8/23 Tigger AMPS 377 PMPS 370 +2=352

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hnkstr

Member Since 2011
Creaping back up again.
I hope that insulin comes today so I can jump him to 10 units
I'm down to 40 units in my pen after this mornings shot
 
Re: 8/23 Tigger AMPS 377

When did you order it? It should be here today, shouldn't it?

Come on Tigger, let's see some yellow, today.
 
Re: 8/23 Tigger AMPS 377

Ordered it on the 15th.
I don't know how long it takes to get it, the website says my order was processed, but doesn't give any shipping details.
 
Re: 8/23 Tigger AMPS 377

Brent,
Just wondering - you have already had Tigger tested for acromegaly and IAA, yes?
On looking at your ss, you are holding dose longer than needed and the longer you hold a dose, the more chance you give for the resistance to set in.
 
Re: 8/23 Tigger AMPS 377

Yes Gayle, about a week ago I got Tigger tested for Acro and IAA, still waiting for the results.
As for the Lantus, I was holding the dose until my lantus shipment came in. Which, it just did.
Must have showed up to my work after I left for the day. I sure hope it stayed cool enough, the packaging wasn't overly cold when I got it this morning.
I put it right in the fridge here at work.

First time ordering the lantus online.
 
Re: 8/23 Tigger AMPS 377

Best of luck on the test results. Be sure to ask for the numbers on the tests; do not accept being told 'positive' or 'negative. For acro, normal range is 12-92; for IAA, over 20%. If you get an IAA result of 19 or 20, I would take it as most likely positive.
Please know that you can follow the protocol as outlined to a degree, but once you get to the dose of 9 or 10unit BID, and you are seeing no real change/improvement in BG, you can start to increase in full units for all increases until you start to get close to a good dose. You basically need to get in front of the train to slow the resistance. If you think of the %, your .5u increases at 5u are twice as large as the .5u increase to 10u.
 
Re: 8/23 Tigger AMPS 377

I will call the Vet today I think and see if they have the results.

Now that I have a new bottle of Lantus i'll up the unit to 10 units and go 1 unit increase doses from there.
 
Re: 8/23 Tigger AMPS 377

Just called the Vet, one result came in late yesterday but she said the Vet has to interpret it when she gets in and will call me back.
She couldn't just give me the number or tell me which test.
 
Re: 8/23 Tigger AMPS 377

Brent,
I had the same issue and also others have as well. There is nothing to interpret, but best to wait for the vet to speak with you and you can discuss any questions you may have at that same time, even if unrelated to the results.

I got my two results separate as well, so just remember if the IGF-1 test for acro is positive, the IAA does not matter all that much because acro trumps IAA.

Pats for Tigger.
 
Re: 8/23 Tigger AMPS 377

IAA came back at 60 so I think we found why Tigger is such a high dose

Sooooo, Vet didn't really know where to go from there. She did wonder if a different Insulin would be more effective, I said I don't think so from what I've read on IAA here at FDMB. I told her I will find out what to do on here.

I'm guessing I up the unit til we get to an optimum dose then? Go up at 1 unit instead of .5?
 
Re: 8/23 Tigger AMPS 377

Gayle, i'm not sure about an automatic 1u increase - i'm still changing punkin's dose by .5 unit, sometimes .25 u and he's at 13.5-14. if you want to do that, brent, do it carefully so you don't have a huge-er reaction than you want. let's see how tigger responds to the bigger increases.

brent, Sandy & Black Kitty dealt with iaa - and they licked it. i'll send her a message to come and talk with you. Patty & Harley are dealing with it now. i'm thinking that's what Do Lou has also. you do have to be aggressive with iaa - but you don't have to do it alone. they can guide you.

good to know what you're up against. iaa is tough, but acro is worse, i think. acro has an expected life span of 1.5-3 years after diagnosis.
 
Re: 8/23 Tigger AMPS 377

oh, as far as the kind of insulin, i think your best choices are lantus and levemir for the bigger doses. lantus apparently stings when it hits the body, but punkin has completely stopped reacting to it. so i haven't done anything about switching him. his numbers are so good on it, unless something changes we'll stay with it. and you just bought a new bottle . . .

i don't know a lot about levemir, but several people on this forum use it, including gayle. the nadir is different - close to the shot time, and it doesn't sting - that's about the sum of my knowledge about it

i wouldn't automatically switch insulins based upon the idea that one is better for iaa - i doubt that's true. see what others have to say.

re the dose size changes - it's true about the percentage, i'm just saying if you're going to change the amount you are increasing by, make sure and do it when you have time to monitor. punkin's responses aren't usually in the first cycle of a change but in the next one or two cycles. you know tigger - you just want to keep him safe. you do have to be aggressive with that iaa because basically, it's tigger's body is building up antibodies to insulin that's injected, and you have to overcome that with your strategies.
 
Re: 8/23 Tigger AMPS 377

Hi Brent,
Just stopped in to say Hi. Harley is dealing with IAA currently, he is not acro. His % came back as 66 and my vet did not know what to do about it. She also suggested switching insulins but finally decided that the lantus would work as well as anything else.

We have had quite a history with it but I think winning the battle. Harley has gone from 10.5 units lantus down to his current 3 units. It's a struggle but well worth it. I have had lots of support from the group: Sandy, Lisa, Gayle - all are wonderful people and very experienced in IAA.

It was frightening the first time they told me to go up in dose, but it really worked. Before I knew it, I was squishing those antibodies and the dose came down.

I will be here if you need me.

Pattie
 
Re: 8/23 Tigger AMPS 377

Thanks everyone!
I am going to go to 10 units tonight and I think i will go up by .5 units but more aggressively than I have been.
The decision is due to my not being home to monitor him as closely as may be needed.
Initial game plan might be 4 doses then up .5 units, rinse and repeat. :lol:
 
Re: 8/23 Tigger AMPS 377

Gayle, i'm not sure about an automatic 1u increase - i'm still changing punkin's dose by .5 unit, sometimes .25 u and he's at 13.5-14. if you want to do that, brent, do it carefully so you don't have a huge-er reaction than you want. let's see how tigger responds to the bigger increases.

If you look at Tigger's ss, Brent was already doing 1u increases but slowed down at 9u despite no change in numbers.
All 300s with the odd 200 here and there does not mean to slow the dose changes.

Brent,
It would be good if you could do some curves on the weekends or when you will be home for a cycle so that you have an idea how Tigger is doing mid cycle - you also want to identify where Tigger's nadir is located.
 
Re: 8/23 Tigger AMPS 377

Hi Brent!

Well, one puzzle piece in place, one to go. Your vet will likely not know how best to proceed. That's OK - we do.

A couple things you should know about IAA:
It's idiopathic (no known cause)
It's self limiting - it will come to an end one day - the antibodies will give up the ghost - that's the good news. However, close monitoring is required - the anntibodies bind to the insulin , so Tiggers body is not able to use it. How much gets bound up - who knows. When it breaks, whatever antibodies are around release the insulin that was bound to them and that's what you have to be alert to. Insulin sensitivity can return at any time, and it's a crazy slide down the dosing ladder. Although a positive Acro result will trump IAA - knowing he is IAA as well is critical - you have to be mindful that there are antibodies with insulin bound to them and they may release it without warning.

In the mean time it's a BG beat down to keep Tigger in a safe number range. I think Lantus is great - worked for us :mrgreen:

I'd stick with .5 increases. You can also add Humlin R (what we refer to as "R") to the mix. it's a fast acting, short duration (this can vary due to binding to/release from antibodies), powerful insulin. It helps to set the stage for Lantus onset. Say you have a PS of 450 and Lantus onset is 2 hrs. The R can bring that PS down to something easier for the Lantus to pick up and run with.

Take a look at BKs ss, back around Sept/Oct 2008 or so (heck look at the whole thing - there's a happy ending :mrgreen: ). You'll see how we worked the 2 insulins. It's a process to figure out an optimal R dose and schedule, what we call an "R scale". I've started to add BKs old R scales onto the 2nd tab of his ss - sill working on it. The R scales continualy evolve and change. I'll be happy to help you with it all.

FYI - BKs vet and internist where both completely freaked out at the amount of insulins I was pushing into him.The only thing that somewhat calmed them was they could clearly see by his ss that we where monitoring very closely and getting results. And when he went OTJ - they were dumbfounded.

ETA- It's going to be a balancing act finding the optimal dose of Lantus and R. You don't want the Lantus dose too high, because when the resistance breaks it's easier to simply cut off the R and the effects of that are immediate, since R has no shed. As an example, when BKs IAA broke - stopping the R at that time was equal to something like a 12u decrease (can't see his ss from tbp right now).
 
Re: 8/23 Tigger AMPS 377

Good Morning to you and welcome to LL this is my first visit to your condo you are already getting some great advice from Sandy ;-) but I found out Do Lou was IAA last summer he was negative for acro I am not as aggressive as others have been with IAA, Do Lou is 64% and right now he is at 6.5 units but that is always changing I also have used R on many a occasion to try and keep his numbers down but it must be used with caution until you know how you boy will react to it. Wishing you the best you are in great hands here :mrgreen:
 
Re: 8/23 Tigger AMPS 377

i was wondering when you're headed off to Mayo for yourself and how long you're going to be gone. i know you have a petsitter that doesn't test (is that right?) so we're going to need to help you get a game plan in place before you go.

sorry you're getting so much to deal with, brent. life is tough sometimes. we'll all try to support you as best as we can - i know you've said your family/friends in real life don't get why you'd do all of this for tigger. we do.
 
Re: 8/23 Tigger AMPS 377

Hey thanks for all the input!
Just a couple tid bits here, I upped via 1 unit doses for a while due to substitute dosers and making it easier (and thus more willing) for them to dose.
I was told to go back to .5 units after things settled down, which I did.

I have no background with "R" and will have to do some research, although i'm a bit nervous adding that to the mix. I live alone and gone most of the day so its hard to get all the monitoring that needs to happen. I'm hoping Acro is negative, then i can set my sights on IAA and do what needs to be done.

The high IAA does make sense now that I look at it, every time I think I hit that magic dose, or getting close, the numbers jumped again.
He probably needs something like "R" but i'm gonna need some dosing help on that one and may need to start very very low since I won't be home to monitor. I get up at 4:30am and dose and get home around 3:30pm. In bed by 8:30-9pm (long story but i have some health issues myself i'm fighting and fatigue makes the whole diabetic Kitty thing a little tough at times). I have more Mayo clinic trips coming up so more substitute dosers, which i need to consider as well.

Once again, thanks for all the input and we'll get a game plan here once I take in all the data! :lol:
 
Re: 8/23 Tigger AMPS 377

Hi guys .. so glad you got one of the test results in and know you are starting a game plan! There seems to be a ton of advice going on in this condo which is awesome .. I know you are in good hands with everyone here!
 
Re: 8/23 Tigger AMPS 377

Hey Julie,
Nice timing there on the Mayo questions. :lol:
I was just pondering that myself as I go back Sept 1st (Ear Nose & throat with Immune testing) and Oct 7th to see sleep specialists. I guess my oxygen drops to 70 when i sleep, not sure why but I guess that's low.

Now Tigger is not real open to people and will hiss and get a little mean, UNLESS you are standing there with a FF can in your hand. Then he LOVES you to death.
:lol: :lol:
So, the dosing goes fine since he couldn't care less who is jabbing him when he's pigging out, but you try to stab his ear when you are not Brent and its gonna go over like a fart in church. He won't let it happen, so I don't even try to get readings with substitute dosers.

I have a few friends/family that are supportive, most think its just a cat and not worth it, and they've learned to keep their opinions to themselves. :lol:

Thanks everyone, I appreciate it and i'm sure Tigger does too. :-D
 
Re: 8/23 Tigger AMPS 377

Brent,
Please hold all changes until you know the results for acro.
If you get a positive number for acro, you do not want to aim for any BG below 100; acro trumps IAA.
If you receive a negative for acro, way under 92, then you need to be much more aggressive and you must push for BG below 100.
Please know that IAA can be temporary.
Sandy and Black Kitty are good examples for beating IAA back, breaking the resistance to reach OTJ status.
The two others who are doing an awesome job of getting ahead of the IAA are Pattie/Harley, and Lisa/DoLou.
If Tigger is IAA only, you will need to be more aggressive but you have 3 experienced IAA helpers, so don't worry.

For higher doses, Levemir would be your better choice, but Lantus is fine as well. My Shadoe does much better on Levemir, but Oliver does the same on Lantus or Levemir.

My Shadoe is positive for acro only; Oliver was positive for acro (325) and also IAA (60%).
You should buy some R as it will come in handy when the BG spike high. There are several people who can help you here. I suspect that I was able to break the IAA resistance as Oliver reached 21u Lev and 7uR, then he came tumbling down for a cycle of BG under 100. After that day, I did not need to use R except on the odd spike. We are now just treating for the acro.

Do you know when you will be getting the acro result?
 
Re: 8/23 Tigger AMPS 377

my brother-in-law (who i fondly refer to as The Groper, guess why) said to me "the pound is full of cats. why would you go to such a bother for this one?"

ohmygod_smile

my vengeance on him is that i feel free to mention his nickname. :lol:

too funny on the timing of the mayo stuff! are you just gone for the day - somehow i thought it was a several day affair.

one possibility might be to test tigger's bg the second you put down the bowl and have the insulin already prepped and by your hand. so set down bowl, test bg, see # of BG, shoot.

would that work? maybe you could try it out with him a few times first.

another - are you using the neosporin with pain relief? some people put that on 20 minutes in advance of testing, then wipe off the excess and test. it does an amazing job of numbing. would that help?
 
Re: 8/23 Tigger AMPS 377

Groper??
Too funny. What a guy!
:lol:

So far the next two are just individual all day appointments. I actually go down the night before for each, but not back to back this time. I will need two subs for each I suppose.
The sleep one could lead to a couple days and an over night for testing I suppose. Not really sure what is up their sleaves. :smile:

I have not used Neosporin, he's taken it like a champ since he knows what follows!
My routine is to bring him in the living room, lay him on his right side and take a prescription bottle and put that in his ear. Then poke the outside of the ear along the edge. I am not sure how he would do during a feeding. His head moves when he eats so you'd almost have to stop him to poke him, wouldn't you?
 
Re: 8/23 Tigger AMPS 377

i was mainly asking that for if you had a pet sitter testing - if that would make it easier for the pet sitter so he didn't have to go without being tested.

i use a vet tech from our veterinary clinic when we have to be gone - at first she brought along a friend, but i think now she does it alone. but punkin doesn't get ferocious when he's getting tested, he's afraid of people and wants to dodge and hide.

you might want some of that neosporin on hand - so far you haven't had him go low, but pushing him you will. if you end up doing a poke fest every 20-30 minutes for a couple of hours, his little ears will be sore. it's a worthwhile $3!
 
Re: 8/23 Tigger AMPS 377 PMPS 370

Well, not sure if he gets ferocious, but he does hiss and is scary to the gals. :smile:
Nobody picks him up but me for that reason.
I know he's all talk, but he's my boy!
:lol: :lol:

Tonight he's high, hungry and very very vocal. Its a brutal catch 22.
His numbers are high, give him more Lantus, his appetite grows, numbers go higher, needs more lantus and his appetite grows, numbers go higher, needs more Lantus, etc, etc, etc. Wow
 
Hang in there, Brent! You will get a handle on it with the help of these experienced beans. You are doing very well. I hope you get the acro test results back soon so that you can plan your strategies. In the meantime, stay cool. Sending positive thoughts for both Tigger and you!

Ella & Rusty
 
I'm hangin and trying to take things in stride, just hard to see him struggle with the hunger sometimes. It makes it a bit easier now knowing what's wrong and what he's going through.
I have a feeling its going to get rockier. Right? :?: :?:
:smile:
 
Just stopping in tonight and to tell Tigger he can come down off the pink floor soon at least he seems to have come down some with his +2 :razz:
 
I wouldn't assume that it will get rockier. You've got great resources here. Sandy's BK had a rocky road because of DKA. (You would not have believed the OTJ party for BK!!) She's a great resource -- look at all of the info she provided today. It may be harder once you actually break through the antibodies. Coming down the dose ladder can mean losing sleep!
 
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