12/31 Moe: amps=93+2.5=71; +7=94;vet update; +10=86; PMPS=101; reduce to 2.5u

Yesterday https://www.felinediabetes.com/FDMB...t-visit-tomorrow-pmps-71.240718/#post-2709046

Good morning. Moe’s amps is 93. I forgot his shot was an hour late last night and gave his am shot at the usual time. Oh well...

We have an 8:00 am vet appointment today to discuss better or different treatment for his arthritis. It’s gotten really bad in his back legs in the last week or so. It hurts my heart to see him in pain and struggling to walk.

I’ve got a four day weekend - hooray! - but I brought some work home to try and get caught up. Blech.

I hope everyone has a good day.

 

good luck at the vet today
and enjoy your time off.

 

71 at +2.5.
Waiting now in the vet’s parking lot while Moe gets examined.

 

I hope the vet can give you something to help with his arthritis.

 

Just back from the vet. “He’s walking fine for us”. Of course! She examined him and said that the arthritis was still worse in his elbows than in his rear legs. Based on my description she felt like it is more likely ataxia or neuropathy than arthritis that is causing the wobblies, possibly caused by too-low blood sugar or the acro tumor.

She wants me to decrease his insulin to 2.5 units and aim for BG of 100-150; and she wants me to do a curve in a couple of days using the AlphaTrak meter so she can get a better feel for the numbers.

She gave me gabapentin for pain and I’m to give his adequan once a week for a month then go back to every other week.

I also still have Zobaline that I can give him if it’s really neuropathy.

So. Not a definitive diagnosis but nothing that she felt was a dire emergency. I asked about low potassium but she thought that was a remote possibility.

 

94 at +7

 

86 at +10.

 

PMPS is 101. Evening dose is 2.5 units, per vet’s instructions. She wants to keep him at 100-150, thinking his wobbliness is due to low blood sugar. She also mentioned that it could be due to growth of the tumor. I so often forget that he actually has a brain tumor. I’m so focused on the diabetes that I forget about the root cause of it all.

 

I'm no expert, but not sure about low blood glucose causing the wobbling...something about that doesn't sound right. Hopefully some of the more experience ACRO moms can comment...

I hope he'll be feeling better soon.

Happy New Year Erin and Moe!

 

Remind me again how many acros your vet has in practice? Why would you keep him at 100-150? You will soon find that it's a very difficult range to keep a cat in, and you will more likely be getting numbers above renal threshold. I doubt the wobbles are due to "low" blood sugar. My current civvie likes the 40's and she's not wobbly. I also don't see any of the kitties on the route to remission here having issues like you are describing. Anyway, with you going back to work, the 2.5 dose may keep him safer, though higher.

By the way, I found it helpful to take a video of any walking issues at home, and send that to the vet. As you say, they often walk fine while there. Or in the case of a previous cat, would just freeze.

As for growth of the tumour - again, I don't understand the medical reason your doctor thinks the tumour itself is impacting mobility. I have seen only a couple acrocats with neurological issues, and that caused circling or vision issue, not painful walking. At that was only at very end stage of the disease, which doesn't sound like Moe now. And I've never seen reference to it as an acro symptom in the many papers I've read on the topic. Did the vet check his spine for arthritis. Having bony growth there is very common in acros. - Neko had it too. I'm glad you got gabepentin at least and the OK to increase the frequency of the Adequan. I've heard of some acro caregivers having to give it every couple weeks for the long term.

 

Yah, Moe is her 1st acro cat, so she’s not got any more knowledge than I do at this point, probably. I think maybe because I’m using a human meter, she doesn’t know the numbers and feels like he’s going hypo and that may be causing the unsteadiness? She did mention neurological issues. Also mentioned neuropathy, but I thought that was more common with high blood sugar and resolved when it went back to normal range??

I don’t know if she checked his spine. I was in a bit of a panic yesterday when I made the appointment for today and didn’t think to video his walk, but I’m definitely going to get some. He drops down nearly to his heels, and his back feet move to the center of his body as he steps (almost looks like they might cross) rather than going in a straight line. That makes his gait look wobbly. I don’t know how to describe it, def need video.

So I’ll try the lower insulin dose for a while, give the gabapentin and increase the frequency of adequan and see how he does. Not sure what to do if there’s no improvement, though. Xrays of the spine and hips? What else should I ask about?

 

If he's in pain, and the gabapentin helps, then pain relief can lower numbers and a dose reduction may turn out to be a good thing. Over time and normal numbers, the neuropathy should resolve. Neko never had it, so I can't speak to it personally. How long did you give the zobaline? If you get a short video, you can post it here too.

Neko never had x-rays done. Though her dental vet showed me a shot of an x-ray he did of her mouth where her elbow was in the pic and you could see the growth. As for elsewhere, even I could feel the spinal bumps. The acupuncture vet showed me how to do acupressure on the spine, and I did that as part of a daily routine for pain relief and to extend the benefits of acupuncture. If he doesn't improve with a higher dose or the gabapentin, then maybe buprenorphine as pain relief. As I said before, acupuncture really worked well for Neko. I've heard of others trying lasers, Assisi Loop.

 

BGbis 61 at pm+3.

I gave Zobaline for a couple of months. He had neuropathy in his front paws, never the back. He walked on his wrists instead of his front toes. Once his glucose stabilized the first time around (October of 2019) that cleared up for the most part; a little bit of weakness remaining in the front right only. Back feet have always been fine until recently, which is why the neuropathy explanation seems off to me.

I did ask about acupuncture but the vet didn’t know of anyone specific. I’ll check with a rescue org that I’ve worked with in the past - I know they use acupuncture with their paraplegic cats.