Insulin Resistance??

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Maresydotes

Maresydotes

Member Since 2011
How do you know when your cat is insulin resistant? I have been told to get more PM numbers, and I am working that. (sorry to whine) :roll: But, based on her AM post shot numbers and what little I have gotten in the PM, I am beginning to wonder if Missy isn't insulin resistant. I do not see a nadir during the AM at all. Could these numbers be a bounce??? I am totally at sea, here.
Thanks

recap of yesterday/this morning

296- +2 PMPS
285- AMPS
300- +2 AMPS
303- +7
345- PMPS
308- +2
314- +9
 
There's no way to give you a definitive answer nor is there a test to determine insulin resistance. The exception is Insulin Auto-Antibodies which is true insulin resistance. IAA can be tested for although we don't usually begin to consider this as a possibility until a cat is in the 6.0u dose area. In this scenario, it's helpful to test for both IAA and acromegaly as both are high dose conditions and the blood needs to be sent to Michigan State. The lab at MSU is the one place these tests are run and why pay for shipping twice?

There are other possibilities. You may be seeing bouncing. Numbers may have dropped lower during the PM cycle. It can take up to 72 hours for a bounce to clear so it may not be immediately apparent that the higher numbers are due to a bounce.

Given how long you were holding the dose when Missy first started on insulin, there's also some slight possibility of glucose toxicity. This is a form of insulin resistance that results from a cat sitting in higher numbers and their body getting used to being in those numbers.
 
Morning Mares ~O)

There is a special blood test for IAA (Insulin Auto Antibodies) . IAA causes extreme insulin resistance. The blood sample has to go to MSU, which is where they do the test.
It's idiopathic (no known reason) and the good news is it's self limiting - eventually it stops.
My BK tested very high - 84%.

Honestly, in Missys case I'm not feeling it. I think there is a strong possibility she is seeing blues, like on 10/26/AM or 10/27/PM and she is bouncing from those.
 
Sienne,
Will her numbers go lower in the PM cycle in a bounce situation? Or do they stay high until the bounce has cleared? If they go lower in the PM cycle, wouldn't I see some indication of lowering in the AM cycles, too? How do you avoid a bounce, or can you?

How do you determine if she has insulin toxicity? What do you do?

If she is resistant, how do you handle that?

It seems the more I learn, the less I know. :roll: Really, all I know is that she was off insulin in less than a month in April and since she relapsed, she seems to be doing less and less well....numbers climbing steadily.
 
Sandy,
What do you suggest I do? I am really confused and seem to be getting more and more confused. We are going to see her vet Monday, so I will ask her about testing for the insulin resistance.....but, if she is bouncing, how do I stop that? Or can I? Do I keep raising her dose or do I hold it untill I see some sort of 'stabilization'? I really don't know what to do with her any more and I am concerned about the high numbers and what damage they are doing to her. nailbite_smile
 
Bouncing is just part of the process. When a cat is diabetic, they have often been in higher numbers for a while. Their bodies adjust to those numbers (i.e., all of our cats were probably experiencing some degree of glucose toxicity initially). As a result, when their numbers drop into lower regions, their livers panic and a bounce results. The more time a cat spends in normal numbers, the less the cat will bounce. Numbers do not necessarily go lower every PM cycle. Numbers could be lower in the AM cycle and you weren't able to catch it. It's just without the PM numbers, everything is a guess.

All of this is normal. Just keep testing and raise the dose when you have the data to do so and follow the protocol. Even with a cat like BK who had significant IAA, Sandy followed the protocol (except where knowing her cat allowed her to deviate) and BK is OTJ.
 
Thanks Sienne....I guess we will keep plugging along. ;-) Check out her number this morning....totally unexpected to me.
 
I suggest you keep testing as much as you can, at different times on different days, so that when you look at a weeks worth of data on her ss you don't see big gaps.
Like Sienne pointed out, raise the dose when you have the data to do so and follow the protocol.
I wouldn't worry about IAA testing unless, after following the protocol, Missys dose gets to 6u and her ss is a sea of pink.
 
Sandy and Black Kitty said:
I suggest you keep testing as much as you can, at different times on different days, so that when you look at a weeks worth of data on her ss you don't see big gaps.
Click to expand...
i agree with sandy. random tests at different times of day and night will yield much more information than a curve done on a single cycle.
 
Thanks!! I will keep plugging away at numbers. I really do appreciate all of your help and sharing of your experiences. I had lots to learn. I just want to do the right thing for her.
 
Mares,
Look at KT's spreadsheet in my sig - he spends a lot more time on bounces right now than down in lower numbers. Missy is 'normal' in that aspect...at least they tell me KT's 'normal'...I wonder sometimes... :o ;-)

Hugs - we'll find what's right for them if we keep doing what we're doing...
 
Squeaky,
Did you see this thread on bounces? viewtopic.php?f=9&t=55306.
It was pretty interesting and informative. Lots of good info.
I've had my doubts about Missy and 'normalcy'. :lol: Maybe abnormal is the new 'normal', eh?
Gotta keep on... so hopefully their da*m livers figure out low is GOOD, one of these days. How long does it take a liver to learn :?: :?:
I really need those patience pants!! I got spoiled on Missy's first trip to the Falls and expected it to go that way again. They love to keep you on your toes. ;-)
Paws crossed they get it sorted out soon :-D
 
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