06/28 Eddie AMPS 196 +3 158 +6 139 PMPS 331 +2.5 203

Nice AMPS.:cool:

From yesterday:
Jodey&Eddie said:
I have to be away most of the day on Thursday. Would increasing be better tomorrow (I can't this morning) or Friday?
Click to expand...
What has Eddie's pattern been lately on increases. Is there a particular cycle after an increase than he tends to respond? How long is it taking Eddie to break his bounces lately? When do you think he'll do it next - you want to avoid increasing same cycle as bounce break.

The answers are in the spreadsheet. I am trying to help you learn how to see them.
 
Wendy&Neko said:
Nice AMPS.:cool:

From yesterday:

What has Eddie's pattern been lately on increases. Is there a particular cycle after an increase than he tends to respond? How long is it taking Eddie to break his bounces lately? When do you think he'll do it next - you want to avoid increasing same cycle as bounce break.

The answers are in the spreadsheet. I am trying to help you learn how to see them.
Click to expand...
Eddie has been on 11.0u since June 9 and has seen some really good numbers in blues and greens since then. He highest numbers (magenta) are at PMPS, for some reason and he seems to land in the yellow zone (average mid-200s) in the morning. The SS shows the 18th was a significant day; he started and stayed in blue with the exception of yellow @ +11 and PMPS and went back into blue again In fact, the 18th was a banner day and he pretty much stayed in the blue zone the next day with the exception of PMPS and then he went green! It's kind of hard to see a pattern but I do know that 11.0u has been the most effective yet. When he bounces it seems it's about 2.5 days to recalibrate and go back into blues and greens. Like look at the 26th! Yesterday he was in yellows and a little higher but he was at the vet getting a blood panel and his nails trimmed. So, I was surprised that he didn't go stratospheric after that and today we started in blue and are still in it @ +6.

This is also the second day in a row that he's gone outside into the catio and spent quite some time there. When I was getting the blood panel done (it's been sent out; results to follow) I actually spoke with the IM vet for 45 minutes! I brought my laptop and since they are still not allowing people into the clinic I set it up on the hood of my car and got him to really look at the SS. He admitted to being impressed, finally! He has always recognized that I walk the walk when it comes to Eddie and so he even gave me an article that he had printed out on IAA and we actually talked about it with Eddie. He noted the rise in BG around PMPS and said one way to avoid that was to give an R insulin but he said he did not want to recommend that and he thought Eddie looked great although Eddie now weighs in a 10.2kg. The IM vet said what is impressive is that Eddie's dose is 11u and he seems to be doing well even though he weighs so much. I told him I suspected the tumour was still a bit active (IGF-1: we did not test for that) but it was faltering these days, hence the good and nice blues and greens.

I'm looking forward to the blood panel results as I wanted to discuss Eddie's medication regime (DDAVP, Prednisolone and Levothyroxine) and if any changes are called for.
 
Good to hear you had some time with the IM vet and saw him face to face. I'd love to know the title of the IAA article. There are so few out there, and mostly studies on just tiny cohorts, ie. 5 cats or so. R is definitely a possible tool. It might help flatten him out a bit if given the last half of the cycle. Of course, with IAA the R action can sometimes lead to active cycles after that (ie. night time) and more night time monitoring

I'm kind of hoping the dose increase threat gets Eddie moving.

10.2 kg! What was he before diabetes diagnosis?
 
Wendy&Neko said:
Good to hear you had some time with the IM vet and saw him face to face. I'd love to know the title of the IAA article. There are so few out there, and mostly studies on just tiny cohorts, ie. 5 cats or so. R is definitely a possible tool. It might help flatten him out a bit if given the last half of the cycle. Of course, with IAA the R action can sometimes lead to active cycles after that (ie. night time) and more night time monitoring

I'm kind of hoping the dose increase threat gets Eddie moving.

10.2 kg! What was he before diabetes diagnosis?
Click to expand...
Article has very tiny cohort: N=1 in fact but the point is that he actually went out of his way to print it and give it to me saying "you've probably read everything before 2021". Of course I haven't but this seems such a conciliatory gesture since he wouldn't even talk about IAA previously. The article appears in The Journal of Veterinary Medical Science, "Relationship between anti-insulin antibody production and severe insulin resistance in a diabetic cat" 83 (4): 661-666, 2021. (multiple authors but you should be able to find it if you wanted).
One of the issues raised in the article is the switch from insulin glargine to insulin detemir when they encountered hyperglycemia after 6 days of various treatment including infusion of R and subcutaneous injection of glargine.
The IM discussed R but said given that we are dealing with SRT and acro that he does not recommend going that route.
He just emailed me to send the report (which I'll try and attach). In the email he says,
The main findings are:
Complete blood count: within normal limits
Biochemical profile:
BG normal range! Electrolytes in normal range!
Alb slightly elevated, in my opinion representing mild dehydration. Clinical Pathologist comes up with other explanation, but neither of us thinks there is pathology involved.
Creat 210 is very mild elevation, unclear if this is renal or pre-renal. I think the latter given the elevated Alb.

Over-all I'm impressed how beautiful these values look. Your are doing many things right with Eddie. That allows you to take some more time for yourself by decreasing the monitoring frequency of Eddie.
I recommend a recheck in 4-6 months, and that you contact Genevieve to decide if a CT is required or not.
No medication changes proposed

I love his exclamation marks!! I also think it kind of sweet that he was concerned about my well-being in doing late night TR.
Eddie's got a slightly higher than normal Creatinine and yet the IM says this might be related to lymphopenia, which can be stress-related and any going to a vet is just that for Eddie.

What kind of intrigues me is the Glucose, Serum: Eddie 142 and this was after loading him into the carrier (which he hates), driving to the vet, sitting in the car and being carried into the clinic, having his neck shaved and nails clipped.

What do you see in all this, Wendy? I'm with you on the dose increase threat. I was surprised that the IM vet said he thought Eddie's spreadsheet numbers were really good.
 

Attachments

@Wendy&Neko also, I forgot to add: prior to diagnosis, Eddie weighed about 6kg; when he came back from WSU, he had lost .5kg and since then he's just packed on the pounds (or the kg if we're in Canada). IM vet says while he would like to see Eddie lose some weight, he recognizes the acro-tendency to bigness. Eddie eats only LC food and even then doesn't overeat.
 
You must log in or register to reply here.
Back
Top