Getting Wilbur inline and on track with Vetsulin

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Kris & Teasel said:
Well, you've thought this through really well and it seems you know what you want to do. I'm here to help. I certainly can't claim I know everything but I've learned quite a bit in my time here on FDMB and am always willing to research something or defer to someone with more knowledge or experience. The numbers speak for themselves! :)
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I agree completely.

tomorrow I am going to take him to 4u as advised and we'll jsut stay on the same path. I get what he's saying and will read the link you sent, but I think you and I have a firm handle on the whole picture and I think this is the better path. it would waste most of what we've accomplished over the last week to drop him back to 2 and start a whole new process.

I know i don't always get him at the perfect +4 or +5 but i have to balance his stress too, and I think i've gotten him tested enough to give us the info we need.
 
johnt said:
I agree completely.

tomorrow I am going to take him to 4u as advised and we'll jsut stay on the same path. I get what he's saying and will read the link you sent, but I think you and I have a firm handle on the whole picture and I think this is the better path. it would waste most of what we've accomplished over the last week to drop him back to 2 and start a whole new process.

I know i don't always get him at the perfect +4 or +5 but i have to balance his stress too, and I think i've gotten him tested enough to give us the info we need.
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I agree. Unless he takes a nose dive into lime green and you're trying to get him up with carbs (and need to track their effect) I don't think you need a ton of tests. Eventually, when you get to a dose that seems to be really good a full curve can be useful to fully evaluate his BG profile over a whole cycle. That involves AM/PMPSs as well as every two hour tests in the time between. Those would be rare though. I almost never do them myself.
 
Kris & Teasel said:
I'm still going to nag about not letting him get into high carb food, though ... ;)
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oh i know. listen I fought him hard today, and I think those red numbers were a direct result of the bouncing, as well as the high carbs from the treats.

Tomorrow I'm going to order a small bag instead of the big one. Just so I can verify that he'll let me replace it. Wait, no I can't do that. The shipping on the 2.2 lb bag means if costs nearly double the price of buying the lower bag. I'll get the big one. I wish they sold those little bags they sent as samples so I could verify it'll work instead of spending $50 on food to do it. if I weren't restricted in cash flow it woudln't matter.

IF i can get him to transition I honestly believe we'll be able to balance in within a week's time of changing. Just have to get him there.

On the horizon I have submitted several proposals for new work (I work from home) and we've been approved for a 7 figure govt contract. We aren't through, but making it this far is very positive.

the only negative with that, is working for the us govt means you have to agree to accept it might take 120 days aftre invoicing to get paid. That'd make it tough, but once past that point I wouldn't have the stress level I do right now
 
johnt said:
oh i know. listen I fought him hard today, and I think those red numbers were a direct result of the bouncing, as well as the high carbs from the treats.

Tomorrow I'm going to order a small bag instead of the big one. Just so I can verify that he'll let me replace it. Wait, no I can't do that. The shipping on the 2.2 lb bag means if costs nearly double the price of buying the lower bag. I'll get the big one. I wish they sold those little bags they sent as samples so I could verify it'll work instead of spending $50 on food to do it. if I weren't restricted in cash flow it woudln't matter.

IF i can get him to transition I honestly believe we'll be able to balance in within a week's time of changing. Just have to get him there.

On the horizon I have submitted several proposals for new work (I work from home) and we've been approved for a 7 figure govt contract. We aren't through, but making it this far is very positive.

the only negative with that, is working for the us govt means you have to agree to accept it might take 120 days aftre invoicing to get paid. That'd make it tough, but once past that point I wouldn't have the stress level I do right now
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The down side of working for the government. One of my brothers works for the federal government here and has endless frustrations with bureaucratic red tape, etc. Good luck on getting the contract.

Re low carb kibble: If it's the YA Zero, I've read here that some cats have adverse effects in the poop department. It's also very concentrated so you don't feed much. Not sure about the Dr. Elsey's.
 
Kris & Teasel said:
The down side of working for the government. One of my brothers works for the federal government here and has endless frustrations with bureaucratic red tape, etc. Good luck on getting the contract.

Re low carb kibble: If it's the YA Zero, I've read here that some cats have adverse effects in the poop department. It's also very concentrated so you don't feed much. Not sure about the Dr. Elsey's.
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i've thought about that too. But I don't know if I want to jump that hard on that side. I don't really buy into that 'they'll eat less' stuff. I think maybe, over a long period, it might decrease, but if just simply eating more healthy food would reduce your intake, why aren't people doing that in swarms to lose weight?

To me it's a combination of diet, exercise and through management. Which I think we're doing. I don't think trying to make myself believe he's suddenly going to eat less is a viable prediction

not to mention i think he's borderline constipated already. when he poops he can't sit down for a while. he 'eases' onto his bum. it's obvious it hurts. and his little tootsie rolls are huge and dry. I was almost worried enough to take action.

On a sidenote, that hacking problem still exists. he'll hack for a few minutes, then be OK. when it happens I can tell it hurts because he swallows real gingerly after, and he jerks his head as though it hurts.

then when he goes to drink water it's audible that he's not swallowing normal.

My problem is i don't think I should introduce that in the middle of what we're doing. I think I need to get him balanced first. Or do you think I should address the hacking first?
 
johnt said:
i've thought about that too. But I don't know if I want to jump that hard on that side. I don't really buy into that 'they'll eat less' stuff. I think maybe, over a long period, it might decrease, but if just simply eating more healthy food would reduce your intake, why aren't people doing that in swarms to lose weight?

To me it's a combination of diet, exercise and through management. Which I think we're doing. I don't think trying to make myself believe he's suddenly going to eat less is a viable prediction

not to mention i think he's borderline constipated already. when he poops he can't sit down for a while. he 'eases' onto his bum. it's obvious it hurts. and his little tootsie rolls are huge and dry. I was almost worried enough to take action.

On a sidenote, that hacking problem still exists. he'll hack for a few minutes, then be OK. when it happens I can tell it hurts because he swallows real gingerly after, and he jerks his head as though it hurts.

then when he goes to drink water it's audible that he's not swallowing normal.

My problem is i don't think I should introduce that in the middle of what we're doing. I think I need to get him balanced first. Or do you think I should address the hacking first?
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I'd keep at the BG/eating thing as you go along. As for the hacking, I wonder if he has something like a nasal polyp or something. That might interfere with proper swallowing. Is the abnormal swallowing all the time or only after a hacking episode? Is he doing fine otherwise? Does he go for an annual checkup any time soon? Maybe think about having the vet assess it when you can spare the cash?
 
johnt said:
i've thought about that too. But I don't know if I want to jump that hard on that side. I don't really buy into that 'they'll eat less' stuff. I think maybe, over a long period, it might decrease, but if just simply eating more healthy food would reduce your intake, why aren't people doing that in swarms to lose weight?

To me it's a combination of diet, exercise and through management. Which I think we're doing. I don't think trying to make myself believe he's suddenly going to eat less is a viable prediction

not to mention i think he's borderline constipated already. when he poops he can't sit down for a while. he 'eases' onto his bum. it's obvious it hurts. and his little tootsie rolls are huge and dry. I was almost worried enough to take action.

On a sidenote, that hacking problem still exists. he'll hack for a few minutes, then be OK. when it happens I can tell it hurts because he swallows real gingerly after, and he jerks his head as though it hurts.

then when he goes to drink water it's audible that he's not swallowing normal.

My problem is i don't think I should introduce that in the middle of what we're doing. I think I need to get him balanced first. Or do you think I should address the hacking first?
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My cat had been eating young again for the past two years in addition to fancy feast twice a day. They don't eat as much of it because it's high in calories and nutrient dense. At first until they get used to eating less they may get diarrhea. If that happens you can only make one serving at a time available rather than free feeding it, or do what I did and put it in a food puzzle so they eat more slowly and realize when they are full.
 
I see that pink PMPS yesterday. If he didn't get into any kibble then it could be a bounce from a possible lower number after AM+3.
 
Kris & Teasel said:
I see that pink PMPS yesterday. If he didn't get into any kibble then it could be a bounce from a possible lower number after AM+3.
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he had to have. I made a comment. I didn't see it but i just don't believe that high number without it. he did not get temptations though.

I'm still waiting on being able to order the food, but should be today.

he was back down to expected numbers this morning. I'll get a +5 today for good measure.
 
Except for that pink last night the last 4 days' numbers are pretty darn good - PSs in the 200s, nadirs roughly 50% of those. I think if the nadir can slowly be nudged down to the 90-110 range and stay there quite consistently you'll be in great BG territory with Wilbur. A low carb diet (99.99% of the time! ;)) will bring on slow and safe weight loss - think a year or more. He's learning new habits even if he protests and he'll be a much healthier kitty. You can have that cough checked as soon as your finances permit. I ssume you haven't seen any of that weird seizure activity?
 
Kris & Teasel said:
Except for that pink last night the last 4 days' numbers are pretty darn good - PSs in the 200s, nadirs roughly 50% of those. I think if the nadir can slowly be nudged down to the 90-110 range and stay there quite consistently you'll be in great BG territory with Wilbur. A low carb diet (99.99% of the time! ;)) will bring on slow and safe weight loss - think a year or more. He's learning new habits even if he protests and he'll be a much healthier kitty. You can have that cough checked as soon as your finances permit. I ssume you haven't seen any of that weird seizure activity?
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No seizures yet but I'm weary. this is very close to the dose i was giving him when he was having them last time. They are so violent and he's broken both canine's off having them when i couldn't get to him or he wasn't in a position where i could pick him up.

When he has those he is messed up for at least a day. he'll run around the whole house sniffing and rubbing on everything, meowing (sounds more like caterwauling) for a day. Then the next several days i can see he fights going to sleep for some reason.

I pray he doesn't have another.

But I think he'll start losing some weight soon too. True he's not happy all the time but he'll get used to it. I can already see just a fractional bit of increased activity in him. He likely hasn't lost much at all, but either way I can see him changing.

I'm happy with the numbers too. I can't wait to get the low carb stuff and keep him out of all the kibble. Not sure it will all happen that way, but i'm steering him the right way best i can

I got the rinse free shampoo the other day. i doubt it really cleans anything but it sure does make his coat soft and fresh again, and boy it smells better :). I've only put it on his belly and back 1/4 of his back. don't want to do too much at once
 
You were up at 5 u earlier in February and he wasn't having seizures then was he? I'm not sure that it was the 4+ u insulin dose that was the underlying reason for them but who knows? Fingers crossed they won't happen. Meanwhile you're doing a lot of things right for him and that has to be helpful to his overall health. For what it's worth, Teasel's brother lost about 2 lbs in a year when I switched him to Teasel's low carb wet diet.
 
Kris & Teasel said:
You were up at 5 u earlier in February and he wasn't having seizures then was he? I'm not sure that it was the 4+ u insulin dose that was the underlying reason for them but who knows? Fingers crossed they won't happen. Meanwhile you're doing a lot of things right for him and that has to be helpful to his overall health. For what it's worth, Teasel's brother lost about 2 lbs in a year when I switched him to Teasel's low carb wet diet.
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I wish i could remember what dose he was on then, but the best I remember he was taking 4u in the morning and 2u at night. his seizures were almost always initially in early to mid evening.

Several times if he had one at night, he'd have another, mild one, about 12 hours later.

They told me he had epilepsy then and put him on phenobarbital, but 1.4 years ago when i moved here we weaned him off right away (well it took awhile because i slowly reduced his dose over a couple months to keep him from withdrawing).

But during that time he was having them sporadically. i believe they were about every 3 to 5 weeks. they told me not to bother coming in when he had them. just to log it.

then i took him in and his blood sugar was over 500. what they failed to consider was, when he has these seizures and comes around he eats like he's starving to death. well no wonder his BG was so high!

Anyway, i'm probably worrying for nothing. time will tell. I wasn't able to test him then so i have no clue what his BG was then. it's entirely possible he was bouncing so it dropped really low? after what you said it sounds like they were shooting in the dark claiming they were from high BG levels.

The strangest part is that when we went from 4/2u to 10/10u they stopped right then.

oh well, i'm rambling. i'm watching him and just praying they don't come back!
 
Two choices this AM: leave him at 4 u for a third day because it’s working quite well or increase to 4.25 u. The goal is to nudge the nadir down a little bit more. The pre shot numbers usually come down a little too.
 
I don't mind raising it. b ut if so i need to get a +4 and +6 at least so i know i'm not putting him too low during nadir

Do you agree?
 
johnt said:
I don't mind raising it. b ut if so i need to get a +4 and +6 at least so i know i'm not putting him too low during nadir

Do you agree?
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I agree. As you get closer to his "magic dose range" you'll need a clearer picture of its action coming up to and moving through and past nadir. That's the determining BG range for a Vetsulin dose because of the insulin's ability to drop them quickly and low. From what I see on your SS, Wilbur doesn't overreact to Vetsulin - his responses are pretty much ideal.

Looking ahead: if you can find a dose that gets his nadir in the 90-110 range with low-ish yellow pre shot numbers and if he can sustain that over time, that's good regulation. It's likely that the good dose will have to be tweaked a little up or down even then and you'll certainly have to stay on top of the food issue but you'll have reached the best end goal. The last few days' data are showing you it's possible. :)
 
Kris & Teasel said:
I agree. As you get closer to his "magic dose range" you'll need a clearer picture of its action coming up to and moving through and past nadir. That's the determining BG range for a Vetsulin dose because of the insulin's ability to drop them quickly and low. From what I see on your SS, Wilbur doesn't overreact to Vetsulin - his responses are pretty much ideal.

Looking ahead: if you can find a dose that gets his nadir in the 90-110 range with low-ish yellow pre shot numbers and if he can sustain that over time, that's good regulation. It's likely that the good dose will have to be tweaked a little up or down even then and you'll certainly have to stay on top of the food issue but you'll have reached the best end goal. The last few days' data are showing you it's possible. :)
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OOOk. so I just took it. His AMPS is only 209 because I was able to keep him out of the kibble (it's the PM that it's hard). SHould I still give him 4.25 right now? that seems to low to dose doesn't it?

Also I'm glad you mentioned the range we're looking for. i thought under 100 was bad. but now I see high 90's low 100's are ideal. so that's very good to know.
 
johnt said:
OOOk. so I just took it. His AMPS is only 209 because I was able to keep him out of the kibble (it's the PM that it's hard). SHould I still give him 4.25 right now? that seems to low to dose doesn't it?

Also I'm glad you mentioned the range we're looking for. i thought under 100 was bad. but now I see high 90's low 100's are ideal. so that's very good to know.
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No, don't raise the dose. I suggest you stay at 4 u but get a +2 as your first test. If he's dropped significantly (say, 50+ points) then you'll need to test a bit more. This is scary but you need this data. The 4 u seems to be working some magic right now and you don't want to lose momentum. I'm at home today so I can check in often.
 
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Ideal ranges showing good regulation on Vetsulin: pre shots in the low to mid 200s/ nadir in the high double digits to low 100s.
 
Kris & Teasel said:
No, don't raise the dose. I suggest you say at 4 u but get a +2 as your first test. If he's dropped significantly (say, 50+ points) then you'll need to test a bit more. This is scary but you need this data. The 4 u seems to be working some magic right now and you don't want to lose momentum. I'm at home today so I can check in often.
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ok no problem. i'll do 4.0 and get a +2. i will need to step out today some time but I will adjust to make sure I can test.
 
And don't forget - if he drops into low green numbers (I really don't think he will but I don't have a crystal ball!) you have a supply of "kitty donuts" (AKA Temptations) to prop him up. ;)
 
I actually let him have some this morning just prior to posting. I didn't give him any last night and thought I should now since his AMPS was so low. but I think today might be the last day for them
 
johnt said:
I actually let him have some this morning just prior to posting. I didn't give him any last night and thought I should now since his AMPS was so low. but I think today might be the last day for them
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Do what you can. :) At least now you have good evidence of their impact when you look at his SS. I'll watch for that +2. It'll be around noon my time.
 
Kris & Teasel said:
Do what you can. :) At least now you have good evidence of their impact when you look at his SS. I'll watch for that +2. It'll be around noon my time.
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Sounds good. I always test at the exact time, but sometimes I get a bit delayed recording them if I have a client call etc. but i'll get it on the sheet ASAP

thanks Kris!
 
blech. well they borked the whole process.

That's it. i'm done with the temptations. whether i have the other food or not, he's done
+2 = 267

It's going to be rough, but that's it. I'm done. I stopped buying them but have a bad habit of stocking up on things. i've got two big bags left and i'm opening them and trashing.

it's time.
 
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johnt said:
blech. well they borked the whole process.

That's it. i'm done with the temptations. whether i have the other food or not, he's done
+2 = 267

It's going to be rough, but that's it. I'm done. I stopped buying them but have a bad habit of stocking up on things. i've got two big bags left and i'm opening them and trashing.

it's time.
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All is not lost - it might actually be a post breakfast food spike with a bit of added oomph from Temptations. Try for a +4 or +5 to see if he's come down - good info.

Keep some Temptations around. They work really well should he ever get into hypo numbers. Maybe donate the bulk to the SPCA or a rescue place?
 
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i can do that. i'll keep one of the big bags.

man, when I was feeding those to him regularly he got so spoiled he wouldn't eat them if they were left out too long because they'd get stale (that's the only thing I can think of).

I have a humidor here and I'd have to put them in that to get the moisture back in them so he'd eat thema again.

Now that's not an issue because it's so rare he gets them he just gobbles up whatever is in his bowl.

I'll keep some on hand, but i'm done feeding them to him.

I'll get a +4 and +6
 
As I said before, if nothing else you've seen the impact of those treats on his BG and know I wasn't just blowing hot air ...
 
Kris & Teasel said:
As I said before, if nothing else you've seen the impact of those treats on his BG and know I wasn't just blowing hot air ...
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I never thought that, but you're correct. I don't think i thought it would be as big of an impact but it certainly validated your statement. I hope I haven't sounded like I didn't believe parts. I trust what you say and have tried to follow all the advice.
 
johnt said:
I just checked him (it's actually +5.5 and it's 80. is that too low? should I give him a few temptations?
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It's a little lower than ideal for a Vetsulin nadir but still above 50, the take action number. Best advice would be a small snack of wet food and save the heavy duty carbs for really low numbers. So -try a couple of teaspoons of whatever wet you're feeding and retest in 30 minutes. No need to panic ...
 
Kris & Teasel said:
It's a little lower than ideal for a Vetsulin nadir but still above 50, the take action number. Best advice would be a small snack of wet food and save the heavy duty carbs for really low numbers. So -try a couple of teaspoons of whatever wet you're feeding and retest in 30 minutes. No need to panic ...
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ok. actually i just fed him a little tuna just before the test.

I tested him because I caught him walking over to the bowl of kibble that is furthest away from me. So i figured i better test now in case he got into it.

I'll retest in 30
 
johnt said:
ok. actually i just fed him a little tuna just before the test.

I tested him because I caught him walking over to the bowl of kibble that is furthest away from me. So i figured i better test now in case he got into it.

I'll retest in 30
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Tuna is a good snack. I'll look for the next test.
 
johnt said:
69
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This +6 now, right? OK - another tuna snack. Retest in 30 minutes. I'm not suggesting Temptations just yet. You need this data to know his behaviour on a dose that might be a tiny bit too high. This cycle is revealing quite a bit about his response to Vetsulin at/near his good dose. Are you OK with that? The "take action now" number is 50 for a human meter and he's not there. Take action doesn't mean he's in a hypo - it means the BG is low enough that a little propping up is in order.

Looking ahead: dose down to 3.75 u tonight.
 
yeah that's fine. honestly? the fact that he survived getting 10u tells me somehow he's able to fight that. I'm not worried at 69 but I'll give him some tuna.
 
Kris & Teasel said:
This +6 now, right? OK - another tuna snack. Retest in 30 minutes. I'm not suggesting Temptations just yet. You need this data to know his behaviour on a dose that might be a tiny bit too high. This cycle is revealing quite a bit about his response to Vetsulin at/near his good dose. Are you OK with that? The "take action now" number is 50 for a human meter and he's not there. Take action doesn't mean he's in a hypo - it means the BG is low enough that a little propping up is in order.

Looking ahead: dose down to 3.75 u tonight.
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OK it's coming up now. it's at 89
 
Kris & Teasel said:
Excellent! He’s told you that 4 u is a bit too much right now so drop the dose to 3.75 u tonight. It might have to go up again because this kind of wobbling around a good dose is common.
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Sounds good. i'm going to sleep awhile. worn out.
 
Kris & Teasel said:
Excellent! He’s told you that 4 u is a bit too much right now so drop the dose to 3.75 u tonight. It might have to go up again because this kind of wobbling around a good dose is common.
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ok back to normal. 265. so i gave him 3.75 correct?
 
I can see after yesterday's lows that Wilbur gave you a perfectly decent PS last night and this AM. He isn't a bouncy cat and that will work in your favour. He also gives you pretty much ideal responses to Vetsulin even if numbers are sometimes a tiny bit too high or influenced by contraband. :)
 
Kris & Teasel said:
I can see after yesterday's lows that Wilbur gave you a perfectly decent PS last night and this AM. He isn't a bouncy cat and that will work in your favour. He also gives you pretty much ideal responses to Vetsulin even if numbers are sometimes a tiny bit too high or influenced by contraband. :)
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good. that makes me feel better. So far I've been able to keep him off the temptations. I can tell when he wants it because he ignores his tuna bowl and sits in front of the temptations bowl.

but what I've been doing is giving him tuna then. I may not even have to introduce other stuff if this works.

This morning I woke up a couple hours before his AMPS. he begged and begged, but after about 20 minutes he gave up and laid down beside me. like he accepted it. so i'm going to keep working on that

i'll get a +5 today in about an hour
 
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