Re: 12/22 Cobb AMPS 369
i think i'd still stick with the 4 cycles plan still. For anyone reading, this is an option from the Tilly Protocol for a cat that is continually producing high nadirs.
at what point do you want to consider getting him tested for a high dose condition? usually when people get to 6 units we suggest having the tests done so that we know what direction to take with dosing suggestions. there are 2 that he may have - acromegaly and insulin auto antibodies. acromegaly is probably slightly more common that the iaa, some cats have one or the other and some have both. Ozy just got diagnosed with iaa only, Neko has both iaa and acro, Pepper has acro, Tip has acro - i don't remember offhand if Pepper or Tip also have iaa. there are probably others that i'm missing. there are quite a few of us with high dose kitties. we love them to pieces, of course!!!!
acromegaly is from a tumor in the pituitary gland. it puts out a hormone that causes the cat to try to grow. soft tissue grows first, so we see bigger feet, the forehead can push forward so it's more vertical than slanted, sometimes there is a rattling, snoring sound when the cat breathes that is from excessive throat tissue rattling. stools can also be larger because the colon grows. the muzzle can spread out so it's rounder more than pointy-er. punkin had acro and the first thing i noticed was that his tongue had enlarged. the mechanism that causes the cat to need more insulin is that the tumor produces a hormone that mimics insulin and it blocks the body's own insulin from getting into the cells. imagine a lock with a key hole in it. insulin is the key that fits the lock and the hormone "clogs" the keyhole with its own cell. with an acro cat, we give higher doses of insulin to get enough to pass through into the cell.
iaa is when the body produces antibodies that bind up the insulin and prevent it from getting into the cells also. it is considered "self-limiting" which means that usually in a year or less, with good blood sugar management, the iaa "breaks" and goes away.
usually people have both tests run. the only lab in the US that does the testing is MSU. The two tests on this page are Insulin-like Growth Factor and Insulin auto-antibodies.
http://animalhealth.msu.edu/Bin/Catalog.exe?Action=Search&SPECIES=Feline&PAGE=6&Page=7 :Your vet would draw the blood sample and send it to the MSU lab. The acro tests are run on Wednesdays and results go to your vet that Friday. the iaa tests are run whenever the blood sample arrives at the lab.
For now, regardless of any test results we would continue to follow this same protocol of 4 doses and increase. but it would be helpful to know which, if any, of these he has. You don't have to do the test right away, but whenever you're ready i wanted you to have the information.
