? 10/11 | Darwin: +35=52, AMBG=41, +2=44, +4=45, +6=51, PMBG=50, +2.5=64

[Tasha & Darwin]

Yesterday's Adventure

Well, I got a "+11" (+35 - I think I'm doing that math right), and he's at +52. Going to get a AMBG in just under an hour, but won't have a lot of time to stall as I work this morning. Is it wise to continue to NS? I don't want to set him back, but 52?!

 

[Beenie (GA)]

Agreed. If you're not home to monitor I wouldn't shoot a 52. But yay Darwin and not diggin' the juice

 

[Alicia & Maggie (GA)]

Looking at D's spreadsheet, I think I would go NS if it were my cat. It's a good thing!!

 

[Gill & George]

Ooops, didn't see your new thread.

below is what I posted in yesterdays condo. To add to that, if you are not able to monitor closely then skipping seems a sensible choice.
Also wanted to add the following:
If he continues to ride this low, you may want to consider feeding the curve with slightly higher LC or even MC in order to continue to support those delicate new Beta cells with some insulin to give them a better chance at full recovery and have him surf a little higher.


Darwin has been racing down that dosing scale.

With all those low numbers he's been getting it makes me wonder if he's a low rider?? some kitties throw numbers in the 40's when they are OTJ. Time will tell if Darwin is one of those.

I do think that you need to consider shooting some insulin. He earn't a reduction to 0.5u, and has been running low with no insulin, has anything changed recently?? removed dry food perhaps? any meds that he was on have been stopped? How is his General Health?

Just wondering if there may be some reason for the sudden change?
Though with some kitties, they do just flick a switch, for Darwin that seemed to happen on october 2 when you shot your first green.

With him running so low, without insulin (though I think the depot from the 1u and 0.75u is still in play here) you could perhaps drop the dose a little further shooting 0.25u or 0.1u.
In an ideal world we'd like to see him have a week of numbers in the normal range (50-80) before we take a reduction, but obviously Darwin has other plans.
Since it's only 4 days since he was on 1.5u, I do think that to safeguard a strong remission, you should be thinking along the lines of continuing with some insulin support, but the trick is to do this safely. You've take reductions as he has earned them and your data gathering has been very complete, so as long as there is nothing else going on, it doesn't look like you should have got yourself into a situation where Darwin has been taking too much insulin and been overdosed.

The way I see it the following are your options
1) shoot the reduced dose of 0.5u, as per the protocol (you may need to hold on to your hat, and for sure you do want to monitor closely and make sure you have supplies)
2) shoot a further reduced dose (you may still need to hold on to your hat, but it's also possible that this would prove a reduction too much and you may find yourself having to bring him up again)
3) No shot and see how he does(not my favorite option, he's had so many reductions so quickly that I fear you will not achieve a strong remission, and/or you might find yourself having to bring the dose back up higher than the 0.75u)

 

[Mandy & Rex (GA)]

It's hard when the bean has to work!! When would you be able to test today during this cycle?

 

[Tasha & Darwin]

ETA: Oops - I did the same thing! And just read your additions. Maybe I will go ahead and NS this morning.

I do think that you need to consider shooting some insulin. He earn't a reduction to 0.5u, and has been running low with no insulin, has anything changed recently?? removed dry food perhaps? any meds that he was on have been stopped? How is his General Health?

Just wondering if there may be some reason for the sudden change?
Though with some kitties, they do just flick a switch, for Darwin that seemed to happen on october 2 when you shot your first green.

I changed to FF canned back in June/July. Otherwise, he's been healthier than he has in ages and is coming down (slowly) to a healthy weight. He is much more active, and happier. Then ONLY change in the last few weeks was my switch from SLGS to TR - hence shooting the lower number. I have only been able to assume that has what has helped jump start Darwin's pancreas?

The way I see it the following are your options
1) shoot the reduced dose of 0.5u, as per the protocol (you may need to hold on to your hat, and for sure you do want to monitor closely and make sure you have supplies)
2) shoot a further reduced dose (you may still need to hold on to your hat, but it's also possible that this would prove a reduction too much and you may find yourself having to bring him up again)
3) No shot and see how he does(not my favorite option, he's had so many reductions so quickly that I fear you will not achieve a strong remission, and/or you might find yourself having to bring the dose back up higher than the 0.75u)

I'm so tied on what to do. I just checked again. and as he ALWAYS seems to do lately, his AMBG is 41. That's LOW to be shooting insulin, right? I mean even a reduced dose of 0.1 makes me a bit nervous. The other thing is, I am leaving for work. My girlfriend, also a vet tech, is home and fully capable of checking Darwin and making sure he's OK, but she's a bit more likely to panic if she gets a low number. We have a busy day at the vet clinic, so I can't be sure I'll be available to check in on here, and get advice if he drops. It just seems like at 41 - he doesn't have anywhere to drop?!

BUT, I don't want to risk taking a step back either. Would it be unwise to NS this morning, and see what he is doing tonight when I am home and can check him through the night? I am also off tomorrow, so it would be better and safer timing for me to continue to monitor should he drop into the 30s.

 

[Tasha & Darwin]

It's hard when the bean has to work!! When would you be able to test today during this cycle?

True! I was halfway tempted to call in sick But with the drop to 41. I think it best to NS, and will maybe shoot a reduced dose tonight and pull an all nighter...again

 

[Doodles & Karen]

Do not shoot the 41. Darwin is making the rules...keep following his lead.

 

[Tasha & Darwin]

Do not shoot the 41. Darwin is making the rules...keep following his lead.

Yeah, he sure is! He knows what he wants, apparently

Also wanted to add the following:
If he continues to ride this low, you may want to consider feeding the curve with slightly higher LC or even MC in order to continue to support those delicate new Beta cells with some insulin to give them a better chance at full recovery and have him surf a little higher.

That I have been aiming to do. I feed him several times throughout the day, and when he's in the 40s/low 50s I've been mixing a little MC gravy into the pate. He's a bit of a stubborn fella though - if I add too much MC, he won't touch it. I've been working on finding some MC pate, but that's harder to come by.

 

[Doodles & Karen]

BTW, technically I do agree with Gill about continuing some insulin but not sure Darwin agrees with that. I don't see the depot bringing him into the 40's as there were skipped shots here and there over the last several days. See what Darwin thinks at PMPS and if it looks like he needs insulin I would try .25.

 

[Doodles & Karen]

when he's in the 40s/low 50s I've been mixing a little MC gravy into the pate

Without insulin he doesn't need the MC. I've seen cats in an OTJ trial test in the 30's.

 

[tiffmaxee]

I wouldn’t give higher carb food just to be able to continue insulin if my cat. Now if he goes up requiring insulin and then goes under 50 causing once a day or every other that would be different JMHO.

 

[Mandy & Rex (GA)]

Just to be clear so you don't keep asking ... never, never shoot a number below 50. I love how Darwin dips below 50 at PS times .. it's like he knows it's that time.

Ultimately, it's your choice what you want to shoot ... 0.5 (I vote no), 0.25, or 0.1. We are all along for the wild ride that Darwin is leading!

 

[Tasha & Darwin]

I wouldn’t give higher carb food just to be able to continue insulin if my cat. Now if he goes up requiring insulin and then goes under 50 causing once a day or every other that would be different JMHO.

Thanks, that’s helpful! I thought this was sort of frowned upon - it’s more of an artificial increase vs him actually going back up and requiring insulin. I’d like to continue him on insulin to make a strong remission, but it’s ultimately Darwin’s choice! Haha!

 

[Tasha & Darwin]

Just to be clear so you don't keep asking ... never, never shoot a number below 50. I love how Darwin dips below 50 at PS times .. it's like he knows it's that time.

Thanks! I kinda figured that was the case - especially since he always dips between +11 and PS time. Oh Darwin!

Ultimately, it's your choice what you want to shoot ... 0.5 (I vote no), 0.25, or 0.1. We are all along for the wild ride that Darwin is leading!

Yeah, I think that with his numbers in the 40s with NS; I’d rather skip 0.5 and shoot lower!

 

[Gill & George]

I cant believe the 41 at amps, though I must admit when I was writing the earlier post I did think 'I bet Darwin tries to make me look stupid'

No shot was a sensible choice, shooting under 50 is not recommended.

Just wondering what your feeding schedule is like with

Now if he goes up requiring insulin and then goes under 50 causing once a day or every other that would be different

Not sure if I have been misunderstood here, just want to clarify, I wasn't suggesting that he should be given higher carb to bring his number above 50 at shot time to continue with insulin.

But rather if he was above 50 at PS, then shooting (because on TR protocol it is encouraged to shoot above 50 on a human meter) and then using carbs if need be to keep his surfing above 50, essentially trying to feed the curve and see if it would be possible to hold on to the dose for a little longer. http://www.felinediabetes.com/FDMB/threads/8-10-tashie-pmps-high-questions.101989/
He is coming down sooooo fast, and something seems to be changing, ideally we would see our kitties earn their reductions by staying a week in normal numbers, giving the Beta cells plenty of time to heal and get strong, at least that is how I understand it, but we all can see that Darwin has other plans, hence the suggestion of perhaps taking the dose down a little further than would be normal for TR to see if that gave the breathing space required to continue the insulin support, all be it at a reduced rate.

I suspect that darwin will have something to say on the matter by PMPS

 

[Mandy & Rex (GA)]

@Gill & George, I see it as something "snapping" and they decide they don't want to be on insulin any longer. Rex is a good example of this. I don't recommend it as you are hanging on for dear life with white knuckles!

 

[Gill & George]

@Gill & George, I see it as something "snapping" and they decide they don't want to be on insulin any longer. Rex is a good example of this. I don't recommend it as you are hanging on for dear life with white knuckles!

Yes, but I have also seen kitties race off the juice/ or down the dosing ladder too fast only to end up on climbing back up again, or remission not sticking.

ECID and some do race down, others saunter, George started off fast and then sauntered, at the time I was impatient and worried about him not going faster worried it was a sign he was never going to go OTJ, but with hindsight I am glad that he took his time, I kept him on a drop dose for 2 weeks, though he did make it easy for me by having numbers that were mostly flat.
But Generally the thinking is that prolonging the insulin support, for as long as it's safe to do so, will in most cases yield a stronger remission, but when dealing with FD/Cats there is always possible that there will be exceptions to the rule.

I guess part of the problem is we don't know how long our cats have had diabetes prior to diagnosis, perhaps with cats that have only had FD for a short time prior to diagnosis there is the possibility that the pancreas bounces back more quickly than for those that have had it for longer???? Maybe that influences the rate at which Mr P seems to recover?? Guess we'll never know the answer to that question.

 

[Tasha & Darwin]

I cant believe the 41 at amps, though I must admit when I was writing the earlier post I did think 'I bet Darwin tries to make me look stupid'

Oh, he's really good at doing that! I was just telling him I was getting discouraged in having to increase his dose constantly, and then he goes and takes me on this rodeo!

Just wondering what your feeding schedule is like with

It somewhat varies depending on our schedule. He gets a bigger meal at AM and PM shots, and then he gets small snack at, typically, 11am (+4), 1pm (+6) and about 3:30-4pm (+8, +9) if one of us doesn't work. He also gets a snack at roughly 9pm (+2), and if I get up to test him in the night and he's low he might get a small snack. [/quote]

He's only on FF canned, so in order to get enough calories in; I do find I have to feed fairly often to get the right amount. He was very heavy at 19 lbs before diagnosis, but is coming down to a NICE weight now.

Not sure if I have been misunderstood here, just want to clarify, I wasn't suggesting that he should be given higher carb to bring his number above 50 at shot time to continue with insulin.

Okay, I thought that's what you meant! I do try to "feed the curve" whenever possible/necessary.

I suspect that darwin will have something to say on the matter by PMPS

I'm quite sure he will...given his numbers through the day...

 

[Tasha & Darwin]

I guess part of the problem is we don't know how long our cats have had diabetes prior to diagnosis, perhaps with cats that have only had FD for a short time prior to diagnosis there is the possibility that the pancreas bounces back more quickly than for those that have had it for longer???? Maybe that influences the rate at which Mr P seems to recover?? Guess we'll never know the answer to that question.

That could play into this as well. I can say, in Darwin's case, that he had full labwork about 6 months prior to diagnosis. His BG was 121, and his urine was clear for Ketones and Glucose.

I hope that has some play - I'd like him to have a strong remission, but with numbers in the 40s I don't even think a drop dose is a great idea?!

 

[Gill & George]

but with numbers in the 40s I don't even think a drop dose is a great idea?

Agreed.
Just watch him and be prepared to act if you need to.

and then he gets small snack at, typically, 11am (+4), 1pm (+6) and about 3:30-4pm (+8, +9) i

George was one of those that dropped early, between +1 and +2, I found that if I fed a drop at +1 +2, that helped flatten him out.
(before I started doing that his food schedule was much the same as you are doing now)

Am I confusing Fluffles with another kitty, or have you also reduced the amount he's been eating to try and control his weight?

 

[Tasha & Darwin]

Am I confusing Fluffles with another kitty, or have you also reduced the amount he's been eating to try and control his weight?

Not sure if you meant Darwin here. I haven't recently reduced his amount. He dropped from 19 to 16 lbs at diagnosis (well, just before - quick weight loss), but has now continued to lose about a pound/month since then as I have got him on canned and am feeding calculated calories. But he's been eating for his ideal weight for several months now. I do think Fluffles food has been reduced to control her weight though...

 

[Gill & George]

Just noticed your updated subject line!!!
Hmmm, Darwin just likes to make life difficult.

Not sure if you meant Darwin here.

I was asking about Darwin, sorry, but I think you are right regarding Fluffles.

 

[Tasha & Darwin]

Just noticed your updated subject line!!!
Hmmm, Darwin just likes to make life difficult.

Doesn't he?! I wasn't going to test him much today, but forgot to tell my girlfriend, so she went ahead and got those readings...he's always been a stubborn guy

 

[Fluffles]

Just recently got home from work and just now able to check the boards. Look at Darwin go!! wow!! Also enjoyed reading the thread and learning more every day!

 

[Tasha & Darwin]

PMPS=50. It's not below 50, but...thoughts?

 

[Mandy & Rex (GA)]

No, no. You have to skip. There's no breathing room.

Eta: I would try 0.1u when you CAN shoot.

 

[Tasha & Darwin]

No, no. You have to skip. There's no breathing room.

Eta: I would try 0.1u when you CAN shoot.

Okay, gotcha. I just get confounded because it doesn't seem like he's going to go above 50, and while I think that's awesome, it sounds like that might not be a "strong remission" but as always, ECID. I'm just going to let Darwin dictate what he wants.

 

[Mandy & Rex (GA)]

Okay, gotcha. I just get confounded because it doesn't seem like he's going to go above 50, and while I think that's awesome, it sounds like that might not be a "strong remission" but as always, ECID. I'm just going to let Darwin dictate what he wants.

With these skips, I'm hoping he will come up enough where you can start a micro dose. He's not cooperating right now.

 

[Tasha & Darwin]

With these skips, I'm hoping he will come up enough where you can start a micro dose. He's not cooperating right now.

I'll be watching for that. I feel like we're in a limbo at the moment, lol. I would never ask if I should shoot a 50 normally, but then I worry when I read that it isn't great to go from 1u to OTJ. And I think, well, what if he never comes up enough to shoot? LOL. I'm sure he will - I just need to not worry about what's GOING to happen next, and take each days as it comes.

ETA: THANK YOU @Mandy & Rex You're always here to encourage me, and help!!

 

[Mandy & Rex (GA)]

You're welcome! I want to pay it forward from everyone helping me with Rex, especially towards the end.

BTW, what does everyone at the vet office thinks of what's happening?

 

[Bobbie And Bubba]

Just catching up! Wow! What a ride. The pilot has decided to keep the fasten seat belt sign lit.

 

[Bobbie And Bubba]

Question: had Darwin ever been on a steroid prior to DX?

 

[Tasha & Darwin]

You're welcome! I want to pay it forward from everyone helping me with Rex, especially towards the end.

I need to learn enough to help out more! I’ve gotten so much help here!

BTW, what does everyone at the vet office thinks of what's happening?

I haven’t had a chance to chat with my vet that sees Darwin - he’ll be so psyched! I spoke to my boss today, and he “has never had a cat on anything under 1u” so he thinks I can just stop insulin as he’s “clearly in remission”
He’s a wonderful vet, but a bit old school when it comes to FD. I’m going to bring in all my info and spreadsheets for him to get a better idea (especially if we go OTJ), and hopefully they can get more people to get on board with proper protocols!

 

[Tasha & Darwin]

Question: had Darwin ever been on a steroid prior to DX?

No, never. He has feline herpes, so even though it might have helped his asthma; we elected not to as it could make his herpes worse. Why do you ask?

 

[Fluffles]

Darwin continues on his mission! I totally understand the ambivalence. My brain hurts from second guessing myself all the time! But you are doing great and so is Darwin!! So happy for you guys

 

[Tasha & Darwin]

Darwin continues on his mission! I totally understand the ambivalence. My brain hurts from second guessing myself all the time! But you are doing great and so is Darwin!! So happy for you guys

He sure is! Haha, he feels great too! He had previously been noticeably "grumpy" and off in green numbers, but now he's happy and active!

I continue to second guess myself, and feel I should KNOW better, haha! But it's different when it's your own baby, and you're nervous!

Looks like Fluffles is on a mission too!

 

[Chris/China (GA)/Garfield]

Why do you ask?

Because sometimes when the diabetes was caused by steroids, removing them and a short term of insulin is enough to get them back to "normal"

Darwin sure is keeping things interesting!!!

Yo Darwin, dude!!...You gots to stay away from doz nasty sharks!! When dey is inviting you to dinner, dey isn't being friendly!! Dey is planning on having YOU!! Show off some of doz surfing skillz I been teaching you!! ~ LagoonMeisterin China

 

[Tasha & Darwin]

Because sometimes when the diabetes was caused by steroids, removing them and a short term of insulin is enough to get them back to "normal"

Oh, I was thinking for a different reason - I've seen that happen a lot at work with steroids in dogs and cats (although typically dogs don't go into remission). I have a civvie on long term Prednisolone, so we’re on the constant worry about FD with him, but he can't really function without it anymore, so it's a double-edge sword.


+2.5=64...couldn't have thrown that out a little earlier Darwin? LOL.