3/14 phoebe amps 280 I shot 4.25 dose increase +2 288 +4 315 +7.5 296 +9.5 309 Pmps 280

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Phoebes (GA)

Phoebes (GA)

Member Since 2017
Yesterday's condo:

http://www.felinediabetes.com/FD
MB/threads/3-13-phoebe-amps-342-3-262-5-272-8-5-266-11-262.174765/#post-1918518

Phoebes did not eat all her overnight fuds. And she has eaten her breakfast in sections. Given her 4.25 per conversation with vet last week. Will be talking to her tomorrow about the progress. Given her B12 injection. Bupe and zofram this am.
 
Sorry you haven't seen progress with Phoebe.

Just remind me Angela, did you get Phoebe tested for high dose conditions?

IAA /acro,

Phoebe got up to 6u on TR, before vet suggested taking the dose back. Just wondering if it might be worth broaching the subject with him. If Phoebe were insulin resistant it might offer some explanation to the numbers you are seeing.

I'm curious as to what your vet expected would happen by taking dose back, did he give you an indication of what he was looking/hoping for?
 
Good luck with the conversation with the vet.

I want to second Gill's suggestion to discuss with your vet the possibility of what we call the high dose conditions, acromegaly and IAA or insulin auto antibodies - think like an insulin allergy. Neko had both conditions. One in four diabetic cats has acromegaly, but not all are on what we consider high doses. The recent study of over 1000 cats that discovered how common acromegaly is, found some with doses as low as one unit, and an average of 7. We suggest that cats that get to 6 units get tested, because we have seen some cats get to 5.5 units then turn it around. Don't be surprised if your vet doesn't think acromegaly is a possibility. Vet's used to be taught, "here is acromegaly, it's so rare you will never see it." My vet thought we had to get to 10 units before testing, but Neko never got that high. Another thing, only 35% of cats with acromegaly show clinic symptoms on diagnosis. I have also heard vet's reluctant to test because a kitty doesn't look like an acro. A lot of the changes come in later stages. Blood work is sent to Michigan State University to test for the conditions.

Something is causing insulin resistance in Phoebe. Knowledge is power, once you know what it is, you can move ahead and get her in better numbers.:bighug::bighug:
 
Gill & George said:
Sorry you haven't seen progress with Phoebe.

Just remind me Angela, did you get Phoebe tested for high dose conditions?

IAA /acro,

Phoebe got up to 6u on TR, before vet suggested taking the dose back. Just wondering if it might be worth broaching the subject with him. If Phoebe were insulin resistant it might offer some explanation to the numbers you are seeing.

I'm curious as to what your vet expected would happen by taking dose back, did he give you an indication of what he was looking/hoping for?
Click to expand...
I am guessing that will be our next step. She thinks she might be, but was not wanting her over 5 units. She wants to see if keeping her on the lower dose she will start to use the juice. She believes some cats need less not more insulin. So i am doing her way for now. She's back tomorrow so will be getting with her. I wouldn't say "no progress" she was in 4 and 500s. Her goal is 240 or below. She stared out today before insulin at 280 which has been the lowest in a while. She did start eating she just didn't want her ff chicken. So she ate beef and chicken. Is the acro test exspensive?
 
Didn't Phoebe's diabetes seem to come on very suddenly, after a course of steroids in December? I don't know much about the high-dose conditions, but is it the kind of thing where they might be "lurking" in the background and just waiting for a push to bring them out in the open?
 
Each high dose condition is different. IAA is a reaction to injected insulin, so won't start until insulin starts. Acromegaly is caused by a benign pituitary tumour sending out excess growth hormone, which in turn can trigger diabetes. The timing on that is completely random. There have been acrocats that don't have diabetes.

The price for the acro (IGF-1) test at MSU is $55 and for IAA it's $17, plus you have to pay the vet for the blood draw and shipping. I got mine done at the same time as regular blood work so there was no extra blood work charge. But since I am in Canada, the shipping charge was pretty fierce.
 
Nan & Amber said:
Didn't Phoebe's diabetes seem to come on very suddenly, after a course of steroids in December? I don't know much about the high-dose conditions, but is it the kind of thing where they might be "lurking" in the background and just waiting for a push to bring them out in the open?
Click to expand...
Correct, she had been on steroids for about a week. Then bg went sky high.
 
Wendy&Neko said:
Good luck with the conversation with the vet.

I want to second Gill's suggestion to discuss with your vet the possibility of what we call the high dose conditions, acromegaly and IAA or insulin auto antibodies - think like an insulin allergy. Neko had both conditions. One in four diabetic cats has acromegaly, but not all are on what we consider high doses. The recent study of over 1000 cats that discovered how common acromegaly is, found some with doses as low as one unit, and an average of 7. We suggest that cats that get to 6 units get tested, because we have seen some cats get to 5.5 units then turn it around. Don't be surprised if your vet doesn't think acromegaly is a possibility. Vet's used to be taught, "here is acromegaly, it's so rare you will never see it." My vet thought we had to get to 10 units before testing, but Neko never got that high. Another thing, only 35% of cats with acromegaly show clinic symptoms on diagnosis. I have also heard vet's reluctant to test because a kitty doesn't look like an acro. A lot of the changes come in later stages. Blood work is sent to Michigan State University to test for the conditions.

Something is causing insulin resistance in Phoebe. Knowledge is power, once you know what it is, you can move ahead and get her in better numbers.:bighug::bighug:
Click to expand...
Ty Wendy, she suggested last time on phone we might be looking at acromegaly, I just didn't know what that would mean as far as treatment wise. So perhaps we can get the tests done abd if nothing else rule out or identify her resistance. I just want for her to feel better.
 
If you do get the tests done, make sure you ask for the IAA test as well. It's a very cheap add on and we do get some cats who have just it or together with acromegaly like my Neko. Our dosing strategies are a bit different if IAA is in the picture. IAA is supposed to be self limiting, meaning that the condition can go away around about a year later.

As for treatments for acromegaly, unfortunately it's still a relatively new area. Most people with acrocats just increase the dose so their kitty spends as much time as possible under rental threshold. And you manage conditions that come with it. Neko's kidney disease and heart condition were likely caused by acromegaly. There are treatments that are curative or at least improve things. One is radiation therapy (SRT), which Neko had, and it slowed down the progression of the disease. There are a number of places in the US and Canada that offer it. Some kitties who have underone SRT have gone OTJ.

Newer treatments include surgical removal of the pituitary gland, called hypophysectomy. It's only available at Washington State U in North America, and is a fairly new offering there. It's probably the gold standard treatment, but the more experienced vet surgeons are only in the Royal Veterinary College (RVC) in England. There are also some medical treatments, unfortunately the most successful one (called pasireotide) is also very expensive. RVC is starting a trial of a much cheaper drug called cabergoline. One of our members Paul, has just started that trial with his kitty Bronx.
 
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