3/18 Mary Grace AMPS 297+2 227 PMPS 264+2 192

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marygracemom

marygracemom

Member Since 2013
This morning bounce from last night's green!

Yesterday's condo: http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=115588

Thanks for the visits yesterday and the replies.
Julie- I will try and figure out how to use Punkin's labs ss tab for Mary Grace. That is great, it will save me some time entering in all the data. The vet just called after consulting with the other vets there and now believes it is an overactive thyroid that is causing her insulin resistance. They did a T4 test, not a Tfree, but the result was 4.4 with a reference range of (0.8-4.7) When she was diagnosed in September with FD, that lab had her at 4.6 with a reference range of 1.0-5.0. So it has gone down, yet not the old vet nor this current vet thought she should be on thyroid medicaine before? She wants her to start on Methimazole 2.5 mg. Wants to use the pills instead of the gel for fear of human contact. ? ... When I went Saturday and they surprised me with the double up fees I had already spent 299 and couldn't fathom spending anymore. I think it was more on principal that I didn't want to pay that also, so I didn't get the tests done. Now in hindsight I wish I would have gone ahead and done it and just eaten the extra expense. Now its going to be a lot of hassle finding another vet to just draw blood. A member here has a vet that did it but she is about 1 1/2 hrs away. SO what to do? Now she says I will have to bring her in every few weeks to monitor her thyroid levels so they can figure out the correct dose for that medicine.
I am not looking to them for any advice or opinions, I know I have all the experts I need here. It is the same way with my own general doctor vs my endroconologist. Unless you live with diabetes or that is your main focus, you are out of the loop! When I talk to my GP about my diabetes I know it is over her head, same way when I am discussing Mary Grace with the vets. I mean they did suggest a third Lantus shot :shock:
At this point I don't know if I have dug in so deep with all the tests done that I should just stick at this vet practice or start all over. Time and money are a big factor here, as I am limited on both. Unbelievable how frustrating this is, but I am so grateful that she is at least stable, I read so many other condo's with really sick kitties, so I feel relieved that my only frustration is dealing with the vets and finances, both can be figured out. :smile:
I will try and get the labs up today.
Thanks Julie, I hope you have a good day!
 
Re: 3/18 Mary Grace AMPS 297+2 227

Hi guys .. nice yellows for mary grace this morning! I don't have any advice on the vets or the testing or the meds, but I understand your frustration on dealing with incompetent vets .. I'm pretty sure most of us have on this site! Have a great day guys!
 
Re: 3/18 Mary Grace AMPS 297+2 227

Mary Grace is starting out nicely, for sure! WTG, you 2! I hope that you both have a very wonderful surf today. Good luck with the vet, and I hope that you're able to find a very good one very soon. Hang in there. :YMHUG:
 
Re: 3/18 Mary Grace AMPS 297+2 227

Hi Angela and Devon-
Yes, my sweet Mary is on the yellow floor, I think with this horrible icy weather here she wanted sunny yellow!!
Hopefully she is happily watching the birds and lounging with her civvies!
Thanks for the visit and I hope you both have a great day. :-D
 
Re: 3/18 Mary Grace AMPS 297+2 227 PMPS 264

I'm sorry about all the confusion with the vet and the blood tests. If she does have hyper-t, she will need to have periodic blood tests until they find a dose that works. Then she can stay on that dose and get checked once a year. At least that's how my vet did it with my civvie who has hyper-t. I don't know how hyper-t affects fd.

I hope all the yellow today means you'll see some blue soon.
 
Mary Grace seems to have gotten over that bounce nice and quickly. :-D And it looks like she prefers to go lower at night. :roll:

Sorry about the frustration with the vets. Hyperthyroidism is a factor in insulin resistance, but of cats I've seen hear with hyperT I haven't seen one get to the size of dose MG is at. Since you've just paid for the labwork, you own it and I'd think you could go to a second vet for a second opinion on the current b/w without getting another blood draw. No way around extra time or cost unfortunately.

I don't know much about HyperT, but maybe you could post on the Health forum if you have specific questions.
 
there are a few cats on here with hyper-t - marje has experience with it too. maybe when you post tomorrow (i know it's late for you now) you could include "hyper t?" in the subject line. then people with experience on that will come offer their free 2 cents worth. ;-)

i think they are fishing for causes for why she needs more insulin, but the answer will be in the sample you sent to MSU. funny that they seem resistant to considering that it could be acro or iaa. the only other one that causes really high doses is Cushings, and if she had it you would know it. There are other health conditions that can cause some elevation in the dose needed, but not in the 10u range. somewhere i have a document that lists a bunch of those - pancreatitis is one of them. i don't think hyper-t is on the list. i'll go look and if i can find it will post it. you can pass it along to your vet.
 
This article on insulin resistance lists the reasons that a cat may be harder to control. And this article also looks at underlying issues in FD. I know I gave the second article to my vet, primarily because it mentions testing for cats whose dose is more than 1U/kg BID. For Neko that meant 6U dose but my vet thought I should wait until 10U.
 
thanks wendy! i think i have those bookmarked on my regular computer. i've swiped DH's tonight. :-D

i looked at http://www.felinediabetes.com/AAHADiabetesGuidelines.pdf and it does say on page 223 (top left column) for the cat with uncontrolled BG's

conduct additional testing to evaluate for endocrine disease, infection, pancreatitis and neoplasia. Rule out continued causes of insulin resistance (obesity, steroid use)
Click to expand...

Elsewhere I found endocrine diseases in cats defined as diabetes and hyperthyroid. http://catsandcritters.com/feline_endocrine.php Acromegaly is also an endocrine disease.

Neoplasia is skin tumors. http://inpractice.bmj.com/content/28/6/320.abstract
 
Elizabeth

Julie asked me to give you some info about hyperT.

While hyperT can make a cat more difficult to regulate, the ones I've seen have not needed really high doses. It's an ECID thing in terms of regulation, really. Take a look at Toms SS. He was started on transdermal gel on 2/15/2014 which is on page 2 of his SS.

First, if you decide to use the gel, they give you little rubber things to put on your finger so you won't absorb it. I had two hyperT cats and gave pills to one and used the gel for another because the pills made her sick. When it comes to methimazole (MMI), I find many vets start the kitties on too high of a dose. It's better to start really low and build up. If you start too high, the kitty gets sick, you have to stop it, and then restart. I think your vet wants too many tests after you start the med. :oops: Usually you would start the med, retest in one month, and if it's normal, retest in two.

Neither of my hyperT cats had FD but my last one, a little female named Teddi, had symptoms for quite some time but her numbers were normal. Sometimes hyperT cats will do this. I belonged to the yahoo hyperT group and the members there generally had their vet draw blood but then sent to sample to Dr. Jean Dodds of HemoPet.

There is a syndrome called euthyroid sick syndrome where other things going on with the kitty make it appear the thyroid is working normally. Dr. Dodds is really good identifying this and also good with geriatric cats and hyperT. She charges $85.00 for the Thyroid Profile 4 test which includes free and total T3 and T4 and she interprets the results for you. Directions are on her site for how much blood/serum she needs and in what kind of tubes. So if you can find a vet to draw it as Dr. Dodds specifies, then you can mail It to her.

I got spoiled with our first cat that was hyperT. We gave him a low dose of MMI, he responded well, we waited six months to be sure his kidneys were functioning and in normal numbers, then we got the I131 treatment. Perfect. But with Teddi, I realized that hyperT can be very complicated and realized how much it can affect other systems, it can be hard to detect, it can be hard to get the dose right, the med can make them sick, etc. I do highly recommend the yahoo hyperT group. The administrator, Alice, is amazing with her knowledge.

One thing.....the best scenario is if a cat is a good candidate for I131 treatment. But you have to have them on the med for several months and numbers have to normalize. Then they have to assess the kidneys because I131 can result in kidney failure if the kidneys are already showing compromise.

Please send me a PM if you have questions. I posted tonight because tomorrow is my work day and it will be a long one but if you send me a PM, I'll be sure to post tomorrow night.
 
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