12/7 Klinger AMPS 567 3.6 PMPS HI 3.6 +1 472 +2 455 +3 333

Status
Not open for further replies.
Marcy & Klinger (GA)

Marcy & Klinger (GA)

Very Active Member
Hi there,
Klinger was in the 300s by +4 last night. Glad I gave him the HC food at PMPS +1. All of his food was gone that I left out over night.

AMPS 567 3.6u
He ate 3 rabbit medallions before I left for work, which was odd.
+2 538

PMPS HI 3.6 (HI on my meter is above 600)
+1 472
Will continue to test.
He pooped outside of the lb and also found more vomit from some time today.
The vomitting makes me think he's getting too much insulin.
I'm not sure what I want to try...maybe going back to 1u, just to see. Especially if I'm going to make the decision to switch to Lev. Doesn't it make sense to rule out rebound on PZ before I switch?
I wish I could try TID, but our schedules won't allow us to.

viewtopic.php?f=24&t=31516
 
Re: 12/7 Klinger AMPS 567 3.6 PMPS HI 3.6 +1 472

It seems strange that he is dropping so much at +1 when I always hear that the onset is around +2 or 3. I agree that it couldn't hurt to test for rebound before giving up on pz and switching. Maybe you'll find that magical dose!
 
Re: 12/7 Klinger AMPS 567 3.6 PMPS HI 3.6 +1 472 +2 455 +3 3

PMPS HI (above 600 on my meter)
+1 472
+2 455
+3 333
...300 point drop in 3 hours.
 
Re: 12/7 Klinger AMPS 567 3.6 PMPS HI 3.6 +1 472 +2 455 +3 3

The problem I think is that you've already tried lower doses and didn't get good results. So the idea of a "rebound test" i.e. lower the dose to 1u or so and see what happens, seems to me like asking for high #s. I haven't been following closely enough to say anything with much authority, but if it were me I would certainly think about going ahead and switching insulins (and skipping the rebound test). It looks like the 4u is giving you a good nadir, but either from liver training or from the steep drop from the high PSs, or both, it's looking fairly see-saw-y. And when you lower the dose a little, you still get a good drop, but there's just so far to go from the PS that it leaves the #s high.

If you haven't already, I would post over on the Lev forum and ask them what their take is. I don't have any Lev experience, and I do know from watching some cats transition to other insulins that it's not a magic bullet - they often sit in high #s for ages as you rebuild the dose on the new insulin, and not all cats get good results even then. So I wouldn't give up on PZI too easily and I wouldn't take a switch lightly.

But at the same time you have IMO given PZI a fair shot, you've tried really hard and are at a place where it doesn't look like lowering the dose is likely to give you good results, and raising the dose may give you good nadirs, but is likely triggering rebound from the steep drops.

I'm happy to be overruled/slapped by those who have been following along more closely. Just my take from stopping by tonight... Bottom line I guess is I don't see the usefullness in a rebound test - not b/c there aren't signs of rebound (b/c the #s DO look pretty reboundy) - more b/c I think you've tried lower doses and that's not the answer from what I see. I'd hate to see him sit in high #s while you determine that yeah, there's some rebound, but you still don't see good #s on a lower dose, so then where do you go?
 
Re: 12/7 Klinger AMPS 567 3.6 PMPS HI 3.6 +1 472 +2 455 +3 3

Marcy- wasn't the reason you were considering the rebound check because of Klinger's recent dental issues that have now been taken care of? I'm not sure if Joanna realized that, or maybe she did, but doesn't think that is the issue. I liked your idea that an infection caused him to need more insulin, then when it was cleaned out his needs may have dropped.
 
Re: 12/7 Klinger AMPS 567 3.6 PMPS HI 3.6 +1 472 +2 455 +3 3

i would think a drop at +1, especially a significant one is an indication of the pancreas at work. i doubt the insulin is doing that. and the pancreas of course is stimulated when food is introduced.
is this a mute point as you already knew that?
 
Re: 12/7 Klinger AMPS 567 3.6 PMPS HI 3.6 +1 472 +2 455 +3 3

Marcy, I would support you if you want to try a rebound check. You will be starting over on the Lev anyway, so if it will put your mind at ease about shooting the higher doses if you get back to them at least you would know for sure that it isn't rebound.

The vomiting concerns me too.
 
Re: 12/7 Klinger AMPS 567 3.6 PMPS HI 3.6 +1 472 +2 455 +3 3

just to muddy the water :lol:
Acro is caused by a tumor on the pituitary which causes fluctuations of growth hormone output. It is typical for the tumor hormone output to fluctuate, therefore acromoms do have to keep a close eye on the numbers, and react by decreasing and increasing dose more often than a regulated normal FD. It is not unusual to see a sudden reduction in insulin needs, and a drop in numbers.

Also, vomiting in Cody is pretty well correspondant with a P'itis flare. Infections can "use up" the glucose floating around in the blood and also cause a sudden drop in numbers. Of course, they can also cause crappy high numbers...

third, I agree that Klinger seems very jittery/ reactive to low numbers, and sharp drops. That is the primary reason I would suggest a switch to levemir. In Cody, lev produces very slow gentle drops that just keep going for hours, and rarely cause any bounce reaction. I have never used it, but I've been told that lev creates an even more gradual drop than lantus.

However, before I switched, I would definitely, definitely, find out the IGF1 and IAA results because a diagnosis would influence how the ramp up process proceeds. However with Klinger's, sudden unpredictable nature, it would probably be best to ramp up right from the bottom and go per the normal FD protocol.

So, if you are getting any blood drawn to find out about that vomiting, draw some extra tubes and send it to MSU. I have noticed many vets are hesitant to test because they have never treated an acromegalic cat, and don't know what to do, from the diagnosis through the treatment. Its almost like they don't want to know. The foot dragging is very typical, so sorry if we push the other way sometimes, to the point of being annoying. :oops:

As for a drop at +1, acrocats have a functioning pancreas, the acro hormones just block the insulin receptor sites (when the tumor is producing)
 
Status
Not open for further replies.
Back
Top