Stoney AMPS 243 - New thread

Let’s just stay with the 7.5 dose for now as long as you can monitor. He may earn a reduction back down to 7 or we may end up tweaking the dose. I am interested to see how it goes.
 
I was just checking in on Stoney. He was doing so well and now I see a lot of pinks and yellows. I am sorry about that. You did right to increase. Did you get his results back?
 
Suzanne & Darcy said:
I was just checking in on Stoney. He was doing so well and now I see a lot of pinks and yellows. I am sorry about that. You did right to increase. Did you get his results back?
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He was doing so well! Then started to come back up. No results yet. We both forgot to call the vet this week, I have been so slammed with work with people out of office for the holidays. This week should be better regulated and I will call on Monday. :(
 

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Am I crazy? I am reading other people’s results on the IAA/Acro thread and theirs are lower than Stoney’s but they have acro. Was my vet mistaken?
 
Hi Suzanne! Long time no see. Stoney is doing great at 8.5u. His numbers are looking much better. Still some in the 200’s, but comparatively, he’s looking great. We have been at 8.5u for 10 cycles (10 days) now. Is it safe to keep him at this dose? Hope you’ve been well. Thanks!!
 
His numbers are really wacky! But he is seeing some green on the 8.5 units dose. Because of that, if I increased, I would not go up more than 8.75. Anything else going on that might explain the wild numbers.
 
Suzanne & Darcy said:
His numbers are really wacky! But he is seeing some green on the 8.5 units dose. Because of that, if I increased, I would not go up more than 8.75. Anything else going on that might explain the wild numbers.
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I am so used to increasing by half units now that it didn’t even cross my mind to go up to 8.75u. We’ll do that tomorrow! His numbers are wonky, but better!! Less pinks! We are having some pinks tonight, so we’ll definitely increase in the morning. 🙂
 
McKenzie & Stoney said:
Am I crazy? I am reading other people’s results on the IAA/Acro thread and theirs are lower than Stoney’s but they have acro. Was my vet mistaken?
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Let’s ask @Wendy&Neko what she thinks about this. I was puzzled by the results because he really seems to have a high dose condition when you look at BG numbers/doses, etc. I know that sometimes results can be inaccurate if the tests are done within three months of diagnosis, but I thought Stoney was far enough out that he could get an accurate test result.
 
McKenzie & Stoney said:
I am so used to increasing by half units now that it didn’t even cross my mind to go up to 8.75u. We’ll do that tomorrow! His numbers are wonky, but better!! Less pinks! We are having some pinks tonight, so we’ll definitely increase in the morning. 🙂
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I know. I was thinking 9 units too, but the greens made me hesitate to just say to go to 9 units. Maybe he just needs some fine tuning for now.
 
Suzanne & Darcy said:
Let’s ask @Wendy&Neko what she thinks about this. I was puzzled by the results because he really seems to have a high dose condition when you look at BG numbers/doses, etc. I know that sometimes results can be inaccurate if the tests are done within three months of diagnosis, but I thought Stoney was far enough out that he could get an accurate test result.
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His testing was done about 2.5 months after official diagnosis of diabetes. Idk if we can afford another. The vet charged us more than I’d like to even speak out loud! I am curious about what Wendy has to say! Now I’m worried 😟
 
MSU changed how they do the assay for IGF-1 a couple years ago. MSU reference range changed for IGF-1 (and paper). For cats tested before that, positive was over 92, now it's over 916. And now uses the same measurements as those in Europe too, though their numbers are a bit different, at least it's the close.

The latest 2025 iCatCare consensus guidelines on the diagnosis and management of diabetes mellitus in cats recommends taking blood for IGF-1 test at least 6-8 weeks after insulin therapy starts. I've seen one study from England that says 1/3 of cats tested less than 73 days after initiating insulin support tested false negative. 9/24 to 12/18 is 11 weeks or 77 days. Not sure what day Stoney started insulin.
 
Wendy&Neko said:
MSU changed how they do the assay for IGF-1 a couple years ago. MSU reference range changed for IGF-1 (and paper). For cats tested before that, positive was over 92, now it's over 916. And now uses the same measurements as those in Europe too, though their numbers are a bit different, at least it's the close.

The latest 2025 iCatCare consensus guidelines on the diagnosis and management of diabetes mellitus in cats recommends taking blood for IGF-1 test at least 6-8 weeks after insulin therapy starts. I've seen one study from England that says 1/3 of cats tested less than 73 days after initiating insulin support tested false negative. 9/24 to 12/18 is 11 weeks or 77 days. Not sure what day Stoney started insulin.
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Stoney started insulin on 9/24/2025. He was then in DKA from 9/25-9/28, and was getting a constant flow of insulin in the emergency room. So, it looks like we are good with the date range. Thank you for this info Wendy!
 
This is from the Michigan State University Veterinary Diagnostic Laboratory:

In cats with diabetes mellitus, IGF-1 concentration in excess of 1,000 ng/mL have been associated with a high probability of hypersomatotropism. IGF-1 results of 800 – 1000 ng/mL have been considered equivocal for the presence of hypersomatotropism in some studies, while others consider this gray zone to extend lower to 500 – 1000 ng/mL in the presence of a compatible clinical presentation. Cats evaluated early in course of diagnosis and treatment of diabetes mellitus may have lowered IGF-1 concentration due to impairment of hepatic IGF-1 production in insulin deficient states. Repeat analysis of IGF-1 in 2 to 6 months may be warranted if suspicion for hypersomatotropism remains in cats with equivocal results.
 
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