What to do for Ruckus

[Zorrain]

Hey all my cat people, I hope everyone having a good day. Were trying think of the next best steps for Ruckus and if I should test him for Acromegaly and IAA. It seems like I keep increasing the insulin but no change or he get higher. I'm not sure where to go now, we have switched his food, raw, different pates, water fountain, different insulin, probiotics, pain medication and antinasual pills, but still no results. I'm so confused how he went into remission in summer off 1 unit of Lantus insulin when he first became diabetic. When he got his second ear infection he went right off the rocker, he was given surolan ear drops and antibiotics. I keep thinking maybe the ear drops changed him because there's a steroids in them, idk just a thought. I read that Acromegaly cats are very large and big heads and paws but I don't see that in Ruckus. I also thought maybe his teeth, the vet said he had gingivitis before was diabetic. I got them looked at by another vet and she thought they were fine but red on the gums. Should I try look into his teeth anymore, I added some photos of them. I just can't figure out where I'm going wrong... what am I missing. Help

His spreadsheet
*2020 there's info in comment box far right

http://docs.googlhttpse.com/spreads...0btZgr_yDdFqI-FioQ2dNzuwmw/edit#gid=254223609

 

[Zorrain]

@Wendy&Neko

 

[Wendy&Neko]

The majority of cats with acromegaly do not have physical signs on diagnosis, I've read it's something like 35% that do. Neko's only sign was her dose and her insatiable hunger. Later on I found out that her one teary eye was from soft tissue growth blocking her tear duct. She was part Maine Coon, but did get any bigger with acromegaly, had hardly any of the symptoms until very late on.

His gums do look inflamed, has he ever had a dental? Infection/inflammation are a very common cause of a cat going out of remission. Given that Ruckus is at 6 units and mostly all yellow from what I can see with the minimal testing, I would get the tests done for acromegaly (IGF-1 test) and IAA. If Ruckus were to test positive for acromegaly, he would not be the first cat we have seen go into remission, and come back and test positive for acromegaly. The pituitary tumour causing acromegaly can pulse up and down.

 

[Zorrain]

The majority of cats with acromegaly do not have physical signs on diagnosis, I've read it's something like 35% that do. Neko's only sign was her dose and her insatiable hunger. Later on I found out that her one teary eye was from soft tissue growth blocking her tear duct. She was part Maine Coon, but did get any bigger with acromegaly, had hardly any of the symptoms until very late on.

His gums do look inflamed, has he ever had a dental? Infection/inflammation are a very common cause of a cat going out of remission. Given that Ruckus is at 6 units and mostly all yellow from what I can see with the minimal testing, I would get the tests done for acromegaly (IGF-1 test) and IAA. If Ruckus were to test positive for acromegaly, he would not be the first cat we have seen go into remission, and come back and test positive for acromegaly. The pituitary tumour causing acromegaly can pulse up and down.

How much do you think in Canada those tests be.

 

[Zorrain]

Also should I increase the insulin?

 

[Wendy&Neko]

How much do you think in Canada those tests be.

There is a shipping cost that is the expensive part. You live closer to Michigan State University than I do and I got the tests years ago. I can't give an answer, but the vet should be able to estimate it.

Also should I increase the insulin?

Not without knowing how low this dose is taking him. Can you do a curve or at least get some more mid cycle tests in so we can answer that question? Increases, if you need them, would be by 0.5 units at a time now with his size of dose.

 

[Zorrain]

I t

There is a shipping cost that is the expensive part. You live closer to Michigan State University than I do and I got the tests years ago. I can't give an answer, but the vet should be able to estimate it.

Not without knowing how low this dose is taking him. Can you do a curve or at least get some more mid cycle tests in so we can answer that question? Increases, if you need them, would be by 0.5 units at a time now with his size of dose.

I thought I was doing a good job getting tests in during the day. Levemir lowest point +8 +10 I thought. So should I do a curve tomorrow, these strips are like gold to me, I have like 30 left. I gotta call one drop tomorrow see how much be to sign up.

 

[Wendy&Neko]

Nadirs can and do change and ideally you'd try to get one test every day. Neko's Levemir nadirs varied from +5 to +15, though most often +9 to +12. To start, get a +4 on the curve - and then every couple hours after that. Onset isn't typically until +4 on Lev, so no need to test earlier than that unless the AMPS is low and you think he's still going lower.

 

[Suzanne & Darcy]

I don't think you should go to that cat-only vet because their lab tests were too expensive last time -- way out of bounds. I hope that other vet who has helped you in the past can do it for you for a lesser price. I understand that you can either get his teeth cleaned right now or you can do the testing -- not both!

 

[Suzanne & Darcy]

Oh man... he is really FLAT today +5 256, +8 256

 

[Zorrain]

Oh man... he is really FLAT today +5 256, +8 256

Yeah very odd, I got stuck traffic so was a bit late but I got one. Going do 6:30 then 8:30

 

[Zorrain]

Nadirs can and do change and ideally you'd try to get one test every day. Neko's Levemir nadirs varied from +5 to +15, though most often +9 to +12. To start, get a +4 on the curve - and then every couple hours after that. Onset isn't typically until +4 on Lev, so no need to test earlier than that unless the AMPS is low and you think he's still going lower.

What do you take of yesterday for mr. ruckus?

 

[Wendy&Neko]

No night time test? He looks pretty flat and I'd go up to 6.5 units.