7/5 Junior AMPS 108 +6 82 +7 77 +8 80

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MauiGuppy

MauiGuppy

Member Since 2011
Good morning LL!

Hope you all had a great holiday weekend. I know Junior did! His appetite seemed better and he surfed the greens yesterday.

I finally got through to the vet's office and they said they had already called in the fructosamine test on Saturday. Booooo. My regular vet is back from vacation and will be calling me with the test results from that, the blood test, urinalysis, and the xray.

Also hoping to get a few more pokes in today besides the +6. WIsh me luck!
Bonnie

Edit: Here is the link that'll take you directly to the post below on the vet call
 
Re: 7/5 Junior AMPS 108

Nice starte for Junior, Bonnie! Bummer about the fructosamine test...I swear, these vets know nothing about FD. As we all know, it should have been obvious that a fructosamine wasn't necessary at all since you home test. Grrr.

Good luck with today's pokies, and for getting the fructosamine fee off your bill!
 
Re: 7/5 Junior AMPS 108

Nice AMPS for Junior. That's too bad the Vet partner went ahead and did the fructosamine test w/out asking you. I hope all the test results turn out fine. Have a nice day.
 
Re: 7/5 Junior AMPS 108

Great start for Junior today! Good luck with the vet discussion. Hope you are able to get out of it.

Have a wonderful day!
 
Re: 7/5 Junior AMPS 108

I agree the test is unnecessary. In the vets' defense, most people don't home test and the vet is attempting to protect the cat. If you search on line about a fructosamine test, the party line is to get the test done. As much as I like my vet, she really pushed for the test. There are times when you have to choose your battles.
 
Re: 7/5 Junior AMPS 108

Morning guys! What a great start for Junior. nice amps!!

Good luck with all the lab tests/results. I hope all come back with great results. I know on the fructosamine. Mine pushed for it too. She doesn't so much anymore, as she knows I test way more than most people. We've reached an understanding on that one.

have a great day today!!
 
Re: 7/5 Junior AMPS 108

I got a quick email from my vet saying that he'll call me later but wanted to let me know that the fructosamine test "came back low, which appears supportive of [the on duty vet's] concern about this Somogyi effect." I sent him an edited version of Sienne's post to Marjorie on Somogyi. Thank you for all that info! It was incredibly helpful.

Ultimately I hope that it's the radiation treatment for HT that will help get his appetite back and crossing my fingers that it's not the fatty liver disease. Sooner I can get that going the sooner I'll know!
 
Re: 7/5 Junior AMPS 108

Yay for the greens and nice amps today Junior!
Good luck with the vets and my fingers are crossed for all the results. Nothing but good news I'm sure.
 
Re: 7/5 Junior AMPS 108 +6 82 +7 77 Vet Called and Dosing Qu

I just want to start by saying that it's a delicate dance with my vet b/c he's been good friends with my brother since high school; there is no doubt that he cares for Junior but I have to be careful on how much I can challenge him.

- He felt that the BG level is too low and that I'm over treating him. He says he understands I'm weaning him off but I need to stop giving Junior insulin now.
- Said that even though I home test on a daily basis, the fructosamine has more data that helps him see the Somogyi effect. He hadn't had a chance to see the edited version of Sienne's post I had emailed him so I gave him a quick recap. He said there has been alot of info on Somogyi and there have been varying opinions, but he looked forward to reading what I sent him.
- Thyroid is lower and Junior is being overmedicated here.We can cut it down to 1/2 pill in the morning and 1/4 in the evening.

Given that one of the side effects of Tapozole is loss of appetite, I hope Junior will start eating better now.

I also told him I'd like to get a second opinion before I take him off insulin (Sienne's vet on Thursday). He supported a second opinion but was against keeping him on insulin during this time. I assured him that I feel prepared if there's a hypo.

I think keeping him on is fine right? Or should I start thinking about reducing his dose?
 
Re: 7/5 Junior AMPS 108 +6 82 +7 77 +8 80 Vet Called and Dos

Hi Bonnie!! You and I started on this board at about the same time so I would never presume to know more than you, especially when it concerns your cat. I do have an opinion, though, and I will not be offended in the least if you disagree. After looking at Junior's spreadsheet, if Champ had numbers like that, I would start shaving the dose down. Here is the excerpt from the protocol that deals with weaning off insulin.

Phase 4: Reducing the dose. Phase out insulin slowly by 0.25-
0.5U depending on dose.
When the cat regularly (every day for at least one week), has its
lowest blood glucose concentration in the normal range of a
healthy cat, and stays under 100 mg/dL overall
Reduce dose by 0.25-0.5 IU depending on if cat on
low or high dose of insulin
If the nadir glucose concentration is 40 - <50 mg/dL (2.2-<2.8
mmol/L) at least three times on separate days
Reduce dose by 0.25-0.5 IU depending on if cat on
low or high dose of insulin
If the cat drops below 40 mg/dL once (2.2 mmol/L) Reduce dose immediately by 0.25-0.5 IU depending
on if cat on low or high dose of insulin
If peak blood glucose concentration > 200mg/dL (11 mmol/L) Immediately increase insulin dose to last effective
dose
Click to expand...

The Tilly Protocol says the same thing, but just in a different way:

Phase 4: Reducing the dose
When the cat regularly has its lowest BGs in the normal range of a healthy cat and stays under 100 mg/dl overall for at least one week, attempt to reduce the dose. Alternatively, if the nadir glucose concentration is 40 - <50 mg/dl at least three times on separate days, try lowering the dose. If the cat drops below 40 mg/dl once, reduce the dose immediately! The reduction is done very slowly in a step-by-step manner (0.25 or 0.5 IU increments). At each newly reduced dose, try to make sure the cat is still stable in the normal range before reducing the dose further.

If the cat will not stay in the normal range after a reduction, immediately increase the dose again to the last good dose. Sometimes, a cat can even manage to keep its BGs low for a day or two, but then the BGs begin to rise again because the beta-cells haven't recovered enough yet. Try to go from 0.25 IU to a drop before stopping the insulin completely. Reducing the dose too quickly generally does not work: most cats do not go into remission with fast reductions.
Click to expand...

It looks to me that Junior is staying under 100 during most, if not all, of his cycles. Again, if it were me, I would start to shave the dose down and see what happens. You can always increase it back up.

Good luck with whatever you do!! :-D
 
Re: 7/5 Junior AMPS 108 +6 82 +7 77 +8 80 Vet Called and Dos

Please ask your vet to provide you with the research (not case studies unless they are controlled case studies and no anecdotal reports) -- original research, like in randomized, controlled comparisons -- documenting the presence of chronic Somogyi rebound in felines on either Lantus or Levemir. If he can produce research I will happily read it and shut up. I'd also suggest that if he has a cat, he test his own cat's BG and/or fructosamine. I'm going to bet that given there are non-FD cats who BG is normally in the 30 - 59 range that their fructosamine would be unusually low and the cat is not at risk.

I gotta say I disagree with Patty. Within the last week, Junior has had numbers that are above 120. His pre-shots are a lot more blue than green. I'd look at Curry's SS as a comparison. Based on the quotes from either the Rand/Queensland or Tilly Protocols that Patty provided, Junior is not under 100mg/dL overall. Pre-shots are mostly blue.
 
Re: 7/5 Junior AMPS 108 +6 82 +7 77 +8 80 Vet Called and Dos

I'm glad Sienne spoke up because I thought, from reading the protocol, that when it said "has its lowest BGs in the normal range of a healthy cat and stays under 100 overall (my italics) for at least a week" that meant the preshot numbers being in the low 100's would be okay. I'm glad I brought this up, though, so I could get this clear in my own head!!
 
Re: 7/5 Junior AMPS 108 +6 82 +7 77 +8 80 Vet Called and Dos

I wish you luck with your decision. been there with my vet: re too much insulin, the Somogyi effect, LC fuds, all of it. She now let's me call the shots as far as dosing, testing, foods. I have to laugh - I am now on their call list when they have issues with other FD kitties. Anyways... I've just told them that I follow protocol here, and that's that. She's seen the results, via Mannie's SS, and likes what she sees. so... I think Junior looks fantastic!, and wouldn't change a thing.... and the thing about testing his own cat - I have done that - I have two others... they continually test in the 60-80 range. It's normal, lots of kitties do. Good luck!!

What a nice surf Junior has going - awesome! :mrgreen: :mrgreen:
 
Re: 7/5 Junior AMPS 108 +6 82 +7 77 +8 80 Vet Called and Dos

I'd trust the people here over a well intentioned vet any day. They are generalists not specialists. They don't take the time to even read the rand protocol for example or know about it. FDMB works with hundreds of cats on a daily basis - more than any vet would in their whole years of practice. It sounds like you have a good approach. I truly feel like I failed Maverick not being able to speak up to his vets. We finally found one and he passed away suddenly at the appointment where he was meeting her. You are Junior's parent and advocate. A second opinion is what I would do.

Maverick's vet came close to killing him. And then we had three headstrong vets after that. I knew in my heart what was best for him and I wanted a vet to read the research. Not spout old school blah blah blah. So I admire you for being able to verbalize and communicate well. Its a regret I will always have. Hugs to you and Junior.

Edit - and regarding fatty liver. It blows me away how little vets know about this. The past three years on the feline assisted feeding forum I see the same thing with vet knowledge over there. They would rather euthanize a cat than propose assist feeding. They just don't know. Or maybe think owners won't step up. Or don't want to manage them through the process. I say thank God for these specialized forums and the educated selfless people on them.
 
Re: 7/5 Junior AMPS 108 +6 82 +7 77 +8 80 Vet Called

Hi Bonnie, I think that you are doing great and that you should just keep on with what you are doing. It's good news that Junior's thyroid medication can be lowered. As I understand it, the lower the dose--if that dose is working--the better. Good luck with the new vet on Thursday.

Ella & Rusty
 
Re: 7/5 Junior AMPS 108 +6 82 +7 77 +8 80 Vet Called

Okay, I'm confused... my understanding of Somajyi is that a too high dose counterintuitively leads to chronically HIGHER numbers. Does your vet believe that Junior is going crazy high at times and you're just not catching it? But wait, the fructosamine confirms that his numbers are typically low... Is there something about the alleged effect that I'm missing? And I've got copies of all of Willie's lab reports. The fructosamine test is literally a number on a piece of paper. There is no way that it is giving the vet "more" information. (BTW... I highly recommend to everyone getting copies of all your kitties' labs... has been invaluable for Willie and I).

From what I can see, Junior's numbers are gorgeous. Before she passed, I tested Miss Jezebelle (she was jealous of Willie getting all the attention for pokes! ), and she was in the 70s on an Alphatrak.

Sorry that you're dealing with all of this. I know I mentioned this before, but I'd strongly suggest getting a second opinion from Dr. Lisa. She will just take the labs that you've already done and tell you what she thinks is going on. I think it would give you an idea of what path to take and will help you have a more informed conversation with your vet and she will guide you through questions to ask, points to make, etc. I know money is tight, but at this point, I think it would be an extremely worthwhile investment for you... and would cost far less than trying another vet who may want to run their own tests.

((hugs)) to you both!!
 
Re: 7/5 Junior AMPS 108 +6 82 +7 77 +8 80 Vet Called

And to top off this day, Junior won't let me test his PM BG. Two time outs, one E3 error and I couldn't tell if the drop off blood spattered on my finger was mine or his. I hate shooting blind, but I did and hope that his numbers are consistent with the data over the last week (blues). Also hope I can test him again soon.

Thank you everyone for sharing me your thoughts. What I love about this board is that I can bounce things off you guys.

@Patty and Sienne, thank you for the dosing advice. I agree that with the blues, we should keep it the same. Just wanted to ask in case I was missing something. Also if there's a sudden change in behavior, it'll be easier to attribute it to the Tapozol. When he goes through radiation treatment for HT, who knows how that'll impact his BG? I'm not letting myself get too excited about starting the trial -- for now!

And Sienne, you read my mind! As my follow up email to him, I was planning on asking about research.

@Michelle and Karrie and Christie: I hear ya! Alot of what he said didn't reconcile in my head. For example he said that the fructosamine test takes into account stress levels b/c the cat can get stressed at home during home testing. I don't know how a cat would be less stressed at a vet's office. At this point we're pretty sure we're changing vets and since he's friends with my brother, I didn't push it. I didn't even want to get into fatty liver disease with him.

@Christie: Yes! A call to Dr. Lisa is on my to do list! Just thought that was a brilliant idea and I've been waiting to get the test results mailed to me (my vet's an hour away).
 
Re: 7/5 Junior AMPS 108 +6 82 +7 77 +8 80 Vet Called

LOL I actually squealed when I read that... amusing given that I'm in a room full of people. :lol: :lol: :lol: :lol: I know you'll get a handle on this... and I think your instincts on the insulin are correct... changing everything at once doesn't allow you to evaluate any side effects, etc... you'd know it was happening, but not know what to attribute it to.

Good luck!!
 
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