9.27 Charlie High Triglycrides (Again)

Sarah & Charlie-cat

Sarah & Charlie-cat

Member Since 2022
https://felinediabetes.com/FDMB/threads/charlie-high-triglycerides-and-dm.280661/#post-3096329

https://felinediabetes.com/FDMB/thr...-stall-95-amps-359-4-275.281982/#post-3108727

My most recent glucose post and the previous post about triglycerides... and fasted bloodwork from Monday, which came with this note from his regular vet:

Charlie's blood work results are attached. Unfortunately, his triglycerides and cholesterol continue to climb. I looked at his glucose readings over the past year - it looks like for the most part he sits in the mid-200s with a few exceptions regardless of what dose of insulin he is on. I did a little research to see if I could figure out why.​

I would like to start with doing a chylomicron test for Charlie. That would require him coming back in to have some blood drawn again but it would be very inexpensive as it would be an in house test to see how the fat in his blood separates over a 12 hour period to let us know if the high triglycerides are a result of diet or if they are are caused endogenously and we need to address other metabolic issues. You can just schedule that blood draw with a tech.​

After doing that test to know if diet is a factor or not, then we can look at what else we can do to try and get those fat levels down in his blood. Let me know if you have any questions on any of that!
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My two cents:
  • He actually was in blues and green numbers in January, then we tried to pull him off the pred in February and his numbers were all over before being largely in the 200s-300s, with the occasional exception (last night for example). But this is what I have been banging on about to his vet, the IM vet(s) but not getting anywhere with any of them. I also could not get the IM vet to test for agromagly, but as a neutered diabetic male, his chances would seem to go up.
  • The food he eats currently is mostly 15% fat by dry matter basis. Which is about 3x as high as the prescription diet I refused. He also typically gets a couple of ounces of homemade chicken breast (with EZ complete), which is very low in fat, I would imagine. He does like his duck heart sprinkles, which probably are higher in fat, but he gets just a sprinkle. I could go back to Fortiflora and it's artificial liver flavor, he seems to find that a decent replacement. Or freeze-dried chicken breast, now that it seems chicken is back on the menu.
  • His triglycerides are higher than the last his regular vet tested, but about half of what they were at the IM vet, which was not fully fasted. That was over 4000, they were insane.
  • I do have omega supplements, which the IM vet thought would be the next step. I need to forward these to the IM vet at Iowa State.
Anyone know what metabolic disorder creates high triglycerides in cats? Maybe that's jumping the gun.

The mystery continues...
 
Just doing some reading, there are lots of causes of high triglycerides in cats, including diabetes and steroids, also pancreatitis. Sounds like you know that already. Two other conditions that can cause the need for higher insulin doses, and triglycerides are acromegaly and Cushings.

Sarah & Charlie-cat said:
I also could not get the IM vet to test for agromagly,
Click to expand...
What was the reasoning behind that? It's your money. Though I admit I had to practically beg my vet - but that was 11 years ago, before the recent research on how common this is condition came out.
 
Process of elimination and high dose of insulin. I don't think he has Cushing's, he doesn't have other symptoms.

Big paws are apparently an Agro thing and his nickname is jumbo paws. He does have extra toes on all his feet but his paws are lorge.

I've been looking at older pictures to see if his face has changed at all. Also apparently sometimes just in their mouths? Someone said something once about his teeth being weird, maybe the vet student at Iowa.

The agro test is expensive. But I've already poured so much money into tests for the same things and been told yup he has pancreatitis. Amazingly, I know that already. It's the only thing people can agree on
 
Sarah & Charlie-cat said:
The agro test is expensive.
Click to expand...
If you’re going to test for acromegaly, I’d test for IAA (Insulin AutoAntibodies) as well. Both are run at Michigan State University, so if you’re sending blood for one, it makes sense to test for both at the same time.

I suspected Tubby had acro well before his insulin dose was high. The testing wasn’t all that expensive, although it likely varies based on the markup of the clinic that pulls and sends off the blood as well as packaging/shipping charges (it does require overnight shipping).

Actual MSU fees per their website (test catalog is located at https://vdl.msu.edu/Bin/Catalog.exe ):
$68 - Insulin Like Growth Factor-1 (code 20005)
(This is the acro test)
$22 - Insulin Autoantibodoes (code 20031)

Back in the day, my local vet was willing to pull the blood and help me package and fill out the paperwork (which I had printed ahead of time) and I shipped the package myself and enclosed a check for payment. I’m not sure a lot of vets would be willing to do that, but I was a “frequent flier” client, lol, so they were willing to work with me. I’m very surprised Iowa State wasn’t willing to send off acro/IAA tests for you—I’m sure they would be familiar with the process and should be willing to handle the request. Even if they thought acro is unlikely or the test unnecessary, Charlie is a complicated case and it would certainly be helpful to rule those things in or out.

I personally would push for the testing.

Edited to add: If you click on the links for the above tests in the MSU catalog, you can see the details about the test, including price, shipping/handling requirements, etc.
 
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Well that seems easy and straightforward

I am having all sorts of thoughts about new projects with my new colleague who studies the democratization of knowledge production... he became frustrated as an engineer that he was making things that were available to only the few well off and not everyone who needed them.

In other news, Mr. Man was 201 PMPS and 154 at +2, so I fed him a little bit of MC with his normal second dinner. Will retest at +3. He just cannot give me a break.
 
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