3/30 Chino|AMPS=145|bounce|PMPS=387|+2=331|+4=198

Status
Not open for further replies.
He's back on his pogo stick. Gave 0.75 units R with his 2nd meal for a +4 reading of 392.

Lab results came back:

  • UA shows protein "1+ (HIGH)" which I was expecting, since his urine is foamy. Not sure what that means.
  • Urine glucose was negative - I wasn't expecting that, but I'm not complaining! :) Blood glucose was 238.
  • RBCs, Hgb, Hct, and platelet count are all down from the last check in December. Anemia and thrombocytopenia are potential adverse effects of methimazole. I'm waiting for the vet to call so I can ask about that.
  • His creatinine went up from 1.1 to 1.8, but it's still within normal range, and his BUN/creatinine ratio is down from 29.9 to 17.
 
I am loving the new trend of colours on Chino's spreadsheet. :cool: And back to back blue preshots again. :) The bounces, oh well, there's a tool for that.

I love it when the urine glucose is negative. That means he was under renal threshold at the time of the test so wasn't spilling glucose into the urine. :) I used to test before and after going to the vet, and used the urinalysis results to give me an idea where Neko's renal threshold was. It's really fun times when you can get both urine and blood glucose in normal range. It can make vet's nervous though.:smuggrin:

As for the proteinuria, at some point you may want to get a urine protein/creatinine ratio done just to see how much protein is getting spilled. It's common enough with acros, but can also be an early sign of kidney disease. Neko had it, There are meds to alleviate it and slow down the kidney progression if that is what it is, And you should get a blood pressure test done sometime too, as there are a few causes of proteinuria that need to be ruled in/out. This probably isn't urgent and I am sure the vet would have said something if she thought it was. We waited until Neko's urine protein was even higher before doing the testing.
 
They checked his BP Saturday, said it was a little high but nothing to be concerned about at this time. The result(s):

Location: Tail / Cuff size: 4

SBP/DBP - MAP - HR
145/120 - 130 - 80
245/170 - 195 - 195 (LOL... judging by the sudden increase, this is probably where he was thinking "WTF are they doing to my tail?!?!")
225/85 - 130 - 195
185/170 - 175 - 205
190/110 - 115 - 190

Average: 185/130 - 150 - 195
 
Good to have that baseline. Neko's first BP attempt came after a long wait in a noisy, barky waiting room. Vetty had an emergency. It was over 220 and I don't want to think what mine was. :rolleyes: Attempt number two was 180 after a puppy jumped her carrier in the waiting room. Try number three at the dental vetty after chilling in a room by herself with Feliways going, 142. Neko had way worse BP stress at the vet than BG stress. The MAP device isn't quite as accurate as the Doppler, but it is quieter.
 
The vet said not to worry about the hematology values since it's a gradual decrease (though he started the methimazole on 2/12). Said the proteinuria is something to keep an eye on. She was concerned about finding no glucose in the urine, but said that since I test throughout the day, she's not worried about his BG going too low. It's such a relief to have found a vet who stands behind what I'm doing with Chino's insulin management. She also said she can coordinate it if I want any imaging studies done.

My primary concerns before the appointment and labs were potential kidney problems and unregulated hyperglycemia. Now that we're starting to see regular greens and blues, and the labs related to renal function don't indicate kidney disease, these are my main concerns:

  • Potential anemia/thrombocytopenia from the methimazole (will follow up with repeat labs in 3 months)
  • Watching for the progression/complications of acromegaly... is there any way to evaluate prognosis?
  • Determining if SRT is affordable, and if not, looking for alternative interventions
  • Confiscating Chino's pogo stick and persuading him to break bounces during the day instead of overnight
 
It's amazing how quickly he's clearing bounces now. While I love these blues and greens, I don't love losing 1-4 hours of sleep every other night... I picked up 4 different cans of cat food, two of them 5% CHO, two of them 7%. Next time it looks like he's about to come down from a bounce, I'm going to split one of these between PMPS and +4 to see if it helps at all to slow the drop.
 
Adrian and Chino said:
these are my main concerns:

  • Potential anemia/thrombocytopenia from the methimazole (will follow up with repeat labs in 3 months)
  • Watching for the progression/complications of acromegaly... is there any way to evaluate prognosis?
  • Determining if SRT is affordable, and if not, looking for alternative interventions
  • Confiscating Chino's pogo stick and persuading him to break bounces during the day instead of overnight
Click to expand...
Looks like number 4 concern is making great progress. :cool: SRT is probably around $5-$10K, depending where, exactly what type of machine, number of days of radiation, and whether they need an MRI on top of the CT scan. Few do. As for the progression/complications of acromegaly - I'm afraid it's EACID, each acrocat is different. Neko's worst symptoms were arthritis (bony growth) and some soft tissue/bony growths in the mouth. She hardly had any other notable symptoms. Other cats get bigger paws/jaws early on and the stridor. I do know that if you are going to do SRT, doing it earlier is better. The SRT just neuters the tumor cells and you can still see impacts of the soft tissue and bony growth for a while.
 
PMPS = 387 (3rd meal, LC 3%)
[10 units Lantus]
+2 = 331
+4 = 198 (4th meal, LC 3%)
+5 = 144

Looks like the pace is slowing. I gave him 3 big chunks of freeze-dried chicken and I'm about to open a can of 7% to give him 3 teaspoons... if he continues to drop by 50 mg/dL per hour, he'll be hypoglycemic by the time I wake up for a +8.
 
Once again, I didn't fully wake up to my 0300 alarm, so I missed my 2nd dose (too late to take it now) and missed his "typical" nadir. Got a +9.5 check and it was 159. The medication takes 4-5 hours to wear off so it's still in effect at +8 when I stay up for a +5 and take it an hour late. I'm not sure what to do about this. I could give him MC/HC every night to keep him above 100, but that would defeat the purpose of treating his diabetes, since he only goes into normal ranges at night.
 
Adrian and Chino said:
I could give him MC/HC every night to keep him above 100, but that would defeat the purpose of treating his diabetes, since he only goes into normal ranges at night.
Click to expand...
Responding here since I don't see today's post and am about to head out for the day. Going forward, feel free to use MC/HC to keep him above 100. Once he stops bouncing as much, he will mix up when he goes low and not just do it at night. And hopefully get flatter. And since Chino's an acro, he likely has a pancreas that's just working fine so you don't need to heal it. Your goal should be under renal threshold most of the time. If you need to abort a surf to get into normal numbers so you can sleep, then so be it. It's OK. :bighug: For night time, my goal was to keep Neko in safe numbers, not to prolong the good numbers.
 
Status
Not open for further replies.
Back
Top