6/7 Lanky AMPS 183; PMPS 348

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Re: 6/7 Lanky +11 141 PMPS xxx

Nice PM green streak. You'll want to make sure he is coming up on his own before AM dosing (not food influenced). If he's up significantly you can probably decide on cutting back dose after rebound clears (if he has one); if he hasn't risen enough for the full dose, stall and/or reduce it some (BCS). Alot depends on if you will be around to monitor.
KB's Numbers
FD DX 10/08; Acromegaly DX 02/09
KB's acro affects his insulin sensitivity making it difficult to achieve regulation. We use two insulins. Do not try to follow his protocol without proper quidance.
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Nina and KB

Joined: Mon Dec 28, 2009 5:32 pm
Member since: 30 Dec 2008
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Re: 6/6 Lanky AMPS 307; PMPS 356, +9 82
by sehjak (Susan & Lanky) » Mon Jun 07, 2010 5:19 am

I am around to monitor all day. Lanky has not had food since +7.5 9% Wellness. In addition to dose, I am wondering what best to feed for breakfast. I have lots to choose from, just pick the % carbs.

I am going to x-post in 6/7's condo -- just opened it.
Click to expand...

Just added for convenience from end of 6/6 condo.
 
Re: 6/7 Lanky +11 141 PMPS xxx

I saw Nina in yesterday's thread :-D . I am in a learning curve with acro advise, help from acromoms appreciated.
I'm leaning on staying at 8u. History says he hasn't carried the green into the second cycle -- of course we all know that can change in a cycle. If I didn't know the test results I wouldn't be hesitating here, I would say shoot the 8u.
 
Re: 6/7 Lanky +11 141 PMPS xxx

You are around to monitor but you need sleep! You've been up all night.
 
Re: 6/7 Lanky +11 141 PMPS xxx

I am OK. If I need a nap, I have my trusty alarm clock to help us monitor. What about food? The usual Fancy Feast 3%?

ETA - I'm leaning towards 8u...
 
Re: 6/7 Lanky +11 141 PMPS xxx

Me too (8u).
Next acromom question:
Food, can we have advice on foods to feed for numbers with acros? I recall reading there is a (slight) difference in feeding acro curves, is that right? I vaguely remember it having do with the usage of HC.
 
Food for green acros

I am going to summarize what I just sent to D.. (PS Hi Susan!)

"Ok I see she shot.. that's the IAA I think.. the sudden drop out of nowhere. I would have chosen to hold the dose too. MSU is incorrect in assuming the cat is not also IAA, he is. Of course that vet doesn't have the luxury of looking at Lanky's numbers, and even then he might not see it. Go look at Jan/Buddy's SS for reference.. those drops come out of nowhere and suddenly the dose will stop working and they'll go right back up.

Secondly. You must know this. Inside and out.

Cat = acro.
acro = functioning pancreas.
functioning pancreas = HORRIBLE hypo's. we're talking hours-long and can be fatal.
acrocat hypo symptoms = can start as high as 70

(Most acrocats do not feel comfortable being below 100 and will act very agitated.)

Why am I saying this? Do NOT mess around with spoonfuls of gravy mixed in lc, hc gravy no meat, hc meat no gravy, 1tsp hc, or a little mc with lc. Drop 1/2-1 CAN of HC, depending on what size can she has. ESPECIALLY if green shows before nadir. An acrocat will eat and eat so don't worry about filling them up. This is very serious.

Those feeding recommendations are for cats going off the juice and Lanky's goal is not to go off the juice. It would be nice if it happened, but the goal is safety, and acrocats do not react to HC the same way a diabetic does. Remember that essentially Lanky is not a diabetic. Tight regulation, which is what LL does for diabetics, can not be used on acrocats without enticing danger.

You're doing great, don't accept what I said as a beat-down, I know you don't know :)
((((hugs))))
..C"

Acrocats can surf, yes, but that's not the goal. The goal is to keep them safe and blue as much as you can, which is difficult when you are up against hormonal interference. Remember that there is nothing wrong with keeping them under the renal threshold. If I never see another acro being fed a little HC gravy mixed with a spoonful of LC it will be too soon for me. ;-)

Susan your IGF result was not extraordinarily high, which basically says the tumor is not in an extremely active state. Many of us have tests well over 300 and 400, which I think is why many of us are dosing much higher than you are. I do see *IAA type* activity in your numbers. This means insulin auto-antibodies attack both the body's own insulin and the injected insulin. With the aggression in dosing you are using for the insulin resistance Lanky has, you will defeat them, and the condition will go away. However, IAA is not your priority. Don't let what I said derail or upset you. Nothing bad is happening to Lanky if in fact he is truly IAA as I suspect. We have many cats who are both, and many who are suspected to be both but were not tested for IAA at the time of their acro tests. The difference between an IAA ss and Acro ss is that acro's will be high and flat until such time as the insulin resistance begins to break under the weight of the increased insulin dose. IAA cats will have periodic, unexplained drops. You will not undo the work you have accomplished by high carbing greens, so do not fear that.

And I have absolutely no doubt that Lanky will relish those delicious times too HEHE

Dosing advice.. if he hits green again this cycle, the dose must be reduced, so I'd knock 1/4u off. Also, when you run out of Lantus, I recommend you switch to Levemir, both for costs and comfort of the kitty.. Your dose is high enough that you will save lots of money and I think you'll be pleasantly surprised at its behavior. :)
 
Re: 6/7 Lanky +11 141 PMPS 183

I think what D may be trying to recall about food is related to an acro kitty having a functioning pancreas. What that means is that prior to knowing about the acro, if numbers were dropping and you wanted to encourage a surf, you'd feed LC to a diabetic kitty. With an acro kitty, if you feed LC in this situation, Lanky's pancreas is likely to kick in and pump out its own insulin and drop numbers even faster. So, you need to think about using MC/HC much sooner.

Um....isn't this AMPS?

I posted pretty much at the same time as Carolyn. She (obviously) gave tons more practical advice.
 
Re: 6/7 Lanky +11 141 PMPS 183

I don't know a thing about this Susan, but I am here to give a hug across the miles! Cheering you on....you are doing a g reat job!
Good boy Lanky...keep up a nice blue surf.... :YMHUG:
 
Re: 6/7 Lanky +11 141 PMPS 183

Hi Susan,
One thing to keep in mind with your acro guy, I got told the other day when both mine went green together on the weekend (how sweet and considerate of them UGH), to forget about that 1tsp of LC to start, because all that is going to do is bring the numbers down more.
With a working pancreas, I do believe that you feed and it does what a non FD kitty does - makes some juice and brings down the numbers.
What I was told was if I see green, open a full can of HC and plop it down. Oliver went through 3 cans, yes I said 3, and he barely budged. Took his sweet time coming up too!

IDK what others have to say about it all, but you want just bloos, and if you start to see those lower bloos, keep an eye on Lanky and maybe even test a bit more, but that's coming from a testaholic (me!) They are sly little devils, they sit there all pretty and purry, and meanwhile their numbers are going down just a wee bit more.

It you take a look at Oliver's ss to see how his numbers went, you will get an idea. Sorry I have not been marking my foods on his ss but when I get the first green, I open a can of HC. I don't even bother with the LC stuff he normally gets. I just need to get out of that green or at the least stop the drop.

Now, that's just me, and how I handle Oliver. Shadoe is more tame and I give her maybe half can of HC and she's good, comes up nicely. That's where the ECID comes in; you need to know your own and so to be safe, give a can of HC and see what happens. I don't know about you, but I can deal with high better than low that is tough to bring up.

When Oliver went green on his new dose, with R, and then with less R, it was decided to be safe and bring him back down by 1u and give no R. Since I am at tbp, I can't do my crazy curve, so I just checked before leaving to ensure he was on his way up. And he was.

I am sure we can get some other input from some acromoms, but that's my view on the green zone.
For sure, don't go past that 8u and maybe it may be too much and a decrease may be suggested. I sure don't know, but that's what I ended up doing with Oliver since he's pulled this green trick a couple times on me.

Pats and scratches from me for Lanky and say good job, good going for both of you!

And of course I show up late again! So yeah, what Carolyn and the others said! :-D
 
Re: 6/7 Lanky AMPS 183

Hi Susan just sending Lanky support your way I know its getting pretty crazy now for you with him going green nice amps today :mrgreen: :YMHUG: :YMHUG: cat_pet_icon
 
Re: 6/7 Lanky AMPS 183

Excellent posts you acromoms! :mrgreen:
I feel tons more informed on the food scene.
 
Re: 6/7 Lanky AMPS 183

Hi Susan,
I'm popping in to say hi. I have not posted in your condo yet. I'm not on the board much these days, but just wanted to introduce myself. You are getting advice from the best peeps here.
 
Re: 6/7 Lanky AMPS 183

Just so us non-acros can learn more - on a regular basis (non-green or dropping numbers), what kind of foods do you want to be using? LC, MC or HC?

Or is this one of those it all depends answers?
 
Re: 6/7 Lanky AMPS 183

Hilary,
The other day when Oliver went green, I fed him THREE (3) cans of friskies HC - 12%, a 16% and an 18%.
The time before that, he got a couple 18% of ff. He does what he pleases and takes his time about it. I think all it does is stop his drop; I honestly don't think it brings him up much if at all.
For Shadoe, I gave her the last time 1/2 can of friskies 18%. She does not need near as much as Oliver.

When they are non-green, I feed both of them around 7% carb foods. And raw chicken is Oliver's idea of treats.
 
I forgot to say something

I have to call out D here.

Where are you D?

:mrgreen:

I have to say, your thinking outside the box has done a fantastic job of pulling Lanky's numbers into range very quickly. I know you did this with the suspicion that you were dealing with a high dose cat, and your methods, while not normal protocol, were effective and ahead of the common thinking. You done good kiddo! :-D

One thing I would like to see change is dose aggression with resistant cats. I know I say it to the point of numbing minds, but with a resistant cat, resistance continues to build if you idle the dose too long, or don't increase it aggressively enough. Many of us ended up far behind on our doses, resulting in astronomical doses that may be much higher than what we could have had with more aggression. We do what we know, but now we know more. We are heavy testers here on LL, and we all know how to stop or stall a drop. If you go too fast, it's easy to drain a shed, and it's easy to reduce a dose. Many experienced LLers can see almost right away when they are dealing with a resistant cat. Maybe we could consider this potential costly outcome when recommending dose increases?


DISCLAIMER: I AM NOT TALKING ABOUT YOUR AVERAGE 3U CAT HERE. I AM TALKING ABOUT CATS WHO HAVE A SS OF NOTHING BUT RED PINK AND BLACK AT DOSES OF 5U OR MORE. PLEASE DO NOT MISINTERPRET THIS INFORMATION AS THE GO-AHEAD TO TREAT YOUR OWN CAT THIS WAY WITHOUT CONFIRMATION FROM SOMEONE THAT YOUR CAT MAY BE RESISTANT. OFF-PROTOCOL AGGRESSION CAN BE EXTREMELY DANGEROUS AND POSSIBLY FATAL TO A NORMAL DIABETIC CAT.

..C
 
Re: 6/7 Lanky AMPS 183

Thanks Gayle - so normal food is under 10%, like we recommend for everyone and when it comes to stopping a drop or upping a BG - we are talking about cans of HC whatever, not spoons or drizzles or the like for non-acros.

Cool, I just learned something new.

Carolyn - Just so I understand better - are you saying that there is a trend to hold acro doses too long and hence creating a need for the cat to need more than what they may actually need of insulin. By more agressive - what kind of timing are you referring to? If the non-acro hold is 4-7 cycles, what could an acro hold or dose change look like?

Again, just trying to learn and better understand.

Thanks!
 
Re: 6/7 Lanky AMPS 183

Hillary & Maui said:
Thanks Gayle - so normal food is under 10%, like we recommend for everyone and when it comes to stopping a drop or upping a BG - we are talking about cans of HC whatever, not spoons or drizzles or the like for non-acros.

Cool, I just learned something new.

Carolyn - Just so I understand better - are you saying that there is a trend to hold acro doses too long and hence creating a need for the cat to need more than what they may actually need of insulin. By more agressive - what kind of timing are you referring to? If the non-acro hold is 4-7 cycles, what could an acro hold or dose change look like?

Again, just trying to learn and better understand.

Thanks!
Click to expand...

Yes, that is what I meant.

Every high dose cat is different, just like every regular dose cat is. I could not lay out a guideline, or blanket treatment strategy for this. Some higher dose cats need less insulin and make more progress using protocol, and there it pays to be patient so their increases should *not* be more aggressive than protocol. KB and Shadoe are excellent examples of that. Other cats make no progress at minimal or standard protocol increases, and those are the ones I am talking about, such as Feeburt, Leo, Milo, Oliver and Girlcat. Girlcat was actually on far more aggressive increases than Leo was and STILL made little progress, but I shudder to think what would have happened if protocol had been followed with her. It is very difficult to explain, and I talk using pictures in my head so it will make even less sense lol Oh.. and I don't believe any Lantus or Levemir cat should hold a dose less than 4 cycles unless they are a long term diabetic, or a problem diabetic, and have a very experienced owner. It's just too risky for people to attempt in the early weeks and months.

Anyway, it's food for thought, not an edict :mrgreen:
 
Re: 6/7 Lanky AMPS 183

Hi Hilary,
What I have been doing is going with 4 cycles, then adjust if no comfy bloos. If I stay longer I guess I am trying to see if maybe more/less R is better to use. IDK, but again it's different for every cat.
For Shadoe, she's been OK for a week or so, then she started doing a sneak up. I guess I could have increased sooner for her, but ...
For Oliver, I was waiting just the 4 cycles, I guess enough to top up the shed, check if it's working, then if no, move on up. The last increase was bigger, 2u, and it worked just a bit too well with the R, so I went back by 1u, after only 2 cycles of a try.

I think the secret is "don't let the enemy get the upper hand." Try 4 - no good - keep moving.
I could be WAAAY out in left field on it, but that's what I am seeing. I am still watching for the locomotive, and I don't want to get run over - I need to get outta the way.

Shadoe is my spitting little dainty lady, and she does not need much, but I still watch for her sneaks.

Oliver is a bull in a china shop, just a lumbering along, saying Is that all you got? That last 2u increase he noticed and took a step back but careful now, cuz he's going to regroup and get his footing, so it's not the end of our tug-of-war. I am keeping my eye on this mountain man, no, BOTH eyes, cuz he is pretty big :lol:
 
Re: 6/7 Lanky AMPS 183

Thanks Carolyn/Gayle. I do appreciate your taking the time to explain this. It's as fascinating as it is scary. I know that Maui is one of the lucky ones and for that I am very grateful that we didn't have to worry about this.

If we could continue with the lesson - guess today is a good learning day ;-) - do ketones and DKA become a concern with an acro? Or is this strictly something that happens to regular FD's? And if they are a concern is the treatment plan the same?
 
Re: 6/7 Lanky AMPS 183

My guess is that an organ is an organ, just like a high temperature. They can damage so you want to watch for them and stay clear of them.

I have been pretty lucky in that neither of mine have had those issues. A renal threshold would be the same no matter what. I test both for ketones all the time - don't want to take any chances adding more issues to the mix.

That's my guess.

*waves to Susan* :-D
 
Re: 6/7 Lanky AMPS 183

Hillary & Maui said:
Thanks Carolyn/Gayle. I do appreciate your taking the time to explain this. It's as fascinating as it is scary. I know that Maui is one of the lucky ones and for that I am very grateful that we didn't have to worry about this.

If we could continue with the lesson - guess today is a good learning day ;-) - do ketones and DKA become a concern with an acro? Or is this strictly something that happens to regular FD's? And if they are a concern is the treatment plan the same?
Click to expand...

Yes and yes.
 
Re: 6/7 Lanky AMPS 183

Susan. Sorry for taking over your condo today. The questions came up here and well since its best to keep to one condo, we thank you for sharing yours!

Carolyn/Gayle. Thanks for the additional insight.
 
Re: 6/7 Lanky AMPS 183

This is the perfect condo for discussing -- what better way to learn?

So the plan is (numbers providing) stick with the 8u tonight and if you see green, are you listening Lanky? open a can of HC.
 
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