12/14 Quintus AMPS 445 +3 425 +6 515 PMPS 401 +3 281 YELLOW!

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Steph & Quintus & L & O

Steph & Quintus & L & O

Member Since 2017
condo: http://www.felinediabetes.com/FDMB/...-ndw-and-failed-reductions.46012/#post-642819

Hi folks! I was hoping to see a reduction this morning, but no... still red :-(

I'm really concerned about these numbers staying high (as I understand when numbers are above 360 or so we have "cell suffering" -- translation from French). Can this still be a bounce?

Reassurance welcome!

PS: I'm continuing to transition to LC food, currently 50/50, though I realised yesterday I did 50 LC but 65% HC instead of 50
 
Stephanie, your journey with Lantus is still in the beginning phases. Quintus' body has to readjust to the new insulin and the transition to wet food. I understand you are frustrated, but give it some time and you'll be glad you did. :bighug:
 
:bighug::bighug::bighug: Give Lantus some time to get up and running in his system. Trust the dosing guidelines here and the advice of the experienced Lantus folks. They can help you but it might take some time to see better numbers. His diagnosis is very recent.
 
Stephanie & Quintus said:
How much time? should I be upping his dose tomorrow if the numbers are still high?
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The amount of time at a dose depends on whether you're following TR or SLGS guidelines outlined in the yellow info stickies on this forum. Dose increases would be closer together on TR (after 6 cycles or 3 days). People use TR if their kitty isn't eating dry food of any sort and they're able to do the more frequent monitoring that TR requires. Have you read through those stickies? This methodical approach might seem very rigid but many kitties have done extremely well when the care giver followed one or the other of the dosing routines.

Patience is so important in getting BG under control. I can't emphasize that enough. Being too reactive to numbers (except for dangerous lows) can make the process much more difficult. :bighug:
 
Kris & Teasel said:
People use TR if their kitty isn't eating dry food of any sort and they're able to do the more frequent monitoring that TR requires. Have you read through those stickies?
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Yes I have read the stickies. I'm transitioning him off dry food at the moment. I'm away 12h 4 days/week in normal times, but I'm ill at home now, so can keep an eye on him at least until Sunday. I'm hoping to have him on 100% LC food by then.
 
Stephanie & Quintus said:
Yes I have read the stickies. I'm transitioning him off dry food at the moment. I'm away 12h 4 days/week in normal times, but I'm ill at home now, so can keep an eye on him at least until Sunday. I'm hoping to have him on 100% LC food by then.
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The food change will help. There's a sticky on doing TR when you're working full time. Yes, I recall now that you'd mentioned your difficult work schedule. These are challenges that can require a little "bending" of the rules occasionally (dose timing) but a good dosing regimen is still possible and will get Quintus moving forward.

It's very hard to see high numbers and not worry. Cats seem to tolerate them better than humans or dogs. It's the unforeseen very low number that can be much more dangerous. Deep breaths ....
 
Extra question: how common is it to have a cat with diabetes and pancreatitis? I know the two are linked, but I'm wondering, with regard to protocols, if the fact that a cat has pancreatitis should make one choose one option over an other. Are there many people doing TR or SLGS when the newly diagnosed cat also has bad pancreatitis?
 
Stephanie & Quintus said:
Extra question: how common is it to have a cat with diabetes and pancreatitis? I know the two are linked, but I'm wondering, with regard to protocols, if the fact that a cat has pancreatitis should make one choose one option over an other. Are there many people doing TR or SLGS when the newly diagnosed cat also has bad pancreatitis?
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Someone corrected me on this one and it's good to know the distinction. TR is a protocol, there is science behind it and a study was involved. SLGS is a method that was developed here, it is built with safety in mind but has a lot more leeway and flexibility, well, because it isn't a protocol. :p

I can't answer your question re: pancreatitis, but I think choosing which strategy is more a matter of what works best for the human involved and less of what's going on with the cat. They both aim to regulate diabetes and go about getting there in slightly different way.

I can share with you how I chose. I liked that TR had the science to back it up, that appealed to me and I didn't have to trust this random group of people I didn't know with "this is what we do and it works for a lot of us". Fast forward to I now very much trust these random people on anything diabetes over my vet!:joyful: Also, early on, I wanted my vets approval and them to be on board with what I was doing since they were supposed to know best and held the rx pad to give my cat insulin. I felt it was an easier sell with TR since it's published in a peer review journal. Lastly, the TR remission rate percentages, I felt Asia had much better odds to have a remission on this protocol. The aggressiveness of it scared me, and still does, that made SLGS more appealing, but the tipping point for me was trying for remission. Asia is old and probably doesn't have as much time as some other cats here, so I felt start low and go slow wasn't going to do her any favors to feel better quickly enough. I'm not suggesting you choose TR, I just wanted to share what things I considered with making my choice.
 
Thanks Stacy, it was helpful.
I’m also worried about the fact Quintus maybe doesn’t have much time, and (also been looking at spreadsheets) it seems to take forever to reach "decent" numbers with Lantus. I'm starting to wonder if Quintus wouldn't be better off back on the faster-acting insulin which at least would give him two dips a day.
 
Stephanie & Quintus said:
Wondering if it makes any sense to measure a +11 here. (Specially if it's just to see another black number.)
Opinions, anybody?
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When the cat is giving you high numbers towards the end of the cycle, you are generally safe to wait until the PS time to test again.

I started with SLGS with Rex. I got really, really frustrated that I had to hold the dose for an entire week before I could increase because he was in reds. Shortly after I switched to TR, I saw movement in his numbers and he went into remission not too long after. Do keep in mind if you look at his SS, that is not the normal way of getting a cat into remission. Rex was done getting insulin and made it obvious. The whole time he was on insulin, I did +11 three times.
 
@Mandy & Rex so did Rex have pancreatitis when he got diabetes? I'm wondering how the two play together, ie, if the pancreatitis improves, could it dramatically improve the numbers? Also, if there is an infection (I have the feeling he responds really positively to his antibiotic shots), how does that affect BG?
 
Stephanie & Quintus said:
So, now we have a lower PMPS: 401
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That could be the double dip of Lantus. It is not as low as the nadir you typically see in mid-cycle.

Stephanie & Quintus said:
@Mandy & Rex so did Rex have pancreatitis when he got diabetes? I'm wondering how the two play together, ie, if the pancreatitis improves, could it dramatically improve the numbers? Also, if there is an infection (I have the feeling he responds really positively to his antibiotic shots), how does that affect BG?
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Rex doesn't have pancreatitis so I cannot testify to anything related to diabetes. I'm in that FB group for my civvie Tanner. However, I do know that if a cat has an active infection, it can cause BG to be high, such as bad teeth, UTI, etc, etc.

I think I know someone who had a cat with diabetes and pancreatitis. Tagging her.. @tiffmaxee
 
Jones had pancreatitis - which lead to a dx of IBD - which lead to a steroid being used - which lead to FD. So, did the pancreatitis come first or the IBD??? Don't know really, however there was disruption of the GI tract.

I chose SLGS. My vet already had him on a pretty high dose of 3 units when I started here. Still took me a month to get with the program. Due to the steroid use and the unlikely event he would get off of it, my main goal was "tightly controlled". The flexibility as well was attractive as all members of the household was working at that time. Low carb food had a huge impact on Jones' dose requirements. The bigger issue for us was the prednisolone. Outside of the initial diagnoses, I don't think Jones has had a pancreatic flare but has had a huge IBD flare.

For us, without the prednisolone, I think Jones probably would of been in remission with about 2-3 months of starting here.

And just a note on SLGS - you don't hold the dose for 7 days if the BG's drop below 90. There was time Jones was on a mission and every 4-5th cycle he was dropping below 90 and we would be dropping his dose. Even when we tried to keep the dose thinking the depot hadn't drained enough he made it clear that he was going lower.


**We are doing a modified SLGS due to the prednisolone so please take that into account when looking at Jones' SS.
 
Stephanie & Quintus said:
Thanks Stacy, it was helpful.
I’m also worried about the fact Quintus maybe doesn’t have much time, and (also been looking at spreadsheets) it seems to take forever to reach "decent" numbers with Lantus. I'm starting to wonder if Quintus wouldn't be better off back on the faster-acting insulin which at least would give him two dips a day.
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Maybe poll the main Feline Health forum on that one. I don't know much about the other insulins other than hearing they are harsh, one was made for dogs, and one of them prozinc maybe? is very expensive. I think people on this forum are all about Lantus & Levemir and several have switched from other insulins, so you probably won't get the most objective opinions here. ;) It also might be helpful to go to the other insulin forums and peruse those SS to see what regulation looks like there.

As far as taking forever, that's relative. Some cats get with the program on week 1, others take much longer and there's lots of in between. Let's just pretend we have a crystal ball and the magic dose for Quintus right now is 4 units, you're just not there yet and you won't see much of a difference until you get there. Some people are lucky to have low dose kitties right off the bat. And the panc stuff and diet can certainly complicate the issue. It can be tough waiting to get to the right dose, but once you do, for the most part it's like magic how quickly things change.
 
Max had pancreatitis for several years before becoming diabetic. I think his episodes were less often once on insulin but then we stopped running tests. I managed him based upon symptoms since that’s all that you can do with pancreatitis. So for Max that meant giving him ondansetron when nauseous. I always fed him several small meals a day which is better for both I think. He didn’t have IBD. he got pancreatitis after my other cat passed away and stress seemed to bring it on. Vet visits often resulted in symptoms. It varies so much from cat to cat and even episode to episode with the same cat so it is really trial and error. Even the tests might not be accurate when they have more than one disease. Max was only on lantus so I can’t say anything about the other insulins.
 
Just tested +2 and we're still "low"!
+3 281, yellow!

- is it finally the 6th cycle magic?
- is it because he didn't eat too much before PMPS?
- is it the antibiotic injection I gave him at noon which is starting to act on his infection and bringing the numbers down?
- the fact he went outside and walked up the stairs twice? (he barely moves on a "normal" day)
 
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Hello Stephanie, welcome. Phoebe has IBD, Pancreatitis, severe arthritis in that order. Was given steroid for pancreatitis and within 7 days had FD. Now she is on 34 units a day, yes you read that right. But that is down from 44 units. We believe she has an issue with insulin resistance and perhaps even acromegaly. But it took us months to see any good numbers. This diabetes treatment is a marathon, not a sprint. It takes alot of patience for you and your kitty. I didn't have much of either in the beginning. But if you follow the protocols and the wisdom of these people here you will see improvements, and just maybe remission. I don't think that is in my girls future, but I've not given up hope just yet.
The pancreatitis can be a bear, but mainly fighting the symptoms of nausea, pain and vomitting. Phoebe went from a robust 23 pounds to a skin and bones kitty 11.4 pounds in a short time. But she's back up to 14.8. That's because we managed the symptoms and found our "patience pants". It's coming up on a year soon, and you can see from her ss her progress. Slow and steady.
We are not perfect here by any means but it's the best group of compassinate, helpful people you will ever meet. They saved my girl, and give us hope.
 
Phoebes said:
The pancreatitis can be a bear, but mainly fighting the symptoms of nausea, pain and vomitting. Phoebe went from a robust 23 pounds to a skin and bones kitty 11.4 pounds in a short time. But she's back up to 14.8.
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Heavens!
I am really lucky that Quintus is pretty asymptomatic (maybe just lethargic). He never lost his appetite, didn't throw up once. Has lost a few hundred grams, which is not good, but it was not a dramatic drop in weight (he's 4.7kg now, his ideal is more around 5, we was at 5.3 for quite some time over the last year).
Thanks for sharing your experience!
 
Stephanie & Quintus said:
Heavens!
I am really lucky that Quintus is pretty asymptomatic (maybe just lethargic). He never lost his appetite, didn't throw up once. Has lost a few hundred grams, which is not good, but it was not a dramatic drop in weight (he's 4.7kg now, his ideal is more around 5, we was at 5.3 for quite some time over the last year).
Thanks for sharing your experience!
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My panc kitty Tanner is asymptomatic as well. The only sign was him losing weight. I have a few medicines on hand if I think he needs help. So far, I haven't given anything. :bighug::bighug:
 
Stephanie & Quintus said:
Very interesting, thanks! Do we have anything of similar quality regarding the "duration" of the depot, ie how much time it stays and how fast it "diffuses"? (Meaning: to back up the "roughly six cycles for the depot to stabilize")
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Not that I'm aware of. I don't even know how you could precisely figure that and even if you could, it would vary from day to day and one individual to another. It has to do with individual biology: metabolism, hormones, exercise, moon tides, and if a shot was injected under the skin, in the fat layer or accidentally a muscle, who knows what else, there are so many variables. I think it's wisdom collected on this forum and the German one. You've seen enough cats go through this and by observation you give an average that covers the majority in the middle, always will have some that fall to either side of that.
 
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