Re: 4/30 Jazzy AMPS 241, PMPS 234 PLUS thoughts on Acromegal
Some of you might not be aware that there are several different opinions on how to best manage acros’ numbers. So many of the conversations between acro beans these days occur off board, and I think it would be great to have more high-dose presence in LL so people can learn. I keep getting a lot of questions about Jazzy and acro, so I know folks are trying to learn and I appreciate that!
Obviously I can only present my own approach and show how I have arrived at my approach. In my opinion, just like with “regular” diabetes, everything boils down to finding a range where your cat is both comfortable and safe. That range might be different for every cat. A lot of my thoughts do begin and end with "what would Jojo do?" but the concepts also have to make sense to me or I won't be able to buy into them.
Here are the acro spreadsheets that I have studied and have chosen to follow. Primarily I follow their methods with Jazzy, because this is what I want her spreadsheet to look like. I’m not there yet, but this is what I’m striving for. :smile:
Porscha
Buckwheat
Chika
Boo
Milo
(Boo and Milo both had Stereotactic Radiosurgery and went OTJ, but the early parts of their spreadsheets are very applicable and impressive).
Long story short, what worked for most of those kitties is following the Tight Regulation Protocol. They increased/decreased according to protocol, sometimes increasing in larger increments but for the most part they did things the same way the rest of us do. I have done some fumbling around with Jazzy, and that is pretty much where I have landed with her too, except that I do skip shots when she is green and I have to leave.
You
do need to be more cautious with acro cats in green numbers – because most acros have a functioning pancreas, sometimes if you use low carb food to try to bump up a number, it can actually stimulate the pancreas to produce more insulin, sending the number lower instead of higher. That can make it difficult to control fast drops. I don’t subscribe to the theory that a green number is dangerous for
all acros, if it is a flat green. Others do try to avoid all green, and for some cats that is a smart choice. Fast drops into green are more of a concern, until you know how your cat responds to carbs.
Just like everything else, you’ll have to experiment to see how your cat responds to low carb and high carb foods, and use that information to determine what range is best for your cat.
Just to use Jazzy as an example, I have learned that she actually gets a good food spike from low carb. High carb can give her 60 points or more, which is usually a lot more of a bump than she needs. I have had an opportunity to shoot low and monitor a couple of times, and she has done fine. I’m perfectly comfortable with Jazzy surfing green when I’m home (I wish she would do it more often). I’m not confident enough yet to do that when I won’t be home, though she would probably be ok. I hope she’ll give me a chance to try again soon. She obviously feels better and is a lot less mean when she is lower, so I would prefer to keep her in blue/green all the time. My other cats would prefer that too, since she doesn’t attack them as often when she is in happy numbers. :lol: I’m running her higher than that right now because I don’t always feel well enough to monitor late at night. My goal for now is to keep her under renal threshold 24/7, and eventually get her to blue/green 24/7. Jazzy is just one cat, and acro cats truly exemplify the “Every Cat is Different” mantra. I’ve seen others that need a whole can of HC (or more) to slow down a drop. If I had one of those cats I’m sure I would be a lot more gun-shy about green!
Lantus vs. Levemir for high dose cats– I believe that is an individual decision as well. I switched Jazzy to Lev mainly so I would have experience using it so I could help others on FDMB. She would growl and try to bite when I shot her with Lantus, so I hoped Lev might help with that if it stings less. Nope, she still growls and tries to bite with Lev! I can’t say whether Lev feels any different to her or not. Jazzy is doing fine on Levemir, but her numbers aren’t all that different than they were once we got to a good dose of Lantus. I’m still not sure if Levemir was the right decision for me. With Levemir’s late onset, I usually go to bed before her onset. That means I have no idea how her PM cycles run, and sometimes she surprises me in the morning. At least with Lantus, if I went to bed at +4, I would have some clue as to how the rest of the cycle was going to go.
I would be interested in reading how others approach treating their acro kitties, spreadsheets, etc. I admit that this is the approach that makes the most sense to me, but I know other people use different methods and those methods must make just as much sense to them.
Comments?
