7/17 Neko PMPS 322 +3 304

Status
Not open for further replies.
Wendy&Neko

Wendy&Neko

Very Active Member
Moderator
Yesterday http://felinediabetes.com/FDMB/viewtopic.php?f=9&t=75108

7/16 Recap
AMPS 297 +3 351 +6.5 224 +9 207
PMPS 269 +3 298

Today is shaping up to look at lot like yesterday. Three yellow PS in a row! The SS is starting to look more like what it did when I used that darn Freestyle meter, but in a good way. Neko had a good nap on the deck before the sun really started hitting it and it now looking cute and looking for scritches by lying on the newspaper. Oops, I stopped, she's now gone to DH's lap again.

I got a call from the IM vet's office and am debating whether to cancel. The consult costs $265 and is for "diagnosis and a treatment plan". Hmm, I have the diagnosis already and I know what the treatment plan is. Just wondering if there is anything else they can tell me about how the acro is affecting her that would be worth the $$. Any thoughts?
 
Re: 7/17 Neko AMPS 271 +3 360 +8 268

Hi Wendy. I'm not sure about the answer to your question, so am bumping your post up for more eyes.
 
Re: 7/17 Neko AMPS 271 +3 360 +8 268

Hi Wendy - I can't really answer the question either, but maybe some input from Julie and Punkin or Tracy and Leo would help, as they have acro kitties. perhaps they can help guide you. That sure seems like an awful lot of money for a consult. I dunno... maybe it could be good to have an IM guy in your corner?

The yellows are nice to see for Neko. I hope there is a great PM cycle. Maybe some blues Neko?

Enjoy the rest of your day. Hope what went before was good.
 
Re: 7/17 Neko AMPS 271 +3 360 +8 268

I tend to agree with you, Wendy. You have the diagnosis and are researching treatment. Unless the IM specialist is very familiar with acromegaly, I suspect that you already have more info from Tracy and Lu-Ann's posts the last few days. Dr. Timian is an IM specialist with considerable expertise in acro, and even though its a lot more expensive to go there for a consult, that is where my $$ would go.
 
Re: 7/17 Neko AMPS 271 +3 360 +8 268

i'd save my money, wendy. i wouldn't be at all surprised if you already know more than the specialist. i have ended up educating vets that i've gone to since punkin's diagnosis - they simply don't encounter this enough to know anything.

dr timian won't charge you to answer questions before you go to CSU, so anything you're wondering about you can get answered for free.

neko's ss is looking pretty great! those blues are quite beautiful!

isn't it funny how they go lower at night!? punkin always does that too and i have even switched food thinking it was related to that, but no, it's not the food.
 
Re: 7/17 Neko AMPS 271 +3 360 +8 268

Wendy, the vets are always suggesting "new treatment plan", sounds familiar? I am sure you'll be getting more "power users" experience from here! There is no immediate need to spend that $265, you can always ask & research more & make your decision later. Taht's my two cents ;-)
 
Re: 7/17 Neko AMPS 271 +3 360 +8 268

I'm adding my voice to the "save your $$$ for CSU"chorus and also agree that at this point you likely know more about FD and high dose conditions than most vets, including the Specialist.

Time to start interviewing other vets though, so you hopefully can find one you like, that is willing to work with you. Best to not delay. That way if/when something comes up you won't have the added stress of scrambling to find one under pressure.

Also remember, you are hiring these people. :cool:
 
Re: 7/17 Neko PMPS 322

Hi Wendy -

Not sure if I shared this with you or not.... I was told that the IGF-1 and IAA were not a "slam-dunk" diagnosis. The next step I took was at the NC State Vet School, where Grayson had an abdominal ultrasound and more bloodwork done. That showed the organs were enlarged... keep in mind, Grayson doesn't have a lot of the outward appearance of an acro... he's long, but not big (anymore). His jaw is large, but I didn't think his head was THAT large. His feet are proportionate to his size.... THEN I noticed his legs looked like a jackrabbit...and I started looking at him more critically. He also had the gap between his canine teeth - about 1/8 inch.

So even with the US, that still wasn't "slam-dunk" per the doc at NCSU... but I spoke w/ Dr. Lunn, who had seen him, and she said she felt confident that given his numbers, the US, his dose, and his inability to be regulated... she thought he was. That was the turning point when I started making arrangements to come here. Don't know if you'd want to have an ultrasound done. IF you do, see if you can have them do both the abdominal and the heart... they're done by 2 different departments at NCSU, so I had to have the heart done here. COuld've had an x-ray, but he had a heart murmur, so I opted to proceed w/ the US (echocardiogram).

I think if you sent your vet records w/ bloodwork, the info link to your SS, and your IGF/IAA results to Dr. Timian, you may be able to skip that US step, and I'm sure she'd be able to offer her thoughts based on what you have. For me, it was good to know that there was organ enlargement, so I'm glad I did that earlier. It's a big trip to take, and I had to be absolutely certain I wasn't just coming for naught. The planning of the trip was done w/ Dr. Timian's schedule, Lynn Griffin (Radiation Oncologist)'s AND mine... so it wasn't like I just hopped on a plane... oh yeah, and the budgeting for the trip too! ;-)

Lu-Ann
 
Re: 7/17 Neko PMPS 322

PMPS 322
Boring pink, upped the dose a notch to see more blue, and now I'm on the line again for easy upward increases :lol:

OK - the consensus is to ditch the local IM. I was leaning that way. The money can be better used for gas for the trip. I talked to Dr. James Custis, the radiation oncologist today, and sent Neko's latest bloodwork/urinalysis results onto him and Dr. Jessica Timian. I'm getting excited about this whole thing. Originally we weren't going to have any vacation this summer, and now we'll have a road trip!

@Dyana - thanks for the bump, it worked.

@Michelle - yellows are nice, but I agree that blues are better. We'll see what the night brings.

@Norma - I suspect you are right. Dr. Timian will know a lot more than the local IM person because she has so much more experience. Plus so far I've had a free quick consult with Dr. Custis. I can tell my vet that I am instead consulting an IM vet with more expertise in acro.

@Julie - I had the feeling I'd be the one doing the instruction during the consult and didn't want to pay to instruct her. Neko used to go lower during the day and higher and night, then something switched. I have no idea what. I used to play with upping the dose during the morning vs. night to see if I could switch it back - no dice. I do like the blues, and Neko's been much more active lately. When she was high all the time I noticed her eyes were all pupil, but now when she is lower her pupils respond to light.

@Sandy - I do have alternate vets I could talk to. My civvie goes to a different vet clinic (needed an all female clinic) and I row with yet another vet who is married to a vet. Both of them are the type of vets who like to continuously learn and I've gotten a bit of free advice from them before. I just don't want to piss off my current vet until I have everything I need before my trip. I still need a rabies certificate for example.

ETA:
@Helen - yes, it's much better to talk to people who have been through the experience than a vet who may have only read about it!
 
Re: 7/17 Neko PMPS 322

Just missed your post Lu-Ann. The bloodwork, urinalysis, IAA, IGF-1 results and link to the spreadsheet were sent today to Dr. Timian. I have asked if I should do anything else first. The clinic where the IM vet is located is a specialty clinic and they could do an US if needed. I'd just need a request from my vet to get it.
 
Re: 7/17 Neko PMPS 322

i'm all excited for you wendy. it's good to know what you're dealing with, and now you have a plan to deal with it. and your plan is all starting to roll forward.

i switched vets when i returned from CSU. never went back to my old vet. he'd messed up several things with the diabetes and i knew he didn't have much experience with it. ie, there were 2 diabetic cats in their 3 vet practice and punkin was 1 of the 2. a good friend (the queen of picky) said she loved this particular vet and that vet had 2 diabetic cats, so i met her and then switched when we returned.

but . . . honestly, she doesn't know that much more than my original vet. yes, she has diabetic cats, but she doesn't test, doesn't follow the tight reg protocol and is just going for maintenance. she knew nothing of acro - i sent her all the same articles i'd sent my original vet. i'd been with him about 20 years with 14 pets and felt a bit scummy switching and truthfully, i don't think it would've made a bit of difference. basically, i'm still doing all the research and educating them, telling them what i want tested and what the treatment for that thing is. it's a bit crazy. acro seems to be such an unknown thing out there.

glad you increased her dose. i think i'd start thinking of a guideline, ie, "if it's been 4 or more cycles on this dose & i see yellow or pink mid-cycle and it's not an obvious bounce, i'll increase" or something like that. you could write it on her ss to help you be consistent.
 
+3 304
Well at least it's going down, but not dramatically so. We'll see what the morning brings.

@Julie, I like the way you describe what I've been thinking of as "the dose going stale".
 
Status
Not open for further replies.
Back
Top