7-24 Gizmo AMPS=364; +2=317; +4=310; +6=266; PMPS=304; +2=306

[Chubba (GA)]

Condo - http://www.felinediabetes.com/FDMB/...-309-3-259-5-221-8-273-pmps-226-2-307.181115/

PMPS = 226
+2 = 307
+4.5 = 249

AMPS = 364

+9 snack was obviously not a good idea. Much higher AMPS than expected and Gizmo still woke me up.
Going back to feeding 1/2 can at shot and 1/4 can at +6. Vet wants me to get a little more food into him, but I'm not sure how to do this without increasing his numbers. He doesn't seem to get satisfied with the smaller meals of 1/8 can. He eats Friskies 5.5 oz cans. Any suggestions? Feeding after his nadir at +6 doesn't appear to be a good idea.

 

[Doodles & Karen]

Yes, the +9 snack is really only for kitties that are just about OTJ but no harm trying. If he needs more food he needs more food and usually they will settle down with the numbers regardless. Maybe try preshot, +2 or 3 & +6?

 

[Bronx's dad (GA)]

What about some raw food? I just started to try frozen Primal Nuggets in the feeder and these cubes thaw out just in time for Bronx to eat. Before Primal, I used Rad Cat which is also frozen but comes in a tub so is not as convenient as Primal.

 

[Chubba (GA)]

Maybe try preshot, +2 or 3 & +6?

I am going to to go with 1/2 can at shot time and 1/4 can at +3 and +6. Although the PM cycle will be at +2 and +6 since my other kitty gets a bed time snack and Gizmo gets jealous. She used to get the +6 snack also, but i found out that she wasn't always getting out of bed to eat at 2am (not sure I blame her) and Gizmo was eating her food also. Today he got his snack at +4 because I forgot and we left for groceries. Hopefully we will see better numbers soon. I wasn't happy with yellows yesterday, but these pinks today are really depressing!

What about some raw food?

I'm just not sure about raw food.

 

[Chubba (GA)]

+6 = 266

@Marje and Gracie
Lab results are updated on spreadsheet

 

[Chubba (GA)]

PMPS = 304

Tomorrow will be 6 cycles since Gizmo's greens. I am going to have to hold off on the increase though because I am unable to monitor again this Wednesday. So Gizmo just show us some more greens so we don't have to increase! I am probably even going to be an hour or two late with his PM shot that night also. I won't have any trouble readjusting his schedule back to normal in 15 minutes per cycle. I will be leaving for the day around +1 and won't be back until late. Very concerned about leaving him again. I don't think I'll ever get used to it. Would it be better to leave his schedule the same for that morning so that I can get a +1 before leaving? Or I could adjust his schedule so that he gets his shot right when we are leaving and then PM shot won't be as late? My mom will be checking on the animals, but isn't quite comfortable giving his shot or testing him yet.

 

[Chubba (GA)]

When adjusting his schedule, is it better to change 15 minutes per cycle or just one 30 minute per day? Which affects the insulin depot less?

 

[Wendy&Neko]

When adjusting his schedule, is it better to change 15 minutes per cycle or just one 30 minute per day? Which affects the insulin depot less?

Depends on the cat, I never noticed a difference. Some people noticed it more with 1/2 hour change. It also depends on what sort of numbers he's running in. If he's not near a good dose, then it's not as critical as if he's tightly regulated. An early shot can act like a bit of an increase.

Would it be better to leave his schedule the same for that morning so that I can get a +1 before leaving? Or I could adjust his schedule so that he gets his shot right when we are leaving and then PM shot won't be as late?

Again, really depends what sort of numbers he's running in. He did greens two days ago and is now bouncing. He should be scheduled to clear the bounce sometime tomorrow. If he does and goes into lower blue/green, then he'll probably bounce and be safe for Wednesday. Yup, bounces can be your friend.

Tomorrow will be 6 cycles since Gizmo's greens. I am going to have to hold off on the increase though because I am unable to monitor again this Wednesday.

That's OK, the protocol says to hold the dose for 10 cycles/5 days after seeing the first green.

 

[Chubba (GA)]

Depends on the cat, I never noticed a difference. Some people noticed it more with 1/2 hour change. It also depends on what sort of numbers he's running in. If he's not near a good dose, then it's not as critical as if he's tightly regulated. An early shot can act like a bit of an increase.

I can stick with 15 minutes per cycle since that is less of a change per cycle. Probably doesn't matter that much, but I feel like it is changing the least amount.

Again, really depends what sort of numbers he's running in. He did greens two days ago and is now bouncing. He should be scheduled to clear the bounce sometime tomorrow. If he does and goes into lower blue/green, then he'll probably bounce and be safe for Wednesday. Yup, bounces can be your friend.

. This is what I am hoping happens. Then I know he is safe and can have fun and actually enjoy my day away.

That's OK, the protocol says to hold the dose for 10 cycles/5 days after seeing the first green.

I'm glad you mentioned that. I forgot about that. I was just thinking 6 cycles after greens.

 

[Marje and Gracie]

+6 = 266

@Marje and Gracie
Lab results are updated on spreadsheet

Thank you. I’m working on a SS for a member and then I’ll take a look.

 

[Chubba (GA)]

Thank you. I’m working on a SS for a member and then I’ll take a look.

Awesome. Thanks.

 

[Marje and Gracie]

I know you mentioned back awhile about potentially testing for acro/IAA. Did you decide on that yet?

There are a variety of reasons why his globulin, neutrophils, and WBCs might be high but often it has to do with infection or inflammation. I’m not really worried about the globulin as it is barely elevated and labs are always just a snapshot in time but it’s definitely something to watch. He’s not had any steroids, right? Sometimes stress can cause the adrenals to release corticosteroids which can increase the neutrophils and band neutrophils.

The creatinine is a little higher than I’d like to see it. While it is in the “normal” range, we usually would do a little more looking at some other things when it gets above 1.6. Yes, it is a number that can go up and down a bit and there are other reasons why creatinine might be elevated other than the kidneys. His BUN is normal which is good but sometimes we see a lower urine specific gravity (below 1.040) and a creatinine above 1.6 and that throws up a red flag to me that a kitty “might” have very early chronic kidney disease. I’m not saying this applies to Gizmo at all and occasionally, I see a creatinine at 1.9 or so and the next test, it is back down below 1.6. The other things is that in very large cats, we might see a higher creatinine but since his creatinine was 1.6 earlier this year, than I don’t think his size is a factor.

Unfortunately, we don’t have a USG here to see what it looks like. What you can do is do a free catch of urine of the very first pee of the day and run it to the vet. They should have a refractometer and be able to run the USG without sending it to the lab. If the USG is above 1.040 in the first sample of the day, then he is concentrating his urine and the creatinine is a little elevated for some other reason. If it’s below 1.040, then he isn’t concentrating his urine as he should be. Also remember USG can vary during the day so if you take his second or third pee of the day in, it wouldn’t surprise me if it’s lower and I wouldn’t consider it to be the best indication of whether there is any early kidney issue or not. Sad to say, but many vets miss this very, very early warning sign. Again, I’m not saying this applies to Gizmo but if it were my cat, I’d have it checked out.

BTW, IDEXX lab usually includes an SDMA test as standard with their superchem. The SDMA along with the creatinine is a really good indicator of kidney function. However, if your vet doesn’t use IDEXX, then it doesn’t really matter.

Other than the above and the T4, which we already discussed, I don’t see anything of concern. Glad to see his ALP came down.

I’m not really sure why vets run “mini labs”. For me, I always have the superchem and cbc done because you see so much more than just with a few tests here and there. And I always have a urinalysis done annually.

Please let me know if you have any questions.

 

[Chubba (GA)]

I know you mentioned back awhile about potentially testing for acro/IAA. Did you decide on that yet?

There are a variety of reasons why his globulin, neutrophils, and WBCs might be high but often it has to do with infection or inflammation. I’m not really worried about the globulin as it is barely elevated and labs are always just a snapshot in time but it’s definitely something to watch. He’s not had any steroids, right? Sometimes stress can cause the adrenals to release corticosteroids which can increase the neutrophils and band neutrophils.

The creatinine is a little higher than I’d like to see it. While it is in the “normal” range, we usually would do a little more looking at some other things when it gets above 1.6. Yes, it is a number that can go up and down a bit and there are other reasons why creatinine might be elevated other than the kidneys. His BUN is normal which is good but sometimes we see a lower urine specific gravity (below 1.040) and a creatinine above 1.6 and that throws up a red flag to me that a kitty “might” have very early chronic kidney disease. I’m not saying this applies to Gizmo at all and occasionally, I see a creatinine at 1.9 or so and the next test, it is back down below 1.6. The other things is that in very large cats, we might see a higher creatinine but since his creatinine was 1.6 earlier this year, than I don’t think his size is a factor.

Unfortunately, we don’t have a USG here to see what it looks like. What you can do is do a free catch of urine of the very first pee of the day and run it to the vet. They should have a refractometer and be able to run the USG without sending it to the lab. If the USG is above 1.040 in the first sample of the day, then he is concentrating his urine and the creatinine is a little elevated for some other reason. If it’s below 1.040, then he isn’t concentrating his urine as he should be. Also remember USG can vary during the day so if you take his second or third pee of the day in, it wouldn’t surprise me if it’s lower and I wouldn’t consider it to be the best indication of whether there is any early kidney issue or not. Sad to say, but many vets miss this very, very early warning sign. Again, I’m not saying this applies to Gizmo but if it were my cat, I’d have it checked out.

BTW, IDEXX lab usually includes an SDMA test as standard with their superchem. The SDMA along with the creatinine is a really good indicator of kidney function. However, if your vet doesn’t use IDEXX, then it doesn’t really matter.

Other than the above and the T4, which we already discussed, I don’t see anything of concern. Glad to see his ALP came down.

I’m not really sure why vets run “mini labs”. For me, I always have the superchem and cbc done because you see so much more than just with a few tests here and there. And I always have a urinalysis done annually.

Please let me know if you have any questions.

Thanks. This is all so very foreign to me, so I appreciate you looking over his results. I went to the vet to have the testing for acro & IAA done, however my vet wasn't prepared to do them. Said he would look into them and get back to me. I emailed him info on both tests later that night. I still want to have them done.

I believe I saw IDEXX on the lab results paperwork, but I added every test that was on there. So SDMA must not have been tested.

I'm not sure when his first pee of the day is. He roams the entire night. That might be a hard one to catch, but I will certainly try. Maybe I'll wait until off antibiotics that way they can also test for any infections (I'm assuming uti, but the vet never said). I will hopefully be able to get the acro & IAA tests done then also.

 

[Marje and Gracie]

Thanks. This is all so very foreign to me, so I appreciate you looking over his results. I went to the vet to have the testing for acro & IAA done, however my vet wasn't prepared to do them. Said he would look into them and get back to me. I emailed him info on both tests later that night. I still want to have them done.

I believe I saw IDEXX on the lab results paperwork, but I added every test that was on there. So SDMA must not have been tested.

I'm not sure when his first pee of the day is. He roams the entire night. That might be a hard one to catch, but I will certainly try. Maybe I'll wait until off antibiotics that way they can also test for any infections (I'm assuming uti, but the vet never said). I will hopefully be able to get the acro & IAA tests done then also.

You're welcome. I certainly don't think any of this warrants you running out and getting labs done again. The simplest thing is to check the USG whenever you can catch a sample early in the day.

Next time you have labs done, be sure and ask for a senior panel to include a superchem (and SDMA), CBC, T4, and urine. It's actually usually cheaper that way. Double check with your vet what IDEXX includes in the senior panel but Antech includes all of that, except the SDMA, for a very reasonable price.

If they have him on antibiotics, I'd want to know why.