3/6 Fred Acro/IAA negative!!

[Purrberry]

After nearly 2 weeks of highly anxious waiting, I received Fred's results this morning. They were emailed to me, and the vet has promised to call later today. I'm sure she just wanted me to have the good news ASAP. I'm shocked but thrilled.

So of course this begs the question....what IS causing Fred's IR? Because he surely is right now. He's been on Veraflox since Wednesday, which coincided with some nasty numbers. I thought perhaps it was the med, but maybe it was just a terrible bounce. (though I can't see when it happened) He did slide into a blue last night, which I was thrilled to see, but as always, we're back up again today.

Now I'll start the worry over Cushing's, though he does not display any symptoms of that at all. (other than the IR...his skin is strong, his fur grows back, no potbelly, and his ultrasound in mid-December was clear) But I promised my husband if the acro test was negative I'd be happy, so I'll keep that promise! Fred is very chipper today as well. I'll take today to be happy and thankful, and start my worry again tomorrow. ;-)

 

[Wendy&Neko]

Awesome news. If you can, get the test result numbers, I am always curious what negative looks like.

 

[Wendy&Neko]

One more comment, with that steep drop to +2 last night, I would have gotten another test in. That was a signal for an active cycle. Hence the bounce this morning.

How are Fred’s teeth? He had a dental lately? That’s a common item making it hard to regulate. That and sneaking dry food from somewhere.

 

[Purrberry]

Fred's results: (from Michigan State)

Insulin-like Growth Factor 1 (Acro)- 56 (ref range 12-91)
IAA- 3 (ref range <=20)

I feel pretty good about the numbers, as he's pretty solidly in the middle. If he were skirting around 90, I'd still be concerned. But I don't like to jink things, so I will keep my fingers crossed!

One more comment, with that steep drop to +2 last night, I would have gotten another test in. That was a signal for an active cycle. Hence the bounce this morning

I know. I was pretty surprised by that quick drop. That happened a few times in the early days, but not usually that early in the cycle. I just had a suspicion that was going to happen, so I tested him before I absolutely conked out asleep. I was so drained after awaiting the phone call regarding the results (and then not receiving it) that I was out cold. I WAS awakened at 2:45 AM by a certain gray cat clawing his way through my hair, which is his favorite technique for waking me up. ;-) As he was chipper and got a snack, I passed back out. I don't think I could have seen straight to test! Normally...yes, absolutely.

How are Fred’s teeth? He had a dental lately? That’s a common item making it hard to regulate. That and sneaking dry food from somewhere.

I believe he DOES need a dental, but I think everyone wanted him regulated first. As that could be a chicken and the egg situation, I've been considering it more and more. He also has a small mast cell tumor on his face. It was due to be removed the day he ended up starting insulin, so they put that off as well. I have also often wondered...mast cells cause inflammation, so could it be...?? The timing is suspect.

As for the dry food, we are trying very hard to cut it all out, but someone (and Miss Sadie) is VERY stubborn. We're on a 50-50 combo of Dr. Elsey's chicken and Young Again Mature LID, so about 2-3% carb. I'm down to about 1/4 of what he used to eat in dry, but we're not 100% there. I have kind of field tested where I withhold the dry as long as I can, and it doesn't move the numbers. But it could take longer than I'm withholding. The process continues!

 

[Suzanne & Darcy]

Excellent news! Congratulations.

 

[Wendy&Neko]

I don't mean to be a Debbie downer, but I just did a little math. I have seen a study that said 1/3 of cats who had their IGF-1 tested less than 73 days after starting insulin, had false negatives. I think with Fred, the blood draw was 71 days after insulin start. You are probably OK as that's pretty close and it's not like he was near the edge of positive. We did see a cat recently that was tested too early with IGF-1 in the 80's and way higher a few months later. If for some reason things don't get better after a dental, you might want to revisit. I'd strongly recommend seeing if you can get an appointment with a dental specialist vet. They are used to complicated kitties. And dentals have made a world of difference in some cats/

The dry if low carb is not so much an issue. I've heard of cats sneaking dog food or if there was higher carb dry available in the house.

 

[Purrberry]

I don't mean to be a Debbie downer, but I just did a little math. I have seen a study that said 1/3 of cats who had their IGF-1 tested less than 73 days after starting insulin, had false negatives

I understand. You're not. I was aware of the 73 day study, but the timing of Fred's vet appointment was the only one I could get. I was thinking, "Well, it's 71 days, and he's so high he's going to be positive anyway...". Now, of course, I will worry. I know that @Howiesmom had a negative IGF-1 earlier on, but I now see that was after 73 days? And if you see this, @Howiesmom, you are doing the most amazing job!

I'm glad Fred's number is currently firmly in the middle, but I do definitely have a fear that could change. It's just not a perfect test, I suppose. I woke at 3 AM, couldn't get back to sleep, and started madly Googling insulin's effect on IGF-1, as well as timing the test. (phone in the middle of the night...bad, bad habit!) It was interesting to see that there seems to be a correlation between how long a cat has been on insulin and a higher IGF-1. However, cats with acromegaly still have much higher numbers than cats that do not.

Fred's numbers are just so wretched that I feel like I'm fighting an invisible enemy. And he bounces SO hard! I have no idea where these mid-cycle blacks are coming from. It seems to break, and then he bounces again. So the bounces way outlast the lower numbers, seeming to ruin any progress.

Sadly the only dental specialists around are over an hour away. Fred and the car do not mix....and that is the understatement of the year! My regular vet is actually very good with dentals, so I will speak to her about it. We haven't discussed it as of yet. With his kidneys, we are very cautious. He's on his 5th day of the antibiotic, and that hasn't seemed to budge anything. *sigh*

 

[Wendy&Neko]

Good luck with the convincing the vet to get a dental done. I thing that taking care of his other medical issues is important. There are anaesthesia guidelines for diabetics.

I wouldn't worry about the timing of the IGF-1 test now. I think the other issues are higher priority. I've seen bad teeth play havoc on BG numbers.

 

[Howiesmom]

@Purrberry
Hello! Howie is doing well regardless. He is on cabergoline and I just increased his dosage to .9mL per my vets recommendation. I broke his glucose antibodies in Jan when he was at 55u BIDand we dropped him down incrementally to 30u BID. But that only lasted so long and I’m back to 53u BID. But cats need what they need and I have to keep remembering that regardless of how frustrating this is. @Wendy&Neko has been my angel and walked me through so many situations. Although this dramatic increase may be seen as a setback, it is what it is. The crazy part is that I got Howie on 3/24/20 and he checked out healthy as a horse, but his complications came on as of June 2020. So in less than a year, he was diagnosed diabetic, IAA, and eventually acromegaly (on top of getting all his teeth removed). I just learned last night that his former owner who passed away in Feb 2020 lived next door to a close acquaintance and we never put 2 and 2 together until recently.