8/9 Nikki AMBG 31 -OTJ Trial Day 9- insulin secreting tumor?

[Alexis & Nikki (GA)]

Yesterday's Condo

Ah, another day, another dollar (except I say dolla' with my NY accent ;-) ). Sadly, the reason it took me so long to get home last night was because a woman jaywalking across 4 lanes of traffic was hit by a car, so they shut the road down while they investigated. :sad:

I should have Nikki's vetty results at some point today. She's been very naughty and aggressive towards Dee since last night, it's like reverse vetty smell! :lol: :roll: Hopefully things will settle down over the weekend. If you count running around and swatting her sister "play", then all 5 P's are accounted for!

Happy Friday LL!

 

[Lkldcatlady]

Re: 8/9 Nikki AMBG 31 - OTJ Trial Day 9

Awwww....poor Dee. She's getting beat up because Nikki had to go to the vet.

Yikes - it sounds like that lady died? How awful to die in the street after being run over. I would never jaywalk in new york! I watch the movies!!

Tell Nikki Bob says Happy Day 9! Only 5 more days.... :mrgreen:

 

[Alexis & Nikki (GA)]

Re: 8/9 Nikki AMBG 31 - OTJ Trial Day 9

Last I heard she was in critical condition. It's scary, cause I'd just driven past there about 7 minutes before she got hit. I don't know why she thought it would be a good idea to cross that particular road outside the crosswalk. It's super busy!

Poor Dee! I finally chased Nikki away from her this morning cause she was being a witch! Ugh. Although I'm not minding that I get bitten far less often now than I did before Dee joined our house! ;-) :lol:

Thanks Bob! Work that dosecrease buddy! :mrgreen:

 

[Alexis & Nikki (GA)]

Re: 8/9 Nikki AMBG 31 -OTJ Trial Day 9- insulin secreting tu

Well, apparently my weirdo cat merited a call from the owner of the practice.... :roll:

The good news is that her fructosamine was 364, down from 680ish in late June. And her BG was 55! :mrgreen:

The bad news is that the vets are concerned with how low her BG is. They suggested that while rare, it's possible that she has an insulin secreting tumor. Ironic, considering that we were just giving her insulin since her pancreas wasn't producing enough! :shock: :?: They want me to bring her back in 2-3 weeks to have another BG done. At $30 a pop, I'll have to really think about that. I'm not sure it's worth dragging her to the vet and spending yet more money chasing something that may or may not be there. Anyone have any experience with this?

 

[Wendy&Neko]

Re: 8/9 Nikki AMBG 31 - OTJ Trial Day 9 - vetty update

HAPPY DAY 9!!

I'm glad to hear that Nikki is feeling up to swatting her sister, though sometimes I do wish they'd stop being such brats! You need to change the subject line of your first post for more eyes on the tumor issue. I haven't heard of such a thing.

The 55 that the vet tested, do you know what meter they used? Or is that from the blood work results? I just tested my civie last week and he was 53. Have you tried testing Dee as a comparison? I know there is some difference between what the meter reads and the b/w results, but it shouldn't be a lot. One time I tested Neko on my Relion confirm right before a vet visit and right after, and the bw results were right in the middle (all were in the 70's). If Dee registers low as well, maybe spend that $30 on a different meter/strips?

 

[Alexis & Nikki (GA)]

Re: 8/9 Nikki AMBG 31 - OTJ Trial Day 9 - vetty update

The 55 that the vet tested, do you know what meter they used? Or is that from the blood work results? I just tested my civie last week and he was 53. Have you tried testing Dee as a comparison? I know there is some difference between what the meter reads and the b/w results, but it shouldn't be a lot. One time I tested Neko on my Relion confirm right before a vet visit and right after, and the bw results were right in the middle (all were in the 70's). If Dee registers low as well, maybe spend that $30 on a different meter/strips?

The 55 was from the blood work. I've used 2 Glucocards and a Freestyle meter and pretty much gotten the same low numbers on all 3. I tried testing Dee once but she was horribly offended ( :lol: ) and I couldn't get enough blood, so I'll have to try again this weekend.

Just from a quick google, it seems like pancreatic cancer and insulinomas are fairly rare in cats. She's not exhibiting hind end weakness, trouble breathing, confusion, or seizures, so I'm not seeing any signs that she's not doing well. It's weird!

 

[Deb & Wink]

Re: 8/9 Nikki AMBG 31 -OTJ Trial Day 9- insulin secreting tu

Sounds like your vet is not used to cats being able to go into remission with the proper diet, home testing and all the hard work you have put into getting Nikki's dose adjusted and get her pancreas to heal. Don't they believe in remission for cats?

Maybe, test her yourself at 2-3 weeks and then decide if you think you need to go back to the vet. Sounds like they are thinking agromegaly but don't think that is what Nikki has.

Nikki this am was being a witch
chasing poor Dee and giving her a stitch
in the side from all that rough play,
Nikki says "I'm here to stay!
Dee got swatted,
Nikki claimed she was allotted!
Vetty smell go away,
I'm raring to go OTJ!

No surprise there.

 

[Alexis & Nikki (GA)]

Re: 8/9 Nikki AMBG 31 -OTJ Trial Day 9- insulin secreting tu

They've had cats go into remission before, although I can tell he is not a fan of human glucometers. :?

I like the vet we see, but I've never been a fan of the owner of the practice. Ever since I first brought Nikki in with the diarrhea, he's been suggesting cancer. Well, that was 4 years ago, and she's still around! The vet we see was much more proactive last fall and spoke with internal medicine specialists and nutritionists, etc.

To be fair, once Nikki lost all the weight this winter (pre FD dx), he did palpate her abdomen and felt a lump near her pancreas. This was in April when I took her in. I just don't know if I want to throw money at x-rays, ultrasounds, etc when she isn't showing any symptoms and seems perfectly happy with her life. And from my reading today, if she does have an endocrine cancer or insulinoma or something along those lines, there isn't much I can do anyway.

I think the best option right now is to monitor and observe. If anything pops up I'll take her in.

 

[Ann & Tess GA]

Re: 8/9 Nikki AMBG 31 -OTJ Trial Day 9- insulin secreting tu

I think it's a good decision to observe for a while. Unless they are going into surgery or have been dx w/ FD few cats get their BG tested, and I'm willing most cats he has seen BGs for have been on dry diets!

 

[Wendy&Neko]

Re: 8/9 Nikki AMBG 31 -OTJ Trial Day 9- insulin secreting tu

Deb - Nikki is showing no signs or symptoms of acromegaly. Acromegaly is a benign tumor of the pituitary gland that puts out excess growth hormone and insulin growth factor. It requires more insulin, most often in large doses. I don't think the vet would think Nikki's an acrocat.

I like the idea of waiting and monitoring for any changes. And see if you can convince Dee it's OK to be tested. :lol: My civie was much more squirmy - Neko has gotten so good at her tests.

 

[Deb & Wink]

Re: 8/9 Nikki AMBG 31 -OTJ Trial Day 9- insulin secreting tu

Wendy, I know Nikki is showing no signs of being an acro cat. Don't think Nikki would be on an OTJ trial if she was an acro cat. I was saying I thought her vet was not used to cat's going into remission and not used to seeing cats in beautiful numbers. I was saying her vet seemed to be reaching for outlandish explanations as to why Nikki was low, not seeming to be willing to accept that Nikki received excellent care from Alexis and excellent suggestions from this board.

I would not put Nikki through a lot of expensive tests if she were my cat and seemed to be doing fine.

 

[Lkldcatlady]

Re: 8/9 Nikki AMBG 31 -OTJ Trial Day 9- insulin secreting tu

Yah, i agree Alexis - I would just wait and see how Nikki does. If she starts to show any signs of being sick, then I would take her in. Otherwise, enjoy the low numbers!

 

[Alexis & Nikki (GA)]

Re: 8/9 Nikki AMBG 31 -OTJ Trial Day 9- insulin secreting tu

I'm also thinking that if I start to see any decline, I would take her to another vet for an opinion. It really frustrated me last fall that she was so sick yet the ultrasound came back "normal". I'm pretty done spending money at this practice. :lol:

Plus, I need to save my pennies so I can insure Dee and make sure I don't have more huge bills in the future!

Thanks for all the input! I know everyone here has a lot of collective cat experience, so I'm hoping to gather any info I can.

 

[Jill & Alex (GA)]

Re: 8/9 Nikki AMBG 31 -OTJ Trial Day 9- insulin secreting tu

I'm also thinking that if I start to see any decline, I would take her to another vet for an opinion. It really frustrated me last fall that she was so sick yet the ultrasound came back "normal".

insulinomas are extremely rare, but given nikki's history and the BG numbers she's experiencing now plus your vet feeling a lump near her pancreas last fall this past spring... there's reason for his suspicions. a single ultrasound is not always conclusive. "if" there is a problem... the dry food you were feeding may have kept her BG numbers up. i think your vet is wise to want to follow-up in order to keep an eye on things. i don't think he's the least bit outlandish. if i were in your shoes, i'd also want another ultrasound done if nikki's BG numbers remain low or there's any change in her behavior. chances are this is nothing to be worried about, but you've googled the condition so you have an idea of symptoms to watch for...

Wendy, I know Nikki is showing no signs of being an acro cat. Don't think Nikki would be on an OTJ trial if she was an acro cat. I was saying I thought her vet was not used to cat's going into remission and not used to seeing cats in beautiful numbers. I was saying her vet seemed to be reaching for outlandish explanations as to why Nikki was low, not seeming to be willing to accept that Nikki received excellent care from Alexis and excellent suggestions from this board.

deb: in addition to the info wendy posted about acrokitties...
an acrocat can most certainly be on an OTJ trial. the output from the tumor can wax and wane. we've seen several kitties with acromegaly go on and off insulin. carolynn's acrokitty, fletcher, made his way to the Falls a couple times. :mrgreen:

 

[Alexis & Nikki (GA)]

Re: 8/9 Nikki AMBG 31 -OTJ Trial Day 9- insulin secreting tu

Thanks for the input Jill. I'm definitely keeping a close eye on her.

I'll have to start saving again I guess. I'm pretty tapped out after her vet bills over the last year and I just don't have another $600 for an ultrasound... :YMSIGH: At this point it feels like throwing good money after bad, since from what I've read there really isn't much one can do for an insulinoma.

I'm wondering if she'd be better off on a slightly higher carb food. Around the 8% mark...Anyone have an opinion?

 

[Jill & Alex (GA)]

Re: 8/9 Nikki AMBG 31 -OTJ Trial Day 9- insulin secreting tu

i know... ultrasounds aren't cheap. found that out awhile back when alex had to have multiple ultrasounds done in a relatively short period of time. at least they gave me a discount. :lol:

if necessary, surgery is an option. you'd have to weigh the pros and cons depending on the information they'd give you, but discussing options at this point is a lot like putting the cart before the horse. this condition is so rare that the likelihood of her having it is slim.

i wish i could offer some sound advice, but i don't feel qualified to comment on whether increasing the carbs in her diet would be beneficial. imho, it's a subject worth discussing with your vet.

 

[Alexis & Nikki (GA)]

Re: 8/9 Nikki AMBG 31 -OTJ Trial Day 9- insulin secreting tu

Yeah, I don't blame you for not advising, it's a totally weird situation! I did try giving MC and it gave a moderate rise and then dropped her further down about 2 hours later so I'm not sure a higher carb LC would be an option. I may call and see if I can speak to the vet that's been treating her, and I'll see where her BG is in a couple of weeks. Hopefully she's just a weirdo! :lol:

 

[Jill & Alex (GA)]

Re: 8/9 Nikki AMBG 31 -OTJ Trial Day 9- insulin secreting tu

I did try giving MC and it gave a moderate rise and then dropped her further down about 2 hours later so I'm not sure a higher carb LC would be an option. I may call and see if I can speak to the vet that's been treating her, and I'll see where her BG is in a couple of weeks.

interesting. i was wondering if she'd drop from MC.

this condition is so rare that i applaud your vet practice for even recognizing the remote possibility of an insulinoma. the possibility of rare conditions are often missed by vets... heck, human doctors, too! the best advice i could give you is to get in touch with your vet if you have questions or observe anything in nikki's behavior that may seem "off".

in the mean time, enjoy being OTJ! nikki may simply be a kitty who runs in low numbers! :mrgreen:

 

[Alexis & Nikki (GA)]

Re: 8/9 Nikki AMBG 31 -OTJ Trial Day 9- insulin secreting tu

The drop from MC means her pancreas is working, correct?

I do think the practice we go to has been really good with all of Nikki's illnesses so far. Unfortunately she's always had symptoms that don't match up to any one thing so she's made their work difficult! I do wish they wouldn't drop the word cancer every time she presents with something unusual though. It stresses me out! ohmygod_smile They've told me she has cancer for going on 4 years now...it's sort of like the boy who cried wolf.

Really hoping she just runs low cause I've worked too hard to get her through being sick last year and the diabetes this year! Either way, this is the best she's looked and acted in years, so I know she's feeling pretty good right now and that's what matters!