10/6 Olive PMPS 575, 550+2, 459+3. Any thoughts on what vet said today?

[OlivesMom]

https://www.felinediabetes.com/FDMB...er-insulin-re-evaluation.236392/#post-2651244

Instead of eye-balling her "tad fat" or "hair fat" 0.5 as I'd done for 9 cycles now, I bit the bullet and changed my caliper settings to what I "think" was those tad and hair numbers. My new caliper setting went from the 0.53 set on the PM cycle of 9/23 to 0.67 on the AM cycle of 10/6 now. I'll hold at this for the duration of the 14 cycles before an increase. I somehow got it in my head that today marked the 14th cycle but it was only the 9th since the hair increase so she went into her 10th cycle this AM at least KNOWING what the EXACT caliper readings are now. It could be slightly less than what I'd been giving, but only time will tell. I error on the side of less verses more. I know she needs more insulin to bring her numbers down and give duration but I want to wait out the remaining 4 cycles before deciding what caliper number to shoot for next. She had such a great night last night playing with her string and batting at it like a kitten. Had a bit more boogie in her step going up the stairs too. Hoping today she'll get into the 200's at least but the drop is slow so we'll see what happens. If anything, lately she's holding steadier even if the numbers are still too high. It's better than bouncing 100 points every time I'd test.

 

[OlivesMom]

So one of two things: her +6 is higher than its been at this point since September 30th. I'm dreading her going back into the black later. So I either gave too little at injection time this morning and I calculated those "hairs and tad" amounts wrong with the caliper, or is it possible that exercise temporarily spiked her? Because just prior to testing she'd been downstairs playing with her string and actually doing pouncing behaviors I haven't seen in ages. So she was quite active for a bit before ascending the stairs to get tested and fed. I know there's a 20% margin for meter error but since I stopped eye-balling the dose with her injection this morning I wondered at the time if she'd gotten less than she has in the past 9 cycles. Any thoughts?

Just read this on WEBMD and it holds true for animals too, so I have some hope her levels will go back down in a while instead of continuing to rise. We shall see. Olive has been changing a lot recently and moving around and playing and just returning to a happy cat of younger years.

3. Too Much (or Too Little) Exercise
Even a mild workout, like walking or doing light housework, can lower your blood sugar and improve how your body responds to insulin.

When you don’t move around enough, your glucose levels can rise. Too much exercise can have the same effect. Tough activities, like bench-pressing weights, or competitive ones, like running a race, can raise your blood sugar.

That doesn’t mean you can’t sweat it out. Exercise is one of the best things you can do for your whole body. But ask your doctor what changes you may need to make in your treatment plan to keep your blood sugar in the right range.

 

[OlivesMom]

We were doing so good for 9 straight cycles and then today absolutely everything goes out the window. She'll be off the meter by the PMPS and the bounces will begin all over again. I don't know what I did wrong. I KNOW she didn't get a fur shot and the teeny amount of insulin I "might" have been under compared to the last 9 cycles was so small I can't imagine it having this kind of effect. Any thoughts?

 

[JaxBenji]

Hi Olives Mom! You know I'm quite new here myself - but I can say (1) we allllll make mistakes and (2) cats do what they want Some of us were talking on another condo about how eloquent @Sue and Luci is with describing all the moving parts of FD - here's the post. It's a great read and helps us remember how complex FD is plus the fact the cats can't talk to us and tell us how they are feeling. Go easy on yourself - you're doing everything you can - Olive is so lucky to have you

 

[thebigfuzz]

Feeling frustrated at times is totally normal, especially when we as caregivers, are trying everything we can to help our kitties. And you are

I am reminded that feline diabetes is a marathon, not a sprint and that every cat is different in how they respond. It looks like Olive seems to bounce from anything blue at the moment and this could be a continued bounce from 10/4? We just have to hang on during the bounces and eventually, those blues (and then greens) aren’t so scary to Mr. Liver. As @JaxBenji said above, FD is complex with so many moving parts. You are doing a great job.

On a more practical side, it looks as though you have been on 0.5 units for quite a while. I’m not sure if I misread that on your SS? Have you chatted dose with anyone lately? @tiffmaxee @Wendy&Neko

 

[Wendy&Neko]

Yes, we chatted about dose yesterday, hence the discussion about 14 cycles at this dose. Thankfully with calipers you should be able to take her up a bit, without going all the way to a dose that took her too low for SLGS.

Looks like Olive is bouncing from those blues a couple nights ago. Some cats have delayed reactions to lower numbers. Nothing you can do but wait it out. More insulin will definitely help lower some of those higher numbers.

 

[thebigfuzz]

Ahh, gotcha. Thanks @Wendy&Neko

 

[OlivesMom]

Looks like Olive is bouncing from those blues a couple nights ago. Some cats have delayed reactions to lower numbers. Nothing you can do but wait it out. More insulin will definitely help lower some of those higher numbers.

I'm back. Had to go to the vet for my dogs yearly exam/shots/tests and while there my vet asked about Olive. I told her what's been going on and one: I discovered what she hadn't touched on when Olive was first diagnosed which was she came in AKA. She is well aware of this group as I've talked about it enough and I listened to all the new things she was telling me that I need to be doing and what wasn't wise to be doing, ect, and you know what?? For the most part she agrees with everything I've been learning from you guys which I thought was super cool. When Olive was first diagnosed I knew NOTHING of what she was explaining to us and now that I have a plethora of information under my belt I not only understood her, but was able to take what she was saying and apply it to what I've learned here and I've come up with a new game plan moving forward. She said that by Olive coming in AKA that makes her need more carbs and not less for the insulin to work properly. I told her I was already toying with the idea of taking her off raw food (until the future...I hope) and onto something else with a better carb/fat/protein ratio. She saw the data I've been collecting and she thinks feeding Olive all these mini meals is absolutely great because she said a cat who came in AKA does better this way. She'd rather see consistency then my going 75% raw to 25% DM during the last half of the cycle and again...it's due to the fact the raw she's on has pretty much no carbs at all and no carbs is absolutely the enemy of a AKA cat she explained. I think my hope of having her on the raw diet at her age and with her issue is just not in HER best interest right now. And we need to do what's best for HER and not US. Until I can find a healthier alternative that matches the DM's 3 basic parts, we've decided to slowly switch her to an all DM diet. I HATE the ingredients in it, and I KNOW there's something healthy out there that matches, but for now she's used to the DM mix and it would be easier to start increasing the amount of that while decreasing the raw than to totally throw a whole new food at her. I just want to stabilize her more first. I definitely think she needs more insulin which I'll increase at the end of those 14 cycles. For tonight's dose I stuck with the new caliper reading of 0.67 which I suspect is still slightly smaller than the tad fat 0.50. I increased her DM to 60% for her dinner and she'll get an increase for the rest of the cycle too. As to her weight, she was quite happy of the amount she gained back and thinks 11 pounds would be just about right on her. So she's got just about another pound to go then.

It looks like Olive seems to bounce from anything blue at the moment and this could be a continued bounce from 10/4? We just have to hang on during the bounces and eventually, those blues (and then greens) aren’t so scary to Mr. Liver.

She doesn't like blue. lol. I hope one day she learns to love it.

Go easy on yourself - you're doing everything you can - Olive is so lucky to have you

Thank you!
Any thoughts on what the vet said? Agree or disagree?

The one thing she did say made my heart sink as she said realistically Olive will never go into remission because of coming in AKA and the fact she bounces so much. Hubby told me to ignore that statement because it's up to Olive and not the vet. I've held such great hope she'll go into remission up until now. She said in all her years as a vet she's only seen a handful of cats ever go off insulin. Any words of hope? Even with today's setback I felt like if I just give it enough time that Olive will find her way and settle. But it's like the wind was taken out of my sails by her statement. I'll do whatever it takes to give Olive the best chance possible so any and all feedback would be appreciated. Thanks guys!

 

[Wendy&Neko]

I think you mean DKA, not AKA? Ketones, Diabetic Ketoacidosis (DKA), and Blood Ketone Meters
If you read that post, you'll see the recipe for DKA is insufficient insulin, not enough calories/inappetance, and system inflammation or infection. Note it's an issue of lack of calories, not carbs. Feeding raw food should not be a problem if it's high in calories. I found this post really helpful in giving me an idea what is happening inside: What is Feline Diabetes?

she said realistically Olive will never go into remission because of coming in AKA and the fact she bounces so much.

We've had cats who were in DKA go into remission, we've had cats who bounce practically all the way into remission. Hubby is right - it really is up to the cat. The way to help her get into remission is first to focus on regulation, and getting her numbers down. That means she has to spend more time in healing green numbers. Tight Regulation is an easier way for that to happen. SLGS has you back off a dose if there are numbers below 90. SLGS works for some cats, but not all.

 

[OlivesMom]

I think you mean DKA, not AKA?

She rattled it off so fast and we were standing outside by the highway so maybe DKA...lol. It would make more sense after reading the article and seeing OLIVE in so much of it. Thank you or else I'd be calling it AKA forever. For Olive, I do think it's a lack of calories because she won't eat any of the other proteins, just raw turkey which is the least and next to nothing in carbs and only 34 calories per nugget. They want her on about 200 calories a day with at least 24% fat. The raw turkey is only 9% fat. The main issue I've had with Olive all this time is that she tends to fill up fast when I've given her plain raw food so I can't seem to get in all the calories she needs in a day's time. I wish she'd eat a higher calorie protein but she's stuck on turkey. She hates the texture of Small Batch turkey. So I'm at a total loss as to what I can feed her in the healthy category.

We've had cats who were in DKA go into remission, we've had cats who bounce practically all the way into remission.

That makes me feel a lot better. If tight regulation is an easier way for her to spend more time in healing numbers then I'm ready to learn how the process works. I've spent all my time on SLGS and as someone on here told me, it doesn't have to be one or the other and I can feel free to return to SLGS if TR doesn't fit. So now I need to study up on TR. Is it scary? At this moment I don't have an idea about it other than a fear of her going too low in the process. If you could walk me through it with a quick run-down of how the process works and then tomorrow I'll spend time reading through the stickies. I feel like if I don't do something now that she'll continue on like she has been for more time than I want to see her go through if there's something I can do to make her feel better faster. It's the whole what to feed her thing that's really getting to me. She just won't eat straight up raw in an amount needed to gain weight. If you can think of any other healthier food options I'm open to it.

 

[Wendy&Neko]

Once you learn how your cat responds to carbs, TR is much easier. Your goal is to balance the food she gets, so you can maintain as much blue/green as possible. With TR, you increase every 3-5 days, depending on where the nadirs are. You decrease if they go below 50 instead of 90 which is the SLGS reduction point. There are minimum test requirements with TR, which you more than meet.

I was too impatient to stay on SLGS. I couldn’t wait a week before increasing when my girl was stuck in high numbers. She never did go into remission, but she had some complicating secondary conditions. However, she eventually was pretty well regulated, though not tightly so.