5/6 Dave AMPS 97, +1.75 126, +4 94, +6 86, +11 203 - Failed decrease

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panda28

panda28

Member Since 2017
http://www.felinediabetes.com/FDMB/...-74-3-5-76-4-5-74-5-5-68.177453/#post-1956031

After an exciting night last night, and a wonderful surf, Dave's still (just) in the green at +12. Should he go back to his normal dose of f1u, or should I give him the o.7u again? I haven't fed him yet, so I technically could stall again, but I really do need him pretty close back to his original shooting time by the end of the weekend. Once again, I can watch him all day, and have lots of LC.
 
I ended up giving him the 0.75u. I figured that because I didn't stall, it might be better to be a bit conservative. I'll keep an eye on him over the next few hours.
 
Firstly I want to just say up front that I can't stay with you.

But if you are going to be round and can monitor, you could go ahead and take him back up to the 1u, since I gather he 0.75 was a BCS due to the low pmps last night, as he didn't earn the reduction.

That said if you don't feel comfortable with that you could equally stick to the 0.75, but be aware that as the reduction wasn't earned you might find that as the depot settles his numbers may creep up and you may need to call it a failed reduction.
 
Good call. I would have given him 0.75 unit as well.
ETA what Gill said is true but I would give this dose a shot and see where it takes him.
 
I see we cross posted, I think it was good not to stall, getting more off schedule can be a real pain.

Remember that to get back on schedule it's normally advisable to only change the shot times by 30min a day (or 15min a cycle)
 
I'm making sure to only bring the shot back 15 minutes each cycle, so he should be back on schedule in 5 more, I think... I'll retest at +1.7 (+1.45? how do you write out a test that is 15/45 minutes from shot time?) and update.
 
panda28 said:
I'm making sure to only bring the shot back 15 minutes each cycle, so he should be back on schedule in 5 more, I think... I'll retest at +1.7 (+1.45? how do you write out a test that is 15/45 minutes from shot time?) and update.
Click to expand...
as an example:
I used to write 94@+3.75 if it was 3hrs 45 min past shot time, then I would manually colour the cell in the relevant colour.
 
I am not going to be around this morning Jacqui either until about 1.30pm our time.
There should be others about if you need advice or help, but you are managing Dave really well and you know what to do to keep him safe.
 
His +11 reading is 203... I think it's pretty obvious that 0.75u isn't enough for him. If this is a failed reduction, then I would go back to the last dose that worked - i.e. f1u, - right?
 
A failed reduction is when Dave does not go down to green numbers after you have reduced the dose. As he was in green numbers today it is not a failed reduction. He actually had a lovely cycle today.
You initially only reduced the dose because of the low preshot.....you did a BCS....a big chicken shot.
However if you want to go back up to the previous dose you can, but you are going to have to monitor him closely as the 0.75 unit is taking him down to greens. Once the depot does not influence the numbers it might not be enough insulin.
You mentioned earlier that the 1 unit fat is more like a 1.25. Maybe you could just go to 1 unit, not 1f.
It is up to you.
 
Bron and Sheba said:
A failed reduction is when Dave does not go down to green numbers after you have reduced the dose. As he was in green numbers today it is not a failed reduction. He actually had a lovely cycle today.
You initially only reduced the dose because of the low preshot.....you did a BCS....a big chicken shot.
However if you want to go back up to the previous dose you can, but you are going to have to monitor him closely as the 0.75 unit is taking him down to greens. Once the depot does not influence the numbers it might not be enough insulin.
You mentioned earlier that the 1 unit fat is more like a 1.25. Maybe you could just go to 1 unit, not 1f.
It is up to you.
Click to expand...


You caught me just in time! Okay, it sounds like the f1u is too much. I'll go 1u then, and keep a close eye on him.
 
panda28 said:
You caught me just in time! Okay, it sounds like the f1u is too much. I'll go 1u then, and keep a close eye on him.
Click to expand...
I think that is a good idea. You can always go up higher if this dose does not work out.
A fat dose is only meant to be just slightly more than the unit dose.
 
Bron and Sheba said:
I think that is a good idea. You can always go up higher if this dose does not work out.
A fat dose is only meant to be just slightly more than the unit dose.
Click to expand...


That makes sense. I'm not sure about how big my fat doses are (I wouldn't be surprised if they're pretty inconsistent) , but I think you're right and it's better to be safe than sorry! The whole doses are lot easier to keep the same, too. I'll retest at least every 2 hours until +6, and then go from there. I'm really happy with how well he's doing! Thanks for all your help!
 
panda28 said:
That makes sense. I'm not sure about how big my fat doses are (I wouldn't be surprised if they're pretty inconsistent) , but I think you're right and it's better to be safe than sorry! The whole doses are lot easier to keep the same, too. I'll retest at least every 2 hours until +6, and then go from there. I'm really happy with how well he's doing! Thanks for all your help!
Click to expand...
He is doing really really well for such a new diabetic.
How does your vet feel about you being on the forum?
 
Last edited:
Bron and Sheba said:
He is doing really really well for such a new diabetic.
How does your vet feel about you being on the forum and doing the dosing without him?
Click to expand...


I'm really proud of him!

Honestly, the vet's not happy. She's told me that if I don't follow a sliding scale (which skips all shots below 160...) then he'll be too high and at high risk of DKA, and that he has no chance of remission. She has also said that his only long term food options are either prescription wet food, or cooked beef. Essentially, she feels that I shouldn't be adjusting his shot based on anything other than his preshot numbers and a set dosing chart...

At the top of Dave's SS you can see the ~6 days that I followed the scale, and frankly I'm 1000x happier with how he's going on TR. I've been putting off going back to see her, because I suspect all that will happen is she'll again tell me that what I'm doing is hurting him, and we'll have to pay for the privilege! I really need to find a new vet, but the problem is that we go to the same vet for all our other animals, and I don't know how much better any of the other vets on the Coast will be...
 
panda28 said:
She's told me that if I don't follow a sliding scale (which skips all shots below 160...) then he'll be too high and at high risk of DKA, and that he has no chance of remission. She has also said that his only long term food options are either prescription wet food, or cooked beef
Click to expand...
I don't understand the above statement that you vet made. If you were to skip shot ( anything below 160 as per the vet) Yes, he will be too high and will be at a risk for DKA so why does she want you to skip shots and to be too high??

And as far as the RX diets and or cooked beef, that is not the case either. There is nothing RX about the diabetic foods; they are expensive and are not even quality food for a cat. The vets make a lot of $$ off those RX diets. And as you can see by Dave's recent cycles , he is doing well with the food you are giving him.

Have you ever read what Dr. Lisa Pierson said about feline diets and the RX foods? She is a renowned Feline Diabetic expert and who we follow for food advice among other issues. You can read lots of her information on http://catinfo.org/
 
panda28 said:
I'm really proud of him!

Honestly, the vet's not happy. She's told me that if I don't follow a sliding scale (which skips all shots below 160...) then he'll be too high and at high risk of DKA, and that he has no chance of remission. She has also said that his only long term food options are either prescription wet food, or cooked beef. Essentially, she feels that I shouldn't be adjusting his shot based on anything other than his preshot numbers and a set dosing chart...

At the top of Dave's SS you can see the ~6 days that I followed the scale, and frankly I'm 1000x happier with how he's going on TR. I've been putting off going back to see her, because I suspect all that will happen is she'll again tell me that what I'm doing is hurting him, and we'll have to pay for the privilege! I really need to find a new vet, but the problem is that we go to the same vet for all our other animals, and I don't know how much better any of the other vets on the Coast will be...
Click to expand...
Vets have to deal with many animals and many different diseases with each animal. A lot of us have found that our vets do not know a lot about feline diabetes...it is not like canine diabetes, which they know more about and it is treated differently. I was very lucky that my vet was happy for me to do the dosing and he left all the diabetic stuff up to me and he just dealt with other issues. But a lot find themselves in the same position as you.
We are not vets and we don't want to take the place of vets who are invaluable, but we deal with FD 24/7 and between us all we have a wealth of information about what works and what doesn't.
You will have a much better chance of remission doing it TR.
And you certainly don't need prescription food or cooked beef to make it all work.
The recipe for DKA is an infection + not enough insulin + not enough food. So if your cat is well and he is eating well and is having enough insulin to get him into good numbers it is unlikely he will get DKA.......but it is always good to have it in the back of your mind if he is unwell.
I know another lady who has a diabetic cat on the central coast....she has gone into remission. Would you like me to find out her vets name.?
 
Bobbie And Bubba said:
I don't understand the above statement that you vet made. If you were to skip shot ( anything below 160 as per the vet) Yes, he will be too high and will be at a risk for DKA so why does she want you to skip shots and to be too high??

And as far as the RX diets and or cooked beef, that is not the case either. There is nothing RX about the diabetic foods; they are expensive and are not even quality food for a cat. The vets make a lot of $$ off those RX diets. And as you can see by Dave's recent cycles , he is doing well with the food you are giving him.

Have you ever read what Dr. Lisa Pierson said about feline diets and the RX foods? She is a renowned Feline Diabetic expert and who we follow for food advice among other issues. You can read lots of her information on http://catinfo.org/
Click to expand...

Bron and Sheba said:
Vets have to deal with many animals and many different diseases with each animal. A lot of us have found that our vets do not know a lot about feline diabetes...it is not like canine diabetes, which they know more about and it is treated differently. I was very lucky that my vet was happy for me to do the dosing and he left all the diabetic stuff up to me and he just dealt with other issues. But a lot find themselves in the same position as you.
We are not vets and we don't want to take the place of vets who are invaluable, but we deal with FD 24/7 and between us all we have a wealth of information about what works and what doesn't.
You will have a much better chance of remission doing it TR.
And you certainly don't need prescription food or cooked beef to make it all work.
The recipe for DKA is an infection + not enough insulin + not enough food. So if your cat is well and he is eating well and is having enough insulin to get him into good numbers it is unlikely he will get DKA.......but it is always good to have it in the back of your mind if he is unwell.
I know another lady who has a diabetic cat on the central coast....she has gone into remission. Would you like me to find out her vets name.?
Click to expand...

The whole thing's pretty ridiculous... To her credit, she is an amazing small animal vet, but I feel that like you both said, she doesn't know much about FD. The whole thing really scared me at first, and I felt like I was a terrible owner for hurting my cat... Spending time here and getting advice from the very knowledgeable people here has made me realize that this way will work a lot better for Dave. The fact is that a lot of the things she said, even when I knew nothing about FD sounded strange, like giving him only 50g of food twice a day. When she's getting things like this wrong, it makes me pretty uncomfortable listening to her about anything FD related.

I actually had him on the RX food for a week, and can clearly see the difference now that he's on a 2% carb food as opposed to a 13% one! Coming to this community with owners with lots of experience seems to make more sense than a vet who is berating me for not doing things that I feel uncomfortable doing to my cat. People here have had to pretty firmly tell me that things I was doing were dangerous or that there were better ways, but they were always very willing to explain why. I feel like a much more active participant in Dave's treatment thanks to people like you guys helping me learn so that I can make informed decisions. I have no clue where we'd be if I hadn't found FDMB, but I do know the whole thing would be a lot more stressful.

That said, it would be wonderful if you could find the name of that lady's vet, Bron!
 
You might like to print this article off. It is the Roomp/Rand management of diabetic cats. Your vet might like to read it and use it for reference! It was written by university professors.

http://www.felinediabetes.com/FDMB/attachments/management-of-diabetic-cats-pdf.14945/

Of course you must be an active participant in Dave's care. He is your cat!....and you are paying the vet for advice and you need to be able to work together with her to help Dave. When Sheba was first diagnosed I knew nothing about FD. I was scared stiff and I am sure I made mistakes. But I learnt as much as I could about FD......most of it from this wonderful site. My vet freely admits that I know a lot more about FD than he does, and he is OK with that.

I will contact Tara re her vet tomorrow and see if she lives anywhere near you.
 
@Tara & Ivana
Hi Tara, I have just noticed you have posted on L&L. I was going to text you tomorrow morning to ask you about your vet. Jacqui is looking at changing vets as her vet wants her to follow another protocol which Jacqui is not happy with. She lives on the Central Coast and I wondered if your vet was more sympathetic to TR and home monitoring.
Are you able to help her??
Thanks Bron
 
Thanks for the link, that's really helpful, and also for contacting Tara. At +2 he's 252, so it looks like it won't too hectic a night. He's surprised me before though, so I'll still test at +4 and +6.
 
Hi Jacqui! Wonderful to have another Coastie on the board :-) Ivana's vet was/is absolutely fully supportive of the TR protocol, and was also happy for us to manage Ivana ourselves for the most part ie. change doses according to TR, etc. I gave the vet the link to Ivana's spreadsheet so she could check on Ivana's numbers whenever she wanted to, although it didn't take long for her to realise that we are doing pretty well and advised us to just keep doing what we were doing unless we had any issues. We've been seeing this vet for about 4yrs for various animals, and wholeheartedly recommend her. I'm not sure if I'm allowed to post actual names/details on here, so I will PM you the details.

One more thing - I have a bit more than a box full of syringes that I've been keeping "just incase" since Ivana went into remission, but seeing it's been over a year now I don't think she's going to need them! Would you like them? Perhaps we could meet up for a coffee or something and go crazy talking about our kitties :cat::D
 
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