3/22 Tommy amps 469, +3 380,+6 422, +8 451, pmps 437

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Re: 3/22 Tommy amps 469

Hi guys .. come on down now tommy! The red floor isn't the happening place .. have a great day guys!
 
Re: 3/22 Tommy amps 469, +3 380

great +3 ! can you become a little lighter shade of pink for us Tommy? :smile: are we going to get a +6? dancing_cat ...and if it were me I'd give some fuds after the +6 too. :smile:
 
Re: 3/22 Tommy amps 469, +3 380

I sure am gonna get the +6 and i thought i would give him another 1 1/2oz ff chicken.
Thanks for dropping in all.. ;-)
 
Re: 3/22 Tommy amps 469, +3 380

Hi, Squirrel & Tommy.. continuing to follow the two of you. Yay for pink!! flip_cat
 
Re: 3/22 Tommy amps 469, +3 380

Hey nicole, thanks. Just updating Tommys ss... negative ketone test again. :smile:
Thanks for checking in. Hope all is well with you and Baby!
 
Re: 3/22 Tommy amps 469, +3 380,+6 422

Tommy's Monday Condo -- Squirrel, can you remember to link the previous day's condo in your first post of the day?

I had a couple of thoughts when I looked at Tommy's condo from yesterday.

Celia mentioned inverted curves can mean that a cat is getting too much insulin. That's true. It can also mean that a cat isn't getting enoughinsulin. (Confusing, isn't it?) I also don't see an inverted curve. IMHO, Tommy's numbers are high and flat. According to the revision in the Tilly Protocol (this happened over a year ago), you can increase the dose in as short a time as 4-cycles and if nadirs are consistently over 300, you can increase the dose by 0.5u. That's exactly what Libby recommended the other day. I don't see the value in holding Tommy's dose for 6 cycles with numbers this high.

In response to your PM about food, I tend to think that food is decidedly an area where the axiom, every cat is different (ECID) holds true. There are some cats, like Jill's Alex, who are incredibly carb sensitive and even a very LC food will bump up numbers. The more you test in relation to when you feed, you'll be able to discern whether this is the case for Tommy. In general, we suggest feeding several small meals a day vs. two big meals. The rationale is that the one large meal each cycle may overwhelm a pancreas that's starting to heal. Instead, feeding several small, LC meals gently stimulates the pancreas to produce endogenous insulin vs. dumping a banquet into your cat's system. The smaller meals may also help to prevent BG levels from dropping too quickly, especially if you have a cat like mine who has a penchant for drama. Again, this is an ECID issue -- not every cat has fast, early drops that we offset by front-loading the cycle with food.

I do think that for many cats, they are not getting the nutrients from food absorbed into their system due to their diabetes. In fact, they lose weight. Once numbers start coming down, you need to begin to cut back on the amount you're feeding otherwise, you will have a very roly poly cat. In general, feeding something above what your cat's necessary caloric intake should be may be fine until Tommy's regulated, as long as your cat doesn't continue to lose weight. When I first started here, the thinking was to feed as much as my cat wanted to eat. Gabby is now overweight which doesn't help with the FD, either.
 
Re: 3/22 Tommy amps 469, +3 380,+6 422

Squirrel.. I only want to comment because Sienne addressed it, but I too agree with her & Libby about not holding the doses for 6 cycles. I read yesterday's condo & it being suggested that you hold the dose 6 cycles & did not want to overstep my boundaries because I am not an advisor, the #s are higher right now & I think increasing as Libby & Sienne say is an excellent plan of care ;-) Good Luck!
 
Re: 3/22 Tommy amps 469, +3 380,+6 422, +8 451

There we go. :RAHCAT I was looking for Sienne, or Libby, or Jill or someone to step in. I must have overlooked Libby's post. Sorry. Nicole... as long as it's with me, you are never overstepping your boundaries. I promise. :-D Just don't smash me and we're all good. There's a nice way to approach everything ;-)

Ok Squirrel, do you understand what Sienne is saying? If not, ask ask ask.. and if need be, PM people so they will come to your condo.
 
Re: 3/22 Tommy amps 469, +3 380,+6 422, +8 451

Evening every one. First, Sienne, again I'm sorry i haven't linked the prior days posting, I've absorbed a lot of info in the past few days and i forgot to tell you that we found how to link i believe but don't know how you made it say "Tommys Monday Condo". Haven't got a clue about that one, but would love to know. I think you tried to explain but i'm guessing it was either overlooked or not understood.
Thanks for the info again, i want to understand as much as i can about what Tommy is going through.
I do understand that ECID and Tommy is no exception. Baby steps I know.
I've started putting in his ss what type of food and how much so I can get a better idea of how it's affecting his numbers.
Again good call on that one Celia, thanks for mentioning it.
I'll be giving him 5.5U starting tonight. You all have been so wonderful so far. Don't stop fillin my head with input! :?
 
Re: 3/22 Tommy amps 469, +3 380,+6 422, +8 451

To fancy up the links, If you click on the URL button above the text box, this is what will appear: . You then type whatever you want to call the link (e.g., Tommy's Monday Condo) in between the two sets of url brackets. You still need to copy the "http://..." location of your previous condo, however, this time you then insert it in the first url bracket with an equal sign (i.e., ).

Here's a link to the [url=http://felinediabetes.com/FDMB/faq.php?mode=bbcode#f4r0]code that is used on the message board. It may be more info than you want!!
 
Re: 3/22 Tommy amps 469, +3 380,+6 422, +8 451

With such high BG numbers, in addition to increasing the dose after 4 cycles, you could also consider using R to help down the numbers. It could help to give some relief to Tommy.

Tommy's ss looks more like you may be having a resistance problem; at a dose of 5u, and getting BG that are high flat pink/red/black, you need to consider a possible high dose condition.
Holding for the 4 cycles and letting Tommy eat what he needs would be preferable. Has Tommy gained some of his weight back?
Please be sure to be testing for ketones daily when you have such high numbers.
 
Re: 3/22 Tommy amps 469, +3 380,+6 422, +8 451

Sienne, once again thank you. I will try to get that to work.
Gayle, your really testing my slang skills here, what the heck does "R" mean. My husband and i just ran every word possible through our minds and got nothing.. You're probably gonna say something that should have been very obvious.
Does it have something to do with Pirates! :lol:
 
Re: 3/22 Tommy amps 469, +3 380,+6 422, +8 451

it's nice to see some pink (and even a yellow!) instead of all that red. Come on, Tommy, keep going!
 
Re: 3/22 Tommy amps 469, +3 380,+6 422, +8 451

I've tested 4 out of the last 5 days for ketones. I'm not sure if you saw that on his ss. So far all is negative.
Tommy never lost any weight that my husband and I can think of. He's always been a big boy and if anything, he's gained probably 2-3lbs since being diagnosed in December.
Up until December of 2010, Tommy mostly had dry food, with maybe a can given every once in a blue moon for a treat.
He's never had a weight issue i.e. too heavy, too thin, just a big sturdy tomboy.
 
Re: 3/22 Tommy amps 469, +3 380,+6 422, +8 451

Ack, sorry. OK here's the scoop on 'R'.

Think of R as a supplement to your regular insulin. It is pretty harsh but it gets the job done.

Here's some insulin info for you that I hope is helpful:
Onset is the length of time before insulin reaches the bloodstream and begins lowering blood glucose. Insulins with long onset (2 to 4 hours) are typically the long-acting insulins, or those that have long duration. Those insulins with the shortest onset times (30 minutes) belong to the fast-acting category, or those with relatively short duration. The intermediate-acting insulins have a 1-2 hour onset with 8-12 hours of duration.
Duration is the length of time an insulin continues to lower blood glucose.
The four duration categories are:
* Rapid-acting or Fast-acting insulin begins to work shortly after injection, peaks in about 1 hour, and continue to work for 2 to 4 hours.
* Regular or Short-acting insulin reaches the bloodstream 30 minutes to an hour after injection, peaks anywhere from 2 to 3 hours after injection, and is effective for approximately 6-8 hours.
* Intermediate-acting insulin generally reaches the bloodstream about 1-2 hours after injection, and is effective for about 8 to 12 hours.
* Long-acting insulin generally reaches the bloodstream about 2 to 4 hours after injection, peaks 4 to 8 hours later and is effective for about 12 to 18 hours.
Note that an insulin that is long-acting in humans may be intermediate-acting in cats. The duration classes used here are for humans and usually match those in dogs -- their classifications in cats are somewhat shorter due to cats' faster metabolism.

Carryover or carry-over refers to insulin effects lasting past the insulin's official duration. It's been observed that some long-acting insulins leave an insulin depot[1] under the skin that has a small residual effect that may last anywhere from 12 to 48 hours, after the principal action has ended. Note* this effect is primarily observed with insulins like Lantus and levemir.

Overlap refers to the period of time when the effect of one insulin shot is diminishing and the next insulin shot is taking effect. Caregivers can purposefully manage overlap to increase the effect of insulin on their pets' blood glucose levels and thus hold the curve of their blood glucose levels fairly flat.
Suppose a cat gets an insulin shot every 12 hours, gets 15 hours duration from each shot, and is on an insulin that has a three hour onset. During the 3 hours after each insulin shot, there will be two insulin shots working to reduce blood glucose levels: the diminishing previous shot and the rising current shot. This may mean that the ongoing insulin dose should be less than if no overlap was used.
*consider the principal action of the insulin to be its onset, peak, and duration. If you shoot insulin again before the duration has expired, there will be overlap. Carryover is whatever small residual effect is left after duration has expired.

OK with your Lantus/Lev basal insulin, it usually does not start to kick in for 3 or 4 hrs, so what you can do is also use a bolus insulin, a fast acting one like Humulin R, and it starts to kick in within the first few hours, then it fizzles out by the time the basal insulin starts to work.... think of a relay race. Have the first guy be really fast and that's the R. Then at the 3hr mark, the R hands the baton off to L, or your basal insulin.

When you get a ps of say 451, you can give Tommy 2 shots. One will be his shot of basal insulin (5.5u Lev), and the other shot will be .25u R, the bolus insulin.
The R will pull that 451 down fast, within a couple hours, but R lasts for maybe 4hrs or so, and just as the R is expired, the Lev kicks in and will take Tommy down a bit lower.

You have Tommy on a leash and he's too far ahead so R is like a big yank on the leash to pull him back fast.

Using R needs to be done carefully because it's quite powerful, and each cat is diff.
I have 2 acros and one is very sensitive so if I give her .5uR, she could come down a good 150 in her BG; if I give Ollie any R, he does not come down as much and I need to give him at least 1uR.

If you want to start using R, just let us know and we can help you get set up. You will need to start with a very tiny dose and be around to test every hour until at least +4. I do not give any R unless numbers are 400 or higher, and not when I will be away from home. Others do use R for higher 300s though.

If you have any questions, please ask.
 
Re: 3/22 Tommy amps 469, +3 380,+6 422, +8 451

My husband and I just got done reading your post and that all makes complete sense to us. I'll let you know about moving in that direction, as of right now we must stick with what we are doing as we are very limited financially. Thank you very much for the care in explaining in such detail so we could understand. Once again, this is a never ending learning experience and i'm glad i found you guys!!! :YMHUG:
P.S. So I'm guessing it had nothing to do with Pirates...... RRRRRRRRRRRRRRRRRRRRRRRgh!!!! :-D
 
Re: 3/22 Tommy amps 469, +3 380,+6 422, +8 451

I should add that the cost of R is very very CHEAP. It lasts forever, and does not expire like Lantus or Levemir. You could also same some money by switching to Levemir as Lantus is iffy after maybe 28days, but Lev is said to be good till maybe 42 days. Lev's also more gentle and you may need a lesser dose of Lev. Just a suggestion to consider.
Using R may bring down Tommy's numbers so that you don't have to worry about his getting very sick, such as with ketones, which is not something you want to have.

I do know that the Lantus is quite an expense as are the strips for testing, but if the use of R can bring down Tommy's numbers, he will be feeling better, all around.

And no pirates or plank-walking.
 
hang in there, Squirrel. Tommy had some yellow yesterday, and he had almost 100 point drops last night and today. His numbers are still high, but they are starting to show some movement so you can see that the insulin is starting to work.

In all honesty, because of those 100 point drops I think adding R right now might be premature. R is best used just to take the edge off of the numbers, not to create huge drops (big drops can cause bigger bounces, and he doesn't need to bounce any higher!). For sure I wouldn't recommend using it at preshot time for Tommy. He is getting drops of almost 100 points with just the Lantus, so adding R at preshot would probably set him up for too fast a drop. Adding a tiny dose of R late in his cycle (after nadir) might help him hold his numbers a little lower, but only if/when you're ready. It does require more testing, and that means more money for insulin, syringes, and test strips.

I realize that there are a lot of opinions about how to use R, but that is my take based on Tommy's spreadsheet. :smile:
 
Hi Squirrel,
What meter are you using for testing Tommy?
The Relion meter is very good, and the strips are a great deal cheaper than the strips for other meters.
 
I believe i've posted it already, i can't remember when, I've been using the reli on meters since the beginning. I have 2 of them.
I really need to get the profile done. So sorry i haven't yet.
I can get 50 of them for $20 at walmart. Best price i have found so far.
Have a good morning all! :smile:
 
I hope you see some progress with this increase to 5.5u. From the looks of Tommy's ss, you could start considering 1u as your next dose increase since Tommy's looking very underdosed.

Aside from the numbers, how is Tommy acting?
 
Since you are starting to see some lower numbers and a bit of movement, I would stick to no more than 0.5u increases, as the protocol suggests. One unit increases are best left to much higher doses than Tommy is currently at with numbers that are showing no movement, IMHO.

I also agree with Sienne and Libby's suggestion regarding getting the dental done. If there is an infection/inflammation in the mix, it can cause/contribute to high numbers that don't respond much to insulin.

Hang in there, you're doing a good job. How is Tommy's behavior? In addition to testing for ketones, any behavior changes are important indicators to watch for. You may notice that some of us talk about the "5 P's"....peeing, pooping, preening, playing and purring. Changes in those things often are early warning signs of issues.
 
Laurie and Mr Tinkles said:
Since you are starting to see some lower numbers and a bit of movement, I would stick to no more than 0.5u increases, as the protocol suggests. One unit increases are best left to much higher doses than Tommy is currently at with numbers that are showing no movement, IMHO.

I also agree with Sienne and Libby's suggestion regarding getting the dental done. If there is an infection/inflammation in the mix, it can cause/contribute to high numbers that don't respond much to insulin.

Hang in there, you're doing a good job. How is Tommy's behavior? In addition to testing for ketones, any behavior changes are important indicators to watch for. You may notice that some of us talk about the "5 P's"....peeing, pooping, preening, playing and purring. Changes in those things often are early warning signs of issues.
Click to expand...

I concur with the 1u increase suggestion. This comes from years of multiple cat experience, both my own and also that of Gayle. I see this wait wait wait mentality that can be very dangerous with a cat with higher insulin needs.

This cat has gained 2-3 lbs since dx. We must learn to read between the lines. Do you know of any unregulated cats that have gained weight? Anyone know of any unregulated cats with infections that have gained weight? Anyone know of any cats that don't move at all that are not afflicted with a form of insulin resistance? Insulin resistance does not go away with minor increases. It does not go away with slow increases. And it does not go away following this protocol. Does anyone know how to recognize insulin resistance? Insulin resistance looks like this spreadsheet. Take the last 7 days: Black red and pink. There are no inverted curves. There are no curves. At these numbers, taking meter variance (allowed 20%) into account, these numbers are not moving. They are the same number, day in day out, hour after hour after hour. 416 becomes 384 becomes 452 becomes 418 becomes .....ONE yellow. Fluke. Hairball? Ran out of food? Big feel-good poop?

We experienced high dosers use a stepped up version of this protocol to break insulin resistance, but it's no less methodical than this one. For those of you who don't know how high these doses can get, we have one user headed for 70u BID, we have one who peaked at 62u BID (+ another 50 or so units of R a day), we have one who peaked at 40u BID (+20u R a day) and we have multiple cats who have hit 30 +/- units BID. The longer you play around with little slow increases, the harder the resistance fights back. The longer you mess around and don't fight that resistance, the higher your ultimate dose will be.

Please do not override a very experienced user who can recognize an insulin-resistant cat at 20 paces. Just because you don't see us doesn't mean we don't know what we are talking about. The reason you don't see us is because of the responses we get when we recognize someone who needs our help. This cat is as safe in Gayle's hands as he would be if he were her own cat. And this cat is not getting enough insulin on this protocol.
 
photosquirrel14 said:
I'll test again at +3. Wish us well.
Click to expand...

Hi there,
I'm sorry I did not stop by sooner but I lost my beautiful boy this weekend, so I've been a bit out of touch. I wanted to stop by earlier, I got a pm asking about your spreadsheet. I'll try to pop in as much as possible and tell you what I see if that would be something you'd be interested in. For now I'd like to commend you on your SS, you've done a great job picking up all those tests! Scritches to your boy..
..C
 
carolyn, with all due respect... and i mean that sincerely. i have absolutely no interest in starting WWIII. i think i can safely say that most, if not all of us, agree there is some sort of insulin resistance going on and therefore, tommy needs more insulin. i also feel confident in saying each and everyone of us wants the best for tommy.

This cat has gained 2-3 lbs since dx. We must learn to read between the lines. Do you know of any unregulated cats that have gained weight? Anyone know of any unregulated cats with infections that have gained weight? Anyone know of any cats that don't move at all that are not afflicted with a form of insulin resistance?
Click to expand...
yes... all of these things have happened from time to time.

Does anyone know how to recognize insulin resistance? Insulin resistance looks like this spreadsheet.
Click to expand...
yes, there are some people on the fdmb and in the lantus isg who are very, very good at recognizing insulin resistance... and agreed. insulin resistance DOES look like this spreadsheet.

however, since when do we recommend increasing the lantus/lev dose in increments of 1u BEFORE the cat reaches somewhere in the vicinity of 10u bid and/or in the absence of a confirmed HD diagnosis? is this something new?

just asking because the method is not what jojo taught us. instead, she usually suggested R as a bolus along with the basal lantus/lev dose before increasing in increments of 1u bid. once kitty hit around that 10u bid mark, she suggested increasing the basal dose in increments of 1u bid and using R in conjunction with the lantus/lev dose when or if needed. some examples (confirmed lantus/lev HD kitties):

joan & madison http://spreadsheets.google.com/pub?key=p_CcmB4pYijiN8Re6MLWxcA

sandy & blackkitty http://spreadsheets.google.com/pub?key=pj18WeQTVaWmyP-SWuUD1Ew

carolyn & spot/leo http://spreadsheets.google.com/pub?key=pkwEJXZdhGd9qOEXJS2VwGg

bonnie & porscha http://spreadsheets.google.com/pub?key=pvl4I2jVAADd8nFaK0NFnaw

KT & buckwheat http://spreadsheets.google.com/pub?key=p8XrdQO76jraLCCP5UlP7Vw

asil & mouf http://spreadsheets.google.com/pub?key=plqcjRqjw-WgTEEGMGHtMNQ

lorna & girlcat http://spreadsheets.google.com/pub?key=p94EDX3UwP_o4qpcvmZ8xYA

gayle & shadoe http://spreadsheets.google.com/pub?key=tYd98PveNPHHTf25HI-iMGQ&output=html

pattie & harley http://spreadsheets.google.com/pub?key=rZPHgg-TSFvA6L9QaiwCymA&output=html


no HD diagnosis (kitty got up to 6u bid, currently OTJ for almost a year)
randi & max http://spreadsheets.google.com/pub?key=tFduqTw-frL8NTG8XRV5IWQ&output=html


some history which you may or may not be aware:

  • squirrel and tommy arrived in the lantus isg last week. prior to that, doses were being held far too long.
  • tommy has had UTIs, blood in urine, bladder infection, and has been on a couple of antibiotics.
  • tommy has a known dental issue which has yet to be resolved. a dental has been suggested.
  • tommy was being fed 15oz-20oz daily.
  • fast-tracking up the dosing scale has been suggested in the form of increasing by 0.5u after every 4 cycles.
  • libby has spoken to the issue of using R with tommy: "In all honesty, because of those 100 point drops I think adding R right now might be premature. R is best used just to take the edge off of the numbers, not to create huge drops (big drops can cause bigger bounces, and he doesn't need to bounce any higher!). For sure I wouldn't recommend using it at preshot time for Tommy. He is getting drops of almost 100 points with just the Lantus, so adding R at preshot would probably set him up for too fast a drop. Adding a tiny dose of R late in his cycle (after nadir) might help him hold his numbers a little lower, but only if/when you're ready. It does require more testing, and that means more money for insulin, syringes, and test strips." http://felinediabetes.com/FDMB/viewtopic.php?f=9&t=39553&p=420628#p420628
  • frequently checking for ketones has been recommended.
  • testing for acromegaly and IAA has been suggested.

as you can see, we've been going about this systematically over the last week, as well we should.


if increasing the dose in increments of 1u bid before
  • a high dose has been reached (no, i no longer consider 5.5u a "high dose", especially when there are other health issues present)
and/or
  • a high dose condition has actually been confirmed
is now an acceptable and successful practice in the acro group on Facebook, will you please point us in the direction of these spreadsheets?

methods change and improvements made constantly. i couldn't begin to list all the changes (for the better) i've seen since I arrived here in 2006.
do share. we not only welcome, but we embrace new methods/improvements which are successful in treating our diabetic kitties.
 
Oliver's ss was missed in the links you provided:

ss link removed

We introduced R into the picture at a dose of 3.5u Lantus, and he had not been confirmed as resistant yet.
I think had we not gone the way of R to pull down numbers, I would have been more aggressive with the dose increases.

Shadoe and Max were neck to neck, going up the dosing, but if you look at the 2 ss, you will see the difference. If you were to compare Max's ss to Tommy's you would see little similarities - comparing Shadoe and Tommy's ss, you will see the same progressions. Actually, if you compare Oliver and Tommy, you see my concerns.

While acro is for life, IAA is not, and without testing, there may well be cats like Max who could have tested positive for IAA but they were able to beat back the resistance and reach OTJ status. We'll never know, but it's a possibility. Just sayin'..

Quite often, methods are adjusted and revised and improved. Based on past experiencess, it is found that quicker reaction could be the better way to nip some high doses in the bud; hesitation only allows the resistance to take root and be harder to treat.
Sometimes, you need to get in front of the bus if you want to be able to slow it down; running behind the bus does not get you very good results.

I am pretty sure that by my being more aggressive upfront with Oliver, by starting the R early, we were able to stop and rid him of the IAA portion because he does not need R now as he once did. It's important to watch for conditions and try to stop them before they get strength and get away from us.

I do believe that with Shadoe, I waited too long, progressed too slowly with dosing, but I learned from those mistakes and improved on approach for Oliver. And I think it made a difference.

When you have been there, you see it in others. Little things jump out at you and bit by bit, it adds up to the point where your spidey sense starts buzzing. It could be wrong, but not often, so best to warn than be silent.

Edited to remove link to SS for Oliver and would appreciate if Shadoe's ss not be used as I am also an other poster.
 
Gayle and Shadoe said:
Oliver's ss was missed in the links you provided:

https://spreadsheets.google.com/ccc?key ... l=en#gid=0

We introduced R into the picture at a dose of 3.5u Lantus, and he had not been confirmed as resistant yet.
I think had we not gone the way of R to pull down numbers, I would have been more aggressive with the dose increases.

Shadoe and Max were neck to neck, going up the dosing, but if you look at the 2 ss, you will see the difference. If you were to compare Max's ss to Tommy's you would see little similarities - comparing Shadoe and Tommy's ss, you will see the same progressions. Actually, if you compare Oliver and Tommy, you see my concerns.

While acro is for life, IAA is not, and without testing, there may well be cats like Max who could have tested positive for IAA but they were able to beat back the resistance and reach OTJ status. We'll never know, but it's a possibility. Just sayin'..

Quite often, methods are adjusted and revised and improved. Based on past experiencess, it is found that quicker reaction could be the better way to nip some high doses in the bud; hesitation only allows the resistance to take root and be harder to treat.
Sometimes, you need to get in front of the bus if you want to be able to slow it down; running behind the bus does not get you very good results.

I am pretty sure that by my being more aggressive upfront with Oliver, by starting the R early, we were able to stop and rid him of the IAA portion because he does not need R now as he once did. It's important to watch for conditions and try to stop them before they get strength and get away from us.

I do believe that with Shadoe, I waited too long, progressed too slowly with dosing, but I learned from those mistakes and improved on approach for Oliver. And I think it made a difference.

When you have been there, you see it in others. Little things jump out at you and bit by bit, it adds up to the point where your spidey sense starts buzzing. It could be wrong, but not often, so best to warn than be silent.
Click to expand...

couldn't agree with you more, gayle. that's why increasing in increments of 0.5u after every four cycles, using R, and the suggestion to have both the IAA and acro tests done have been made. i think what you're seeing is something several of us have seen in the past week.
 
Sorry to bump this old condo again.

Carolyn, you asked if anybody here knew how to spot insulin resistance. I think we do, but if we are getting it wrong then please teach us. I think you would be surprised at how many people on FDMB *want* to learn how to recognize and handle cats that appear to be resistant, but there is little opportunity on FDMB to do so.

To that end, I have opened a condo for Jazzy: viewtopic.php?f=9&t=39706 I don't mind using myself to start a conversation, so please comment there.
 
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