MISSY: AMPS 136 NEW INSULIN BOX, STILL WONKY NUMBERS

MISSY + Simone&MICIO (GA)

MISSY + Simone&MICIO (GA)

Member Since 2021
Yesterday: AMPS: 121, 125@ +3, 184@ +6, PMPS 153, 156@ +3, 152@ +6

For continuity: ? - MISSY AMPS 154, 156@ +3, 167@ +6, PMPS 198, 157@ +3.5 Rising numbers, possible causes? | Feline Diabetes Message Board - FDMB

UPDATE ON MISSY: @Suzanne & Darcy , @tiffmaxee, @Wendy&Neko I did get a brand new box of Insulin Glargine a few days ago and, although at one point it seemed the numbers were suddenly getting lower, then went back up high and currently bouncing (Missy has always been very flat up 'till weeks ago); at this point I don't think the older insul went bad but instead Missy conditions are slowly worsening. Still giving her 2.5mg Pred every other day but not sure is doing anything; some days she seems better and some days like yesterday she sounds like the "whatever" there's inside her sinus is going to burst and bleed pretty soon (I can hear she's gotten stuffier again). IM doctor's not giving me any imput anymore other then constantly suggesting end of life option...lovely!
Missy's looking very tired though

@Wendy&Neko I was able to take a few pics of her skin growths : exact same thing that my Micio had, the base of it is narrow and barely attached to the skin but they keep growing and release a mixture of oils, blood and nastiness making a mess all over her long hair coat. Here and there I try to clean it but they also bleed pretty easy and she's so sensitive and gets very hangry...
She has these all over her back: head, neck, along her spine, a small one on her foot, some on her tail and probably on her sides but cannot even try to touch there.
All of these, just like on Micio, started with diabetes and gotten worse with Acromegaly I guess.
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Those are some really strange and nasty-looking growths. And the IM doctor doesn’t know what they are? Maybe she has something similar growing in her nasal passageway?

Was yesterday a prednisolone day or not? Have you noticed higher BG on pred days? She is still relatively flat, but in blue. Are you going to try to increase her dose to get her BG a little lower or do want to leave things as they are? You never know, but she may feel better in more green, and it could perhaps create a less inflammatory environment in her body overall? I am just throwing that out there.
 
Suzanne & Darcy said:
Those are some really strange and nasty-looking growths. And the IM doctor doesn’t know what they are? Maybe she has something similar growing in her nasal passageway?

Was yesterday a prednisolone day or not? Have you noticed higher BG on pred days? She is still relatively flat, but in blue. Are you going to try to increase her dose to get her BG a little lower or do want to leave things as they are? You never know, but she may feel better in more green, and it could perhaps create a less inflammatory environment in her body overall? I am just throwing that out there.
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As soon as I noticed those growths when they first showed up, vets/IM doctor were never concerned and always told me it's just a "skin tag" and better to leave it alone. As they were growing more and, especially after what I experienced with Micio too, I kept raising my concernes but still vets have no clue and suggested to maybe try an endocrinologist?! They all seem to underestimate all of the strange/out of ordinary symptoms I've been reporting and don't care to investigate in order to put things together and try to get a better understanding on what's going on...probably too difficult to do so!
And I agree, well possible that one of those are growing more and more on her sinus and I also believe it's greatly affecting her sense of smell which would also explain zero appetite. That's also why I'm not considering appetite stimulant meds, also tried it before and she reacted badly to it.
Thanks for pointing that out...indeed, the numbers on Pred days are usually higher. Probably will increase dose dose soon, just wanted to wait a few more days with the new insulin but I don't think the old insulin went bad as I was hoping.
 
Those are strange looking growths. And not something I've seen people with acro cats mention before. Any chance a dermatology vet could take a look at them?

As for dosing, at this point I don't think your goal is remission. I'd aim for just basic regulation and hopefully under renal threshold. Her numbers do look pretty good. My goal would be comfort and quality of life. If the dose is giving solid blues, it's pretty good and you don't need to poke her as much.

Changing to a fat 5.5 should make little difference at that size of dose. You'd need at least a 0.25 unit change to get any difference in results, if that was what you wanted to do.

As others have said, the pred seems to be increasing the numbers the day it's given, but she comes back down the next day. That's pretty typical of a pred boost to numbers so I'd ignore the temporary slight rise in numbers.
 
Wendy&Neko said:
Those are strange looking growths. And not something I've seen people with acro cats mention before. Any chance a dermatology vet could take a look at them?

As for dosing, at this point I don't think your goal is remission. I'd aim for just basic regulation and hopefully under renal threshold. Her numbers do look pretty good. My goal would be comfort and quality of life. If the dose is giving solid blues, it's pretty good and you don't need to poke her as much.

Changing to a fat 5.5 should make little difference at that size of dose. You'd need at least a 0.25 unit change to get any difference in results, if that was what you wanted to do.

As others have said, the pred seems to be increasing the numbers the day it's given, but she comes back down the next day. That's pretty typical of a pred boost to numbers so I'd ignore the temporary slight rise in numbers.
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That's my plan, adjusting the insulin to keep her on safe numbers. Because I don't really see a positive change with Pred, I'm thinking of quit that, one less pill to give her that causes her unecessary stress. Should I move down to 2x 2.5mg Pred per week for a week maybe? and then stop?
 
MISSY + Simone&MICIO (GA) said:
actually wonder if that can cause constipation
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If there is inflammation in the GI system, it should actually help constipation. I would not change the pred dose without talking to the vet first and get a plan to taper it safely. By the way, I have a cat I give pred to, and I get it compounded into a chew treat. Makes giving it much easier.
 
Wendy&Neko said:
If there is inflammation in the GI system, it should actually help constipation. I would not change the pred dose without talking to the vet first and get a plan to taper it safely. By the way, I have a cat I give pred to, and I get it compounded into a chew treat. Makes giving it much easier.
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Missy's IBD has been under control for a long time, even after we slowly stopped Budesonide. Some pancreatitis flare ups may take place sometimes and Denamarin along with tons of good pro/prebiotics, fiber and increased fat content on her diet seems to help a lot with her bowl movements (even though it's not easy to balance since she's very sensitive to any change), but still, coincidentally, constipation gotten worse since starting Pred. which was prescribed by the IM doctor in an attempt to possibly reduce inflammation on her sinus but didn't seem to have helped much. Finally the IM just got back to me last night and we agreed on lowering the Pred intake to a 2.5mg every 3 days and see what happens, if no change then we may just stop it as well. Pilling Missy has never been a problem as I don't have to fight her (I put all meds and even CBD oil inside gel caps and I slightly coat them with a drop of coconut oil for easier swallow) bu t reducing the number of pills throughout every day may help also to reduce some stress. Meds compounded to chew treats are a great option but not for Missy, the only treat she still like and eat on her own is Vital Essential Freeze Dried Chicken...that's all, but can't give her too much of it cause I don't want to imbalance her diet.
 
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