12/13 Makoto AM(166) +2 (45), +2.4 (148)+3 (248) PMps (124)+1 (212) +2 (181)

Si am cat mom

Si am cat mom

Member Since 2019
I guess we are done with the 0.5 Unit dose?
I am worried we won't find the right dose as often as we are taking reductions. I haven't held a dose for a week since we were on the 1 Unit.
+2 (45) was checked on both paw pads- similar numbers. Fed MC (10-14%) food with 1/2 teaspoon HC...really just a few flakes of his C/D that I had on hand. After 22 minutes or so (148). He was feisty, resting now.

yesterday http://www.felinediabetes.com/FDMB/threads/12-12-makoto-8-268-pmps-225-2-66-what.222860/
 
I'd suggest doing what you can to prevent Makoto from getting more reductions. At this point, your kitty isn't quite ready to be looking at remission -- there's still too much yellow for a successful OTJ trial. You're already testing a good deal but you may need to get some tests in earlier in the cycle so you can intervene with food and help keep the numbers propped up. Alternatively, you could use food that's higher in carbs.
 
It does look like 0.5u is too much, you have to let the numbers guide you. It is better to be safe, and take the reduction. You can always go back up if 0.25u isn't doing the trick.
 
I was thinking about the carbs as well after seeing Makato's cycle last night. You might want to feed something at preshot other than Tiki which is zero carb. It does seem that you might be getting some carryover from the previous dose, and with no carbs he doesn't get much of a bump, then he drops by +1ish. You'd have to play around a bit to see which % carbs are enough to prop him up early in the cycle.
 
Sienne and Gabby (GA) said:
I'd suggest doing what you can to prevent Makoto from getting more reductions. At this point, your kitty isn't quite ready to be looking at remission -- there's still too much yellow for a successful OTJ trial. You're already testing a good deal but you may need to get some tests in earlier in the cycle so you can intervene with food and help keep the numbers propped up. Alternatively, you could use food that's higher in carbs.
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That's what I am trying to figure out... I don't know what to do. I tried to catch him today at +2 before the number would cause a bounce and missed it. Maybe I rushed the zero carb food change and should be looking at a balanced lower carb option- that makes sense. I just need a food that is also low phos for all his urinary issues. I will bump up his morning and evening snacks so that hopefully I can catch him before he drops too far... and maybe skinny this dose , but not take a full reduction ? I go back to work tomorrow night and testing overnight won't be possible
 
Christie & Maverick said:
I was thinking about the carbs as well after seeing Makato's cycle last night. You might want to feed something at preshot other than Tiki which is zero carb. It does seem that you might be getting some carryover from the previous dose, and with no carbs he doesn't get much of a bump, then he drops by +1ish. You'd have to play around a bit to see which % carbs are enough to prop him up early in the cycle.
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Sounds good. Last night, he got some of his older low-med carb food mixed in with the Tiki after that (66) reading. I will look around and see what foods I can come up with....hopefully that will help a bit without messing with his allergies again. I didn't catch it today, but will try a different food combo PMps and then with his AMps and see what the numbers do. When I work, his overnight snack is the glycobalance (14% carb) frozen in cubes with the Tiki and it's broth... It doesn't help I am also late with his AM dose when I am working by 15 to 30 minutes after he gets his PM dose 15 mins early the night before.
 
You may just be seeing the food bump from your MC snack, he does seem to come back down very well. There are some foods on Dr. Lisa's list that have lower phos and are lower MC (11-12%). Have you tried your glycobalance/Tiki mix yet at any preshots?
 
...well, looking back at the week I tried to increase his dose on the 1st this all makes more sense...
That was also about a week after I weaned him off his LC food and onto the Tiki Cat exclusively. Poor guy.
 
Christie & Maverick said:
You may just be seeing the food bump from your MC snack, he does seem to come back down very well. There are some foods on Dr. Lisa's list that have lower phos and are lower MC (11-12%). Have you tried your glycobalance/Tiki mix yet at any preshots?
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I leave the mixture overnight sometimes when I work, so he gets that in his automatic feeder at +4 and +8, but I think now that is too late in his cycle with this dose. I will move it up to his PMPS meal and then maybe do the same mixture again at +3 and +6 this evening and see how he does. I had some of his older Blue Buffalo , and gave that last night since it's 8-10% carbs, but the phos in that is 300+ I think. I think I thought with the variation in the carb calculations that the Tiki food and some of the dark meat varieties would have some carbs, but I think I was wrong. I will make small changes to his meals and try to test more earlier in the cycle and then +10,+11 more consistently while holding this dose I think ?
 
I agree with everything you are planning, except I'd suggest you reduce. Last night's lower numbers, plus today's are too low for AT2. That, and since you are following SLGS and are fairly recently collecting data, you should actually reduce with a number under 90 ;). Caregivers who follow SLGS can modify the reduction point once they have a sense of how their kitty responds to insulin and how food influences the BG numbers, but as I said, with AT2 the 40s are just too low.
 
Christie & Maverick said:
I agree with everything you are planning, except I'd suggest you reduce. Last night's lower numbers, plus today's are too low for AT2. That, and since you are following SLGS and are fairly recently collecting data, you should actually reduce with a number under 90 ;). Caregivers who follow SLGS can modify the reduction point once they have a sense of how their kitty responds to insulin and how food influences the BG numbers, but as I said, with AT2 the 40s are just too low.
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dang it ... Okay. So not the skinny dose, a full reduction tonight to 0.25 given that he was not only below 90s but also did go less than 50? Or hold tonight and change the food to see what it does?
I think I was just worried to take a full reduction and then be gone all night tomorrow night - not know what he's doing...but that sounds like it would be better for him to be in the lemon tree and not the lime, right? Just answered myself I guess.
 
Thanks everyone for the advice.
Makes more sense now... we'll get there. I just have to stop being impatient and changing everything or nothing it seems.:facepalm:
 
I'd give 0.25u a try. The skinny/fat doses are better when you are trying to focus in on the right dose that keeps Makato in a good range. Full reduction is the safest thing to do, IMHO.

You should have technically done the reducie this morning, I wouldn't hold this dose any longer.
 
Does Makoto have urinary track issues or kidney issues? Your signature says crystals (which is urinary track) but you're mentioning phos (which is kidney). If this is a kidney issue, have you gotten blood work that include SDMA, creatinine, phos, and BUN along with urine concentration. Did your vet tell you what IRIS stage Makoto is?

If you're feeding Makoto a zero carb food, you may want to think about something that's 5% or even a bit higher to prevent reductions.
 
Sienne and Gabby (GA) said:
Does Makoto have urinary track issues or kidney issues? Your signature says crystals (which is urinary track) but you're mentioning phos (which is kidney). If this is a kidney issue, have you gotten blood work that include SDMA, creatinine, phos, and BUN along with urine concentration. Did your vet tell you what IRIS stage Makoto is?

If you're feeding Makoto a zero carb food, you may want to think about something that's 5% or even a bit higher to prevent reductions.
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Just urinary issues. In comparing foods for the stones/crystals etc. I noticed that they all had lower phos levels. My understanding was in trying to keep with those lower levels, you create a chemical environment in the urine where crystals are less likely to form. With the increased protein levels also, I figured anything that would stave off urinary issues and be Kidney friendly would be smarter. Plenty of diabetic cats and cats with urinary issues seem to develop Kidney disease. When he was diagnosed, the Antech lab included some test called a SDMA indicator test which predicted that a cat with his blood work " would develop kidney disease in the next 6-18 months". I plan on following up on his blood work after treating the Diabetes for 3 months to see if anything had changed and then going from there. I have always been more concerned about his liver values, but I don't remember ever seeing Kidney values much out of whack. He had protein in his urine once when he was being treated for a clotting disorder briefly... the vet seemed to think that was due to the blood from doing the cystocentesis to get urine.

I am definitely planning on looking for a slightly higher carb content and feeding that with his AM and PM shots, plus a small snack around +2 to keep him in the safer numbers longer. I wish I wouldn't have changed his food over the course of a week without testing more, but I am glad to have figured it out now. I'll look for maybe 5-10% since I already have the glyco which is more medium carb at 14%. He's been sneezing- occasionally coughing- so much that part of me worried that these food changes flared his allergies up, so I am hoping that resolves too.
 
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If you've not done so already, Dr. Lisa has solid information on kidney issues. Her basic message is "water." I think it's wise as a general rule to keep an eye on phos values given how hard diabetes is on the kidneys. Of course, getting your cat regulated is also a big factor in that keeping BG numbers under renal threshold helps to keep the kidneys protected.

Re. your SS, I'd suggest color coding your AM +2 as green since it's in dose reduction territory.
 
PMPS (124) fed LC/MC mixture ( glyco and Tiki) with his omega supplement on top since he likes it and seemed suspicious of the Glycobalance. Reduced dose of 0.25 ( eyeballed it since I can't tell with the calipers what it really should be...maybe I need a light box)
+1 (212) and gave two teaspoons of the same
+2 (181) gave him a few raw freeze dried treats and 1 teaspoon of his Tiki Cat- mostly the broth- because he has figured out how to lift his food dish and I believe he flung it at me ....

I got (28) at first on a strip that had been left out and took forever to read, so ...after panicking for .5 seconds I retested with his new batch of test strips and got the (181) ;)
 
Christie & Maverick said:
I'm sorry, Ari, I've been spelling Makoto's name wrong :facepalm:, time to get some new reading glasses! Well so far so good with the food experiment. He really is looking good :)
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it's okay, he doesn't mind :)

so far, so good :nailbiting: still nervous. I bet he can't wait for me to leave him alone and go back to work tomorrow
 
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