Saturday morning, Shadoe's dose increased to 6 units Levemir. It's been quite a mild roller coaster compared to what some acro cats experience. When I think of one whose been up to 60+ units BID, or another around 40
units, I have to say that Shadoe's high of 14 units was more of a mole hill compared to others' mountains.
That's OK; I'd rather start with a mild climb and drop than a scary extreme one.
Right now, I don't know our path or where we will end up this time. From a start at 1 umit Lantus on November 10, 2009, after a short stint with Caninsulin from October 16,2009, we moved onward to a high of 14 units Lantus by March 10, 2010, after Shadoe's tests February 21, positive results March 05. She then had an ultrasound March 18, and dental March 19, with a switch to Levemir and a free fall down to an eventual bottom dose of 2.5 units by March 29, 2010, we are now exhausted.
It seems that there are no breaks in all of this journey because after less than a week at the 2.5 units, she had a weird spike on the eve of April 02, and from there, we started to rise.
So here we are today, at a dose of 6 units with a need to use Humulin R, to pull her numbers down at ps, mid cycle, or any other time when the numbers need a bit of lowering. I don't know if we are repeating the past because this time around, we are using R along with the Levemir and still need to raise the dose. I am just hoping we can have a slower rise and the R can pull her down to a better range, even if just to the 200-300 range.
Tonight is cycle 4 at this dose, 6 units Lev; I suppose we will be raising the dose tomorrow or the day after because we can't get any numbers under 200, so following the protocol aggressively, it is time to go up.
Sunday, April 25, 2010
Friday, April 9, 2010
It's been awhile ...
And so much has happened.
Shadoe was sitting at a dose of 14 units of Lantus, and we were using small doses of Humulin R to bring down her numbers to a manageable range so she could continue at a range less harmful until her next shot. Then many things happened all at the same time resulting in our finally ending up at a dose of 2.5 units after a 12 day freefall.
Once we received her IGF-1 and IAA test results, we arranged for her to get a full dental check, clean and any work required plus an ultrasound to check her organs and especially her heart. Because we do not know which came first, the tumor or the diabetes, and acro does cause enlarged heart, organs, etc, I wanted a snapshot to know where we are at this point in time.
I am sure that the ultrasound was traumatic for Shadoe, with her belly shaved, but at least she did not have to fast for it. Unfortunately, no sooner does she come home when she gets one meal and then it's fasting time for the dental the very next day on March 18, 2010.
If the ultrasound experience didn't make her dislike the vet office, I bet the dental experience did.
First, you are starved, then taken to a place where the knock you out, and you wake up feeling like crap with a very sore mouth. You are then taken home, and twice a day for a week, you get some horrid antibiotics mixed with some tuna juice squirted into your mouth.
Needless to say, Shadoe's numbers were all over the place, and with missed shots thrown into the mix plus some lower shots combined with the effects that anesthesia has on BG numbers, she headed down in dose quickly. At one point, her dose was decreasing every cycle. The icing on the cake was that we also switched from Lantus to Levemir a day after her dental was done, and also had an addition to our household when Oliver arrived on the scene. Another diabetic cat who also needed attention to settle in after his trip from the US.
Poor Shadoe; poor me! Talk about a free fall!
Anyways, when we hit the 2.5unit dose on Levemir, Shadoe seemed to level out. We need to keep her at a higher number than other diabetic cats as acro cats are harder to bring up in numbers. Normally, high carb (HC) foods or karo on the gums will bring up a cat's BG numbers for a short time, but an acro cat does not respond as readily to that sort of treatment for low numbers. Thus, it's wiser to stay about 100 mg/dL (5.6mmol/L).
Something happened in the middle of the night on April 02, 2010; Shadoe's numbers shot way up into the 400s and since that time, she has gone up and stayed in the 300s. Sadly, it looks like Shadoe's needs are increasing again. We grudgingly increased to 2.75 units on April 5th and then to 3.0 units on April 8th. Unless she has a turnaround over the weekend, it looks like will be going up again, to 3.25 units as she did get below 300 as nadir once.
I have been told that some acro cats can and do go OTJ (off the juice) when the tumor revs down. This quick drop in her dose needs may have been a revving down and may also explain her lower IFG-1 of 120. Apparently the results reflect the secretion so if it's low, the number will be lower. So we can hope that Shadoe may go OTJ too, as it is possible, even if only temporary.
Today, Shadoe seems OK. Her BG at pmps is 19.7/355, so we may just see some nice numbers in the 200s from this shot. While the numbers play a part, they are only part of the picture. If Shadoe is happy, and eating, purring, and using the litter box, then a number a little on the high side is acceptable
And always remember, tomorrow will be a better day.
Be strong. Stay positive.
Shadoe was sitting at a dose of 14 units of Lantus, and we were using small doses of Humulin R to bring down her numbers to a manageable range so she could continue at a range less harmful until her next shot. Then many things happened all at the same time resulting in our finally ending up at a dose of 2.5 units after a 12 day freefall.
Once we received her IGF-1 and IAA test results, we arranged for her to get a full dental check, clean and any work required plus an ultrasound to check her organs and especially her heart. Because we do not know which came first, the tumor or the diabetes, and acro does cause enlarged heart, organs, etc, I wanted a snapshot to know where we are at this point in time.
I am sure that the ultrasound was traumatic for Shadoe, with her belly shaved, but at least she did not have to fast for it. Unfortunately, no sooner does she come home when she gets one meal and then it's fasting time for the dental the very next day on March 18, 2010.
If the ultrasound experience didn't make her dislike the vet office, I bet the dental experience did.
First, you are starved, then taken to a place where the knock you out, and you wake up feeling like crap with a very sore mouth. You are then taken home, and twice a day for a week, you get some horrid antibiotics mixed with some tuna juice squirted into your mouth.
Needless to say, Shadoe's numbers were all over the place, and with missed shots thrown into the mix plus some lower shots combined with the effects that anesthesia has on BG numbers, she headed down in dose quickly. At one point, her dose was decreasing every cycle. The icing on the cake was that we also switched from Lantus to Levemir a day after her dental was done, and also had an addition to our household when Oliver arrived on the scene. Another diabetic cat who also needed attention to settle in after his trip from the US.
Poor Shadoe; poor me! Talk about a free fall!
Anyways, when we hit the 2.5unit dose on Levemir, Shadoe seemed to level out. We need to keep her at a higher number than other diabetic cats as acro cats are harder to bring up in numbers. Normally, high carb (HC) foods or karo on the gums will bring up a cat's BG numbers for a short time, but an acro cat does not respond as readily to that sort of treatment for low numbers. Thus, it's wiser to stay about 100 mg/dL (5.6mmol/L).
Something happened in the middle of the night on April 02, 2010; Shadoe's numbers shot way up into the 400s and since that time, she has gone up and stayed in the 300s. Sadly, it looks like Shadoe's needs are increasing again. We grudgingly increased to 2.75 units on April 5th and then to 3.0 units on April 8th. Unless she has a turnaround over the weekend, it looks like will be going up again, to 3.25 units as she did get below 300 as nadir once.
I have been told that some acro cats can and do go OTJ (off the juice) when the tumor revs down. This quick drop in her dose needs may have been a revving down and may also explain her lower IFG-1 of 120. Apparently the results reflect the secretion so if it's low, the number will be lower. So we can hope that Shadoe may go OTJ too, as it is possible, even if only temporary.
Today, Shadoe seems OK. Her BG at pmps is 19.7/355, so we may just see some nice numbers in the 200s from this shot. While the numbers play a part, they are only part of the picture. If Shadoe is happy, and eating, purring, and using the litter box, then a number a little on the high side is acceptable
And always remember, tomorrow will be a better day.
Be strong. Stay positive.
Monday, March 8, 2010
Shadoe is diabetic
Where to start?
Shadoe has feline diabetes mellitus, diagnosed October 4, 2009, from tests done Septemter 18, 2009. After treating her with insulin since that time and having her doses get higher and higher, she was tested for IAA and acromegaly, to investigate the reason for her resistance to the insulin.
Shadoe was March 5, 2010, positive for acromegaly with a value of 120, and negative for IAA with a value of 7%
How Shadoe is treated now, will be more aggressive, yet still paced and slow.
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