Charlie's amps 394, +10/427 pmps 520 acro test neg

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EllieKozak

EllieKozak

Member Since 2014
Hi guys. Charlie's numbers are in the 500s again and were on 5 shots at the increased 6 u. I am so confused Bc they haven't improved really at all. Seems like no matter how high we go he just gets higher too. Acro test results are in and neg. link is in signature. His appetite was insatiable yesterday. He's eating today but not as frantically as yesterday. I will give him some sc fluids tonight. Neg ketones but he's looking like he's on the ketone road. Not sure what is triggering it.
 
Hi Ellie - that's great news on the acro results! I can't read the document - I think you have to change the permissions on the file. Was the IAA (insulin auto antibodies) test done too?

Cats in high numbers will be very hungry.
 
With high numbers, you may want to increase Charlie's dose every 2 days until you start seeing nadirs that are below 300. It's entirely possible that Charlie has IAA.

BTW, you need to set the access permission on the acro results so anyone with the link can view the document. It's not opening.
 
Is there a tutorial or something that explains how to allow anyone to view the report? Also having trouble w signature attachments. I had the ultrasound report listed too but had to remove it because I ran out of space. I want to put a profile for Charlie n some pics too but don't know how
 
If you look at the link on how to set up your SS and publish it to the web, there are sections both how how to set up the permissions so others can read the document, and point 7 towards the bottom gives you an example of how to change the contents between the URL so that it becomes a word link instead of the long list starting out as http:.... Changing that to a word will reduce the word count on your signature and allow you to put more in there.
 
that's great news! i'm so glad the acro is negative.

he likely has iaa then - but you haven't said if you had that test done, and i'm thinking you might not have. Is that right?

Has his thyroid been tested? I don't remember what your labs said.
 
Thyroid was fine. He's freakin showing trace ketones again. I'm beside myself. Just gave him 150 ml lrs and he's eating and acting ok. He has eaten 6 cans of food so fat today and is on metro m zeniquin and not dehydrated. If those 3 criteria for ketone recipe aren't lacking then why does this keep happening? I asked his dr if that test (acro) indicated anythung about insulin resistance and she didn't really answer me so if someone could tell me the name of the test and who runs them I will most definitely do it. How is that treated if that is what he has? And does anyone thinking should start using R again to lower his numbers or just increase again tomor? I will mess with the report in just a few min. Thanks
 
Here is the information on the IAA test. It's done the same place as the acro test was. Since I can't read the acro test doc, could you tell us what the number was? Just curious.
 
Wendy&Neko said:
Here is the information on the IAA test. It's done the same place as the acro test was. Since I can't read the acro test doc, could you tell us what the number was? Just curious.
Click to expand...
it was low at 4 with a range of 12-92
 
This is the test you want: http://animalhealth.msu.edu/Bin/Catalog.exe?Action=Test&SPECIES=Feline&PAGE=7&Id=1494 for Insulin Auto Antibodies. Knowing whether or not he has that will help us decide how aggressive to be/or not be in his dosing. It's too bad your vet didn't do it at the same time because that would've saved you the duplicate blood draw and shipping/handling fees - the test itself is only $16.

We don't have as much accumulated on iaa, but both Wendy & Sandy have personal experience with it. To my eye, the "signature" look of a cat with iaa is when the dose is increased and at first the cat's BGs respond by coming down within the first few cycles, but then the cat goes high and won't go back into lower numbers again on the same dose. You increase the dose and the process repeats. Wendy has labeled it as "the dose going stale." It's a very good description.

If a cat is known to have iaa we are more aggressive with the dosing to try to get "on top" of the antibodies before they bind up the insulin. There is more to it than that, but that's a brief look at it.

If he doesn't have iaa that would be important to know.

As far as his dose, you should be re-evaluating and increasing every 4 cycles as long as all the tests are still high like this. Holding them too long doesn't help. I would increase him by 0.5u with his next shot.

I'll defer to Sandy on the R advice.
 
my very helpful computer shut off while i was in the midst of posting that last post. danged battery doesn't give notice when it's about to die.

perhaps that AB isn't working on whatever infection he's got going on. you just have to be really on top of everything with cats that are prone to ketones. beyond that, i don't know the answer to your questions.

most vets don't have experience with acromegaly or iaa. we've been told that the total time spent in vet school on feline diabetes is literally 20 minutes. they don't often encounter it, were told these things were extremely rare if they were even mentioned. most people euthanize diabetic cats or don't hometest, so the vets don't see these conditions. most of us with cats with high dose conditions end up educating our vets about it. that's ok - that is just the way it is. not the vet's fault. fortunately we have people on FDMB to learn about them and what steps to take next.
 
Definitely increase the Lantus tomorrow.

As for vet knowledge, most have been taught that acromegaly is vary rare. Recent studies have changed that knowledge. I've even seen an endocrinologist vet dismiss the importance of IAA. When I went to get the acro/IAA tests, the senior vet at the practice thought I was wasting money on the "exotic tests" as he called them. They have since seen another acro cat at their practice. So, that's two acros at one practice, once they knew what to look for. I know or have heard of 6 acros within 45 minutes drive from me. IAA is less common.
 
HI there :cool:

EllieKozak said:
He has eaten 6 cans of food so fat today and is on metro m zeniquin and not dehydrated. If those 3 criteria for ketone recipe aren't lacking then why does this keep happening?
Click to expand...
Not enough insulin. If he had enough insulin the energy from the food would make it into all the cells of his body.

Since ketones are again being produced a little R may help turn it back around and keep him out of danger until you find out if the high BGs are a result of his immune system producing Insulin Auto Antibodies (IAA).

Raise the Lantus dose next cycle.

At the same time start with this R scale, AM & PM:
PS 300-350 -- 0.5uR
+6 300-350 -- 0.5uR
PS 350-450 -- 1uR
+6 350-450 -- 1uR
Give the above scale at least 2 cycles, testing BG so that there are no 'wide open spaces' on the ss. then we can evaluate and and adjust.
Test for ketones at least 2x per day (once each cycle)
 
Staying home from work today to monitor Charlie. Have tomorrow off too so I will test throughout the night. I just gave 6.5 L and .5u r. Will also start a new condo with today's numbers. So far amps is 398. On relion meter. Phasing out of alphatrak but will keep the meter on hand just in case. Thank you all for your help. A little ticked off at vet for not sending the iaa test too :( poor "pin cushion" Charlie.
 
Elie:

When numbers are this high AND you're seeing recurrent bouts of ketones, unless you want to go through another episode of DKA, you have to be aggressive with the basal (i.e., Lantus) insulin. Please consider raising Charlie's dose to 6.5u. In addition, once you're at a larger dose, the percentage increase does make a difference. An increase of 0.25u for a cat that's on a 1.0u dose is, percentage-wise, much bigger than for a cat that's on 6.0u.

Both Sandy and I have suggested a number of time to increase the dose by 0.5u and to increase every 2 days/4 cycles if you want to get the ketones under control. It's up to you but this is what I would be doing if Charlie were my cat.
 
Hi Ellie. My Polly is a high dose cat. Even the lab at MSU suggested just the acro test and if that came back negative, then do the IAA. Julie and Wendy advised "get them both." Glad I did. Polly has both conditions! Even Polly's IM at Colorado State thought it was rare for a cat to have IAA.

So don't blame the vet. Let the advice you get here help you be proactive in finding out what's going on with your Charlie. I'm lucky my local vet has let me take the lead in Polly's treatment. He sees that it works.

If you look at Polly's ss you'll see we've been able to keep her numbers in a reasonable range. Why? 'Cuz we had help here. We were much more aggressive in dosing than my vet wanted me to be. We're even more aggressive in dosing than Polly's IM wants me to be. But I test, test, test, test and listen to the experienced acro/iaa wisdom on this board. Polly is lucky I found this place.

FYI, Polly had radiation therapy just about a month ago for her acro tumor. In time that may help bring her dosing down. We just have to wait and see.

Sending lots of light for you and your special Charlie.

Marilyn and Polly
 
Hi ellie!

I see you gave 6.25u this morning - maybe that's a typo. I see moderate ketones in the ss too.

Please go ahead and go to 6.5u with tonight's shot.

Keep this mantra "4 cycles and increase by 0.5u" in your head. Until we see significantly different things happening, that's what's going to be helpful at this stage. You want to get in control of his blood sugar.
 
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