Spot is surfing finally!!! 177

Normally I think of surfing as doing the greens, but a couple hours of upper blues is good progress for Spot. The TR guidelines for seeing nadirs under 200 is to hold the dose for 6-10 cycles. Increases between 5 and 10 units are by 0.5 units, unless you are just tweaking a mostly good dose to sneak the green nadirs down a bit. So up by 0.5 units. Over 10 units, increases are generally by 1.0 units at a time. Think of the increase as a percent of the total dose, so around 10-15% of the total dose.

Blues don't mean resistance is broken, but is a good sign of progress. Spot may in fact have a couple types of resistance going a this point. The first is glucose toxicity, just from his body spending so much time in higher numbers that his body is used to those higher numbers. Generally you need to see greens to break through glucose toxicity. The other thing(s) causing insulin resistance is TBD without tests.
 
Sad. :( 11.5 years ago when I was trying to get my long black and white kitty tested, some of this vet's comments were "what was known". That you should get to 2 units per kg before testing (though I had also seen 1.5) and that the condition was rare. Then in 2015 the paper from the Royal Vet Clinic research came out that shattered all that. I suspect this vet is of an age where he was shown the slide in school "this is acro, you won't ever see it". On the up side, he does seem to be willing to be convinced otherwise. FYI, weight in kg times 2 would be 11 units, the magic two times when testing should be done by the old standard. The 2015 paper found acros on as low as 1 unit. If Annette thinks it worthwhile, she could give him that paper.

Other things, the vet said he's not gaining weight, but in fact Spot is now gaining weight now after an initial loss. Also, the vet detected organomegaly (enlarged organs), also a hallmark of acromegaly.

I would ask the vet to research the real cost of the acro/IAA testing. Costs from Michigan State University are $68+$21 so total of $89. There is the cost of blood draw and shipping too. $400 does seem a stretch. Why do I keep harping on testing? With knowledge comes power, and the ability to treat. The earlier you can treat acromegaly, the less the side effects. Cabergoline is a reasonably priced medication.
 
Other things, the vet said he's not gaining weight, but in fact Spot is now gaining weight now after an initial loss. Also, the vet detected organomegaly (enlarged organs), also a hallmark of acromegaly.

I want to reply to this part first before I forgot. I reread the pages again to see if I missed that.
To me it reads that there were no masses or no free fluids & no organomegaly detected.


Also her weight on the cat was just her weighing herself on scale then picking up the cat so it may not be completely accurate. We just did that to get an idea of what he weighed.
I know his writing is confusing & so much info. Am I wrong?

And I am not aware of that article your talking about. Do you have a copy of that?
 
Article is post #7 in this thread: https://www.felinediabetes.com/FDMB/threads/acromegaly-the-basics-hope-you-will-read-n-like.45324/

I can see how I might have misread the organomegaly comment.

March 2023 - 13.7 lbs before diabetes dx
June 2023 - 11.2 lbs, lost weight from previous appointment to time of diabetes dx
Dec 21/2023 - 12 lbs, started to put it back on

Note: only 35% of cats diagnosed with acromegaly show physical signs at the time of diagnosis. To me, the dose tells the story.
 
Article is post #7 in this thread: https://www.felinediabetes.com/FDMB/threads/acromegaly-the-basics-hope-you-will-read-n-like.45324/

I can see how I might have misread the organomegaly comment.

March 2023 - 13.7 lbs before diabetes dx
June 2023 - 11.2 lbs, lost weight from previous appointment to time of diabetes dx
Dec 21/2023 - 12 lbs, started to put it back on

Note: only 35% of cats diagnosed with acromegaly show physical signs at the time of diagnosis. To me, the dose tells the story.

thanks for the article, will read soon.

happy that you misread that but good info to know too.
I didn’t realize the weight loss part. I never saw the old records.

I pray he doesn’t have Acro because they probably couldnt afford that treatment.
I dont know I could handle it. Just the thought of 10 units to give a cat makes me cringe already so I cant imagine the higher numbers.
 
Cabergoline is a relatively cheap drug. It's the current treatment that most here are using these days. Most of the time it means a reduction in insulin dose, but more important some of the acro side effects. We've had about 4 cats go OTJ on cabergoline.
 
Glad to hear Leo is improving
I post for a friend that isnt good with computers & websites.
My diabetic passed on in 2019. I have two other special needs kitties now that still keep me on my toes.

Thanks for explaining that. I figured you had more than one kitty. Almost correct. What a sweetheart to help your friend! ♡♡♡
 
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