Cindy Update

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Dragonnns

Dragonnns

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Hi all,

I just thought I'd throw an update out there and ask for some feedback.

To recap: Cindy is unregulated and has been in the reds and pinks when both on Lantus and on ProZinc. Right now she is getting 3 units ProZinc BID. Her numbers are all over the place, not really curving. Heck on 11/22 she looked like this:
AMPS 405,
+2 381,
+4 358,
+6 403,
+8 396,
+10 376,
PMPS 400

Last night her PMPS was 304 but at +2, was 419. Tonight, with no food available for the last 4 hours (normally she is fed all day/night) her PMPS was 426.

I have an appointment to have her tested for acromegaly (and a few other things) on Thursday. The vet has recommended I move her from 3 units BID to 4 units BID tomorrow. My gut feeling is to wait until I get the results back from the test or at least from the vet visit before I make more changes. I can't see that a two day wait is going to make a huge difference at this point.

I'm guessing that it will be a few days before I get the results from the acromegaly testing. Should I up her dose to 4 units BID once she is back from the vet's on Thursday evening? Or should I wait on that until I get the results back on the acromegaly?

Thanks!
 
I agree with you that two days is not going to make a difference at this point.

You can still increase but if it were me I would not do it by 1 unit at this point. at 3u, .4u is probably the most I would move up at once without knowing more.

How long does the vet wish you to hold increases? If you care about what they think you could try to sell them that you will go up in smaller increments over shorter periods that may work out to the same rough time line that had in mind with larger increments.

I hopeful the testing will provide you the info you need to make the best decisions for Cindy.
 
Hi, glad to see you back.

Usually onset for PZ is +2 or +3 so they will rise for the first two hours mostly from food spike then the insulin should start to kick in. So that isn't that unusual.

If you want to raise Cindy's dose I would not increase by whole units. With PZ we like to increase by smaller amounts like .25u or with your higher doses already you could increase by .5u but I wouldn't increase by any more than that at one time and I would do it when I would be home to test through the new dose. I don't think there would be any medical reason to wait to increase until after your vet visit, if there is I hope someone chimes in. But waiting a few more days to find out what your dealing with probably wont hurt either. It's your call.

Come back more often.

Robin
 
Hi Rob - I'm here, just not posting so much. Mostly just lurking <g>

On a completely unrelated note, I can't seem to find definitions to these two acronyms: GA and FB. I'm assuming that GA means that the cat has passed on (Gone Ahead?) and FB is something to do with the FDMB(?) but otherwise am clueless. If someone can fill me in, I'd feel a tad bit less ignorant.

Thanks!
 
Hi Dragonns,

GA is either gone ahead or guardian angel, meaning that they have passed.

FB is face book.

Don't be a stranger, there is alot of crazy things to learn here. :-D
 
Don't be a stranger, there is alot of crazy things to learn here.
Click to expand...

LOL! Now ain't that the truth! But realistically, wouldn't life be boring if we didn't have something to learn every day??

:D
 
I like "Guardian Angel." :smile:

FB should have nothing to do with FDMB but for some reason it sometimes does. grr_red
 
Have you read the info on testing over in High dose, and printed out the MSU links which tells you the lab price, and details of the tests. Many vets are clueless, so it is very helpful.

It is only done at (Mich) MSU and it is set up on Wed's only, and the IAA is done Thurs. It is ideal to draw Monday, ship overnight with ice packs directly to the lab address via Fed ex or UPS, so it's there for testing on wed. I think the blood can be frozen but it would be smart to call first. If you have blood drawn and frozen on Thursday, shipped Monday, it wont be tested until next week Wed, with results to the vet early the following week.

I would avoid letting it sit wherever, in transit, over the weekend.

In the meantime, I would continue your normal increases.
 
Good luck with cindy's test! Looks like Charlie and I will be following in your footsteps probably after the new year. I hope the results, whatever they may be, help you treat her successfully!
 
If you add the acceptable level of error which is +/- 20%, there isn't that much difference in your numbers...makes it a rather flat 'curve'.

Jen
 
I would avoid letting it sit wherever, in transit, over the weekend.
Click to expand...

She has to be seen by the cardiologist as she has an enlarged left atrium which we need to keep tabs on. He is only available on Thursday so rather than stress her out by going more than once, I thought I'd give this a go tomorrow. We are also suspecting potential IBD and/or mild pancreatitis which we'll look at tomorrow as well.

Here's hoping for some definitive diagnosis somewhere!
 
I think its fine to freeze the blood over the weekend at the vet, and ship monday.

Were you able to get a blood draw?

If you didn't bring in the print outs for the lab/testing info, I'm wondering if they told you not to worry,"she's not acro. She doesn't look like it" Most vets aren't familiar with the test. Its only done one place.... Almost every one of us (acro beans) has heard those words. Its rare to find a vet who knows its not rare. :lol:

If you want to call MSU to check about the freezing/handling, the number is 517-353-1683

Heres the direct link which describes the first test.
http://www.animalhealth.msu.edu/Bin/Cat ... st&Id=1401

She should be checked for IAA as well, it was about $14.

Cody, and Carolyn's Leo, and several other acrocats have enlarged hearts, as well.
 
Well, after an echocardiogram, she was diagnosed with restrictive cardiomyopathy and is now on enalapril and asprin. They also did an ultrasound and feel that the thickening in her small intestine is likely IBD. Without a biospy, they can't know for sure. Since I wouldn't treat that any other way than I would without a positive diagnosis, we won't be doing the biopsy. She also shows possible evidence of pancreatitis so we're testing for that. All of these conditions can lead to insulin resistance.

They are also doing a urinalysis to confirm she doesn't have some form of URI (I highly doubt it but can't hurt to check) as well as the IGF-1 at MSU. I asked the vet about the IAA testing but he really didn't feel it was necessary and I didn't feel like battling him on it (this is her internal medicine specialist). If the IGF-1 comes up negative, I'll have my local vet (who is a tad more open minded) do the blood draw and send it in.

Once I know the results of the IGF-1 test, I'll post it.
 
IAA Test
IGF-1 (Acro) Test

Please read over the two sheets, you can have your vet call the destination for any specifics; my vet called to ask her questions and make sure all shipping was done correctly.
Please have both tests done as the tests are not the costly part, rather the vet visit, draw charge, packing and shipping charges are the bulk so why pay twice.
Have your vet ask when to expect the results and then call back at that time. My vet office did not call on the Friday so I ended up waiting longer.

Do NOT be allowed to be told that IAA is not necessary; get both tests done at the same time, unless of course that your vet will pay for the next lot of charges to test for IAA. My total charges were in the hundreds because of shipping, for each cat, one was positive for both.

My Oliver also has enlarged heart and a mild murmur to be checked again soon.
NOTE: there was another cat recently tested for acro and IAA. The results: acro was negative. IAA was positive.
Have both tests done because each is treated differently in the approach.
 
Gayle,
I knew that some other acrocats had enlarged hearts, I know there's at least one more- just cant remember the name. It was somebody diagnosed in early summer I think... I'll bet there are quite a few others I'm not aware of. FYI Cody and Leo also take aspirin and enelapril.

Dragonnn's
Gayle is really right about the IAA test. The blood draw and shipping is the costly part of these tests, so it would be awesome if they had enough blood sent for the IGF1 to spare some for the IAA.

Anyway its awesome they are doing the tests! :-D Hopefully you will know something at the end of the week.
 
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