2/19 Shishi AMPS 271 +5 264 +10 262 constant yellows??

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will and shishi

will and shishi

Member Since 2010
viewtopic.php?f=9&t=36886

recap.
-went to vet, blood and urine and ultrasound done.
-intestinal bacterial imbalance causing diarrhea, tylosin has since made stools formed again.
-confirmed kidney infection, causing urine not being concentrated. prescribed zeniquin
no other significant diseases detectable at this moment.

despite increasing the dose, I am seeing nothing but yellows in her curve, could be worse though but since starting the zeniquin 25mg 1x daily, her BG curve seems very unresponsive to insulin. She is currently on 5.25 units of lantus.

Vet said that there should be no steroids in both tylosin and zeniquin, and should not be causing the BG to rise, methinks there is something else going on but do not know what.

5 P's as follows.
-Pooping is formed, but not as formed as it can be.
-she doesn't play and this is normal for her.
-purring has stopped again, she usually purrs when shes in the low greens.
-peeing has increased from baseball size clumps to tennis ball size clumps.
-she grooms but her coat is still full of dandruff, also her hair does not grow back even after 1 year of being shaved for IV.
-she has a very good appetite and finishes food always, no puking.

Will just keep increasing the dose and see what happens, if anyone has experience with insulin unresponsiveness, please let me know.
 
Re: 2/19 Shishi AMPS 271 +5 264 constant yellows??

Will,

I think there are a number of possibilities that could be contributing to Shishi's high dose and yellow numbers.

1. The bacterial imbalance - for sure if she is not feeling well, that can lead to higher numbers.

2. The kidney infection - infections usually lead to higher numbers, and the numbers can drop once the infection starts to clear and the cat starts to feel better.

3. The Zenequin - some cats experience high or inconsistent numbers when they are taking antibiotics. Sometimes it is hard to tell whether the high numbers are from the antibiotic, or from the infection the antibiotic is treating, or for the gastrointestinal upset that also comes as a response to taking antibiotics. How much longer will she be taking Zenequin?

There are a few other conditions that can cause a cat to need a higher than usual dose of insulin. The best place to start is by reading the information in this sticky: viewtopic.php?f=12&t=375 Feel free to ask any questions and either we can try to answer them, or find someone who can. My foster kitty Jazzy has acromegaly.

Normally we start thinking about the possibility of these conditions when a cat gets to around 5 units BID without much response to insulin. Shishi is a bit different because she does respond to the insulin, just not consistently. Also, your dose was not reached in the way we normally build up to doses in Lantus Land. There is a possibility the dose is just higher than she needs, though I do think we would have seen more signs of that by now if that was the case. I'm just trying to let you know of all the possibilities that are coming to my mind right now, and that is definitely a possibility. The best way to find out is to just keep getting as many spot checks as you can so we can be sure of what is happening in her cycles.

Unfortunately, testing for acromegaly and IAA are very expensive in Canada. You will need to consider whether the test results would affect your treatment decisions enough to be worth the expense. In your case, especially because of the expense of testing for high dose conditions, it might be easiest to focus first on getting the other health issues cleared up, keep increasing the dose as needed, and then see what is going on once she is off the other meds. Please ask questions, though. It's a lot to think about.
 
Re: 2/19 Shishi AMPS 271 +5 264 constant yellows??

This was very helpful, I just wanted to say thanks first of all.

The game plan for zeniquin is to treat her for 2 weeks initially, do a urine test and see if the urine is concentrating. If not, then we have to switch antibiotics. Vet mentioned that the antibiotics has to be done for 8 weeks for her infection to clear.

They were not successful culturing anything in the urine despite taking a sterile sample, so as of this moment, we don't know what antibiotic is best for Shishi.

During the ultrasound, there was no cushings in the adrenal glands, but uncertain of the pituitary glands. So this isn't ruled out.

I may have to put in more spot checks to make sure she is not on rebound, although the ss does not suggest this.

I am increasing the dose every 6 cycles as the minimum length stated in the protocol, I know it was a bit of a mess on Shishi's BG 2 weeks back, buts shes been doing very inconsistent curves at me.
 
Re: 2/19 Shishi AMPS 271 +5 264 constant yellows??

I don't think she is rebounding either, but you're correct that spot checks will help us see what is going on. Let me know how I can help.
 
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