3/29 Doodles AMPS 301 PMPS 336 +1 354 +2 392 +3 461 +4 455- IAA Results = 72

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Doodles & Karen

Doodles & Karen

Member Since 2015
Doodles 3/28 Doodles was not visible this morning so started searching the house. Luckily within a few minutes he appeared from our bedroom. Told him not to do that. When he hears my alarm it's he knows it's food time. Pretty good appy and spirits this morning. I've noticed that although Lasik jumps his numbers up he is a little more perky after the shot. Guess it really does help him breath better. There were a few times shortly before PMPS that it looked like he was have bouts of short breath :(

He got a dosecrease at PMPS last night to 5.5 units and I did give him .25 R and .25 again this morning to help minimize any potential NDW. Waiting for a copy of various test results since the vet simply can't answer a direct question. We're scheduled to follow up with the cardiologist in 2-3 months and the IM vet pretty much said "you know diabetes" so good luck and keep us posted if you want. Thank you L&LL family for being here.

Sending lots of vines and prayers to all the kitties and their beans:bighug:
 
Looks like Doodles recovered from the PFS. Sorry to hear about the shortness of breath last night. That must be scary to witness. Don't you just hate when they don't respond to you call? It always makes me think for the worse.....Karen, how are you holding up with all the extra testing that the R brings to the table? Are you getting enough sleep?
 
Bobbie And Bubba said:
That must be scary to witness
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It's not fun for sure. Just wish I'd gotten him to the cardiologist in early February when I saw it the first time. Luckily it didn't last but a few minutes and wasn't super heavy.

Bobbie And Bubba said:
Karen, how are you holding up with all the extra testing that the R brings to the table? Are you getting enough sleep?
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I didn't mean to sound hostile yesterday about my comments with the testing. If Doodles was green and hunting for reductions it would be more justifiable in my brain. Most days I get a nap in even if it's after PMPS. Otherwise 5/6 hours of sleep catches up with me by Sunday.
 
Doodles & Karen said:
It's not fun for sure. Just wish I'd gotten him to the cardiologist in early February when I saw it the first time. Luckily it didn't last but a few minutes and wasn't super heavy.


I didn't mean to sound hostile yesterday about my comments with the testing. If Doodles was green and hunting for reductions it would be more justifiable in my brain. Most days I get a nap in even if it's after PMPS. Otherwise 5/6 hours of sleep catches up with me by Sunday.
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Ah, you didn't sound hostile, just tired. You have a lot on your plate, Karen and juggling different meds and conditions............. The R will take time and Jill is a wizard with the dosing and timing of it. Hang in there. :bighug::bighug::bighug::bighug:
 
Bobbie And Bubba said:
Ah, you didn't sound hostile, just tired. You have a lot on your plate, Karen and juggling different meds and conditions............. The R will take time and Jill is a wizard with the dosing and timing of it. Hang in there. :bighug::bighug::bighug::bighug:
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The goal is to find a Lantus dose that will keep Doodles between 125 & 225 give or take. A lot of running around is really not good for him at this point.
 
Doodles & Karen said:
I didn't mean to sound hostile yesterday about my comments with the testing. If Doodles was green and hunting for reductions it would be more justifiable in my brain.
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Well, you're probably not going to like what I'm about to say because I'm pretty sure I'm treading on a sore subject. In fact, you may even get po'd at me, but no one has said anything and somebody has to speak up for the sake of all... for your sake, for Doodles' sake, and for the sake of everyone who offers suggestions or advice on when and how much R to give. So, in the interest of safety, I'll be the bad guy.

Your thinking about testing is spot on for Lantus use, but flawed when it comes to using R. It's probably our fault. We must not have done a very good job explaining the importance of testing when using R. Initially, testing at +1, +2, +3, +4 and sometimes beyond (until the BG numbers begin to rise) is basically a requirement when using R because R has the ability to drop BG numbers like a rock. R can be downright dangerous if one doesn't use it carefully. Testing is imperative to determine onset, nadir, and duration. If I've counted accurately, since you began using R, you've tested at R +1 thru +4 once out of 10 R shots... and Doodles was still dropping at that time. This morning is the 11th R shot. There are too many holes in that data to conclude much.

When the timing of the lasix dose was changed, the previous R data became pretty much obsolete for all practical purposes. I believe I mentioned the other day it would be like starting over with R data because of the change in timing of the lasix. Heck, testing may even show us a better time to shoot the R dose in relation to administering lasix. You never know!

I/we really need current R data to proceed safely. Our hands are tied without the whole picture. Once we can determine how Doodles is responding and predict that response with some degree of certainty, it won't be necessary to test so much after giving R. The thing is... we're not there yet.

Karen, I've hesitated to say anything because I know you have so much on your plate and I know all too well the caregiver's emotional and physical stress is heightened when one has a sick kitty, but in the interest of safety, somebody had to say something.

Pleased don't shoot the messenger. It wasn't easy to write this post. Think about what I've said. My remarks are not a criticism in any way, shape, or form. My sole intention is to keep Doodles safe and to be very clear about letting you know what we need to insure his safety when using R.

Remaining silent would only be a disservice to you, to Doodles, and to those in this forum who offer R advice...




 
Karen, it's okay to be hostile, mad, angry, tired, overwhelmed. Sometimes I just want it all to stop and be done with it. Days where I want to give Smokey back or let him go meet my mother.

But then a day like today happens, he lays against me purring and his head is using my leg as a pillow and he wants human contact. His BS promising at least for this cycle. How do we not keep going for them.

I have faith in you and Doodles. You will persevere and figure it out. Catch naps when you can. :bighug::bighug::bighug:
 
Jill & Alex (GA) said:
Well, you're probably not going to like what I'm about to say because I'm pretty sure I'm treading on a sore subject. In fact, you may even get po'd at me
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I'm not even in in the slightest way upset and realize I haven't held up my end of the deal with R testing. Almost made all 4 in a row this morning but frankly had to shower. TMI, I know. In all seriousness my intent was to pick it up a bit but yesterday was real crappy and only gave it again in the afternoon because of the fur shot. Also part of the reason I've stuck with .25 because I do feel it's safe for now. My goal is to eliminate R sooner rather than later and continue to find the right Lantus does that keeps him Blue & Yellow...that's it.

If I decide to give R at PMPS tonight I'll get the additional tests in. Appreciate all your help Jill, I really do.
 
IAA Results are 72...normal is below 20 and she thinks this is just a little high?? Her note on the paperwork indicates she's not sure it's significant because of the heart condition and wants to see if we regain control of this BG's. Wow, that's all.

Also added the renal panel blood work. They said his kidneys are handling the meds...can someone take a look on his Labs tab on the SS and let me know what you think? A few things went up since the meds started.

Total Protein- 8.1 High
BUN - 51
Creatinine - 1.6
Bun Creatinine ratio - 31.9
 
Doodles & Karen said:
IAA Results are 72...normal is below 20 and she thinks this is just a little high?? Her note on the paperwork indicates she's not sure it's significant because of the heart condition and wants to see if we regain control of this BG's. Wow, that's all.

Also added the renal panel blood work. They said his kidneys are handling the meds...can someone take a look on his Labs tab on the SS and let me know what you think? A few things went up since the meds started.

Total Protein- 8.1 High
BUN - 51
Creatinine - 1.6
Bun Creatinine ratio - 31.9
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I don't know anything about IAA except what I read in your post yesterday. But it would certainly explain his BGs for the last 2 months. On the labs report does it give any range for the IAA?
 
Doodles & Karen said:
IAA Results are 72...normal is below 20 and she thinks this is just a little high?? Her note on the paperwork indicates she's not sure it's significant because of the heart condition and wants to see if we regain control of this BG's. Wow, that's all.

Also added the renal panel blood work. They said his kidneys are handling the meds...can someone take a look on his Labs tab on the SS and let me know what you think? A few things went up since the meds started.

Total Protein- 8.1 High
BUN - 51
Creatinine - 1.6
Bun Creatinine ratio - 31.9
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I know nothing about IAA or your labs, but just wanted to say that I am so glad that you see some yellow today! I know how scary all of the reds and blacks are as Shoes spreadsheet is mostly that. Glad that you saw a drop today.
 
Doodles & Karen said:
IAA Results are 72...normal is below 20 and she thinks this is just a little high??
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I do know a little about IAA, there is actually a severity scale. Neko was 52. Maybe @Sandy and Black Kitty can comment on the 72. This is not a "little" high. I often see IAA present with other conditions, such as acromegaly, skin allergies, needing a dental, etc. Very seldom is it just by itself, or at least not high enough the beans get a test done. It could be the heart condition is a contributing condition, just speculation. But knowing IAA is in the picture explains a lot. And may impact how aggressive to get on dosing.
 
Wendy&Neko said:
acromegaly, skin allergies, needing a dental,
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His acro came back 72, doesn't need dental and who knows if there is skin allergies...no signs that I can see other than occasional scratching. Her thought is the heart condition is contributing but agree 72 is more than " a little high". I would accept up to 40 as "a little high' but what do I know.
 
@Sandy and Black Kitty our question is do you know the severity scale for IAA? My vet said 72 is a "little high" and is contributing his high BG's to the heart disease, not IAA. Personally I think 72 is more than "a little high". Thanks.
 
Well now Doodles, that is not a nice thing to do.

Is there anything that can be done or is this where using the R to keep numbers down is what you have to continue?
 
Thanks for clarifying.

As you can see in my signature line BKs result was 84% which, according to the MSU vet that interpreted the result, is 'extreme insulin resistance'

Although I'm not aware of a scale, IMHO 72 is (more than a little) high.

I will respond later tonight with a whole lot of info - I'd like to review your ss before I elaborate. Also I'm a very very slow typist.

For now I'll say-
BK was the first LL kitty to test for IAA .
He was also the last kitty anyone thought would go OTJ.
It's been 6.5 years since he did just that :cool:

hang in there - and hang in here.
BBL
 
Sandy and Black Kitty said:
I will respond later tonight with a whole lot of info - I'd like to review your ss before I elaborate
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Thank you for taking the time Sandy. I've been reading about it and have read your miracle story. Unfortunately with Doodles congestive heart failure and severe HCM it's hard to remain positive. Instead I spend 99% of my time with him.
Sandy and Black Kitty said:
hang in there - and hang in here
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I'm really trying
 
Woodsywife said:
I wonder what she considers a big high is
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She probably didn't want to tell me since I broke down in tears twice in her office - lol. Does explain why no one wanted to answer my question and basically told me good luck with his diabetes and to keep them informed. Basically it's a "can't help you, sorry".
 
Hi Karen:)

:bighug: for you and
cat.gif
for Doodles.
 
((((Karen))))

I am so happy it is not acro. You can be more aggressive with dosing...and I think the R can really help....to break through the IAA. Normally, IAA is eventually self-limiting. Because I don't understand how it connects with his HCM and whether there is a cause:effect, I don't know if the self-limiting part applies in this case.

I'll take a peek at his labs. BRB.

You can do this....you have been doing great and you always have us!

Edited to add: total protein can be high due to dehydration...so can BUN. It can also be high, as globulin can, due to inflammation. I wouldn't worry based on one test. It's w good idea to keep an eye on the kidney levels. He's had a creatinine of 1.6 before and it can sometimes go up and down in a cat that doesn't have CKD whereas you'd probably just see it going up in a cat with CKD (unless the kitty had stones or infection). I don't see anything right now that worries me. Labs are always just a snapshot at that moment and so you have to follow trends.

Hugs.....
 
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Karen - :bighug::bighug::bighug:

I did a little searching this afternoon. I'm sure Sandy will have more later. A couple of posts you may be interested in:
Wendy's packrat post on Hyde 10/29

Test Results of Buddy - IAA 72

A number I've seen tossed in a few places:
This (IAA) is less common in cats - affecting less than 5% of cats on human recombinant insulin.

We can help you, we've seen a number of cats (including my girl) break through the IAA resistance. Disclaimer, I did not use R back then. At that time, Neko was the only IAA cat here and R experience was a lot harder to find.
 
Doodles & Karen said:
She probably didn't want to tell me since I broke down in tears twice in her office - lol. Does explain why no one wanted to answer my question and basically told me good luck with his diabetes and to keep them informed. Basically it's a "can't help you, sorry".
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I am so sorry Karen! Your love shines through for Doodles!
 
Doodles & Karen said:
She probably didn't want to tell me since I broke down in tears twice in her office - lol. Does explain why no one wanted to answer my question and basically told me good luck with his diabetes and to keep them informed. Basically it's a "can't help you, sorry".
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:(:(:(

That just made my heart break for you when I read that. I don't know anything about IAA so I don't have any advice but just want to send you the biggest hugs and vines to Doodles. :bighug::bighug:
 
Marje and Gracie said:
You can be more aggressive with dosing...and I think the R can really help
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I assume every 6 cycles we go up .5 units. Not happy about R as mentioned yesterday. My boy is toward his end and I hate the fact that all I do is poke him. Not what I want him to remember. Sorry, just angry at the moment.

Thanks for double checking his labs. Our recheck is in 3/4 months unless otherwise needed. They said his labs were stable but your confirmation helps!

Marje and Gracie said:
You can do this....you have been doing great and you always have us!
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I'm very thankful to have all of you. Hopefully we can at least get him yellow again.
 
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