5/3 Max AMPS 340 PMPS 179 +4 197

Max & Lori

Max & Lori

Member Since 2021
I’m giving Max today and if he doesn’t give me any good numbers, I’m going back up to the 7 units he was on before. I still don’t have the results of his antibody testing, so I will call this morning to check on that. Going forward, I’m considering giving him two chances on a dose (if it’s above 65) before I drop his dose. Seems like if it’s 70 or very close to it, he can’t handle the reduction. If we have to increase, we will use 0.25 increments going forward. I think that’s playing it safe enough but also letting me get away more to do the things I like doing. I love the warm weather and being outside. Last year FD was so new to me and the anxiety of learning it all, pretty much stole my summer. I hope to get some day trips to the beach very soon. I love my Max, but I need to be able to enjoy my outdoor activities and rest when I need to. That’s for my own health. I have the grandkids tomorrow morning so I will stay where we are for one more day.

Yesterday https://felinediabetes.com/FDMB/thr...292-7-251-9-231-pmps-270.262772/#post-2945067
 
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Suzanne & Darcy said:
So you are saying if he drops below 70 twice (not just once) you will then reduce?
Good morning!
Click to expand...

Good morning! Yes I’m thinking so… if it’s 70 or very close to 70, I may do that. Of course it all depends on the situation… like if he’s earning a whole bunch of reductions close together, or my inability to monitor extra carefully, then I would go back to using 70.
 
Oh and I just want to say that I’ve been officially retired from the world of medicine for one year now! Except not really lol. Max had other plans.:) After my last day at work, one month later he was diagnosed. I’ve learned way more than I ever wanted to know about FD and feline acromegaly in the last year. The blessing in it all was finding FDMB. To those of you who have taught me, encouraged me, and taught me patience through all of the frustrations and tears, I cannot thank you enough. We are still trying to get somewhat regulated, but the main thing is having a happy Max and enjoying him for the wonderful kitty he is. :cat: Thank you!
 
I just received a call from Max’s vet who says that Max is IAA positive. His result was 24%. She said any greater than 20% is considered positive according to MSU. @Wendy&Neko as if I don’t call on you enough lol, would you mind giving me some of your knowledge and experience with this? Anyone else with information experience is welcome also. I really appreciate it. This is completely new to us and I know hardly nothing about it. Thank you so much. I guess this changes what my plans were in my first post. I’d better stick with 70 as my reduction point.
 
Vet said she would call MSU for more info tomorrow. I will also call back tomorrow to get a copy of his test results. Poor Max, it seems like his has everything going against him, but we keep trying.
 
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There's not a whole lot to know/do. Mr kitty had both IAA and acro. IAA is usually resolves on its own after a year. The more you can keep him in lower numbers the better, as it seems for whatever reason the antibodies tend to grab hold in higher numbers and make it harder to come down. That said Max is a bouncy boy so you can only do your best. I don't think you necessarily need to change your 2x under 70 plan if it helps keep him in lower numbers
 
Even though IAA may resolve in a year, not all cats are that predictable. Neko was a bit shorter, Oberon still's at it over a year later. Max is barely in the positive range for IAA. The following is a quote from Sandy who's Black Kitty was the first here to test positive for IAA (but not acro).

A few important things to know and keep in mind-

With IAA injected insulin first gets bound to the antibodies. Any insulin that does not get bound goes toward metabolizing sugars and delivering energy to the cells of Max's body. How much goes to antibodies and how much goes to metabolizing sugars is anybody’s guess and a moving target

IAA can retard the initial rise of available insulin after an injection.

IAA can lead to an increase in the half-life of free (unbound) insulin in circulation because some bound insulin gets released into circulation. The increase in half-life can lead to prolongation of action.

Most importantly when it does break, the release of insulin from the antibodies can happen at inopportune times.

Some things you may or may not notice due to IAA (Neko's was about twice that number), is later nadirs with insulin, both Levemir and R if you were using it. Max doesn't seem unduly late with his onset/nadir though. I've seen a couple of papers on studies of small numbers of cats. One said IAA is uncommon in diabetic cats, the other said it's common. :rolleyes: There are very little papers or research on it, many vets dismiss it's importance. As Melissa said, keeping normal numbers as much as safely possible is good, but given that IAA can break and Max is post SRT, both can mean sudden drops in the need for exogenous insulin. Caution is key. Reductions in dose can come fast and furious when antibodies break, so mostly be aware of the possibility. Don't be afraid to used BCS or skipped doses if it seems reductions are coming fast and furious.
 
Thank you both. I don’t want to ask a dumb question but does the percentage mean anything at all? How do you know when he’s been positive for a year when he was just now diagnosed? Does it typically occur in acro cats because Max was diagnosed with acro July 2021? I hope I’m making sense. I’m kind of overwhelmed with a bunch of stuff. I guess I’m not surprised that he’s positive though given his difficulty getting a good dose for him. It sounds like an impossible thing to try keeping him in lower numbers but then it could break at anytime. He’s already so bouncy and that’s difficult enough. Wow.@Wendy&Neko @FrostD
 
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I've seen some cats with much higher IAA referred to as extreme IAA. IAA can happen spontaneously. We had one cat happily on his way down dose to remission when he got heart disease and subsequently tested positive for IAA (Doodles). The number likely won't change over the course of time he is diabetic. You might find this post interesting: https://felinediabetes.com/FDMB/threads/04-30-black-kitty-iaa-update.118064/ http://: https://felinediabetes.com/FDMB/threads/04-30-black-kitty-iaa-update.118064
 
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https://felinediabetes.com/FDMB/threads/04-30-black-kitty-iaa-update.118064/
For some reason the link wouldn’t open on your post Wendy so I copied and pasted it. Anyway that is very interesting. So bottom line is that we don’t know how long Max has been IAA positive but it really doesn’t matter how long anyway? Is IAA something that could come back at another time after it breaks? Please forgive me with the questions. I’ve just got to understand this.
 
Odd, got the link to work, not sure why it wasn't. I've not seen IAA go away and come back. Not saying it's impossible, there just hasn't been research on it.
 
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