Smiffy's progress end September

[Looby & Smiffy]

Sounds like a plan.

She's sitting in the garden in the grass in the sun as happy as a bunny right now - full of confidence and happy just being ... sooo lovely to see

Did you see her lower +4 today - just 10.1 (180) so nicely back in the blues today

And I bit of pancreas activity overnight holding that +4 number last night until this morning

My faith in Caninsulin and Smiffy's pancreas restored

 

[MrWorfMen's Mom]

Smiffy is looking good! GO SMIFFY! A whole lot of patience is required with our sweet furry kids! Like us they have their ups and downs but they can't tell us about them so we're left guessing about what's going on. Sometimes it's better not to focus so much on the individual numbers and pay more attention to other signs of how they are feeling. Sometimes Menace is more playful when her numbers are higher than I'd like so I've learned to just take one day at a time and not get in a tizzy over a day of yucky numbers.

 

[Looby & Smiffy]

I agree that over 150 I would have given a small dose, esp since it's a human meter. A reading of 180 could easily be like a 220 on my alpha track. She isn't using needles though which is limiting what she can dose.

Eh hem "she" has a name! Only kidding

Smiffy is looking good! GO SMIFFY! A whole lot of patience is required with our sweet furry kids! Like us they have their ups and downs but they can't tell us about them so we're left guessing about what's going on. Sometimes it's better not to focus so much on the individual numbers and pay more attention to other signs of how they are feeling. Sometimes Menace is more playful when her numbers are higher than I'd like so I've learned to just take one day at a time and not get in a tizzy over a day of yucky numbers.

You are so encouraging and positive and helpful - like a breath of fresh air .... so pleased Smiffy has you as her friend

 

[Capoo]

Smiffy was 16.2 (290) last night at +3 and she is the same this morning at her AMPS so she has held that number for 9 hours even though it is a high one. Surely that would indicate that there is some pancreas activity and/or the Caninsulin/Vetsulin lasts the full 12 hours for Smiffy.

I don't understand your conclusion when you say that there is some pancreas activity when Smiffy keeps a BG at 290.

 

[Looby & Smiffy]

I don't understand your conclusion when you say that there is some pancreas activity when Smiffy keeps a BG at 290.

To hold the same number for 9 hours .... either that or the Caninsulin held her number for the full 12 hour duration.

I said and/or not definitely pancreas activity ... it must be one or the other or a combination of the two so I am optimistic

 

[Capoo]

To hold the same number for 9 hours .... either that or the Caninsulin held her number for the full 12 hour duration.

I said and/or not definitely pancreas activity.

I cannot agree with that sentence.
If there was some pancreas activity, or an effect of Caninsulin for the full 12 hours, you would see a drop in BG between AMPS and PMPS.
Here, when BG keeps constant with Caninsulin, you can :
- have done a fur shot (or something else that ends in your cat not receiving any insulin, or not enough of it),
- meet a Somogy effect (or a rebund, whatever you name it).

 

[Looby & Smiffy]

I cannot agree with that sentence.
If there was some pancreas activity, or an effect of Caninsulin for the full 12 hours, you would see a drop in BG between AMPS and PMPS.
Here, when BG keeps constant with Caninsulin, you can :
- have done a fur shot (or something else that ends in your cat not receiving any insulin, or not enough of it),
- meet a Somogy effect (or a rebund, whatever you name it).

That's OK Sophie - we can agree to disagree

I definitely didn't give Smiffy a fur shot and if I had done then I think her BG would have been even higher by the morning preshot number.

I don't know what the 'Somogi' or 'Somogy' effect is but I don't think it is the same thing as a 'bounce' from the liver?

The reason I say it could be her pancreas working a bit is beacuse she has demonstrted more than a few times that her pancreas is working sometimes for example of course when hse had the run of low numbers for five days.

Also she has had more than a few days when she goes down after her AMPS, then goes up a bit as you would expect but then by her PMPS she has gone down again. In this instance I don't think there is any other explaination for it even taking monitor variance into consideration.

 

[Capoo]

Lucille,

The Somogy effect, still subject of controversy, is well explained on the website of Vetsulin:

http://www.vetsulin.com/vet/Monitoring_Somogyi.aspx

It can be assimilated to the bounce effect.

What is interesting in that article is:
- what can suggest a Somogy effect is when you have persistently high blood glucose values (I would say that your reading of 290 with a human meter is a high value) with no discernible nadir (rebound hyperglycemia can persist for a few days following the hypoglycemic event),
- Hyperglycemia due to a Somogyi effect can persist for as long as 3 days after a single hypoglycemic episode. As a result, blood glucose concentrations do not always stabilize within a few days after lowering the insulin dose.

They say that the Somogy effect is seen when BG approache hypoglycemia, but also when the blood glucose concentration falls too rapidly. With your case, I would more suspect a too rapid fall than an approach of the hypoglycemia range.

I'm also a little bit concerned by your story about Smiffy peeing outside the litter box.

 

[Looby & Smiffy]

Lucille,

The Somogy effect, still subject of controversy, is well explained on the website of Vetsulin:

http://www.vetsulin.com/vet/Monitoring_Somogyi.aspx
It can be assimilated to the bounce effect.

What is interesting in that article is:
- what can suggest a Somogy effect is when you have persistently high blood glucose values (I would say that your reading of 290 with a human meter is a high value) with no discernible nadir (rebound hyperglycemia can persist for a few days following the hypoglycemic event),
- Hyperglycemia due to a Somogyi effect can persist for as long as 3 days after a single hypoglycemic episode. As a result, blood glucose concentrations do not always stabilize within a few days after lowering the insulin dose.

They say that the Somogy effect is seen when BG approache hypoglycemia, but also when the blood glucose concentration falls too rapidly. With your case, I would more suspect a too rapid fall than an approach of the hypoglycemia range.

I'm also a little bit concerned by your story about Smiffy peeing outside the litter box.

Sophie,

That is really interesting and I am going to study it more later so thank you for that

Don't worry about Smiffy peeing outside the litter box - she has been doing if for well over a year if not more! She has brought up the laminate where she has peed on the floor when we are not around .... she is so fussy about her litter tray and she is quite a big cat so if she has done a poo as well she pees towards the front of the litter tray house and it goes on the floor.

 

[Looby & Smiffy]

Lucille,

The Somogy effect, still subject of controversy, is well explained on the website of Vetsulin:

http://www.vetsulin.com/vet/Monitoring_Somogyi.aspx
It can be assimilated to the bounce effect.

What is interesting in that article is:
- what can suggest a Somogy effect is when you have persistently high blood glucose values (I would say that your reading of 290 with a human meter is a high value) with no discernible nadir (rebound hyperglycemia can persist for a few days following the hypoglycemic event),
- Hyperglycemia due to a Somogyi effect can persist for as long as 3 days after a single hypoglycemic episode. As a result, blood glucose concentrations do not always stabilize within a few days after lowering the insulin dose.

They say that the Somogy effect is seen when BG approache hypoglycemia, but also when the blood glucose concentration falls too rapidly. With your case, I would more suspect a too rapid fall than an approach of the hypoglycemia range.

I'm also a little bit concerned by your story about Smiffy peeing outside the litter box.

@Capoo
Sophie,

Are you saying that Smiffy's higher yellow numbers recently have been a Somogyi reaction to the lower blue numbers that she had for five days when I didn't feel the need to dose her?

Are you also saying that I should be careful how I dose Smiffy and not be 'fooled' by the high numbers in case I overdose her and run the risk of causing a hypo?

I was thinking that if Smiffy is back down in the 10 (180) range tonight (and she eats) that I would give her 0.5 units and if she is around 12 (216) to give her one unit. I think you might be warning me not to give her 1.5 units even if she gets up to 16 (290) again?

 

[Capoo]

@Capoo
Sophie,

Are you saying that Smiffy's higher yellow numbers recently have been a Somogyi reaction to the lower blue numbers that she had for five days when I didn't feel the need to dose her?

Are you also saying that I should be careful how I dose Smiffy and not be 'fooled' by the high numbers in case I overdose her and run the risk of causing a hypo?

I was thinking that if Smiffy is back down in the 10 (180) range tonight (and she eats) that I would give her 0.5 units and if she is around 12 (216) to give her one unit. I think you might be warning me not to give her 1.5 units even if she gets up to 16 (290) again?

I'm just saying that:
- For the time being, I don't see any evidence of Smiffy 's pancreas working well again,
- I don't see any evidence of a 12h duration of Vetsulin in Smiffy's organism.

But what I can see is that you still have a lot of levers to pull in order to improve Smiffy 's regulation:
- her diet,
- her insulin dose,
- her type of insulin.

 

[Looby & Smiffy]

@Marlena @JanetNJ @MrWorfMen's Mom

So Smiffy's AMPS was 16.1 (290) but at +4 it went down to a lovely blue 10.1 (180) then it went up a bit at +6 to 12 (216).

She is at PMPS 10.6 (190) so she has come down again in her cycle

I am just giving her 0.5 units and at +2 she is 11.8 (212) and +3 she is 11.6 (209)

 

[Looby & Smiffy]

I'm just saying that:
- For the time being, I don't see any evidence of Smiffy 's pancreas working well again,
- I don't see any evidence of a 12h duration of Vetsulin in Smiffy's organism.

But what I can see is that you still have a lot of levers to pull in order to improve Smiffy 's regulation:
- her diet,
- her insulin dose,
- her type of insulin.

I still don't understand how you meant the symogyi (bouncing) affect was relevant to Smiffy over the last few days? I know she has bounced for her AMPS plenty of times in the past.

I didn't say that Smiffy's pancreas was working well again, I said there have been signs that it is spluttering and working a bit for her again at times.
I believe (and others do too) that there is plenty of evidence that Caninsulin/Vetsulin lasts the full 12 hours for Smiffy most of the time and so I have no real reason to change it at the moment (although as I have already said in this thread, that is up for discussion when I next see Roberta, Smiffy's Vet)

I agree her diet is not the 'ideal' but I am still working on it and it is a lot lower than it used to be even though Smiffy is very stubborn about it.

I am careful with Smiffy's dosing after her AMPS reading as I am not around for her morning Nadir and I don't believe in dosing aggressively with Caninsuiln to push her numbers down into the greens and I have been warned against doing that by one of our mutual colleagues earlier in this thread.

Smiffy's numbers are going down again now so I am very optimistic that her recent higher numbers were a blip or because she was getting used to a few changes recently like her Daddy being away, the thunderstorm and the change of weather and the fact that perhaps her bit of arthritis is giving her a little more trouble than it does in the warmer weather (she is on Seraquin). I am optimistic now that I can hold her under the renal threshold again - fingers crossed

She has made a steady improvement since she has been on Caninsuiln/Vetsulin which is apparent in all her clinical signs and her behaviour. Today I was delighted to see her rolling around in the sun in the grass in our bottom garden unescorted (she had lost her confidence a bit because of changing neighbours and because she felt unwell when she was first diagnosed) and she is purring, playing and wanting to be out and climbing on furniture again just like our old Smiffy.

That is not to say that I don't still need advice and support for her as I do and a lot of time I just need reassurance so thank you for taking the time to read her post and contributing

 

[Elizabeth and Bertie]

INFORMATION FOR NEW CANINSULIN/VETSULIN USERS READING THIS THREAD:

The general advice often given here for newcomers to Caninsulin/Vetsulin is not to aim for a nadir (lowest blood glucose level) lower than 5 - 5.6 (90 - 100). This allows some buffer of safety if the blood glucose actually drops lower than that.
This is because Caninsulin/Vetsulin can drop the blood glucose 'hard and fast' in many cats. A caregiver needs time to learn how their cat will respond.

When the caregiver is comfortable with hometesting and has gathered sufficient data about how their cat responds to insulin, then they should be guided by what their own experience tells them may be appropriate for their cat.


See also:
Vetsulin/Caninsulin user guide
.

 

[Marlena]

Dear Looby, dear all!
I'm really sorry but I can not participate in this discussion any more.
I'm struggling with my own issues and am very stressed, my brain is so affected that I can not trust myself to provide the right advise to Looby.
I will come back when I'm feeling better and strong enough to give support.
I hope that you understand.
Lots of love to everybody, sending healing vines.
Marlena

 

[Capoo]

Dear Looby, dear all!
I'm really sorry but I can not participate in this discussion any more.
I'm struggling with my own issues and am very stressed, my brain is so affected that I can not trust myself to provide the right advise to Looby.
I will come back when I'm feeling better and strong enough to give support.
I hope that you understand.
Lots of love to everybody, sending healing vines.
Marlena

Take care of yourself, that's the most important.

 

[Marlena]

Take care of yourself, that's the most important.

Thank you so much.

 

[Looby & Smiffy]

INFORMATION FOR NEW CANINSULIN/VETSULIN USERS READING THIS THREAD:

The general advice often given here for newcomers to Caninsulin/Vetsulin is not to aim for a nadir (lowest blood glucose level) lower than 5 - 5.6 (90 - 100). This allows some buffer of safety if the blood glucose actually drops lower than that.
This is because Caninsulin/Vetsulin can drop the blood glucose 'hard and fast' in many cats. A caregiver needs time to learn how their cat will respond.

When the caregiver is comfortable with testing and has gathered sufficient data about how their cat responds to insulin then they should be guided by what their own experience tells them is safe.


See also:
Vetsulin/Caninsulin user guide
.

Thank you Elizabeth

 

[Looby & Smiffy]

Dear Looby, dear all!
I'm really sorry but I can not participate in this discussion any more.
I'm struggling with my own issues and am very stressed, my brain is so affected that I can not trust myself to provide the right advise to Looby.
I will come back when I'm feeling better and strong enough to give support.
I hope that you understand.
Lots of love to everybody, sending healing vines.
Marlena

I am so sorry to hear that things are so stressed for you at the moment .. well I knew that you had a lot on your plate my lovely.

Hope that Simon and Rocky get better soon and that you can have some peace of mind.

Thanks for your help for so very long and hope that things get better for you soon and that we will see you again soon.

Love and hugs,

Looby and Smiffy xxxxxx

PS Will stay in touch otherwise every now and then

 

[Looby & Smiffy]

@MrWorfMen's Mom @Alexi @Louise1989 @Woodsywife

Smiffy's AMPS is 10.6 so as I am not around to test her at her Nadir I am not going to give her her shot until I know a bit more about what is going on with her numbers now that they are falling lower again .....

I am really pleased for her but I am not going to risk her going into dangerous numbers during the day ......

She is 9.7 (175) at +4 so she is still holding that number from her PMPS last night

 

[Capoo]

I still don't understand how you meant the symogyi (bouncing) affect was relevant to Smiffy over the last few days? I know she has bounced for her AMPS plenty of times in the past.

I didn't say that Smiffy's pancreas was working well again, I said there have been signs that it is spluttering and working a bit for her again at times.
I believe (and others do too) that there is plenty of evidence that Caninsulin/Vetsulin lasts the full 12 hours for Smiffy most of the time and so I have no real reason to change it at the moment (although as I have already said in this thread, that is up for discussion when I next see Roberta, Smiffy's Vet)

I agree her diet is not the 'ideal' but I am still working on it and it is a lot lower than it used to be even though Smiffy is very stubborn about it.

I am careful with Smiffy's dosing after her AMPS reading as I am not around for her morning Nadir and I don't believe in dosing aggressively with Caninsuiln to push her numbers down into the greens and I have been warned against doing that by one of our mutual colleagues earlier in this thread.

Smiffy's numbers are going down again now so I am very optimistic that her recent higher numbers were a blip or because she was getting used to a few changes recently like her Daddy being away, the thunderstorm and the change of weather and the fact that perhaps her bit of arthritis is giving her a little more trouble than it does in the warmer weather (she is on Seraquin). I am optimistic now that I can hold her under the renal threshold again - fingers crossed

She has made a steady improvement since she has been on Caninsuiln/Vetsulin which is apparent in all her clinical signs and her behaviour. Today I was delighted to see her rolling around in the sun in the grass in our bottom garden unescorted (she had lost her confidence a bit because of changing neighbours and because she felt unwell when she was first diagnosed) and she is purring, playing and wanting to be out and climbing on furniture again just like our old Smiffy.

That is not to say that I don't still need advice and support for her as I do and a lot of time I just need reassurance so thank you for taking the time to read her post and contributing

Lucille, I'm sure that my following post is going to be reported, but anyway, I just have to get this off my chest:

- Comment removed by Moderator. -

Now, it's time for you to pull your finger out!!!!

I can easily admit that you have some problems:
- your DH is often abroad,
- you live in a small house,
- you have some anxiety problems,
- you have an aversion for syringe,
- Smiffy doesn't like wet food,
- you have server problem (you gave me this excuse last night when you "were unable to open the link I gave you, and thus, you felt obligated to directly go to FB to pray for a paraphrase about Somogy effect)....
- and a lot of other excuses....

- Comment removed by Moderator. -

In your SS, we cannot see that Smiffy is hitting the healing range, at any time. You have now in hand enough data to predict Smiffy's reactions.
And please, avoid the excuse "I'm not here to watch on Smiffy during the morning", in that case, please find another schedule time for shots that allow you to watch carefully your cat.
You have the advantage, compared to other caregivers, who work all day long, to be able to monitor during the day. At least, take benefit of it!!!!

- Comment removed by Moderator. -

Sorry, I had to tell that. I can of course understand that my post will be reported, but anyway, that's what I think....

 

[Looby & Smiffy]

- Quote removed by Moderator. -

Wow!!!!!

That is really really unkind and uncalled for Sophie - I am really surprised at you! If you really understood my circumstances you would know that I have done very well with Smiffy.

I am really disappointed and terribly hurt by your comments!

Actually I could do very little on my new laptop yesterday - even 'chat' on Facebook was going in and out so I was having a really rough time of it - especially as I am on my own.

I am speechless

@Marje and Gracie help me out here ... I don't want to report Capoo but this is really horrible treatment ..... I am shaking I am so upset .... I don't know what to say!

 

[Capoo]

Lucille,

You need a kick ass in order to improve Smiffy's regulation!

You are on this board for nearly 6 months, you have already received a lot of information, a terrible amount of good advises,...
Now, everything is in your hands : you apply what has been given to you, or you continue as usual....

Once again, I'm totally sure that if Smiffy was transitioned to a 100% wet food diet, she would be in remission. That's not a big deal, isn't it, compared to shoots, tests....

Please note - Switching to a 100% wet diet and a short stint on insulin has often been all it takes for kitty to go into remission, but there are no guarantees.

 

[Looby & Smiffy]

Lucille,

You need a kick ass in order to improve Smiffy's regulation!

You are on this board for nearly 6 months, you have already received a lot of information, a terrible amount of good advises,...
Now, everything is in your hands : you apply what has been given to you, or you continue as usual....

Once again, I'm totally sure that if Smiffy was transitioned to a 100% wet food diet, she would be in remission. That's not a big deal, isn't it, compared to shoots, tests....

I didn't realise you had such a cold heart ....

If you could see the difference in Smiffy and understood my circumstances you would not be so unkind.

There are a lot of people who think I have done really well with Smiffy and it is because I have learned here and followed advice ....

I CANNOT FORCE Smiffy to eat wet food .... some cats just don't eat it .... she has a wet lunch snack and that is the best I have been able to achieve thus far and even then she mostly just licks the jelly and doesn't actaully eat the meat ...

I am beyond speechless - I don't know why I am trying to defend myself .... please don't try to sabotage this thread for Smiffy any further please Sophie!

@Marje and Gracie

 

[Capoo]

please don't try to sabotage this thread for Smiffy any further please Sophie!

To sabotage this thread for Smiffy????
Are you kidding????

I'm telling that's Smiffy isn't the problem here, but that you are the problem here.

You are no more a new-by, you need a kick-ass....

 

[Looby & Smiffy]

To sabotage this thread for Smiffy????
Are you kidding????

I'm telling that's Smiffy isn't the problem here, but that you are the problem here.

You are no more a new-by, you need a kick-ass....

Until I can get Smiffy to Roberta her Vet my aim is to keep Smiffy in numbers under the renal threshold and at the same time not in risk of a hypo by me over dosing her.

Please try to understand my circumstances and all that I have achieved for Smiffy and respect what I am trying to do for her ... I have been following advice here on the Board regarding her sliding scale and dosing and this advice has come from some of your peers.

 

[Jill & Alex (GA)]

THIS THREAD IS NOW CLOSED!
Comments to follow after I've had a chance to review this thread.

@Looby & Smiffy -- Start a new thread if you want to... or don't. It's up to you. However, if you bring up anything posted in this thread I will close that one, too.

​

 

[Jill & Alex (GA)]

This is a purr-fect opportunity for everyone to review the following documents:

Feline Diabetes Message Board (FDMB) Guide to Posting Etiquette
Summary of Community Rules:
The purpose of this community is to help people give their diabetic cats the best care possible. We also recognize that dealing with the illness of a beloved animal companion is often very stressful. Therefore, we follow these basic rules of behavior:

• Be kind.
• Be polite.
• Inform yourself.
• Never personally attack anyone.
• Recognize that reasonable people can differ on many aspects of treatment.
• Check your ego at the door.

Terms of Use/Rules

Suggestions for Advice Givers



Removing my moderator hat, a personal comment...

I've been a member of the FDMB for a long time. I understand and remember all too well the frustration felt as a caregiver. I can also feel the aggravation sometimes felt when being the one offering advice.

That said, the best advice I can offer today...

For those offering suggestions/advice: Sometimes it's best for someone offering advice or suggestions to simply walk away from a given situation. One of my favorite lines from the Suggestions for Advice Givers: "You can offer help and advice, but it's up to the other person to decide what advice to take for their cat. They won't always agree with you -- that's life. If it makes you crazy, move on to someone who is interested in what you have to say."

For caregivers: Sometimes it's in your kitty's best interest to listen and rethink/reconsider advice and suggestions made even when the comments may seem brutal... especially when the same suggestions and advice appears to follow a recurring theme. When the same advice is offered over and over again from multiple members, it may be the best damn advice you're going to get!