Rocky's update 7th July

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Marlena

Marlena

Very Active Member
Rocky's BG is a bit higher today but still considered normal however he is drinking more.
Decided to book him in for a dental work as he's got a bit of tartar and gingivitis. The state of his gums might be causing issues with BGs, he is due for a dental anyway and now, I think is a good time to do it as he is off insulin. I'm going to discuss things with the vet later on and suggest that they perform an abdominal scan at the same time to see his organs. I have a feeling that something is not right as he constantly licks himself under the tail, his stomach (which is almost bald but no skin problem) and his thighs.
Blood and urine tests did not show any particular problem so I think further testing is warranted.
Could you guys let me know what you think and maybe suggest tests which could help to determine what the problem is.
Many thanks for your thoughts.
 
Marlena, a dental cleaning sounds like a good idea and I agree now would be a good time to do that. Might even bring his numbers down a bit more.
As for the licking, if his bloodwork/urine has been normal and he is not displaying any symptoms of GI or elimination issues, I'm not sure an abdominal scan is going to help. Might end up being a big expense for nothing. When did all this licking start? If this started about the time of his diabetes diagnosis, is it possible it's simply become obsessive cleaning as a result of the excess peeing he no doubt was doing before he got regulated? I'd also get the vet to check his anal glands given he is licking under his tail.

Just speculating. Hopefully others will chime in with some other ideas/thoughts.
 
Thank you Linda.
As for cost I don't have to worry about it as I have a good insurance.
I can not observe his toileting habits as he would not use indoor litter tray, he goes outside. If something is very unusual like recently (he probably had bladder infection) then I would notice as I watch him as much as I can. But he might have a bladder stones, it is very common and his brother had it years ago. His urine test only showed that he does not concentrate urine very well which the vet said is due to diabetes. His test was in April. Blood test only showed elevated B12 (I used to give him methylcobalamin for neuropathy) and very low folate which indicates proximal or diffuse small intestinal disease. Vet said that the level of folate is just below the range and did not offer me any advice but I'm not happy with such approach. I know something is not right and I would think investigating before the problem becomes so severe that the cat is very ill makes more sense. Rocky also eats a lot of grass to the point that it bothers me because I know animals eat grass but not like that - every time I see him in the garden he is at it! Very often pica (which is a term for eating non food items) points out to some digestive problems. Rocky also seems very tired and he just flops on the floor which is a bit worrying. I personally don't believe that if blood test is OK but a cat has got some symptoms there is no problem. The problem is that we can not rely on tests 100 percent. I thought once he is under anaesthetic it would be a good idea to see his bladder, pancreas, kidneys etc.
I'm not sure when his licking started but I would say long time ago.
 
If there is a family history of bladder stones and you're only able to monitor his toileting to a certain degree, then maybe a scan would be of some benefit. I agree that if there is a behaviour or symptom that continues no matter the blood or urine results, more investigation is warranted. My theory is that you best of all know your own cat, so if you have a feeling/suspicion something else may be going on, then the vet should go along with your request. Even if they think they are just humouring you, sometimes they get a surprise as my vet did when I insisted on having my girl tested for IAA which is considered rare and my suspicions were proven spot on. :)
 
Wow, thank you.
I often rely on my intuition - it is a primal thing! Ha ha ha.
I don't care what the vet thinks of me as long as I get what I want!:)
BTW what is IAA?
 
Marlena said:
I don't care what the vet thinks of me as long as I get what I want!
Click to expand...
I'm with you all the way on that!

IAA is Insulin Auto Antibodies. All cats have insulin antibodies but some have such high levels that they can't use the insulin effectively and often require huge doses of insulin to get any effect at all. My girl was up to 16u twice daily for a while and that is a tiny dose compared to some cats with IAA. Thankfully the condition seems to wear itself out around about the 1 year mark and that's the phase we are in now. I had her down to 8u twice daily but just had to increase her to 9u this morning because the ride down the dosing scale is a roller coaster ride with some very scary surprise BG drops along the way. I never thought I'd be able to handle this without being totally panic stricken all the time but as with so many things, you become accustomed to your own cat's behaviour and I can usually predict when one of those drops is likely to happen now by her BG patterns and her behaviour so I usually catch her before I end up having a fire drill! :woot:
 
Rocky's BG is going up unfortunately - 9.2 this evening.
I know you going to say it is just one number and still within the range but I have a feeling that I will have to start insulin again soon.
I've just told the vet that Rocky is off insulin and booked him for his dental on Tuesday! We have also discussed other tests Rocky could have and scans as the vet (different that my regular one) thinks he has some intestinal problems.
@MrWorfMen's Mom - you're a clever girl! I would insist on that test as well if my kitty was such a huge dose cat.
Rocky had test for acromegaly twice as I wanted that checked as some cats don't have typical features and symptoms. First test came above the range but not as high as to diagnose acromegaly and the second came just within the range but I was glad I had that cleared from my head.
It is amazing what they can do for our cats now and I'm grateful for that but it is important to have a good vet.
Now I'm watching Rocky's BGs and getting frustrated as I hoped we were heading for that remission!:(
 
Marlena, I think Rocky overheard you talking to the vet about the dental and that made his BG go up! I'm hoping desperately that my silly conjecture is right! ;)

I'm sure there will be a lot of angst when you take the next reading but there's every chance it will be lower again so no panicking! Getting the dental done may bring his numbers down. He's still within the IDEXX range albeit just barely. A smidge over the range is not necessarily an indicator that insulin is needed so don't jump the gun.....he's soooooo close to OTJ!
 
Thank you sweet Linda but I have a gut feeling that there will be no joy as yet.
I hope I'm wrong.
Maybe he will start regulating himself, we shall see.
The good thing is that the new vet seems to be on the right track - I think he is very good so I feel more positive.
See what tomorrow brings.
Thank you for your support.:):cat::cat::cat:
 
Cross my fingers for you and Rocky that his Bg doesn't go up more. Maybe it's just a little spike, it does happen.
Will watch his SS :kiss:
 
Thanks Ruby, maybe it is a spike, I don't know.
He is getting very vocal for more food - to me it's a usual sign that his BG is getting too high. I'm not going to test him anymore tonight as I don't want to get upset about high number which I wouldn't be able to do anything about.
See what numbers we are getting tomorrow.
 
Probably that's the best to do now. Let it go for now and pick up your routine tomorrow.
I know, it gets frustrating, and you are only driving yourself crazy, and that's something we don't want you to do Marlena.
Poor yourself a nice glass of wine (if you drink) otherwise a nice glass of soda, go sit on the sofa and watch your favorite series with your feet up on the table. You deserve to give yourself you time :kiss:
 
Damn! I saw your spreadsheet just now... :banghead: Hope it will be just a spike and that Rocky after this dose will pick up his good numbers again.
 
Ruby, another surprise is that I started using my human glucometer alongside AT2 and guess what? The numbers are the same so yesterday AT2 read 8.4 and OT 8.3 and this morning 10.2 v 10. I don't know what to think about this as previous testing usually showed me a much bigger difference eg. 6.9 v 5.6, 5.7 v 4.1, 7.6 v 6.1.
Have you actually seen some writings about remission on FDMB?
From what I read you need to aim for 50 - 80 (2.7 - 4.4) (on human meter) for strong remission. It is of course for people with a lot of experience and who can monitor closely.
Tanya's site in the L/L forum has all the info.
I'm going to be more aggressive with Rocky as I think he still needs small doses of insulin as 2 failed OTJ trials proved. I really had a gut feeling that he was not ready for OTJ trial but we have to be flexible and try different approaches as what works for one cat does not necessarily work for another.
Oh maybe I feel something is missing from my life when I don't give Rocky insulin (ha ha ha)?
I'm in a good position right now as I'm at home a lot at the moment and I'm going to push my DH to be more helpful so I can go and see my friends and have some fun.
My main concern is the health of Rox and I want him to feel well which means good control of his diabetes and good care - he is going to the vets on Tuesday and I will report everything. I think I will like my new vet and I'm rather hopeful.
Glad you and Baco are doing well and hopefully your BF as well.
Keep us in the know.
Love
Marlena
 
Hey Marlena,

Well that's strang about the difference 'not being different at all' ? Like you said in the past it was a bigger difference.... Strange, I don't know what that could be?

What do you mean? If i've seen kitties in remission on here or do you mean just like a sticky note?

Well you know I don't agree with the remission numbers you are talking about. Because even though Baco is of insulin, sometimes here numbers is a little higher than 4.4. But I know what they mean with that, that are the numbers of a kitty that don't have diabetes. But like you and I've heard earlier, the numbers are between 50 -120 to aim for a remission.

Marlena said:
Oh maybe I feel something is missing from my life when I don't give Rocky insulin (ha ha ha)?
Click to expand...
Haha well I hope not ;)

I understand that you want to be a little more agressive with the insulin dosing, maybe that will work for Rocky.. It's not a bas thing to try it, and you will see in time if that works for Rocky!

Why is he going to the vet?

Thanks Marlena, we are doing great, Baco is still not losing weight but I hope in time with this new diet of counting calories, she will...
My BF is doing great for now, he's here this weekend. Tonight we have been invited to a BBQ at his friends house so we are excited to go!
We just woke up, slept in, and Minnie and Baco weren't pleased that we slept in because if we sleep in that means they get food later! Haha so they were trying to wake us up really bad! :p


Xx:bighug::kiss:
 
Ruby&Baco said:
What do you mean? If i've seen kitties in remission on here or do you mean just like a sticky note?
Click to expand...
Have you seen any articles how to achieve remission?
I don't think there is anything on ProZinc forum, there is a lot on L/L forum though that's why I directed you to Tanya's site. But it is all (I think) about TR so if you prefer a different option which I think you do, it would be a different approach.
Like with everything in life there is no one fits all and there are always two, contradicting ways of doing things. This is just my observation.
Rocky is going to the vet's for dental and other investigations since he's going to be under sedation it is worth checking his organs as there is some indication that he has intestinal disease.
Vet thinks he's got allergies and mentioned prednisolone and it made me scream so I want to test whatever we can in order to try to see whether we can have a better picture. There is definitely something not right I think, that's why Rocky's regulation was so difficult.
I'm observing that his fur is really nice and I think it is due to his FD being under control as sometime ago he had greasy fur and a lot of dandruff.
Please keep your fingers crossed for poor Rox on Tuesday.
I hope Baco will start cooperating with your efforts to slim her down.
:cat::cat::cat:
 
No I haven't seen articles about remission maybe @Sue and Oliver (GA) or @Rachel can help you with that?

Yes I know in the L&L topics there are more article about it but like you said it's TR.
And you know what, every cat is indeed different, not all methods work for every cat and if it did, we would all have our kitties OTJ:p so that would be too easy! Haha. I hope TR works for Rocky!
For Baco I did monitor her really closely and because of all the data I collected I could change the dose a lot so I could 'chase' her a little you know what I mean? I didn't use TR but I was intense working with her and her numbers to understand how much she needed and everytime I could change the dose I would see results most off the times.

Prednisolone, isn't that prednison? Because if it is, don't do it! Baco got it earlier this year and in combo with her being overweight she got diabetes.

I will keep my fingers crossed for you and Rocky, please keep us informed!

:kiss::bighug:
 
Thanks Ruby.
I have read about remission on L/L forum because there is not much on ProZinc about it and I don't know why.
:cat:
 
Boy Rocky is giving you a challenge!

Marlena said:
The numbers are the same so yesterday AT2 read 8.4 and OT 8.3 and this morning 10.2 v 10. I don't know what to think about this as previous testing usually showed me a much bigger difference eg. 6.9 v 5.6, 5.7 v 4.1, 7.6 v 6.1.
Click to expand...

Marlena, you just hit on exactly why it is impossible to accurately convert a pet meter reading to a human one and vice versa.
All meters have a variance allowance as per your country's health regulators. Not sure what that is in the UK but using the 20% allowance from the FDA in the US, each of those meters could at any time be reading 20% higher or lower than actual. Even comparing two human meters, some read a bit higher others a bit lower. If you take your AT2 reading of 8.4 and the OT reading of 8.3 here are the possibilities.
The equivalent lab reading according to the AT2 could have been a high of 10.8 all the way to a low of 6.7.
On the OT is could have been a high of 10 to a low of 6.6.
So if the AT2 meter reads a bit low and the OT meter reads high, the readings could very well appear to be very close.
Usually the results are not that close between a pet and human meter except at low range numbers but it does happen and probably more with some meters than others. Some meters are more accurate at high readings, some at low readings and some across the board so meter comparisons of any sort are approximate at best but they all have to conform to the local health regulators specs for variance allowance.
That is partly why I'm not sure jumping on the insulin for one or two slightly higher readings is necessary but you know how Rocky is feeling/acting and have to judge accordingly and do what you think is best for him.

Fingers crossed that the vet appt. goes well and you figure out what is causing his issues.
 
You can read about and see spreadsheets from remission kitties on ProZinc at the top of this page. IMHO, it is dangerous to apply remission protocols from Lantus to ProZinc. Lantus acts differently -it tends to have a slower onset, lasts longer with a flatter cycle and if the cat drops too low, that onset is slower and easier to slowly bring up. So, yes, a Lantus cat can get a dose on lower numbers and may be okay. But with TR, the protocol often includes having the cat drop into very low numbers and steering those with food. Not something I can advocate.

You might try sending @Robin&BB a private message. She has not been feeling well, but maybe could shed some light on your issue. BB has been getting minuscule amounts of insulin for many months, staying near remission numbers but not able to sustain them without an occasional bit of insulin.

The best idea I have is to pick your shoot number and chase it. So, if you decide you'll shoot 150, wait until he reaches that and give him a tiny dose. Then test until you see 150 again (probably much longer than 12 hours - but always be sure it is at least +10/11) and shoot again. Several people have tried that method with success. It throws you completely off schedule but gives him more time in healing numbers.

I think the vet is a good idea. It could be a tooth issue or small infection that is keeping those levels higher.
 
Yep, I'm with Sue. Applying any protocol from Lantus to ProZinc isn't a great idea, IMHO. Lantus is a different insulin. The reason that Lantus and Lev have a forum together and Prozinc has a forum separate is because you just can't apply one insulins protocol to the other.
 
Thank you girls, you're are great.
It is a shame that this information is not available anywhere, at least I did not find it. I mean information about dealing with numbers leading to remission on ProZinc forum.
I have done some research on the web sometime ago and I remember reading that TR can be done with any insulin apart from Novolin, Humulin but they are not good anyway.
Another point is that the insulin I'm using is so much different then ProZinc and I'm surprised that it is grouped with it.
How familiar are you with Hypurin? Maybe you have information I don't and you could help me understand Rocky's situation better.
The only person who used to advise me in the beginning was Elizabeth but at the moment she is not active here and I will not bother her as she has her own struggles at the moment (we have private contact sometimes).
Many thanks for your input and time.
Best regards
Marlena:cat:
 
You are right in that the ProZinc prescribed in the UK is different than ours. I know little about the way it is different. I'm sorry to hear Elizabeth is having a difficult time; she is such a valued member of this forum. Do you know anyone else who uses it?
 
The ProZinc in the US and the UK are identical. ProZinc and Hypurin PZI however are different insulins. ProZinc is pork based and Hypurin PZI is beef based. My understanding is that Hypurin PZI can last a bit longer than 12 hours so it's similar to but not identical to ProZinc in its action.
 
Sue and Oliver (GA) said:
Do you know anyone else who uses it?
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Sue, it is only Eliz and I using Hypurin. I used to have consultations with Juliet (Dr Schrodinger) but I think she is not active any more.
In the UK we have ProZinc which is human recombinant (synthetic) insulin and 100 percent bovine Hypurin which is long lasting one.
 
In the meantime update on Rocky:
his BGs today are better as you can see on the SS and he seems to be more himself, very patient when waiting for his food, not like on previous days when he would not settle down after food meowing constantly. I have also noticed no drinking as opposed to previous few days when he was drinking too much.
I would prefer not to give insulin but if he's feeling better on it, to me, it signals that maybe he still needs it.
I'm not going to use TR protocol as I understand it from L/L users but I'm using variable dosing and as I've read about it some people like it and use it with great results and some people don't like it.
My main goal is to regulate Rocky and keep him safe, I managed to get him in remission twice already when on Caninsulin so I hope I might be able to do it again.
Wish me luck.
Best regards to everybody,
Marlena:):D:cat:
 
Hi Marlena, how is the beautiful Rocky doing? And how are you doing?
I looked at the ss and it looks okay, not totally on the 'perfect' human BG numbers but he's getting pretty close!
Keeping you two in mind tomorrow when you go to the vets. Keep us updated :bighug::kiss:
 
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