Is it time to try something new???

[Emily'smom]

Good Morning, All! I have been trying to do things "right". We have been home testing. When my schedule allows, I have been trying to take mid-day tests. I have learned to test myself, something I never thought I could do, due to Emily's disposition. We bought new needles, with half unit markings, because the vet said 1/2 a unit was too much. So, we are giving her 1/4 units. I have completely gotten her off of dry food (she had been on Purina DM, since her June diagnosis), and she is only eating low-carb wet for about 4 weeks now. With the help of people on this forum, I set up a chart, and have been trying to be diligent about posting in it. Yet, despite all this, Emily does not appear to be stable. Sometimes we inject her, and then test a few hours later and her number is HIGHER. Sometimes we go to bed and she is at a great number, so we think we will wake up and she will be at a good number, and she is not. Sometimes inexplicably, her pre-test evening number is under 100 (so what would her +6 number be???) so we don't inject because we are fearful of bringing her too low. We went to bed last night, and she was at 147, and we wake up this morning and she is at 501???!!!! (My husband did notice a stray cat walking around outside, and this cat does come on our deck, so it is possible she was "facing off" with this cat from inside the house and it got her stressed). The bottom line is she does not appear to be falling into any sort of pattern or curve since I have set up the chart, which is over two weeks now. I really can't make sense of what the insulin is doing or not doing for her, but then I am not really sure what it should be doing. In a perfect world, should her number be "high", we inject, at some point if we can get a mid-day test I assume the number should be lower, and then climb back up, so at the point of her evening test/shot, she is back up again? I just don't know what I am trying to accomplish here, but by looking at Emily's chart would you agree that what we are doing is not working?? Is it time to try a new insulin? Does she need more than the .25 unit being on the Lantus? I just don't know how to proceed and am once again frustrated, aggravated, and most importantly, worried for Emily. FYI, she seems to be acting fine, (not sluggish) although the other typical diabetes signs are there, although not as bad as they had been during her initial diagnosis (when she was in the 400's). HELP!!! xoxo

 

[Tracey&Jones (GA)]

Welcome to the FD dance. And IMHO, it is more of a tango some days vs. a waltz.

Insulin is a hormone not a drug, so unfortunetly, there is no give X dose and I get Y outcome. It is a pretty complex process for the body and each day will be different.

Sometimes we inject her, and then test a few hours later and her number is HIGHER

This can either be due to a bounce or because she ate! For Jones - if it isn't higher at +2 - means I may be in for a very active cycle.

Sometimes we go to bed and she is at a great number, so we think we will wake up and she will be at a good number, and she is not.

Again, maybe bounce. Is all food removed 2 hours before her AM test?

Sometimes inexplicably, her pre-test evening number is under 100 (so what would her +6 number be???) so we don't inject because we are fearful of bringing her too low.

Not sure on the Lev but I know with Lantus - you can sometimes get a 18 hour cycle out of the AM shot. It has happened to me a few times.

 

[Beenie (GA)]

Hi Emily's Mom!!
It looks like this morning was a bounce. Emily was at 197 at PMPS and went down to 141 at +3 which usually means you're going to have an active cycle. She most likely went low later in the night. I would stick with the .25 dose for now until she clears this bounce. I don't think she needs more insulin. She may need less. If you try to get some late nights tests in once in a while (requires setting an alarm) to see how low she goes overnight it will tell you if you perhaps need to decrease. The change 4 weeks ago to all wet is a good thing but that can impact BG levels...in a good way.
The fact that Emily is acting good and other symptoms are improving are all pluses. It takes time to get our kitties regulated. Some tend to be more bouncy than others. You're headed in the right direction.

 

[Tracey&Jones (GA)]

Hit post too quickly

From what I see:

6 cycles in - 8/26 - you saw some blue that night and 8/27 morning and hung onto the blues to that night. Which most likely a bounce as her body are not used to those lower numbers. Which cleared pretty quickly to back down to the blues till the evening of the 8/29. Then she bounced again but came right back down to green on 9/1. Then you had a skipped shot (I am assuming as the dose box is blank?) Bounced again/depot drained till 9/3.

The skipped doses - that will drain the depot. Once that happens it will take a few cycles for it to fill back up again. So you will most likely see high numbers again till it does. These depot insulins need consistency in the dosing to be really work.

If you are worried about shooting lower numbers, do a test and stall - don't feed and shoot. Post the information here asking for dosing advice. Someone will help you decided what dose to shoot and stay with you through the cycle. It can be very nerve racking shooting lower numbers. However once you do, you will find the numbers start to flatten out. Shoot low to stay low.

 

[Tuxedo Mom]

Good job on home testing and setting up a spreadsheet. These are two very important tools for keeping your kitty safe and getting good data.

Lantus will "usually" have an onset around +2 to +3 after the shot. The nadir or lowest number "usually" is around +5 to +7. These can vary with each kitty. On Sept 1 you had a preshot of 257 and a +6 of 91. Although 91 is a safe number that is a bigger drop from the preshot which can cause a "bounce" into higher number for a day or so. It takes time for your kitty's body to become "accustomed" to being in normal numbers. As was already mentioned there is no linear effect with insulin. Since it is a hormone absorption rates and responses can vary day to day and bounces can give higher numbers while the body "resets" iteself to more normal numbers.

The high preshot today may very well indicate that the numbers went lower last night which leads to another bounce. It would be useful to do a curve...testing every 2 hours for 12 hours. This will show what pattern the Lantus is giving with your Emily. If this is not possible a test every 3 hours for 12 hours will still be useful. Today may not be the best day for a curve if this is a bounce. But more tests whenever possible will fill in missing pieces of the puzzle.

This is an example of an active Lantus cycle:


Example of an ACTIVE, but NOT necessarily typical Lantus cycle:
NOTE: Until kitty is pretty well regulated, the description below is NOT not what you'd consider a "typical" Lantus cycle. It takes time and patience for kitty to achieve a "typical" cycle! The example below is what you're working towards (a nice shallow curve). A relatively flat cycle is the ultimate goal.

+0 - PreShot number.
+1 - Usually higher than PreShot number because of the last shot wearing off. May see a food spike in this number.
+2 - Often similar to the PreShot number. Onset begins around +2 for most cats. You'll probably see an active cycle if the +2 is the same/similar OR lower than the preshot number. Continue testing!
+3 - Often lower than the PreShot number.
+4 - Lower.
+5 - Lower.
+6 - Nadir/Peak (the lowest number of cycle. NOTE: ECID. Not every cat has a mid-cycle nadir. Adjust the hours on this example to fit your cat.)
+7 - Surf (hang around the nadir number).
+8 - Slight rise.
+9 - Slight rise.
+10 - Rising.
+11 - Rising (one of the quirks of Lantus/Levemir: some cat's blood glucose numbers dip around +10 or +11... not to be confused with nadir).
+12 - PreShot number.


http://www.felinediabetes.com/FDMB/...the-basics-new-to-the-group-start-here.18139/

This is merely an example how a Lantus cycle may work and can certainly be different for each kitty, but it gives a guideline. The important thing is to find how quickly Emily drops and how far she drops and determine the nadir time (lowest number)

 

[rhiannon and shadow (GA)]

Hello.
I'm betting that last night in the wee hours, she hit a green, likely a low green which is why you are seeing that black this morning.
Of course you want sleep.... but it looks like she might need you to get some random tests in those wee hours.
Many of us just set an alarm and grab a quick test.

Are you leaving food out for her in the night? Depending on your house temperature, you could add lots of water to the canned, and make it soupy
and it will stay moist for many hours. The other thing you can do is make a foodcicle..... freeze a watered down dish of food and let it thaw in her eating spot.

Secondly, when was her last dental?
Does she have any tartar buildup or any sore spots?
If she has never had one at all, then this could be your indicator that she needs one. And if so, make sure they do an xray because that is how they find
cracked teeth or bad roots.

I think the reason your cycles are so irregular could be the teeth, and could be that she's just hitting lows in those testing gaps.

Would you be able to get a curve on weekends? Tomorrow could be a good day for one. You could test every 4 hours.... or 3 hours....
I think today she needs to come down from her high number.

 

[Emily'smom]

Good job on home testing and setting up a spreadsheet. These are two very important tools for keeping your kitty safe and getting good data.

Lantus will "usually" have an onset around +2 to +3 after the shot. The nadir or lowest number "usually" is around +5 to +7. These can vary with each kitty. On Sept 1 you had a preshot of 257 and a +6 of 91. Although 91 is a safe number that is a bigger drop from the preshot which can cause a "bounce" into higher number for a day or so. It takes time for your kitty's body to become "accustomed" to being in normal numbers. As was already mentioned there is no linear effect with insulin. Since it is a hormone absorption rates and responses can vary day to day and bounces can give higher numbers while the body "resets" iteself to more normal numbers.

The high preshot today may very well indicate that the numbers went lower last night which leads to another bounce. It would be useful to do a curve...testing every 2 hours for 12 hours. This will show what pattern the Lantus is giving with your Emily. If this is not possible a test every 3 hours for 12 hours will still be useful. Today may not be the best day for a curve if this is a bounce. But more tests whenever possible will fill in missing pieces of the puzzle.

This is an example of an active Lantus cycle:


Example of an ACTIVE, but NOT necessarily typical Lantus cycle:
NOTE: Until kitty is pretty well regulated, the description below is NOT not what you'd consider a "typical" Lantus cycle. It takes time and patience for kitty to achieve a "typical" cycle! The example below is what you're working towards (a nice shallow curve). A relatively flat cycle is the ultimate goal.

+0 - PreShot number.
+1 - Usually higher than PreShot number because of the last shot wearing off. May see a food spike in this number.
+2 - Often similar to the PreShot number. Onset begins around +2 for most cats. You'll probably see an active cycle if the +2 is the same/similar OR lower than the preshot number. Continue testing!
+3 - Often lower than the PreShot number.
+4 - Lower.
+5 - Lower.
+6 - Nadir/Peak (the lowest number of cycle. NOTE: ECID. Not every cat has a mid-cycle nadir. Adjust the hours on this example to fit your cat.)
+7 - Surf (hang around the nadir number).
+8 - Slight rise.
+9 - Slight rise.
+10 - Rising.
+11 - Rising (one of the quirks of Lantus/Levemir: some cat's blood glucose numbers dip around +10 or +11... not to be confused with nadir).
+12 - PreShot number.


http://www.felinediabetes.com/FDMB/...the-basics-new-to-the-group-start-here.18139/

This is merely an example how a Lantus cycle may work and can certainly be different for each kitty, but it gives a guideline. The important thing is to find how quickly Emily drops and how far she drops and determine the nadir time (lowest number)

Hello! Thanks for this detailed response, along with the chart for the "typical" way that Lantus works. Honestly, I did not know that insulin was a hormone. Which brings up another point. I have a new vet, one that comes to the house. On her first visit here (about a month ago), she did a very detailed blood work up on Emily, as she wanted to assess her complete health history. Her thyroid tested LOW (.8) I believe. The vet said it is very unusual or a cat to have a LOW thyroid, but since we were focused on the diabetes as well as a bad tooth, AND a UTI at that time, we did not get into discussing this low thyroid. Since the thyroid is also part of the endocrine system, do you think this "problem" could have any bearing on her reaction to the insulin? The tooth was pulled (at least part of it...the part that was "bad", and she was given an antibiotic shot for the UTI). Since we have been traveling, I have not had the vet back, but plan on making an appointment tomorrow. Thoughts? Thank you!

 

[Emily'smom]

Hello.
I'm betting that last night in the wee hours, she hit a green, likely a low green which is why you are seeing that black this morning.
Of course you want sleep.... but it looks like she might need you to get some random tests in those wee hours.
Many of us just set an alarm and grab a quick test.

Are you leaving food out for her in the night? Depending on your house temperature, you could add lots of water to the canned, and make it soupy
and it will stay moist for many hours. The other thing you can do is make a foodcicle..... freeze a watered down dish of food and let it thaw in her eating spot.

Secondly, when was her last dental?
Does she have any tartar buildup or any sore spots?
If she has never had one at all, then this could be your indicator that she needs one. And if so, make sure they do an xray because that is how they find
cracked teeth or bad roots.

I think the reason your cycles are so irregular could be the teeth, and could be that she's just hitting lows in those testing gaps.

Would you be able to get a curve on weekends? Tomorrow could be a good day for one. You could test every 4 hours.... or 3 hours....
I think today she needs to come down from her high number.

Thank you so much for the response. Funny you should mention a tooth problem. I have a new vet - one that comes to the house. When here for the first time a month ago, she had a bad tooth. At least part of it was pulled. I am not sure if she got the whole thing, or if only part was bad, so that was all that was taken out. Also, she had a UTI, for which she was given an antibiotic shot. I have not had the vet back, but plan on making an appointment tomorrow. We are home for part of the day today, so we will do some periodic tests during the day to see what her numbers are. Can you please explain about leaving food out? I am not sure I understand that process. Emily has always been a grazer. If I feed her and then took food away, she would starve, because she only eats a few bites at a time, walks away, comes back later, eats a few bites, etc., until eventually the bowl is gone. I typically only put food down twice a day...once in the morning, and once in the evening at dinner time. It is impossible for me to judge when she eats. For example, if I feed her in the morning, and she eats a bit, and then I leave for work, unless she is in a diabetes ravenous state, her food is still in her bowl. When I come home, her food is usually gone, but I do not know when she ate that food ... she could have eaten it at 10:00 am., or 1:00 pm, or 4:00 pm. or more likely, a little bit all of those times. The same goes for night...if I go to bed and she still has food in he bowl, I can't take that away, because that is her daily portion of food. Emily naturally weighs 6.7 lbs, but has lost some weight during these last few months. I am concerned about her eating enough to maintain her weight. Any thoughts on how I should be handling her food now that she is diabetic would be appreciated!

 

[Emily'smom]

Welcome to the FD dance. And IMHO, it is more of a tango some days vs. a waltz.

Insulin is a hormone not a drug, so unfortunetly, there is no give X dose and I get Y outcome. It is a pretty complex process for the body and each day will be different.


This can either be due to a bounce or because she ate! For Jones - if it isn't higher at +2 - means I may be in for a very active cycle.


Again, maybe bounce. Is all food removed 2 hours before her AM test?

Not sure on the Lev but I know with Lantus - you can sometimes get a 18 hour cycle out of the AM shot. It has happened to me a few times.

Honestly, I did not know insulin was a hormone! About a month ago, Emily was given a full blood work up with a new vet. She discovered Emily had a low thyroid (.8), which apparently is very rare in cats. Since we were focused on the diabetes, a bad tooth and a UTI, we didn't really discuss this thyroid, but knowing that it also involves the endocrine system, do you think this could have some bearing on what I perceive to be erratic glucose numbers? Regarding removing food before a test: I am not sure how to monitor this. Emily is a grazer...always has been. She is also tiny...always has been (naturally 6.7 lbs., now down around 6.2 when last weighed). If I feed her "dinner" unless she is in a diabetic ravenous state, she eats a few bites and walks away. She will do this all day/night. I cannot take her food away before I go to bed, because she will not have eaten her daily caloric requirement. So, she eats throughout the night. I have no way of knowing when her last bites were. I am trying a new schedule now, where I don't feed her right when i get up...I wait a bit, so that if I get up at 6:00 a.m, and her dish is empty, I don't test her until 7:30ish so that I do know that she has not eaten in that time. If her dish still has food in it, I take it away.

 

[Tracey&Jones (GA)]

Jones free feeds as well. It is the best way for me to get him to eat. I put out extra food so if he wants more, he can eat more. It has been a struggle to get him to gain weight.

I too don't really know when he last ate...but I keep that in mind when looking at his PS numbers. Sometimes the PMPS have some food influence but most times in the morning he is cuddling with me before he eats!

 

[Tracey&Jones (GA)]

we didn't really discuss this thyroid, but knowing that it also involves the endocrine system, do you think this could have some bearing on what I perceive to be erratic glucose numbers?

I am no vet, but I thought the pancreas was the organ that was controlling insulin production. That is where Jones' journey started...pancreatitis which lead to IBD which lead to a steroid being used that lead itself to diabetes.

 

[Sienne and Gabby (GA)]

Welcome, Mary!

Any source of inflammation or infection can cause blood glucose (BG) numbers to be inflated. Any animal's body will interpret inflammation or infection as a source of stress which causes stress hormones (catecholamines) to be released. These hormones cause an increase in BG. Your vet's thoroughness has provided you with a good piece of information as to why you may be feeling frustrated with Emily's numbers. Hopefully, the vet is treating the UTI and you have plans to get the tooth taken care of, There are quite a few kitties here who have come out of remission because of a dental issue. If this were my cat, I would also want to get the thyroid test repeated to double check whether the result was just an "off" finding.

I'd also urge you to keep in mind that managing your cat's diabetes is a marathon, not a sprint. I know you want Emily to be regulated as soon as possible but the reality is that she's leading in this dance and you've been at this for a relatively short period of time. Most of us haven't a clue as to how long our cats were diabetic prior to their being diagnosed. One of the things that happens pre-diagnosis is that your cat's body can become accustomed to being in high BG numbers and treats those levels as a "new normal." (The technical term for this is glucose toxicity and it can also happen if a cat stays at an insulin dose that isn't bringing numbers into a normal range.) Looking at your spreadsheet, there's a possibility that some glucose toxicity is present but you're also seeing variability in Emily's numbers which would argue against glucose toxicity.

I agree with what others have observed above. Some of the higher numbers can be the result of a bounce. If a cat drops into low numbers, if there's a fast drop in numbers, or a kitty is seeing numbers that her body isn't used to, the liver and pancreas can panic. When this happens, these organs release a stored form of glucose along with counterregulatory hormones that cause BG to spike upward. It's a wonderful protective mechanism but one that frustrates the heck out of us.

Lantus likes consistency especially with regard to the depot. It may help if when you ran into a pre-shot number you are uncomfortable shooting if you could post and we could help you weigh options rather than just routinely skipping the shot. I would also strongly encourage you to get at least one test every night before you turn in for the night (i.e., a "before bed" test).

As for food, free feeding is fine. You just want to pick up any food at least 2 hours prior to shot time. You don't want to have food influence your pre-shot number. You might consider getting a timed feeder. I'm not sure if that will completely resolve the issue of when Emily grazes but it may insure that she's not scarfing down a huge portion of her food close to shot time.

@Tracey&Jones - You are correct that it's the beta cells in the pancreas that produce insulin and are directly involved in diabetes. However, the various organs in the endocrine system interact. As an example, a diabetic cat that's hyperthyroid may have difficulty becoming regulated. Acromegaly involves the pituitary gland whereby growth hormone levels wax and wane which also influences numbers. As you noted with Jones, even an external source of steroids (i.e., hormones which are part of the endocrine system) can have an effect on BG levels. They are all interrelated.

 

[rhiannon and shadow (GA)]

Sienne gave you an excellent explanation.

I would not trust that the tooth is a non issue now. Roots don't always come out as easily as other parts of the tooth.


Have you tried sprinkling one of the freeze dried treats on her food as she walks away. It might encourage her to eat more at a time.
Don't get too focused on the 2 meals a day....
diabetics do much better with several meals spread out.... so she's doing the right thing with her grazing. It helps keep the blood sugar more even.

 

[Emily'smom]

Welcome, Mary!

Any source of inflammation or infection can cause blood glucose (BG) numbers to be inflated. Any animal's body will interpret inflammation or infection as a source of stress which causes stress hormones (catecholamines) to be released. These hormones cause an increase in BG. Your vet's thoroughness has provided you with a good piece of information as to why you may be feeling frustrated with Emily's numbers. Hopefully, the vet is treating the UTI and you have plans to get the tooth taken care of, There are quite a few kitties here who have come out of remission because of a dental issue. If this were my cat, I would also want to get the thyroid test repeated to double check whether the result was just an "off" finding.

I'd also urge you to keep in mind that managing your cat's diabetes is a marathon, not a sprint. I know you want Emily to be regulated as soon as possible but the reality is that she's leading in this dance and you've been at this for a relatively short period of time. Most of us haven't a clue as to how long our cats were diabetic prior to their being diagnosed. One of the things that happens pre-diagnosis is that your cat's body can become accustomed to being in high BG numbers and treats those levels as a "new normal." (The technical term for this is glucose toxicity and it can also happen if a cat stays at an insulin dose that isn't bringing numbers into a normal range.) Looking at your spreadsheet, there's a possibility that some glucose toxicity is present but you're also seeing variability in Emily's numbers which would argue against glucose toxicity.

I agree with what others have observed above. Some of the higher numbers can be the result of a bounce. If a cat drops into low numbers, if there's a fast drop in numbers, or a kitty is seeing numbers that her body isn't used to, the liver and pancreas can panic. When this happens, these organs release a stored form of glucose along with counterregulatory hormones that cause BG to spike upward. It's a wonderful protective mechanism but one that frustrates the heck out of us.

Lantus likes consistency especially with regard to the depot. It may help if when you ran into a pre-shot number you are uncomfortable shooting if you could post and we could help you weigh options rather than just routinely skipping the shot. I would also strongly encourage you to get at least one test every night before you turn in for the night (i.e., a "before bed" test).

As for food, free feeding is fine. You just want to pick up any food at least 2 hours prior to shot time. You don't want to have food influence your pre-shot number. You might consider getting a timed feeder. I'm not sure if that will completely resolve the issue of when Emily grazes but it may insure that she's not scarfing down a huge portion of her food close to shot time.

@Tracey&Jones - You are correct that it's the beta cells in the pancreas that produce insulin and are directly involved in diabetes. However, the various organs in the endocrine system interact. As an example, a diabetic cat that's hyperthyroid may have difficulty becoming regulated. Acromegaly involves the pituitary gland whereby growth hormone levels wax and wane which also influences numbers. As you noted with Jones, even an external source of steroids (i.e., hormones which are part of the endocrine system) can have an effect on BG levels. They are all interrelated.

Hi Sienne (pretty name!) Thank you for your thoughts and detailed reply. The UTI was treated a month ago, with an antibiotic shot that was equal to two weeks of oral antibiotics. She also removed PART of the bad tooth, as it came out easily and she felt that the remaining part of the tooth was "ok". I can certainly have her recheck that tooth and perhaps make a plan to remove the entire thing. It was a small tooth, on the top. I am contacting her today, as I have not had her out for a follow up for Emily, given our vacation schedule and also we were hosting seven of our friends from overseas, and they just left on Thursday. Hence, some of the missed doses you noticed in my chart.

So, I am feeling encouraged that we are not necessarily experiencing anything "out of the norm" when dealing with a diabetic cat. Honestly, I was under the assumption that you got a diagnosis, were given a course of insulin action, and you just shot away, and things would be fine. At least that is what my prior vet made it seem like. I can see now, being a few months in, and taking things step by step (we were not home testing initially, did not have a chart until recently, etc) that this requires more effort and patience than I initially expected.

If you take a look at the chart, we were home yesterday morning, and tested every two hours for the first 4 hours after her morning shot. We were gone for the afternoon. When we returned for her evening shot, she was up to 380. Down to 202 at +3 (and at that point we went to bed). This morning, she tested at 239 and since I am home today, I am going to attempt testing her every 2-3 hours by myself. Treats or not, this is sometimes not an easy process to do alone, with Emily. Her +2 this morning is 208, so she is coming down. One thing I have noticed over the last few days is that she is really eating ravenously, which is not the norm for this cat. As mentioned earlier, she is a grazer, and often can be quite picky. I know with consistently high numbers (initial diagnoses) she was eating ravenously, but for the most part, that has not been the case since she has been on the insulin. Any thoughts on this? And also, should I give in to her hunger? In other words, if she wants to eat three cans of food a day, should I be feeding her that. Please keep in mind that she is a tiny cat (with BIG fur) that typically weights 6.7 lbs, but she has lost weight. My guess is that she is around 6 lbs right now. I would appreciate your thoughts, or the thoughts of anyone who might want to chime in. Thank you!!

 

[Sienne and Gabby (GA)]

As far as the dental issue, it's my experience that it's unusual to leave part of the tooth in place and amputate the crown. Usually, this is only done in cats with reabsorptive leasions (FORL).

If Emily is eating ravenously, it's usually for one or two reasons. As you noted, when she was first diagnosed, she was eating this way. It's a sign of a cat that's diabetic and in high BG numbers. Despite eating like she's starving, the results of the food being metabolized (i.e., turning into glucose) are that the glucose is still floating around in the blood stream versus getting into the cells where it's supposed to go. The result is that your cat is starving and losing weight if nutrition isn't going into the cells. The other reason is because numbers may be dropping. Many cats instinctively look for food if their BG is dropping. It sounds like Emily may be giving you a "heads up."

 

[Emily'smom]

I think because this vet comes to the house (in a well-equipped van), and the tooth was being attended to on the kitchen table, she took off the part that obviously had a problem. I could be wrong (Emily will not let ME look in her mouth), the "stump" is still there, but based on what the vet said, I thought that part was not decayed or whatever was wrong with the tooth. I will have this looked into further when the vet comes back.

So, since Emily's numbers (for the most part) in the last 2 days have been in the 200s or lower, do you think the fact that she is hungry is a good thing, meaning her numbers are perhaps getting more in a more positive range, so she is giving me a heads up that that is happening? In other words, if her numbers were in the 400s (like initial diagnoses) and she were eating ravenously, it would be for the reason first described. Since for the majority of the last few weeks her numbers are not in the 400s or even 300s, she is adjusting to these new lower numbers, so she is eating to try and compensate for the drop???

 

[Emily'smom]

As far as the dental issue, it's my experience that it's unusual to leave part of the tooth in place and amputate the crown. Usually, this is only done in cats with reabsorptive leasions (FORL).

If Emily is eating ravenously, it's usually for one or two reasons. As you noted, when she was first diagnosed, she was eating this way. It's a sign of a cat that's diabetic and in high BG numbers. Despite eating like she's starving, the results of the food being metabolized (i.e., turning into glucose) are that the glucose is still floating around in the blood stream versus getting into the cells where it's supposed to go. The result is that your cat is starving and losing weight if nutrition isn't going into the cells. The other reason is because numbers may be dropping. Many cats instinctively look for food if their BG is dropping. It sounds like Emily may be giving you a "heads up."

I think because this vet comes to the house (in a well-equipped van), and the tooth was being attended to on the kitchen table, she took off the part that obviously had a problem. I could be wrong (Emily will not let ME look in her mouth), the "stump" is still there, but based on what the vet said, I thought that part was not decayed or whatever was wrong with the tooth. I will have this looked into further when the vet comes back.

So, since Emily's numbers (for the most part) in the last 2 days have been in the 200s or lower, do you think the fact that she is hungry is a good thing, meaning her numbers are perhaps getting more in a more positive range, so she is giving me a heads up that that is happening? In other words, if her numbers were in the 400s (like initial diagnoses) and she were eating ravenously, it would be for the reason first described. Since for the majority of the last few weeks her numbers are not in the 400s or even 300s, she is adjusting to these new lower numbers, so she is eating to try and compensate for the drop???

And regardless of the reason, should I be feeding her however much she wants to eat??

 

[Tracey&Jones (GA)]

I noticed a couple of things with Jones. He eats a lot when higher - like bouncing. And he eats a lot when dropping. When he is kind of steady in the mid-high blue range - he isn't so hungry.

Until Emily is regulated - she will eat because her body is still not getting all the benefits of the food taken in and she will eat when dropping (which may need to be controlled if dropping too low too fast).

And regardless of the reason, should I be feeding her however much she wants to eat??

I do, for now, until she is back to her normal weight and regulated.

 

[Emily'smom]

Thanks, Tracey! I will feed her as much as she wants, pretty much when she wants, (except for the 2 hours before shot) for now. If she were a 20 lb cat, I wouldn't be so worried. But, this little 6 lb munchkin cannot afford to lose too much...I am well aware of that and the problems that alone can cause. UGH!

 

[Emily'smom]

I noticed a couple of things with Jones. He eats a lot when higher - like bouncing. And he eats a lot when dropping. When he is kind of steady in the mid-high blue range - he isn't so hungry.

Until Emily is regulated - she will eat because her body is still not getting all the benefits of the food taken in and she will eat when dropping (which may need to be controlled if dropping too low too fast).



I do, for now, until she is back to her normal weight and regulated.

Thanks, Tracey! I will feed her as much as she wants, pretty much when she wants, (except for the 2 hours before shot) for now. If she were a 20 lb cat, I wouldn't be so worried. But, this little 6 lb munchkin cannot afford to lose too much...I am well aware of that and the problems that alone can cause. UGH!

 

[Sienne and Gabby (GA)]

FWIW, my vet makes housecalls and comes equipped with even ultrasound equipment. She will not do anything dental anywhere but in the clinic. Dental work should involve anesthesia, sterile conditions, and x-rays. Chopping off a portion of the tooth may mean either there is an exposed nerve or the roots are going to be left to gradually die. Either could be painful. The latter risks infection.

It's hard to know what Emily being hungry means. Like Tracey noted, it could be either or both dropping or high numbers. One other thought is that with some cats, a flat yellow cycle is a heads up for an active upcoming cycle. Just keep an eye on Emily's numbers into the evening.

 

[rhiannon and shadow (GA)]

I , too, want to encourage you to take her to a vet with a clinic to address the tooth issue.

I would bet money ( and I don't gamble at all, no sirree ) that this is a huge factor in her FD.

 

[Emily'smom]

FWIW, my vet makes housecalls and comes equipped with even ultrasound equipment. She will not do anything dental anywhere but in the clinic. Dental work should involve anesthesia, sterile conditions, and x-rays. Chopping off a portion of the tooth may mean either there is an exposed nerve or the roots are going to be left to gradually die. Either could be painful. The latter risks infection.

It's hard to know what Emily being hungry means. Like Tracey noted, it could be either or both dropping or high numbers. One other thought is that with some cats, a flat yellow cycle is a heads up for an active upcoming cycle. Just keep an eye on Emily's numbers into the evening.

I believe this huge van that the vet comes with has a sterile area where surgery can actually be performed. And, I know she does have the ability to run scans, etc. I will need to check with her on all of this, as I honestly am not sure...she has only been here once. But, perhaps the tooth is part of the problem. I have been testing Emily just about every 2 hours today, because I am home. She isn't making much movement with her numbers. I am not sure what you mean about "active upcoming cycle", (can you explain?) but she has been in the yellow all day today, and eating "really well". I have been feeding her small portions after each time I take a test. The last test, I waited three hours so as to get a more accurate reading, without any food being in her belly.

 

[Emily'smom]

I , too, want to encourage you to take her to a vet with a clinic to address the tooth issue.

I would bet money ( and I don't gamble at all, no sirree ) that this is a huge factor in her FD.

Thank you for your thoughts! I have a call in to the vet to try and schedule an appointment, with a through tooth check being one of the concerns I will address with her. The van she comes in actually has an operating room, I believe. She has only been here once, I so don't have the specifics, but I will find out and hopefully we can get to the bottom of the "problem" (if there is one...perhaps this is just feline diabetes being feline diabetes). I am checking her every 2 hours today. She is staying in the 200's, and eating a lot. Not sure what is going on. UGH!

 

[Sienne and Gabby (GA)]

An "active" cycle is one where the numbers drop and you are busy testing.

It's helpful if you can keep Emily's spreadsheet up to date. (Sorry to nag.)

 

[Emily'smom]

An "active" cycle is one where the numbers drop and you are busy testing.

It's helpful if you can keep Emily's spreadsheet up to date. (Sorry to nag.)

Not nagging at all! Had to head out last night, and didn't have a chance to update this morning before running out to work.

I just updated the chart. I tested most of the day yesterday. There was hardly any movement in her numbers. Not sure why. This makes me doubt myself. Since we are giving her such small amounts, am I eyeing this up correctly?? I think I am (I've been doing it long enough). Did I shoot through because she is so thin?? Insulin smells terrible...I don't remember smelling that smell once it is out of the needle. Again, a frustrating few days. I am trying to schedule the vet. When I am available, she is not. Hoping to speak with her tomorrow morning so we can get something on the calendar.

 

[Tracey&Jones (GA)]

It maybe that tooth...but it looks like a bounce from those blues. That can take up to 6 cycles or more to clear.

This makes me doubt myself.

Don't do that. You are testing and recording...Emily will reveal her insulin needs, just takes time for her body to figure it out.

 

[Sienne and Gabby (GA)]

If you're concerned about whether you're drawing up a dose consistently, many of us use digital calipers to help measure a dose. I purchased mine through Harbor Freight. There are also instructions that are most likely in the "Where do I find...?" post.

 

[Emily'smom]

It maybe that tooth...but it looks like a bounce from those blues. That can take up to 6 cycles or more to clear.



Don't do that. You are testing and recording...Emily will reveal her insulin needs, just takes time for her body to figure it out.

Thank you, Tracey.

 

[Emily'smom]

If you're concerned about whether you're drawing up a dose consistently, many of us use digital calipers to help measure a dose. I purchased mine through Harbor Freight. There are also instructions that are most likely in the "Where do I find...?" post.

I've read the caliper information before. Someone also suggested putting colored water in a syringe so that you can do a visual each time you shoot. I am going to start with that ... especially since both my husband and I are filling syringes, so perhaps we are each doing it slightly differently. I just don't know.