12/30 Luna checking in

For_Luna

Member Since 2019
It's been a while since we posted, so just wanted to check-in and let everyone know that Luna is doing fine. She's eating without any issues, is more active, and back to waking us up in the middle of the night to play.

The two weeks before Christmas, we were getting some good numbers; a majority of PMPS numbers were blue or green, and we stopped the crazy days of all black/HI readings. While we were done at the in-laws, she hung out in the 300s most of the time. We did get a green 76 early Christmas morning, so I think some of those high numbers were from a bounce. The stress of being in a new place probably didn't help either. Yesterday looked a little bit better, and I'm hopeful we can get back on track today.

We're still getting used to this new food and new insulin dose. Nadir is a lot later than it used to be. A few times it's been +11 or even dropped to PMPS. Luckily, PMPS hasn't been too low on those days, so we felt comfortable still giving the full dose. If/when her numbers start to come down, we'll have to stall more to see what she's going to do. I suspect this new normal is due to the higher carb % in this new food. Before we were feeding RAWZ which was super low carb (0-2% i think). This new food is around 10%. I think the food is keeping the higher insulin dose in check. If we tried this dose with a lower carb food, it would probably be too much.

We're still following the advice of all of our doctors and trying to keep her in the 150-300 range. (Also the reason we haven't been around as much. Not following either protocol). I sent the numbers we collected the 2 weeks before Christmas to our vet and he said they looked good and to keep going with the 1.5u. It's kind of nice to not obsess over her numbers as much. Luna looks good, she's back to acting like her old self, she putting on weight (6.7lbs at last weigh-in), and she's not drinking or peeing excessively. A few of the doctors told us we need to treat the cat and not the numbers. It's starting to make sense.

We hope everyone is doing well and we wanted to say thank you again for all of the support while Luna was hospitalized. Happy Holidays and Happy New Year.
 
I'm so happy to hear Luna is doing better and eating for you. Thank you for the update. Please make sure you stop by & give us updates so we can know how Luna is doing.
 
It's so good to hear that Luna is her old self!

I just want to put a point out for your consideration. Most vets do not have caregivers who home test let alone know how to steer a curve with food. As a result, they advise people to keep their cats in higher numbers than we do here. I am also concerned about having Luna stay in numbers over 200. If your goal is regulation, you want Luna's numbers to be below renal threshold. Diabetes is hard on the kidneys and kidney disease is a common problem in even non-diabetic cats. The more time Luna is in numbers that are below renal threshold (around 200), the less stress on the kidneys.
 
It's so good to hear that Luna is her old self!

I just want to put a point out for your consideration. Most vets do not have caregivers who home test let alone know how to steer a curve with food. As a result, they advise people to keep their cats in higher numbers than we do here. I am also concerned about having Luna stay in numbers over 200. If your goal is regulation, you want Luna's numbers to be below renal threshold. Diabetes is hard on the kidneys and kidney disease is a common problem in even non-diabetic cats. The more time Luna is in numbers that are below renal threshold (around 200), the less stress on the kidneys.
Thank you. We're getting conflicting information. The board tends to aim lower than vets. I did read the 2018 Diabetes Management Guidelines from the AAHA, and it says, "The overarching goal of monitoring diabetic cats and dogs is to
control clinical signs of DM while avoiding hypoglycemia. Stated another way, the definition of a controlled diabetic is absence of clinical signs and hypoglycemia. Blood glucose levels do fluctuate and short periods of mild hyperglycemia are acceptable. The goal is not necessarily to normalize BG, but to keep the BG below the renal threshold(200 mg/dL in dogs and 250–300 mg/dL in cats) and to avoid hypoglycemia. When BG is above the renal threshold, glucosuria occurs, resulting in PU/PD."

I know we've been higher a few days, but we were starting to come down. We'll continue to monitor and work with our vets to make sure she's safe. That all being said, I wouldn't mind seeing her closer to 250 as a high. She's a bouncer, so it's never been easy keeping her numbers down.
 
Renal threshold is an ECID thing. The easiest way to know is to get Ketodiastix. They are like ketostix but also test urinary glucose. If there's no glucose in Luna's urine, she's below renal threshold.
 
I'm glad you checked in! We were wondering how Luna is doing. Good to see she's still wearing the Libre and getting lots of test recorded. :)

Merry Christmas and Happy New Year to you and your family!
 
It’s great to get a Luna update. Glad she is feeling well.

That 250-300 you saw referenced for renal threshold in cats, was likely on an AT. We’ve had some members report renal threshold via ketodiastix as low as 180 on a human meter. I didn’t use the ketodiastix, but would test BG right before Neko got an urinalysis. Figured hers was around 220 on my human meter.
 
It’s great to get a Luna update. Glad she is feeling well.

That 250-300 you saw referenced for renal threshold in cats, was likely on an AT. We’ve had some members report renal threshold via ketodiastix as low as 180 on a human meter. I didn’t use the ketodiastix, but would test BG right before Neko got an urinalysis. Figured hers was around 220 on my human meter.
I'll certainly bring it up next time I check in with our vet. We send BG readings and get feedback every 2 weeks or so. He hasn't mentioned renal threshold, and after everything they did for Luna and how invested they are, I imagine they would say something if it was a concern. But we definitely appreciate the information. We're going back in a month for follow up tests.
 
Nice to see you, Dan. And thanks for the report on Luna. So happy to hear that she is eating and playing, even if it is the middle of the night.
 
Some recent publications on the subject-Renal. Most likely why you are not hearing concerns expressed by your awesome vets :). I know I made sure to ask about this early on as well. I’ve had a CKD cat and wanted to make sure I wasn’t going to cause an issue.

Each cat is going to be different to begin with and science continues to redefine what is “normal” & demonstrate what may be an issue or concern for one feline may not be an issue for another feline. There is no simple or set hard and fast number, but instead only data that one must use with other additional findings along with the presence or lack of clinical symptomology to determine what necessary treatment adjustments (if any) need to be made. Typically they just do not see the issues that arise in humans. You will see that in the one article I’ve attached, they specifically make mention that the renal threshold in felines “has a wide interindividual variation”.

Happy and Healthy 2020!!

https://www.americanveterinarian.com/news/when-glucosuria-in-cats-is-a-normal-finding


https://onlinelibrary.wiley.com/doi/full/10.1111/jpn.13018

https://www.ncbi.nlm.nih.gov/m/pubmed/25425599/
 
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