Blitzy Update

Discussion in 'Prozinc / PZI' started by schlania, Oct 19, 2020.

  1. schlania

    schlania Member

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    Aug 11, 2020
    Hello, So I am a bit worried about blitzey, I think there is something else going, I took him to new vet a week ago, she said he looked great and had gained a pound, so she thought he is doing well and I shouldn't worry. I have Lantus in my fridge, was hoping for her to give me the go ahead to switch.. Any ideas or suggestions? Is the dose to high or not high enough. He is currently at 4 units of prozinc, the past week he sleeps a lot and not very active, and is hanging by his water bowl. I am just wondering if his other problems are not doing well.. @Panic
     
  2. Panic

    Panic Well-Known Member

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    Apr 10, 2019
    Let me tag @Deb & Wink and maybe @Critter Mom
    Those numbers are really high and I'm not sure if it's because the dose is too high or not.
     
  3. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    Blitzey has rarely gotten into good BG number ranges. So I don't think the dose is too high.
    Some cats are high dose kitties.
    IAA (Insulin Auto Antibodies) and acromegaly (1 in 4 diabetic cats) are 2 of the reasons for the higher doses.

    I think you have to keep increasing the dose per the protocols, until you see some better BG ranges, and seeing those consistently.
    A single blue number here and there over weeks doesn't count as being in better BG levels.

    Blitzey is still unregulated. So he needs more "juice", insulin being the juice.
     
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  4. Panic

    Panic Well-Known Member

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    Apr 10, 2019
    Thank you for confirming Deb.

    Normally we don't recommend testing for IAA or Acromegaly until they hit 6 units, though there's nothing wrong with checking right now. Might be beneficial for you. If Blitzy is in fact a high dose kitty, we recommend using Levemir over Lantus as Lantus can sting in high doses. He probably won't start feeling better until his BG goes down and you're doing a really good job testing. Good to see you're checking for ketones, keep doing that as long as the numbers stay high. Hope he feels better soon. :bighug:
     
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  5. schlania

    schlania Member

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    Aug 11, 2020
    so tonight i tested for ketones and he it was little pink, he is getting a little twitchy also and seems to cry if i pick him him up by the chest. I have him to 5 units and still pretty high sugars.. I am going to call vet first thing in the am or is there more i should be doing.. I almost think it is time to let him go. he is eating less also. any suggestions?@panic
     
  6. Panic

    Panic Well-Known Member

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    Apr 10, 2019
    Tagging @Bron and Sheba (GA) or @Chris & China (GA) in case they're online around this time in concern with the ketone test. I'm not sure what pink is in regards to your particular strips, but if it's over "trace" according to the bottle it needs to be handled ASAP. It's more expensive to wait it out because by then you run the risk of DKA.

    I would request an acromegaly and IAA test. He may just be a high dose kitty that needs a lot more insulin before he starts feeling better.
     
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  7. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    Agree with Elizabeth, that getting those acromegaly and IAA tests would help you see if Blitzy is a high dose kitty.

    Taggin @JanetNJ too, since she has a cat with acromegaly.
     
  8. schlania

    schlania Member

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    Aug 11, 2020
    His ketone would be trace i am at the emergency vet with him and I am going to do the other tests but my other vet has not gotten back to me yet. Might be on a vet search again.
     
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  9. Panic

    Panic Well-Known Member

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    Apr 10, 2019
    Please let us know what they say. If it was only trace it's something to keep an eye on but not necessarily an emergency. Hugs to you and Blitzy. :bighug:
     
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  10. schlania

    schlania Member

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    Aug 11, 2020
    So I guess I overreacted, it is very small trace and vet said not a emergency, he was a little dehydrated so they gave him fluids. She said he looks good and the weird thing is at the vet his bg was lower.. So tomorrow am I am going to to call the vet and see if they will test for acromegaly and iaa, i have left a few messages and have not heard back this week which is odd.. sorry I freaked.. it is always neg and then tonight was turning pink, had me real worried.
     
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  11. Panic

    Panic Well-Known Member

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    Apr 10, 2019
    It's ALWAYS better to be on the safe side! Even trace ketones and dehydration is important so you stayed on top of it with the fluids. :bighug: Those fluids will help flush out the trace ketones too.
    Some kitties actually do experience lower BG at the vet - crazy right?

    I think I saw someone say that the tests take a few days to come back (they have to send them out) so will be looking forward to the results. If IAA, it is self-limiting. And there are records of cats with both conditions going into remission as well. Pretty cool! I would not be surprised if Blitzy has one of them. That just means you keep doing what you're doing and he'll feel better soon.
     
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  12. JanetNJ

    JanetNJ Well-Known Member

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    Hi. My cat was a lot like this when she came out of remission. Dose kept raising. Finally got up to about 12 before I saw progress. She's currently between 6-7 units now. Sometimes they just need what they need. She was finally officially diagnosed acro may of last year, but I believe she was since Jan 2018, so almost three years ago.
     
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  13. JanetNJ

    JanetNJ Well-Known Member

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    Jun 8, 2016
    Hi. My cat was a lot like this when she came out of remission. Dose kept raising. Finally got up to about 12 before I saw progress. She's currently between 6-7 units now. Sometimes they just need what they need. She was finally officially diagnosed acro
     
  14. Panic

    Panic Well-Known Member

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    Apr 10, 2019
    @schlania how are you and Blitzey doing?
     
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  15. schlania

    schlania Member

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    Aug 11, 2020
    We are om, besides me being a little stressed, he went to vet today. She think his pancreatitis is causing him issues, so she did the test for it and the igf test for acromegaly and a panel to check his liver and kidneys.. She said his insides feel a little mushy. So maybe a little inflammation, she put him on cerenia again and orbifloaxin, also showed me how to give him fluids so I can do that for him at home. She said he looks really good, he is gaining weight, only ounces but better than losing. He is bright and alert. And yesterday neg ketones. She won't give me levemir but if I want to start with lantus, I have 4 pens and I bought u100 syringes that I could start with that when I am going to be home to watch him. He is a trooper. He looks pretty good today. Do you think I should go with the lantus.@panic
     
  16. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    Lantus is a very good insulin. Plus there are lots of people to help you over on the Lantus/Basaglar/Levemir ISG (Insulin Support Group) forum part of this message board.

    Look at the stickies at the top of that forum. Lots of good information there to get you started.

    Glad to hear that Blitzey is doing a bit better, and you will be able to give him fluids at home.
    What did you get for the pain, that is associated with pancreatitis?
     
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  17. Panic

    Panic Well-Known Member

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    Apr 10, 2019
    Hang in there! Vet visits are about as stressful for us as it is them.
    Good to hear about the weight gain! Let us know what the tests say when they come back, I'm curious. :)
    You could start with the Lantus but if he starts getting upset at shot-time that's going to be an indication that the Lantus stings, it's acidity can hurt in higher doses. Why is she not wanting to try Levemir? No experience with it?
     
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  18. schlania

    schlania Member

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    Aug 11, 2020
    She has no experience with levimir and said that my next step should be lantus that at 4 or 5 units it shouldn't sting? She said i should start at 4 ?if I do it will be Saturday so I can be here, my mom is here and does his bg mid cycle but I would rather be here to watch to see if he has any reaction. She didn't give him pain meds today but said if I think he is painful I could pick some up. I should probably see if I can get the pain meds he was on buprenorphine before. I think it is the vets that stress me out it seems they just dont want to listen to me. I am seriously thinking about calling my horse vet to see if he will work with me. Hopefully the test will come back soon and I will take it from there. Will definitely post as soon I get results. And thank you for being here.
     
  19. schlania

    schlania Member

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    Aug 11, 2020
    She didn't give me pain meds but I think i will call tomorrow and go pick some up he was buprenorphine before. Thank you for being here
     
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  20. Panic

    Panic Well-Known Member

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    Apr 10, 2019
    Perhaps not at 4-5 but we don't know how high Blitzey needs yet. There are acro kitties on 20 units of insulin, some on only 3. Every cat is different. :rolleyes:
    If you switch to Lantus you want to stay on the dose he is on now otherwise you're just backtracking. I think it is fine to wait until you are there to start, but keep in mind Lantus is a depot insulin ... it will take 5-7 days for the depot to fill and you see real results from the dose, meaning you don't want to increase until after it has filled. Now again, every cat is different. I saw amazing improvement switching Panic from Prozinc to Lantus after the first day. But if that is not the case for Blitzey, it's normal.

    When you switch, I strongly recommend posting over on the L&L forum. Their method of posting is a little different, but it is a larger support system with more cats as well. I would make a daily post with titles such as "10/28 Blitzey - Day 1 of Lantus" or what-not. They prefer you to start thread titles with date/kitty name so they can browse easier. You can always ping us as well, I am not a big dosage helper on Lantus since so many more people are more experienced over there than me, but I'm a great cheerleader. :cat:
     
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  21. schlania

    schlania Member

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    Aug 11, 2020
    So his igf came back at 336, so the vet said she was going give his results to a internist on Monday , usually for acro it would be over 100, but she said he is halfway? His pancreatitis test came back positive, which I knew it would..@panic
     
  22. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    336 is more than 3 times the 100 IGF1 level that indicates acromegaly.
    Halfway to what?

    Right now, Elizabeth (aka Panic) is taking some time off from the message board. No idea when she will be back.

    Tagging @Wendy&Neko as she is one of the more experienced people here that has had a cat with acromegaly.
    Also tagging @JanetNJ as she currently is treating her cat for acromegaly and has been doing so for at least 18 months.
     
  23. schlania

    schlania Member

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    Aug 11, 2020
    The vet said a IGF of 1000 was positive for ACRO. So i guess she was saying he was halfway to that..
     
  24. JanetNJ

    JanetNJ Well-Known Member

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    Jun 8, 2016
    Your vet is mistaken about the range. A cat in the 300’s is a definite positive. My cat tested at 302 when she was diagnosed. Over 100 is positive, not 1000. Here’s a thread where people discus their results at diagnosis.

    https://www.felinediabetes.com/FDMB/threads/acrocats-what-were-your-igf-1-results.2024/
     
  25. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    Feb 28, 2012
    You know how you in the US measure BG's in mg/dl, but the rest of the world uses mmol/L? Same thing with acromegaly tests. Those done in the US measure it in mg/dl (and over 92 is positive) and tests done in England - the only other place that does the testing, they test in nmol/L and the positive is over 1000. Most of the recent papers that have come out have been from the Royal Veterinary College in England and if the vet has done some reading (good for her), she's seen positive is over 1000. But she also won't be the first vet we've seen tripped up by the conversions.

    Did the vet test for IAA as well? Looks like not, which is unfortunate, but common.:rolleyes:
     
  26. schlania

    schlania Member

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    Aug 11, 2020
    I will have her test for Iaa also. Was supposed to be done with the other test but I guess they did not. Hopefully she will give .e script for levemir and I will figure what to do about treatment.
     
  27. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    Feb 28, 2012
    So sorry about the IAA test not being done. It goes to the same place as the IGF-1 and is a really cheap add on if done at the same time.
     

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