Update on Ricky

[PamJV]

Hello,
This is an update on Ricky. Chris just created a spreadsheet for me, but I don't know how to create a link for it to post here. Also after entering data on the spreadsheet to have have to press "Save" or do something to keep the data there? Can someone tell me?

Ricky looked good at the end of March. He had a Fructosamine test March 17th, and I was told that was a good number. He had a heart ultrasound March 27th and that looked stable. Then after that I started noticing plantigait. I posted about that here. Based on on a few home tests at the time it was thought that he might have had a bounce which threw him off. I did have a couple times of giving a "fur shot" and then giving an additional dose, and I was also experimenting with giving a little more than the prescribed 2 units. I now know that was wrong, and yes he could have had a bounce. But I corrected that by sticking to the 2 units exactly twice a day ever after that.

I had much trouble trying to do home testing and basically had given up. But Ricky was looking worse and worse with his plantigait and has has been hiding through out the day so I have pushed my self these last few days to test at home. So I have some results in my spreadsheet called "Ricky's Spreadsheet" but I don't know how to create a link to post here.

To do the tests I have been placing him on my kitchen counter where the lighting is better and I can line up the supplies and reach them easily. Plus it's good that I can be standing rather than trying to squat on the floor for all this. However, this is not a situation where he's going to his favorite place. He is always hiding any way, and I always have to search for him to do a test and pick him up and carry him to the kitchen. He's hiding because he doesn't want to be tested. He feels nervous when I pick him up and place him there, but he does calm down a bit when I wrap him in a towel and pet him. Some times I have poked 3 times before getting any blood. So of course I know these results of mine could be off due to nerves, but it's the best I can do. I know he's not regulated because of the fact the numbers appear all over and are too high.

Pam

 

[Kris & Teasel]

I'm not techie but you might find the answer in here if you read through it carefully:

http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/

 

[PamJV]

Kris, I went to that link with the already existing spreadsheet that Chris had created. I did those steps about Publish to the web and copied the URL. I put that URL in my signature. What I wondered is others seem to be able to use a replacement name for the URL link, and I would like it to appear as "Ricky's Spreadsheet" instead of seeing the URL itself.

Let me know if you can see the spreadsheet. But also I am not aware if I need to do saves on the spreedsheet each time I make a change.
The first entry on the spread sheet, is that of the curve done at the vet office in February when Ricky was looking good. I have made comments in the comment section.
Pam

 

[Kris & Teasel]

Kris, I went to that link with the already existing spreadsheet that Chris had created. I did those steps about Publish to the web and copied the URL. I put that URL in my signature. What I wondered is others seem to be able to use a replacement name for the URL link, and I would like it to appear as "Ricky's Spreadsheet" instead of seeing the URL itself.

Let me know if you can see the spreadsheet. But also I am not aware if I need to do saves on the spreedsheet each time I make a change.
Pam

Yes, I can see your SS. Not sure how to make it be "Ricky's Spreadsheet" in your signature though. Try this:

1. open Ricky's editable SS and copy the URL from the browser bar
2. go to your signature (menu under your name in the upper right hand corner of the forum page) and click on it
3. type "Ricky's Spreadsheet" in the text box that appears (The URL will be there - don't remove it yet) and then highlight "Ricky's Spreadsheet"
4. click on the paperclip icon at the top of the signature text box and paste the SS URL into the navy blue bar that appears
5. click "save changes" or whatever it says to save
6. check to see if that "Ricky's Spreadsheet" now shows in the light grey type under your post
7. go back and delete the URL in the signature text box.

 

[Sienne and Gabby (GA)]

Pam --

Great job getting your spreadsheet (SS) up and running.

Are you still feeding Ricky dry DM? If so, this is a food that's rather high in carbohydrates -- it's approx. 19% carb. We consider low carb to be under 10% and most of us give our cats food that is considerably lower than 10%. If you've not changed Ricky's food, the dry food is contributing to his high numbers.

Also, how long has Ricky been at the 2.0u dose?

 

[PamJV]

Pam --

Great job getting your spreadsheet (SS) up and running.

Are you still feeding Ricky dry DM? If so, this is a food that's rather high in carbohydrates -- it's approx. 19% carb. We consider low carb to be under 10% and most of us give our cats food that is considerably lower than 10%. If you've not changed Ricky's food, the dry food is contributing to his high numbers.

Also, how long has Ricky been at the 2.0u dose?

Sienne, Ricky's initial numbers done at the vet office were considered good at the time. When Ricky was first diagnosed he had been eating EVO Grain Free, which is lower in carb than Purina DM. The vet specifically told me to switch Ricky to the Purina DM. He said even though the carb is a little more what matters it it being a complex carb. Well I really can't tell on an ingredient list what is complex or simple in cat food. I don't know.

I am not really sure of the exact date when the complete switch to Purina DM was made. It has to be about 2 months ago. I do wonder if this has made Ricky worse. I am ordering a bag of the Young Again Zero Carb, also to try. I just don't know it is so confusing. Ricky was very much improved in the first month but then started going down hill. Right now it looks like the Lantus doesn't even do anything.

Pam

 

[PamJV]

Kris, I tried what you said. Very slick! Thanks

Pam

 

[Chris/China (GA)/Garfield]

He said even though the carb is a little more what matters it it being a complex carb.

This line is total BS......What your vet doesn't tell you is that he didn't get any education on nutrition in school (and if he did, it was a matter of hours, not days or semesters) Once they leave school, the only continuing education they get on nutrition is from the Hills salesmen that want to sell more product.....and of course the fact that there's a nice little profit in it for the vet doesn't hurt either.

The "prescription" foods are garbage......if you look on the ingredient list, they are no better (and some are worse) than foods you can buy at your local supermarket. It also contains a lovely little ingredient called "powdered cellulous"......that's a nice word for sawdust!!!

A "complex" carb is still a carb....the body doesn't know the difference. You'll do a lot better if you'll switch Ricky over to a low carb canned diet like Fancy Feast Classics, Friskies pates or 9-Lives ground (as well as saving some money)

There's lots of great information on feline nutrition on Dr. Lisa's site, "Feeding your cat...knowing the basics of feline nutrition"

There's more information on the scam behind "prescription" foods in THIS article

There's even a class action lawsuit that was recently filed against Hills for it's deceptive practices

 

[rhiannon and shadow (GA)]

Hi Pam,
Welcome to Fdmb. I hope you will start posting with us daily so we can help you. There is a lot of info to process and we can guide you and help get
Ricky feeling better.

The first thing is the plantigait.
I assume you mean he is walking on his hocks.
This is diabetic neuropathy and there is something to reverse that. There is zobaline or you can get some methylcobalamin , thats methyl b12.
I used one from vitacost.
I like it because it was a capsule with a pink powder that I could see on the canned food but it had no taste. That way I knew it was getting eaten.
The vitacost one does have a trace of rice flour in it but my cat was not carb sensitive.
They need at least 3 mg a day. this is water soluble so they pee out what the body doesn't need. It can take 3 months to reverse the neuropathy which is painful.

Second, I'm glad you will switch to young again.... but if you can get him to eat canned food that's even better.
Cats don't get enough water and a diabetic cat is even more compromised so every bit of water you can get in him for the rest of his life is good.
Many of us add water to the canned food. It keeps it fresher longer too.

We have food lists if you want to see the carb values for the canned food.

IF Ricky is a dry addict, it may take time to get him to switch . But they can learn, it just takes time.

and Third, the insulin dose is a moving target.
It will change over time so just because 2 units was good once doesn't mean it will stay that way. There are many factors that contribute to the fluctuations.
We can help you find the right dose now that you have a spreadsheet and are testing.

and lastly,
testing....

it sounds like you need to find a nice low carb treat that you give every time you poke him.
There are many different freeze dried treats ( no carbs) available now, you just have to try a few to find out what really gets him interested.

here are some examples that I personally have had the best luck with.
each line will take you to a link where you can buy

chicken hearts
duck hearts
turkey giblets that crumble easily
purebites shrimp
boar
salmon
freeze dried turkey ( Shadow liked this one)


the right treat will help him get more cooperative. Some cats even come running when you pull out your meter to test.
We all have lots of tips to help you with testing.


Ask questions....
We all like to pay it forward.

 

[rhiannon and shadow (GA)]

by the way, the blue words are links to click on ....
you probably already know that but not everyone does at first.

 

[Sienne and Gabby (GA)]

I would have tried to be a bit more tactful than Chris but she's correct. Vets get very little training in nutrition and when they do, it's across species. Cats are obligate carnivores vs dogs, which are omnivores. Maybe it's more important for dogs to get complete carbs -- not so much for cats. Cats' bodies cannot process carbohydrates. Cats living in the wild get their carbs in a partially digested form (i.e., from the GI track of their prey). The bottom line is that all cats do best on a low carb diet and this is especially the case for diabetic cats. Dr. Lisa's site, which Chris linked, is very good and she is a strong proponent of a species specific diet.

To be honest, when Gabby was first diagnosed, I came home with tons of Hills and Purina prescription food. Then I found FDMB, learned about the carb counts, read the ingredients in these food, and returned them to my vet. She wasn't happy. I then pointed out that Wellness cost a lot less than the prescription food, was widely available, and it was significantly lower in carbs. Once we hit on the issue of the carbs, she agreed with me. I don't think she was aware of just how high in carbs the prescription food was.

Why not try an experiment? Give Ricky a try on Fancy Feast Classics (pate style and low carb) or Wellness in the pate style and see what happens with Ricky's numbers. Even if you eliminate the dry DM, I suspect you'll see an improvement in his numbers. (Dry food is really terrible for cats. Cats have a very limited thirst drive. They typically don't drink much water. They are used to getting their fluids from food and canned food contains substantially more liquid than dry. In addition, if you pay attention to food recalls, it's usually dry food that gets recalled. It tends to turn rancid.)

Just as an FYI, if you opt to use a dry food, even Young Again Zero Carb, you are restricted with regard to which approach to dosing you use. With Tight Regulation, your cat must be on a low carb, canned food diet. Of course, if Ricky is a dry food junkie, it may take a while to transition him over to a fully canned food diet. Once he's transitioned, you can always switch from Start Low Go Slow to Tight Regulation if you so desire.

 

[PamJV]

You'll do a lot better if you'll switch Ricky over to a low carb canned diet like Fancy Feast Classics, Friskies pates or 9-Lives ground (as well as saving some money)

Chris, Ricky will not eat canned food. He's very definite about that. Prior to the diagnosis of Diabetes he was eating EVO Grain Free - Chicken-Turkey Dry Food. When the vet told me Purina DM was a better choice I introduced it and Ricky went for it. I think they tend to like something new. Now after weeks of getting only Purina DM, I now re-introduced the EVO and Ricky is going for that more.

I'm sure the last couple of days of my tests Ricky was eating the EVO. I do wonder if Ricky needs a tiny bit more than 2 units of insulin?

Pam

 

[PamJV]

Why not try an experiment? Give Ricky a try on Fancy Feast Classics (pate style and low carb) or Wellness in the pate style and see what happens with Ricky's numbers. Even if you eliminate the dry DM, I suspect you'll see an improvement in his numbers. (Dry food is really terrible for cats. Cats have a very limited thirst drive. They typically don't drink much water. They are used to getting their fluids from food and canned food contains substantially more liquid than dry. In addition, if you pay attention to food recalls, it's usually dry food that gets recalled. It tends to turn rancid.)

Just as an FYI, if you opt to use a dry food, even Young Again Zero Carb, you are restricted with regard to which approach to dosing you use. With Tight Regulation, your cat must be on a low carb, canned food diet. Of course, if Ricky is a dry food junkie, it may take a while to transition him over to a fully canned food diet. Once he's transitioned, you can always switch from Start Low Go Slow to Tight Regulation if you so desire.

Sienne, Ricky will never eat canned food. He's been that way since he was a kitten. To him canned food smells like excrement. He turns and runs from it. I have 3 other cats that eat canned food. It's never been that I have done this out of my own convenience.

My choices are finding the best dry food he will eat, and finding the right insulin dose that works for him. Actually I've been having a tough time even giving him the Zobaline supplement!

 

[Bobbie And Bubba]

I just wanted to pop in and say hello and welcome the best place you never wanted to be. You have all ready received some good info. All I will add is that Young Again Dry food, you can order it online, is almost zero carbs and if Ricky will only eat dry, it would be a better choice for you. You can call the company and they will send a sample to you and their customer service is awesome. Being that he is eating dry food you would need to follow the Start Low Go Slow method rather than TR since dry food is metabolized slower than wet food.

 

[Bobbie And Bubba]

Also, the way I transited my two dry crack addicts to wet food was with the YA. They loved it so after a few days, I ground up some of the Young Again ( YA ) in my magic bullet and sprinkled it on top of the wet. Each day, I gave less ground up YA and more of the wet food and soon I had two cats eating all wet food.

 

[rhiannon and shadow (GA)]

Pam....
you mentioned when to increase the dose?
I know you've been doing this longer than your spreadsheet has up....

you can generally increase by 0.25 u after 6 cycles when numbers are higher as Ricky's are.
So if it's been 6 cycles , increase to 2.25u....

and did you skip a dose or is it you just need to go fill in the spreadsheet?
If you skipped, then put NS for no shot.....

 

[rhiannon and shadow (GA)]

Pam just told me her vet wants to increase to 3 units.....

could use other's words to explain why that's a bad idea.....


Pam, here are the instructions for go slow protocol.
Remember your vet works for you...... you hired him.... that doesn't mean he is always right.
You mentioned that sounded like too much.....
I will add to go with your gut.... if something doesn't feel right, your gut is probably your best guide.
And you were about to change the food.....

I personally would go with the 2.25 unit dose while you are waiting for your food to be delivered.

fter 1 week at a given dose perform a 12 hour curve, testing every 2 hours OR perform an 18 hour curve, testing every 3 hours:
Note: Random spot checks are often helpful to "fill in the blanks" on kitty's spreadsheet.

• If nadirs are more than 150 mg/dl (8.3 mmol/L), increase the dose by 0.25 unit

• If nadirs are between 90 (5 mmol/L) and 149 mg/dl (8.2 mmol/L), maintain the same dose

• If nadirs are below 90 mg/dl (5mmol/L), decrease the dose by 0.25 unit

As your cat's blood glucose begins to fall mostly in the desired range [lowest point of the curve approaching 100 mg/dl (5.5 mmol/L) and pre-shot value around or below 300 mg/dl (16.6 mmol/L)], do lengthen the waiting time between dose increases.

If you decide to change another factor (e.g., diet or other medications), don't increase the insulin dose until the other change is complete (but do decrease the dose if your cat's glucose numbers consistently fall below 90 mg/dl (5.0 mmol/L) as a result of the change).

Don't be tempted to rush the process along by increasing the dose more quickly or in larger increments-- no matter how high your cat's blood glucose is! Rushing towards regulation will cost you time in the long run, because you may shoot past the right dose.

 

[Chris/China (GA)/Garfield]

I agree with Rhiannon....we don't ever do dose increase in whole units (at least not until they're up around 10 units)

If you go too fast, you could skip over what might be a "perfect" dose for Ricky and start him bouncing high, crashing low and bouncing high again.

It's better to go up slowly so you know for sure that you haven't bypassed a good dose

 

[PamJV]

I just wanted to pop in and say hello and welcome the best place you never wanted to be. You have all ready received some good info. All I will add is that Young Again Dry food, you can order it online, is almost zero carbs and if Ricky will only eat dry, it would be a better choice for you. You can call the company and they will send a sample to you and their customer service is awesome. Being that he is eating dry food you would need to follow the Start Low Go Slow method rather than TR since dry food is metabolized slower than wet food.

I did get a bag of YA in the mail just today. I was going to mix a little in his food and gradually increase. I am disappointed that YA uses meat meal instead of whole meat.

 

[PamJV]

Pam....
you mentioned when to increase the dose?
I know you've been doing this longer than your spreadsheet has up....

you can generally increase by 0.25 u after 6 cycles when numbers are higher as Ricky's are.
So if it's been 6 cycles , increase to 2.25u....

and did you skip a dose or is it you just need to go fill in the spreadsheet?
If you skipped, then put NS for no shot.....

Rhiannon, How would I see 2.25 on the syringe? I have some syringes with half marks, which is already hard to see.

 

[rhiannon and shadow (GA)]

this is the 0.25 u ....

and add 2 units....

it doesn't matter if it's perfect as long as you repeat it while you are at this dose.
I would mark a piece of paper or a ruler..... or save a syringe with colored liquid so you can repeat the same measurement at the next shot.

 

[PamJV]

this is the 0.25 u ....

and add 2 units....

it doesn't matter if it's perfect as long as you repeat it while you are at this dose.
I would mark a piece of paper or a ruler..... or save a syringe with colored liquid so you can repeat the same measurement at the next shot.

That looks like the stopper is right on the half mark. Wouldn't that make it 0.50 ? I was told the dosages are with the stoppers being right on the line not just below.

 

[PamJV]

I just wanted to pop in and say hello and welcome the best place you never wanted to be. You have all ready received some good info. All I will add is that Young Again Dry food, you can order it online, is almost zero carbs and if Ricky will only eat dry, it would be a better choice for you. You can call the company and they will send a sample to you and their customer service is awesome. Being that he is eating dry food you would need to follow the Start Low Go Slow method rather than TR since dry food is metabolized slower than wet food.

Bobbie, so far no one likes the YA. I tried mixed a little in Ricky's EVO bowl last night, and he hardly ate any. So then I made two bowls this morning, one with EVO and one with YA. He went immediately and started eating the EVO.

I may have to try putting some YA in a bag with EVO and shaking it up so the flavors mix, to slowly introduce. Not sure how this will go.
Pam

 

[rhiannon and shadow (GA)]

That looks like the stopper is right on the half mark. Wouldn't that make it 0.50 ? I was told the dosages are with the stoppers being right on the line not just below.

if you look at the black edge of the stopper.....it's not on a line.... it's a smidge more..... almost two hair widths....

when you are giving insulin to an average 12 lb cat, one drop of insulin can be a lot....
remember this insulin was created for humans, not cats.....

it is hard.
I remember wearing a headlamp, stronger reading glasses just to see the lines and try to imagine the tiny space between them......



sorry they aren't liking the ya....
its probably because of the lack of carbs in it....

they get addicted to cheetos just like we do.....

imho, some of the dry foods are like eating cheetos all the time.... ( cheetos is my substitute for any junky food we eat)

 

[Bobbie And Bubba]

Bobbie, so far no one likes the YA. I tried mixed a little in Ricky's EVO bowl last night, and he hardly ate any. So then I made two bowls this morning, one with EVO and one with YA. He went immediately and started eating the EVO.

I may have to try putting some YA in a bag with EVO and shaking it up so the flavors mix, to slowly introduce. Not sure how this will go.
Pam

That is a good idea!

 

[PamJV]

if you look at the black edge of the stopper.....it's not on a line.... it's a smidge more..... almost two hair widths....

when you are giving insulin to an average 12 lb cat, one drop of insulin can be a lot....
remember this insulin was created for humans, not cats.....

it is hard.
I remember wearing a headlamp, stronger reading glasses just to see the lines and try to imagine the tiny space between them......
sorry they aren't liking the ya....
its probably because of the lack of carbs in it....

they get addicted to cheetos just like we do.....imho, some of the dry foods are like eating cheetos all the time.... ( cheetos is my substitute for any junky food we eat)

The food Ricky has been eating is EVO grain free. I don't think that's like junk food. Its main ingredients are meat. I would say it's probably a matter of the smell of YA that they don't like. The YA bag instructs to leave it out so they get used to the smell.

About that pic of the syringe.....when you see it super enlarged like that you can notice a hair this way or that. However in practice using a syringe for 30 units or less ....the itty bitty ones, there's no way I'm going to see that. In fact what I have found is that I can't even adjust my eyes to those syringes with the half marks. I prefer the ones with no half marks and to just base on how close to the stopper is to the whole line. To my eyes, if I see the stopper resting above the 3 unit mark that makes it look like a 2.5 unit. Would that be correct? I have such a hard time when the stopper is near the spot to advance it without it going past the mark ! Seems like they don't move easily when it is for a precise small move.

I have some very hard things going on with my father who seems to have severe dehydration and maybe Dementia in the house right now and that takes all my time. So I'm just giving Ricky his doses and not testing him. If I can get things settled here with my father and what to do, then I plan to test Ricky when I have a good day.

At least one good thing is I found Ricky will take the Zobaline supplement better if I don't use a pill pocket.

Pam