? 12/4 Spot amps364,+4.5-206,+7.4-250, at cycle 7 of 6.5unit dose

[Darnell & Sprocket (GA)]

Where’s the dancing cat?!!!
Spot FINALLY got in lower yellow & is staying 4 hrs already!!!
7th cycle on 6.5units.
Should she go to 6.75units or 7units?
He is still bouncing to black but getting lower in yellow. i know Annette is getting 2 tests a cycle mostly but they work alot so its not always possible to do.
Tell me how it usually works if this is insulin resistance to break it please?
This is new to me.

we are trying to figure out how to get him tested for acro & IAA.
Vets in her area seem to be very old school.
Thanks for any help.


https://docs.google.com/spreadsheets/d/1SF96F9mHVKPW1YyyLa0PcMDU8rbxxDLtMRfy_IGVmBc/edit?usp=sharing

 

[Wendy&Neko]

Great to see that progress! Ignore the bouncing, tell Annette is the low points that count. Some cats bounce for years. It took Neko a year to stop bouncing to reds. I was "happy" when she only bounced to pinks. Spot has been in high numbers for quite a while now, it's not surprising and expected it'll take a while until he eases off the bounces.

7 units is next. At this point (over 5 units total dose), you save those 0.25 unit changes for tweaking a dose already seeing some high green or low blue.

Tell me how it usually works if this is insulin resistance to break it please?

I wish I could tell you - ECID. It won't be sudden, but I've seen a cat go from yellows and pinks to greens and blues, like a light turned on. That's not common, typically you'll start seeing better nadirs gradually. I have also seen cats with resistance be stuck in nothing but yellows and blues with very rare pink, for ages, until the right dose is hit. Remember, insulin is a hormone not a drug. You just have to keep increasing until you get to where the change will happen.

Does Annette think giving her vets papers will help? We got lots of published journal articles that might be helpful. One link in post 7 is this thread is a good one: Acromegaly - the basics It's harder to find articles on IAA, as it's little studied. But if you are getting the acro test, the IAA is a cheap add on if done at the same time.

 

[Darnell & Sprocket (GA)]

Does Annette think giving her vets papers will help?

Her first vet had no clue about lantus & would only give the insulin for dogs & refused to treat her cat if she home tested.
2nd vet is more open but still is clueless as he wouldn’t give a script for lantus pen because HE doesn’t know how to use the pen for a cat.
DCIN was going to have someone call him to try to talk to him but that person had a life crisis & hasn’t been able to call yet.
I told her to find out how much the specialist charges as it may not be too much. Yet that specialist might know more about diabetic care.

 

[Wendy&Neko]

If she can get into see an internal medicine vet, there is a good chance they will be a much better fit. And if they don't, more willing to learn.

 

[Darnell & Sprocket (GA)]

If she can get into see an internal medicine vet, there is a good chance they will be a much better fit. And if they don't, more willing to learn.

Trying to help her find one. She is in a dead zone.
Its almost 2 hrs to an ER hospital. with do many farms i would think there would be more veterinarians.

 

[Darnell & Sprocket (GA)]

If she can get into see an internal medicine vet, there is a good chance they will be a much better fit. And if they don't, more willing to learn.

so how do we know it’s insulin resistance or we passed the right dose?
I have seen many posts in past say the right dose was missed.
He seemed flattered in pinks & some yellows at 2 units. Could his body just need more time to adjust?

 

[Wendy&Neko]

so how do we know it’s insulin resistance or we passed the right dose?

You ask and answer a few basic questions.

Is she holding the dose long enough to build the depot? - Yes. Is she testing enough to catch any lows? - Yes. Is she increasing in safe amounts? - Yes. Did she start at a low enough dose? - Yes. Therefore, she has not bypassed the right dose. Has he reached a good dose yet? - No. Very seldom is the right dose missed, and not if following the dosing methods as written. Following the dosing methods will get her to a good dose.

His body doesn't need more time to adjust, his body needs more insulin. There is some insulin resistance at play, TBD what. Holding the dose too long just makes it worse.

 

[Bron and Sheba (GA)]

I agree with everything Wendy has said in post 7

 

[Darnell & Sprocket (GA)]

I agree with everything Wendy has said in post 7

@Wendy&Neko & @Bron and Sheba (GA)

any ideas on how to explain this group & the protocols so a vet doesn’t think its just not legit?
I never know
How to explain it so they take it seriously.

 

[Wendy&Neko]

Maybe give the copy of this peer reviewed and published paper: Management of Diabetic Cats with Long-acting Insulin and/or this one: Journal of Feline Medicine and Surgery Then give the vet a copy of the spreadsheet. The second paper also mentions the German Diabetes Katzen forum that did the initial research, showing that on line forums can do good work.

The vet should have heard of this work. Even in 2011 when I started the FD journey, the vet clinic owner who insisted on using Caninsulin, still knew about the U of Queensland research. It was a locum vet at that same clinic who got me onto Lantus early 2012, and pointed me to FDMB and said "do what they say for dosing". Of course, I was already lurking here.

 

[Darnell & Sprocket (GA)]

Maybe give the copy of this peer reviewed and published paper: Management of Diabetic Cats with Long-acting Insulin and/or this one: Journal of Feline Medicine and Surgery Then give the vet a copy of the spreadsheet. The second paper also mentions the German Diabetes Katzen forum that did the initial research, showing that on line forums can do good work.

The vet should have heard of this work. Even in 2011 when I started the FD journey, the vet clinic owner who insisted on using Caninsulin, still knew about the U of Queensland research. It was a locum vet at that same clinic who got me onto Lantus early 2012, and pointed me to FDMB and said "do what they say for dosing". Of course, I was already lurking here.

I will keep & pass those articles on. thanks.
one other question we got.
Of insulin resistance, when it breaks, how does it happen?
And do you know of a cat that had insulin resistance & it broke? Do you have a spreadsheet to look at?

this question is from Annette,

If they’re insulin resistant, does that mean that there’s a problem that’s keeping it from lowering

 

[Wendy&Neko]

You need to know what causes the insulin resistance first, and there can also be multiple conditions going on at the same time. For example, Neko had both acromegaly and IAA. Possibly also some glucose toxicity. And depending on the cause(s), different treatments. Depending on which condition causes insulin resistance, there could be multiple treatment types, all resulting in different responses. There is no one spreadsheet I can point you to when I don't know what I'm looking at. And even then ECID. Cats needing higher doses even more different.

What sort of thing is Annette looking for in a spreadsheet?

If they’re insulin resistant, does that mean that there’s a problem that’s keeping it from lowering

Insulin resistance means there is a decreased response to insulin, for some reason. That would result is blood sugar number not going down and more insulin needed to have an effect.

 

[Darnell & Sprocket (GA)]

You need to know what causes the insulin resistance first, and there can also be multiple conditions going on at the same time. For example, Neko had both acromegaly and IAA. Possibly also some glucose toxicity. And depending on the cause(s), different treatments. Depending on which condition causes insulin resistance, there could be multiple treatment types, all resulting in different responses. There is no one spreadsheet I can point you to when I don't know what I'm looking at. And even then ECID. Cats needing higher doses even more different.

What sort of thing is Annette looking for in a spreadsheet?


Insulin resistance means there is a decreased response to insulin, for some reason. That would result is blood sugar number not going down and more insulin needed to have an effect.

we are not sure how to reply to that as we just want him in safe numbers. 100s with nadir & back up after. Normal drops & back up.

I know I want to know if insulin resistance what happens when it breaks? Does it go in 100s suddenly or gradually goes lower? How do we know its broken?
And why dont vets know about this?
Talking to the vet offices in Annette’s area in North Carolina last week, they acted like they dont know anything about it & try to pass you to a “specialist” & I went to two specialists with Sprocket & they told me all the info I already learned in this group.
I wish they would take the initiative to educate themselves more to help their patients.
It kinda pisses me off that more vets dont do this. I shouldn’t have to tell a vet to educate themselves.

 

[Wendy&Neko]

Does it go in 100s suddenly or gradually goes lower? How do we know its broken?

We know insulin resistance is broken when less insulin is needed. There is no one answer to how blood sugar goes lower when resistance is broken. As I said above, it depends on the causes of the resistance, if there is treatment and what kind. As long as she is testing enough, kitty should be safe. We also provide help and guidance once we know more (type of resistance and what type of treatment if done).

Vets have to look after many different kinds of animals, and many types of conditions for each one. North Carolina State University has a highly recommended vet school if she's anywhere near that. Often vet schools have reasonable treatment prices and lots of specialists on staff. At one point, Neko's vet "fired us" because she got just a little too complicated. I was glad she did as the internal medicine vet was very helpful in balancing all her multiple conditions.