Ballonee 12/27/17 AMPS 400, +3=371, +9 455 and a question about dosing tonight

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SpencerLindley

SpencerLindley

Member Since 2017
Well she didn't go low today that's for sure. I'm almost positive I didn't do a fur shot this morning. So I'd conclude that the reduction in dose isn't effective for her. Is it okay to increase tonight? She's been quite sleepy all day.. like too sleepy. I have an appointment with her vet tomorrow and then an appointment with a feline specialist vet (who has a cat with diabetes herself) on Jan 4th so Im really hoping she can help me and Ballonee :(
 
She's bouncing today. I would hold the dose until the bounce is over, to see what short of numbers she shows then. Are you following the TR protocol or SLGS method for dosing? It'sll help us help you if you put either SLGS or TR in your signature. What you do for dosing can differ between the two.
 
Hi Spencer,

When you're updating your signature, could you please also add the full names of the foods that Ballonee is eating at the moment so that responders to your threads will be able to gauge the carb content in them. Also, as Marje recommended yesterday, some shorthand notes in the Remarks column about what you fed and at what point in the cycle will start to help you better gauge the carb load Ballonee is receiving so that you'll be able to work out the level that best suits Ballonee's needs at the moment (e.g. PMPS: x amount of food A; PM+2 y amount of food B; etc., etc.).

EDITED TO ADD:

Quick kwestions:

In general, is Ballonee a fussy eater? Also, how well/badly does Ballonee handle changes to a different food? Does her GI tract get upset (vomiting/diarrhoea)? Does she go off her food (nausea with/without inappetence; refusal to eat new foods?)


Mogs
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Critter Mom said:
Also, as Marje recommended yesterday, some shorthand notes in the Remarks column about what you fed and at what point in the cycle will start to help you better gauge the carb level that best suits Ballonee's needs at the moment
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Will do on the signature update. I have been putting down notes in the remarks are they not showing up? :( or do you just mean I need to be more specific?
 
Found them!

If you can include the full brand/product names of the foods it will enable people here to help you work out the carb % in the different foods.

BTW, I amended my previous post to add a few kwestions it would be helpful to get answered. (I have a very disordered brain. :rolleyes:) Could you pop back to it and have a look?


Mogs
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Critter Mom said:
In general, is Ballonee a fussy eater? Also, how well/badly does Ballonee handle changes to a different food? (Does her GI tract get upset (vomiting/diarrhoea)? Does she go off her food (nausea/dislike of new foods?)
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Ballonee is a fussy eater in that I have to sit with her, place the food in front of her and sit there and hold my breath and hope she starts eating lol. Once she starts she's generally pretty good. Her appetite has definitely gotten better since she's been home. I hope that's a good sign.. I know sometimes with diabetes excess hunger isn't always good. But I'm glad she's gaining noticeable weight. It means the insulin is actually effective in that way.

I think she's not bad about handling changes.. She changed to this new diabetic and recovery food quite well. The vet mentioned not a lot of cats like the diabetic formula and she took it.

No vomiting.. throughout all of her DKA there was no vomiting thank god. no diarrhoea.. the opposite actually.. she has really hard stools usually (another thing I'm hoping to address tomorrow with the vet). Today however she is particularly gassy but that def not a normal thing for her. No nausea and I think she's pretty good with adapting to new foods.. I think it depends on what it is though.. I cant imagine her eating pumpkin for example :/ but I guess I'd need to try to find out.
 
You could try introducing canned plain pumpkin v-e-r-y slowly at first, mixed into her regular food (see felineconstipation.org). Miralax is a dose-to-effect stool softener that many members recommend. (Helped Saoirse.) Worth chatting with your vet about these.

BTW, I never got as far as trialling it but there is freeze-dried organic pumpkin available. (I got it online from Amazon UK). Haven't a clue about dosing. Presumably one would try reconstituting a known quantity of the stuff with water to see how much it would bulk up?


Mogs
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Thank you! I really liked that link lot's of great information. I definitely want to ask about Miralax.. I think it's restor-a-lax in Canada.. Ill have to bring a list of questions tomorrow so I dont forget. I also updated my signature now :)
 
Ta for the sig update, Spencer. The Feline Constipation site is a great resource for learning more about gut health, not just treating the condition. IBDkitties.net is another very informative site for GI stuff.

  • Are the Proplan and RC Recovery foods wet or dry?

Mogs
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Yes, it's Restoralax in Canada. Make sure you are also adding water to her wet foods. Water helps move everything along.

Regarding the signature, dosing method is also important, TR or SLGS.
 
Wendy&Neko said:
Yes, it's Restoralax in Canada. Make sure you are also adding water to her wet foods. Water helps move everything along.

Regarding the signature, dosing method is also important, TR or SLGS.
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I read about someone doing that on the forum and I have been adding water to her food :) Ive noticed she actually eats it better that way too!

To be honest, the vet started her on 2 units and I've basically been lowering her from that just to get her relatively stable on something. He did this at the clinic when she was staying there and we didn't really talk about treatment options. So that being said I haven't had much opportunity to choose a dosing method. My dosing method has been "try and get Ballonee not to become hypoglycemic." I really wish he would have started her lower and worked his way up if needed. I'm sure he had his rationale though. I have an appointment with the vet tomorrow and I'm hoping to get some order and structure into how I'm treating her because right now it just feels very chaotic and her levels are showing it. As soon as I know what Im doing Ill add it to my signature :) <3
 
OK, maybe put "not sure about dosing method" or dosing TBD or something like that in your signature or people will keep asking. It's also going to make it harder to make dosing suggestions. Regardless, I'd keep on this dose until the bounce is over, then re-evaluate. Unless she goes low again of course.
 
SpencerLindley said:
Her appetite has definitely gotten better since she's been home. I hope that's a good sign.. I know sometimes with diabetes excess hunger isn't always good. But I'm glad she's gaining noticeable weight. It means the insulin is actually effective in that way
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The much-needed weight gain is a good sign and it's also very good - indeed, a great relief - that her appetite is improving now she's back home with her Momma Bean. :)

When you're making your list of questions for the vets tomorrow I'd suggest that, in addition to getting the vet to check Ballonee's current weight, you ask the vet for an estimate of what Ballonee's approximate ideal weight should be. (This will give you some bit of a yardstick by which to gauge Ballonee's progress.)


Mogs
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Hi Spencer,

Here's a link to a body condition chart to help you with monitoring Ballonee's progress. If you can swing it, it's a great help to invest in a reasonably-priced digital baby scale to keep track of a kitty's weight at home. (Try Amazon or eBay.)

Keen to hear what Ballonee's weight will be ... :nailbiting:

:bighug:


Mogs
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We just got back!! <3 so she is up from 1.98 kg to 2.35 kg and he said her ideal weight is 3 kg. He wants me to try and stick with 0.25 units morning and 0.1 unit evening (Ill re discuss with the vet I'm seeing on the 4th because I'm not sure how to handle her constant low numbers .. He wasn't bothered by the lime greens. I'm bothered by the lime greens though lol. Her blood work is perfect :) she pooped a couple times for me this week and he said to not give the lactulose for now because she doesn't feel constipated .. He said she most likely just needs some time getting used to the change in diet.
 
I'd be very worried by the lime greens too, Spencer.

Good news on the weight gain, blood work results and the pooping activity. :) Keep an eye on her if you can when she goes to the litter box to see if she's straining at all. Maybe try an eensy-weensy bit of pumpkin mixed into her grub if she's showing any difficulty?

I'm tagging @Marje and Gracie to ask for her comments on the dosing suggestion from the vet and also on Ballonee's sleepiness. Usually the best results come from having the same dose of Lantus AM and PM. One also gets a much better handle on what the insulin depot is doing when the doses are the same.

Ballonee had a very good cycle numbers-wise this AM (although the depot is still building on the 0.1 IU dose so keep monitoring carefully).

It's good to hear you sounding a little calmer in yourself this evening. :bighug:

Sending some scritches for your gorgeous little girl. (((Ballonee)))


Mogs
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Critter Mom said:
I'm tagging @Marje and Gracie to ask for her comments on the dosing suggestion from the vet and also on Ballonee's sleepiness. Usually the best results come from having the same dose of Lantus AM and PM. One also gets a much better handle on what the insulin depot is doing when the doses are the same.

Ballonee had a very good cycle numbers-wise this AM (although the depot is still building on the 0.1 IU dose so keep monitoring carefully)
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We often see vets recommend a different dose in the a.m. and p.m. but, due to the depot, we strongly suggest against this. Consistent dosing will generally provide better results.

Depots don’t build on reductions. The depot adjusts to the lower dose. When you increase a dose, the depot builds as one shot becomes cumulative to the ones before it. Think of it as filling a bucket of water. When the bucket becomes full, the water overflows the bucket. The only way to stop it is to turn off the water (which equates to reducing the dose).
It then becomes at equilibrium.

As you reduce the dose, if the dose is a good one, the depot becomes at equilibrium. That’s why we don’t hold reduced doses a certain number of cycles. If the kitty doesn’t bounce, numbers should stay in green. If the kitty does bounce, the numbers should come right back to green when the bounce clears.

All green numbers should be taken seriously and the BG she got to on the AT are lower than we like to see newly diagnosed cats. There is a built in safety factor to the numbers we use for reductions.

She’s clearing a bounce today and I don’t see any updated numbers for this cycle. Once you update the SS, please tag me and I can give you some dosing thoughts.
 
Marje and Gracie said:
Depots don’t build on reductions. The depot adjusts to the lower dose.
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I know and understand this, Marje. However, Ballonee has only been on the 0.1IU for the last two cycles. The previous 2 doses were 'drop' doses, so I regarded the change to 0.1IU as a dose increase (albeit a very tiny one). My understanding is that the depot would now need to adjust up slightly by holding at 0.1 IU for a total of 6 cycles (if following TR) before assessing whether to adjust the dose again? If this is not correct, I'd like to understand why not (if you don't mind :) ).

Marje and Gracie said:
There is a built in safety factor to the numbers we use for reductions.
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Is there anywhere on the forum where I could read and learn more about this, Marje?

ETA - Thank you for answering the tag! :)


Mogs
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I'm really hoping the vet that I see on the forth has some insight to Ballonee's situation. I heard she is an awesome vet from so many people and deals just with cats in particular. She also has her own diabetic kitty. I'm extremely hesitant to go back up to the 0.25 units. and really want to just hold her at the 0.1 right now. Considering all of the information given above should I just stick to the 0.1 units? Or do what he suggests? @Marje and Gracie I updated a couple numbers. Didn't check her too much tonight. She's winding down from the vet playing with other kitty looking happy and bright <3

Marje and Gracie said:
All green numbers should be taken seriously and the BG she got to on the AT are lower than we like to see newly diagnosed cats.
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I kept pointing out the lime green numbers to him especially the 2.8 where she was symptomatic and he said it's okay for a curve (the numbers are expected to go up and down) and that I'm never going to get perfect numbers.. I understand that.. but honestly it didn't seem to sink in that she could be seriously harmed at that level :/
 
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Critter Mom said:
I'm tagging @Marje and Gracie to ask for her comments on the dosing suggestion from the vet and also on Ballonee's sleepiness.
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Yeah the sleepiness actually starts occurring in the lower blue numbers.. I think it was mentioned a few times before that she just has to adjust to these new numbers?
Critter Mom said:
It's good to hear you sounding a little calmer in yourself this evening. :bighug:

Sending some scritches for your gorgeous little girl. (((Ballonee)))
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Thank you <3 <3 She was fighting me today at the vets haha a good sign but she was so stressed!
 
Critter Mom said:
I know and understand this, Marje. However, Ballonee has only been on the 0.1IU for the last two cycles. The previous 2 doses were 'drop' doses, so I regarded the change to 0.1IU as a dose increase (albeit a very tiny one). My understanding is that the depot would now need to adjust up slightly by holding at 0.1 IU for a total of 6 cycles (if following TR) before assessing whether to adjust the dose again? If this is not correct, I'd like to understand why not (if you don't mind :) ).


Is there anywhere on the forum where I could read and learn more about this, Marje?

ETA - Thank you for answering the tag! :)

Mogs.
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You’re welcome! With the inaccuracy of syringes, there is very likely not a big difference between her drop and 0.1u especially when it was only two cycles. It all still looks like a reduction from 0.25u to me...IMHO. Her note that she “filled to the zero line” doesn’t tell us anything about the dose because I’ve seen the zero line (on many, many occasions) be so far away from where it should be that the dose was actually close to 0.25u.

Insofar as where to direct you on reading about the safety guidelines built in, I can only give you some examples (these are not all of them) but please note that on the TR Protocol and SLGS Approach Sticky’s, it specifically states there are built in safety guidelines and recommends not to mix approaches.
  • Dose changes made, in general, in small increments of 0.25u
  • Reductions given at 50 (human meter) or 68 (AT) for TR for newly diagnosed cats
  • Reductions given at 90 for SLGS
  • Cautions to not shave doses after drops below 40
SpencerLindley said:
I kept pointing out the lime green numbers to him especially the 2.8 where she was symptomatic and he said it's okay for a curve (the numbers are expected to go up and down) and that I'm never going to get perfect numbers.. I understand that.. but honestly it didn't seem to sink in that she could be seriously harmed at that level :/
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Boy, that is unfortunate. That’s a low number on a human meter much less the AT.
 
Marje and Gracie said:
Her note that she “filled to the zero line” doesn’t tell us anything about the dose because I’ve seen the zero line (on many, many occasions) be so far away from where it should be that the dose was actually close to 0.25u.
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oh geeze that's scary :( I read that sticky about drawing up fine doses so the 0.25 would have been between the zero line and the 0.5 line and then the 0.1 dose would be almost touching the zero line but not quite and then I basically followed the instructions for giving, I think what they called, "some" insulin. That's what I meant by filling to the zero line but I guess I could have just wrote "some" or "drop."
 
SpencerLindley said:
oh geeze that's scary :( I read that sticky about drawing up fine doses so the 0.25 would have been between the zero line and the 0.5 line and then the 0.1 dose would be almost touching the zero line but not quite and then I basically followed the instructions for giving, I think what they called, "some" insulin. That's what I meant by filling to the zero line but I guess I could have just wrote "some" or "drop."
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Insulin syringes are terribly inaccurate. That’s why many here dose using calipers.

I did a series of measurements from a box of syringes in the same lot number. I drew to the 1u line and then measured the insulin using a micropipette and the actual dose varied by up to 0.5u (i.e. some syringes that I drew to 1u actually had 1.5u of insulin in them because the zero line was so far off). Roomp and Rand also found the same occurrence as have many others.
 
SpencerLindley said:
^^ I just read your post on dosing with calipers .. might consider. I hate that inaccuracy.. they literally had one job.. make the syringe accurate otherwise whats the point :p haha
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I didn’t link it because you have had so much thrown at you right now.

You wouldn’t believe the conversations I had with the syringe companies about that. Their response...”we don’t make them for pets”. There are now some companies that do make them for pets but they aren’t any more accurate than the others....it’s because they are all machine made with no quality control. Interestingly, I exchanged emails with a group of angry moms because, while 0.5u might not make a difference in an adult, it can in a child, and they were getting no response from the syringe companies on inaccuracy.

BTW, it is true that it takes them some time to get used to normal numbers and they can be a little sleepy at first.

Nice start today. If she doesn’t come down into green this cycle, I’d suggest we tweak the dose.
 
Gosh, that's so unfortunate to hear. Inaccurate insulin syringes shouldnt be a thing.. Insulin is not really a drug that can afford inaccuracies.

Marje and Gracie said:
”we don’t make them for pets”
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Also, since her diagnosis I've realized how many people actually care so little for animals.. I only had about two friends who actually seemed to care about Ballonee's diagnoses.. others were like "Oh I would have had my cat put down" or "I can't take this seriously.. a diabetic cat?" one friend started laughing at me when I talked about her constant gluc checks.. I actually lost a friend because I cancelled a coffee date because Ballonee was having a low number episode because "it's just a cat and shouldn't interrupt your life." It's so very hard to get support. Even the vet when I whipped out her spreadsheet to talk about commended me and was like "most people don't even home test" :( The supplies.. it's almost like they try and make it not affordable for pet owners in comparison to humans. The vet was charging me 5$ for 10 lancets... I got the exact same lancets 7$ for 100 at the drug store.. and yesterday they tried to tell me the strips are actually $131 for 50 instead of the $101 they were charging me.. after fighting it they said they'd "honor" the $101 they originally quoted. why would they want to take advantage of people who are trying to navigate their way around a new stressful diagnosis... Sorry for that rant.. A little off topic but it's just what I've been experiencing. Long story short I hate that their syringes are inaccurate and I hate that their only response about it was "we don't make them for pets."

She had a nice start today but unfortunately I just tested her and shes at 260.. I'm positive this morning wasn't a fur shot as I felt and saw the needle go in. I'll also start her a new thread for today :) Thank you for all of your help.
 
and from me. @Marje and Gracie
Thanks about this syringe thing.
@SpencerLindley Soz to clog your thread/condo but I did want to say thanks.

I had that over Tyler @SpencerLindley I think I wrote that somewhere here. I told a couple of pals and they were aghast I had not put Ty to sleep. I mean - really? The vet put in notes I have only just seen that he judged my cat too 'stressy' for home testing. To repeat - I mean - Really?
Yesterday my online supplier did not ship my strips so I had to locate a box from somewhere/anywhere. I found a box but it was well over twice the price. Repeating record - I mean - Really?

You have a rant. I'm right there with you. Come onto any of my own condo's and share. We'll all support each other. I mean it love.
 
PussCatPrince said:
and from me. @Marje and Gracie
Thanks about this syringe thing.
@SpencerLindley Soz to clog your thread/condo but I did want to say thanks.

I had that over Tyler @SpencerLindley I think I wrote that somewhere here. I told a couple of pals and they were aghast I had not put Ty to sleep. I mean - really? The vet put in notes I have only just seen that he judged my cat too 'stressy' for home testing. To repeat - I mean - Really?
Yesterday my online supplier did not ship my strips so I had to locate a box from somewhere/anywhere. I found a box but it was well over twice the price. Repeating record - I mean - Really?

You have a rant. I'm right there with you. Come onto any of my own condo's and share. We'll all support each other. I mean it love.
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You’re welcome!:)
 
SpencerLindley said:
Agreed. Thank you so much for your support <3 and sorry you are experiencing the same thing :( :(
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S'ok . We are both tough . We'll sort it . I mean me and you. Say after me in a sorta London ( Landan) South ( Sarf) England accent - 'stuff 'em'

Yup. My vet did the 2 units thing too. *sigh*

Anyway. This fur shot thing . I just realised on the 45 degree angle thing. Are you doing that? I'm sure you are.

You get to have a hug from me and I'm not a squishy sort. It's a bum when people look at you as though you are mentals over a mere cat BUT we both know it actually means a whole lot more in terms of life & it means a whole lot more in terms of who you are as a person.

You Rock!

Say after me....Stuff'em.
 
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