possible I furshotted him this morning without being aware of it? I always feel around afterward for wetness, but there wasn’t any after his am injection (nor last night). I’m totally second-guessing myself and my shot-giving abilities (or disabilities) now..
     
  18. JanetNJ

    JanetNJ Well-Known Member

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    If you didn't feel any wetness then it probably went in fine. You just have a tricky case here.
     
  19. Emily Tuomey

    Emily Tuomey Member

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    Well nothing about my life (or medical history) is normal, so I’m not totally surprised. Still think we are seeing progress though, right?
     
  20. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    As you said yourself, he's more than just a number. How our cat's are acting is also important! A cat that feels crummy isn't going to play and interact the same as a cat that's feeling good, so despite the lousy numbers, take joy in the fact that he's feeling better overall!

    The numbers will eventually come down.
     
  21. JanetNJ

    JanetNJ Well-Known Member

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    there are more yellows mid cycle this week
     
  22. Deb & Wink

    Deb & Wink Well-Known Member

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    Emily, your SS says you are using the SLGS dosing method. But we have been making recommendations based on the MPM (Modifed Prozinc Mthod). I think that is the best dosing method for you to use with Nico.

    If you agree, please change your SS at the very top, to say MPM instead of SLGS.

    As Chris said, how a cat feels and acts is also a big part of the picture on how they are doing. The 5 P's (purring, preening, playing, peeing, pooping) plus the appetite are a simple visual assessment quick check you can make for Nico.

    Him playing sounds fantastic!
     
  23. Emily Tuomey

    Emily Tuomey Member

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    You guys. His PMPS was LOWER than his +5. WHATTTT??!?!!! Feel like I’m going bonkers :joyful: a good bonkers, but bonkers nonetheless.

    My baby boy is unique it seems, a class all his own. :cat:
     
  24. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    Those are actually pretty much the exact same numbers. Remember, all meters are allowed a 20% variance so even if you test the exact same drop of blood at the exact same time you could get two different numbers. As long as they are within 20% high or low, they're considered valid.
     
  25. Emily Tuomey

    Emily Tuomey Member

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    I guess I just wouldn’t have expected a (relatively similar) lower number at his PMPS just given his “usual” PMPS of 600+ or HI, that’s all. I just I didn’t really explain that very well...
     
  26. Emily Tuomey

    Emily Tuomey Member

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    258 at +4 (pm). I’ll leave him for a bit more over the next few days to see how his body does without obsessing over it; enjoy the holiday. He will do his curve Friday, which will be communicated with his vet and we will go from there. Thank you all again!
     
  27. JanetNJ

    JanetNJ Well-Known Member

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    Hooray for something other than black in the pmps!!!!
     
  28. Emily Tuomey

    Emily Tuomey Member

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    Was 600+ this morning, AMPS. Oh well. But, I had a thought: what happens on a ReliOn Prime if there is too much blood on the strip? Does it give an error code, or maybe it just reads as 600+HI?? This morning it seemed like perhaps the strip was overfilled, but did not give an error code so I figured it was okay. But, maybe not! I’ll ask the rest of the group too..
     
  29. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

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    Too much blood usually results in error code
     
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  30. JanetNJ

    JanetNJ Well-Known Member

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    You could always do a second test if you aren't sure of the accuracy.
     
  31. Emily Tuomey

    Emily Tuomey Member

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    That’s what I thought, but couldn’t find where it said that definitively in the user manual. Do you happen to know what the error code for it is?
     
  32. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

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    I havent looked at a meter since 2010. I'm sure the code is no longer the same. Also I has some weird brand monitor. Keep asking someone will know. ;):coffee:
     
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  33. Emily Tuomey

    Emily Tuomey Member

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    Thank you. Here’s another, probably ignorant, question. When you get lab results back for glucose (also interested in the answer for Fructosamine) what is the measurement system they are using? Is it similar to what numbers I’m getting at home with the ReliOn Prime? Or is it totally different? Just curious what his lab results actually mean in relation to his numbers now. Does that make sense?
     
  34. Shelley & Jess

    Shelley & Jess Member

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    I copied and saved this from a past thread, it might help answer part of your question:

    "Fructosamine is an average of a couple of weeks. Not affected by stress.

    It measures one of the proteins in the blood, measuring mean (average) glucose concentration.

    Some resources say the average is about 2 weeks, other sources says the average is 3-4 weeks.

    Remember, if you take 30 and 100, the average is 65.

    If you take 200 and 100 and 50 the average is 116.

    If you take 300 and 100 and 50 and the average is 150.

    If you take 500 and 100, the average is 300.

    So those averages can make things look better than they really are, which is why blood glucose testing is also key to determining what is going on. BG testing tells you more in real time what is happening with your cat. It helps with catching those daily swings in the BG levels.

    Basically, the Fructosamine is equivalent to the A1C test in human diabetes, which averages a humans glycemic control over 2-3 months. Gives an idea of how the diabetes is being controlled over a period of time. But no human diabetic would ever rely on an A1C average to help them know how much daily insulin to give themselves.

    Same thing for cats. No way to know how much insulin a cat needs, based on the Fructosamine. Nor does the fructosamine test alone tell a vet a cat is diabetic. Vets need to take other signs and symptoms into consideration, to diagnosis a feline diabetic and to see how well the diabetes is being controlled and regulated.

    Personally, I think the fructosamine test is not of much use if someone is home testing. But vets run it because so many of their clients do NOT home test their cat's BG levels and never will.

    Think of it as another tool in the toolbox, and use at your discretion."


    (ETA: I agree, other than using a fructosamine test as part of the initial diagnosis, it's not much use otherwise if someone is home testing.)
     
    Last edited: Nov 24, 2020
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  35. JanetNJ

    JanetNJ Well-Known Member

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    They will be using values closer to a pet meter (alphatrak) So don't be surprised if they are higher. Shelly explai ed the fructosamine test. Fructosamine tests are good for diagnosis, but otherwise not really helpful.
     
  36. Emily Tuomey

    Emily Tuomey Member

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    What are the ranges for an Alphatrak? I’m not familiar, because I decided not to purchase one after my vet recommended it, haha.
     
  37. Critter Mom

    Critter Mom Well-Known Member

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    Normal feline BG reference ranges:

    Alphatrak: 68-150mg/dL

    Human Meter (FDMB): 50-120mg/dL


    Mogs
    .
     
  38. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

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    Glad you got your questions answered MUCH better than I can do! :oops::)
     
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  39. JanetNJ

    JanetNJ Well-Known Member

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    The alpha and human meters are similar at lower values (for example a 50 on a human meter might be a 70 on a pet meter) but further apart on higher numbers. So a 300 on a human meter could be a 400 on a pet meter. I use an Alphatrak just because I like having the same readings as my vet.
     
  40. Deb & Wink

    Deb & Wink Well-Known Member

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    Could not find any information in the Relion Prime user manual about an error code if there is too much blood on the test strip.
    The manual only showed a picture of a test strip, with blood smeared all over the area where the black strip is, that sips up the blood.
    There is an error code if there is not enough blood on the test strip. E13

    To prevent too much blood from smearing that black strip, you have to gently touch the end of the test strip to the drop of blood, but let the test strip itself "sip up" the blood. It does this using capillary action. Think of it as touching the very corner of a paper towel to a drop of water, and that gives you an idea of the "sipping" or capillary action the test strip is doing for you.

    If you put more of the paper towel down on the drop of water, it "smears" the water instead of sipping it gently up.
    Go ahead and try it for yourself!

    If you look closely at the test strip, on the end where the black strip is, you will notice there are actually 2 layers of plastic, with a truly tiny bit of space between. This is where the blood is drawn into, by that capillary action.

    Pictures are always worth a thousand words. I haven't used any test strips since Wink's passing, so I can't take pictures for you.

    But if you could take a picture of your test strip, and post it here, we could see if there is too much blood on the test strip and let you know. It never hurts to verify something, in my opinion.

    Do you think you could do that Emily? Take a picture and post it here?
     
  41. Emily Tuomey

    Emily Tuomey Member

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    I can, but I’m pretty sure I’m usually just fine. I think, in all honesty, that I just don’t like that I don’t have anything to explain his numbers— in general not having a “why” for something isn’t a feeling I enjoy, hence my insatiable thirst for knowledge. Patience isn’t my strong suit either, well it is, but only in the short term haha. Tonight Nico was 500 at his PMPS. I plan on leaving him be until his AMPS, as we need to do a curve for his vet either tomorrow or Friday and I don’t wanna overdo it. Although, we don’t have an Alphatrak so I’m not sure how his vet is planning on converting that but I guess we will find out... if anyone has any words of wisdom on that, I’d certainly welcome them!!
     
  42. Emily Tuomey

    Emily Tuomey Member

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    THANK YOU!!
     
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  43. JanetNJ

    JanetNJ Well-Known Member

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    When I get a number on the boarder of another color I always take a second reading hoping the second one will be one number lower. Just so it's the other color Lol
     
  44. Emily Tuomey

    Emily Tuomey Member

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    I should’ve done that this morning!! 500 even at AMPS. Wished it was 499. Haha! Curve day— wish us luck!
     
  45. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

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  46. Emily Tuomey

    Emily Tuomey Member

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    Not great numbers today (he must know we have to send these over to his vet, or something..).

    AMPS: 544
    +3: 537
    +6: 342
    (+9 & PMPS remain, but honestly I’m not holding my breath they’ll be anything but red and/or black :()
     
    Last edited: Nov 25, 2020
  47. Deb & Wink

    Deb & Wink Well-Known Member

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    Emily, when you color code the yellow numbers, it makes it very hard to see them on the screen. You can simply use black text for all the BG readings.
     
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  48. Emily Tuomey

    Emily Tuomey Member

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    Personal preference, but I will change it. Sorry.

    His +9 was 527.
     
  49. Deb & Wink

    Deb & Wink Well-Known Member

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    I just could not see what the number was at all. Had to look at the SS. No apologies needed. Aging eyes can't see as well.

    At least 500's are lower than the HI, which means the BG level is down a bit. Still too high though.

    I'd recommend increasing the dose again. You've given the 3.5U dose enough time now. I think you should increase by another 0.5U.

    Let's see if @JanetNJ concurs.
     
  50. Emily Tuomey

    Emily Tuomey Member

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    I was going to ask. Thank you.
     
  51. JanetNJ

    JanetNJ Well-Known Member

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    Yep. I agree
     
  52. Emily Tuomey

    Emily Tuomey Member

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    PMPS was 568. 4.0u given. I’ll take a +3 or +4 tonight just to make sure everything’s smooth sailing. Happy Thanksgiving Eve, everyone!
     
  53. Emily Tuomey

    Emily Tuomey Member

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    +4 331. Meh. I’m looking forward to not being neurotic about his numbers tomorrow.. it’s doing my head in at the moment. Goodnight, all.
     
  54. JanetNJ

    JanetNJ Well-Known Member

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    That's over a 230 point drop in just a few hours. Nothing wrong with that number! 41% decrease.
     
  55. Emily Tuomey

    Emily Tuomey Member

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    That’s a good point. He stayed relatively low throughout the night too because his AMPS was 331. I’m gonna just grab a mid (probably +5 since we did +3 & +6 yesterday) and call it good until his PMPS. HAPPY THANKSGIVING!!
     

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    Last edited: Nov 26, 2020
  56. JanetNJ

    JanetNJ Well-Known Member

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    Happy Thanksgiving to you too
     
  57. JanetNJ

    JanetNJ Well-Known Member

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    You have 331 on your spreadsheet. Was it 331 or 441?
     
  58. Emily Tuomey

    Emily Tuomey Member

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    Hahaha now I don’t know, lol. I’ll go check!
     
  59. Emily Tuomey

    Emily Tuomey Member

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    Sorry. 331. I’ll change it above too. Thanks for checking! I’m a wee bit tired. Was up until midnight then back up at 4a to get Thanksgiving dinner going.
     
  60. JanetNJ

    JanetNJ Well-Known Member

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    Oh well that's a great preshot for him!
     
  61. Emily Tuomey

    Emily Tuomey Member

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    Yes, it really is! He generally has better preshots in the morning than in the evening. Why would that be, or is that common? Just curious.
     
  62. Emily Tuomey

    Emily Tuomey Member

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    Just an evening check in before I waddle my little turkey and pie-laden bum off to bed. Nico was at 301 for his +5 and 450 for his PMPS. We will see what tomorrow brings. Sleep well, and Happy Thanksgiving from our little crew to yours!
     
  63. JanetNJ

    JanetNJ Well-Known Member

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    A whole day with no black numbers!!
     
  64. Critter Mom

    Critter Mom Well-Known Member

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    Woot! :woot:


    Mogs
    .
     
  65. Emily Tuomey

    Emily Tuomey Member

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    And started this morning with a PURPLE AMPS (331. Which is sorta funny because it was that same exact number yesterday for AMPS. I had to double check it like twelve times just to be sure :joyful:) Just sent his curve numbers off to the vet, so we will see what she has to say, I’d anticipate later today or tomorrow; I’ll keep you guys posted on that. We are starting our weekend a bit early and laying low today after all the chaos of yesterday’s holiday. We had a fabulous Thanksgiving, and hope you all did too. Here’s our meal, would love to see yours too!
    upload_2020-11-27_10-7-20.png
     
    Last edited: Nov 27, 2020
  66. Emily Tuomey

    Emily Tuomey Member

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    +6 315. I’ve started a new thread for my next question, but link and question below (I’ll link this thread over there as well!):

    https://www.felinediabetes.com/FDMB/threads/more-steady-numbers-for-nico-good-whats-next.239213/

    Okay, so. Since we bumped Nico up to 4.0u he seems to be holding fairly steady (in the minimal data I have because we just changed it..) in the 300s (PURPLE!!). I’m assuming it’s good to see less huge jumps throughout the day, while also hoping to get him down a little further— maybe steady in the 150-250 range?— does that sound correct? Can someone talk to me about what I should or could expect to see now as we get closer to having a more correct dose? Just curious. I feel like right now I’m so thankful for 300s, but also have zero idea what to expect next, or what to hope for. Hoping someone knows the answer(s)!
     
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  67. JanetNJ

    JanetNJ Well-Known Member

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    I feel like I want to see her on this dose at least through tomorrow or the next day. We may start to see the numbers move a bit.
     
  68. Emily Tuomey

    Emily Tuomey Member

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    Absolutely. I was just curious as to what I should be on the lookout for in terms of staying a bit longer (more than 8 cycles) on a dose. He was 449 at PMPS and just received 4.0u of PZI.
     
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  69. JanetNJ

    JanetNJ Well-Known Member

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    Day 2 of no black numbers!!
     
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  70. JanetNJ

    JanetNJ Well-Known Member

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    it's interesting that you got almost the same number as yesterday again.
     
  71. Emily Tuomey

    Emily Tuomey Member

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    YES. Super weird. Not sure why that would be. I’m doing the same as I/we always do..
     
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  72. Deb & Wink

    Deb & Wink Well-Known Member

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    Nadirs that are < 200 mg/dL would be a good indication that the dose increases could slow down a bit. If the nadirs do hit that <200 mark, then the increases would only be in 0.25U increments.

    If those nadirs stay > 200 mg/dL, then you still need to increase, preferably reevaluating every 3-6 cycles.

    If by some weird chance, you get a BG >50 but <100, then Nico may need to hold the dose for longer. He has a ways to go before he hits BG levels that low. But ECID and he could surprise us.
     
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  73. Emily Tuomey

    Emily Tuomey Member

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    All great info, thank you!! What is considered a high dose of Prozinc? I feel like some people think 4.0u is A LOT. Maybe it is, I don’t know.. ? For tomorrow I’ll just wish, hope, and pray for some more yellow. :nailbiting:
     
  74. Deb & Wink

    Deb & Wink Well-Known Member

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    A high dose, when you want to consider having your cat tested for high dose conditions, like acromegaly or IAA, would be a dose that is >6U per 12 hour cycle.
    Most cats don't need more than around 3U, before they start to turn around and get better BG numbers. So that is likely why some people might think that 4U is a lot of insulin.

    I've read on this message board of cats getting more than 20-30 units. Now to me, that is a LOT of insulin. But those cats usually have acromegaly, the pituitary tumor that makes it tricky to regulate a diabetic cat, since the amount of hormones raising the BG levels can fluctuate with time.

    We will too.
     
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  75. Emily Tuomey

    Emily Tuomey Member

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    Thank you. Would acromegaly show up in preliminary bloodwork? Or not usually? I guess I still have a lot to learn.. and yes, 20-30u :bookworm::bookworm::bookworm::bookworm: YIKES.
     
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  76. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    No, it would not show up in preliminary or any kind of standard bloodwork. There are special tests that have to be done for acromegaly, and the blood has to be sent to the University of Michigan if you live in the US. They are the only ones that test for acromegaly and IAA here in the USA and North America.

    Last studies I saw from 2014, showed that 1 in 4 diabetic cats can have acromegaly. So it's much more common than many vets think it is.
    Acromegaly in Cats

    "Prevalence of acromegaly amongst diabetic cats in North America and the UK was found to be around 1 in 4 diabetic cats seen in primary practice. The disease is therefore likely currently underdiagnosed."
     
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  77. Emily Tuomey

    Emily Tuomey Member

    Joined:
    Oct 1, 2020
    I googled it and effectively freaked myself out: tumor, cancer, radiation, average of 25 months post-treatment survival... Sounds like a 1 in 4 chance of a death sentence... :eek::(
     
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  78. Little Bit’s Mom

    Little Bit’s Mom Member

    Joined:
    Feb 9, 2020
    Janet’s CC has acromegaly and she is doing an amazing job with her! Things aren’t always as they seem. :)
     
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  79. JanetNJ

    JanetNJ Well-Known Member

    Joined:
    Jun 8, 2016
    My cat has acromegaly. We didn't do the radiation because it cost about 9000. We've just treat with insulin. She was diagnosed with it 19 months ago but I suspect she's had it for 3 years. I change doses frequently because I find of I don't and she gets into high numbers for a few days it becomes difficult to get them back down. The most she ever needed was 12.5. She's down to needing around 5-6 this week.
     
    Last edited: Nov 28, 2020
  80. JanetNJ

    JanetNJ Well-Known Member

    Joined:
    Jun 8, 2016
    You have to remember that a lot of cats that develope it are already very old so that would contribute to the death rate, and a majority of owners aren't vigilant with home testing and are not dosing what they need to. You are in top of things and have a pool of people to help you.

    Two months ago I was chatting with my vet... We are having trouble getting her hyperthyroidism under control (that or her kidneys are going to get her before the acro does!) and I said well her thyroid might not be cooperating but her diabetes numbers are doing good. And she complimented me saying what an amazing job I'm doing with her and that if she had any other owner she would have probably not lived nearly so long and be doing as well as she is. It was such a sweet compliment. I really owe what I know to this site.
     
  81. Emily Tuomey

    Emily Tuomey Member

    Joined:
    Oct 1, 2020
    HAPPY NEWS TO REPORT: A YELLOW PRESHOT— THE FIRST ONE EVER!!! A far cry from blue, but I will absolutely take it!!!
    AMPS 293.
     

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  82. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    That yellow pre-shot this AM, 11/28/20 is absolutely awesome Em!
    AND Nico got another yellow at +6 which is also fantastic!

    Keep up the good work you are doing.
     
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  83. Emily Tuomey

    Emily Tuomey Member

    Joined:
    Oct 1, 2020
    Thank you. I am doing the very best I can for him!
     
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