02/28 Willow PMPS 104/ REDUCTION TONIGHT/ +2 72/ +3 67/ +4 70/ +6 76/ +9 79

nslade001

nslade001

Member Since 2018
yesterday

Hello everyone, Willow is doing very well; I believe this morning would have been a green preshot except she tried to hack up a hairball 15 minutes before the test! I hope you all had a good nights sleep and wishing you and your kitties a safe day of green surfing! :) With love, Nikki

AMPS 5.8 (104)
1.8 U Lantus
+3 2.8 (50) fed usual 1/8 can LC FF
+3.5 2.4 (43) fed 2 tsp HC 21% FF (Delights w/ cheddar/grilled/tuna & cheddar cheese feast in gravy) (fed meat and gravy)
+3.75 2.8 (50) fed 1 tsp LC FF
+4.25 2.8 (50) fed 1 tsp LC FF
+4.75 2.7 (49) fed 1 tsp HC 21% (fed mostly the gravy)
+5 3.2 (58)
+5.5 3.5 (63)
+6.5 3.8 (68)
+9 4.6 (83)
PMPS 5.8 (104)
1.55 U Lantus
+2 4.0 (72)
+3 3.7 (67)
+4 3.9 (70)
+6 4.2 (76)
+9 4.4 (79)
 
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LOL I *knew* she was really a green preshot! Her +3 is 50, fed her usual meal of 1/8 can (approx 2 tsp) LC FF, will retest in 20.
 
not actually calling for 911 but would like eyes if she isn't rising, will retest in around 5 minutes...
 
Sandy and Black Kitty said:
Watching :cool:
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Thanks :)
+3.75 is 2.8 (50) so I fed a tsp of LC FF.
Will retest in 20 mins. I took off my 911 because I know you're there, thanks so much :)
Just so I'm sure, if she's under 50 I feed 2 tsp HC gravy, but over 50 I should continue to give a tsp or 2 LC unless she's rising?
Thanks!
 
So, Willow apparently misses carbs...she's standing up trying to climb up the table where I have the gravy meal out just in case, meowing....she hasn't done this since before diagnosis in November lol
 
nslade001 said:
Thanks :)
+3.75 is 2.8 (50) so I fed a tsp of LC FF.
Will retest in 20 mins. I took off my 911 because I know you're there, thanks so much :)
Just so I'm sure, if she's under 50 I feed 2 tsp HC gravy, but over 50 I should continue to give a tsp or 2 LC unless she's rising?
Thanks!
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Yes if. under 50 feed 1-2 tsp HC. Easy does it.
What is her normal feeding schedule?
 
Sandy and Black Kitty said:
Yes if. under 50 feed 1-2 tsp HC. Easy does it.
What is her normal feeding schedule?
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Thanks. Her am feedings are (LC FF):
8 am-1/4 can
+1- 1/4 can
+2- 1/8 can
+3- 1/8 can
+4- 1/8 can
+6- 1/8 can
+9- 3/16 can weruva

She usually nadirs around +3/+4, so this schedule seems to carry her easily through most lower drops; she has a lovely flat cycle. I know the +9 seems heavy, but it doesn't seem to really impact her pmps, and stops her from getting too hungry/stressed.

It's currently 12:20 so she's not *due* until her +6.
 
BTW She has earned a .25u reduction in dose.

nslade001 said:
Thanks. Her am feedings are (LC FF):
8 am-1/4 can
+1- 1/4 can
+2- 1/8 can
+3- 1/8 can
+4- 1/8 can
+6- 1/8 can
+9- 3/16 can weruva

She usually nadirs around +3/+4, so this schedule seems to carry her easily through most lower drops; she has a lovely flat cycle. I know the +9 seems heavy, but it doesn't seem to really impact her pmps, and stops her from getting too hungry/stressed.

It's currently 12:20 so she's not *due* until her +6.
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Beautiful.
I found it best to consider the next regularly scheduled meal when deciding on how much propping up was in order, assuming I was able to monitor closely.

eta- do the PM feedings differ?
 
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+4.5 was back to 49; I fed 1 tsp HC although I suspect LC would have been fine at that number. I hope she starts to climb soon, normally she would...

A question on the reduction: I've only been increasing her by 0.1 U increments because her nadirs have been quite low; should I decrease by 0.25 U or 0.1 U? I assumed the 0.1 U just because that's what the increases have been, but maybe 0.25 U is safer?

Thanks so much!
 
Yes, the pm feedings differ just slightly:
8 pm- 1/4 can
+1- 1/4 can
+2- 1/8 can
+3- 1/4 can (this is different from the am, if she's running lower I just give 1/8 here and the other 1/8 a bit later since we're likely staying up)
+4- 1/8 can
+9- 3/16 can weruva in feeder
 
nslade001 said:
+4.5 was back to 49; I fed 1 tsp HC although I suspect LC would have been fine at that number. I hope she starts to climb soon, normally she would...

A question on the reduction: I've only been increasing her by 0.1 U increments because her nadirs have been quite low; should I decrease by 0.25 U or 0.1 U? I assumed the 0.1 U just because that's what the increases have been, but maybe 0.25 U is safer?

Thanks so much!
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. Safety first. 0.25u.
“Better a day too high than an hour too low”
 
Sandy and Black Kitty said:
How did you discover she was diabetic?
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She'd been PUPD for quite a while, assumed CKD because no weight loss/hyperactivity to indicate hyperthyroidism, and she was a perfectly normal weight so assumed not diabetes. (and we prove what "assume" means, unfortuately. Should have known better, since I'm a retired AHT). Brought to vet for sudden onset hematuria and peeing outside box, U/A showed glucosuria. Bloodwork confirmed.
She'd also been exhibiting what we thought was hyperextension, (she did have a pretty bad injury to the paw when she was a kitten) but turned out that was neuropathy. (Again, my experience as an AHT only ever showed hind leg neuropathy, so diabetic neuropathy never crossed my mind. sigh.) Luckily, zobaline is helping with that :)
 
nslade001 said:
She'd been PUPD for quite a while, assumed CKD because no weight loss/hyperactivity to indicate hyperthyroidism, and she was a perfectly normal weight so assumed not diabetes. (and we prove what "assume" means, unfortuately. Should have known better, since I'm a retired AHT). Brought to vet for sudden onset hematuria and peeing outside box, U/A showed glucosuria. Bloodwork confirmed.
She'd also been exhibiting what we thought was hyperextension, (she did have a pretty bad injury to the paw when she was a kitten) but turned out that was neuropathy. (Again, my experience as an AHT only ever showed hind leg neuropathy, so diabetic neuropathy never crossed my mind. sigh.) Luckily, zobaline is helping with that :)
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So how long would you say she has been diabetic?
 
That's difficult. She developed really bad PUPD maybe 2 months before diagnosis, and a ravenous appetite the last month. Neuropathy progressed rapidly after diagnosis. But before that, I'm thinking we just really didn't see it. I was engrossed in care of a very sick parrot for 3 years, and after that we became fulltime caregivers for my father-in-law with alzheimers as well as fostered greyhounds for a year, so think we just didn't notice it since we split litterbox duties and Wayne fed her. I honestly suspect she may have had a very, very low grade diabetes for quite a while,if that's possible, as I seem to remember commenting on urine quantity, and I'm sure I was concerned about her paw (slight lameness) for well over a year before (did see a vet about that)
I really believe we caused her diabetes by feeding a species-inappropriate diet (vegan), with supplements to make a "nutritionally complete" diet from Veggiecat. And I suspect the death of our parrot, a move, and bringing in my father-in-law plus greyhounds added enough stress to bring everything to a head.

Why do you ask?

+5.5 is 63. Safe to leave an hour before the next test you think? Didn't feed her.
 
nslade001 said:
That's difficult. She developed really bad PUPD maybe 2 months before diagnosis, and a ravenous appetite the last month. Neuropathy progressed rapidly after diagnosis. But before that, I'm thinking we just really didn't see it. I was engrossed in care of a very sick parrot for 3 years, and after that we became fulltime caregivers for my father-in-law with alzheimers as well as fostered greyhounds for a year, so think we just didn't anotice it since we split litterbox duties and Wayne fed her. I honestly suspect she may have had a very, very low grade diabetes for quite a while,if that's possible, as I seem to remember commenting on urine quantity, and I'm sure I was concerned about her paw (slight lameness) for well over a year before (did see a vet about that)
I really believe we caused her diabetes by feeding a species-inappropriate diet (vegan), with supplements to make a "nutritionally complete" diet from Veggiecat. And I suspect the death of our parrot, a move, and bringing in my father-in-law plus greyhounds added enough stress to bring everything to a head.

Why do you ask.
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To get a feel for approximately when her pancreas became overwhelmed.

She is very well regulated - all blue and green for the past two of the three months she has been on insulin.

Is this the first time you have had to intervene with HC?
 
Hi, yes it is, except for when we very first started on insulin and I panicked lol. That would have been Nov 18; she was diagnosed on Nov 12. Her first green, she hit 3.9 on caninsulin at +3; I then overloaded her with carbs :)

How important do you feel that is? If it hasn't been too long, do you think she has a chance of diet-controlled remission? (I didn't really think so, because most of the SS's I see that are similar with greens/blues belong to kitties getting much lower doses).

Thanks so much for being there for me today! With love, Nikki
 
nslade001 said:
How important do you feel that is? If it hasn't been too long, do you think she has a chance of diet-controlled remission? (I didn't really think so, because most of the SS's I see that are similar with greens/blues belong to kitties getting much lower doses).
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There is always a chance:D
(our 21 month journey is a testament to that).

Willow is spending practically all her time in the “healing numbers” (50-120) which is the best place to be. Will her pancreas heal to the point of making enough insulin to once again handle her metabolic needs full time? No one can say. ECID.
What I can say is healing can’t be rushed. It has its own timetable and likely takes longer with age.
If healing is taking place understand that it’s incremental. The pancreas may start sputtering insulin insulin here and there. That’s why it’s important to take the full reduction.

I’d like to understand the strategy you have been using for increasing dose. Please explain.
 
Thanks :)
Strategy. Well. lol

The first while on Lantus from caninsulin we increased dose confidently pretty much as per protocol, because we were seeing all blues/ yellow and were comfy there (every 3-4 days, we increased 0.25 U up to 1.25 U.)

When we hit 1.25 U we got our first green on the 2nd cycle, the first 3 on the 6th cycle. By day 7 we had a run of 3s with a nadir of 61, so we thought we'd hold a bit longer than protocol called for to see if her nadirs would drop more. We then sort of got stuck on the 1.25 U dose :) There were constipation issues, hiding, peeing outside of the box...I wasn't sure if something else might be going on that was driving up her BG that might sort itself out. I asked once or twice during that dosing period for advice re if I should increase, but got some no's because she still had the occasional nadir in the 3s. On the 21st I decided to increase the following night, but on the 22nd she dropped to 2.8 (50), so I decided to hold off again (she'd just started pooping large regular poops again, so I hoped maybe that constipation had been holding her numbers up).

While she continued with on again/off again constipation I started looking into calipers, and I also asked again on Jan 28th about increasing, but was advised to hold the dose unless I saw an increase.

So I got calipers, and realized that I had probably been dosing more along the lines of 1.5 U rather than the 1.25 I'd been eyeballing. Also realized how really, really poorly marked the BD syringes were. I recognized that most likely the times she hit a lower nadir, she'd actually been given a far higher dose than intended. We decided to give her 3 days on a stable dose of 1.5 U, then 3 days on a new bottle of lantus (our first had been dropped a few times and I wanted to make sure this time we started off everything as best as possible) and reassess her nadirs on a stable dose of good insulin.

Before we increased from 1.5 U, the most recent low nadirs were 65 to 70. We weren't comfortable increasing a full 0.25 U since she was generally so flat and low, so decided we'd increase by 0.1 U increments (not the protocol) holding the dose at least 10 cycles (as per protocol). So that's what we did.

I don't know if that was the wrong thing to do, but it felt safer with the nadirs she'd been having. If we'd increased by 0.25 U we'd be (almost) where we are now, just faster. So I guess we tweaked the dose rather than increased the dose.

Tonight we'll drop her to 1.55 Unit. Any advice you can offer on how we should carry on from here would be greatly appreciated! And probably more confidently taken, now that we've gotten a bit of experience and data on how she responds :)

Thanks again for all you do, with love, Nikki
 
Willow really doesn't seem to be feeling well, I don't know if it was the low numbers throwing her off or the high carb, different protein food. From her super-happy, purry morning, she's been hiding under the bed a few times, sleeping *really* hard (although that may be because we had to interrupt her sleep for pokes), peed over the LB tonight, and just looks uncomfortable. Hope her preshot is ok, and that her appetite is good. She's earned a reduction, so hopefully she'll get a good sleep tonight free of pokes, unless the depot causes a drop.
 
Congrats on the reduction! Sorry she is not acting herself. Some kitty are sensitive to the higher carb gravies and it can upset their tummies. Or she could be reacting to being poked a bit more today. Hope she will be forgiving and start to feel herself soon.
ETA: I would get at least a before you go to bed test in tonight. Even though you reduced tonight the higher depot could still be talking tonight.
 
Bobbie And Bubba said:
Congrats on the reduction! Sorry she is not acting herself. Some kitty are sensitive to the higher carb gravies and it can upset their tummies. Or she could be reacting to being poked a bit more today. Hope she will be forgiving and start to feel herself soon.
ETA: I would get at least a before you go to bed test in tonight. Even though you reduced tonight the higher depot could still be talking tonight.
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Thanks, I will absolutely get at least a couple of tests tonight (I'm a bit of a worrier lol)... I meant free of an all-night-poke-a-thon lol.
 
Congrats on handling the first lime green. Sorry she is feeling off. The wheat in some high carb foods can disagree with some kitties, it did my girl. I switched to the Weruva high carb foods that do carbs from potatoes. The Cats in the Kitchen pouches have some products in the high teens. The Grandma’s Chicken Soup is 21% I believe.
 
Wendy&Neko said:
Congrats on handling the first lime green. Sorry she is feeling off. The wheat in some high carb foods can disagree with some kitties, it did my girl. I switched to the Weruva high carb foods that do carbs from potatoes. The Cats in the Kitchen pouches have some products in the high teens. The Grandma’s Chicken Soup is 21% I believe.
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Thanks so much, I'll definitely look into different HC options :)
 
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