? 04/14 Henry, AMPS 104. Need help with dose.

Hi everyone,

Henry didn't get his shot yesterday morning as he wasn't allowed breakfast for a test he needed done. He was at the Vet all day.

Gave him his usual 1u at PMPS last night, he ate normally. He dropped fast, and although we did not hit hypo levels it took a lot of medium carb food to keep him steady. I probably overreacted but I was scared. The lowest part of Henry's cycles are always +2/+3, never in the 50's and he generally climbs steady from there without needing 14% carb food like he did yesterday.

He was only at 104 this morning so I gave him .1, as I'm at work and can't monitor him. I would've been too stressed out giving 1u and leaving him alone for 9 hours after what happened yesterday.

Any idea on what the heck happened last night? Was it because he missed his morning shot?

Vet thinks he has Addison's Disease, he was there for an ACTH Stim test. He got an injection of Cortrosyn which is a hormone that stimulates the adrenal gland to release steroids. Wondering if this may have had something to do with it.

I don't imagine I'll get much responses here on the Addison's as it's so rare in cats, but if anyone has any thoughts or opinions on the diabetes I'd really appreciate it. I'm feeling very defeated right now. I have no idea how I'm going to handle diabetes and Addison's. I have no idea what to shoot tonight either. I need some sleep, I'm running on empty.

Previous

https://felinediabetes.com/FDMB/thr...03-need-advice-on-dosage.245717/#post-2772988

 

Odd on the Addisons. Did the vet see any symptoms that indicated that conditions? Typically Addisons is a result of over treatment for Cushings. And the ACTH stim test and test for cortisol levels is to test for Cushings. Might want to do some reading. I've attached an article, sorry, not the best print quality, but the pictures are good.

Yes, it's not uncommon to see a strong reaction the cycle after a missed shot - in my case mostly due to fur shots.

 

Hi Wendy,

The specialist that did his ultrasound said his adrenal glands looked abnormal, very small compared to normal. I can't remember exactly what he said, I don't have the report with me. They think some kind of immune reaction destroyed them.

They did a random cortisol test when he was there last week and it came back very low, like almost non existent cortisol, which to my understanding ruled out Cushings as that's when cortisol is in excess. Addison's is the opposite, it's when the adrenal glands aren't producing anything. The Stim test is used to diagnose both diseases. They did the ACTH Stim to see if his cortisol would rise to normal levels after the hormone injection. Baseline blood test, another one an hour after the hormone injection, and then another one an hour later I think?

Thank you for letting me know about the shot, I'll resume his regular 1U tonight so we can get back on track again!

 

Learning something new every day, thanks for that. Keep us posted. This might be the first Addisons kitty I have seen here. I did know an Addisons dog and one of our members here has it herself. If you post over on Feline Health, you might find it any of the kitties on other insulins have had it.

 

Lol right? I did a search of this forum and the Facebook group, and nothing all I can find digging on Google is very in depth scholarly articles.

My Vet has been practicing 20 years, the owner of the clinic has been practicing 35 years and they have never diagnosed a kitty with Addison's. Vet staff is also excited to learn something new They haven't received the test results back yet but if he does have it, he'll need to be on glucocorticoids the rest of his life. Vet doesn't think it'll affect the diabetes but it's a steroid, how could it not? She's consulting with the internal med specialist who did his ultrasound because she has no experience treating this.

I'm stressed out thinking about how I'm going to treat both these issues, and if there's any correlation between the two? Felt like I was just getting a good handle on the diabetes, now I have to master endocrine diseases. We'll see what happens I suppose!

I appreciate all of your help, thank you!

 

I can somewhat sympathize. Back in the day when Neko got her dual acromegaly/IAA diagnosis - the clinic thought they were "exotic" tests and no one had ever dealt with it in a cat. Turns out 1 in 4 diabetic cats has it, so they had seen it, just didn't know it. At least I had a few people here to help out.

If you do get a positive Addisons, let me know and I'll see if the member from here with it herself will stop in. The Addisons dog I knew started out Cushings from too much steroids for a skin allergy, then he was dumped at the shelter where I worked/volunteered. One of the staff adopted him and the Cushings treatment didn't go so well so he went Addisons. Which ended up being surprisingly well controlled. As we say with steroids, if it's what he needs to manage a more urgent condition, we just manage the diabetes around it with dosing. You won't be the first person whose diabetic cat has been on prednisolone.

 

Thank you Wendy, I'll be sure to keep you updated. This brings me a lot of comfort, that people are willing to help - even if the situation isn't usual.

I really appreciate your help and am very thankful for this forum, thank you!