10/17 Missy AMPS 348 :-(

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Maresydotes

Maresydotes

Member Since 2011
Previous thread: viewtopic.php?f=9&t=54398

I keep thinking I need to bump Missy up to 4.5U. I know I don't have any real PM data, but her numbers just keep continuing to rise. Our vet is hoping that she will settle out since we stopped the Clavamox. Maybe I should wait a couple days.....I seem to be thinking that constantly and she keeps climbing. It worries me. She didn't even come upstairs to wake me up this morning like she usually does.
And we now put her brother on EVO, since he was always in her dish....so I have the added concern of keeping each out of the other's dish, for weight reasons. I have to stay on top of them so she keeps losing. Nothing like adding a new step to the dance :lol:
 
You are doing great! And believe me, there are always going to be new steps to this dance.....I think sometimes think Zoe stays awake at night planning/plotting what new she can throw at me! :roll: :mrgreen:
 
hadn't you guys heard?
Every Lantus Land get together that the kitties attend, they dedicate 1 hour to brainstorming & sharing ideas
on how to keep the humans dazed & confused :lol:

sorry i can't help with the dosing question...but you might want to put "question" in your subject line to catch some eyes...
 
I realize that Missy is a big girl & you have done amazing getting her weight down, but is it possible she is getting too much insulin? I think the idea of putting dosing into your subject line could help.
And please try to test when you can mid-cycle, It could be a tremendous help.
 
Hi there,

I can't comment on dose at the moment as I am at tbp and a firewall prevents me from seeing Missys ss.
I'll have a look when I get home and throw in my $0.02.

Besides not coming to wake you this morning, is there any other behavior that's unusual?

bbl
 
I DO believe they plot!!! How can I mess with my bean today? Sadly, mine are better at plots than I am at foiling them. :roll:

Sandy, I would love to hear what you think! Really not much in unusual behavior....a little lethargic, but I expect that looking at her numbers. But she did go on a nice walk with us yesterday, much longer than usual, so that was good.

Roni, Her being on too much insulin is something that I have been struggling with for a while. Some other people here have suggested that to me, as well. But back in March, when we first started this dance, she was put on 3 units to start. I realize now that wasn't maybe the best thing to do, but she did go into remission quite quickly at that dose.
I was considering backing her down slowly, as I was afraid of what would happen if I suddenly dropped her to, say 2.25U. Plus, that is not per the protocol. Some people don't think it is too much insulin....I talked it over with my vet, expressed what had been said here about it being too high a dose. She did some research, talked to collegues and they are all on board with the dose she is on. So, I feel stuck between a rock and a hard place, with opinions on both sides of the fence. I wanted to do a phone consult with Dr. Lisa to help me make up my mind, but DH would probably have a cow about the money. :sad:
I have been trying to fill in some of the gaps in my data and have been doing a lot more testing since my back is now cooperating. ;-) Working on a plan to do some PM testing because my MS really keeps me down sometimes, so hopefully I will be getting more data at night.
Any words of wisdom would be welcome. I know I make the ultimate decision, but it helps to hear what others think....
Thanks
 
Without some data on what happens overnight, I honestly can't say if Missy is overdose. Maybe, maybe not. We only have half the picture.
I can say that although ECID, most kitties run lower on the PM cycles.
Is DH able to test? A good friend?

I don't consider a kitty as "high dose" until a dose gets higher than 5u.

Do you test for ketones?
 
Hi Mary - sorry for the pink this morning. I too think you are doing great. I'm not totally convinced that it is too much insulin - without some PM data it is hard to say. It is good that you are feeling better and can get in a PM test of too, it will help you and others make a decision. I wish you luck!

In the meantime, Missy - come on down to the lower floors!
 
I think you are wonderful to do all you do AND deal with your MS. Try not to stress and worry too much as that won't do you any good. But I know how stressful it can be when you don't know which way to go and you question some previous decision over and over. Don't worry --we are all doing the best we can and it isn't easy to know what is the best course of action at the time. But MIssy got OTJ once and sooner or later you will see some positive action. But it is agonizing to see the dose go up and up. My Pinky is a little, little girl and is already up to 4 units twice a day and I just messed her up with bad dosing and now she is getting lots of pinks, unheard of for her. These things happen and we just have to persevere.

Best wishes Missy from your friend Pinky.

Elaine
 
Thank you everybody, for the encouragement! It helps. And thank you for the wishes for her to get out of the pink!
I have been trying to recruit DH to get on board with testing. He says he will, but shows no interest. He supports me as far as treating her, but he is not very hands on with it. He had done some injections in March, when I would get overwhelmed. This go around, I am not so freaked out, so haven't really bugged him. Guess I should.....he does generally stay up later than I do. He shouldn't have too much trouble, he injects me when we rotate to sites I can't do easily.

I still plan to nap and try to stay up later. I really would like that information, too, before a dose change.

Sandy,
I have not tested for ketones. She did not have any ketones in her urine when she was dx'd. (she was in the high 400s or low 500s when dx'd in March) And her appetite has never been bad. :sad: However, since she is getting up there in numbers, I had planned on going out tomorrow and getting one of the meters that test for that for it using blood. There is absolutely NO way she would let me catch urine. She barely ever uses the litterbox...prefers the outdoors. The only time she uses it is if she is peeing excessive amounts. But, it has been a thought in the back of my mind I ought to check, since she is getting up there. I will let you know how that comes out.

Thank you so much....I promise to get the data I need to make an informed decision on her dosage.
 
The strips for the meters that test for ketones are expensive! However, whenever I hear about "lethargy," I think ketones. You're wise to test. No matter what the cost, testing for ketones is a small price to pay for prevention or an early warning.

Has Missy had recent blood work to rule out any source of infection? Has she had a dental within recent memory?
 
Sienne,
I definitely do want to check her out, ketone-wise. It has been bouncing around in the back of my mind for a while. I saw the strips are pricey, but I think it is my best bet for checking her. Her and her brother would rather pop than pee in front of me. And whenever I have changed ther litter to another brand, they refuse to use it...using the floor instead. :sad:
Missy just got off a course of Clavamox (6weeks) for her acne, so hopefully nothing is going on, infection-wise. She was in to the vet in June (and Aug. When checked her and found her BG was up again) for her shots and check up. At that time my vet said her teeth were ok.
I have been thinking about taking her back in for blood work, just to see if something is going on there that we haven't picked up on. I am thinking that would be worthwhile. Maybe wait a week or so, in case the antibiotics knocked something back.... But something caused her to relapse. She did so well for so many months....even losing a fair amount of weight (5 lbs in the last 7 months) that you would think she would be doing better, not worse.....unless we are missing something underlying...not obvious.
My vet may not be as up on FD as this board is, but she is very "progressive" from what I have heard from others here. She sent us home with instructions to home test (and how to) to get on a low carb diet...gave us the URL to Binky's page,
told me about this board.....she truly cares. She would do whatever she could to narrow down the reason for the relapse. We are in pretty close contact. There is a bit of friendship, not a totally business relationship. (our last GA kitty, who she saw through cardiomyopathy...when he passed, she brought us a plant...I am a bit of a horticulture nerd...and a card with
a kitty who looked like him, signed by the entire staff...and left it on our front porch. Way over & above for a vet.) So, i
trust her a lot, but you can't be an expert on everything, can you?
I totally agree that testing her for ketones is the way to go. Especially given her numbers, lately. I will get the
meter, even though it is expensive (but DKA is more expensive, so it's worth it) and check her out.
I will get back with my vet to do some blood work, just in case.....she was in remission for 4 months...and with her
numbers continuing to climb, you have to suspect something is getting missed when nothing obvious, like food or routine
has changed.
Any thoughts or advice you have are more than welcome. I know I need to do some PM tests and am working on a plan to make that happen, but anything else I am missing.....I want to know about. Please let me know of any other thoughts
you may have on her. I will be sure to let you all know any new info I get....ketones, labs...
Thanks so much.....she is my girl and I want her to feel like she like she did when she was in remission. I will do what it takes...
And I wanted to say, your cats are so pretty! I think Gabby's facial markings are so cool and Gizmo's eyes are amazing.
Every cat is so unique... You gotta love them. :smile:
Mares and Miss
 
mares, there are a couple of other conditions probably worth mentioning, especially since your vet seems to be fairly on top of things. if you're going to do more testing, you might talk to your vet about acromegaly/iaa. acromegaly could explain missy having/coming out of remission. it's checked by a blood test that is sent to Michigan - usually people have the test for acro and insulin auto antibodies at the same time because the conditions can look similar.

punkin has acro - acromegaly is a benign tumor in the pituitary gland that puts out a growth hormone. that hormone causes the insulin to not be able to get into the cells, so we keep increasing the dose so enough "leaks" by and gets in. the symptoms are increasing insulin needed to bring BG down, and a variety of physical symptoms. i'll run through some of them - most acro cats are male, average about 10 years old at diagnosis, some have "stridor" a rattling sound when they breathe from excess tissue in the airways. as the growth hormone works on their bodies they can get muscular or bigger than average, their feet, tongue, forehead can grow. punkin's voice changed - that was probably his first symptom. his stool is larger than average because his colon has grown. they also have an insatiable appetite.

the reason i mention acromegaly is because the tumor can increase/decrease hormone productions and there are cases of cats that have gone into remission for a time when the tumor was inactive.

not all acro cats have all of the symptoms - i'm just throwing them out there in case you recognize any of them. some acro cats are petite girls.

insulin resistance is a condition where the cat's body develops antibodies against the injected insulin, so the dose goes higher and higher and it seems like the BG gets higher right along with it.

both conditions have particular tactics to deal with them.

now, it's perfectly possible that missy has come out of remission because of needing a dental, or something else ordinary. i'm just mentioning these because you are trying to figure out the remission thing.
 
Julie,
I have been wondering about acro and Miss. She doesn't really sound like she has symptoms of it, except maybe the 'stridor'. I am not sure if what she has is stridor, but she does snore a lot and she has heavy breathing. She has had it all her life (we got them at 5 wks old, I think) and her brother also snores,but not as bad as she does.
I am thinking about taking her in for some blood work, so I will mention that...and get her tested. Nothing apparent caused the relapse....and maybe that is just the way it is, but I want to be sure. After 6 weeks on Clavamox, you would think it would rule out an infection. She had a check up in June and was told her teeth were ok. I am pretty sure if they were marginal, the vet would have said so.....if only for the money
I appreciate you mentioning the acro. I think at some point in the ER, they made mention of it, but I was in such shock it didn't really register...and my vet never mentioned it, so I let it go. At the very least, I can have her check for it.
I guess it will be more testing and data gathering and see what comes of that. I think blood work needs to happen, if for no other reason than to rule out any causes for the relapse. It seemed to be sudden....she started begging for food enough for me to wonder and test...and then started the drinking and peeing.
Well, despite my intentions to stay up late, I think I have to call it a night.....
 
I believe it is Julie that recommened the Breeze litter box for testing ketones and I just got one and it is worth every penny.

My cat took it right away--unlike aquarium rocks. The tray underneath collects the urine and you simply dip in the stick and then dump tray of urine in the toilet. Rinse tray and your done. Don't use the 'pad' that comes with it . I even have a NOva Max blood ketone tester but I get alot of error messages even when I do everything right. Much prefer the Breeze.

Elaine
 
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