6/23 Jack: 239@amps, 188@+2, 89@+7- IAA positive (questions)

[Jack & Mopem'sMom]

I apologize for being off the board for so long. These guys keep me hopping, and the last few weeks at work have been brutal, plus the family front has been 'special' as well. I've been trying to keep the SS updated with some comments though.

First, this is the last post (I think): 6/11 Jack: 183@amps, 251@+2

Next, Jack had his 2 week, post dental recheck and did very well. He has been cleared to eat kibble/hard food again (that's another story) and his mouth is healing well. So, yay for that. He's back to his normal self, and overall I'm pleased with the outcome and the vet clinic.

Finally, his insulin resistance re-tests came back. I am seriously dumbfounded. I thought once negative, always negative, but Jack has his own agenda apparently. His IGF-1 came back negative again, but the IAA came back positive. (see lab tab on SS for numbers) I would have expected the result to be the other way around since the IGF-1 was the test that had the changes made, but ...NO. So, tagging @Wendy&Neko for some insight? From what I have read in the IAA/Acromegaly/Cushings threads here and on the original board, not much I can do for him?? The vet said she would do some research, but didn't have a good recommendation at the time of the recheck when I got the results (this past Friday 6/20) I've seen differing opinions on changing insulin, but what to change it to?? He did go back and forth from Vetsulin to Pro-Zinc for the first four months of diagnosis (Vetsulin for the first 4 days, then ProZinc for 9 days, then Vetsulin for 19 days, then ProZinc for about 2 months) because he was not responding to either, and then we made the switch to the generic Semglee (glargine-yfgn) and stayed there. I had his original resistance tests done 2 months after the switch to the Glargine-yfgn, which I was told was enough time to let antibodies develop if they were going to, but I guess not for Jack. So, here we sit. An unfortunate case study in ECID and no clear path forward. Any suggestions, experience, etc. would be most welcome and very much appreciated.

Hope all have been well, and the kitties are all doing ok.

Here's a picture from Friday of Jack waiting to see the vet, just hanging out on the exam room furniture like he owns the place.

 

[Staci & Ivy]

Oh, Jack. Just look at him running the vet office waiting room

I’m sorry to hear about the test results, but maybe now that will lead to a better plan of attack to help sweet Jack!
You’re the best cat mom to so many, Christine!
I’m sure Wendy will have lots of great ideas for you.
We are sending you love and light and lots of vines for the gang

 

[Wendy&Neko]

I'm sorry to see the IAA number, but not entirely surprised. Now there is an explanation for his higher than average dose. The good news is that it's not super high, 32 with the upper end of normal being 20. For reference, Neko was 52. I've seen research that says IAA is quite common, and another research paper saying it's uncommon. Both studies done on small numbers of cats, so no real definitive answer. I don't know of any other examples of people having cats test negative, then later positive. I see it's be almost 3 years since the original tests. I do remember one sweet kitty Doodles, who was heading down in dose and almost at remission before his numbers changed from green/blue to red/pink and his dose soared. Got up to I think around 10 units and tested positive for IAA. However, he wasn't tested for IAA in the before picture. He also had some heart issues show up, and maybe that combo triggered antibodies? Who knows, merely speculation here.

IAA is supposed to be self limiting over time, about a year? But we don't know how long Jack has had positive IAA so when the IAA clock started. Also, I am super happy the acro remains negative. In the mean time, IAA seems to respond best if kitty is spending some quality time in green. I think you are doing what needs to be done now, given his interest in hard food. Speaking of which, look how much his dose has come down without kibble!

We do have a couple other IAA only kitties here, Bell (IAA 82%) and Minner (IAA 77%). It's unusual to see IAA only kitties, and now there are three of them!

I had heard that once positive for IAA, they would still test positive, even if off of insulin. That's until Sandy's Black Kitty (first IAA kitty on FDMB) was OTJ for many years did his IAA go back to normal.

BBL with some more tips on IAA.

 

[Seth&Bell]

I'm not sure it is a club you want to be in, but welcome to the club, Jack!! What a cutie at the vet! He doesn't seem fazed at all!

Bell just hit her 1-year anniversary for FD so you might find her spreadsheet interesting to look through. Right now they are even on the same dose. She's been through some swings where she's scaled down with her dosage needs and then come back up again. Now back down

Wendy will have you covered here! Super good news about the negative for IGF-1. Here's my post back on the old board with some good details from Wendy:
Bell Positive for IAA

 

[Jack & Mopem'sMom]

I'm sorry to see the IAA number, but not entirely surprised. Now there is an explanation for his higher than average dose. The good news is that it's not super high, 32 with the upper end of normal being 20. For reference, Neko was 52. I've seen research that says IAA is quite common, and another research paper saying it's uncommon. Both studies done on small numbers of cats, so no real definitive answer. I don't know of any other examples of people having cats test negative, then later positive. I see it's be almost 3 years since the original tests. I do remember one sweet kitty Doodles, who was heading down in dose and almost at remission before his numbers changed from green/blue to red/pink and his dose soared. Got up to I think around 10 units and tested positive for IAA. However, he wasn't tested for IAA in the before picture. He also had some heart issues show up, and maybe that combo triggered antibodies? Who knows, merely speculation here.

IAA is supposed to be self limiting over time, about a year? But we don't know how long Jack has had positive IAA so when the IAA clock started. Also, I am super happy the acro remains negative. In the mean time, IAA seems to respond best if kitty is spending some quality time in green. I think you are doing what needs to be done now, given his interest in hard food. Speaking of which, look how much his dose has come down without kibble!

We do have a couple other IAA only kitties here, Bell (IAA 82%) and Minner (IAA 77%). It's unusual to see IAA only kitties, and now there are three of them!

I had heard that once positive for IAA, they would still test positive, even if off of insulin. That's until Sandy's Black Kitty (first IAA kitty on FDMB) was OTJ for many years did his IAA go back to normal.

BBL with some more tips on IAA.

Thank you SO much for this!

 

[Jack & Mopem'sMom]

I'm not sure it is a club you want to be in, but welcome to the club, Jack!! What a cutie at the vet! He doesn't seem fazed at all!

Bell just hit her 1-year anniversary for FD so you might find her spreadsheet interesting to look through. Right now they are even on the same dose. She's been through some swings where she's scaled down with her dosage needs and then come back up again. Now back down

Wendy will have you covered here! Super good news about the negative for IGF-1. Here's my post back on the old board with some good details from Wendy:
Bell Positive for IAA

Hello Seth and Bell! Thank you for popping in and for sharing Bell's journey....Jack is similar with his up and down, up and down dosing. We got to almost 11u and now we are on 6

 

[Seth&Bell]

Progress!! . It is a wild and frustrating ride, indeed

 

[Wendy&Neko]

Thanks Seth - now I don't have to go hunting for the information I was going to post.

 

[Jack & Mopem'sMom]

Thanks again everyone!