Ramone AMPS 303 - Wanting to get IAA/Acro tests

[Jerica&ramone]

Hi there,

So Ramone's journey has been interesting. In the last month I really thought we were making progress to get him regulated but since April 19th I skipped his dose that evening and since then been slowly increasing his dose back up to where it was before and not really seeing any results like we were...

I've reached out to my vet about getting him tested for Acro/ IAA. Question is are there other tests that should be done or things that should be looked at? I haven't done much reading lately on insulin resistance, but I've seen IGF-1 ? And Cushings? Are those separate tests ? ? Same thing ?

Any info and tips to ask my vet is really appreciated.

 

[Karen&Rocket]

Hello I'm sorry you're finding yourself in a spot where you're struggling with dose increases and regulation. I know the feeling all too well. I'm sure @Wendy&Neko will have more to say, but I'll chime in with what I can. You're over 6U now, which is usually the point where vets will agree to send in your kitty's blood for acro testing. With Rocket, I knew something was up when we hit 4 units, and got my vet to humor me and get the test done "just to rule it out." Well, it turned out positive. Which wasn't a surprise to me really, but heart wrenching nonetheless.

As for other tests -- I would definitely recommend getting the IAA (insulin resistance) test done at the same time. The same lab does it, so it should be just a small additional cost. I didn't know about the IAA test until it was too late, and I really wish I had gotten it done. I highly suspect Rocket is insulin resistant as well as acro. It would be nice to know for sure.

Cushings -- I don't know much about it, and it's been a while since I've checked out the info here. What I do remember is that it is fairly rare, and can cause the skin to become thin and delicate.

Best of luck to you It's hard not knowing what's going on... but once you do, you'll have a better idea what your options are. Give Ramone a hug for me.

 

[Wendy&Neko]

The IGF-1 (insulin growth factor 1) test is the one that tests for acromegaly. There isn't a test for feline growth hormone, and the excess growth hormone increases the IGF-1 output, so that is what can be tested. The ultimate test is a CT scan or MRI, but that's way more expensive, so most of us start with the IGF-1 test and that's usually good enough to diagnose acromegaly. The IAA (insulin auto antibodies) test is just a small cost add on to getting the IGF-1 done so it makes sense to do it at the same time. Your bigger expenses will be the vet blood draw and the shipping cost to Michigan State University. As Karen says the words "just humour me" come in handy. My vet didn't think we needed to do either test until she got to 10 units (which she never did). A lot of vets don't think it's important to do the IAA - but those same vets have never dealt with an IAA cat. Just mentioning you might have to insist on it because we've had an annoying number decide it wasn't important and drop it from the list. It's so much cheaper to test at the same time. And we've had some cats be just IAA and not acromegaly, so it's worth knowing what you are dealing with.

I would get the test for acromegaly and IAA done first, then the Cushings test if the above are negative. They are more commonly seen here. Cushings is also something that can be tested locally.

A comment on dosing. If you are over 5 units total dose, you should be increasing by 0.5 units at a time, as long as there isn't any green in the picture. Glad you increased to 7.5 this morning. Also, when dealing with insulin resistance of some form, it's best not to linger on a dose. If you are seeing only very high blues or above, don't hold longer than 6 cycles, as long as you are getting at least the preshot test and one other that cycle. Unfortunately with insulin resistance, a dose that looked good until recently can be no longer any good. I called it "the dose going stale". Don't worry about the size of the dose you are giving, the important numbers are the blood sugars.

How is Ramone acting/feeling these days?

 

[Jerica&ramone]

The IGF-1 (insulin growth factor 1) test is the one that tests for acromegaly. There isn't a test for feline growth hormone, and the excess growth hormone increases the IGF-1 output, so that is what can be tested. The ultimate test is a CT scan or MRI, but that's way more expensive, so most of us start with the IGF-1 test and that's usually good enough to diagnose acromegaly. The IAA (insulin auto antibodies) test is just a small cost add on to getting the IGF-1 done so it makes sense to do it at the same time. Your bigger expenses will be the vet blood draw and the shipping cost to Michigan State University. As Karen says the words "just humour me" come in handy. My vet didn't think we needed to do either test until she got to 10 units (which she never did). A lot of vets don't think it's important to do the IAA - but those same vets have never dealt with an IAA cat. Just mentioning you might have to insist on it because we've had an annoying number decide it wasn't important and drop it from the list. It's so much cheaper to test at the same time. And we've had some cats be just IAA and not acromegaly, so it's worth knowing what you are dealing with.

I would get the test for acromegaly and IAA done first, then the Cushings test if the above are negative. They are more commonly seen here. Cushings is also something that can be tested locally.

A comment on dosing. If you are over 5 units total dose, you should be increasing by 0.5 units at a time, as long as there isn't any green in the picture. Glad you increased to 7.5 this morning. Also, when dealing with insulin resistance of some form, it's best not to linger on a dose. If you are seeing only very high blues or above, don't hold longer than 6 cycles, as long as you are getting at least the preshot test and one other that cycle. Unfortunately with insulin resistance, a dose that looked good until recently can be no longer any good. I called it "the dose going stale". Don't worry about the size of the dose you are giving, the important numbers are the blood sugars.

How is Ramone acting/feeling these days?

Thank you @Karen&Rocket !! Rocket is Beautiful!!! Its been a journey and @Wendy&Neko has been help me significantly over this past month.

Okay - so I'm going to INSIST on getting a IGF-1 test and have the IAA test be included. I find it funny how some vets resist it for so long! Its our money we are spending... Oh well. My vet is good and she will help me get the tests done. We are just about at a year of his diagnosis and I want some answers. I was glad to see the past month that he was at least responding to the insulin ... but it was short lived.

And thank you Wendy on the dosing, "the dose going stale" could very well apply to our scenario.... I'll see how the 7.5 units goes over next day. I can no problem get a test done in each cycle to see what might be going on.

Ramone these days - he's just the sweetest boy. He's pretty active ( more active than his brother ) Will always play when I instigate something. He gets the "zoomies" after his potty breaks. He's always grooming himself or his brother and also fighting with him too. Just like 2 brothers lol. And loves to lay in the sun on our patio when its a nice day.

He is definitely urinating more - and slightly more hungry since April 19th. He has been having some very small dry stools... any recommendations there? My other boy Tony, has had a lot of "plumbing" issues in the past, so I have this powdered Cisapride medicine that I give him every night and lactulose - IS that OK to give Ramone a bit ? I haven't changed food or anything. Or is there a holistic recommendation, I see a lot about slippery elm bark ? Pumpkin is a no go, I've tried that.

Do you recall how long it took to get results back once blood tests were submitted ?

 

[Wendy&Neko]

I find it funny how some vets resist it for so long

I think they think they know better and we are wasting our money. Both my vet and the clinic owner (who called them the "exotic tests") were very surprised when both came back positive.

It's great to hear Ramone is feeling good and pretty active. That's a good sign. As for the dry stools, are you adding water to his food to make it a bit more soupy? Have you tried babyfood squash? Some cats will eat that but not pumpkin. Cisapride and lactulose are a bit heavy duty meds at this point. You could try a little bit of Restoralax, but you have to make sure he's getting lots of water too. Maybe when he's more regulated and not peeing as much, the dryness will be less. You could try SEB, you just have to give it a couple hours apart from any other oral meds. I used to give the odd bit of butter or virgin coconut oil.

Do you recall how long it took to get results back once blood tests were submitted ?

The IGF-1 test is just done once a week and is a two day test, so I think it has to get there by Tuesday (?) or it won't get run until the following week. Typically the results come end of week. You have to factor in time for the blood to travel to Michigan as well.

 

[Jerica&ramone]

I think they think they know better and we are wasting our money. Both my vet and the clinic owner (who called them the "exotic tests") were very surprised when both came back positive.

It's great to hear Ramone is feeling good and pretty active. That's a good sign. As for the dry stools, are you adding water to his food to make it a bit more soupy? Have you tried babyfood squash? Some cats will eat that but not pumpkin. Cisapride and lactulose are a bit heavy duty meds at this point. You could try a little bit of Restoralax, but you have to make sure he's getting lots of water too. Maybe when he's more regulated and not peeing as much, the dryness will be less. You could try SEB, you just have to give it a couple hours apart from any other oral meds. I used to give the odd bit of butter or virgin coconut oil.


The IGF-1 test is just done once a week and is a two day test, so I think it has to get there by Tuesday (?) or it won't get run until the following week. Typically the results come end of week. You have to factor in time for the blood to travel to Michigan as well.

Exotic tests - interesting! lol . Well at this point with the money and time I've put in trying to "regulate" him, spending whatever it might be to get these test will be worth it. At least then we will know what we are potentially dealing with or NOT dealing with and know how to manage it better.

I'm going to try the baby food squash. I've not tried that yet. I do have restoralax too but I want to just keep it as natural as possible for him. I do add water to his food each time , its crazy that once I started doing that (when I found out about this page and the FB group) he barely drinks for his water dish now - and get all his water from the food now. I'll maybe up the water a little bit too in his food just to make sure he is staying hydrated.

Going to reach out to my vet and get him booked in to do the blood work - thanks for the encouragement, my hubby is NOT for getting these tests but this isn't the first time on these forums & FB groups that I've inquired about it and that have also asked me if I've got him tested. With all the data I've gathered since December when I started testing him, it's time to find out once and for all.

Stay tuned.... and pray for better #'s with this dose!

 

[Cleocatra]

Welcome to the acro club. Cleo is also exhibiting insulin resistance for past 8 months. We're up to 7U 2x day now and I've decided to start ramping up every 3 days or so until I can see the BG#s drop. Poor Cleo has neuropathy in her hinds legs and is causing litter box/carpeting messes almost every morning when I let her out of her room. Luckily I have a carpet scrubber. But I'm afraid if her hinds legs give out her days will be numbered. And it's a caused by high blood sugar that I can't reduce. My vet will let me ramp up every 5 days but I think I will reduce to every 3 days. I just can't bear seeing all these 500's every day.

 

[BubbasMama]

Bubba is up to 6 units of Lantis a day. Think about having him tested. What is the cost of the blood tests? I've already blown out my $3,000 pet insurance limit on his diabetes. He is 16 going on 17, so I would never put him through surgery or radiation at this point. Having his teeth done a few years back was super traumatic for him and the pain meds made his so sick. His back legs are getting weaker and he has this wheezy rubbling thing going on with his breathing especially when he is resting, so I want to get his BG down asap. Is that even possible with an acro cat? I appreciate all the information here. Its been wonderful. Obviously I'm still learning. Sending his spredsheet to this vet tomorrow. Doing another curve today. Any thoughts?

 

[Cleocatra]

Bubba is up to 6 units of Lantis a day. Think about having him tested. What is the cost of the blood tests? I've already blown out my $3,000 pet insurance limit on his diabetes. He is 16 going on 17, so I would never put him through surgery or radiation at this point. Having his teeth done a few years back was super traumatic for him and the pain meds made his so sick. His back legs are getting weaker and he has this wheezy rubbling thing going on with his breathing especially when he is resting, so I want to get his BG down asap. Is that even possible with an acro cat? I appreciate all the information here. Its been wonderful. Obviously I'm still learning. Sending his spredsheet to this vet tomorrow. Doing another curve today. Any thoughts?

yeah looks like Cleo- 400-500 in am, followed by a 100+ nadir, then right back up to hi #'s in pm. We had a complete blood panel + ultrasound on her GI tract. We were somewhere around $2000 for all tests & consult. Cleo has neuropathy in hind legs too. Very hungry. She's on cabergoline, not sure it's doing much to reduce the growth factor emission, but her ravenous hunger has decreased somewhat. My vet has been very slow to let me ramp up the dosing, but after 9 months of high #'s and very slow dose increase, I'm going to ramp it up by 1U every 4 days. I know she fears that the cats body needs more time to "get used to the dose" but the BG#'s are not responding so I don't think she's at much of risk of going hypo. Some cats go into crazy high doses, like 15, 20, 30, even 50 units 2x day. Maybe that will be your only course of action. I agree, the radiation treatment is crazy expensive ($~10,000) and can cause bad side effects, and then it might not be a complete cure. Cleo is only 10+ years and we make sure she has a great quality of life and gets tons of TLC but the radiation treatment seems to be over the top. From what I've read on the net, high dosing insulin is usually the way most people go with this condition.

 

[Karen&Rocket]

Bubba is up to 6 units of Lantis a day. Think about having him tested. What is the cost of the blood tests? I've already blown out my $3,000 pet insurance limit on his diabetes. He is 16 going on 17, so I would never put him through surgery or radiation at this point. Having his teeth done a few years back was super traumatic for him and the pain meds made his so sick. His back legs are getting weaker and he has this wheezy rubbling thing going on with his breathing especially when he is resting, so I want to get his BG down asap. Is that even possible with an acro cat? I appreciate all the information here. Its been wonderful. Obviously I'm still learning. Sending his spredsheet to this vet tomorrow. Doing another curve today. Any thoughts?

I would definitely recommend starting a separate thread for Bubba (grey kitties are the best btw!) so that you get some more eyes on him. One thing I noticed is you raised his dose very quickly - the recommendation around here is usually to raise .25 units at first, .5 when you get to 5U, and 1 unit when the base dose is 10 or more. But that may not be an issue with Bubba at this point. I'd rather have someone like @Wendy&Neko take a look at your chart. But I just wanted to chime in and say that the IGF-1 test (which indicates acromegaly) was around $200 for me (I’m in California). The same lab tests for IAA (insulin resistance), and I think it’s fairly cheap to add that on.

 

[Wendy&Neko]

Like Karen, I recommend starting a different post for Bubba. Besides raising his dose by larger increases that we do, you did so without enough test data to know how low the dose was taking him. Plus you are holding onto doses way longer than you should. If you start your own post, we can give you more help.

 

[BubbasMama]

I would definitely recommend starting a separate thread for Bubba (grey kitties are the best btw!) so that you get some more eyes on him. One thing I noticed is you raised his dose very quickly - the recommendation around here is usually to raise .25 units at first, .5 when you get to 5U, and 1 unit when the base dose is 10 or more. But that may not be an issue with Bubba at this point. I'd rather have someone like @Wendy&Neko take a look at your chart. But I just wanted to chime in and say that the IGF-1 test (which indicates acromegaly) was around $200 for me (I’m in California). The same lab tests for IAA (insulin resistance), and I think it’s fairly cheap to add that on.

Thank You for your response- I'll start another thread