Allie: Triple DKA Whammy in just one month

[martah]

Hello all, we are new to this forum and I’m so happy to have found you. I don’t know what to do anymore and I have my suspicion our vets, here in Hong Kong, don’t know either. I apologize in advance for this long post.

Diagnosis

Allie has been diagnosed with DM and DKA in early December 2017. Usually a 7.7lb kitty, she lost 2lbs in one month leading to diagnosis. It happened when I was in hospital, and I didn’t see these dramatic changes happening.

She has been hospitalized three times since then. Twice with the local SPCA branch who did a great job pulling her out of DKA, and the last time with a private pet hospital here in Hong Kong. We changed the vets because SPCA told us they don’t know what to do anymore and they referred us to this clinic. They referred us to an internal medicine specialist, and while the new doctor got Allie out of the last DKA episode fast, I am questioning the follow up treatment.

Glargine conundrum

Why? Because he insisted on putting her back on the insulin that yielded no effects and resulted in 3 DKAs in the past 5 weeks.

The insulin is really the tricky part. She has been put on Glargine but with no success. Her BG has been going up instead of down after 35 days of treatment.

The doctors can’t get the dosage right. We started with 0.5 dose twice daily, we went through a phase of one dose per day because she was going hypoglycaemic, then we were back on a twice daily dose of 0.25. It has also been a rollercoaster on a daily basis, with BG readings ranging from 1.8 mmol/L (32.4 mg/dL) to 25.4 (257.2), just 12 hours apart in the most extreme case. The average spread between the minimum and maximum reading is at 260 mg/dL. In the past week or so, her BG was consistently over 320 mg/dL.

She started eating more as we progressed with the treatment, but she kept on losing weight, on average 100 grams per week. She was also thirsty like a desert cat and peeing a lot. My conclusion is that Glargine is not her drug.

Caninsulin

Yesterday, I had a loooong back-and-forth with the vets at the clinic and they finally agreed to try something else. They gave her Caninsulin and I’m waiting for an update. After hours of tongue pulling, they have admitted that she was not switched to another drug because they had nothing else in stock.

I hate when someone tries to make me believe their decision is based on medical evidence when it clearly is just an inventory issue. And it is happening at Allie’s expense. Shameful practice, considering she has been with this hospital for 5 days, they had her entire history of illness, and yet, they made no arrangements to provide better options.

My understanding is that Caninsulin is not as common and good in leading to remission. And that it is shorter-acting than Glargine. I understand why, having the two options, the vet wanted to try Glargine one more time as a long-term measure. I am wondering, Fellow DM Cat Carers, what are our other, better options. I want my vet to order something ASAP.

Our Routine: BG & Food

I often work from home during the day, so we have been testing her BG regularly, every 2-3 hours during the day and sometimes once or twice at night depending on the last reading at 11pm. We use Freestyle Optimum Neo, which was recommended to us by our vet. We are also using a smartphone app, RVC Pet Diabetes, to chart her BG curves and record food and insulin intake.

She is so skinny, I would give her anything she wants, but the reason kicked in and she has been on diabetic and grain free diet for the past 3 weeks. When at home, she eats dry m/d kibbles from Hills Diet, Diabetic pouches from Royal Canin, and Wellness Core Grain Free cans. I put my other two cats on the same diet to avoid temptations and slip-ups.

We feed them twice a day, 1-2 hours before the insulin shot. Now I realize that it may be a bit too early, but we did it for practical reasons.

The shots are scheduled for 9AM and 9PM so that hubby and I can take care of it without crazy rushes back home (we work very long hours in Hong Kong and if I need to go to the office, I’m never back before 8PM).

Other Issues

Allie has a long history of skin allergies and, recently, she suffered from an eye ulcer. Obviously, she has been prescribed steroids to treat both conditions. While we kept the skin treatment on very low and sporadic doses (think 5 years of treatment and no problems), the eye ulcer steroids pushed her into the DKA and DM condition. She has been off steroids since she has been diagnosed. The ulcer is still there, although smaller after an antiviral medication.

********************
Thank you in advance for reading all this. I am heartbroken. I’m in desperate need for advice what to do next.

Marta

 

[Squalliesmom]

Hi, Marta and Allie, and welcome. I'm sorry you have been going through so much difficulty.

Lantus (glargine) is best dosed twice daily at 12 hour intervals. Cats' metabolisms are 3x as fast as a human's, so once-a-day dosing with Lantus is not recommended for FD kitties. If Allie is having such steep drops from the Lantus, I'm not sure that Caninsulin will work any better for her. Some others you can try are ProZinc and Levemir. If you look HERE you will see our protocols for several different types of insulin.

We usually start our cats out at 1 unit of Lantus, and make adjustments of 0.25 unit either up or down. If one, or even 0.5 U is too much for her, you could try starting her at 0.25 and go from there. If she is still eating foods high in carbohydrates, her blood glucose will continue to be high. We recommend feeding foods with less than 10% carbs. The Hill's dry is somewhere around 30 carbs, if memory serves me correctly - it is way too high in carbs, even if my memory of the exact number if wrong. The only dry food under 10% carbs are Dr. Elsey's clean protein chicken and Young Again Zero Carb (only available through their website). The Hill's is pretty much just overpriced garbage, the equivalent of cardboard, full of cellulose; I would not feed it to my cats. Canned or wet pate formula under 10% carbs food is the best for diabetic kitties; I'm not sure what's available in your part of the world but HERE is a link to one of our food charts that may help you. Lots of us feed Fancy Feast or Friskies, or the like. It doesn't have to be expensive food. Is her skin allergy related to food? If so, that might be an issue when choosing a food. And as you already know, the steroids definitely raise her glucose. However, you have to treat the other condition(s) first and adjust insulin to work around it.

If Allie is still losing weight I would increase the amount of food she gets. Until her diabetes is regulated, you really can't over-feed her; she is literally starving as her system cannot properly utilize the nutrients from her food. We have found that most diabetic kitties seem to do best if fed several small meals throughout the day, rather than two larger ones. Lots of people use automatic, timed feeders, if they are gone long hours of the day. We also suggest not feeding at least two hours prior to shot-time. We suggest a routine of test-feed-shoot; this enables you to get a blood glucose test that is not influenced by food, then feeding so kitty has a bit in the tummy, then shooting (usually while kitty is eating and therefore distracted, lol!) We have a spreadsheet we use that makes tracking patterns and shifts in her glucose levels easy to follow and manage. It also allows us to view it and be better able to help you if you need advice or information.

Since Allie has had more than one experience with DKA, she may be more sensitive to shifts in her glucose levels. Do you test her urine for ketones at home? If not, I would highly recommend it! The ketone test strips are inexpensive and all you need to do is get a small amount of urine (several different ways to do this!) and read the strip after the appropriate amount of time,usually 15 seconds but that depends on the manufacturer. You can euther stick the dtrip in her urine stream as she pees, put a long-handles spoon under her to catch some urine, use some crumples saran-wrap in a spot where she pees in the litterbox, or use some clean, plain gravel in the box, instead of litter, so you can "harvest" the urine. These are some of the methods I am familiar with, maybe others will have some other ideas, as well.

I hope this information has helped you a bit, and not just overwhelmed you! We are here to help, so always feel free to ask questions! The only stupid question is the one that isn't asked.

 

[martah]

Thank you for your fast response - I will try to digest it and come back if I have any questions.

One thing I would like to clarify: You say "The Hill's is pretty much just overpriced garbage, the equivalent of cardboard, full of cellulose; I would not feed it to my cats. Canned or wet pate formula under 10% carbs food is the best for diabetic kitties; I'm not sure what's available in your part of the world but HERE is a link to one of our food charts that may help you. "

- I am using the special diabetic diet from Hill's, called m/d - is it still such garbage? It has been recommended to me by the vet. I use this and Royal Canin Diabetic Pouches, both designed especially for diabetic cats. They made me switch from regular diet to this special type of food because it helps with managing the blood glucose levels.

Thank you!

 

[Critter Mom]

Hi Marta, and welcome to you and Allie.

Your poor girl! One DKA episode is awful, but three!!! My heart goes out to you as well; must have been an utter nightmare for you and still there is so much you're contending with.

I'm in the UK and it's stupid o'clock here right now so I apologise in advance that the following response is a bit hit 'n' miss. I'll post more tomorrow but I just wanted to get some key info out there tonight for you to ponder on, and also to let you know that there is a way forward.

Freestyle Optimum Neo,

Easy bit out of the way first.

It's great that you're already home testing BG. I'm fairly sure that the above meter can also check for blood beta ketones (you need to use the meter's matching ketone strips for this). You should be able to check in the instructions that come with the meter to confirm whether or not it supports both blood glucose and blood beta ketone testing. Granted the ketone strips are pricey but they make ketone monitoring much more manageable and they can give a little bit of an earlier warning of ketone build-up than urine testing. Bearing in mind all that Allie's been through and the difficulty you're currently having trying to regulate her, a blood ketone meter could be a very wise investment if the Optium Neo you have doesn't support ketone testing. One advantage of having both a glucose meter and a BBK meter is that you can check both BG and blood ketone levels at the same time (even from the same blood droplet if you've got everything poised and ready to go as soon as the sample's drawn).

She is so skinny,

This is probably a major factor behind the wild swings in blood glucose levels Allie's been experiencing, not the insulin choice as such. Here's an explanation of problems that may arise when trying to regulate underweight/DKA cats by member @Meya14 (who is highly knowledgeable about DKA). I think some of the content will sound very familiar to what you're going through with Allie:

As far as the "insulin not working" part - When there are no fat stores left in a diabetic the liver has a very hard time compensating for insulin doses. This in humans is referred to as "brittle" diabetes. What happens is that the blood sugars go very high, then insulin is given, then you get dangerously low sugars, and back and forth. The solution is actually to increase the amount of carbs you are feeding, so that you can give larger insulin doses - this will allow her to gain weight faster and for her sugars to be less "brittle". Once she is more stable, slowly reduce the carbs in the food, and monitor weight closely. The only way she'll gain weight and be healthier is with larger insulin doses than what she's been getting and that's going to mean increasing intake.

DKA happens when the body either isn't getting enough calories (in starvation or chronic illness) or not enough insulin to allow for food to be used as energy and stored as fat. The body starts burning fat instead as an emergency fuel, but over a few days, the biproducts of this, ketones, build up in the blood and cause problems.

[...] When she comes out, if it were my cat, I would aim for about 20% carb food - wet or dry (other's will disagree, I know) and increase insulin to match the intake until she gains some weight. Because she can't compensate when she goes low, you need the extra carbs from the diet to even out the blood sugar swings.

WRT insulin choice, [ETA:] any insulin in use may have produced the wild swings you've seen in Allie's BG levels at times because she is underweight. Of the two insulins mentioned in your opening post, Lantus (insulin glargine) is the gentler-acting and, in general, is easier to microdose. Caninsulin can be a bit of a sledgehammer by comparison and it typically doesn't have anything like the duration of effect of Lantus. While it's true that Caninsulin can be good at yanking high numbers down, it can end up yanking them down too far - even on a microdose - and that's true in 'uncomplicated' feline diabetics, not just kitties who need to regain weight.

In general - and in a stable cat - with appropriate home testing Lantus can enable much tighter regulation of a diabetic cat and, yes, this can significantly increase the chance of achieving diabetic remission.

As you've seen, using Lantus in an underweight kitty can present challenges. Typically, it's very good at keeping numbers down but not as good at pulling them down from high levels as other insulins, but those others tend to have shorter duration than the Lantus. However, with appropriate testing, feeding and dosing, you can level a kitty out to safer, 'flatter' BG numbers overall and thereafter use small, gradual adjustments, to refine the dose and improve overall regulation.

I've used both Caninsulin and Lantus. My Saoirse responded far better after the switch to Lantus (both in terms of blood glucose regulation and overall clinical signs/quality of life) and she went into remission 6 months after initial Dx (might have been sooner were it not for her issues with pancreatitis).

WRT diet, Lucy has given you good general advice on diet for stable, uncomplicated feline diabetics. However, Allie is severely underweight and struggling to stay ketone-free at the moment. Per Meya's comments quoted above, at the moment Allie is more likely to need a higher carb load than is normally recommended for an 'uncomplicated' feline diabetic in order to enable her to receive enough insulin and keep her in safe numbers. As dry foods go, the Hill's m/d dry is relatively moderate in carbs compared to other dry diets. Right now is not the time to be reducing Allie's carb load. Once she has regained weight, her BG is more stable (even if it is on the slightly high side at times) and she's well and truly clear of the ketosis/DKA you can then revisit dietary choices.

In Allie's situation food manipulation may well be needed in order to enable Allie to receive enough insulin to keep ketones at bay and help her to regain weight. As her weight improves her system will become more resilient and it should get progressively easier to regulate her.

I'm tagging @Meya14 to alert her to this thread. If she is online she may be able to give you much more specific advice. (@Meya14 - if you can manage to pop by, I'm concerned about how the eye ulcer/cessation of steroid treatment might interplay with the high BGs/ketone issues going forward and I would be grateful if you could comment on this.)

In the meantime, Marta, it would be helpful if you could answer the following questions:

1. Does Allie have a strong appetite at mealtimes?

2. Would she eat more between insulin doses if it was offered?

3. When did Allie last test positive for ketones?

4. How much does Allie weigh at the moment and is she still losing weight?

5. What is her current dose of Lantus (glargine)?



Mogs
.

 

[Critter Mom]

PS: Try not to lose heart, Marta. Even in the most straightforward of cases, regulation can take time. Things will get better.




Mogs
.

 

[Critter Mom]

Re blood ketone testing, the Abbot site says that the following strips can be used in the Optium Neo meter:

https://freestylediabetes.co.uk/our-products/testing-strips/freestyle-optium-ketone-test-strips

As noted earlier, the ketone strips are pricey but you don't need to test for ketones as often as you check blood glucose levels.


Mogs
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[Squalliesmom]

I am using the special diabetic diet from Hill's, called m/d - is it still such garbage?

Sadly, yes, it really is. It's first six ingredients are "Chicken By-Product Meal, Corn Gluten Meal, Pork Fat, Brewer's Rice, Wheat Gluten, Powdered Cellulose..." and it comes in at around 25% carbs. Dry food in general is just not an optimum food for cats. Cats are obligate carnivores, which means they are genetically engineered to be meat-eaters; their digestive system is not designed, by nature, to process carbohydrates, and almost all dry foods (and even quite a few if the canned foods!) are primarily carbs. Cats also have a very low thirst drive; they do not drink enough water to meet their hydration needs. As hunters of living prey, their system is set up to acquire most of their moisture from body fluids of their prey. Since most of our domestic cats are not hunting live prey for their meals, they are almost always mildly dehydrated, and dry food does not help this situation at all. Canned food helps provide extra, much-needed moisture in their diet. A lot of us add extra water to our cats' meals - I add about 2 tbsp to each dish at mealtime.

This is a wonderful article on feline nutrition, written by a vet. Worth the read! She has also posted information here at FDMB regarding dry food, HERE is the link for that.

A word on "Prescription" foods: very few, if any, of them have anything in them that would truly make them need a prescription to purchase. The manufacturers of these foods make me furious. They know there is nothing "prescription" about the food but if they sell it as such they can jack up the price of plain ol' dry cat food which is, yes, mostly garbage. Most vets only get a brief smattering of education in feline nutrition while in vet school, so these manufacturers peddle these foods to vets, who honestly believe they are helping your cat when they push you to buy them. As you may be able to guess, lol, this is one of my pet peeves. I wish I could educate everybody, all cat owners the world over, about this farce, because it is so bad for our beloved kitties, and it just makes me see red!

at the moment Allie is more likely to need a higher carb load than is normally recommended for an 'uncomplicated' feline diabetic in order to enable her to receive enough insulin and keep her in safe numbers.

Mogs is absolutely correct here. I failed to take into account Allie's dramatic weight loss. "Because she can't compensate when she goes low, you need the extra carbs from the diet to even out the blood sugar swings." (@Critter Mom Thanks for having my back, Mogs!)

We have a saying here that this is a marathon, not a sprint, and it is very true. I have been here for three years and it has taken me almost two of those years to truly regulate my cat. It has been SO worth the time and effort, to see him back to being himself again, even at 19! So don't get discouraged, you and Allie can do this!

BTW, Allie is adorable, I love her markings, and the expression on her face is wonderful!

 

[martah]

Wow, thank you Mogs & Lucy for this amazing support and the ocean of advice! I'm so grateful.

I am definitely not giving up, far from that! I'm just a little bit disappointed by the amount of information that has been shared with me by the vets. Now, I understand that they may just be as lost as I am.

Yesterday, I spent several hours with Allie at the hospital - didn't have the heart to get her off my lap; she was purring so much! I also have spoken with the vet. The Caninsulin had the sledgehammer effect, as you predicted. It brought the BG levels down and she went hypoglycemic for a while at the hospital. They have adjusted her dose and I am waiting for a new update. We also spoke in greater detail about next steps; the doctor are thinking to putting her back on long-acting insulin, Detemir, to increase her chances of remission.

I will also be ditching the prescription diet. How awful, something that is supposed to help is packed with so much rubbish ingredients. My vet told me they will teach me how to prepare high-nutrition meals for her that are safe. If I have to cook for my cats, I will. I already enjoy doing it for my human family, why excluding the furballs? They have been stealing stuff off our plates anyway.

Also, I'm getting the ketone strips. I thought they were expensive, but you are right to say that they are much cheaper than the potential hospital stay that follows non-detection of the ketone build-up.

Right, now for the questions:

1. Does Allie have a strong appetite at mealtimes?
Very much. She can't wait until I put the plate in front of her. She shows me the can she wants and supervises the can-to-bowl transfer.

2. Would she eat more between insulin doses if it was offered?
I am sure she would. She actually comes and asks for more food. When we figured out she was losing weight again, we relaxed the 2x a day feeding policy and started giving her smaller and more frequent meals.

3. When did Allie last test positive for ketones?
On January 10. I took her straight to hospital and she has been there since.

4. How much does Allie weigh at the moment and is she still losing weight?
Her current weight is 5.07 lb. I am not sure how and whether it has changed since she has been hospitalized for the past 5 days.

5. What is her current dose of Lantus (glargine)?
She is off Galargine and now on Caninsulin. She gets 0.46 unit twice daily. Last time the vet tried Glargine, they gave her 1.2 unit twice a day, which was 5x the dose we were giving her prior to the hospitalization. The increased Lantus dose did nothing to bring her BG down.

*********
Finally, thank you for complimenting her - she is one vocal and opinionated cookie and you can read her mind like a book from her expressions
Can you tell she was fed up with me for taking too many photos of her that night?

Here is here yesterday:

 

[Squalliesmom]

Awww, such a sweet girl.

It's great that you were able to spend a lot of time with Allie at the hospital? The more time you can spend with her, the faster she heals, I firmly believe that! You can also taken in an unwashed T-shirt or pillowcase, something with your scent on it; that will help her feel more secure while she's away from home.

Detemir (Levemir) is a good choice for a long-acting insulins. Cats seem to do very well on the longer-acting insulins, but they definitely need to be on a twelve-hour shot cycle. It seems some vets recommend a 24 hr cycle just because they are so much longer-lasting, but since our cats' metabolisms are so much faster than a human's, they need two shots a day. Most veterinarians, unless they specialize in treating cats, don't really get a lot of info in vet school for treating cats with FD; they get much more training on dogs, and believe they can apply the same protocols for cats. This does not work.

It's great that you will be making your own cat food! You can get commercially-prepared packets of the necessary vitamins and minerals, etc, needed and just add them in, so you know your kitties are all getting the proper nutrition. While Allie is still underweight, if she is hungry, feed her, as long as she doesn't eat 2 hours before test and shot time. Right now you really can't over-feed her!

I'm glad to hear you will be getting ketone test strips, it's really vital that you test her for ketones. It can mean the difference between life and death.

Your love and commitment to Allie is so apparent, in everything you say and do concerning her. That's half the battle, right there! I think you guys will do really well coping with this "sugar dance"!

 

[Kris & Teasel]

I'm so glad you came here and have seen how much help is available from very knowledgeable people. Having a kitty who's a good eater is a huge bonus. You're testing her BG at home and will be adding ketone testing to that so you have that covered. Making food for her that's low carb will help a lot. As has been said previously, getting more weight on her can help moderate her reactions to insulin.

 

[Critter Mom]

BTW, Allie is adorable [...] and the expression on her face is wonderful!

♫
What are you lookin' at?
♫

(Strike a pose!)


Mogs
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[Critter Mom]

@martah -

Thanks for the additional info. Will post again later.


Mogs
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[Meya14]

1. Does Allie have a strong appetite at mealtimes?
Very much. She can't wait until I put the plate in front of her. She shows me the can she wants and supervises the can-to-bowl transfer.

2. Would she eat more between insulin doses if it was offered?
I am sure she would. She actually comes and asks for more food. When we figured out she was losing weight again, we relaxed the 2x a day feeding policy and started giving her smaller and more frequent meals.

If your kitty is underweight and ketone prone, there isn't any reason to restrict the amount of feedings/food. Let her eat as much as she wants, have food offered for her to graze on during the day. When you do this, you will see her blood sugar raise, but that's not a bad thing. When the blood sugar goes higher it allows you to give more insulin. More insulin will decrease ketones and also cause her body to switch metabolism and start storing fat and gain weight.

Remember, the real mechanism of insulin is not to lower blood sugar, but to build tissues, provide energy for tissues and to allow fat to be stored. By decreasing food and insulin in a skinny cat, it is depriving her body of the energy it needs. Blood sugar control is really just a side effect of insulins primary functions. Cats develop ketones not because of high blood sugars really, but because of lack of insulin (or in some cases, food).

 

[Critter Mom]

@Meya14 - Thank you!

Belated best wishes for a good year in 2018.


Mogs
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[Critter Mom]

Hi Marta,

For general background, I've attached below a study on treatment of feline diabetics with long-acting insulins (Lantus and Levemir, aka glargine and detemir respectively).

NB: The recommendation about low carb food in the guidelines is appropriate to more 'stable' diabetic kitties. Per the posts by Meya that I referenced above, underweight kitties are more likely to do better initially with a higher carb load in order to enable them to receive sufficient insulin without regularly going hypo or throwing ketones and also to enable them to regain weight more quickly.


Mogs
.

 

[martah]

Hi Marta,

For general background, I've attached below a study on treatment of feline diabetics with long-acting insulins (Lantus and Levemir, aka glargine and detemir respectively).

NB: The recommendation about low carb food in the guidelines is appropriate to more 'stable' diabetic kitties. Per the posts by Meya that I referenced above, underweight kitties are more likely to do better initially with a higher carb load in order to enable them to receive sufficient insulin without regularly going hypo or throwing ketones and also to enable them to regain weight more quickly.


Mogs
.

Thank you, Mogs. I will read this tomorrow.

Allie is back home since Monday and doing quite well on Caninsulin. I can see a big change comparing to the Glargine regime. Her BG average lowers every day and she is more and more active and vocal as well. My parents in-law are visiting these days and they have noticed she has been more present comparing to when they have arrived (she knows them well and feels very comfortable around them, so there is no 'getting used to them' adjustment period).

I have started testing her urine for glucose and ketones, so far so good.

If your kitty is underweight and ketone prone, there isn't any reason to restrict the amount of feedings/food. Let her eat as much as she wants, have food offered for her to graze on during the day.

@Meya14

Thank you for the insights. I wish my usual vets were as knowledgeable. It would have spared us from 2 DKAs.

We leave the food out at all times, ditched the diabetic prescription wet food for now. She is having human-grade food for now and she finishes her plates eagerly. Seeing her waiting for her meal and hearing her complain about me being slow are the best things in long time.

 

[Critter Mom]

Hi Marta,

What an encouraging update! I'm really glad to hear that Allie is doing so much better. Goodness knows she deserves a break; one bout of DKA would have been bad but after three episodes she really has had a tough time of things. (((Allie))) Hopefully she'll be back to vogueing all round the place very soon.

I know that you're already using the RVC app to track Allie's progress but if you were to record Allie's BG readings in an FDMB spreadsheet it would greatly help members here to help you going forward. (Members need to get an understanding of Allie's BG response pattern in order to offer better suggestions). Here are the links you'll need should you choose to use one:

FDMB spreadsheet instructions

Understanding the spreadsheet grid

The spreadsheet is a very valuable tool: it provides a great way of getting an at-a-glance view of weeks' worth of data and it aids much better understanding of an individual kitty's pattern of response to the insulin in use. The spreadsheet can also act as a guide to making more effective, safer dosing decisions, thus helping to optimise regulation.


Mogs
.

 

[Tracey&Jones (GA)]

No advice to give but sending chin rubs for Allie and hugs to you.

 

[Critter Mom]

For general info, here's a helpful FDMB sticky post on Caninsulin/Vetsulin:

FDMB Beginners' Guide to Caninsulin/Vetsulin


Mogs
.

 

[Kris & Teasel]

I'm very glad that Allie is doing better.

 

[martah]

Hi Marta,

What an encouraging update! I'm really glad to hear that Allie is doing so much better. Goodness knows she deserves a break; one bout of DKA would have been bad but after three episodes she really has had a tough time of things. (((Allie))) Hopefully she'll be back to vogueing all round the place very soon.

I know that you're already using the RVC app to track Allie's progress but if you were to record Allie's BG readings in an FDMB spreadsheet it would greatly help members here to help you going forward. (Members need to get an understanding of Allie's BG response pattern in order to offer better suggestions). Here are the links you'll need should you choose to use one:

FDMB spreadsheet instructions

Understanding the spreadsheet grid

The spreadsheet is a very valuable tool: it provides a great way of getting an at-a-glance view of weeks' worth of data and it aids much better understanding of an individual kitty's pattern of response to the insulin in use. The spreadsheet can also act as a guide to making more effective, safer dosing decisions, thus helping to optimise regulation.


Mogs
.

Thanks - I will work on this over the weekend and keep you posted!

 

[martah]

Hi all,

just a quick update because I'm so thrilled about this - we finally see some results on Caninsulin and I hope this will continue.
On Monday, the average BG was 443; on Friday, it dropped to 340. Also, she stopped experiencing these crazy swings from hypo to hyper with the daily variance in BG readings more stable.

Today, I caught her doing her nails on the back of my couch for the first time since November - usually, I would give her the look (she responds to the look, no need for words ;-), but I was so happy to see her going back to her old (albeit bad) habits, I was ready to let it go. She knows it's bad, so she stopped almost the second she saw me though, so the couch is safe. For now.

I know we still have a long way to go, but this is so encouraging!

Enjoy your weekend and scratch your furry darlings' chins for me!

 

[Critter Mom]

she stopped experiencing these crazy swings from hypo to hyper

This is great news!

Out of curiosity, what are you currently feeding Allie?

Today, I caught her doing her nails on the back of my couch for the first time since November [...] I was so happy to see her going back to her old (albeit bad) habits,

This is even better news!

I'm so pleased for you both, Marta. Thanks for sharing this news with us and be sure to keep us updated with Allie's progress.

The Noodle (my civvie) says thank you for the chin scratches (loves 'em!).


Mogs
.

 

[martah]

Out of curiosity, what are you currently feeding Allie?

She eats Kakato wet food, it's a premium brand from New Zealand, with human-grade ingredients and no additives. She loves anything with tuna. We also leave out a plate of Hill's m/d prescription diet kibbles at all times as a snack. We stopped rationing, she can eat whenever she wants. If she asks for a new plate during the day, I give it to her, no questions asked.

I put her on a scale this morning and she went up from 5.07 to 5.4 lbs since she came back from the hospital.