5/8 Dose advice Mr Grey AMPS 121 +2 105 +5.5 89 PMPS 104 +2

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Rick & Mr. Grey

Rick & Mr. Grey

Member Since 2012
Hello. Where do I go with Mr Grey's dose. Please refer to his SS. Do I lower it at PMPS tonight. Do I stop all together to see what he does without insulin. Do I raise the dose to have numbers all in the green over a cycle ? When a shot is skipped, he does very well working off the shed. Does this mean that he is also producing insulin on his own in conjunction with the injections ?
I know he is a special "High Dose, suspected Acro cat", but at what point do I test him to see how he does OTJ ?
Thanks
 
Re: 5/8 Dose advice Mr Grey AMPS 121 +2 105 +5.5 89

Others may have different opinions, and I have asked for more help for you in this condo.

I don't think it's really time to try OTJ, yet, but maybe to try a smaller dose BID (you've been skipping a lot of PM shots). Perhaps a 2.00, or maybe even a 1.50 dose twice a day, to see how he does. And, he is doing Great! :mrgreen: Let's see what others have to say.
 
Re: 5/8 Dose advice Mr Grey AMPS 121 +2 105 +5.5 89

Rick --

I don't know that anyone concluded that Mr. Grey is acro. He may have been insulin resistant and you broke through the resistance. It could be either and without the tests, there's no way to really know.

I agree with Dyana. I'd sooner see Mr. Grey on a smaller dose that you could shoot BID. Hopefully, you'll then be able to gradually further reduce the dose.
 
Re: 5/8 Dose advice Mr Grey AMPS 121 +2 105 +5.5 89 PMPS 104

He tested BG 104 @ PMPS. I elected to reduce dose to 2u. I have a feeling this will be a good dose for a few cycles. Paws crossed :-D
 
Re: 5/8 Dose advice Mr Grey AMPS 121 +2 105 +5.5 89 PMPS 104

Good luck with he new dose.
 
Re: 5/8 Dose advice Mr Grey AMPS 121 +2 105 +5.5 89 PMPS 104

Rick & Mr. Grey said:
Hello. Where do I go with Mr Grey's dose. Please refer to his SS. Do I lower it at PMPS tonight. Do I stop all together to see what he does without insulin. Do I raise the dose to have numbers all in the green over a cycle ? When a shot is skipped, he does very well working off the shed. Does this mean that he is also producing insulin on his own in conjunction with the injections ?
I know he is a special "High Dose, suspected Acro cat", but at what point do I test him to see how he does OTJ ?
Thanks
Click to expand...

You broke through the resistance, or the GH output stopped around 3/21/13.
I would be surprised if Mr. Grey tested negative for acro, but since he's dropping now, you could delay testing..... just don't stop watching and testing him because acros can and do go off insulin and then back on later. The pituitary tumor does not go away on its own. Also, the next time you are at the vet, please DO have the vet check his heart because heart issues are common in acros, and cardiomyopathy is not called the silent killer for no reason.

I know one acro who was tested at 6u, got one shot of 7u, then went off insulin in a couple weeks.
There was one cat on FDMB who was on insulin for only 3 weeks, then went off insulin for almost 2 years.... honeymoon over and shortly after the dose kept rising, that cat tested positive for acromegaly and he also had heart issues by that time.
My own Oliver was at 37u BID his highest but he has been off insulin since Jan7/12 with no signs of going back on insulin yet.

Why don't you stop the insulin right now? I found that I was giving Oliver insulin and he was not dropping too low, and since I had no idea how an acro goes OTJ, he had one shot of 5u, then nothing for a few days, and because we did not know if he still needed insulin, he got a 3u shot on Jan7/12, but I don't think he even needed that shot.

You've got good numbers going on, so why not start a trial. Acros have perfectly functional pancreas and they can adjust better, unlike diabetic cats.

Gayle
 
Re: 5/8 Dose advice Mr Grey AMPS 121 +2 105 +5.5 89 PMPS 104

I don't know that I agree with stopping insulin cold when the dose is 1.5u. That seems like a rather abrupt discontinuation vs. tapering the dose down based on the Tight Regulation protocol. I'm not sure that I understand the value of an abrupt discontinuation.
 
Re: 5/8 Dose advice Mr Grey AMPS 121 +2 105 +5.5 89 PMPS 104

Acro cats are not diabetic cats.
What was Sooty's dose on his last few shots? 6u/5.75u/5.5u/5u/3u, then nothing.
What was Oliver's dose on his last shot? 5u, off a few days, 3u, then nothing.
What was Chuck's dose on his last few shots? 3u then nothing for a few days, then 1u, then nothing.
What about Linda's Guinness who was on insulin for 3weeks, went OTJ for almost 2yrs? He was not a high dose in 2009 and was not suspected to be acro, but he was.

Surely, if Mr. Grey still needs that 1.5u dose, his numbers would rise quickly after a missed shot, yes?
If Rick wants to try it, why not?

For diabetics, that tapering is fine, but acros are not diabetics.
 
Re: 5/8 Dose advice Mr Grey AMPS 121 +2 105 +5.5 89 PMPS 104

Sure, no tests were done, so will you say the same about Nancy and Pepper? No tests have been done for Pepper either.... his dose is 25u BID.

Hey, I don't know any cat who gets up to 9.5u BID and was a normal diabetic; can you please provide an example?
There is no harm in trying to stop, is there? Do you honestly believe Mr. Grey is not acro?

All I did was put the idea on the table because other acros were completely fine to stop at 3u, so trying at 1.5u would not create any chaos.
 
Re: 5/8 Dose advice Mr Grey AMPS 121 +2 105 +5.5 89 PMPS 104

@ Blue and Sienne, I apologize for not having Mr Grey tested yet for Acro. I do appreciate that there are those like you who are watching our progress and studying the data and giving me advice and ideas. Mr. Grey is still at 1.5u and I think tomorrow I will drop to 1u and see how that goes over 3 cycles. I don't know what will come first, me getting him tested for Acro or stopping insulin with continued monitoring and testing as an experiment. I have to do more research to learn about Acro because the thought of a tumor causing this sounds more serious and scary to me than diabetes caused by a sick pancreas. Mr Grey is showing no indications that he has any disease so at the moment I feel like I'm injecting a healthy cat.
 
Re: 5/8 Dose advice Mr Grey AMPS 121 +2 105 +5.5 89 PMPS 104

Hi Rick, I think you are doing a great job with dosing for Mr. Grey. His SS continues to look fabulous. Good luck with the decrease.

The advice I heard from an internal medicine vet about acromegaly is that treating the diabetes is the most important thing you can do for an acrocat. However, there are side effects from the growth hormone that is also produced by the pituitary tumor, which is why we recommend tests for acromegaly. Organ growth, especially the heart is of some concern. The tumor itself is benign. If the cat has acromegaly, periodic monitoring of the heart is recommended. My Neko got a baseline echocardiogram (ultrasound) that showed a tiny bit of growth. She also has a heart murmur, but for now we just need to monitor. These kinds of internal changes can happen without any external indication. Enlarged hearts can be managed, but you have to know about it.

Some of the posts on the acromegaly forum here have lots of information and references and are a good place to start your research.
 
Re: 5/8 Dose advice Mr Grey AMPS 121 +2 105 +5.5 89 PMPS 104

Rick & Mr. Grey said:
@ Blue and Sienne, I apologize for not having Mr Grey tested yet for Acro. I do appreciate that there are those like you who are watching our progress and studying the data and giving me advice and ideas. Mr. Grey is still at 1.5u and I think tomorrow I will drop to 1u and see how that goes over 3 cycles. I don't know what will come first, me getting him tested for Acro or stopping insulin with continued monitoring and testing as an experiment. I have to do more research to learn about Acro because the thought of a tumor causing this sounds more serious and scary to me than diabetes caused by a sick pancreas. Mr Grey is showing no indications that he has any disease so at the moment I feel like I'm injecting a healthy cat.
Click to expand...

Rick,
Please never apologize for doing what you feel is best. Testing is not important, but taking precautions are. There have been others who did not test until later, or until their cats went back on insulin.

I know that you feel Mr. Grey is showing no indications but there are many that don't show externally, one of them being heart disease. There have been too many acros with heart issues and cardiomyopathy is often called the silent killer. Organ enlargement and soft tissue growth are not things that become noticeable until far along.

I suppose you can continue as you have been as an experiment, but I truly don't think it's necessary. If you look at any other cat who is going off insulin, not a one is going to drop down at the same rate as when going up the dosing ladder, by 6 shots, then dropping.

I would also suggest having your vet check the heart. Soft tissue growth is also a concern.
If you have any questions about acromegaly, just ask.

Gayle
 
Re: 5/8 Dose advice Mr Grey AMPS 121 +2 105 +5.5 89 PMPS 104

I suppose you can continue as you have been as an experiment, but I truly don't think it's necessary
Click to expand...
Gayle what don't you think is necessary, stopping insulin or lowering his dose. I'm not sure what you mean ?
If you look at any other cat who is going off insulin, not a one is going to drop down at the same rate as when going up the dosing ladder, by 6 shots, then dropping
Click to expand...
I'm not sure what this means either :smile:
 
Re: 5/8 Dose advice Mr Grey AMPS 121 +2 105 +5.5 89 PMPS 104

Rick --

My point wasn't to push you to test. That's your decision. My only point was that a presumptive diagnosis of acro is just that -- a presumption. Gayle is reaching for a conclusion . It may be a very reasonable conclusion based on her experience and intuition. I just prefer to have data and consider all of the possibilities. Insulin resistance (insulin auto-antibodies/IAA) may have been just as likely. Both Wendy and Gayle have given you a good reason for either getting the test done or asking your vet to pay very close attention to Mr. Grey's heart function. An x-ray would show if his heart is enlarged.

I think tapering the dose like you intended sounds like a solid plan.
 
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