Spicoli pt1

Status
Not open for further replies.
Wesley and Spicoli

Wesley and Spicoli

Member Since 2017
So today was day 5 with no need for insulin. He's just getting over a bout with pancreatitis, but his numbers have been the best and most consistent since dx.

Besides continued testing and of course insulin if necessary what should my next steps be?
 
W.K. said:
So today was day 5 with no need for insulin. He's just getting over a bout with pancreatitis, but his numbers have been the best and most consistent since dx.

Besides continued testing and of course insulin if necessary what should my next steps be?
Click to expand...
I believe that after 14 days without insulin you can say your kitty is officially "off the juice". You can post on the main health forum to see if there are other criteria.
 
Recommendation is to continue testing for 14 days without insulin. After that, you can start to spread out the testing more, but continue to monitor for the rest of the cat's life. Some say to test weekly, some say monthly. Cats can go out of remission quickly, so I would recommend about every two weeks. A cat who doesn't need insulin will always be considered a diabetic, but now a diet-controlled diabetic. So always be very careful about food choices going forward. I got a little complacent and we ended up back here again. Also keep an eye on thirst and increased urination as they may be your 1st clues if his glucose starts rising. Also keep an eye on your kitty's weight, as that is a contributing factor in FD.

Congrats on the great numbers so far!!! Fingers crossed they keep going that direction!
 
W.K. said:
So today was day 5 with no need for insulin. He's just getting over a bout with pancreatitis, but his numbers have been the best and most consistent since dx.

Besides continued testing and of course insulin if necessary what should my next steps be?
Click to expand...
Very cool! Good luck
 
Thanks! I think we'll need it. I'm just positive he'll throw me a curve ball tomorrow.
Djamila said:
A cat who doesn't need insulin will always be considered a diabetic
Click to expand...
I know he will always be a diabetic but hopefully we can keep him diet controlled. I have NO plans on changing his diet or our civies since this is the diet any cat should be on.

Paws and fingers crossed!! And knock on wood!! Either way we've been headed in a pretty positive direction either way :) But who can't hope for OTJ!!!!
 
upload_2017-4-26_9-28-36.png
 
As expected he threw me a curve ball the next morning.

So I have a question. This morning his bg was 388. I think that's the second highest we've ever been. I gave his .25u (earned an official reduction 4/27 when he hit hypo numbers on .5) and tested when I got home from work- +10 254. His PMPS was 105 so I thought no way and tested about 1 min later and it was 133.

Is this normal? I don't think it was a bounce and we've gotten great numbers from .25u before.
 
Woah! That's really odd. I'm wondering if the 254 you got at +10 wasn't a wonky strip or something. It seems really odd that he would go DOWN over 100 points at the end of the cycle.

Any chance you could run a curve soon? I'd really like to see what his numbers do over a cycle.
 
Ahhh... I won't have a chance to run a curve till Sunday. But I can and will Sun/Mon. This past sun/mon was all wonky, so I wasn't around like I usually am. At most till then all I can get is a +2, +10.

He usually is lower in the evenings but dropping that much after eating his afternoon snack, no way.

I'll tag you Rachel when I can get a curve in.
 
That's fine! If you can grab those extra tests when you can this week and then curve this weekend, that'll give us some good info to hopefully see what's going on!
 
So the past 8 days I haven't been able to control Spicoli's numbers. After our hospitalization my vet and I had a long talk since the cat bounces around alot. He said I should continue to increase his dose until the numbers came down. I'm worried that this is why he's staying so high and we're seeing numbers that we've never had before.

I could just use some advice from all you prozinc pros out there. Starting over, gradually reducing, whatever.
Any advice is greatly apprectiated :)
 
W.K. said:
So the past 8 days I haven't been able to control Spicoli's numbers. After our hospitalization my vet and I had a long talk since the cat bounces around alot. He said I should continue to increase his dose until the numbers came down. I'm worried that this is why he's staying so high and we're seeing numbers that we've never had before.

I could just use some advice from all you prozinc pros out there. Starting over, gradually reducing, whatever.
Any advice is greatly apprectiated :)
Click to expand...
Usually a cat that starts having high numbers after no insulin for a while has another issue going on - UTI, need for a dental, food change, etc. Is there anything happening with your kitty that's out of the ordinary?

Yes, he is bouncing a lot and frequent dose changes can make that worse. How about trying a set dose AM/PM for two/three days, then increase by 0.25 u if that doesn't help. Why not backtrack to 0.25 u BID because that's where this began a week ago. After two/three days, go to 0.5 u BID and so on. What we know for sure is that throwing more insulin at a bouncing cat doesn't help.
 
Yes, start over. The dosing is all over the place, and you have numbers that indicate bouncing and possibly too much insulin. I would say back down to 0.5 units and let's see how that does for a few cycles. I would also really encourage you to keep testing and posting (you're doing great on the testing!). Dosing is much more complicated than it might seem, and having some other folks looking at your numbers and making suggestions will help get this sorted out.

It's also possible that there is something else going on. Have you had your cat's teeth checked recently? Any chance there is a UTI or something else going on?
 
Oops. forgot to hit refresh before I posted. Looks like Kris said pretty much the same thing! I think it would be fine to go down to 0.25 as she suggested and move up from there. It's usually better to err on the side of caution.
 
He's no longer an indoor/outdoor so I can monitor him better - this has been a challenge and im sure stresses him. He's urinating fine and not frequently. I had his teeth checked on the 6th of this month after our hospitalization. Said no need for dental. Food is the same. He does have IBD (recently dx) but nothing seems out of the ordinary.

Will start over tonight.
 
W.K. said:
He's no longer an indoor/outdoor so I can monitor him better - this has been a challenge and im sure stresses him. He's urinating fine and not frequently. I had his teeth checked on the 6th of this month after our hospitalization. Said no need for dental. Food is the same. He does have IBD (recently dx) but nothing seems out of the ordinary.

Will start over tonight.
Click to expand...
Good plan. IBD is an inflammatory condition so it might affect BG. Is he getting meds for it? You can still find a good dose range though.
 
He isn't currently getting meds... actually i guess his food isnt the same. We're still feeding low carb (according to the amazing food chart) but trying duck, quail, rabbit, venison, and other proteins he hasnt had before. Just trying to stay away from chicken/turkey. Vet is looking into Texas a&m lab to see if they're doing any trials since he is the perfect candidate, but either way we're going to be sending off a serum sample to see if it can shed some light on if this is IDB or something more sinister. But no steroids yet. His IBD symptoms have greatly improved since adding in FortiFlora and changing proteins.
 
W.K. said:
He isn't currently getting meds... actually i guess his food isnt the same. We're still feeding low carb (according to the amazing food chart) but trying duck, quail, rabbit, venison, and other proteins he hasnt had before. Just trying to stay away from chicken/turkey. Vet is looking into Texas a&m lab to see if they're doing any trials since he is the perfect candidate, but either way we're going to be sending off a serum sample to see if it can shed some light on if this is IDB or something more sinister. But no steroids yet. His IBD symptoms have greatly improved since adding in FortiFlora and changing proteins.
Click to expand...
All good as far as BG effects. Any low carb food should be good and there are no meds to cloud the picture. :)
 
We are on our 6th cycle of .25 but his numbers haven't come down too far. Haven't had time to do a curve on this dose but I could do one today, or at least a partial. Should I go ahead and move up to .5 or give it some more time at .25?
 
so ive only done +2 +4 so far but his numbers have already started to go back up... amps 461, +2 402, +4 452
also i made sure the insulin wasnt bad and bought a new bottle... ive had the same results with both.
 
Time to go to 0.5 u in your "starting over" experiment. Hold for no more than three cycles if you get no positive effect. The longer he stays in high numbers, the harder it can be to shift him. I'd also keep an eye out for anything that might be bothering him that could explain his bump into higher numbers.
 
Still no improvement with his numbers..(ss not fully updated) Noticed an ulcer/sore on his mouth this morning so we're going in to get checked out today. Unfortunately his vet is gone for the rest of this week and next so we're going to have to see our backup. Either way maybe a blood panel/ urinalysis will shed some light on what's going on with our problem child. Will update after our visit.
 
A vet visit and some lab work is a good idea. Assuming everything checks out, just keep going with the increases, but we usually recommend holding an increase for 3-6 cycles before making the next move up. Sometimes cats don't show a response for the first couple of cycles. Since his numbers are so high, I would aim for the lower end of that and just hold for 3-4 cycles though.

Honestly, you almost hope there is something else going on and a quick round of antibiotics or a dental cleaning could get him back on track! Please keep us posted on what you find out from the vet. Any idea what causes mouth ulcers in cats? For humans it can be iron deficiency or B12 deficiency, but I don't know if that's true for cats too?
 
Im hoping its an infection or something we can easily deal with. There are "rodent ulcers" but aside from that I have no idea what can cause an ulcer in cats. Maybe the feline version of herpes? I don't think it's feline acne but I suppose it *could* be. There was a little bit of puss that come out when accidentally touched it this morning, but he was pawing at it so I had to look. Today may also be the day we have his blood serum sent to Texas A&M concerning is IBD. Our primary vet wanted to start here before doing surgery for a biopsy since he's older and has FD. Maybe this will also give us more of an idea if it really is IBD or intestinal lymphoma.
 
So the vet visit went well. His labs were completely unremarkable. He did have a little plaque around his gums but the vet said it shouldn't be the cause of his high numbers. Also, what I thought was an ulcer, he thinks is just acne. As of now the vet thinks the high numbers are due to the Somogyi effect and recommended that we go back down to .25u for 1 week and see where that takes us. If his numbers don't move then we will be going back and exploring other possible causes.
 
Glad Spicoli's labs were good, is the ulcer inside his mouth like soft tissue or on his gums? I'll give my thought on the ulcer after hearing confirmation:)
 
Hmmm...I don't know if I would start over at 0.25 if it was me. You've done that recently and showed that the numbers were staying high and flat, which is not a sign of somogyi (which we call bouncing). Did your vet get to look at your SS and see that you've done that? I guess my thought is you've done it, so doing it again isn't really helpful, but staying the course of constant, steady increases will help you get there.

It is, of course, ENTIRELY your decision, but just wanted to voice my thoughts. :) If you do decide to go back, please make sure you're getting ketone tests as often as you can. Those higher numbers can be one of the causes of ketones (not for a SECOND saying he's got them or will get them, but better safe than sorry!). The earlier you catch those the better if they happen.
 
I haven't quite decided what to do yet. I'm leaning more towards staying a 1u for a few more cycles. I didn't bring him my SS but he knows that I home test and I did tell him about what had been going on and the rough numbers. So basically he thinks that cat is bouncing. Going back and starting over at .25 now is a waste of time and insulin lol. But seriously. I do ketone tests but according to the ss it's been a week so I'll try to grab one tonight if possible, if not in the morning.

I will say the cat has been acting pretty good aside from his IBD and the once a week (ok maybe 2 times) vomit. I do give him 1cc of Metoclopramide if he throws up. He's actually gained weight in the last 2 weeks.

Any thoughts from you guys? Should I stay at 1u or maybe back down a little and give those doses more time?

There are only 2 cycles on the ss but we've done 3, and they've all been the same - high and flat.. Just havent logged those numbers.

Yong said:
is the ulcer inside his mouth like soft tissue or on his gums?
Click to expand...
Well neither. I guess it isn't really an ulcer, more of a sore. It's on the outside on his lower lip.
 
Vet said I could, but that because of where it is he would just lick it off... It's right and the upper edge of his bottom lip. It doesn't look bad but I have a tendency to overreact and was looking for ANYTHING that could be keeping the bg lvls elevated. It's no bigger than well... it's really small. No bigger than the biggest blood drop I've ever gotten from poking his ear.

And yes YAY! I think I'm going to stay at 1u for a couple days and see how that goes. Thoughts?
 
W.K. said:
Still no improvement with his numbers..(ss not fully updated) Noticed an ulcer/sore on his mouth this morning so we're going in to get checked out today. Unfortunately his vet is gone for the rest of this week and next so we're going to have to see our backup. Either way maybe a blood panel/ urinalysis will shed some light on what's going on with our problem child. Will update after our visit.
Click to expand...
Is it a little lump on his lip? Pogo had one and I had it surgically removed. I should have spent the $100 to get it biopsied because Pogo died of cancer a year later. He once had acne from eating out of plastic bowls, but that was just small pimple-like bumps. It sounds like that's what it is and antibiotics should clear it right up.
 
Nice PMPS!!!! I think I'd stick with 1 too...especially after getting a lower PMPS last night!
 
It isn't a lump, it's just a little sore. ANY lumps we have checked biopsied and/or aspirated. I completely freaked when I first found his lipoma, but luckily that's all it was. And he has a little mole beside the top of his ear. I had that checked too :)
I haven't checked his sore today yet, but if it doesn't improve/gets worse we will have it biopsied within the next week. Side note - I don't feed them out of plastic bowls - just ceramic bowls for water/dry food and plates for wet food.

He was a little high this morning at 427 but he is always higher in the morning. I think i experience the dawn effect with him, as even the stretches we've not needed insulin he was still higher in the AM vs PM.

We've been at 1u for 5 cycles now. Going to run a curve today and try to grab a ketone test. I think I may hold for a few more cycles, but I think 1.25u might be our magic number as it sent him into the greens 2 weeks ago. Just don't want him to start bouncing again. I really think that his super high 500 numbers were a result of too much insulin so I will proceed with extreme caution. I guess that's why I want to stay a 1u for a little while longer.
 
Quick question to go along with everything. My ER vet (i really like) fussed at me for feeding him more than just 2 times a day saying it would be harder to control his numbers. He has breakfast, maybe a snack around noon and 4 (when I'm home or free feeds on wet/evo dry when I'm gone) then nothing till pmps around 8. Spicoli is back up to his target weight at just over 14 lbs and there's no way he can eat half of what he should in the am or pm. I always thought that feeding more than 2 times was acceptable am I wrong?
 
W.K. said:
Quick question to go along with everything. My ER vet (i really like) fussed at me for feeding him more than just 2 times a day saying it would be harder to control his numbers. He has breakfast, maybe a snack around noon and 4 (when I'm home or free feeds on wet/evo dry when I'm gone) then nothing till pmps around 8. Spicoli is back up to his target weight at just over 14 lbs and there's no way he can eat half of what he should in the am or pm. I always thought that feeding more than 2 times was acceptable am I wrong?
Click to expand...
It's acceptable here but many vets promote feeding only twice a day. It's like a lot of other things we recommend here that are at odds with vet recommendations. I say the proof is in the pudding. :)
 
342 amps!! lowest in nearly 2 weeks!! i havent been home today so no extra tests but will update for pmps and hopefully do a curve tomorrow.

Djamila said:
If I only fed Sam twice/day he would eat me!
Click to expand...
That's exactly how this one is. He'll howl his head off if there's no food to be found. I tried 2x daily (had to do it with our other 2 as well) and it just didn't work for any of us.
Our civvie Addy would scarf and barf, Taco would be left with nothing because of greedy little Addy, and I felt Spicoli was never eating the right amount for his target weight. He had dropped down to under 11 lbs (he's a big kitty) and the vet wanted to see him back around 13-14 lbs. With the issues we've had with his FD, stomach ulcer, and IBD I was afraid he'd never get back to that, but Wednesday he had hit 14! yay!!
 
Oh one more thing. We're at 1u and we've been here for 7 cycles. I just tested and at +8 he's way up - 517. Should I hold at 1u or bump it up to 1.25? Or could this be a bounce?
 
I suppose it could be a bounce, but I don't see any other data that would suggest he's going lower, so I would be more inclined to think an increase is a good idea. If you're going to be monitoring tomorrow anyway, I'd think it's a good time to try an increase.
 
Yeah I really doubt it was a bounce...just has me a little confused. He didn't eat while I was gone so I don't understand how his bg can be so high. I guess that's why they call it a sugar dance.

Will up to 1.25 tonight and get at least a +3, and curve tomorrow.
 
Status
Not open for further replies.
Back
Top