Insulin increase and Diet

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Sorry, I had to step away for a while and do what I thought was right for Ninja. I was so stressed, and I didn't want to start reading and second guessing myself. I just reached the end of my rope, and I said, "God, he's in your hands. I don't know what to do." I think I had to give up on the idea that the vet was going to fix Ninja. If you look at his spreadsheet, you will see his BG is starting to come into range. I think divine intervention brought me to a solution in the form of a bag of fluid and Liver Shakes!!! I think the spirulina in the shake moved him out of insulin resistance. I got to wondering about spirulina and it is actually very good for insulin sensitivity problems and helps to lower the blood sugar. Long story, but the point is he is better. He still has a ways to go but you would be shocked at how much progress he has made in 24 hours!!! He has gone from being syringe fed every couple hours to eating on his own!!!! :bighug: :) :cat: :p :D :joyful: :smuggrin: :woot:
 
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Ninja & Baby said:
Long story, but the point is he is better. He still has a ways to go but you would be shocked at how much progress he has made in 24 hours!!! He has gone from being syringe fed every couple hours to eating on his own!!!!
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So happy to hear this!!!!!!!

Please do keep us posted when you can, we're all keeping you guys in our thoughts. Go Ninja! :):):):):)
 
:bighug:I'm so happy and grateful to all of you because without you guys I wouldn't have even had any idea where to start going out on my own or even knowing I need to home test. If I hadn't done that, I would have never known what was causing his problem. How many others are losing their pets because of vets that don't know or just want to keep their hands in your pockets???
 
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Oh Paula I am so very happy to hear Ninja is improving. :D Your TLC and persistence is paying off. Testing is a big part of this dance and yet there are so many vets that don't suggest it and far too many who try to discourage it. Please do keep us posted and tell Ninja he looks great in pink! :cat::bighug::bighug::bighug:
 
Well, I've been too depressed to post. Ninja went back to his high numbers. However, I put him on a zero carb diet and having success. I noticed he got a little better on the liver shakes, but his numbers were still through the roof. I decided maybe low carbs weren't low enough so I started him on NO carbs. His numbers are quickly getting better. Check out his spreadsheet. He is still very lethargic and has terrible neuropathy. Very sad to see, but I'm hoping that will resolve. Anyone else notice this kind of behavior? It's like he's in a fog. He's that way this morning and his BG was 123 AMPS.
 
Paula, I was wondering why I had not seen any posts from you lately. I'm glad to see the diet change is helping though :). I recently (yesterday) discovered how much the DM dry was keeping Maury's #'s up. Fun times (sarcasm) yesterday with our first double digit #'s. When Maury's numbers were staying high, he did seem like he was in a fog. I hope Ninja has some good days coming with new diet, we'll call it "Catkins" :):bighug:
 
Yong said:
When Maury's numbers were staying high, he did seem like he was in a fog.
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This morning his BG was 123 and he seemed almost worse. Almost like a rag doll! Maybe glucose dropping from numbers too high to register on a monitor to almost normal may be causing it???????? Depression from the almost inability to walk???

I'm thinking diabetic cats need no dry food at all--not even Young Again. They are so sensitive to every little thing. I have some of the Young Again, but neither of mine liked it at all!!!

Yong, congratulations on the double digits!!!!!!!!!!!!!!!! :joyful: :D :smuggrin: :cat:
 
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I have seen a few people who agree with the no dry food for diabetic cats but ECID :cat:. As I have learned quite fast :). I just sent for my free sample of Young Again because Maury looooves his crunchy dry food and he needs to gain weight.

I am still very inexperienced compared to others here but maybe since his BG was low for the first time in a while he feels weird at a lower BG? It is possible he is feeling a bit down with the moving restrictions. Maury was definitely sad when he realized he struggled to get to his usual places. I'm hoping to see him progress more as I get his BG under better control:).

Hang in there though! Ninja is a strong spirited boy! He has shown us he still has fight and knows you are doing all you can to help him. :bighug::bighug::bighug:
 
I think human diabetics report that big swings in blood glucose make them feel just as yucky as high numbers alone, and I think our kitties are no different. Ninja's body has gotten very used to those high numbers, so the 123 must feel very very weird.

Is he still eating and drinking well on his own? Any recent ketone tests?

If the neuropathy is the typical diabetic neuropathy, many caregivers have seen dramatic improvements (over the course of weeks-months) using B12 supplementation. The one most people use is called "Zobaline" (NOT "Xobaline"-- it's for humans, and has a cat-toxic ingredient).

I'm still worried there's "something else" that's the root cause of Ninja's high numbers and feeling so unwell, but for now, yay on the lower BG number!
 
Paula, I just saw the note on your spreadsheet about doing furshots and shooting again yesterday. Two important thoughts about that:

1. We don't recommend shooting again after a furshot, because there's no way to know just how much insulin actually went in the first time, so you could end up over-dosing your cat.

2. That said, it's only after doing that yesterday that you finally started to see some movement off of the "HI" readings (I'm assuming that when you say you did the furshot-reshoot "both times" that means the same thing happened for morning and evening shots?). This makes me think that possibly he did get higher doses yesterday and the resulting lower numbers indicate that, possibly, increasing the dose is just what Ninja needs.

If I were you, I'd maybe get a test or two today just to see how he does without insulin (and definitely keep an eye on ketones, too, after the skipped shot this morning), and depending on how the day goes I'd strongly consider upping the dose again tonight, to 2.25U or maybe even 2.5U if you are able to monitor this evening. Again, depending on his numbers today and tonight, so keep posting to get people (esp. the Vetsulin-experienced people) thinking about the issues.

I'm going to go ahead and tag @Jill & Alex (GA) right now, because she has tons of experience in general, and has already given some thought to Ninja's situation. She may have some insights into what is going on with this sudden (welcome!) movement in numbers and what to do next.
 
Thanks for all of your input. I have just updated my spreadsheet with more information. Make sure you check that out.

Yes, Linda, I checked for ketones and not even a trace....but sometimes I look so hard I can't figure out if it's negative or trace.
 
Ninja & Baby said:
Thanks for all of your input. I have just updated my spreadsheet with more information. Make sure you check that out.

Yes, Linda, I checked for ketones and not even a trace....but sometimes I look so hard I can't figure out if it's negative or trace.
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It can be very hard to distinguish between negative and trace even under a bright light. Do the best you can.
 
Nan, I thought about the fur shot maybe being just the extra insulin he needed. At the very least, he had to have gotten at least a little extra when I pulled the needle back out. I increased Ninja's insulin this morning to 2.3. The doctor advised 3u, but I was a little nervous about that.
 
Ah, OK, I saw a 0.0U in the dose column this morning and assumed you'd skipped.

Can you clarify what it is saying-- is it saying that you shot after you got the reading of 561, at what would have normally been around +5 for you? That will make a difference in interpreting the +2 and +4 numbers, if they are not actually +2 and +4, as well as any future numbers. It's tough to get a clear record of a case like this, I might be inclined to start a second row for 2/24 where you can start counting as usual at +1, +2, etc.

As an aside, no matter what we'd expect to see high numbers today, just because we'd expect Ninja's body to react to the low numbers by increasing BG. This can happen in response to low numbers until a cat gets used to them again. We call it a "bounce".
 
Nan & Amber said:
Paula, I just saw the note on your spreadsheet about doing furshots and shooting again yesterday. Two important thoughts about that:

1. We don't recommend shooting again after a furshot, because there's no way to know just how much insulin actually went in the first time, so you could end up over-dosing your cat.

2. That said, it's only after doing that yesterday that you finally started to see some movement off of the "HI" readings (I'm assuming that when you say you did the furshot-reshoot "both times" that means the same thing happened for morning and evening shots?). This makes me think that possibly he did get higher doses yesterday and the resulting lower numbers indicate that, possibly, increasing the dose is just what Ninja needs.
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I agree with both of Nan & Amber's points. I think you'll probably have to take Ninja's dose higher than 2u BID to pull his numbers down into a better range. However, my experience with insulins used for feline diabetes is limited to Lantus, Levemir, and N. I'd like to see those experienced with vetsulin or prozinc dosing with a ketone prone cat guide you with dosing. Have you continued with vetsulin or prozinc? I can't be sure by looking at his spreadsheet.
Nan & Amber said:
I'm going to go ahead and tag @Jill & Alex (GA) right now, because she has tons of experience in general, and has already given some thought to Ninja's situation. She may have some insights into what is going on with this sudden (welcome!) movement in numbers and what to do next.
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Ninja simply needed insulin. IMHO, we're seeing movement now that he's getting insulin on a regular basis and because the dose is being increased commensurate with need.
Ninja & Baby said:
Thanks for all of your input. I have just updated my spreadsheet with more information. Make sure you check that out.
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I see you stalled his AM shot and administered 2.3 units insulin. Just a suggestion... it would be helpful if you made a notation somewhere on his spreadsheet noting at what +hour the shot was given because we're all in different time zones and we don't know the usual clock time of his shots.
Ninja & Baby said:
... I checked for ketones and not even a trace....but sometimes I look so hard I can't figure out if it's negative or trace.
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Sometimes it is hard to tell the difference. I found it helpful to view ketone test strips in natural light, but if it's not sunny enough, try looking under the brightest light you have in the house.
Ninja & Baby said:
Nan, I thought about the fur shot maybe being just the extra insulin he needed. At the very least, he had to have gotten at least a little extra when I pulled the needle back out. I increased Ninja's insulin this morning to 2.3. The doctor advised 3u, but I was a little nervous about that.
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I'm following your logic, but please be careful about shooting again after a fur shot. The fact that Ninja needed a dose increase definitely worked in your favor this time, but it could turn out to be a mistake under a different set of circumstances.


Edited to add: I'm sooooooooo happy he's not throwing ketones!
 
Still a little confused about the times of those two tests (350 and 561) and the shot itself relative to the usual shot time (and last night's shot)-- you can add those in as notes somewhere without having to do a lot more re-formatting if you like.

I don't think there's anything to do but sit tight, keep him eating/drinking, keep an eye on ketone status, and monitor BG as usual. We'll see if the 2.3 can bring that down some!
 
I'm confused how to note it. What happened was I checked his BG first thing (5:10 a.m.) this morning and it was 123. At that point, I chose not to inject. I fed him a small meal and checked again at 7:59 a.m. It was 350. I fed him a larger meal and checked in about an hour and a half (9:40 a.m.) and it was 561. At that point, I injected him with 2.3u. I checked BG again at 12:08 and it was Hi. Shouldn't it have already brought it down by then? I just checked his ketones and he is clear.
 
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Great news on ketones!

On the spreadsheet: sorry if I'm making this more confusing! The main thing is just to stick with the "+" time notations, so maybe just go back to the way you had it but change the 9:45am to +whatever it would be relative to your usual shot time. I think if you do that it should be pretty clear to other users, especially if you also write a little note in the "notes" column.

Where it might become important is tonight when you go to shoot, anyone offering advice will need to be aware of the shift in times. Vetsulin is largely short-acting so there isn't likely to be a huge problem with shot overlap if you shoot closer to your usual time (which would be less than 12hrs from this morning's shot), but the possibility is something people should be taking into account when giving advice.
 
Well since I gave him his shot at 9:53 this morning, I thought maybe 9 p.m. I'm so tired and so burnt out, and so broken hearted I can't even think to share all the necessary information.
 
I think I agree that I'd like to see the numbers in the note entered into colored boxes on the spreadsheet (they are easy to miss if they are only in the note). Probably best the way you had it originally-- 123 for AMPS, blank for the shot, then the 350 and 561 in +3 and +4.5, then the shot noted in +5.

I totally hear you on the fatigue-- when we care so much for these little guys, it's heartbreaking to see them feeling lousy. :bighug::bighug::bighug:
 
Just checked the spreadsheet, and it has a dose of 3.0U for tonight I think? Would be good to monitor on this one-- I do think he needs more than 2.0U, but that's a big jump.

Really wish some of the Vetsulin people would weigh in with opinions. Paula, would it be possible to start a new thread with a "?", and asking for specific Vetsulin dosing guidance? It might get some fresh eyes on Ninja's situation.
 
I unfortunately am going to have to sign off now-- Paula, please do start another thread, especially if you start getting some low numbers. We do want the low numbers, but we also want to keep Ninja safe, and we don't know yet what the dose jump from 2.0 to 3.0 is going to do-- please get a few numbers tonight, and post if you need guidance! :bighug::bighug::bighug::bighug::bighug::bighug:
 
Paula, just checking to see how things are going. How are you doing? Have you been able to get any rest? How's Ninja? Have you had a chance to test for ketones lately? Sorry, one more question... would you clarify for us... are you still administering prozinc or did you go back to vetsulin?
 
@Yong I had a bad feeling when Ninja started reading high and wasn't dropping at all despite getting insulin. I've never seen anything like that and wonder if there was something else going on. And now with the silence and the SS, I fear the worst. This can be such a complicated disease to deal with and sometimes it's a guessing game. I still have a feeling the insulin dose was too high rather than too low but with the history of DKA, deciding what to do was a gamble at best. It's times like this that I wish with all my heart that vet's were far better educated and cautious about dealing with our sweet fur kids. Far too many don't seem to know enough to deal with situations like this.:(
 
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