01/13 Eddie AMPS 209 +4.5 261 +8 239 PMPS 308 +9 324

Nice start. I hope Eddie slides down.
The thing is, with Levemir, he usually goes in the opposite direction of down in the first while, which makes it hard to predict because I can't rely on "usually" given the potential of his SRT response. Anyway, I keep an eye on him...
 
The fact that he's only up a little bit is a good sign for this cycle. :) (and has nothing to do with SRT but rather cats on Levemir).
 
The fact that he's only up a little bit is a good sign for this cycle. :) (and has nothing to do with SRT but rather cats on Levemir).
When I talk about SRT and it's potential I am talking about the fact that one of the side effects of radiation is demyelination, which is why the radiation oncologist wrote me to provide a rationale for Eddie's higher than previous insulin dose. She says, "The recommendation to maintain the steroid dosage until at least 3 months is based on the probability of side effects to the normal brain tissue that receives radiation. For Eddie, I think we would want to keep this dose at least until 4 months. It is difficult as I know that it interferes with insulin, etc, but the side effects from demyelination are severe as well."

In her conversation she also makes the point that SRT can influence GH secretion and therefore reduce insulin resistance. If that happens, Eddie might not need the same dose of insulin so the point is to treat the side effects of radiation and balance that with DM but recognize the variability when it is associated with acromegaly and the complications or results of interventionist treatments. That's what I mean by SRT involvement.

Now if only I could follow Levemir's logic... :)
 
When I asked about the higher levels of steroid, I was curious because Eddie is the only of the many cats I've seen here get SRT that needed to have any steroid for more than a week or two for effects of SRT. Just wondering why Eddie? She also said 4 months vs 3 months "for Eddie". What is it about him? Have yet to see another SRT kitty have demyelination. I'm curious and want to learn more. Is it because he's also had hypophysectomy?

Check out this paper, section 3.6, for a list of post SRT effect requiring steroids, in a study of 53 cats. The max length of prednisolone dosing was 6 weeks.
 
When I asked about the higher levels of steroid, I was curious because Eddie is the only of the many cats I've seen here get SRT that needed to have any steroid for more than a week or two for effects of SRT. Just wondering why Eddie? She also said 4 months vs 3 months "for Eddie". What is it about him? Have yet to see another SRT kitty have demyelination. I'm curious and want to learn more. Is it because he's also had hypophysectomy?

Check out this paper, section 3.6, for a list of post SRT effect requiring steroids, in a study of 53 cats. The max length of prednisolone dosing was 6 weeks.
The question of Why Eddie I think has to do with the fact he's had two SRT treatments in a relatively small window of time. One in 2021 (March 3 fractions) and now the second in 2022 (Oct 3 fractions). Eddie has had hypophysectomy but it was also determined at the time surgery could remove only 60% of the tumour and at the time it was determined Eddie's acromegaly tumour consisted of "two different cell populations, they are mixed into one mass rather than forming two discrete adenomas (double adenoma)." I suspect this situation made it difficult to excise in the first place and then challenging in administering SRT.

So the Why Eddie points to his particular complications. I was reading that "Early-delayed brain effects [can] occur 2 weeks to 3 months after irradiation, and animals present with stupor or neurologic abnormalities that may be similar to those at initial presentation.11 The pathogenesis is thought to be changes in blood-brain barrier permeability and transient demyelination resulting from radiationdamage to oligodendrocytes" ( https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1939-1676.2006.tb00714.x ).

Eddie is holding steady is about all I can say. He's not presenting with what I would say are any abnormalities and is eating, drinking, kittyboxing, etc. as can be expected. He's grumpy only when his BG is high and I'm hoping to see further improvement as we go beyond 10 weeks, which is where we are now.
 
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