? Post-relapse woes

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Squeakycats

Squeakycats

Member Since 2017
Hi, all--

I'm taking a second stab at getting my kitty Misha into remission--he was doing great for a while, then we gave him Tresaderm ear drops for a bad infection...won't do that again :banghead: . I of course foolishly hoped we'd be able to get him better quickly; no such luck. So I'm trying to start SLGS.

I'm particularly wondering what folks think about the last 3 days or so of his spreadsheet. I don't *think* I'm giving fur-shots...it just all seems really odd. I'm going to clip his hair in a couple of spots so I can be 100% sure I'm getting the needle in, and I guess I'm going to reduce his dose from .5 to .25, since he went below 90--should've done that this morning? I'm working from home today and hanging out with him, and he didn't seem like he was feeling super-well this morning--slept under the bed instead of in his usual spot. Otherwise he has seemed fine--not quite as relaxed and happy as he was while OTJ, but it's hard to be 100% relaxed and happy when people are poking you with needles all day.

I greatly appreciate any advice, and I apologize for doing various stupid things. I should really have known better, after all the amazing help and education I have received on this board.

I need to get him to lose about a pound, too, but that's a somewhat separate problem--right? Sigh. Civvie-cat Willa loves having some dry Young Again food available during the day to munch--her severe food anxiety is gone, and she's so happy and looking good. And I've been glad to think Misha has constant access to food if his blood sugar gets low. And DH has been happy because there's not a ton of uneaten, expensive canned food sitting around all day attracting bugs. But snacking so much has not been good for Misha. Tips on this are welcome also...:( :banghead: :(
 
Hello and welcome back. I hope your stay is a short one.

First thoughts, on SLGS, the initial dose should be held for 7 days. There is too much changing of dose going on. Even on TR, you would hold the initial dose 5 days, unless his numbers were higher. Remember patience pants? :p So stick to 0.25 units since he earned a reduction, and re-evaluate the dose in a week.

It's unfortunate about the YA food. Without it and on canned, you'd be able to follow TR. It can be harder to get them into remission the second time so being able to be a bit more aggressive can help with that. Does Misha play much?
 
He might play more if we got some more of his favorite feather toys. I'll do that! Prior to the diabetes, we let him roam in our neighborhood because it made him so happy, but I was never truly comfortable with it--and now with this, and the food allergy (we know some neighbors leave food outside their houses), I'm just not comfortable with it. He has a nice yard (one of those "Purrfect Fence" set-ups) but can't really run the way he used to--so he's getting less exercise.

I would be so afraid to do TR with me and my husband both working full-time. But I think during our last adventure (when I wasn't using a protocol, really), what we did was more aggressive than SLGS. I definitely didn't regard 90 as concerning enough to change the dose. Hmm. I'll read up on TR again.

Maybe I can set it up so he can't get at the dry snacks but the other one can...which would actually also allow me to feed her poultry-based canned food, which he definitely can't have. I haven't been nuts about feeding them so much fish (they do both get canned morning and evening), so that would be nice. He likes his freeze-dried raw and will let me rehydrate it, so I could maybe focus more on that with him.

I am going to need so many pairs of patience pants, and whatever the "don't be such a coward" equivalent is--courage culottes? I see him in the 200s and freak out, when really I know a lot of cats spend a lot of time in that range. And I give him his injection in the morning and freak out because we'll both be gone for at least 9 hours most days, when realistically, it's unlikely he's going to have severe hypoglycemia if we're dosing him consistently and carefully (right?). The dry food was sort of a hedge against that--like, "if he starts feeling bad, at least he'll be able to eat!"

Thank you for always being so incredibly kind and helpful and knowledgeable!
 
Oh wow, his starting dose for TR would be 1.5 units! He started on 2 back at the very beginning of this, per the vet's recommendation; we went down to 1 pretty quickly. (He has an Alpha Trak spreadsheet from before we switched meters; maybe I should link to that.) After a long time give "drops," that sounds so high...but again, I know lots of kitties are on much higher doses. Oh, brain. Why must you be so panicky?
 
Squeakycats said:
Oh wow, his starting dose for TR would be 1.5 units!
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If he was brand new to insulin, which he isn't. We do look at what his dosing was the previous time on insulin when they relapse. Having a link to his old spreadsheet would help.
 
So does this seem like a good plan?
  • Keep him on .5 for at least 5 days (10 cycles), per the TR protocol
  • Decrease immediately to .25 if he ever drops below 40 or 50
  • Test at least at pre-shot, +3, +6, and +9 for the next 6 cycles (which should be possible starting tonight)(**I assume this means I do need to get up multiple times during the night to test, even if he does not seem to be in trouble; is that right?**)
  • Remove all dry food (leave canned available for free feeding if it seems necessary)
  • Play more
  • Be prepared for hypos, obviously (I have the supplies and have printed the instructions)
And then on Monday when we have to go to work...
  • Continue to follow the protocol, testing as often as possible (at least at both pre-shots)(**what I could do consistently is pre-shot and +2 in the morning, then preshot and +2, +4 at night--I could do more on weekends and might be able to arrange for my husband to stay home one day a week to test more frequently)
  • Possibly adjust somehow when we go out of town and the sitter has to care for him--August 19-22. We'll miss most of four days; the sitter is quite competent and willing to give shots, but I don't know about testing...she's going to have a hard enough time hauling him out from wherever he is hiding when she arrives. She can't stay with him--she'd have to shoot and leave. Getting him to eat immediately beforehand might be impossible, but he'll eat during the day. I don't know if she can test--I'll ask.
What do y'all think? Is this the right idea? I wish I didn't have to be away from home so much.
 
Wendy said to do 0.25u because Misha earned a reduction last night, according to SLGS (dry food). With you taking away dry food now, that could cause his BG to lower so it's better to give the 0.25u dose.

I wouldn't worry about testing so often at night. Get +2 and before bed tests to see if it could be an active cycle. Then set your alarm if necessary.

Otherwise, your plan sounds good.
 
Thank you, Mandy! I'm going to go for it with the .25 and the TR and just do my best on the testing front. And I'm going to cut out a picture of a pair of nice pants and put it on the counter where I keep his supplies, because I know when I see numbers in the 200s, I'm going to think "oh no, oh no, maybe we should be doing .5, I'm doing it wrong!" PATIENCE PANTS.

I know the insulin is good; I just got a fresh pen a few days ago. I'm going to do a little strategic hairstyling for him to be absolutely sure I'm getting it into him.

I'm surprised at how hard it is to be starting this process over--really accepting that he's not just suddenly going to snap back into remission--but I know it will start to feel more ok again at some point. I wish so much that we hadn't gone anywhere near the Tresaderm--the infection was bad, but I know now that there are other effective things to try and we didn't have to go that route. No changing the past, unfortunately--all the steroids he got for his allergies before I had any idea that they might cause problems, and the supplement he got that turned out to have a corn syrup base...I feel like I made him sick then, by being ignorant, and have done it again, by making a bad choice. He's such a trusting little guy, and I hate that I have let him down. I wonder if other people feel this way...

Mandy, I see you sometimes use the YA food on vacation...do you think that's something I could try during the period where our petsitter is here, just to be sure he eats? Am I thinking too far ahead?

I appreciate your help so very, very much--both of you. (And I always enjoy seeing the photos of Rex and Neko--it's sad to be reminded that Neko has passed, but he continues to have such an impact on so many of us, through you, Wendy.)
 
There was someone else who used Tresaderm drops for her cat's ear infection and her cat needed more insulin afterwards. It's scary how a medicine can affect your blood sugar and insulin requirements that much. But that is in the past - you are trying your best for your kitty and that's what is important.

As for YA, that could be a possibility, but I am sure Wendy will have an opinion. She's the pro! I give YA only if I'm not home. I don't give it all the time for 2 reasons, 1-it's expensive! and 2-dry food isn't the best for kidneys and I have a kitty who is in Stage 2 kidney disease so I want to do what I can so it doesn't worsen. August 19th is still over 2 weeks away! :) But I am like you, analyzing and overthinking everything. :oops:
 
Squeakycats said:
I wish so much that we hadn't gone anywhere near the Tresaderm--the infection was bad, but I know now that there are other effective things to try and we didn't have to go that route. No changing the past, unfortunately--all the steroids he got for his allergies before I had any idea that they might cause problems, and the supplement he got that turned out to have a corn syrup base...I feel like I made him sick then, by being ignorant, and have done it again, by making a bad choice. He's such a trusting little guy, and I hate that I have let him down. I wonder if other people feel this way...
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Don't be hard on yourself for giving him the medicine the vet prescribed. All we can do is the best we can with the knowledge we have at that time. You were just trying to help him like you are doing now with treating his diabetes. :bighug:
 
I used Tresaderm drops and didn't notice any change. But then again Smokey was rarely under 200. I must also say since his and another cats ear infections were misdiagnosed for years, and the drops worked I would be willing to put up with slightly higher numbers for the week. That's just me and I'm not recommending it for anyone else. I had a previous cat that I think, now that I knew the problem had the same yeast infection of his ears. He suffered for 16 years with them because no vet could see past the microscope. As long as they didn't have mites, they just had gunky ears. If only I knew back then.
 
Woodsywife said:
I used Tresaderm drops and didn't notice any change. But then again Smokey was rarely under 200. I must also say since his and another cats ear infections were misdiagnosed for years, and the drops worked I would be willing to put up with slightly higher numbers for the week. That's just me and I'm not recommending it for anyone else. I had a previous cat that I think, now that I knew the problem had the same yeast infection of his ears. He suffered for 16 years with them because no vet could see past the microscope. As long as they didn't have mites, they just had gunky ears. If only I knew back then.
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Poor little guy--for a long time I thought "gunky ears" were normal, too. :(
 
I know all to well the feelings you are experiencing with losing remission as Bubba is on his 3rd time OTJ ( fingers crossed) The realization that the insulin and testing would resume was quite anxiety producing but, I did what I had to do as you will too. You definetley test enough for TR so if you could get him off the YA dry so that you could do the TR and get him back OTJ faster. That is the key, to get them into lower numbers as fast and safely as you can.

My vet told me for my civvie with gunky ears to use equal parts water and white vinegar and take a cotton ball and moisten it (ring out the extra liquid) and clean the inside folds of the ears when ever I see gunk. I did that and he is doing fine, knock on wood.
 
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Bobbie And Bubba said:
I know all to well the feelings you are experiencing with losing remission as Bubba is on his 3rd time OTJ ( fingers crossed) The realization that the insulin and testing would resume was quite anxiety producing but, I did what I had to do as you will too. You definetley test enough for TR so if you could get him off the YA dry so that you could do the TR and get him back OTJ faster. That is the key, to get them into lower numbers as fast and safely as you can..
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He's off the YA as of now, to his horror. We got out a feeding box we rigged for him a while back, to keep his greedy civvie sister out of his snacks--but this time we rigged it to let her in and keep him out! (It has a door that uses a microchip reader so you can control which cat/cats can get inside.) She'll be able to get a snack if she starts freaking out, and he...well, he'll be able to kill me in my sleep, probably. He acts like he knows exactly what is going on, and he is seriously offended.

I hope that Bubba will be back OTJ in no time!!! Thank you for understanding...it really helps to know that others have felt the same way and gone through the same processes and are doing ok!
 
Good luck with the feeding box and Misha not killing you in your sleep, LOL.

As of right now, Bubba is OTJ. This is his third time, so hoping 3 times a charm?!
 
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