5/19 Tiggy PMPS 59

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Wendy&Tiggy(GA)

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Pink.. still... sigh. ohmygod_smile Seems happy enough though - no signs of excessive drinking to anything. Currently lying under the coffee table with his feets in the air. I don't think this is a bounce now and wonder if its time to go to 8 units

Wendy
 
Re: 5/19 Tiggy AMPS 354 :(

Why don't you think this is a bounce? He's gotten to the 40's four times on this dose and that generally means going down not up in dose. I'd give him today to clear out the bounce and see where he's at.
 
Re: 5/19 Tiggy AMPS 354 +5 74

I didn't think it was a bounce from the 42. but maybe another bounce from the 99...

He is such a bouncy boy.. like his name sake Tiggrrr I guess :)
 
Re: 5/19 Tiggy AMPS 354 +5 74

So far so good Tikaani Tiggrrry! :thumbup

But 300 points in 5 hours may be a bit dramatic? @-)
 
Re: 5/19 Tiggy AMPS 354 +5 74 +6 53 +7 54 +8 40

No wonder he is so bouncy. Now he is at 40.... One more little drop and he gets a decrease. Although with this being the fifth time under 50 maybe he earns one any way?
 
Re: 5/19 Tiggy AMPS 354 +5 74 +6 53 +7 54 +8 40

Dramatic is right! Of course he'll probably bounce from this. :roll:
 
Re: 5/19 Tiggy AMPS 354 +5 74 +6 53 +7 54 +8 40

I would. I wonder how he would respond to a .25U decrease? What do you think?
 
Re: 5/19 Tiggy AMPS 354 +5 74 +6 53 +7 54 +8 40

Goes to show what may be hiding between those lonely pink spot checks.
 
Re: 5/19 Tiggy AMPS 354 +5 74 +6 53 +7 54 +8 40 +9 57

That's why I try to check every 6-8 hours no matter what.

Chip had a 300 point dive from pink last night I might have missed had he not alerted me.

Of course I wouldn't have missed the green AMPS, but I try to steer a softer landing when possible.
 
Re: 5/19 Tiggy AMPS 354 +5 74 +6 53 +7 54 +8 40 +9 57

Something has changed it seems. He never used to dive that fast, he would drop slowly to yellow first. Interesting.
 
i just now saw your condo from yesterday and the conversation about iaa. his spreadsheet doesn't say iaa to me at all. the ones that i've seen - it's like you increase to a new dose and at first it'll bring the kitty down, but then it stops working and you don't see good numbers again until the dose goes up.

with acro, my experience was that the numbers kept going up, i'd raise the dose, then the numbers would go up, i'd raise the dose, then the numbers would go up . . . etc. repeat until you're really discouraged! ;-)

Regarding Dale's comment about Ozy - Sandy has said she thinks that Ozy's iaa has broken through. He doesn't seem to have nearly as much of the "dose becoming ineffective" symptoms that he had months ago. Ozy has had chronic pancreatitis for quite a while - i don't know if that's why he still needs more than the average amount of insulin. We do know that chronic pancreatitis can cause a cat to need more. I wouldn't assume that needing 7 units would all be from pancreatitis, but i don't know. I think Ozy's dose is also kept down because Donaleen keeps him most of the time in green numbers. I'm sure you & Dale have both read the information on Glucose Toxicity. Sustained high numbers cause the dose to go up and up and a cat kept in normal numbers typically seems to need less and less insulin.

i don't know why TIggy needs more than the average amount of insulin. You've probably said, Wendy, but I'm not sure i've ever heard - have you considered getting him tested?

overall, i gotta say that Tiggy's spreadsheet looks great, wendy! you've done a super job with him, regardless of what is causing his need for a slightly higher than average dose.
 
I got him tested for acromegaly and the lab said even though he was 104 and slightly above the normal range (goes up to 94 or something), they don't consider him acro. we never tested for IAA.

But I do feel I have been seeing the dose stop working a lot and having to increase all the time to keep on top of it. Sometimes he stabilizes or even merits a decrease but overall the trend has been up.

Wendy
 
i emailed Dr. Lunn at Colorado State (actually, she's at North Carolina State now) about Ozy's IGF-1 ( i think it was 84 or so) and she said under 120 is normal.

are you wanting to test for iaa? it's less expensive than the acro test. i'm not sure you would change anything you are doing based upon the test results.
 
julie & punkin (ga) said:
i emailed Dr. Lunn at Colorado State (actually, she's at North Carolina State now) about Ozy's IGF-1 ( i think it was 84 or so) and she said under 120 is normal.

Ozy tested IGF-1 88 and Dr. Lunn replied "truly positive" for acromegaly is "above 150."

No - I do not consider that borderline - it is perfectly normal. Cats with acromegaly are generally much higher. I don't really consider them truly positive until they are above 150. Rechecking in a few months makes sense to me, but in the meantime I would not worry about it too much.

Tiggy at IGF-1 104 fortunately didn't meet that standard for "truly positive" for acromegaly.
 
I had real problems getting my vet to test for IAA. I kept asking and he never did it. But I don't know how I would do things different?
 
IAA testing was the same process for me as acromegaly testing. It does cost more in Canada than the US. Something around $150. Since Tiggy likes to play in greens, I don't think you'd do much different if he did come back positive for IAA.

At the same time Julie was getting information from Dr. Lunn, I put in an email to the internal medicine and radiation oncology vets at CSU. There is the answer I got from them:
it has been shown that IGF-1 levels can be normal in some acromegalic cats and can be increased in some cats that do not have acromegaly. Typically we combine a lot of factors in addition to the IGF-1 level when trying to determine whether the index of suspicion is high enough to pursue advanced imaging of the pituitary gland. Interpretation of serum IGF-I test results should always take into consideration the status of control of the diabetic state, the presence and severity of insulin resistance, and the index of suspicion for acromegaly based on review of the history, physical examination, serial blood glucose concentrations, routine blood and urine tests, thoracic radiography, and abdominal ultrasonography. The finding of increased serum IGF-I concentration in a poorly controlled diabetic cat with insulin resistance and clinical features suggestive of acromegaly supports the diagnosis and provides justification for CT or magnetic resonance imaging of the pituitary gland.

... Most of the cats that we have seen tend to have an IGF-1 level at is pretty elevated. In one study they found the average IGF-1 level in the acromegalic cats was 148 nm, however there was a large range.

Some questions about this cat would be what has it's weight been doing - stable, increase, or decrease. A continued increase in weight despite poor diabetic control may be more suggestive of acromegaly. Ultimately, it is possible this could also be the early stages and considering repeating an IGF-1 level in 3 months could be beneficial.
The bolding is mine. What I took out of this is that IGF-1 results by itself are not the only indicator they look at. Neko's IGF-1 at 440 was well over average, but they also looked at her SS and description of her before deciding it was worth while doing SRT.
 
IAA Test $16.00
IGF-1 (Acro) Test $52.00

Most people seem to find the biggest expense is the vet's markup for the blood draw and the FedEx shipping to Michigan. If you do have blood sent for the IAA test be sure to redo IGF-1 again also since that *should* realistically only be $52 more. Not sure sure if the lab can do both tests from the same sample but both samples could be drawn and shipped together perhaps with the official DCPAH insulated mailer from MSU.

I did reading on the site and they offer IGF-1 testing for other species and in some cases they request control serum samples from healthy representative large and small animals of the same species to determine the normal reference range. What that suggests to me is a large cat (without acro) most likely has a higher IGF-1 than a genetically small cat (without acro) both being entirely normal and healthy... no pituitary tumor. So it might be expected for Ozy and Tiggy to have numbers at the high end of normal since they are both naturally large cats.

But of course any size cat may have any number which is probably why it's not the only thing they look at to determine acromegaly.
 
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