<Le sigh> Nico, the “rollercoaster” cat

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Deb & Wink said:
I just could not see what the number was at all. Had to look at the SS. No apologies needed. Aging eyes can't see as well.

At least 500's are lower than the HI, which means the BG level is down a bit. Still too high though.

I'd recommend increasing the dose again. You've given the 3.5U dose enough time now. I think you should increase by another 0.5U.

Let's see if @JanetNJ concurs.
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Yep. I agree
 
JanetNJ said:
That's over a 230 point drop in just a few hours. Nothing wrong with that number! 41% decrease.
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That’s a good point. He stayed relatively low throughout the night too because his AMPS was 331. I’m gonna just grab a mid (probably +5 since we did +3 & +6 yesterday) and call it good until his PMPS. HAPPY THANKSGIVING!!
 

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JanetNJ said:
A whole day with no black numbers!!
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And started this morning with a PURPLE AMPS (331. Which is sorta funny because it was that same exact number yesterday for AMPS. I had to double check it like twelve times just to be sure :joyful:) Just sent his curve numbers off to the vet, so we will see what she has to say, I’d anticipate later today or tomorrow; I’ll keep you guys posted on that. We are starting our weekend a bit early and laying low today after all the chaos of yesterday’s holiday. We had a fabulous Thanksgiving, and hope you all did too. Here’s our meal, would love to see yours too!
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+6 315. I’ve started a new thread for my next question, but link and question below (I’ll link this thread over there as well!):

https://www.felinediabetes.com/FDMB/threads/more-steady-numbers-for-nico-good-whats-next.239213/

Okay, so. Since we bumped Nico up to 4.0u he seems to be holding fairly steady (in the minimal data I have because we just changed it..) in the 300s (PURPLE!!). I’m assuming it’s good to see less huge jumps throughout the day, while also hoping to get him down a little further— maybe steady in the 150-250 range?— does that sound correct? Can someone talk to me about what I should or could expect to see now as we get closer to having a more correct dose? Just curious. I feel like right now I’m so thankful for 300s, but also have zero idea what to expect next, or what to hope for. Hoping someone knows the answer(s)!
 
Emily Tuomey said:
+6 315. I’ve started a new thread for my next question, but link and question below (I’ll link this thread over there as well!):

https://www.felinediabetes.com/FDMB/threads/more-steady-numbers-for-nico-good-whats-next.239213/

Okay, so. Since we bumped Nico up to 4.0u he seems to be holding fairly steady (in the minimal data I have because we just changed it..) in the 300s (PURPLE!!). I’m assuming it’s good to see less huge jumps throughout the day, while also hoping to get him down a little further— maybe steady in the 150-250 range?— does that sound correct? Can someone talk to me about what I should or could expect to see now as we get closer to having a more correct dose? Just curious. I feel like right now I’m so thankful for 300s, but also have zero idea what to expect next, or what to hope for. Hoping someone knows the answer(s)!
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I feel like I want to see her on this dose at least through tomorrow or the next day. We may start to see the numbers move a bit.
 
Emily Tuomey said:
Absolutely. I was just curious as to what I should be on the lookout for in terms of staying a bit longer (more than 8 cycles) on a dose. He was 449 at PMPS and just received 4.0u of PZI.
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Nadirs that are < 200 mg/dL would be a good indication that the dose increases could slow down a bit. If the nadirs do hit that <200 mark, then the increases would only be in 0.25U increments.

If those nadirs stay > 200 mg/dL, then you still need to increase, preferably reevaluating every 3-6 cycles.

If by some weird chance, you get a BG >50 but <100, then Nico may need to hold the dose for longer. He has a ways to go before he hits BG levels that low. But ECID and he could surprise us.
 
Deb & Wink said:
Nadirs that are < 200 mg/dL would be a good indication that the dose increases could slow down a bit. If the nadirs do hit that <200 mark, then the increases would only be in 0.25U increments.

If those nadirs stay > 200 mg/dL, then you still need to increase, preferably reevaluating every 3-6 cycles.

If by some weird chance, you get a BG >50 but <100, then Nico may need to hold the dose for longer. He has a ways to go before he hits BG levels that low. But ECID and he could surprise us.
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All great info, thank you!! What is considered a high dose of Prozinc? I feel like some people think 4.0u is A LOT. Maybe it is, I don’t know.. ? For tomorrow I’ll just wish, hope, and pray for some more yellow. :nailbiting:
 
A high dose, when you want to consider having your cat tested for high dose conditions, like acromegaly or IAA, would be a dose that is >6U per 12 hour cycle.
Most cats don't need more than around 3U, before they start to turn around and get better BG numbers. So that is likely why some people might think that 4U is a lot of insulin.

I've read on this message board of cats getting more than 20-30 units. Now to me, that is a LOT of insulin. But those cats usually have acromegaly, the pituitary tumor that makes it tricky to regulate a diabetic cat, since the amount of hormones raising the BG levels can fluctuate with time.

Emily Tuomey said:
For tomorrow I’ll just wish, hope, and pray for some more yellow.
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We will too.
 
Deb & Wink said:
A high dose, when you want to consider having your cat tested for high dose conditions, like acromegaly or IAA, would be a dose that is >6U per 12 hour cycle.
Most cats don't need more than around 3U, before they start to turn around and get better BG numbers. So that is likely why some people might think that 4U is a lot of insulin.

I've read on this message board of cats getting more than 20-30 units. Now to me, that is a LOT of insulin. But those cats usually have acromegaly, the pituitary tumor that makes it tricky to regulate a diabetic cat, since the amount of hormones raising the BG levels can fluctuate with time.


We will too.
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Thank you. Would acromegaly show up in preliminary bloodwork? Or not usually? I guess I still have a lot to learn.. and yes, 20-30u :bookworm::bookworm::bookworm::bookworm: YIKES.
 
No, it would not show up in preliminary or any kind of standard bloodwork. There are special tests that have to be done for acromegaly, and the blood has to be sent to the University of Michigan if you live in the US. They are the only ones that test for acromegaly and IAA here in the USA and North America.

Last studies I saw from 2014, showed that 1 in 4 diabetic cats can have acromegaly. So it's much more common than many vets think it is.
Acromegaly in Cats

"Prevalence of acromegaly amongst diabetic cats in North America and the UK was found to be around 1 in 4 diabetic cats seen in primary practice. The disease is therefore likely currently underdiagnosed."
 
Deb & Wink said:
No, it would not show up in preliminary or any kind of standard bloodwork. There are special tests that have to be done for acromegaly, and the blood has to be sent to the University of Michigan if you live in the US. They are the only ones that test for acromegaly and IAA here in the USA and North America.

Last studies I saw from 2014, showed that 1 in 4 diabetic cats can have acromegaly. So it's much more common than many vets think it is.
Acromegaly in Cats

"Prevalence of acromegaly amongst diabetic cats in North America and the UK was found to be around 1 in 4 diabetic cats seen in primary practice. The disease is therefore likely currently underdiagnosed."
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I googled it and effectively freaked myself out: tumor, cancer, radiation, average of 25 months post-treatment survival... Sounds like a 1 in 4 chance of a death sentence... :eek::(
 
Emily Tuomey said:
I googled it and effectively freaked myself out: tumor, cancer, radiation, average of 25 months post-treatment survival... Sounds like a 1 in 4 chance of a death sentence... :eek::(
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My cat has acromegaly. We didn't do the radiation because it cost about 9000. We've just treat with insulin. She was diagnosed with it 19 months ago but I suspect she's had it for 3 years. I change doses frequently because I find of I don't and she gets into high numbers for a few days it becomes difficult to get them back down. The most she ever needed was 12.5. She's down to needing around 5-6 this week.
 
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You have to remember that a lot of cats that develope it are already very old so that would contribute to the death rate, and a majority of owners aren't vigilant with home testing and are not dosing what they need to. You are in top of things and have a pool of people to help you.

Two months ago I was chatting with my vet... We are having trouble getting her hyperthyroidism under control (that or her kidneys are going to get her before the acro does!) and I said well her thyroid might not be cooperating but her diabetes numbers are doing good. And she complimented me saying what an amazing job I'm doing with her and that if she had any other owner she would have probably not lived nearly so long and be doing as well as she is. It was such a sweet compliment. I really owe what I know to this site.
 
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