Chloe's Frown

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I finally put away what was left of the dry food a couple hours before her PMPS and she went down. So the whole curve was affected by food since she was grazing. The vet said to give 1 unit and wants to refer me to an internist because Chloe's ups and downs baffle her. I'll be careful with her food tomorrow and get a +2, but then I have to go somewhere. I'll be back at about 3 pm to get a +8.
 
srk4cats said:
How do I combine threads? I don't want to have to scroll down forever to see the latest comment.
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It took me a bit to figure out the easiest way to do this.
Click on your profile name. Then click on “Your Content”. That will show posts and threads you’ve made. Scroll down until you find your previous days thread. Click on it. The thread will open and you can copy the link and go back an paste it into your new thread.
 
Another factor to consider in addition to the bounce is that Chloe has only been on Lantus for a few cycles, as you noted. Lantus is a depot type of insulin. It takes about a week for the depot to form and stabilize. Every time you give a shot, a little bit of the Lantus is added to the depot so not all of what you're shooting is being actively used until the depot has fully formed. (This also means that when you change doses -- either increase or decrease) it will take a few days for the depot to re-stabilize.) The depot is what gives Lantus it's long duration and is another way that Lantus differs from most other insulin. Until you're used to thinking in terms of not just the immediate effect of a dose, the action of the depot can seem confusing.
 
Until a cat is regulated, you're kitty is going to be starving -- literally. Insulin is what allows glucose to get into the cells. When BG numbers are high, insulin is floating around in the blood stream and not getting where it's supposed to go. This is why many cats can lose a dramatic amount of weight prior to being diagnosed. It's fine to be giving Chloe extra food. However, this is a balancing act. You don't want to be giving Chloe so much food that she becomes overweight which can contribute to diabetes. On the other hand, you don't want her gnawing on your ankle.


 
Did Chloe lose weight before diagnosis? If so, she probably does need more food and while she is unregulated she is going to be hungry. A good solution would be to spread out her calories through out the day every 3-4 hours. I organized my feeding times so that Bubba would not be eating within 2 hours of a test so I would know that the BG test was not food influenced.

A lot of us here use an automatic timed food safe for when we are not home.
 
srk4cats said:
Big time. That's how I knew something was wrong.
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Then give her the amount of calories to take her back up to her ideal weight. As a guide to determine calories needed, I like this formula:

Ideal weight X 13.5 + 70 = calories needed a day.

That will help you know whether you are in the ball park of the calories she needs a day while her hunger is still so ravenous.
 
Bobbie And Bubba said:
automatic timed food safe
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I have 3 civvies and Chloe steps aside if they want her food, so I like to be home when she eats. I feed the other cats dry food in the back room where Chloe doesn't go. Chloe knows when it's time for a meal and lets me know. In between, she sleeps.
 
Bobbie And Bubba said:
Then give her the amount of calories to take her back up to her ideal weight. As a guide to determine calories needed, I like this formula:

Ideal weight X 13.5 + 70 = calories needed a day.

That will help you know whether you are in the ball park of the calories she needs a day while her hunger is still so ravenous.
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I love her little eyepatch, though I'm sure she doesn't. Did she try to take it off at first?
 
Bobbie And Bubba said:
Then give her the amount of calories to take her back up to her ideal weight. As a guide to determine calories needed, I like this formula:

Ideal weight X 13.5 + 70 = calories needed a day.

That will help you know whether you are in the ball park of the calories she needs a day while her hunger is still so ravenous.
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I trust her to tell me when she needs more food and I never deny her. Her weight has remained a steady 7-8 pounds since diagnosis.
 
srk4cats said:
Yep, I stepped in it. She knows which part of the kitchen to pee in so I'll step in it. I washed the floor today and it still smells like pee.
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Why is she urinating on the floor? Weren't you using an empty litter box?
Cat urine is pretty hard to get out. I suggest use some vinegar;however, I also suggest guiding her back to the litter box.

Normally I would say voiding outside the box could be a sign of a UTI.
 
Bobbie And Bubba said:
Then give her the amount of calories to take her back up to her ideal weight. As a guide to determine calories needed, I like this formula:

Ideal weight X 13.5 + 70 = calories needed a day.

That will help you know whether you are in the ball park of the calories she needs a day while her hunger is still so ravenous.
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Interesting. Where did you find that?
 
Kris & Teasel said:
I take it you're following SLGS with Chloe, Roberta? She gets dry food so that's what you have to do. The dose should be held constant for a week, no tweaking up and down based on PS. With Lantus dosing is based on nadirs, not PSs. The curve you do after a week on Lantus (SLGS) will be what you use to decide on dosing the following week.
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No, she gets wet food.
 
Teenuh said:
I also suggest guiding her back to the litter box.
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I have the empty litter box in the bedroom and she hasn't used it lately. I have no idea why. I just got a new floor last summer. She's using the box right now, but I think it's a poop. Yep. It's a stinky poop.
 
srk4cats said:
No, she gets wet food.
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I was going by the note on your SS on 23 Mar that RC Glycobalance dry food was left out all day. Was that a one time only event? Are you following TR or SLGS? The Lantus advice givers here will want to know. You can always try one and switch later but you can't do TR if there's any dry out at all.
 
TR = short for Tight Regulation.

Roberta, if you haven't, do yourself a favor and do the prep work (read, study, and click on the hyperlinks in the stickys marked with a yellow tags at the top of this forum). A couple weeks ago before you left the PZI/Prozinc ISG the suggestion was made to spend some time studying the stickys in L & L because there will be an expectation that an experienced caregiver will have done their homework. It was a real good suggestion. :)

I posted some of the links above. They're a good place to start. If you have questions, please ask.
 
Keep testing as often as you can. If you're home, you should test as often as you can. Especially after an increase. Get a before bed, one when you get up at night (if you do)...
You don't need a curve every day but those spot tests will help figure out how the dose is working. Late cycle tests are a good idea since lantus can last much longer than prozinc.
 
srk4cats said:
I have the empty litter box in the bedroom and she hasn't used it lately. I have no idea why. I just got a new floor last summer. She's using the box right now, but I think it's a poop. Yep. It's a stinky poop.
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If it is a recently new floor then all the more reason to guide her back to box. I would just be careful. You really don't want peeing on the floor to be the new thing.
 
Teenuh said:
If it is a recently new floor then all the more reason to guide her back to box. I would just be careful. You really don't want peeing on the floor to be the new thing.
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Well, I can never catch her peeing. I wipe it up after I get the ketone sample strip.
 
srk4cats said:
Yep, I stepped in it.
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Not as bad as stepping on a big pile of vomit. Squishy.
It's been a week since she's been on Lantus and her numbers are still all over the place. I'll do a curve on Friday when I have the day off from work.
 
StephG said:
Late cycle tests are a good idea since lantus can last much longer than prozinc.
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Hi Steph. Surprisingly, her late cycle BG is significantly higher than her PMPS. It doesn't seem like the Lantus is having any effect. This morning, I woke up to 2 empty cat food cans in my bedroom, one of which was next to my pillow. Here's a new one: she even dragged her empty cat bowl in. Her morning yowls were especially shrill until I gave her breakfast.
 
srk4cats said:
Hi Steph. Surprisingly, her late cycle BG is significantly higher than her PMPS. It doesn't seem like the Lantus is having any effect. This morning, I woke up to 2 empty cat food cans in my bedroom, one of which was next to my pillow. Here's a new one: she even dragged her empty cat bowl in. Her morning yowls were especially shrill until I gave her breakfast.
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There's less red and less black. That's a good sign. She can still bounce on lantus. Chuck does it often. The bounces are usually a little more controlled though.
Once you find her ideal dose, you'll see better control and then that dose will change! Haha the joys of the FD dance.
Chuck started lantus in the beginning of April, so almost a year ago. He's on a high dose but if you want to look back at his SS you'll see it took some time to get better control. He got greens on much lower doses than he's on now. I don't expect Chloe to go up in dose like Chuck.
Keep testing and if she's waking you at night for food, get a test then.
I think it's kinda cute she brings you the things she expects you to give her. Of course, I'm not the one waking up with empty cans on my pillow so it's much cuter that way.
 
Teenuh said:
@srk4cats I just peeked at your SS. What is going on with Chloe. She drank lots of water yesterday.
How is she otherwise?
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@Teenuh Thank you for checking in. She was yowling when I woke up, but this time she was near the water bowl. It was empty. I don't remember when I had last filled it, but after I did, Chloe drank for about 5 minutes straight. She wasn't as interested in her food, but she ate a bit. She had peed by the stove (I stepped in it again) and it showed trace ketones. Since then, she has been sleeping. Should I make her drink more water?
 
srk4cats said:
@Teenuh Thank you for checking in. She was yowling when I woke up, but this time she was near the water bowl. It was empty. I don't remember when I had last filled it, but after I did, Chloe drank for about 5 minutes straight. She wasn't as interested in her food, but she ate a bit. She had peed by the stove (I stepped in it again) and it showed trace ketones. Since then, she has been sleeping. Should I make her drink more water?
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Definitely push the water and food. Or get her to the cry for fluids/treatment ASAP.
 
srk4cats said:
@Teenuh Thank you for checking in. She was yowling when I woke up, but this time she was near the water bowl. It was empty. I don't remember when I had last filled it, but after I did, Chloe drank for about 5 minutes straight. She wasn't as interested in her food, but she ate a bit. She had peed by the stove (I stepped in it again) and it showed trace ketones. Since then, she has been sleeping. Should I make her drink more water?
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You’ve been giving her a cautious low dose since your switch to Lantus. It’s probably too low for her and given her three bouts of DKA it would be best to get it up ASAP but safely and with the guidance of experienced Lantus users on this forum. The trace reading on the recent ketone test is very concerning given her history.

I’d get her to the vet as Steph suggested and then think long and hard about what you’re prepared to do to get better control over Chloe’s BG. I’m sorry for being blunt but we all worry about Chloe and can see another crisis in the making, Roberta.
 
Teenuh said:
I’m sure @Jill & Alex (GA) would echo what we have all said, as well as other users here.
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Actually, I'd like to echo what Kris said because it sums my feelings up in a nut shell, "I’d get her to the vet as Steph suggested and then think long and hard about what you’re prepared to do to get better control over Chloe’s BG. I’m sorry for being blunt but we all worry about Chloe and can see another crisis in the making, Roberta."

None of us are feline diabetes police. You have choices to make. Treat Chloe aggressively which will take more effort and commitment than not... let the vet$ treat her every time $he begin$ to throw ketone$, or do her a favor and re-home her if that's what is best for you. No judgement here. You have to figure out what you want to do and do it for both of you.

We're here to help... if you want our help.
 
Jill & Alex (GA) said:
Actually, I'd like to echo what Kris said because it sums my feelings up in a nut shell, "I’d get her to the vet as Steph suggested and then think long and hard about what you’re prepared to do to get better control over Chloe’s BG. I’m sorry for being blunt but we all worry about Chloe and can see another crisis in the making, Roberta."

None of us are feline diabetes police. You have choices to make. Treat Chloe aggressively which will take more effort and commitment than not... let the vet$ treat her every time $he begin$ to throw ketone$, or do her a favor and re-home her if that's what is best for you. No judgement here. You have to figure out what you want to do and do it for both of you.

We're here to help... if you want our help.
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Roberta, please keep us posted. I know this is stressful. Hang in there Chloe. We all love you Chloe!!:bighug:
 
Roberta, you know that Chloe is throwing ketones again and you KNOW what that leads to. She could go DKA at any point. She's done it before. If she was mine, I'd already be at the vet. I would have gone straight there hoping they could help me get the ketones under control BEFORE she gets worse rather than waiting around. I'm sorry if this sounds harsh, but I'm really horrified at this point....I have watched you and Chloe go through this sugar dance for a VERY long time and have grown to care a great deal for Chloe. I'm extremely worried about her right now and I wish you'd go to the vet.
 
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