FAQs on main page are very out of date, especially the mentions of acromegaly

Discussion in 'Acromegaly / IAA / Cushings Cats' started by cabreu, Dec 30, 2020.

  1. cabreu

    cabreu Member

    Jul 30, 2020
    Not sure how others made it to the FDMB, but I first looked at the information on the main page, and the FAQs were one of the first things I read. I recently took another look and realized how out-of-date they are. There are several mentions of how acromegaly is very rare. This point in particular has become inaccurate:

    Q6.4. My cat has been on insulin for a while and her diabetes is still out of control. Why can’t I regulate her?

    A6.4. The most common causes for poor control of blood sugar are:
    • Somogyi rebound from too much insulin-- especially if the insulin was started at more than 2 units twice per day, and/or was increased more frequently than 0.5 unit every 7 days. In some cats, rebound occurs at normal or high blood sugar levels, keeping blood glucose levels high all the time. For more on Somogyi rebound, see Gorbzilla's mini-FAQ and Steve & Jock's Wikipedia page.
    • Wrong insulin type for your cat (especially Humulin 70/30 or Humulin N (NPH), which don’t last long enough for many cats).

    • Wrong insulin schedule for your cat (most commonly, shots once per day when the cat needs them twice per day).
    • Not enough insulin -- the insulin dose needs to be increased, slowly and cautiously.
    • Food issues (e.g., constant free feeding on high-carbohydrate food such as Hills W/D or inconsistency in feeding times, amounts and/or types of food)
    • Poor or irregular absorption of insulin (may happen with long-lasting insulins or injections in the scruff)

    • Ongoing infection or inflammatory condition (for example, dental problems, subclinical pancreatitis, or urinary tract infection) which is keeping the blood glucose values high.
    Other medical issues (such as insulin resistance, acromegaly, and Cushing’s disease / hyperadrenocorticism) may also cause obstacles to regulation. These problems are relatively uncommon, and should not be prime suspects until the more common causes have been ruled out. More details can be found at The Hard-to-Regulate Pet.

    If a previously regulated cat suddenly starts showing poor response to insulin, two likely reasons are infection and loss of potency of insulin.
  2. JanetNJ

    JanetNJ Well-Known Member

    Jun 8, 2016
    Acro is relatively rare, although not as uncommon as once thought.
    sbluhrs likes this.
  3. cabreu

    cabreu Member

    Jul 30, 2020
    I wouldn't say that it's rare if it occurs in up to 25% of diabetic cats. I agree that feline diabetes is rare, but if acro is even in 10% of diabetes cases, it's above the threshold commonly used to define significance (at most 5%).
    sbluhrs and JanetNJ like this.
  4. Wendy&Neko

    Wendy&Neko Senior Member Moderator

    Feb 28, 2012
    It's on my "to-do" list to revamp the Sticky Notes in this forum. Also on our list is revamping the information on the main Feline Diabetes main pages. Can you send me the link to the out of date information, and I'll add it to the list when we get to it. We know there are broken links and out of date info there. Just need to make sure we have it all identified.

    Acromegaly is definitely a lot more common than previously thought. The paper that came out with the 25% number was published in 2015, well after some of the older content we have.
    cabreu and JanetNJ like this.
  5. cabreu

    cabreu Member

    Jul 30, 2020
    Sure, here is the link to the FAQs: https://felinediabetes.com/fdmb-faq.htm
    And to the "Regulation" section that I quoted: https://felinediabetes.com/fdmb-faq.htm#regulation

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