? 4/23 Malcolm AM PS 533 PM PS 507

I keep getting 400 or 500 pre shot numbers and it seems ever since I upped his dose (now on 6.75!) his numbers go up. He has had some 200 numbers, but he's never really had 500s until I upped his dose to 6.25+. I'm so frustrated. Hes only eating pate wet food (now friskies) and freeze dried chicken treats. With an occasional tiki cats pumpkin treat and a Purina hydra packet because he keeps getting constipated. I have an appointment on Thursday for an ultrasound to see if there's something causing him to have high numbers. I guess I just need some guidance to see if I should keep raising his dose. Also, what to do on the day of his ultrasound. He goes in at 8 am and his shot is at 9:30 am. My vet said not to feed him and they'd give him 1/2 a dose.

 

Here's the link to your last post here.https://felinediabetes.com/FDMB/threads/3-13-malcolm-amps-277.287686/

I have another suggestion for your appointment on Thursday. Ask the vet to draw blood and have him tested for acromegaly and IAA (insulin auto antibodies). The blood goes to the same place - Michigan State University. Once a kitty gets over 6 units, there's a good change one or both of those conditions is present. Neko had both. There are treatments for acromegaly - recent research shows one in four diabetic cats has it. It can mean cats need higher doses, though there are some lower dose ones too. Neko got to 8.75 units before turning it around.

As for ultrasound, I never had to fast Neko for ultrasound, but I guess that's what the vet wants. Was it the vet who said no feeding? Or tech/front desk. I often had to remind the person I was talking to that she was diabetic and to go ask the vet. Usually they have different guidelines for diabetics. Hopefully you can feed him fairly late before you go home to bed. A half dose is standard if they can't eat.

I do see some progress on the dose. His yellows are getting lower, and causing him to bounce. Since he's now on all low carb wet, you could switch to dosing with TR, which would allow you to increase faster and get to a good dose quicker too. Over 5 units we do increases of 0.5 units at a time. And you could increase every 3 days if he's not seeing anything under 200.

 

I've been to several vets asking them to do both of those tests. One said they could only do the IGF test but not the IAA test. I even sent her the code but she still said they couldn't do it. Another vet I went to said they could do both tests when I called. But when I arrived, the vet ended up being the worst vet I have ever had and told me that i was testing too much and to not even test before shots! And that 300 numbers aren't bad. And she wouldnt do the tests. I found another vet who would do the IGF test, but never heard of the IAA test. But she would look into it. I would have just gone to them for the ultra sound, but it was very expensive compared to my old vet. So I'm going to my old vet for that. They don't do those tests there. It was my friend who is a vet tech there who told me not to feed him before I bring him in and they'd give him 1/2 a dose there. I'm just concerned about what dose I should give him at the PM shot

 

PM shot would be his regular dose.

Have you ever been to an internal medicine vet? I'd hope they'd be more knowledgeable. We had one member who had to get his vet to do the blood draw, and then set up the account with MSU and ship himself to get it done.
MSU VDL testing instructions for IGF-1 and IAA

 

One vet referred me to an internal medicine vet but they called to tell me they weren't accepting new clients at the moment. I haven't researched it more though because I'm going broke from all of the vets I've been to. Plus now I'm about to spend more money for the ultrasound.
Maybe I can suggest doing that at the other vet that said she'd look into the IAA test when I go back in for his solensia shot next month.

 

Thank you for that information as well. I joined the acromelegy group and a woman over there helped me with that as well as a member of the feline diabetes group. I will try and talk to the new vet I liked about doing that. She seemed more open to it compared to all of the other vets I've been to. I'll see what the ultrasound says and then go from there.
Also, thank you for letting me know about the pm shot dose. I was concerned since they'll be giving him 1/2 the dose in the AM

 

Best of luck with the ultrasound. I'm not sure what the vet thinks they can find on an ultrasound that is causing high numbers.

 

Malcom is at 6.75 units. He's been getting some mid day 200s. Do I go up or down on his dose?