01/13 Booger AMBG 218 PMBG 205 Vet Phone Call

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MartinJA527

MartinJA527

Member Since 2014
Ok.. so I know I'm going to get a lot of mixed opinions about this.. Booger is still off insulin (for the moment in time).. I received a call from the vet today and we are going back for repeat labs as the results were likely all skewed due to hemolyis/lipemia.

Booger continues to drop despite the lack of insulin. My vet has been in contact with Idexx and NC state veterinarians. At his instruction we are going to start insulin at a reduced dose when her numbers begin to increase.. in hopes of finding the appropriate dose to put her into remission.

I truly believe this is what is safest for Booger at this time.. and this is why.. If a cat can bounce from a low number which has been proven.. and is all over the message boards (for up to 6 cycles).. I don't see the difference in this and what is being referred to as symoygi effect or chronic insulin overdose.. and maybe I just have the term all wrong.. but here's what I'm seeing that may be going on.. Booger drops low and then she bounces for 6 or more cycles (or less if I don't catch her next low).. how is this happening over long term and increasing her dosage.. and repeated more severe increases and drops into the lows, bounces to highs NOT an insulin overdose? Maybe I'm looking at this wrong.. but I was here Friday night.. with my cat vomiting, not eating.. and unable to hold up her head.. with her glucose continuing to fall.. and it was scary. She has been cleared this far by a veterinarian and her numbers drop despite any insulin.. she's still high.. so I understand she needs some.. but I really feel like this is the right thing.. and my thought is that at least I know I won't come home to a cat in a coma.. or worse.. because I didn't go with my gut...

I won't ask you guys to back me on this.. but please support my decision to do what I feel is safest for her.. and I ALWAYS ALWAYS appreciate your feedback.. I look up every single link you post... every term I don't understand and for the most part.. listen to all your advice.. I just feel like... at this point..it's almost like starting over... which is a little disheartening.. :(but.. I will begin increasin again just like usual.. as soon as she lets me know she's ready..
 
Here's your post from yesterday.

oh how scary.

You know that we're going to support you in whatever path you choose. As you said, you were there. I was out of state on Friday but did look back and read what happened. There are times when a symptomatic hypo will "turn on" the pancreas and it will begin putting out insulin again. Here BGs weren't that low, but she clearly was sick. I also know of at least one case where a cat became very ill and that caused the cat to go OTJ. While I'm not saying that either of those things have happened to Booger, there are unusual responses to illnesses or insulin that can really change what is going on in a diabetic cat.

6 cycles should be enough to let the insulin clear out of her system and the depot to drain for you to see where she is without insulin.

We're here for you & miss Booger. :bighug:
 
I hope things will become clear. When Max first started insulin he had a Nadir under 60 and my vet had me stop insulin as I wasn't able to test at that time. I brought him in to the vet twice a week and it took 3 weeks to see that he did need insulin. We started with very low doses. I must say I will always wonder if I had increased a little quicker if he would have stopped bouncing sooner but it did keep him safe. You and your vet will figure it out.
 
Paws crossed for Booger! I know you will do whats best for her, and if she ends up going back on the juice, at least you will know for sure she needs it.
 
Safety always has to come first, and many - if not most - times the gut instinct is the right one. My Trix is one of the cats who suddenly went OTJ after being seriously ill. Last year she went from 2.25U to OTJ after a severe case of pancreatitis. She was sick/went OTJ last April - you can see the details in her SS. Weird but true!

I see in Booger's SS that her vetty determined no p-titis. Just out of curiosity, how was that conclusion drawn? After dealing with it with Trix and my vet (who I happen to think is pretty awesome :)), I've learned that it is not the easiest thing to rule in or out...my vet feels that the standard blood test can easily be skewed by other "things" going on within the body, so even though she used to use the fPLI tests, she now feels they don't offer her concrete proof of p-titis (or lack there of), and basically now she draws her diagnosis from clinical signs.

Booger probably does need insulin to help out her pancreas, but it also looks like her pancreas is putting in an effort. I'm sure you'll figure out the balance, and we're here to support you in any way you need.
 
Thank you all so much for your continued support.. I'm relieved as I was a little nervous about posting that..

Trixie.. I suppose you are right but I have no idea right now where to begin.. this is what went down at the vet's office:

"How long would food affect the blood draw do you think Elise? Should she have been fasting overnight? I didn't see it so I can't attest to the degree.. He did a lot of deep palpation to determine if there was a pain response elicited.. he wasn't completely satisfied with that (she didn't move, didn't cry, but really didn't give him any info to go off of). Temperature and other vital signs were normal. CBC was WNL. Amylase and Lipase were good too (still questioning the specimen). Don't have the fpl back yet.. so I guess technically it's not a definitive conclusion.."

Right now I'm not too confident in any of our blood tests.. as the specimens were positively grossly lipemic and likely hemolyzed.. We are going for repeat tests on the 30th.

I'm so thankful for all of you! :bighug:
 
MartinJA527 said:
Thank you all so much for your continued support.. I'm relieved as I was a little nervous about posting that..


"How long would food affect the blood draw do you think Elise? Should she have been fasting overnight? I didn't see it so I can't attest to the degree.. He did a lot of deep palpation to determine if there was a pain response elicited.. he wasn't completely satisfied with that (she didn't move, didn't cry, but really didn't give him any info to go off of). Temperature and other vital signs were normal. CBC was WNL. Amylase and Lipase were good too (still questioning the specimen). Don't have the fpl back yet.. so I guess technically it's not a definitive conclusion.."

I'm not sure how long to fast. I will try to find out for you though. When do you plan to run the labs again?
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Hugs to you and Booger! With a previous (anti-jinx) master bouncer, I can definitely relate to how hard it is not to question and rack your brain for whether you're going in the right direction when you've got a tough to figure out kitty. We're here for you!
 
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