We've decided on SRT for Rocket.

Love the photos - he is photogenic indeed. And looking very well for a kitteh who just had a week of traumatic driving and vet experiences. Watching bugs outside can be a full time job for most cats.:bighug::bighug::bighug:

LD is snuggled into bed with his Mom and the little doglets tonight. A nice regular habit that he has continued for the past month.
 
JeffJ said:
Love the photos - he is photogenic indeed. And looking very well for a kitteh who just had a week of traumatic driving and vet experiences. Watching bugs outside can be a full time job for most cats.:bighug::bighug::bighug:

LD is snuggled into bed with his Mom and the little doglets tonight. A nice regular habit that he has continued for the past month.
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I need a soft velvety center pic fix Jeff, please. It's been awhile and I miss the family pics very much.
 
JeffJ said:
Love the photos - he is photogenic indeed. And looking very well for a kitteh who just had a week of traumatic driving and vet experiences. Watching bugs outside can be a full time job for most cats.:bighug::bighug::bighug:

LD is snuggled into bed with his Mom and the little doglets tonight. A nice regular habit that he has continued for the past month.
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Thanks. :) He's my little cutie. I love him to pieces. And I agree with Lou - we need some snuggly photos! :bighug::bighug::bighug:
 
Karen - I'm so happy you and Rocket are finished with treatment, and I wish you and that gorgeous boy a wonderful weekend :bighug::bighug: The Acro kitties are super super special in my opinion. It can be heartbreaking to have such a special cat, but I imagine the bonding might be super special too.
 
Love those pics! He's such a handsome little man! Scritches to Rocket for being such a trooper!
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Hope you all have a very relaxing weekend!
 
Collecting a few cat-velvety-center pics over next few days. Little Dude is mostly hanging out in the house because it is 100 degrees everyday.

Now Rocket is done with SRT, and the Acro healing can begin. At the least, Rocket is probably a very happy little man because he doesn't have to go to the vet everyday (for SRT). No more hiding Rocket!
 
Thank you all. :bighug: This is a hard thing to go through, and it's wonderful having the support here. I feel better now that the treatment is done, but I'm really good at worrying and "what ifs," and I just wish we had known something sooner. So few vets know anything about acro. I'll feel better once I see Rocket's numbers come down a bit. His numbers have been high all day today, either from getting over the stress of treatments, or maybe bouncing from some of the low numbers he got this week. At any rate I just hope the treatment helps, and doesn't take tooooo long. I just want Rocket to feel better.

Jeff, tell LD to stay cool, and we're all looking forward to seeing some cat belly! :p
 
The week is over! Bronx's numbers didn't go down too much at first, it ended up being a more gradual decline that took 2yrs. But ECID, many others drop pretty fast.
 
He was snuggly again this morning :) and he seems alert and happy, as much as any cat on a hot day, hehe. His numbers are still high, so I raised his dose to 9U this morning (we didn't make any adjustments during his treatment week). But overall he seems like he feels better, so that's a good thing. Thank you for asking. :bighug:
 
Keskat&Rocket said:
He was snuggly again this morning :) and he seems alert and happy, as much as any cat on a hot day, hehe. His numbers are still high, so I raised his dose to 9U this morning (we didn't make any adjustments during his treatment week). But overall he seems like he feels better, so that's a good thing. Thank you for asking. :bighug:
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So good to hear Rocket is feeling better
 
Good idea on the increase, let’s see if we can get a bit more blue back in Rocket’s spreadsheet and give his kidneys a break.

Do we need an intervention on you using the AT meter? ;)

Did the vet talk about any follow up plan after SRT? It is suggested to keep an eye on the T4 for a year after SRT. I did once a quarter as per CSU suggestion. A small number of kitties become hypothyroid after SRT treatment, it is easily managed with a pill if that happens,
 
Wendy&Neko said:
Do we need an intervention on you using the AT meter? ;)

Did the vet talk about any follow up plan after SRT? It is suggested to keep an eye on the T4 for a year after SRT. I did once a quarter as per CSU suggestion. A small number of kitties become hypothyroid after SRT treatment, it is easily managed with a pill if that happens,
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Ok, I finally have some time to sit and write a bit. Dr. Bommarito (the Dr. who did Rocket's SRT) had set up a consult appt. for us with an internal medicine specialist (and endocrinologist, I believe) who he has sent acro kitties to in the past. I figured she might not like the human meter numbers, so I got some spot checks with my AT over the last couple days, just in case. And boy, was I right. She really tried to discourage using the human meter, trying to explain that the numbers aren't going to be the same (I KNOW that; duh?). I tried (nicely) explaining about being more concerned with nadir than high numbers, and overall trends up or down, etc., but it's really hard to not come off the wrong way and either sound like I'm being combative and/or just stupid when talking to a "specialist." Oh! And she suggested only checking BG at shot times, and doing a curve once a week or so "if" his clinical signs aren't good. So, strike two. Strike three was when she tried selling us on prescription food. :banghead: I almost couldn't believe it. It was almost as bad as when we first went to our regular vet (who in his defense, is a lot better now).

So, I guess I'm just going to continue what we've been doing, and I'm sure I'll have some questions for all the wonderful folks here if/when Rocket's needs start changing. I was hoping to get some input from her about lowering doses on a depot insulin, but nope. And whether we should consider switching back to Prozinc at some point. Anyway it was a frustrating and basically useless meeting. Have any of you seen specialists to help post-SRT?

Thank you Wendy, for the advice on T4. I've heard about the (small) risk of going hypothyroid after SRT, but I didn't know what exactly to check for. Hopefully this is something that can be done at his regular vet.
 
Oh boy on the specialist you saw! That was a “smile and nod” moment for sure.:rolleyes:

The “specialists” I “saw” post SRT were folks here, plus I kept in email contact with the IM vet at CSU who was in charge of Neko. When you get to lower numbers, I can give you ideas on how to handle the depot. For now, I would stick with Levemir. I think it’s a better insulin overall for cats. To be fair, I did see an IM vet locally when Neko added lymphoma/heart issued to the acro and kidney list. I liked him, trained in Europe and seemed more knowledgeable, though I still debated with him. But he was willing to research for me so we worked together. Until I needed the IM expertise, I worked with my regular vet.
 
Wendy&Neko said:
Oh boy on the specialist you saw! That was a “smile and nod” moment for sure.:rolleyes:
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Seriously. :facepalm:

Thank you Wendy. It's too bad this meeting didn't work out. It was also a busy specialist/emergency vet and was very impersonal (very different from our experience at Dr. Bommarito's place). I'm so grateful to have the help here. Hopefully Rocket's numbers will start to get a little better, and I can bug you for some more advice. :cat:
 
Feel free to make another appointment with that specialist and flick them on the ear for me too!

I got lucky. Our primary cat-only vet had personal diabetic cats, and experience with a lot of diabetic patient cats. Then an internal-only specialist we consulted with, pre-SRT, immediately recognized that Leo had Acro from his features. The specialist also gave us good advice. So we got lucky with 2 vets in Austin.

I am glad to see those nice blue nadirs for Rocket, after months of struggling to get there. And meters - it seems like most of the FDMB members are using human meters. I used AT for Leo, but got the Freestyle strips from Ebay. The human meters are fine too.

Did you know JanetNJ did a informal study of AT2 with Alphatrak strips vs Insulinx strips? It's on CC's spreadsheet under the Insulinx tab. (CC link here) (Hi Janet!)

You know what is missing from your posts - there are no big issues from Rocket after SRT yet! I hope it stays that way too!:bighug::bighug::bighug:
 
Wendy&Neko said:
It is suggested to keep an eye on the T4 for a year after SRT. I did once a quarter as per CSU suggestion. A small number of kitties become hypothyroid after SRT treatment, it is easily managed with a pill if that happens,
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Ditto that. I worked with the IM specialists here and we even sent blood to MI State several times for a comprehensive thyroid panel to determine whether Tubby had become hypoT. His results were questionable and even the experts didn't agree on the interpretation.

I'd also monitor kidney values closely (including a baseline SDMA).

I've been following along quietly, btw. Good luck!
 
JeffJ said:
Feel free to make another appointment with that specialist and flick them on the ear for me too!

I got lucky. Our primary cat-only vet had personal diabetic cats, and experience with a lot of diabetic patient cats. Then an internal-only specialist we consulted with, pre-SRT, immediately recognized that Leo had Acro from his features. The specialist also gave us good advice. So we got lucky with 2 vets in Austin.

I am glad to see those nice blue nadirs for Rocket, after months of struggling to get there. And meters - it seems like most of the FDMB members are using human meters. I used AT for Leo, but got the Freestyle strips from Ebay. The human meters are fine too.

Did you know JanetNJ did a informal study of AT2 with Alphatrak strips vs Insulinx strips? It's on CC's spreadsheet under the Insulinx tab. (CC link here) (Hi Janet!)

You know what is missing from your posts - there are no big issues from Rocket after SRT yet! I hope it stays that way too!:bighug::bighug::bighug:
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Me too!!! Thanks :cat: And I had seen Janet's chart before, but I was looking for it a couple days ago and couldn't find it. Thanks for the link. :)
 
JL and Chip said:
Ditto that. I worked with the IM specialists here and we even sent blood to MI State several times for a comprehensive thyroid panel to determine whether Tubby had become hypoT. His results were questionable and even the experts didn't agree on the interpretation.

I'd also monitor kidney values closely (including a baseline SDMA).

I've been following along quietly, btw. Good luck!
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This helps too. I'm making a list of things to follow up on. Thank you. :bighug:
 
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Keskat&Rocket said:
This helps too. I'm making a list of things to follow up on. Thank you. :bighug:
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Keskat&Rocket said:
Me too!!! Thanks :cat: And I had seen Janet's chart before, but I was looking for it a couple days ago and couldn't find it. Thanks for the link. :)
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Yeah the chart is part of my spreadsheet. Here's a a screenshot. I wish screenshot posted clearer. Anyway it's in ccs spreadsheet link under the insulinx tab. The insulinx strips are usually very good... I even use ones that are expired by less then six months and they have worked fine. I get them on eBay. I wait for a good deal. I haven't had to buy any in about 6 months because I still have about 20 50 strip vials. When I get down to 10 I'll start looking again.
 
Thanks Janet! I checked eBay a while back but there weren’t great deals at the time. I do like having the AT, even as just a backup.
 
@Wendy&Neko
And anyone else who’d like to chime in...

I’m up early, because Rocket decided to hit a 99 at PM+8.25, and a 73 at PM+9.5. He’s never been this low. I decided to feed him some of his regular food (not high carb) and test again in a bit. PMPS last night was 321. Big bounce incoming, you think? Not sure how much to shoot at 9 am today.
 
Delay is good. See if he’s rising or still dropping. This was always the hardest part with Colin and I didn’t have SRT to factor in!
 
A little update... we're just eight days post-SRT, and Rocket is doing something, but I don't think he knows what yet. :cat:

He's hit some nice / interesting numbers in the last few days. I'm happy to see those numbers, but... man is he bouncy right now. One hour pre-AM shot on Aug 21st he hit an all-time low of 62. I toyed with the idea of giving a half dose, but ended up skipping to be safe. I mean this was only the second time I've seen green on his chart since we started keeping track. And, of course he ended up in the red by the end of the day. :(

He went low-ish again pre-shot two days later, and I tried giving a reduced dose. Boom, in the red again at the end of the day.

This morning started off nice, with a 134... again, 1 hour preshot. This guy's gonna give me a migraine lol. Knowing that he was probably going to bounce back up, I just gave him his full 8.5u dose (and knowing I would be home all day). And now, about 7 hours later, he's in the mid 300s again.

What do you guys think? Are these just normal bounces; do I just hold the dose until the roller coaster stops? Or is this a result of the SRT treatment already, and I have to get used to the idea of his numbers being wonky for a while? It's hard when his nadirs are at +11 and shot time. Like I said, I'm happy to see greens and blues, but it's scary that he's so unpredictable, and that his daytime / overnight cycles are so completely different. :confused:
 
These are “normal” changes due to the upset in the depot from missed or reduced doses. Looks like Rocket also likes to nadir near preshot like my girl did. Takes some used to shooting low. There is a phenomenon we call New Dose Wonkiness that results in temporary high numbers for a cycle or two soon after an increase, could be seeing NDW today. Plus he still isn’t used to blue, could be a bounce component.
 
Hopefully in those couple weeks you'll see enough good numbers to get a feel for when Rocket needs extra monitoring or food. If not, you can always be extra cautious about reductions until you can monitor more on weekends.
 
Wendy&Neko said:
Hopefully in those couple weeks you'll see enough good numbers to get a feel for when Rocket needs extra monitoring or food. If not, you can always be extra cautious about reductions until you can monitor more on weekends.
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Ok, I'm really not liking Rocket's spreadsheet last few days. After looking like something good was starting to happen, he's been high and flat-ish since the evening of the 24th. This morning was his 3rd shot at 9.0U - should we increase early, or still hold for 6 cycles before increasing? And at this point, increase to 9.5, or maybe 10?

Also, something I don't really want to risk, but I'm starting to wonder if we should consider Novilin R if this continues. :(
 
Continue to hold the dose, at least six cycles. There is a phenomenon called NDW or new dose Wonkiness that gives higher numbers in the first few cycles after an increase. Patience is rewarded. :)
 
You are being impatient and increasing after five cycles. Give it six so the depot has time to fill. Rocket will find his good numbers soon enough. :bighug:
 
:oops: Yeah, I guess we are getting a little impatient... my husband said to blame him (lol!). Just yesterday we noticed what might be the start of neuropathy in his left front leg too, so that ups the stakes a bit. I hear you though... he's just been high and flat for so long. Hopefully this dose will be ok. I'm monitoring very closely. Thank you. :bighug:
 
Wendy&Neko said:
You are being impatient and increasing after five cycles. Give it six so the depot has time to fill. Rocket will find his good numbers soon enough. :bighug:
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Ok, so Rocket has been on 11u for 8 cycles now. Yesterday we finally had a breakthrough - he was in blues from the early morning thru the afternoon. Yay! And then... the inevitable bounce. Last night he hit 426 at his PMPS, and is at 378 right now. His AM shot is in 2.5 hrs... do I hold the dose and wait for the bounce to clear? Or increase today? If we hold at 11u and he stays high, how many days til increasing? Still unsure how to handle bounces (obviously). Rocket just loves those high numbers. I’m assuming the acro makes this much more complicated. :banghead:

Edit: I’m not looking to get perfect cycles right this minute; I would be happy to see if we could get those blues back for now, and not be so darn bouncy.

We had a good follow up appointment yesterday with the Dr. that did his SRT. I’ll update a little later. For now I’m going to get a bit more sleep. :)
 
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Mostly ignore the bounces. Just try to avoid the increase on a cycle they are breaking the bounce because there can be extra downward momentum. You are fine to increase today. You have seen what 11 units can do, and it’s better, but not quite enough.

Those blues were lovely, maybe a little more juice will bring down the highs and make the blues last longer. That’s the only way he’ll get used to them and stop bouncing as much. Being acro doesn’t make much difference to bouncing, just can take a higher dose to get to the point where they get used to normal numbers again.

Looking forward to the vet visit report.
 
Wendy&Neko said:
Mostly ignore the bounces. Just try to avoid the increase on a cycle they are breaking the bounce because there can be extra downward momentum. You are fine to increase today. You have seen what 11 units can do, and it’s better, but not quite enough.

Those blues were lovely, maybe a little more juice will bring down the highs and make the blues last longer. That’s the only way he’ll get used to them and stop bouncing as much. Being acro doesn’t make much difference to bouncing, just can take a higher dose to get to the point where they get used to normal numbers again.

Looking forward to the vet visit report.
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Thank you Wendy. I saw your post right before shot time, so he's now at 12u. Fingers crossed for a good couple of days. Should I post these kinds of questions in a separate post, and not in Rocket's general SRT thread?

I'll write about the vet visit this afternoon when I have a bit more time. No major news, just some info.
 
Dosing questions should be a separate thread, otherwise the thread on SRT gets kind of busy. My suggestion is posting dosing quesitons in the Lantus/Levemir forum, to get more eyes on you. Not may of the people comfortable with aswering dosing questions monitor this forum. And I'm not always around. The flip side to the L/B/L forum is that you might get answers from those not familiar with high dose cats. Read their signature and spreadsheet to see if it's someone you want to listen to. There are a couple of senior members who can still provide good advice, in spite of not having acros themselves.
 
So the week got away from me, and I forgot to post about our follow up appt. last Tuesday. :cat:

Not much to report really; Dr. Bommarito took a look at Rocket, and asked how he was doing. We let him know that Rocket was pretty much the same; appetite good, etc., but his BG numbers are still high and flat, and that we are still increasing insulin doses. He said that it could take 4-6 weeks or more to start seeing improvement (which we knew already, of course). He said we shouldn't expect to see any negative side effects (hair loss, vision changes, etc.). He knew we were not happy with the IM Dr. he had referred us to, and we talked about that for a bit, as well as the state of veterinary medicine in general (mainly independent vs. corporate-owned hospitals), and he gave us a couple more names in case we decide we need an endocrine specialist in the future.

We talked again about his past experience with acro kitties (which we had done in our consult appt. too) -- I don't have exact numbers unfortunately, but he's had a few go into remission after SRT, and a few that had insulin needs reduce markedly. I asked if any had come back to re-do the procedure -- he said only one had ever come back for re-imaging, but that cat had a larger tumor to begin with, and ended up passing from other causes.

Overall it was a good visit; we like the Dr. and I would recommend him to anyone in the area. Now we just have to wait to see if Rocket will start responding... we keep increasing his dose, and I'm getting a little nervous about what that big depot we're building will mean if Rocket does start dropping. Have any of the SRT kitties gone back to an in-and-out insulin like ProZinc once they started responding to treatment?
 
Keskat&Rocket said:
Have any of the SRT kitties gone back to an in-and-out insulin like ProZinc once they started responding to treatment?
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You could be the first!

I'm glad to hear that Rocket is doing well. And particularly that there have been no SRT bad side effects (yet). They listed some of them at CSU, and none of them happened to Leoberry either.
 
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