10/17 Toby,s AMS=439+4=375 PMS=432

[Peg and Toby]

Went to 9.5 units today. Started out high again. Going to the vets. today for shots and discuss Toby's Diabeties Treatment.
Will see if she will test for high dose conditions. Let you know how we make out. Take care, Peg and Toby

 

[Wendy&Neko]

Re: 10/17 Toby,s AMS=439

Good luck at the vet. Here's the link to yesterday's condo: http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=127037

Some vets are reluctant to do the high dose tests because they think it's a rare condition - that used to be what was taught. But recent research has shown it's more common. My vet thought we didn't need to do the tests until we got to 10U but we stopped just shy of that. I insisted, she humored me, she was surprised by the results and I was not. She has since diagnosed a second acro cat at her practice. You might want to print off and take in the information about the IGF-1 test for acromegaly and the IAA test. The only thing "complicated" for the vet is the shipping. For us it was trickier, for some reason it's not straight forward to send blood across the border. :roll:

 

[Peg and Toby]

Re: 10/17 Toby,s AMS=439+4=375

My vet. said she didn't see any reason to run the high dosage tests because we are still going to have to give more insulin no matter how it turned out. She was alright with going up on the dosage. She said that the pred. is almost like a chemical induced
Cushings. She was impressed with how good his coat looked . Said he looked pretty healthy except for his bg numbers. Said his mouth and teeth looked wonderful. Over all got good report. She agreed if insulin resistance you have to break through it to get it to come down again. She decided we didn't need all the shots and just gave rabies. Said she wasn't against using the R insulin
to help bring the numbers down. I told her about the forum and about all the people helping each other with their cats. She said she would have to go on line and look it up. She was glad to get Tilly's protocol said she was going to read it over. Peg and Toby

 

[julie & punkin (ga)]

Re: 10/17 Toby,s AMS=439+4=375

There are reasons to know what's going on to cause the high dose condition - that's why we've suggested having him tested. That's too bad that the vet didn't just do it - we wouldn't suggest it if it weren't important. It really helps us to know what direction to advise you.

If a cat has iaa, we encourage aggressive dosing because you want to break through the resistance, but you might use more R and less L because when the iaa does break (take a look at what's going on with Cobb this week), the insulin that was bound to the antibodies is released, causing an increase in the amount of insulin now available in the body. With iaa, you really want to concentrate on getting a cat into normal (green) numbers as much as possible.

If a cat has acromegaly, that is caused by a benign tumor on the pituitary gland. The tumor can ramp up and down production of the growth hormone that blocks the insulin from being able to get into the cells. A cat with acromegaly can be treated by Steriotactic Radiation - some then go off of insulin, but if not, the dosage will be significantly reduced. If you choose not to treat the acro with SRT, you will just give more and more insulin. In that situation, you're not going to be aggressive about putting a cat into green numbers necessarily. You might be content with trying to just keep Toby in blue numbers.

The strategies are different. The saying here is that if a cat has acromegaly, it "trumps" iaa, meaning that if a cat has acro, and you're not getting him treated, it is going to be safer to act as though the cat has acro only and let the cat run a little higher.

Without knowing, we're just stabbing in the dark and telling you to give more insulin as the numbers suggest. It's a bit like saying that an infection requires an antibiotic, so just give one without knowing what the bacteria is and targeting the AB towards that particular bacteria. I'd call it a half-way job and not the best strategy for Toby. To me, it really hinders those of us who are trying to help you.

 

[Peg and Toby]

I knew Toby would be high tonight because he was so stressed at the vets. He was panting all the time we were there.
Have a good night> Peg and Toby