12/27, Bell, AMPS 250 +2 268 +4 288 +6 263, no UTI

[bluesunshine]

Yesterday

I took Bell into the vet today for her Solensia injection. They did have the results of her urine culture and they were not able to grow anything. Sooooooo, worst good news I've gotten in awhile . I asked the tech about testing for IGF-1 and IAA, and she had actually had a friend's cat treated for acromegaly in Colorado, so she was somewhat familiar with it. The main vet was on vacation, but the tech called her to ask about those two tests. I think the vet was actually taking a family member home from surgery, so she didn't have time to talk in detail, but said she wanted to take a close look at Bell's history early next week and make a gameplan for going forward. She also said that Bell doesn't have acromegaly because she would have physical changes from that condition.

I know the last part of that is not true, thanks to all you kind folks. I told the tech that I would send a message in their pet portal for the vet to take a look at next week. In it, I tried very hard not to come off as a arm-chair vet, but I did say I wanted to test for IGF-1 and IAA, if not for just peace of mind. I mentioned that 1 in 4 diabetic cats have acro and that most don't present physical symptoms at the time of their diagnosis (thanks @Wendy&Neko for that nugget). I mentioned that knowing if Bell had IAA would help me be extra cautious once we broke through Bell's insulin resistance. I detailed how to send those samples to Michigan State and provided the links to do that, which I found in the stickies of the Acro/IAA/Cushings subforum. I also was honest that I do not want to switch insulins, which is my guess on what my vet would want to try next. I also mentioned that if both those tests come back negative that maybe we need to take a closer look at Bell's dental stuff, even if all looked good on her outside examination.

I did read through some of the content on acro and IAA. I find it pretty fascinating how the IGF-1 hormone binds to the same receptor as insulin does. Makes a lot of sense from a high level to me. I do have a bunch of questions related to Bell about acro, but it is probably best not to put the cart before the horse on that. I am reallllllly hoping the IGF-1 does not show positives for acro. The IAA seems pretty straightforward to handle, but the acro stuff scares me. Bell is a female and has not displayed any of the symptoms of acro, which I know doesn't mean much if the tumor is new, but it makes me feel a tad more hopeful on that front.

Thanks all for the help.

 

[bluesunshine]

 

[Heike & BInie]

Hi Seth,

I am sorry there is no easy explanation for Bells numbers. It sounds like you have a very good plan how to go on from here and I am sure, you have a perfect way to communicate it to your vet. I think, even if they would not have suggested it, they will not deny you a test you pay.

I didn't see people here talk about it a lot but in Germany, one thing we check very often is, if cats have FORL. It's a dental disease you can usually only see with a dental x-ray. Every second cat older than five has it. Binie was one of them. In her normal checks they always said her teeth are o.k. When I brought her for dental cleaning and they did an x-ray, it was a total different story.

I keep my fingers crossed you find the reason soon and Bell shows her beautiful green numbers again! You are really doing such a perfect job with her. All fingers and paws are crossed the test comes back negative.

 

[Staci & Ivy]

Yesterday

I took Bell into the vet today for her Solensia injection. They did have the results of her urine culture and they were not able to grow anything. Sooooooo, worst good news I've gotten in awhile . I asked the tech about testing for IGF-1 and IAA, and she had actually had a friend's cat treated for acromegaly in Colorado, so she was somewhat familiar with it. The main vet was on vacation, but the tech called her to ask about those two tests. I think the vet was actually taking a family member home from surgery, so she didn't have time to talk in detail, but said she wanted to take a close look at Bell's history early next week and make a gameplan for going forward. She also said that Bell doesn't have acromegaly because she would have physical changes from that condition.

I know the last part of that is not true, thanks to all you kind folks. I told the tech that I would send a message in their pet portal for the vet to take a look at next week. In it, I tried very hard not to come off as a arm-chair vet, but I did say I wanted to test for IGF-1 and IAA, if not for just peace of mind. I mentioned that 1 in 4 diabetic cats have acro and that most don't present physical symptoms at the time of their diagnosis (thanks @Wendy&Neko for that nugget). I mentioned that knowing if Bell had IAA would help me be extra cautious once we broke through Bell's insulin resistance. I detailed how to send those samples to Michigan State and provided the links to do that, which I found in the stickies of the Acro/IAA/Cushings subforum. I also was honest that I do not want to switch insulins, which is my guess on what my vet would want to try next. I also mentioned that if both those tests come back negative that maybe we need to take a closer look at Bell's dental stuff, even if all looked good on her outside examination.

I did read through some of the content on acro and IAA. I find it pretty fascinating how the IGF-1 hormone binds to the same receptor as insulin does. Makes a lot of sense from a high level to me. I do have a bunch of questions related to Bell about acro, but it is probably best not to put the cart before the horse on that. I am reallllllly hoping the IGF-1 does not show positives for acro. The IAA seems pretty straightforward to handle, but the acro stuff scares me. Bell is a female and has not displayed any of the symptoms of acro, which I know doesn't mean much if the tumor is new, but it makes me feel a tad more hopeful on that front.

Thanks all for the help.

Hi Seth, first glad no UTI. Second, bigggg hugs to you. And… you got this.
You’re so smart and on top of everything. You will systematically check into everything and take it one step at a time.
And Wendy knows so much and is so helpful in guiding you.
Breathe.
And give both of your girls lots of hugs.
Ps, love the pic of Bell, as usual.
Thanks for sharing her beauty with us

 

[bluesunshine]

Hi Seth,

I am sorry there is no easy explanation for Bells numbers. It sounds like you have a very good plan how to go on from here and I am sure, you have a perfect way to communicate it to your vet. I think, even if they would not have suggested it, they will not deny you a test you pay.

I didn't see people here talk about it a lot but in Germany, one thing we check very often is, if cats have FORL. It's a dental disease you can usually only see with a dental x-ray. Every second cat older than five has it. Binie was one of them. In her normal checks they always said her teeth are o.k. When I brought her for dental cleaning and they did an x-ray, it was a total different story.

I keep my fingers crossed you find the reason soon and Bell shows her beautiful green numbers again! You are really doing such a perfect job with her. All fingers and paws are crossed the test comes back negative.

Thanks so much, Heike. The dental stuff is definitely in the back of my mind. Bell has had multiple rounds of teeth extraction and has bad dental genes. A lot of her back teeth have been reabsorbed… I think I will pursue this as a next step if we rule out the acro/IAA.

 

[bluesunshine]

Hi Seth, first glad no UTI. Second, bigggg hugs to you. And… you got this.
You’re so smart and on top of everything. You will systematically check into everything and take it one step at a time.
And Wendy knows so much and is so helpful in guiding you.
Breathe.
And give both of your girls lots of hugs.
Ps, love the pic of Bell, as usual.
Thanks for sharing her beauty with us

Thanks so much, Staci, hugs right back to you. Bell gets super affectionate at the vet. She will just stick her head out of her carrier and constantly rub it on my hand. She is such a sweetie.

 

[Wendy&Neko]

She also said that Bell doesn't have acromegaly because she would have physical changes from that condition.

Sigh, only 35% of acros were shown to have clinical signs in the largest study of acros done to date. Neko's only sign was her insulin dose, ravenous appetite, and one teary eye. Which I only later found was probably due to soft tissue growth in her eye duct. One of the classic symptoms, noisy breathing, didn't happen until 4 years later and it wasn't really noisy at all, just breathy. I practically had to beg my vet to run the tests, for my peace of mind. I finally asked her to humour me. When both came back positive, I earned a lot of cred at the clinic. Mind you, that was several years before the 2015 article about the large scale study results came out.

If she does test positive for IAA, I would also investigate the dental, at least getting dental x-rays. Fixing Black Kitty's mouth (first IAA kitty here) was key to breaking his IAA and eventual remission.

FYI - Neko's SRT was done at Colorado State University too. In case you are interested, look at her 2015 SS, starting mid July. I felt like I was chasing a run away train.

 

[bluesunshine]

Yeah… I am super glad you mentioned that most cats don’t exhibit physical signs so I didn’t just take that comment as truth.

Good to know about the dentals. I’ve read a few comments by you in the acro forum saying to be cautious of using anesthesia for cats with acromegaly due to heart issues. Would dental X-rays be worth the risk, if she’s positive for acro? Maybe we cross that bridge when we come to it…

Neko’s spreadsheet does look very similar to Bell’s. You had her very well regulated until July, which is similar to Bell’s flip after October. Reading about acromegaly, I pictured the fluctuations of IGF-1 to be more of a weekly rollercoaster, but that’s obviously not the case. Looks like it can cause insulin ineffectiveness over longer periods.

 

[Wendy&Neko]

If there is an acro tumour, it can wax and wane, but it can also occur in fits and spurts. The tumour cells have a life time, they grow, divide and die off. One of the treatments, SRT, neuters the tumour cells.

Once I knew Neko had acro, she had an echocardiogram before she had a dental. Not all acros have heart issues, but it can have an otherwise silent presence. Neko did have HCM (enlarged heart) in her first echo, but it was just barely out of normal size and she had some Maine Coon in her so larger organs not a surprise. The cardio vet said I didn't to do anything special but keep monitoring, and anaesthesia was OK. Her heart didn't change for a couple years after that. Every time she went into the vet, I got her to check her heart murmur (benign) for degree and location - no changes meant still OK. Neko did go to the dental specialist vet after that, for extra monitoring during anaesthesia. Turns out the specialist knew acro too.

 

[MinnerPip]

Hi Seth. You are so very thorough. Your approach with your vet seems so reasonable and thoughtful. I hope she works with you on this and is willing to learn more. My vet isn’t familiar with IAA and acro at the level found here. His clinic had never tested for either, but he supported doing the tests for me.

Bell is in the best of hands.

 

[cecile & bella]

Hi Seth. Your vet will probably appreciate the thoughful message. I think pursuing a dental exam and xray is a good idea as well, especially if Bell already had dental reabsorption. Bella had several extractions and the effects of the last one on her numbers were extraordinary. And on her general health, actually., too.
I hope you get answers soon

 

[bluesunshine]

Hi Seth. You are so very thorough. Your approach with your vet seems so reasonable and thoughtful. I hope she works with you on this and is willing to learn more. My vet isn’t familiar with IAA and acro at the level found here. His clinic had never tested for either, but he supported doing the tests for me.

Bell is in the best of hands.

Thank you so much for the kind words, Laura! Minner’s spreadsheet gives me a lot of hope for Bell!

 

[bluesunshine]

Hi Seth. Your vet will probably appreciate the thoughful message. I think pursuing a dental exam and xray is a good idea as well, especially if Bell already had dental reabsorption. Bella had several extractions and the effects of the last one on her numbers were extraordinary. And on her general health, actually., too.
I hope you get answers soon

Thank you, Cecile! I will keep pushing an X-ray as the next step for Bell.