Nearing Remission Post SRT

[pablo'smom]

Hi everyone,

It's been a long time since I've checked in, but Pablo is doing good. I haven't updated his spreadsheet in a while, but I updated the last few days. It seems we might be nearing remission, but I'm trying to not get my hopes up. He usually shoots between 85-100 and I started decreasing him a little bit to see if he stays steady. He's been at 1.5 for the last month or so and today I tried 0.5 for the first time and so far he is doing okay. I read the OTJ page, but since he is an acro cat post SRT I was wondering if I should approach things differently or follow the directions on the page. Also, at what pre-shot number should I take him off insulin to see how he does? I usually decrease his dose once he hits low 80s or below because the decreases with SRT can be sudden and drastic. Also, do they make syringes that go below 0.5 and if so, what dose is usually considered the lowest before trying a no insulin?

Update on overall health:

His CKD is steady. His recent followup showed his SDMA 11 and creatinine 1.8. His SDMA went down which is good and his last creatinine before this one was 1.7 so it's staying steady. However, his specific gravity did go below normal but his specialist didn't seem concerned and said his CKD is stable. He is very hydrated so I'm hoping the specific gravity was not pathological and just from lots of hydration since it's never been abnormal.

He weighs 17.5 lbs which means the insulin is working, but now he has to go on a diet. He is a big framed cat so the vet wants him around 16. He was around 16 in December but gained a lot of weight since then which I think is from the insulin and low sugar levels. However, I'm happy he gained all his weight back since he was only 10 lbs last May when his diabetes was its worst.

Overall I am really happy with his health. I'm glad the SRT is working and a year ago I would never have imagined him having normal sugars as this was the cat that sat in the 300-400s regularly and needed 18 units.

 

[Wendy&Neko]

Thanks for the Pablo update, good to hear he's doing well. Great that the SRT is working so well!

For the specific gravity, best to get him in for a first thing in the morning test if you can, it tends to be more concentrated then. Or you can grab a pee into a sterile container first thing in the morning and run it into the vet. They should have a spectrometer there to test the levels.

Hard to tell how the 0.5 units is doing, as the depot from the 1.5 units would still be influencing the numbers. You should have a good idea in a couple of days if the 0.5 is still working well.

Also, at what pre-shot number should I take him off insulin to see how he does?

We don't use the pre shot numbers that way. Basically, if he's on a smaller dose like 0.25 units and all under 100 for several days, then you can try him without insulin and see if he goes 14 days and stays under 100. Note for any lurkers, this is specific for cats with acromegaly that have had stereotactic radiation therapy. I'm glad you are testing more now, it'll be important to make sure he's not going too low if the SRT is working to help him into remission.