? Hyperthyroidism Testing 7-25 Gizmo AMPS=195; +2=191; +5=108; +6=119; +9=183; PMPS=217

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Chubba (GA)

Chubba (GA)

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Condo -http://www.felinediabetes.com/FDMB/...310-6-266-pmps-304-2-306.181166/#post-2007662

PMPS = 304
+2 = 306
+4.5 = 238
+6 = 162
+8 = 254

AMPS = 195

I'm beginning to think Gizmo is a cat that has a second dip at the end of his cycle (sometimes ... not always ... that would be to predictable). I was shocked at AMPS this morning. Hoping for some good numbers today and bouncing tomorrow while we are gone. Since I am pretty sure we will be late for his pm shot, should I leave some extra food out later in tomorrow's am cycle? I know this will lead to him having a higher PMPS, but I'm worried he will be starving if PMPS and food is an hour or two late. I was thinking maybe food at +9 that was if we do make it home in time for his pm shot, he wouldn't have food within 2 hour before, but would have a snack if we end up being later.
 
Gizmo's vet just left a message (I didn't recognize the number, so I didn't answer :(). Anyways ... he has looked into the tests for insulin resistance and acro, although mentioned that insulin resistance is considered 1 unit per pound, not 1 unit per kilogram like he thought. Therefore, Gizmo is far from that number. He is at 7.5 units and weighs almost 14 lbs. He also looked into hyperthyroidism, which I have been reading a lot about as well, and recommended possibly starting meds for that condition. From what I was reading, the medication is very nasty (side effects) and is really bad to give to a cat without being positive he/she has hyperthyroidism. I was reading about 3 different tests to confirm this. I am going to research some more, but thought I would get some advice from you guys as well.

@Marje and Gracie
Does pursuing hyperthyroidism seem like a reasonable approach to you based on his labs? I think I would definitely push for all 3 tests to confirm first. Should I still look into the acro and IAA as well or just go one route at a time?
 
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Chubba said:
although mentioned that insulin resistance is considered 1 unit per pound, not 1 unit per kilogram like he thought.
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:banghead::banghead: That's old school thinking. If your vet likes scientific research, give him the link to this article publishing the latest results. Note that the measurements of IGF-1 used in that article are the "world" version of numbers, not the US version that Michigan State University uses.

Neko's vet said we need needed to get up to 10 units before testing (she was 14 lbs), never did get that high, yet tested positive for both high dose conditions. The latest research in the article above found acros on 1.0, yup that's "one", unit of insulin. We have seen kitties here test postivie at 2.5 and 4.0 units - though we don't typically suggest people test until over 6.0 units. Ask your vet to humour you, that's what I had to do.
Chubba said:
Should I still look into the acro and IAA as well or just go one route at a time?
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Get the high dose tests done. I would get the tests for hyperT done at the same time. Saves you money on the blood draw charge. Adrian's Chino @Adrian and Chino tested positive for both hyperT and acro and is on hyperT meds.
 
I'm not Marje but just glancing at his labs his T4 is still in the normal range. It doesn't hurt to get all the labs run for Hyper-T but certainly wouldn't start meds for it without a formative diagnosis. I just had additional tests for my civie done through Hemopet...the Thyroid Profile 4. My vet drew the blood according to the instructions and I sent it off since there was no way she could compete with the price. Marje recommended these tests and my Civie came back negative for Hyper T. Instructions http://www.hemopet.org/clients/1414...ELINE_TEST_REQ_FORM_and_INSTRUCTIONS_2016.pdf

There is a "look" to insulin resistance and Acro in a kitty's SS. Although we can't say for sure I would certainly push for both Acro & IAA. My Doodles was once regulated on a small dose of Lantus and one day a light switch went off. After pushing for the tests, he was negative for Acro but positive for IAA (78%) and only on 6.5u of insulin at the time and weighed 18lbs. The highest in dose we got to was 12.5u. Vets don't really recognize IAA and are just starting to acknowledge Acro a little more.
 
I agree with the opinions with not starting the meds for hyperT. The meds are hard on the cat. Get a confirmation first. 2.2 is within the normal range. Weight gain is not one of the symptoms, but ECID. My cat didn't lose any weight, but he looked rough with his pointy fur. He wasn't active like you would think with a hyperT cat either. His only symptom was yowling at night, but now that he's hypOt, he still yowls. It must be a habit now. Good luck figuring all of this out! :bighug:
 
Wendy&Neko said:
Get the high dose tests done. I would get the tests for hyperT done at the same time. Saves you money on the blood draw charge.
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That's what I was thinking as well get all 3 tests done and get answers. What tests do you recommend to diagnose hyperthyroidism? We only had T4. Should we also have him tested for freeT4 and I read about another test as well, but that I read that was an old school way of diagnosing.
 
Chubba said:
That's what I was thinking as well get all 3 tests done and get answers. What tests do you recommend to diagnose hyperthyroidism? We only had T4. Should we also have him tested for freeT4 and I read about another test as well, but that I read that was an old school way of diagnosing.
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There's scintigraphy, but not many places have that.
 
Doodles & Karen said:
his T4 is still in the normal range.
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Gizmo is 12 years old, and total T4 for an older cat is expected to be at the low end of normal. Chino's T4 was 3.1 when I asked for a free T4, which came back at 6.5 (high). Though I didn't see much improvement in his BG until we reached an effective dose of insulin, I did notice after a few weeks on methimazole that he wasn't as ravenous as before and didn't spend as much time sleeping in front of his water bowl.
 
Adrian and Chino said:
Gizmo is 12 years old, and total T4 for an older cat is expected to be at the low end of normal. Chino's T4 was 3.1 when I asked for a free T4, which came back at 6.5 (high). Though I didn't see much improvement in his BG until we reached an effective dose of insulin, I did notice after a few weeks on methimazole that he wasn't as ravenous as before and didn't spend as much time sleeping in front of his water bowl.
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Thanks for your response. Gizmo was around the same on the T4 (3.4). My plan is to request farther testing for hyperthyroidism, IAA, and acro when he finishes his antibiotics. That will be Aug 2nd, so I will see about getting him another appt scheduled around then. Although, Gizmo is starting to see better numbers (**antijinx**), I still want answers as to why he is on such a high dose.
 
Just for my two cents, I pushed for IAA and IGF-1, I went with the suggestion on here to look into it when kitty reaches 6U. Another reason I pushed is I already started researching acromegaly, it's symtoms and had come across one of @Bronx's dad post about the cabergoline trail, and he had mention the cat that was doing the best on the trail was on the lower side of high dose kitty. Since Marvin was still lowish (6U) dose, and I had just seen some movement in his BG for the first time I figured I had nothing to lose and didn't want to wait any more. Also my inner voice was already telling me that he was most likely Acro Kitty. I am glad I didn't wait for the testing. Gizmo SS shows a bit more movement than what Marvin had, so is a good thing. I think knowing sooner will at least let you know what you are dealing with if positive with one of the conditions, allowing you to decide on the best plan of action for both you and Gizmo.
 
Just dropping a note to share some info regarding Hyperthyroidism. While on this journey I found a local vet that I thought would be a god send for FD but he now only limits his practice to Hyperthroidism. Not sure where anyone is located but if anyone is local and needed a specialist for HyperT, its a place worth looking into.

http://www.animalendocrine.com/
 
Beenie said:
Just dropping a note to share some info regarding Hyperthyroidism. While on this journey I found a local vet that I thought would be a god send for FD but he now only limits his practice to Hyperthroidism. Not sure where anyone is located but if anyone is local and needed a specialist for HyperT, its a place worth looking into.

http://www.animalendocrine.com/
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Wow...that place looks amazing.
 
Marvin's Mom - Nat said:
I think knowing sooner will at least let you know what you are dealing with if positive with one of the conditions, allowing you to decide on the best plan of action for both you and Gizmo.
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I completely agree and if acro Marvin's progress gives so much hope! My vet actually said there isn't much you can do if you get a positive acro test. I had to tell him about Marvin's progress and that I would want to try the same (if positive for acro). I'm still hoping for insulin resistance or just a high dose kitty, but I need to know (for the sake of my sanity lol).
 
Chubba said:
I need to know (for the sake of my sanity lol).
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Yes I know that feeling, I felt like I was out of my mind, until I got the diagnosis. I was actually relieved in a way, because I knew why his BG was not budging, and then focused on getting in touch with RVC. When I told my vet about it, no questions, she said yes immediately, we had nothing to lose.
 
Chubba said:
Wow...that place looks amazing.
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I know, right?. I literally drove by it and had to circle back and read the sign again. Pulled in to the parking lot, they were closed at the time, and viewed the website. My heart was pounding!! I couldn't believe there was a endocrine vet specialist in my own back yard. After reading the website a few times and then calling their office was I made aware that Dr Peterson limits his practice. Very unfortunate but I wanted to share for anyone who could use a place like this. Wish there were more vet specialists out there :cat:
 
Chubba said:
Gizmo's vet just left a message (I didn't recognize the number, so I didn't answer :(). Anyways ... he has looked into the tests for insulin resistance and acro, although mentioned that insulin resistance is considered 1 unit per pound, not 1 unit per kilogram like he thought. Therefore, Gizmo is far from that number. He is at 7.5 units and weighs almost 14 lbs. He also looked into hyperthyroidism, which I have been reading a lot about as well, and recommended possibly starting meds for that condition. From what I was reading, the medication is very nasty (side effects) and is really bad to give to a cat without being positive he/she has hyperthyroidism. I was reading about 3 different tests to confirm this. I am going to research some more, but thought I would get some advice from you guys as well.

@Marje and Gracie
Does pursuing hyperthyroidism seem like a reasonable approach to you based on his labs? I think I would definitely push for all 3 tests to confirm first. Should I still look into the acro and IAA as well or just go one route at a time?
Click to expand...
Just want to underscore to readers that any tT4 value above 3 in a cat that is over ten is the gray zone. Because concurrent diseases can make the tT4 seem lower than it may be, it's really important to do some additional testing before you start the meds.

While I don't think the felimazole (aka methimazole) is a nasty drug, I'd prefer to not give it to my cat longterm. What I find with most vets is that they start at way too high of a dose and the cat has a reaction. I gave my hyperT cat compounded, flavored (no sugar) methimazole for a few months until we could get him in for I131 treatment.

Karen gave you the link to Hemopet.com and told you the appropriate test. I've used Dr. Dodds for years and I trust her tests more than the labs. She has a lot of good info on her site as well. The instructions for how much blood your vet needs to draw and which tubes he puts it in is on the website. I always had my vet draw the blood and put it in the correct tubes and then we fedexed it to Hemopet ourselves.

I agree with Wendy that your vet sounds pretty old school about acro and IAA. IMHO, there is no vet (other than the ones at CSU or RVC where they treat acro) who knows more about acro than Wendy.
 
There's a good group on Facebook called Hyperthyroid Cats. You need to ask to join.
You're lucky Dr. Peterson is so close to you. He is the guru of hyperthyroidism in cats. He now limits his practice to treating only hyperthyroidism in cats.

I have to run to work, but if you have any questions, let me know and I'll answer them when I get home.
 
Marje and Gracie said:
Just want to underscore to readers that any tT4 value above 3 in a cat that is over ten is the gray zone. Because concurrent diseases can make the tT4 seem lower than it may be, it's really important to do some additional testing before you start the meds.

While I don't think the felimazole (aka methimazole) is a nasty drug, I'd prefer to not give it to my cat longterm. What I find with most vets is that they start at way too high of a dose and the cat has a reaction. I gave my hyperT cat compounded, flavored (no sugar) methimazole for a few months until we could get him in for I131 treatment.

Karen gave you the link to Hemopet.com and told you the appropriate test. I've used Dr. Dodds for years and I trust her tests more than the labs. She has a lot of good info on her site as well. The instructions for how much blood your vet needs to draw and which tubes he puts it in is on the website. I always had my vet draw the blood and put it in the correct tubes and then we fedexed it to Hemopet ourselves.

I agree with Wendy that your vet sounds pretty old school about acro and IAA. IMHO, there is no vet (other than the ones at CSU or RVC where they treat acro) who knows more about acro than Wendy.
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Marje, I'm losing track of what I read and where. I thought I saw recently that there is a animal clinic in Yonkers, NY that treats Acro..??

https://vcahospitals.com/animal-spe...=organic&utm_campaign=Animal_Specialty_Center

Or I could be confusing this center for treating another condition.
 
Hi. I thought of something. Karen told you about the Thyroid Profile 4 test. You may want to add on TSH, which is at the bottom of the list of tests. TSH tells you if the thyroid is working right. For example, with untreated hypOt, the thyroid isn't making enough T4 hormone so TSH (Thyroid Stimulating Hormone) is high, trying to get T4 to work. It's $25 extra, but you might as well get the complete picture of what the thyroid is doing.
 
Beenie said:
Marje, I'm losing track of what I read and where. I thought I saw recently that there is a animal clinic in Yonkers, NY that treats Acro..??

https://vcahospitals.com/animal-spe...=organic&utm_campaign=Animal_Specialty_Center

Or I could be confusing this center for treating another condition.
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Acro and hyperT are very different and have different treatments.

It does not appear that VCA hospital does I131 treatment for hyperthyroidism and I there are very limited options in the US to treat acromegaly. One is Colorado State University. @Wendy&Neko will have to let you know if any other universities have started treating it but I believe, to date, all the acro parents that have treated it have gone to CSU. There is also a drug out that a member has just successfully used. Again, Wendy is the best resource for that but first, you have to know if he has acro and/or IAA.

If Dr. Peterson is close to you and if you are dealing with hyperT, he would be the one to see. He is the prime expert in that condition.

Mandy & Rex said:
Hi. I thought of something. Karen told you about the Thyroid Profile 4 test. You may want to add on TSH, which is at the bottom of the list of tests. TSH tells you if the thyroid is working right. For example, with untreated hypOt, the thyroid isn't making enough T4 hormone so TSH (Thyroid Stimulating Hormone) is high, trying to get T4 to work. It's $25 extra, but you might as well get the complete picture of what the thyroid is doing.
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I've worked with Dr. Dodds before and she had recommended just the Feline Thyroid panel that had tT4, fT4, fT3, and fT3. That has been a few years ago, though. @Chubba, you can always call Hemopet and ask what they are recommending now to diagnose hyperT in a cat.
 
Yonkers does the Cyberknife treatment for acromegaly. It is more expensive than SRT, but I don't have current prices. It is even more precise than SRT and I have heard of good results from there. A local vet oncologist I know and loke was on their board. In the NJ area, Red Bank does SRT now, Paul @Bronx's dad took Bronx there recently. Not quite as close, but North Carolina State U has very knowledgeable people there with regards to acromegaly. Dr.Kathy Lunn, originally at CSU, is there now. The high dose forum has a post listed current places as of a couple of years ago.
 
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Wendy&Neko said:
Yonkers does the Cyberknife treatment for acromegaly. It is more expensive than SRT, but I don't have current prices. It is even more precise than SRT and I have heard of good results from there. A local vet oncologist I know and loke was on their board. In the NJ area, Red Bank does SRT now, Paul @Bronx's dad took Bronx there recently. Not quite as close, but North Carolina State U has very knowledgeable people there with regards to acromegaly. Dr.Kathy Lynn, originally at CSU, is there now. The high dose forum has a post listed current places as of a couple of years ago.
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Thanks Wendy, good to know. Yonkers, NY is a very short drive for us and I actually lived in that city for three years. Don't need their services as of yet just checking to see what options there were with regards to treatment centers should Beenie test positive for Acro.
 
Beenie said:
Thanks Wendy, good to know. Yonkers, NY is a very short drive for us and I actually lived in that city for three years. Don't need their services as of yet just checking to see what options there were with regards to treatment centers should Beenie test positive for Acro.
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Yonkers quoted me at $10-12K for the Cyberknife, Red Bank was about $8K for SRT.
 
We didn't have one member from Canada have all of her SRT covered by pet insurance. And the following year they put a cap on her spending. :rolleyes: Probably each pet insurance company is different.
 
Trial drug Cabergoline will run about $80-100/mo, Marvin is doing great on it, but official trial has shown 1 of the 6 cats has responded well. That cat was not on a huge amount of insulin.
 
Wendy&Neko said:
We didn't have one member from Canada have all of her SRT covered by pet insurance. And the following year they put a cap on her spending. :rolleyes: Probably each pet insurance company is different.
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Oh sure each company is different just curious if anyone has it and treatments like this are ever partially covered.
 
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