7/2 Guinness AMPS 223 Shot reduced dose

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linda and guinness

linda and guinness

Member Since 2009
Good Morning Lantus Land!

Well, I guess Guinness wanted me to see some early fireworks last night. Not 30 minutes after I shot his lowest pre-shot number did I get the call from my vet that he was positive for Acro. Normally, I would feel very comfortable shooting a 128 preshot number, but since I'm still just learning about Acro and where I should keep his BGs and the fact that he is on such a high dose of insulin, I realized I probably shot too much. And of course, Guinness agreed.

He took a fast track elevator down to the lobby and freaked me out! Thank you all for you help last night. Julie, Margie and Sienne. Julie your thoughts regarding dosing were greatly appreciated, but I couldn't get my computer to respond this am and had to decide before I could read it. I dropped his dose from 11u to 10.5u. I will be around this am to test up until +5, so I feel comfortable with that. I am a little worried about this evening because I have to shot and run.

Thank you again all for the support last night. I know I haven't been posting much lately, but you guys truly are the best, dedicated bunch of pet owners I've ever met and I am grateful you helped us out!

Last night's show:
http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=46773
 
From what I've seen Libby post, there are times when you really do need to trust your gut when it comes to dose reductions. In my head, I think the decrease to 10.5u makes sense given the size of Guinness' shed. I suspect that this is the case with any cat that's on a high(er) dose of insulin regardless of whether the cat has a high dose condition or not.

The one thing to keep in mind is that Guinness has had acro for a while. You wouldn't have freaked out 3 days ago with green numbers. You know how to steer the cycle. That knowledge doesn't go away. All you will be doing is reaching for the HC a little sooner.
 
Guess I better get to the pet store and stock up on the HC...I used FF Chicken Feast with Gravy and Beef Feast with Gravy... are there anymore that are better or should I just keep some vanilla ice cream on hand too?
 
good luck with the new dose!

I think you made a good decision about his dose. It will take some experimenting to learn what works best for Guinness (and once you figure it out, he will change it!). Try doing 0.5 reductions, and if it turns out that he has trouble holding 0.5 reductions then you can always go back to 0.25 reductions. On Jazzy's trip down the dosing ladder the past few weeks, I have even had to do some 1 unit reductions just to try to keep ahead of her monster shed. Especially since you will be going out of town soon, it makes sense to try to get him stable in higher blue and yellow at least until you get back.

For what it's worth, I have learned that I can usually shoot a number like 128 for Jazzy. There are some times, though, when my gut just says "don't do it," even though I have done it before, and when my gut says that I follow it. Even if she is high at the next preshot, she recovers quickly and it's not worth taking risks.

One thing acro has taught me is to be a lot less rigid about my dosing decisions. I'm not aiming for OTJ and I'm not riding the edge, so if I need to be 1/2 hour early or late or if I need to skip or BCS something, I just do it and don't worry about it. I know she is probably going to be on insulin for the rest of her life, so it is important for me to be able to balance what is best for her with what works for ME. It did take me quite a while to get to that point, though, after all that time trying to be perfect with Lucy. It's quite a mindset adjustment! You'll figure it out, though.
 
Just stopping in to say that I am sorry for the dx. that Guinness received. Also to say that the dosing routine Gus was on, is the same way I handle it now. The biggest difference is the way that I use R. Way not so much anymore. If Gus is in the very high numbers (that does not include 300s at all) I may use .25UR, but that's all. It is a blow to our way of thinking to hear that our fur baby has a tumor that we're doing battle with instead of a liver/pancreas foe. Julie is a great new-acro mom. She has done lots of research and will most likely share with you. Any of us with acro babies will support you and the dosing experts are still the greatest. Libby has been a wonderful source of encouragement to me. All that being said, most of us with acro cats have chosen to remain in LL because the dosing advice is still appicable to most of our dosing situations. Personally, I'm much more comfortable here than any of the other acro sites I've researched. Big hugs to you and Guinness. :YMHUG:
 
morning linda! i think your gut is working just fine - you knew what to do without someone even telling you.

libby's last paragraph - i'm getting there too. i just feel like the pressure is off for me to keep trying to get punkin OTJ. we've switched into maintenance mode. and yes, while i'm still basically trying to hit 12/12 on the shots, i've also realized that large shed makes perfection less important. if i'm late on a shot the shed is still giving punkin insulin. i think one of the links i added to that post last night talks about how lantus and levemir work - the chemistry of how they work. that was very helpful to me in understanding the whole shed thing better.

there is plenty of help still available for you when you need it. don't feel alone. this is manageable - just another bit of info to add to the overall plan of keeping guinness healthy.

have a super day today.
 
Hi Linda!

Smokey and I check Guinness's SS every day and I was shocked to see this new diagnosis! I will continue to follow you both closely to see what happens from day to day! I'm going to do some reading this weekend on Acro so I can also educate myself on this!

Keep us all posted!
((Gunniess))
 
I am glad you now know the reason for the high dose, but I think the testing was just for the confirmation. Did your vet tell you the result value for the IGF-1 test?

The fluids often have an effect on BG and could have contributed to the low green cycle. Also, bupe will play a part in the picture. You may find that his dose could drop more as the pancreatitis problem is resolved.
I have found that Shadoe's dose will rise with her pancreas problems, but after a few days of fluids and bupe, she starts to feel better and her dose drops a bit. One thing I have learned is that giving her 1/4tab pepcid BID helps to settle her and we have less p-titis problems now.

If Guinness is not that carb sensitive, be prepared to feed a whole can of HC if he drops under 100 - acros have functioning pancreas so they need much more HC to bring up their BG.
 
Hi Linda & Guinness - This is Susan & Lanky, another ACRO combo team (Mom & kitty). I wanted to be sure you are aware that there is also vet in the LA area that does pituitary surgery which is another option since you are relatively close. See attached article from the FaceBook Acro group (Patti Fuchs). Also, I am most happy to chat with you any time, just P me with you ph# &/or I'll give you mine. I also have had 3 kitties needing fluids so I have a few tricks on that if you like.

This is a lot of work but so very well worth the effort for us.

PS File too big to attach so here is just part:
Pituitary Surgery

Loki- a 13 year old male kitty was diagnosed with diabetes in March 2010 and acromegaly 3 months later. In October 2010 he had a transphenoidal hypophysectomy. The surgeon - Dr Bruyette at VCA West Los Angeles Hospital in California, felt he had removed all of the tumor but was able to leave the pituitary gland so that Loki would not need any hormone replacement medication. The recuperation period is a long road. 1 month post surgery Loki no longer needed insulin. 2 months after surgery Loki still has muscle weakness, loss of balance, and confusion. However his mom Johanna felt that,”his paws look smaller after the surgery but maybe that is my imagination (they grew pretty big with the acromegaly). Overall, I think his quality of life is better, his coat is way better and he has more energy.”

The surgery is expensive and not without risks but it is one more option now open to our cats who face this disease with little other treatments. You can contact Dr Bruyette @:

David.Bruyette@vcamail.com

Link to information about Dr Bruyette @
http://vcaspecialtyvets.com/west-los-an ... ts-doctors
 
Hi Linda & Guinness,
My charlie was recently dx with acro, too. Even though I knew in my heart that he had it, I was in denial. It was a bit of a shock to hear the vet say he was positive. So, I know what you're going through. You'll do great, though. Every bean on here does great with whatever dx or new issue is thrown at them. Give Guinness some extra scritches and give yourself a piece of chocolate (or a glass of wine...whatever your preference!)

claudia & charlie
 
Hi Linda and Guiness,
I'm Patti (and Merlin) - I'm one of the very old acro moms now - there's a lot of info in the acro group right here on fdmb. The info Susan posted is all linked here too on fdmb and on facebook - so everyone can try to find it everywhere. THANKS SUSAN for posting it - I so appreciate it!

And Libby - I loved your gathering of info - that's incredible!!!!

Just thought I'd pop in Linda and introduce myself - also I keep a list of names of all the acromoms - I'd love to add you and Guiness to it. I also make a calendar every year for the acrocats - and would love to have Guiness in it - I'll check back with you!!!

xxx
patti
 
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