9/12 Klinger AMPS 204; +2 263 +4.5 439; PMPS 62; HI, 553

Status
Not open for further replies.
Marcy & Klinger (GA)

Marcy & Klinger (GA)

Very Active Member
Woke up to Klinger demanding his food and took me directly to the kitchen. He hasn't done that in a really long time.
His AMPS 204
So, based on his #'s on 9/5 where he gave me a 202 AMPS and went HI for the rest of the day on .50, I gave him .75. I expect him to go HI again today.
Mr. P apparently stopped by last night.
+2 263
 
Re: 9/12 Klinger AMPS 204; +2 263

Will do. That would be nice if he remained out of the HI's today. +4 will be in an hour, so I'm going to run out and grocery shop.
See you later!
 
Re: 9/12 Klinger AMPS 204; +2 263 +4.5 439

I wish i could stick around for this but i'm hurrying off to work..will be back 3 pacific time.
but wow, it's almost as if he got no insulin at all! and some crack for breakfast as well :shock: this is a VERY interesting case. i'll run over to health and have a look. i'm baffled.
 
Re: 9/12 Klinger AMPS 204; +2 263 +4.5 439

I see what she means about holding the dose, I usually tried to hold it for 3 to 5 days, once I held the dose for 2 weeks before he finally came around.

Have you given any thought to trying 3 times a day injections? It might help him even out some instead of sitting in high numbers most of the day. Although I have never done it and have no experience with it I have heard that others have had good luck with it. Morning at 5:30 again at 1:30 and again at 9:30. You work from home right?

Just a thought, since he shot up again at +4 he might need a booster to bring him down a little sooner.

I'm going to look at his ss again.
 
Re: 9/12 Klinger AMPS 204; +2 263 +4.5 439

could'nt help it had to look and come back..kate might have something with holding a dose for a while...i;ll take a very very good look at your ss this afternoon k?
 
Re: 9/12 Klinger AMPS 204; +2 263 +4.5 439

Unfortunately I don't work from home and I'm gone for about 11 hours during the day. So, I've been giving him 3u's for 4 days. This morning he gave me at 204 and I thought that I shouldn't give him the 3u's on that low of a number and only gave him .75. Is that not right? Should I have given him the full 3u's? Should I give him a booster now to get him through the the next 7 hours? Should I go back to 2u's like Kate suggested?
Sorry for all the questions.
 
Re: 9/12 Klinger AMPS 204; +2 263 +4.5 439

back! nooooo no booster. and i do understand your logic, i think it may have been just a tad too drastic...when lowering go in smaller increments. we now know that micro doses don't really work for him..you could have just cut your dose in half?
 
Re: 9/12 Klinger AMPS 204; +2 263 +4.5 439

If you were home to monitor, I would have given the full dose (3.0u) and tested through the cycle to gather data. Next time you are home and get a PS # around 200, shoot the full dose and monitor, as long as you have high carb food in the house (in case of low numbers) and enough test strips to test frequently if needed. If you are not going to be home, then reduce the dose, but not by so much...maybe shoot 50-75% dose. That 0.75u was much too low. But don't feel bad....the only way you learn is by trying different things, it's ok!

The 3.0u *might* be a little high, but I would stick with it for now unless you are uncomfortable with it. ProZinc needs time to settle as kate said....6-10 cycles, especially when you are getting liver bounces like you are....you need to allow time for the dose to settle, and bounces to clear, before evaluating dose. The 3.0u looks pretty good to me, he had a beautiful PS # this morning! I think you are getting into the ballpark.

Are you using the u100 syringes, or are you still using the u40 syringes? If you haven't switched to the u100s, I would suggest that you do that...make sure you get the ones with the half unit markings. From here on out, you will need to start making smaller dose adjustments and it's MUCH easier with the u100 syringes. When we used ProZinc, we adjusted by 0.05-0.1u to fine tune doses, and that is impossible with u40 syringes. Just make sure you print out the conversion chart and check it before you shoot...like Rob said, check it every time so you don't make a mistake!

Hang in there, try to be patient....things will come together. You're doing fine! :-D

ETA: No booster shot. That will only confuse the issue for you.
 
Re: 9/12 Klinger AMPS 204; +2 263 +4.5 439

i'm assuming pmps has come and gone for you...you shoot 5:30 but still take into consideration the # you get but change dose in smaller increments...looks like you'll be in the 400's so yep stick to 3U
 
Re: 9/12 Klinger AMPS 204; +2 263 +4.5 439

Hi Marcy,
Joanna pm'ed me to come take a look at Klinger's ss because I have a high dose kitty (with a condition called acromegaly). I use to have Cody on Prozinc and post on PZI frequently, but have been elsewhere lately. I haven't read every post you made, so feel free to fill me in on some missing details.

As many have told you , it is best to start low and increase slowly with insulin BUT

I did notice that Klinger went for over 2 months on Prozinc doses up over 6 units, and that he did respond with a "curve" to those doses. This is a fairly big dose for a normal diabetic cat, and when cats increase slowly and reach doses over 5-6 units, its time to consider WHY... so if you don't mind sharing a bit about your sweet fella...

1) I noticed after about the 3rd week of 7u he suddenly went low. Was he possibly sick at that time? Being sick can lower insulin needs because infection, inflammation, pancreatiitis etc can eat up the sugar, so suddenly the numbers drop.

2) Can you describe his size, appearance, age, weight changes, and appetite ? Does he have a large belly, like he's pregnant?

3) Does he have any other medical conditions that you know about? Has he ever had an US? Any diagnosis of pancreatitis, or urine infection? Do you test for ketones?
4) Does he have anything unusual about his breathing, purring or voice? Does he snore?
5) Are you using a human or animal glucometer? readings from human glucometers tend to give lower numbers I think.
6) any behavior changes you have noticed? hiding, avoiding light, sitting in odd postures?
7) tell us briefly about your vet

8) and I'm assuming others have covered the food issues- were these doses on low carb canned food? I noticed the WD, at one point- Pretty sure that's a high fiber, high carb food (that might be appropriate for a CANINE diabetic lol)

You may notice that the FDMB has a special insulin support group for kitties that require higher doses. Heres the link viewforum.php?f=12

If it turns out that Klinger does best on the higher doses, please feel free to post there. Over about 5u is usually considered high dose, depending on the size of the cat. There are GREAT informational stickies there, and you can ask any questions you may have, and folks can give you the "low down" if you decide that getting him tested, is something you are interested in.

Many of us have felt the frustration of not being able to get out kitties regulated on less than 5u, and it turns out to be a relief to find out WHY, so that we know we can safely give the doses of insulin needed to keep our cats alive and happy.

WELCOME! :-D
 
Re: 9/12 Klinger AMPS 204; +2 263 +4.5 439; PMPS 62!?

Thanks for the suggestions and feedback everyone. Nancy I will be sure to answer your questions ASAP. Wanted to bump this because Klinger's PMPS are 62.
The only thing that we did last night and about two hours ago was to give him 1/8 of a 25mg Benedryl pill for his allergies. Yikes!
He's eating a little bit -not his normal intake.
 
Re: 9/12 Klinger AMPS 204; +2 263 +4.5 439; PMPS 62!?

YIKES PMPS 62!
Maybe he has been in rebound all this time.
of course you did'nt shoot but this is kind of amazing...did you check twice? :shock: I would'nt have believed my eyes!
 
Re: 9/12 Klinger AMPS 204; +2 263 +4.5 439; PMPS 62 or maybe not

Or maybe not. After he ate - retested HI, re-retested 553. We use the ReliOn Micro.
So, I don't know what happened, but now I don't know if I should give him a shot or not??? I'm freaked out thinking that I poisoned my cat!
 
Re: 9/12 Klinger AMPS 204; +2 263 +4.5 439; PMPS 62!?

Dont freak out, but please retest one more time. Meters frequently can have out of place readings, and I am frequently retesting to see which one was right. If the blood drop looks thin at all I get higher readings (sometimes 100 points higher. this has happened with all 3 of the different brand meters I have used.

I have given benedryl tabs- its been awhile but it seems like I gave a lot more than that. Seems like I gave a small 1/2 a tab (12mg for my 15 pound cat, but really cant remember exactly) Does he have breathing trouble?
 
Hon, something is wrong..maybe with the meter?
You did not poison the cat...no, don't even think that. can you stay on line for a bit?
yes, shoot the 3U
 
perhaps the strips have an expiration date? maybe you could try it on yourself?
 
I will retest Klinger in 15 minutes. In the meantime I will answer Nancy's questions:
1. I didn't notice anything different about his behavior to indicate if he was sick or not. So, that's not helpful because I know kitties hide their pain, sickness.
2. When dx he was 19lbs. When we went to the vet last week he was 21 lbs. I give him a small ff can in the a.m. and another in the p.m. he usually eats about 1/4 when first given and then a 1/4 throughout the day. He does have a large belly that swings. He's a big cat. His coat sometimes looks oily, sometimes not. His nose is pink and when he is tired or hungry it turns white.
3. He had an US when dx - nothing showed up. Last week they took a urine sample to test for a UTI - came back negative. I haven't been able to catch him in the act to test for keytones yet.
4. Nothing I've noticed that's unusual about his breathing, purring, voice. He does snore.
5. Using ReliOn Micro.
6. He has been in our computer room with us for the last two weeks. He usually likes to hang out in the living room or bedroom. So that's different. Not sitting in odd postures.
7. Vet is young, didn't tell me about preshot testing. Only wanted me to curve on the weekends - which is what my spreadsheet reflects in the beginning - until I started reading this board and told her that I was preshot testing and spot testing. She thought that was a wonderful idea. She gave me the hills M/D to try. Thinks his number reflect a possible pancreatitis -need to schedule a test when he can fast for 12 hours. Not really sure what you want to know here...
8. They were on FF Kitten, which I believe is lc. One accidential feeding of the hills M/D.
Please let me know if I can answer anything else or if you would like more detail on any of the above.
 
Aw shucks, I was getting all excited about that 62, lol, looks like it was a mis-reading. I just got one of those with Bix today cat(2)_steam I got not enough blood, but then redipped and got a full strip & a nice sweet 87. I was a little suspicious so retested and it was more like 180. Guess my redip trick was not a winner, oh well.

So the #s are more consistent with the 0.75 shot, so at least it makes sense (though frankly I would take a baffling 62 over a logical HI! angry(2)_cat ).

Just in the informational category, I would have done what others suggested - shot the full 3u this morning if I were home to monitor, and then get in a check at probably +2 and +4 to check for unexpected lows (of course testing more often if needed based on the #s). If not home to monitor, I probably would have shot 2u or 2.5.

The lower PSs are scary, but that is why we set a no-shoot # that is higher than it really needs to be. It is generally fine to shoot on a 150, so the idea of a 200 no-shoot is that you have that much margin for error built in. That lets you stick with the full dose on anything above the no-shoot. It's when you get below the no-shoot that you might try a lower dose (or retest and shoot full dose once over the no-shoot).

With PZI, most cats only seem to need a small reduction, if any, on lower PSs, but you still want to gather some data before shooting a regular dose on something like a 150. So that's where you shoot it at a 200 and gather data. If the #s aren't low on a 200 PS, then when you get a 180 PS you try the full dose. If #s are still higher than a nadir of maybe 50 or 60, then you can shoot full dose on something like a 160, and lower things that way to your 150 no-shoot, where in most cases you can stick, with some exceptions.

Just my view of the no-shoots. Everyone has some variations in how they do it and exactly when & what to shoot, so that's just a general guideline. And since I'm a chicken, I still would have pulled back a little on the 204, even though technically it's above 200. But since you haven't shot much on PSs like that, makes sense to have some caution. You don't want to lose progress (if that's what you've got) either though - sometimes a PS like that is a breakthrough and sticking with the dose that got you there is what is needed to get good #s. But hard to tell with him, he's a puzzle! :-D
 
Thanks Marcy,

That's great info,
-how old do you think he is?
-does he have big paws?
-has he always had a pot belly or is this recent?
-does he seem really hungry? 2 cans of FF seems like not enough food for a 21 pound cat- but then I'm used to feeding an "acro-piggy"
-did they say anything about having generally large organs after the US?
-where on his body do you inject the insulin? Now that you are on a lower dose again, you might want to try 1) areas away from the scruff and 2) as you increase dose I would inject it into 2 (or more) places. This makes a huge difference.( For example, I actually shoot the sides of his belly and divide his 15u into 3-4 spots)

Definitely get the food thing figured out before you go back up on dose, You've seen the JAnet and Binky page?

I asked about the vet, because until recently vets thought this was rare- it is not, it is way under diagnosed; and all/most of us were told we were crazy by our vets until the test came back positive.

AND I think you should definitely take a look at the informational stickies in the acromegaly ISG. (Link above)
There are quite a few things you told me, along with his ss, that make me suspicious that this isn't garden variety feline diabetes. After reading them you may see some things that do, or do not fit with your experience.

Many acros are big cats, but not all (Cody is only 12 pounds). the pot belly is a clue, the snoring is a clue, the "allergies" may even be a clue (are we talking respiratory allergies?), the ss is a clue, the gaining weight that rapidly is a clue.

Hope this is helpful.
 
Oh and as for a 'no shot' or 'half shot number', I would personally tend to be conservative for now (like 200). Acros (if that turns out to be the case), aim for a nadir of bl glucose near 120-150 (rather than <100). The explanation for this is a bit complicated without understanding the biology, but an acro can be more difficult to bring out of a hypo situation, because they have functioning pancreas. On the re assuring side, Prozinc is pretty well tapering off well before 12 hrs, (it lasted about 10 hrs for Cody)
 
Thanks again everyone for the advice.
Nancy,
Klinger's approx. 13 years old. Approx 34 inches long from forehead to the tip of his tail.
I don't think he has big paws.
He's always had a pot belly.
Not really overly hungry.
No one told us that he had large organs after his u/s.
I try to rotate where he gets his shot, sometimes in the scruff, sometimes sides of belly.
I mentioned acros to my vet when we were up to 6units and she said that wasn't a large enough dose to make her think that he's acro. I'll have to send her some information.
Hope everyone had a great day!
 
and she may very well be right, he's a big cat, so maybe he just requires more insulin. But if you continue up the dosing scale and it turns out he does better on bigger doses, you are always welcome to post over with the other "big gulpers".

Here is a link to an online Jan 2010 Med /Surg Vet Journal about Acromegaly. I copied it to a CD for my vet. Open it as a PDF to see the full article.

http://www.sciencedirect.com/science?_o ... 58b97d9ea5

Best of luck with Klinger- PM me if you need anything at all :-D
 
Hi Marcy,
My name is Patti and I was asked by nancy to come take a look at your Klinger. My Merlin was an earlier kitty with acromegaly and used PZI idexx (no longer around but similar to prozinc).

REading thru your post some red flags went up for me. Merlin was diagnosed in 2006 and I've been involved with helping get acro more recognized since then. some of my concerns for your kitty are:

He's a big cat
He's male
He has a pot belly
incredibly hungry all the time
he has wonky numbers - one minute hi - next minute low - on similar doses - for no reason - this is soooooo typical of an acro cat on a pzi type insulin. It's one of the telltale signs we found on these kitties. It's not your meter! It's NOT rebound and you can test a million times - it's NOT rebound. I repeat that as us original acromoms went thru that a million times and that is what we fight against - the constant retesting for rebound!

Acrocats do NOT have to be on incredibly HUGE doses of insulin. You have already been up to 6 units bid tho and that is high enough. And the above symptoms/notes play into this too. We have been keeping notes/track of acro issues now more closely since 2006 and have more documentation. Your vet has probably never seen an acrocat and is only going by what she has read/learned. Please I mean no disrespect here. It's just what we've all learned in our experience of caring for our own kitty.

Just from what you've been going thru - I would strongly suggest you might want to get an IGF1 and IAA blood test drawn. It may give you peace of mind to find out what is happening and allow you to dose without second guessing yourself about the doses.

The Acro sticky has all the links for the blood tests for your vet. We also have the catacro site with even more info. Again - here are the links:
http://www.felinediabetes.com/FDMB/view ... f=12&t=375
catacro:
http://catacromegaly.com/index2.html

please let us know how us hi dose moms can help - we've all been thru a similar story to yours. IF you have any questions to what we are suggesting let us know. Nancy, myself and some of the others will check back in or c'mon over to the acro/iaa/cushings group too - we'll be watching for you too.
 
Status
Not open for further replies.
Back
Top