Fred AMPS 331

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Jamye and Fred

Jamye and Fred

Member Since 2015
Sorry I edited the title and took out the pertinent # of 54 @ +5 .
He's never been this low. He's eating FF liver and chicken feast in gravy. His PMPS was 326. What a drop! He's playing with his toy mouse right now. Checking numbers again in 20. Oh this is worrisome. Advise ???
 
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At the moment, he's fine as he's still above 50 but you do want to check him again in 20-30 minutes to make sure he doesn't go lower. As you're following the SLGS protocol, he's also earned a reduction for going under 90 so congratulations on that! :D It looks as though you could actually have taken the reduction last night as he went under 90 yesterday as well - I think he's telling you he's done with this dose. You can reduce by 0.25 to 1 unit in the morning. Please post his next number when you test again so we can make sure he stays above 50 and take action to stop him dropping further if he's gone under 50.
 
Thank you for the quick response. Will reduce to 1.0 at 7 am. Isn't it weird that he went from 326 to 54 in 5 hours post shoot?
 
Great stuff. :) You did well getting him the carbs before he dropped further! :D You might want to give him a little more gravy to bring him up just a bit further - the 60 isn't much of a rise, although definitely more comfortable than 54. And as you're following the SLGS protocol, it's fine to bring him up a bit further at least into more comfortable green numbers at this point. You will need to test again after about another 30 minutes - we don't want him dropping back down at this point.

It was a very big drop and quite fast too so I wouldn't be too surprised if he bounces once his numbers start to come up a bit higher and you see higher numbers for the next couple of cycles at least (a bounce can last up to 6 cycles). It seems like he was determined to be dramatic about having a reduction!! If you do see the higher numbers, don't worry - he'll clear the bounce when he's ready so just stick with the 1 unit until you can be sure that any bounce should be over.
 
Important to note how the cat is behaving. If he's behaving normally with numbers like that, you don't need to go crazy. A normal high protein low carb meal is all that's required and that's more for you than for him. A cat on a low carb diet is less likely to clinically hypo as the homeostatic mechanisms to prevent his are more active. For a tight-regulation regimen, numbers in the 50-120 range are actually the goal of therapy and the more you can keep a newly diagnosed feline diabetic in that range early in therapy, the more likely you are to get a remission.

If you look at my own spreadsheet, you'll note my sluggo had numbers like this yesterday close to peak for his prozinc. All I did was put out another half can of his blue wilderness chicken pate which he ate with relish and I checked him some hours later. It's a good thing, not bad.

Concern is useful. Panic is not.
 
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Sandman said:
For a tight-regulation regimen, numbers in the 50-120 range are actually the goal of therapy
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I fully appreciate that as I follow TR with Rosa and would only give her lc food in the 60s, but Fred is SLGS so already earned his reduction today - I'm not sure we need to keep him hanging around in the 60s and possibly have Jayme having to stay up for 3 or 4 more hours late at night (and with meter variance he might only really be level not actually rising at this point).
 
OK, that's a definite rise. You're doing great! :D If you can offer him some of his regular lc food now - let's see if he'll just rise gradually from this point by himself. Good for another test in 30 minutes?
 
manxcat419 said:
I fully appreciate that as I follow TR with Rosa and would only give her lc food in the 60s, but Fred is SLGS so already earned his reduction today - I'm not sure we need to keep him hanging around in the 60s and possibly have Jayme having to stay up for 3 or 4 more hours late at night (and with meter variance he might only really be level not actually rising at this point).
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Looked at your spreadsheet. Yes, you have seen the benefits of TR. Nicely done!!!
 
Thank you! :D I was lucky enough to have the time to really focus on her dosing and numbers. And I'm glad I did - Rosa's been a real star with her response to insulin and a diet change!!
 
Sorry for the confusion Jayme. You are on SLGS hence the slightly different information I've given you compared to what I'd do with Rosa. We were talking about Rosa's ss in the last 2 posts.
 
manxcat419 said:
Thank you! :D I was lucky enough to have the time to really focus on her dosing and numbers. And I'm glad I did - Rosa's been a real star with her response to insulin and a diet change!!
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A little time and attention spent in TR early on pays big dividends later. Looks like you've had a pretty long go of it, but you managed the reduction methodically and it looks like her pancreas has slowly started to function again. My guess would have been that she'd remain insulin dependent as long as she's gone. But I've been proven wrong.
 
Fred is at 92. Getting him to eat his non-gravy food ain't gonna be easy. :-) Yeah I was really confused there ! I think we're good here. Thanks again and goodnight. GBY
 
Jamye and Fred said:
Fred is at 92. Getting him to eat his non-gravy food ain't gonna be easy.
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We usually like to see another test after 1 more hour to make sure he doesn't drop back as the hc food wears off. If you have to sleep, please leave him a lot of food out - more than you think he could possibly need to make sure he's safe.
 
Sandman said:
A little time and attention spent in TR early on pays big dividends later. Looks like you've had a pretty long go of it, but you managed the reduction methodically and it looks like her pancreas has slowly started to function again. My guess would have been that she'd remain insulin dependent as long as she's gone. But I've been proven wrong.
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I was convinced when she was diagnosed that there was no way she'd ever get off insulin. Her numbers were hideous - higher than almost any other cat I've seen on here...and they stayed there! But like I said, there was some luck involved in Rosa's story - when she was diagnosed I wasn't working so I was able to concentrate on her 24/7. And the last 3 weeks she was on insulin were tough - I was working at that point and my husband was testing her while I was at work as he can work from home most days. But then she decided no-one but me was allowed within 10 feet of her with the test kit so I ended up having to finish my 3 month contract a couple of weeks early and skip a load of AM shots while I was working my notice. Of course she grabbed her last reduction 2 days before I finished work...typical :cat: because at that point I'd changed my hours so I could be here until her +3 in the morning. But I think the skipped shots gave her 3 weeks' more support at a very low level that she wouldn't have got if she'd had the last reduction earlier and I really think that's made a difference. :) Everything happens for a reason I guess even if it feels like it means everything's going wrong at the time!!
 
What's critical I think is the length of time a cat stays hyperglycemic. More important than the numbers. My sluggo had acute pancreatitis, probably hepatic lipidosis and a blood glucose of 560 at diagnosis from a veterinary therapeutic misadventure with steroids for a rodent ulcer on his lip (I subsequently treated by taking away his toys!). But what's critical is those numbers were controlled within a few weeks, so he was OTJ in about a month. It was an ugly time, surgically implanted feeding tubes, multi-pharmacy, a vet hinting at euthanasia because of his anorexia, and TR insulin to boot, but short duration compared with yours.

Now out of remission because of abscessed teeth (since extracted) and with an ongoing insulin requirement. But I'm still optimistic I can get him OTJ. He's pretty close now. Not quite yet, but soon.

But you had a really, really long go of it. Required patience.
 
Well I do know she was diabetic less than 6 months before she was diagnosed which might well have helped - she'd had full bloodwork done at the end of August 2014 for a dental in September and all her values were fine then. And she went downhill from looking and acting fine to really looking like she was at death's door in the space of 2-3 weeks. It does make me wonder if she'd had pancreatitis - with 6 cats in the house (and one that insists on eating plastic and then vomiting on a regular basis) it's really difficult to tell if one isn't eating well or if another one as well as our housemate's crazy idiot has vomited. And we had no reason to monitor her more closely than the others as we had no idea anything was wrong! It really does sound as though Sluggo had a really bad time of it both at his initial diagnosis and with coming out of remission because of his teeth. But his numbers are looking good again now - I'd have thought he's a good candidate for a second remission, especially as you know why he had to go back on insulin for a bit.

I do have patience when it's required - even when I had to finish my work contract early, it really didn't feel like that big of a deal. There are other jobs and I have other opportunities for days or evenings out, but I've only got one Rosa and I had the luxury of being able to put her first for a while. Thankfully it did pay off in the end. And having her back to her normal self is the greatest thing I've seen! :D
 
Sandman said:
If he's behaving normally with numbers like that, you don't need to go crazy. A normal high protein low carb meal is all that's required and that's more for you than for him. A cat on a low carb diet is less likely to clinically hypo as the homeostatic mechanisms to prevent his are more active.
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Just wanted to say - for anyone coming across this thread in the future - that if a cat is in very low numbers and is behaving normally, do not think that they are safe from hypoglycemia.

Absence of symptoms does not mean absence of hypo.
A cat can seem perfectly fine one minute and be having a seizure a moment later. It has happened to members of this forum; and the fact that their kitties were on low carb diets did not prevent that from happening.

Some cats show symptoms when their blood glucose is starting to drop low (maybe they suddenly get hungrier than usual). Some cats show symptoms when the hypo is moderately advanced. But some cats do not show symptoms until the hypo is severe.

Some caregivers know from experience that their cat is fine in lower numbers. Any caregiver who doesn't have that experience should always err on the side of caution. "Better too high for a day than too low for a minute."

Eliz
 
Elizabeth and Bertie said:
Just wanted to say - for anyone coming across this thread in the future - that if a cat is in very low numbers and is behaving normally, do not think that they are safe from hypoglycemia.

Absence of symptoms does not mean absence of hypo.
A cat can seem perfectly fine one minute and be having a seizure a moment later. It has happened to members of this forum; and the fact that their kitties were on low carb diets did not prevent that from happening.

Some cats show symptoms when their blood glucose is starting to drop low (maybe they suddenly get hungrier than usual). Some cats show symptoms when the hypo is moderately advanced. But some cats do not show symptoms until the hypo is severe.

Some caregivers know from experience that their cat is fine in lower numbers. Any caregiver who doesn't have that experience should always err on the side of caution. "Better too high for a day than too low for a minute."

Eliz
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Good grief, man. A little context, please!! We're talking a BG of 54 on a HUMAN METER, which we know reads lower than an alphatrack or any sort of "gold standard" for a feline blood glucose. Furthermore, while I agree extremely low (e.g., <40) numbers should be avoided, and treated when they do occur, you do need to balance that against what is pretty good solid evidence hyperglycemia kills pancreatic beta cells. You really do have a window of time in which to get things under control or you can look forward to a lifetime of pricking your cat's ear and chasing him around your place with an insulin syringe (delightful). So, I think your sanguine opinion with ongoing feline hyperglycemia is as ill-advised as panic over marginally low blood glucose values in a kitty behaving normally, particularly when the cat is already on a low-carb diet and therefore resistant to clinical hypoglycemia in the first place. I'm not saying one should ignore a hypo, but that persistent hyperglycemia may permanently damage a cat as well even when it's not extreme. I was actually quite surprised and impressed the prior poster managed to get her cat OTJ, looking at her spreadsheet. With the glucoses that cat had and the length of time that went on, that was the exception and not the rule. Some kitties may face a lifetime on insulin regardless of anything you do or don't do. Medical students often get depressed when they realize clinical science isn't science at all but horse racing and betting a handicap. I know I did. But your best odds of getting a good outcome mean getting those glucoses under tight control QUICKLY and keeping them there. I did that for my kitty once and am hoping to repeat the experiment a second time.

Diagnosed two months ago with blood sugars in the 300's? Clock is ticking. Time lost is beta cells lost.
 
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Clock is ticking??? I set my alarm for 7 a.m. and he's at 331 AMPS. The challenge now is getting him to eat the non-gravy FF so I can shoot the 1.0.
 
He's happy and playful this morning but +2 @ 343....it was all that gravy. Thanks for your assistance in the wee hours, but y'all wanna take your disagreements elsewhere? Have a blessed day.
 
He's very likely bouncing Jamye - he might hang out in the 300s for a bit or possibly even a little higher before he makes his way back down. Try not to worry - bouncing is normal after time spent in lower numbers than he's used to. It can last anywhere between a few hours and 6 cycles so it might take him a day or so to come back down into blue and green, but he'll get there. :)
 
Lantus takes considerable patience. Small moves and wait quite a while. There's nothing really wrong with it and it has a proven track-record in getting patients otj. But it doesn't suit my control-freak anesthesiologist personality. That and I'd have to much existential angst worrying about dying beta cells...
 
Sandman said:
Lantus takes considerable patience. Small moves and wait quite a while. There's nothing really wrong with it and it has a proven track-record in getting patients otj. But it doesn't suit my control-freak anesthesiologist personality. That and I'd have to much existential angst worrying about dying beta cells...
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Sorry to be blunt, but you aren't qualified to advise a Lantus user following SLGS based on your experience with Prozinc following TR (the Hodgkin's protocol I assume?).
The two protocols are not remotely the same, nor are the two types of insulin.

I am happy for you and your cat that you were able to achieve remission using those methods. I used a sliding scale with PZI and my cat went OTJ in 10 weeks. It worked for him, and for me. But I would never consider advising anyone here to do what I did. IMHO it is a high risk method that requires even more on the caregivers part than Lantus/Lev TR does. Maybe try to adjust your advice on the specific cat and caregiver here or anywhere else you choose to offer advice? What worked for you isn't necessarily the best way to treat FD for everyone. Or every cat for that matter.

@Jamye and Fred - I agree completely with your suggestion to "take the disagreements elsewhere". Probably the Think Tank might be the correct place. I hope that by putting on my " Moderator Hat", I can help make that happen.

Best to you and Fred!

Carl
 
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