6/10 Mr Grey AMPS 232+3=332,PMPS 412+4=401

[Rick & Mr. Grey]

This morning I raised dose to 10u but I probably should have stayed at 9.5u for at least 1-2 more cycles. As a result, his numbers went up. I reverted at PMPS to 9.5u to give this dose more of a chance. Was it a good idea to revert to 9.5u, the numbers dictate the dose, but Mr Grey seems to defy standard Lantus protocol. If you look at my last condo, viewtopic.php?f=9&t=119935
and from day one on the forum, there is a general consensus here that MR Grey could have Acromegaly and or IAA which would explain his high doses and wandering BG. Due to circumstances in my life it has been impossible for me to have Mr Grey tested for these two conditions. I am hoping that in the near future I will be able to. How do I approach the vet since I can only image them wanting to do tests and exploratory exams that are very $$$. With sustained BGL 's like Mr Grey is living through, isn't it only a matter of time before diabetes related organ or nerve damage will set in ? I'm scared and do not want him to be suffering while taking insulin that's not working or giving him any relief. Thank you forum for your continued support and advice.

 

[Marje and Gracie]

Re: 6/10 Mr Grey AMPS 232+3=332,PMPS 412

I wish we knew where he went from 130 on 6/8. He could be bouncing from those numbers.

I think I would have left the dose at 10u once I took him up just for consistency for the depot. The reason he might have gone up could be New Dose Wonkiness.
But since you took him back down, I'd leave him at this dose for a total of four cycles. If he stays high in pink/yellow, I'd increase the dose.

I think Julie gave you the links for the IAA/acro tests? If/when you are ready to do them, I'd take the info to my vet and just tell him those are the tests, and the only tests, you want run.

 

[julie & punkin (ga)]

Re: 6/10 Mr Grey AMPS 232+3=332,PMPS 412

You go in to your vet appt with these documents printed out and say "Mr. Grey is now getting about 20u of insulin per day. I'd like to have mr. grey tested for insulin auto-antibodies and acromegaly. Here are the tests."

http://www.animalhealth.msu.edu/Bin/Catalog.exe?Action=Test&Id=1494
http://www.animalhealth.msu.edu/Bin/Catalog.exe?Action=Test&Id=1401
Shipping Options
Submittal Forms

Be aware that vets will add their own charges for drawing the blood and "interpreting" the tests. Some vets will double the charges that MSU costs for the testing, some will add something that is less than that. Ask first what the costs will be that are added on.

Also pay careful attention to the directions on shipping and have it sent exactly like MSU suggests.

The acromegaly tests are started on Wednesdays, the iaa tests are run whenever the blood sample arrives. the iaa test comes back first and the acro test takes a little longer.

it might help with dosing if you can vary the times you get tests in. While it would be easy to assume he's always high, when you get an amps of 130, that tells you that he's not just staying high all the time. i suspect he maybe have some lower numbers in the middle of the night.

When you look at his ss and see those wide open white spaces, those are times that would be good to test. it doesn't mean you have to test every hour of every day/night, but varying the time really helps tell the story. If you got an am+4 today, instead, get an am+2 tomorrow and an am+6 the next day. Same at night - just move the test times around. It's hard to comment on dose at this point. I'd have thought he needed a dose increase too, but that little 130 tells us that he may even have been green 2 hrs prior to the 130. or maybe not, we don't know.

today's numbers look pretty clearly like the start of a bounce. He's gone straight up since this morning 232 -> 332 -> 412. That also suggests that he got to something lower last night to cause the bounce.

 

[julie & punkin (ga)]

Re: 6/10 Mr Grey AMPS 232+3=332,PMPS 412

i take forever to find links and write posts sometimes - i see marje posted while i was writing.

i do think varying your testing times, especially between +3 and +11 in the night cycle, will help with figuring out dosing. i agree with marje about holding this dose for 4 cycles and re-evaluating.

 

[Suzanne & Cobb(GA)]

Hey Rick, this is my first time visiting your condo. Ugh. I totally understand your frustration!

Regarding your vet, remember the vet works for you. Like Julie and Marje said, tell them what you want done. The vet I used to test Cobb for IAA charged 3x what MSU charged for the tests, plus $$ for a blood draw, and $77 for shipping. The vet can request a mailer from MSU that is only $15 for shipping. Make sure they request this mailer. It will save you a good amount of money.

Cobb is on 30 units of Lantus, twice a day now. We confirmed his IAA dx. We did not test for acro. If he has IAA, you'll want to be more aggressive in your dosing, which is why Marje and Julie are suggesting re-evaluating after 4 cycles. Grabbing those extra tests will also tell us if he's dipping too low and bouncing, which can be contributing to your high preshot.

Any time I adjust Cobb's dose, his numbers initially go up. I've found if Cobb hasn't seen good numbers by the 5th cycle, it's time to go up. But every cat is different. ECID (I hate hearing that!). He should adjust to the new dose by the 4th cycle. If not, like Marge said, I'd go back up to 10u.