Peeka 8/30 Neuropathy getting worse

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Peter (Boo) (Peeka GA)

Peter (Boo) (Peeka GA)

Member Since 2020
Hey everyone,

I posted an update to my daily updates last night, but this morning we are seeing more of the same. Peekas BG numbers look to be somewhat normal I think, her neuropathy is getting worse though. As bad as it did the day we took her to emergency vet and I’m honestly at a loss.

She’s been taking the methyl b12 with her food. I’m just honestly not sure what else I need to do. If this is the norm, and it can sometimes get bad again, please let me know.

She’s still able to walk around, I know that because last night she fell asleep under the living room table and when I woke up around 4:30 to feed our dog, she was on the ottoman she likes to lay on.

If someone could look at her numbers and let me know if this could be considered normal for her to have regressions this badly, please let me know. I’m losing faith in my abilities as a cat dad.
 
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+3.5 update: She came in at 196 this morning. I’m just frustrated that her levels are what they are but still not seeing improvement with the neuropathy. I’m sorry again for venting here. Off to work, wanted to give y’all some data to work with while I’m away.

Hope everyone has a good Sunday.
 
Awww (((Peter))) Yes it is normal. Peeka didnt get neuropathy/ diabetes in a few days. It sometimes takes longer to see the results of all your and Peeka's hard work. Trouble was walking on his hocks for weeks before he finally made progress. I was one of the hardest things I ever witnessed but not for Trouble. He plodded along the best he could.
I sure you will get more replies with stories . Take heart. This too shall pass.
j
 
Peter Ramos said:
Hey everyone,

I posted an update to my daily updates last night, but this morning we are seeing more of the same. Peekas BG numbers look to be somewhat normal I think, her neuropathy is getting worse though. As bad as it did the day we took her to emergency vet and I’m honestly at a loss.

She’s been taking the methyl b12 with her food. I’m just honestly not sure what else I need to do. If this is the norm, and it can sometimes get bad again, please let me know.

She’s still able to walk around, I know that because last night she fell asleep under the living room table and when I woke up around 4:30 to feed our dog, she was on the ottoman she likes to lay on.

If someone could look at her numbers and let me know if this could be considered normal for her to have regressions this badly, please let me know. I’m losing faith in my abilities as a cat dad.
Click to expand...
Peter, the nadir range you want is 80-150. Peeka is not there yet. The current numbers are not helping her neuropathy. In order to be regulated you want her to be under 300 most of the time and within the above nadir

did you post in the Vetsulin forum?
 
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I just saw that you did. Now you need to read all the yellow sticky notes from the Vetsulin forum. I think I mentioned that before. So here is the one on dosing:

https://www.felinediabetes.com/FDMB/threads/beginners-guide-to-caninsulin-vetsulin.231587/

from this post:

Changing the Dose

Hold the starting dose for at least a week UNLESS

  • your cat won’t eat or you suspect hypoglycemia
  • your kitty falls below 90 mg/dL (5 mmol/L). If kitty falls below 90 mg/dL (5 mmol/L) decrease the dose by 0.25 unit immediately.
After 1 week at a given dose perform a 12-hour curve (i.e., testing every 2 hours) OR perform an 18 hour curve (i.e., testing every 3 hours). Note: Random spot checks are essential in order to "fill in the blanks" on your kitty's spreadsheet. The goal is to learn how low the current dose is dropping kitty prior to making dose adjustments.

The general guidelines for making dose changes are:
  • If nadirs are more than 150 mg/dl (8.3 mmol/L), increase the dose by 0.25 unit
  • If nadirs are between 90 (5 mmol/L) and 149 mg/dl (8.2 mmol/L), maintain the same dose
  • If nadirs are below 90 mg/dl (5mmol/L), decrease the dose by 0.25 unit
  • HOWEVER, there are some situations which signal that a larger than usual dose reduction is needed. If you are unsure, please post on this forum or in the Health forum and ask for input about your dose.
As your cat's blood glucose begins to fall mostly in the desired range [lowest point of the curve approaching 100 mg/dl (5.5 mmol/L) and pre-shot value around or below 300 mg/dl (16.6 mmol/L)], lengthen the waiting time between dose increases. If you decide to change another factor (e.g. diet or other medications), don't increase the insulin dose until the other change is complete but decrease the dose if your cat's glucose numbers consistently fall below 90 mg/dl (5.0 mmol/L) as a result of the change.

Don't be tempted to rush the process along by increasing the dose more quickly or in larger increments no matter how high your cat's blood glucose is! Rushing towards regulation will cost you time in the long run, because you may race past the right dose for your cat.
 
I know how heartbreaking it is to see them like that. I knew I couldn’t heal her as fast as I wanted to, so I switched gears to making her as comfortable as I could and her environment neuropathy friendly. I went to Ross and bought an assortment of cheap dog beds and she took to them immediately and was just happy to have something comfy to lay on at ground level. They were cheap so I could wash them everyday if she peed on them. I got steps she could pull herself onto if she wanted to get on her favorite higher spots.

I don’t know how much this helped, but she was also on antioxidants and Gabapentin per her nutritionist. The antioxidant was to combat the oxidation on the nerves caused by the excess glucose and the gabapentin to help the muscles with arthritis that could be a side effect of the neuropathy. Since she was on this trio of meds, I can’t say which or if the 3 combined is what helped, but you may want to ask your vet about gabapentin too as a treatment option. The antioxidant is something you can get over the counter
 
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Peter Ramos said:
I posted an update to my daily updates last night, but this morning we are seeing more of the same.
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This is a marathon Peter, not a sprint! :p

You're seeing more of the same because you haven't made any changes we suggested. I understand being frustrated and venting (we all do it) but you can't expect better results when you haven't taken any steps forward.
Peter Ramos said:
I’m just frustrated that her levels are what they are but still not seeing improvement with the neuropathy.
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It can take weeks for any improvement. Higher BG (which Peeka has) makes it take longer. Your mission? Get her BG down. That means:

Get rid of the dry food! Feeding the dry is like adding gas to the fire. Shooting yourself in the foot. Rubbing salt in the wound. Take your pick.
Switch to Prozinc or Lantus insulin. Vetsulin is hot garbage. It doesn't last long enough in cats, burns up early, and by pre-shot the insulin is long gone. Imagine getting pain meds that only last you half the day.
Increase the dose, please. He has been at 3u long enough. We want to see numbers under 120 and haven't yet. The longer you keep a dose that isn't doing enough, the greater likelihood that glucose toxicity sets in. Glucose toxicity is basically insulin resistance from high BG numbers. To break it, you have to up the dose, sometimes multiple times, until the "barrier" is broken. Then you're often chasing the dose back down to where it needs to be.

Note that holding the dose, staying on Vetsulin, and continuing to feed dry is only making your challenge with Peeka harder than it needs to be. I understand your schedule is hectic, but as long as the changes for Peeka aren't being made, you can't be surprised or discouraged by the lack of improvement. I also want to point out that cats make it harder on themselves ... they are VERY good at hiding pain and discomfort, and high BG makes them feel cruddy. Cats experience the same discomforts as human diabetics with high BG, the only difference is they can't tell us they feel bad and actually prefer that you don't know. It's why it's so much harder to catch diseases and illnesses early in cats. They are such solitary creatures they'd rather you never know they feel poorly. I do wish they were more vocal about things, as it's easy for us humans to assume there's nothing wrong because they "look fine". Ignorance is bliss I guess.

I am glad to see you're getting at least a mid-cycle test in, that is very helpful already. It's time to up the dose or kick the dry, one thing at a time.
 
Panic said:
This is a marathon Peter, not a sprint! :p

You're seeing more of the same because you haven't made any changes we suggested. I understand being frustrated and venting (we all do it) but you can't expect better results when you haven't taken any steps forward.

It can take weeks for any improvement. Higher BG (which Peeka has) makes it take longer. Your mission? Get her BG down. That means:

Get rid of the dry food! Feeding the dry is like adding gas to the fire. Shooting yourself in the foot. Rubbing salt in the wound. Take your pick.
Switch to Prozinc or Lantus insulin. Vetsulin is hot garbage. It doesn't last long enough in cats, burns up early, and by pre-shot the insulin is long gone. Imagine getting pain meds that only last you half the day.
Increase the dose, please. He has been at 3u long enough. We want to see numbers under 120 and haven't yet. The longer you keep a dose that isn't doing enough, the greater likelihood that glucose toxicity sets in. Glucose toxicity is basically insulin resistance from high BG numbers. To break it, you have to up the dose, sometimes multiple times, until the "barrier" is broken. Then you're often chasing the dose back down to where it needs to be.

Note that holding the dose, staying on Vetsulin, and continuing to feed dry is only making your challenge with Peeka harder than it needs to be. I understand your schedule is hectic, but as long as the changes for Peeka aren't being made, you can't be surprised or discouraged by the lack of improvement. I also want to point out that cats make it harder on themselves ... they are VERY good at hiding pain and discomfort, and high BG makes them feel cruddy. Cats experience the same discomforts as human diabetics with high BG, the only difference is they can't tell us they feel bad and actually prefer that you don't know. It's why it's so much harder to catch diseases and illnesses early in cats. They are such solitary creatures they'd rather you never know they feel poorly. I do wish they were more vocal about things, as it's easy for us humans to assume there's nothing wrong because they "look fine". Ignorance is bliss I guess.

I am glad to see you're getting at least a mid-cycle test in, that is very helpful already. It's time to up the dose or kick the dry, one thing at a time.
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Panic, do you agree that he should start testing the other cat as well since the food transition would affect both?

I wonder if Peter is reluctant to switch insulin because Vetsulin has been working on Peeka’s companion. The reality Peter is that we don’t know without testing if that’s true. It could be that your other cat is still in high numbers but not as prone to neuropathy as Peeka. Just a thought
 
Aleluia Grugru & Minnie said:
Panic, do you agree that he should start testing the other cat as well since the food transition would affect both?

I wonder if Peter is reluctant to switch insulin because Vetsulin has been working on Peeka’s companion. The reality Peter is that we don’t know without testing if that’s true. It could be that your other cat is still in high numbers but not as prone to neuropathy as Peeka. Just a thought
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Yes, the thing about neuropathy is as humans, it's a physical disability we can see, so we KNOW there's something wrong. Just like some people are convinced mental illness isn't real because they can't "see" anything wrong, people act similarly to their animals. If they can't see an issue, they assume there isn't one. For all we know, Boo isn't feel well either but isn't showing symptoms. Just like cats in hypoglycemic numbers, we don't always see the symptoms, but the meter reveals the problem.

Every Cat Is Different. ;) Some miracle cats do okay on Vetsulin, but that is the exception.
 
I think guys (if you will allow me) Vetsulin was chosen for its flexibility. Peter and his dear lady both work demanding jobs. I know in the grand scheme of things Lantus would be optimum and Peeka might see quicker benefits but they have to work with what they have.

*Peter please excuse me if my thinking is off.
 
Peter Ramos said:
Hey everyone,

I posted an update to my daily updates last night, but this morning we are seeing more of the same. Peekas BG numbers look to be somewhat normal I think, her neuropathy is getting worse though. As bad as it did the day we took her to emergency vet and I’m honestly at a loss.

She’s been taking the methyl b12 with her food. I’m just honestly not sure what else I need to do. If this is the norm, and it can sometimes get bad again, please let me know.

She’s still able to walk around, I know that because last night she fell asleep under the living room table and when I woke up around 4:30 to feed our dog, she was on the ottoman she likes to lay on.

If someone could look at her numbers and let me know if this could be considered normal for her to have regressions this badly, please let me know. I’m losing faith in my abilities as a cat dad.
Click to expand...

Hi Peter,
You have already gotten excellent advice. Time will be your friend - it can take weeks to months of good diabetes control, before neuropathy improves much. You may see changes after just a few weeks - with good blood glucose. I started using methyl B12 (Zobaline) right away, but getting the blood sugar at lower/healthy levels, is key.

Tina had such bad neuropathy, she was practically dragging her whole back end, when diagnosed w/diabetes. She was a complete couch potato. Vet had been treating for arthritis/spondylosis which she has, along w/collapsed lumbosacral joint space in one hip. I was flabbergasted at how fast she was going downhill.
Long story short, it took about 3-4 months after starting insulin to see nice improvements. Even with her pre-existing conditions, she gets around awfully well now. She has been, and will stay on Gabapentin (nerve pain and arthritis), and Zobaline.
Those cat steps I put up around the house, she jumps around them a lot of the time now! The neuropathy was causing more trouble than her spine and hip. She is like a new cat compared to her condition a year ago.
Sending get better wishes to Peeka:cat:
 
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Tina Marie and Jan said:
Hi Peter,
You have already gotten excellent advice. Time will be your friend - it can take weeks to months of good diabetes control, before neuropathy improves much. You may see changes after just a few weeks - with good blood glucose. I started using methyl B12 (Zobaline) right away, but getting the blood sugar at lower/healthy levels, is key.

Tina had such bad neuropathy, she was practically dragging her whole back end, when diagnosed w/diabetes. She was a complete couch potato. Vet had been treating for arthritis/spondylosis which she has, along w/collapsed lumbosacral joint space in one hip. I was flabbergasted at how fast she was going downhill.
Long story short, it took about 3-4 months after starting insulin to see nice improvements. Even with her pre-existing conditions, she gets around awfully well now. She has been, and will stay on Gabapentin (nerve pain and arthritis), and Zobaline.
Those cat steps I put up around the house, she jumps around them a lot of the time now! The neuropathy was causing more trouble than her spine and hip. She is like a new cat from a year ago.
Sending get better wishes to Peeka:cat:
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Thanks Tina, I forgot gabapentin worked on the nerve pain too!
 
Hey everyone,

Took a quick break to address some points above and hopefully paint a better picture.


-The dosage. I will be increasing .25 starting today, I appreciate everyone’s advice, and I will continue to try and get testing in as I am able, Peeka has been awesome about allowing me to get it done, sometimes the meter just doesn’t cooperate.

-Food switch/Boo Our main hesitancy about switching food is the fact that Boo has looked better now than he has since he was first DX. We are not opposed to making a change, but Boo is a sort of outlier. I will get to a point where I test both cats, but Boo is sort of out of sight, out of mind. He is eating well and looking much better than ever, standing on his toes again, etc. he had neuropathy as well, just never as bad as Peeka.

Insulin choice- to be honest, we never knew much about anything regarding feline diabetes until just a week or two ago. We would take the cats in for a check up, get told what dosage to do, and move on. It wasn’t until Peeka neuropathy got bad, seemingly overnight, did I start researching and learning about this. We’re not married to any insulin to be honest, and would be willing to make a change so long as we were prepared with how to make the switch.
 
All in all, the reason we are trying to take it slow is in part due to our schedules, another part in due to wanting to keep Boo on his upwards trajectory. I’ll be 100% honest, when we first started, I felt overwhelmed and have had anxiety regarding all of this and still do. This morning, seeing her struggle was heartbreaking. That said, I am willing to do whatever it takes to get her better, I just want to try and take care of my mental state too, if that makes sense.
 
I'm glad you are going to up Peekas dose. I think it is warranted. ( I by no means am a dosing expert) I see shes been on that same dose overlong. I bet you see some better results I think up above in the thread Panic's explanation of Prozinc that may be what you need to do.

Once Peeka is walking around like Boo you will look back and feel a sensation of euphoria. So be ready for it cause its comin! ;)
 
Update: Got home, Peeka had peed on the tile floor not too far from where she was laying down, so that didn’t do much to boost my spirits. Wife and I are discussing switching to Dr. Elseys currently, I have seen some things in here regarding that, and I’m hoping to get further insight about that and making the change. When we do start to change the diet, hopefully in the next week, I’ll be testing Boo as well. I don’t want to continue his dosage if he is going to be getting less carbohydrates as well.
 
Peter Ramos said:
All in all, the reason we are trying to take it slow is in part due to our schedules, another part in due to wanting to keep Boo on his upwards trajectory. I’ll be 100% honest, when we first started, I felt overwhelmed and have had anxiety regarding all of this and still do. This morning, seeing her struggle was heartbreaking. That said, I am willing to do whatever it takes to get her better, I just want to try and take care of my mental state too, if that makes sense.
Click to expand...

My mental state is in the garbage, so I can relate. The biggest thrill I have had recently is watching the video that the camera caught of her walking on her own to use he litter box. Amazing how little things can perk you up.

Weenie was sleeping on mattress pads - we have, like, 6 of them for her. She would pee on them each night. We had an area rug that we tried to clean when she would pee on them, that has been tossed. Hang in there, things can improve! For us it was a switch to low-carb and regulation. I'm pretty sure we have a return of her food allergies now (like an idiot I let her settle in on a fish food she liked), trying to work through that now.
 
MelanieAndJosh said:
My mental state is in the garbage, so I can relate
Click to expand...

that’s pretty much where I’m at right now. I’m trying to keep a positive attitude about everything for my wife’s sake, but it’s an absolute beating right now. But I think we’ve decided to make further changes. Specifically an increase in dosage starting tonight, and then purchasing low carb dry food.
 
MelanieAndJosh said:
My mental state is in the garbage, so I can relate. The biggest thrill I have had recently is watching the video that the camera caught of her walking on her own to use he litter box. Amazing how little things can perk you up.

Weenie was sleeping on mattress pads - we have, like, 6 of them for her. She would pee on them each night. We had an area rug that we tried to clean when she would pee on them, that has been tossed. Hang in there, things can improve! For us it was a switch to low-carb and regulation. I'm pretty sure we have a return of her food allergies now (like an idiot I let her settle in on a fish food she liked), trying to work through that now.
Click to expand...
I did something similar with cheap dog beds and my floors were almost entirely covered with pee pads. That did save my mind from exploding. I also had to wash my clothes constantly because she squatted after pooping and when I picked her up to clean her it would get on my clothes and arms. I used to carry her to and from the right spots to pee so many times that she’s now almost as potty trained as a dog. It was a very dark time and every day I’d wake up feeling I don’t know how much longer I can keep this up. I felt like her quality of life was almost completely gone. Then this January, I come back from xmas vacation and she’s on my bed. I texted the sitter to ask if she put her there and she said no that she must have climbed on the steps I put there for her by herself. It all just kept improving from there and I look at her and it’s like it never happened. I still will stop and watch her when I see she’s pooping because it’s a miracle to me she can do it perfectly now and stand on her back feet. I think you allow yourself to feel crappy but then you have pick yourself up and do what needs to be done for their sake. Just like you would for a child :cat:
 
I guess plenty people here feed the Dr Elseys dry. I dunno I'm on the fence with this food. AT LEAST its lower carbs. I'm just not a dry food proponent. But I wish you luck with this decision. Lets hope that AND the new dose works wonders. Dont be surprised if it doesnt at first. This is by all standards a Marathon. ;):coffee:
 
jt and trouble (GA) said:
I guess plenty people here feed the Dr Elseys dry. I dunno I'm on the fence with this food. AT LEAST its lower carbs. I'm just not a dry food proponent. But I wish you luck with this decision. Lets hope that AND the new dose works wonders. Dont be surprised if it doesnt at first. This is by all standards a Marathon. ;):coffee:
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I agree, this is just the first stage of our transition to wet food, we’re going to start testing Boo also, and I figure this will be a good transition. I’ll be posting a thread separately when the time comes to make sure I’m 100% prepared for the transition.
 
I think it's a good transition food, there's a few people who weaned their cats over with Dr. Elsey's.
Diabetes is a funny thing. My girl's numbers were constantly in the 500s yet she never had neuropathy. She did have muscle wasting though, and it took her months to be able to jump up on the washer or the porch railing.

I used puppy pads throughout the house for months until she was able to get a better control of her bladder. Easy clean-up. :)
 
Last update for the night, Peeka BG +4 came in around 291. Definitely not where we’d like to be. Dr. Elseys comes in next week, here’s hoping a combination of that integrated with her current food and this higher dose will help her out and we can have a better few days ahead.
 
jt and trouble (GA) said:
I guess plenty people here feed the Dr Elseys dry. I dunno I'm on the fence with this food. AT LEAST its lower carbs. I'm just not a dry food proponent. But I wish you luck with this decision. Lets hope that AND the new dose works wonders. Dont be surprised if it doesnt at first. This is by all standards a Marathon. ;):coffee:
Click to expand...
Might make the initial transition easier on the GI tract to go first to a dry low carb option.


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