Need expert thoughts on Harley's IAA

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Harley and Pattie

Harley and Pattie

Member Since 2010
I need some expert opinions here. As you know, Harley is IAA positive. A quote from High Dose ISG: “When insulin is injected into a diabetic cat, the body views it as a foreign substance and the immune system sets out to destroy the "invader" insulin, just as it would destroy cold and flu viruses. When this happens to injected insulin - most of it never reaches the bloodstream thus being unable to control blood glucose. Insulin doses may be increased but the immune system only goes into higher gear and continues to effectively destroy any additional injected insulin. Over time this becomes officially known as insulin resistance.” and “IAA is supposed to be self-limiting, meaning it goes away at some point. “We have a couple of anecdotal reports of kitties who, by continuing to raise the insulin doses, were able to overwhelm the antibodies, eventually lower the insulin doses and gain control of the BG’s.”

Here is my question on Harley. Looking at his ss, he did better (achieved lower number, more often) on a higher dose on insulin. It makes sense to me that if after 6 cycles, he has not gone into acceptable numbers (100’s for me), I should be raising his insulin needs to counteract the anti-bodies. I do not want the anti-bodies to become accustom (or take over) to a lower dose that will increase his bg.

Does anyone have any thoughts on my thoughts (does that even make sense?)

Now, I don't want to make any changes until after vacation which is 7/16. I take Harley to the U of MN for a medical boarding for the week I am gone. I hate to leave him alone with only someone stopping in twice a day to shoot and feed. At the U there is 24/7 care and I can vacation with peace of mind.

Thanks

Pattie
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Hi Pattie!

I'm kind of an old-timer who has been absent for a couple years. Black Kitty is an IAA kitty and has been OTJ since October 2009. I'm still at tbp and blocked from access to google docs, so I can't see Harleys ss. Once I get home I'll have a look and respond. I'll see if I can figure out how to get the link to BKs ss into my signature as well so you can see how his 21 months on insuln played out.

Hang in there!
Sandy & Black Kitty
 
Oh, and I am also kind of an impatient owner and it's like - I want his number low - now. Most of you on board can attest to my impatience..although I am trying to develop more patience.

Pattie
 
I think when BK went OTJ everyone here cried, happy tears ..
And you are doing a great aka magnificent job, Patty. Hang in there. Just looking at Harley's ss and how far he has come, shows what a great caring and hard working mom you are. I wish I could say, learn to meditate, go out in a field and sit and become one with the earth, three days doesn't take that long. Sorry :oops: I said it :-D <3 u
 
sandy is the expert. i'm sure she'll give you more details, but it looks to me like reductions were taken for nadirs in the 30s and 40s and she mostly waited out the bounces.
 
Hi Pattie,

Let me start by saying I've not been around or thought in depth about FD for nearly 2 years now - I'm way rusty and have forgotten many of the nuances. I can offer experience.

We don't know how long BK was diabetic before we took him in - he came to us that way. I can say with confidence that BK made the greatest progress when his teeth and gums were addressed. Gum disease is his Achilles heel. We now make sure he gets regular dentals (he has 3 teeth left). Also very helpful are many evenly spaced small meals around the clock. We use a 5 compartment automatic feeder. Something else\e that really helped is that I work from home and BK lives in my office (a cottage out back) which has been dubbed "BK Central". I'm with him the entire working day and could very closely monitor. And when my day was done DBF aka "The Night Watchman" took over monitoring the overnight cycle as needed.

It took time to make sure any infections were resolved and BK was at a nice stable weight. It took a while to get him from 7.2 lbs (after 2 DKA episodes) up to a healthy and fit 12lbs (he is now 11.2lbs, which is ideal for him). In the beginning he ate the equivalent of 5 FF cans p/day - he now eats 2.

Harley and Pattie said:
Here is my question on Harley. Looking at his ss, he did better (achieved lower number, more often) on a higher dose on insulin. It makes sense to me that if after 6 cycles, he has not gone into acceptable numbers (100’s for me), I should be raising his insulin needs to counteract the anti-bodies.
Click to expand...

I think that "acceptable numbers" is relative. When BK had a lot of pink going on, yellow was very acceptable to us. Liver training - I think that is a very big part of regulation and it is something that takes time and probably is affected by how long the cat has been diabetic. We followed the LL modified version of the Tight Regulation Protocol guidelines about increases and decreases; being patient and avoiding dose hopping. You have to go step by step.

Have a good look at BKs SS, I have not really looked at it in a long time. Like Jill said,reductions were taken for nadirs in the 30s and 40s and we mostly waited out the bounces. It takes boatloads of patience and perseverance, I know.

Hang in there .
 
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