3-12 Rui almost 8 weeks post-SRT blue numbers gone

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katieroc

katieroc

Member Since 2014
Hello all. Checking in with you about Rui. His "blue period" seems to have come and gone. He has some yellow numbers, but mostly in the 300's in the a.m. and p.m. I'll get some mid-cycle numbers this weekend. Since he had his low numbers, I kept him at 27 u twice daily, but after a number of days of no noticable bg reduction, raised him to 27.5 and now I raised him again to 28 u. I hope I'll see lower numbers tonight. The radiation oncologist said it's probably too early to see steadier low numbers, but as you say here--every cat is different. Rui is kind of all over the map. Part of me is optimistic and the other part is wondering if the SRT is working. Since I haven't seen low numbers like this since September/October, I'm hoping that this is the start of a change and I just have to be patient. Rui's appetite is the most ravenous I've experienced. He is constantly crying for food. Eventually, he calms down, but if you walk into the kitchen is starts all over again. I'm trying to feed him smaller portions at intervals thinking it will satisfy him, but not cause him to gain weight. The relentless crying is heartbreaking and nerve racking at the same time. I'm wondering if there is something else going on besides acromegaly and diabetes (how much more could there be--can the poor cat please get a break!). The SS is updated. Last night I gave a fur shot. This is the 3rd in the last several weeks. Is it me or is something going on at the injection site/s. I give him the shots in the scruff, but rotate the area. Rui goes back to his regular vet for follow up testing for the urine protein on 3/23. Also, a blood pressure check. I hope all is well with your kitties. Thanks to you all for sharing your experience and advice. Susan
 
Are you weighing Rui? It helps to keep in mind that macro involves the production of growth hormone which will cause him to be hungry. If you're feeding him and he's gaining weight, that may be a cue to decrease his calorie consumption. If his weight is stable, then see if more food makes a difference. The other issue that will affect his appetite is where his BG levels are. When numbers are better regulated, appetite is decreased. When BG is higher, glucose isn't getting into the cells and Rui is going to be hungry.

You may want to check with some of the other members with acro kitties, but you may want to consider increasing in larger increments (i.e., 1.0u). An increase of 0.5u is rather small when compared with Rui's usual dose.
 
Hi Katie - sorry to see that Rui lost his blues. :( Can you remind me if you had him tested for IAA? With IAA, the antibodies will often take over and you'll lose the lower BG's. With Neko, I used to call it "the dose going stale". If he was positive for IAA, then you have to take action to try to stay ahead of it. Regardless, Sienne is right about the size of increases. As long as you are getting enough mid cycle tests to show that he's not going any lower during the day or night, then you can do bigger increases. Think in terms of increasing by 10%. Over 20 units you can increase by 2 units at once, and at 28, you could increase by 2.5u units at once, then 3 units in the 30's. The larger increases help you stay ahead of the resistance. I'd save the smaller increases for times when you are tweaking a dose that is getting upper green or low blue nadirs, and at his current dose, a small increase would still be a 1 unit increase.

As for appetite, whenever Neko was seeing reds or high pinks, I'd have to watch my fingers when I gave her treats.:oops: She too was frantic for food. That will go away - I'm now safe letting her lick my fingers. :) Getting Rui out of high numbers will help, as will the SRT over time. Weighing regularly, maybe every couple of weeks, is a good idea. The acro tumor is putting out growth hormone, so acro kitties will likely gain some weight, you just don't want it to be very much. One of the possible effects of acromegaly is arthritis (which Neko has), so I'm constantly trying to control her weight to make it easier on her. Make sure you add lots of water to his food, the more to fill his belly.

I find fur shots come in multiples here. :oops:

Are you getting the urine protein creatinine (UPC) ratio done? It's common for acrocats to have proteinuria. Neko's on benazapril which is helping her there. Good luck with the test results. Tanya's CRF site has good information on proteinuria.
 
You've already gotten some good advice - I just wanted to lend you a little support. :bighug:

When punkin was really starving I gave him plain cooked chicken breast. It doesn't have many calories or carbs and - like you - it broke my heart that he was so hungry.

I do agree that when you increase, you'ld probably have more success in seeing a change in larger increments.

Hang in there!
 
Thanks to all. I was increasing his dose by 1 u every 4th day. The reason I increased by the .5 the other day was the radiation oncologist advised me to stay at 27 u when he was in the blue. After a few days, I tried to reach him unsuccessfully, and was unsure what to do when I wasn't seeing the lower numbers. I decided to up it by .5. Since he is getting well over 20 u, you think it's OK to increase by 2 u increments? Again, I would do this after the 6 cycles. About the IAA, I mentioned it to the vet at his 1 month SRT follow up and he said there would be no benefit to testing for that since he is insulin resistant and he would be positive anyway. Is that incorrect? About the UPC test, I'm not sure if that was the "regular vet" is going to do, but she did mention a test other than the test he had a few weeks ago. I'll be sure to talk to her about it. I do weight Rui and he did have weight gain since the last weigh-in. He was 13.13 on 3/5 and a few days ago he was 14.4. I mix Tiki Cat (very low carb) in his Purina DM or Fancy Feast, so I think he gets a good amount of water since the Tiki Cat has consumme in it. I have noticed a decrease in his begging for water at the faucet. But, his hunger is just crazy. He jumps in the fridge when I open it and the other night I found him on top of the pizza box on the counter. I have to tell you all--I am so very unsure about dosing. I'm scared to death sometimes when I walk out the door for work that Rui is going to "crash". I also feel such guilt leaving him for the day. All the what-if's. I get mid-cycles on weekends and try to get some at night, but I'm always anxious that something is going to happen to him.
 
Any of us that work know that "what if" feeling. Think about getting a timed feeder. It may help you feel less guilty knowing that Rui can get food if his numbers are dropping when you're not home.
 
I second Sienne's suggestion of a timed feeder. I don't know what your timing is in the morning, but some people change their PS time so that they do preshot when they get up and get an out the door test a couple hours later. Depending on the difference, you can load up the autofeeder with higher carb food. For many kitties on Lantus, if the +2 is lower than the preshot test, it's a good indicator of an active cycle. When Neko was on Lantus, the +2.5 or +3 was a better indication of action. Of if you simply have to shoot as you go out the door, get a test when you get up and then before shooting. If Rui is going down into preshot and is in lower numbers, that would be a good time to load higher carb food into the autofeeder.

As for IAA, not all acrocats test positive for IAA. Julie's Punkin did not have IAA. All acrocats have resistance, but the Insulin Auto Antibodies is a second kind of resistance. Think of it like an allergy to injected insulin. The autobodies seek out and trap injected insulin and can release it later. It is a self limiting condition that is supposed to last around a year. With Neko it was 9 months. The vet is right that it is still resistance, but with an IAA positive cat, you have to be a bit more aggressive to overcome the resistance, and when the IAA breaks (stops), reductions can come a little faster and you have to be more cautious, so it's helpful to know if it exists.

For dosing, as long as you aren't seeing any greens or very low blues, you should be fine with 2 unit increases after 6 cycles. However, since you had a fur shot a couple of nights ago, you'll have to wait until 6 good cycles after the fur shot to refill the depot and to get a good idea of what this current dose is doing, before increasing.
 
Hello everyone. Well, Rui had some blue numbers again this weekend. :cat: I did increase him to 29 u on Saturday a.m. It seems he has lower numbers every other day. Seeing blue numbers again does give me hope things are changing for him. Except for the constant crying for food:woot: I really do need to get a timed feeder. Thanks for your suggestions and support. I'll keep you posted.
 
Hi Susan, have a look at Crystal's SS and you will see that I increased by more than 2u once I got past 26u so I would follow Wendy's advice above and go for a bigger increase. I know what you mean about these large numbers, they terrified me but proportionately it's not a big increase. Go for it, good luck.
 
Thanks Suki, Wenday, Julie, Sienne (The high numbers do terrify me!) BTW--Those of you who have auto feeders, what type do you have? I was reading that some aren't "cat-proof" and they can advance the feeding mechanism and have a real feast!
 
Great to see those blues back!

I'm currently using the PetSafe 5 (also available on Amazon and at Petsmart for example). That's the one that Julie used too. I also used the QPet 4 feeder when Neko was in her crazy hunger stage. But I didn't like the user interface and when it died after a couple of years service, I replaced it with the PetSafe.
 
I liked the Petsafe 5 compartment feeder. Here's a little bit of a conversation about auto-feeders. Wish I had one with a more extensive discussion saved, but at least this is something.

Punkin never broke into ours - and he had the voracious acro appetite. He did learn when it was going to open and he'd wait a few feet away, then leap for it when it rotated and opened. :eek::D
 
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