5/17 Lanky AMPS 378, PMPS 331

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sehjak (Susan & Lanky)

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Yesterday's Condo

Morning All - All pretty well at the infirmary: Lanky, Otis, Miss Nubbins & now husband. Bruski (fat cat but less so now with no dry kibble & I just told him how handsome he is looking these day, but I digress). It is MONDAY morning, a new day. Lanky just ate breakfast, great appetite as usual. He is so cute the way he chatters as I am putting his dish of food on the floor (on a paper napkin table cloth of course). Actually it is more like chirps & singing. We served 3% Fancy Feast again as everyone like it.

Another dose increase this AM & I am almost thru the Lantus pen, maybe 1 or 2 more doses. I'll be watching all my boys & my little girl today as everyone is hopefully on the mend.

Happy Monday Lantus Land!
 
Re: 5/17 Lanky AMPS 378

There are concerns about me suggesting to raise the dose this morning. I'd like to offer a possible solution for the future. The problem with what I did was no one had a chance to chime in. I will try to post a cycle before hand -- that will give everyone a chance to offer their welcomed input.
 
Re: 5/17 Lanky AMPS 378

Hoping others stop in on the vet "to do" list.
I'm headed out but wanted to start my vet list.
check for pancreatitis
IAA test
Acro test
prescription for Levemir (since your vet is so far away I thought it would be good to get one while your there, then you'll have it on hand in case you want to try it)
 
Re: 5/17 Lanky AMPS 378

D and Noisy said:
Hoping others stop in on the vet "to do" list.
I'm headed out but wanted to start my vet list.
check for pancreatitis
IAA test
Acro test
prescription for Levemir (since your vet is so far away I thought it would be good to get one while your there, then you'll have it on hand in case you want to try it)

is the check for pancreatitis the same as an ultra sound? - the ultra sound mentioned by the vet costs ~$350...
And, then I would mention the trends we've observed.

Anything else??
 
Re: 5/17 Lanky AMPS 378

I have to run back out -- be back in about 3 hrs. Always nice to see yellow.
I don't know if that is how pancreatitus is checked. I've not had first hand experience with CP. I will find out though and report back when I return.
 
Re: 5/17 Lanky AMPS 378

D and Noisy said:
I have to run back out -- be back in about 3 hrs. Always nice to see yellow.
I don't know if that is how pancreatitus is checked. I've not had first hand experience with CP. I will find out though and report back when I return.

We check for it with a bloodwork at our clinic to see if the amyl and lipa values are elevated could be other tests too that I am not familiar with as a tech but this is how its dx'd where I work anyway, do Lou's mother had chronic CP
 
Re: 5/17 Lanky AMPS 378

Libby and Lucy said:
Here is Jojo's post on chronic pancreatitis: http://www.felinediabetes.com/phorum5/r ... msg-876722

There is a newer test called spec-fPL that is faster than the fPLI. http://www.idexx.dk/animalhealth/labora ... l_1208.pdf and http://www.idexx.com/view/xhtml/en_us/s ... nId=248778

There is a link on the High Dose forum on FDMB that contains information on the test for acro and IAA.

http://www.cvm.tamu.edu/gilab/assays/index.shtml I wanted to add this info if you are going to to do the TLI/PLI test we use Texas A&M where I work they have a combo panel that includes both of these tests so that covers 2 pancreas tests at one time just my input to add once again
 
Re: 5/17 Lanky AMPS 378

Lisa - this is so helpful, thank you.
ETA - Lucy - just finished reviewing the information you provided too, again, very helpful, thanks too.
 
Re: 5/17 Lanky AMPS 378

sehjak (Susan & Lanky) said:
Lisa - this is so helpful, thank you.
ETA - Lucy - just finished reviewing the information you provided too, again, very helpful, thanks too.

No problem best to you with Lanky will be checking your condo for updates on you two cat_pet_icon
 
Re: 5/17 Lanky AMPS 378, PMPS dose input please

Please take a look at today's SS and tell us your thoughts on dose and progress in general. Specifically, I'd like to hear concerns about the recent dose increase. I will be talking to our regular vet tomorrow & hope to give him the most compete & fair update as possible. And, if you have anything to add for my vet conversation, please do. This could include questions I should ask, additional requests I should make, etc, etc, etc. See D's post above.

My vet is a really good guy & has helped me over the years with multiple kitties including one with Diabetes dx'd way back in the early 90"s. Her name was SweetPea and she certainly was too. Actually she was pound cat who looked like a long hair Siamese princess. We adopted SweetPea & her sister Itsy-Bitsy, a short hair Siamese. She survived about 10 years with FD and died of breast cancer at about 18 years of age. She is still my sweetheart too. PS Always shot blind, scary now!
 
Re: 5/17 Lanky AMPS 378, PMPS dose input please

I'll put a call out for other eyes.
ETA: I feel the same way I did this morning about the 7u.
 
Re: 5/17 Lanky AMPS 378, PMPS dose input please

My opinion about Lanky's dose is that since you have already increased, you might as well keep it. You do a good job getting tests, so just keep an eye on the numbers in case he drops when his bounce clears. Next time he hits blue, though, I would rather wait 2-3 days after the blue to be sure rebound has cleared before increasing again. I think Lanky is getting close to his dose, he got pretty close to green on 6.5 so I don't think it's too far away.
 
Re: 5/17 Lanky AMPS 378, PMPS dose input please

Great & thank you. I hope & believe we are close to the dose too. I can't imagine what my vet will say about the dose though. When I saw the sub Vet, he wanted me to hold the dose at 4.5u---yep, a surprise in store.
 
Just wanted to send good vibes and feel betters for the household.
You are doing an amazing job with Lanky.
When is the vet visit? Sorry I missed a bit of days :(
 
Re: 5/17 Lanky AMPS 378, PMPS dose input please

Libby and Lucy said:
My opinion about Lanky's dose is that since you have already increased, you might as well keep it. You do a good job getting tests, so just keep an eye on the numbers in case he drops when his bounce clears. Next time he hits blue, though, I would rather wait 2-3 days after the blue to be sure rebound has cleared before increasing again. I think Lanky is getting close to his dose, he got pretty close to green on 6.5 so I don't think it's too far away.
i share libby's opinion about lanky's dose. generally speaking, when kitty hits blue (especially below 150) we like to hold onto the dose for a little longer. this allows time for the bounce to clear. it can take up to 72 hours (3 days) for the counterregulatory hormones to clear the body. if one repeatedly increases the dose without allowing time for the bounce to clear, there's a chance for kitty to become over dose. when a kitty is over dose, sometimes the numbers remain high. sometimes they're high and then unexpectedly drop.

the german tr protocol suggests holding each dose for 5 - 7 days unless nadirs are greater than 200.
from the STICKY: LANTUS & LEVEMIR - TIGHT REGULATION PROTOCOLS, the "modified version" of the tr protocol followed in LL suggests the following guidelines:

Increasing the dose...
--- Hold the dose for 3 - 5 days (6 - 10 cycles) if nadirs are less than 200 before increasing the dose.

--- After 3 consecutive days (6 cycles)... if nadirs are greater than 200, but less than 300 increase the dose by 0.25 unit.

--- After 3 consecutive days (6 cycles)... if nadirs are greater than 300 increase the dose by 0.5 unit.



good luck with your vet visit!
 
I think I found one reason why we are disagreeing -- you guys feel Lanky is/was in a bounce, I don't think Lanky is/was in a bounce. I do see where I think bounces occur but they aren't the same place you guys are seeing. I agree with the plan -- it will show one way or the other.

What I see is 1. dose gets raised, 2. 3rd or so cycle he responds, then 3. his body acclimates to the new dose and goes back to the higher numbers. What I was trying to do was head off the 3rd part of the pattern I see by staying ahead of it.

I had 7u in my mind as my cut off for proceeding without further tests and Lanky is going to vet today -- I couldn't have asked for better timing.
 
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