Trawling the depths

Status
Not open for further replies.
S

Sergei

Member Since 2020
Sorry for long post. I'm just venting a bit. I feel utterly confused about Sergei's numbers, blue about FD, and I'm hating the whole routine.

It's late here and I was feeling like I needed to do a pre-bed test just because Sergei has been behaving pretty much like his old self today (which is most unusual these days) and his box had his pre-diabetes amount of sawdust in it this evening. The test session was miserable: Serg refused to hold still and he would not let me get near the first two drops of blood I managed coax out of his capillaries. Finally after three tries I got my sample... Unfortunately I hit the vein and it was a bloody mess (he's a bleeder).

The result at +2 was 6.3 mmol/L (113 mg/DL). This seems low for the point in the cycle, and especially given that last night at the same time we were at 25.1 (452). This afternoon our +4 was 12.3 (221), so nowhere even close to where we are tonight. He must have had a huge glucose drop in the first two hours after insulin, otherwise the only thing I can think of is that he may be intermittently producing some insulin... is that even possible?

Yesterday in the AM cycle we were trawling the depths in the 4s. He was 4.6 (83) at +4, but then we were way back up in the mid 20s at PM +2. I know that could have been a bounce but how did we get from a nadir in the 12s this afternoon back down to 6s at +2 tonight? Vet seems unconcerned, but I'm obviously worried about all of this. Every time I want to lower his insulin dose we get weirdly high numbers again. Vet told us to test him only once every three days. I'm doing the opposite and increasing my testing. Vet has not asked for a curve yet but I'm thinking about doing one this weekend anyway. Something is just not quite right. I know part of it is the insulin, but I'm wondering if the food routine might be playing a role. I worry that we are pressing his system too hard.

We don't seem to have many other options other than Caninsulin at the moment. The legal situation here requires you first use Caninsulin or Prozinc before they will even consider prescribing anything else, at which point you are off label. Lantus is not approved for cats in the Netherlands and from what I can tell, most vets don't really seem to want to deal with it. So I'm feeling frustrated about that too.

Right now we are just about at +4, in the nadir window, and he seems to be fine. I fed Sergei some wet food at +2 and some treats and will monitor him very closely for the next few hours. I'll put out a bit more food just to be safe.
 
Hi Scott I feel your stress!
I think a curve is a GOOD idea. You dont need your vets permission to test your cat or run a curve.
I'm thinking maybe the Hills wet food may have too many carbs. Can you get Fancy Feast Classics or Frisky's pate there? You've probably been asked this question before but I cant remember.:(

More testing is the only way to really figure this out. 2 tests in between injections would be better. Is there any way that could be possible?
Sergei feeling better to fight off a test is both good and bad. Give him lots of lovins and treats even if you dont get a sample. You want him to crave his treats enough to get a test.
We have ALL hit the vein before. It is messy but trudge on.

Sending positive thoughts for your evening. Please give Sergei some scritches for me.:bighug:
jeanne
 
Ann & Scatcats said:
If you can, since you mentioned the Prozinc, I would change to that, simce it is a Bovine insulin, which has the exact same molecyle insulin match with Feline insulin. So it should be much better with Prozinc than that Caninsulin.
Click to expand...
Ann do you know any good choices for food where Scott lives? I know youre not in the same country.. just hoping... maybe

And YES Scott Prozinc is a MUCH better insulin.
 
jt and trouble (GA) said:
Hi Scott I feel your stress!
I think a curve is a GOOD idea. You dont need your vets permission to test your cat or run a curve.
I'm thinking maybe the Hills wet food may have too many carbs. Can you get Fancy Feast Classics or Frisky's pate there? You've probably been asked this question before but I cant remember.:(

More testing is the only way to really figure this out. 2 tests in between injections would be better. Is there any way that could be possible?
Sergei feeling better to fight off a test is both good and bad. Give him lots of lovins and treats even if you dont get a sample. You want him to crave his treats enough to get a test.
We have ALL hit the vein before. It is messy but trudge on.

Sending positive thoughts for your evening. Please give Sergei some scritches for me.:bighug:
jeanne
Click to expand...
Jeanne, thanks so much for your encouragement. Sergei sends you his appreciation too!

Your question about food prompted me to really look more closely at what we are feeding him. Hill's wet food definitely has much higher carbohydrate content than one would expect for a diabetes food. That really could account for some of the BG instability, especially further in the cycle. I think we are going to transition away from it, albeit gradually, by mixing in a lower carb food and seeing how that affects the numbers. I feel cautious about taking too much carb out too quickly, especially while Serg is on Caninsulin. The Integra "Diabetes" food we are feeding Sergei as his main food turns out not to be exactly low carb either, so gradually replacing the Hill's with something else might be just fine in the meantime. It's in the 7 -8 range.

Switching insulins is another story. I'm open to switching to ProZinc and would welcome getting Sergei on something that works better with his system, if that is an option. My partner administers the injections (In exchange I do the testing), and I think he might feel a little intimidated by the syringe method versus the pen. It would be interesting to hear what people who have used both have to say. We are both a little petrified of injecting into a vein on accident, but I'm not sure why using a syringe would be any different than using the Vet Pen in that respect.

Thanks so much again for the support. I hope you have a lovely Thursday.
 
Ann & Scatcats said:
They have A 5 Star Restaurant Menue :cat:

I've already since 2008 here written about it. I'll include the texts here so you read through itself. Saves repetition time :)

See
1. Vet DVM Lisa Pierson's own Feline Nutrition and Medical www.catinfo.org

2. and mine since Vet Lisa Pierson and Swedish State Animal University SLU Diabetes Vet Researcher Tove Fall really direct helped us from the Fall 2006 and January 2008 here.

mine earlier concerning in Sweden.

"I live in Sweden where we have very clean and good quality water, and I give mine tap water. I think they are water alcoholics because they drink 1 liter a day:and that's a lot. They tend to drink more now when they are seniors, 16 and 17 years old.

When it comes to food, they've been on special foods for their entire lives.

Gustav the oldest, 17, already as young had elevated kidney creatinine values, so he has been eating Hill's k/d special dry food all his life until January last year 2011. And he hasn't developed diabetes because of that. Now, in his senior days, he has gotten high blood pressure and are on Norvasc and Fortekor for that, and he also has a thickening of the left heart chambers, but the vet thinks it is secondary to the high blood pressure. He also got elusive high plasma protein, it's the immunoglobulins that sky rocketed last year, and the vet suggested it could be a rare skeletal cancer in cats called multiple myeloma. So we started Gustav on chemotherapy last year, Alkeran is the chemo, and cortison. But I have stopped that treatment now, sinceGustav's white blood cells went down to zero and he became infection sensitive and I didn't want that. BUT in spite of this Gustav is in very good shape. Last January 2011 I switched his k/d food too Simba's diabetic special food Hill's m/d dry food. I wasn't sure how Gustav's kidneys would cope with that, but we go to see the vet for health check ups regularly, and lo and behold but Gustav's kidney creatinine values had normalized and so had his high cholesterol values.


Simba the youngest, 16, is the diabetic. But already as young did I have to rush him to the hospital twice for what they then said was gastritis, but in hindsight I think he already then had pancreatitis. He was then given special food Hill's i/d, which he had for years until he became diabetic when he was 10 years old, 5 years ago 2006. Since he became diabetic he has been through a lot. In 2007 he survived both a very severe pancreatitis and DKA. He got staphylococcus all over his face, in his ears and in the neck where we give the insulin needle shots. He also survived a very severe hypo where he had 0.8 when I caught it, but he got minor brain damages after that. And then he survived a vet induced anasthetic paralysation and coma, also adding to his minor brain damages and nerve system damages. He eats special Hill's m/d food. Mainly dry food, and sometimes wet when I can afford it.


I have to give them this special m/d food, because we don't have any low carb food options in the stores as you have over in US, and nor do we have EVO on the market here, so the m/d food is the best I can do.

Gustav is fine and his creatinine values resolved, became normal, when he got the m/d wet and dry food.


I feed them both wet and dry, but mainly dry because over here the wet food cost me 3 times as much as the dry food does, which costs 85 dollars for a 5 kilo bag which last a month. In addition to buying food for my own two, I also buy food every month to 4 other cats, the rescue babies we found outside in fall 2010. So I spend 255 dollars on dry food every month and nearly 300 dollars on wet food every month. I also spend 38 dollars each month on cat litter.

Plus I pay health insurance for 16 cats a year which is 2255 dollars a year and also pays for regular vet health check up visits and emergency visits for 6 cats for nearly 2820 dollars a year. Then I've donated 5000 dollars to cat rescue groups in US, and 900 dollars to 2 rescue Venita's DCIN babies here who needed extensive emergency care.


So there is a lot of $$$$$$ going out every month and year here ....


According to dr Lisa's raw food, she is substituting hearts with taurine. But my Simba doesn't like organs like liver or hearts and just won't eat them. So I've spent 4 years looking for taurine here, but it is just not available here in Sweden. However, I talked with one of the dietary specialist and researcher vet, Birgit Holm http://www.blastjarnan.se/default.asp?v ... p?sida=280 , at my animal hospital about source of taurine, and she said no need to add hearts, because ALL meat contains taurine and that it is safe to only use muscle meat of beef, lamb, shrimps, etc.


That's very good because they love shrimps. They are having a 5 star restaurant menue now, fresh raw beef, lamb, shrimps. It is cheaper to buy fresh meat here than cat wet food. "



Hope it gave the info you wanted to know concerning best proper food.
Click to expand...
Ann, thanks so much for sending this. Lots of good information. You are such a dedicated friend to the felines. So great. Your cats are lucky to have such a friend.
 
At the bottom of the UK Food List are some EU specific foods. You might want to check out zooplus.
Tagging @SashaV just to the north of you to see if she has any ideas.

It is important to get a preshot test with any insulin. Testing more will allow you to see the bigger picture. The same hour of each day is not is going to be the same. More testing will help you convince your vet to switch to Prozinc.

Tagging
@Critter Mom
@Panic
@Elizabeth and Bertie
for advice on Caninsulin
 
I have to Remind all in U.S, Canada, Australia and UK that UK is No Longer A Brexit Part Of Neither EU, and Europe. And American Cat Food and UK Cat Food Manufactures Do Not Have The Proper EU Permissions to even sell their Cat Foods Within EU.
And Scott With Partner And Sergei Have North Holland Veterinarian Themselves. Who handles their Insulin Prescription Switches e.t.c.
Just An FYI.
Plus Rampaged Covid In Holland.
 
Sergei said:
I think he might feel a little intimidated by the syringe method versus the pen. It would be interesting to hear what people who have used both have to say. We are both a little petrified of injecting into a vein on accident, but I'm not sure why using a syringe would be any different than using the Vet Pen in that respect.
Click to expand...
Syringes are much less cumbersome to handle than the Caninsulin Vetpen. Also you are limited to dose adjustments of 0.5IU with the Vetpen, whereas you can make finer dose adjustments when using a syringe.

Some members use U100 syringes along with a dosing conversion chart to administer U40 insulins (Prozinc and Caninsulin are such insulins). The advantages to this are that some U100 syringes have shorter needles and it can be easier to measure finer doses.


Mogs
.
 
Last edited:
Scott, I never used a pen, but shared your nervousness with syringes.... Yet, these days I don't even think about it. Hitting the "wrong" thing was my big worry, but you are supposed to pull the skin up (search videos on you tube), and inject under the skin. Very, very little chance of hitting anything (at least that is what I think!)
 
Ann & Scatcats said:
Of Course. 1996. https://www.sciencedirect.com/topic...ogy-and-pharmaceutical-science/bovine-insulin
Click to expand...
From the cited reference:

Protamine-zinc insulin (PZI): Developed from recombinant human insulin and longer acting. Veterinary form is called ProZinc in a 40-unit/mL form for cats. The forms used in animals are identical to the forms marketed for people. Response and pharmacokinetics among dogs can be highly variable. Peak is 4-14 hours in dogs and 5-7 hours in cats, with a duration of 6-28 hours in dogs and 13-24 hours in cats. PZI insulin of animal origin (90% bovine and 10% porcine) has been unavailable, but the human recombinant PZI form of insulin has been shown in canine studies to be an effective alternative.

[Emphasis mine]
​
The above does not seem to support your statement that Prozinc is of animal origin but that it is instead based on human insulin, nor does it make any mention about bovine insulin having exactly the same molecular structure as feline insulin. While the structure of bovine insulin is very close to feline insulin, it is not identical.

According to this document from the EMA:

The active ingredient of ProZinc, human insulin, is produced by a method known as ‘recombinant DNA technology’: it is made by yeast cells into which a gene (segment of DNA) has been introduced that makes the yeast cells able to produce insulin.

[Emphasis mine]​

I know that insulins of bovine origin have historically been used to treat feline diabetics (and there may still be some places that continue to offer such products) but to the very best of my knowledge Prozinc is not a bovine PZI insulin. (@Deb & Wink - Not urgent, but when you have a moment I'd be grateful if you could advise whether or not I am correct in my understanding here.)


Mogs
.
 
Last edited:
Red & Rover (GA) said:
At the bottom of the UK Food List are some EU specific foods. You might want to check out zooplus.
Tagging @SashaV just to the north of you to see if she has any ideas.

It is important to get a preshot test with any insulin. Testing more will allow you to see the bigger picture. The same hour of each day is not is going to be the same. More testing will help you convince your vet to switch to Prozinc.

Tagging
@Critter Mom
@Panic
@Elizabeth and Bertie
for advice on Caninsulin[/
Red & Rover (GA) said:
At the bottom of the UK Food List are some EU specific foods. You might want to check out zooplus.
Tagging @SashaV just to the north of you to see if she has any ideas.

It is important to get a preshot test with any insulin. Testing more will allow you to see the bigger picture. The same hour of each day is not is going to be the same. More testing will help you convince your vet to switch to Prozinc.

Tagging
@Critter Mom
@Panic
@Elizabeth and Bertie
for advice on Caninsulin
Click to expand...
Thanks you. I've discovered Zooplus and have had good luck with my two orders so far. Choosing the right food is difficult but for the moment Sergei likes his primary food, the Animonda Integra Diabetes trays. I'm going to experiment with gradually replacing his +2 Hill's wet with something a little lower in carbs or maybe use a mix of carb levels.

I'm going to try to do our first curve within the next week, hopefully at the weekend, and see what we learn. Our current testing regimen at +4 was the vet's idea. I'm interested to know what's happening at +2, +3, and +5. Then again around +9.
Click to expand...
 
Hercule's mum said:
Scott, I never used a pen, but shared your nervousness with syringes.... Yet, these days I don't even think about it. Hitting the "wrong" thing was my big worry, but you are supposed to pull the skin up (search videos on you tube), and inject under the skin. Very, very little chance of hitting anything (at least that is what I think!)
Click to expand...
I think you are correct. I can't imagine why injecting with a syringe would be any different than injecting with a pen in that respect ... the pen does not even give you the option of pulling back to see if you are in a vein. I think we would adjust quickly. I tend to worry about technology malfunctions so using syringes might not be the worst for me. Thanks!!
 
Last edited:
Critter Mom said:
Syringes are much less cumbersome to handle than the Caninsulin Vetpen. Also you are limited to dose adjustments of 0.5IU with the Vetpen, whereas you can make finer dose adjustments when using a syringe.

Some members use U100 syringes along with a conversion chart to administer U40 insulins (Prozinc and Caninsulin are such insulins). The advantages to this are that some U100 syringes have shorter needles and it can be easier to measure finer doses.


Mogs
.
Click to expand...
Thanks, this is very useful information. I’ve only used the vetpen a few times myself. Found it really awkward and having to wait 5 seconds after pressing the lever is not ideal. Legally vets here are obligated to try Caninsulin or ProZinc before going to insuline that are off label for cats. I think vets tend to figure the average client will be more willing to adhere to a routine with the pen and so it becomes a one-size-fits-all protocol.
 
Sergei said:
Legally vets here are obligated to try Caninsulin or ProZinc before going to insuline that are off label for cats.
Click to expand...
At time of posting, it's the same over here. When I was treating Saoirse's diabetes I was lucky in that Prozinc hadn't yet been licensed so once I was able to demonstrate that she wasn't well-regulated on Caninsulin our vet could then prescribe Lantus under drug cascade rules. Similarly he could have prescribed Prozinc or Levemir as alternatives.

While it's good that Prozinc has now received a licence and it can now be offered as a first choice, it is in some ways a backward step overall because there's now another hurdle to overcome in order to secure a prescription for one of the depot insulins - and having to go to via Caninsulin is statistically very likely to be a backward step.

I didn't use my Vetpen for very long. Instead I made the switch to U100 syringes with a shorter needle (used with a dose conversion chart). I found giving injections to be much, much easier after the switch.


Mogs
.
 
Yes, the cascade protocol is excactly the same here. It locks vets (and patients) into the very limited choices of Caninsulin or ProZinc until both are ruled out because the cat does not respond well to treatment with either. I need to read more about ProZinc. My intuition tells me that Caninsulin is not the right choice for Sergei's particular physiology. I hope a curve will show this conclusively, but I can't imagine why my vet would be opposed to trying a different insulin that is permitted under the cascade rule. I'm going to save your thoughts bout the 100 U syringes (with dose conversion chart) for my future wishlist because it sounds very promising. Thanks again for everything! Scott
 
Critter Mom said:
but to the very best of my knowledge Prozinc is not a bovine PZI insulin. (@Deb & Wink - Not urgent, but when you have a moment I'd be grateful if you could advise whether or not I am correct in my understanding here.)
Click to expand...
I believe that bovine based PZI (aka BCP PZI) was actually discontinued several years ago (back in 2009). I know that @Elizabeth and Bertie used the bovine PZI for one of her diabetic cats some time ago. Perhaps she has more to add to this conversation.

Prozinc is a recombinant human insulin. See the manufacturers information site here. https://www.boehringer-ingelheim.com/animal-health/companion-animals-products/prozinc
 
Welcome Scott :bighug:
Great place to be!

You have zooplus like the rest of us, I believe. Don't know if it cheaper for you to use the Deutch one, but it is for me :D
Mine is fed mainly raw, but they get a can of canned food to eat during the night, and a tiny amount during the day.
I mainly use those from the list, and avoid anything with added sugar and salt, without vegetables.
Do you have Aldi in the Netherlands? If you do, I'll recommend their Topic big canned food, very important that you pick only the big cans. The small ones have the same name, but isn't nearly as good. And it's cheap!

If you're interested in trying raw food I can recommend Mush Barf. Its small balls of 25g, you just take them out of the freezer and serve. It's so easy and it has everything a cat needs.

And don't worry about the syringes, its really easy :D
 
Deb & Wink said:
I believe that bovine based PZI (aka BCP PZI) was actually discontinued several years ago (back in 2009).
Click to expand...
BCP PZI is still available
https://bcpvetpharm.com/products/bcp-pzi-bovine-insulin
I used BCP PZI in the past before Lantus (and Levemir) were available and had a track recork for cats. I also tried it later than that when neither Lantus, Levemir or ProZinc seems to work well on my Badger. Badger's problem was resolved when polyps were surgically removed from his left ear.
 
Larry and Kitties said:
BCP PZI is still available
https://bcpvetpharm.com/products/bcp-pzi-bovine-insulin
I used BCP PZI in the past before Lantus (and Levemir) were available and had a track recork for cats. I also tried it later than that when neither Lantus, Levemir or ProZinc seems to work well on my Badger. Badger's problem was resolved when polyps were surgically removed from his left ear.
Click to expand...
@Larry and Kitties Do they ship to the Netherlands? That's where this member lives.
 
Sergei said:
I feel utterly confused about Sergei's numbers
Click to expand...
Hi Scott, it looks to me as though your Caninsulin dose is too high. It looks as though Sergei's blood glucose is 'bouncing' from low to high numbers. In my view it is 'very possible' that reducing the dose could help stop the bouncing (rebounding) and help to even out the numbers.
What dose did Sergei start on? And how gradually was that dose increased?

I'd also suggest that you try to test blood glucose before every insulin shot, to check that Sergei's blood glucose is high enough for that shot.
On the forum here we suggest that those new to using Caninsulin only give the shot if the pre-shot blood glucose is above 11. And we also suggest that the caregiver 'aims' to not have the blood glucose drop below about 5 - 5.5 at the peak of the cycle at first, just to give some buffer of safety in case it does actually drop lower than that (sometimes Caninsulin can drop the blood glucose very fast).

Caninsulin users have found that feeding the kitty about 20 - 30 minutes before giving the insulin shot can ensure that there is food in the system for when the insulin starts working. So, the sequence would be Test, Feed, Wait, Shoot.
And if the cat's blood glucose tends to drop fast then feeding a snack (or part of a main meal) an hour or hour and a half after the shot can further slow down the rate at which the blood glucose drops. Food can be quite helpful in manipulating the rate at which the blood glucose drops/rises.

If Caninsulin doesn't work for your boy then Prozinc is certainly an option. And there are cats in the Netherlands on Lantus also.
Regarding food, since you have a Zooplus you have lots of wonderful yummy options! :cat:
The UK food list in my signature has a large section of Zooplus foods at the top of the list.
If a food that you're interested in isn't on the list then you can use this calculator to work out the 'percentage of calories from carbs' for any European food:
https://secure.balanceit.com/tools/_gaconverter/index.php?

Deb & Wink said:
I know that @Elizabeth and Bertie used the bovine PZI for one of her diabetic cats some time ago. Perhaps she has more to add to this conversation.
Click to expand...
Hi Deb, yes I used two different PZI insulins; a veterinary PZI that was probably similar to the BCP PZI, and then a very long lasting (human) depot PZI. Both are now sadly discontinued... :(

Eliz
 
Elizabeth and Bertie said:
On the forum here we suggest that those new to using Caninsulin only give the shot if the pre-shot blood glucose is above 11. And we also suggest that the caregiver 'aims' to not have the blood glucose drop below about 5 - 5.5 at the peak of the cycle at first, just to give some buffer of safety in case it does actually drop lower than that (sometimes Caninsulin can drop the blood glucose very fast).
Click to expand...
I can't thank you enough for this information. Sergei had a very low reading at +4 today (3.7), so we fed him some extra wet food (He gets his AMPS main meal in four instalments at 15 minutes apart starting 45 minutes before insulin and ending with the last dose while insulin is being given and then a morning snack at +2 along with a treat when we test him at +4). Because he was so low at nadir, we tested him PMPS and he was 11.0. I remembered your post and because the vet was closed, we called our local Animal Hospital Emergency line and they said definitively don't give insulin this evening. We will test him again tomorrow AMPS and go from there. Thank you!!
 
jt and trouble (GA) said:
Hi Scott I feel your stress!
I think a curve is a GOOD idea. You dont need your vets permission to test your cat or run a curve.
I'm thinking maybe the Hills wet food may have too many carbs. Can you get Fancy Feast Classics or Frisky's pate there? You've probably been asked this question before but I cant remember.:(

More testing is the only way to really figure this out. 2 tests in between injections would be better. Is there any way that could be possible?
Sergei feeling better to fight off a test is both good and bad. Give him lots of lovins and treats even if you dont get a sample. You want him to crave his treats enough to get a test.
We have ALL hit the vein before. It is messy but trudge on.

Sending positive thoughts for your evening. Please give Sergei some scritches for me.:bighug:
jeanne
Click to expand...
Hi Jeanne, your hypothesis that the Hills may have too many carbs for Sergei is very interesting. I always give Sergei a snack at +2, just to buffer him against the steep Caninsulin BG drops that start shortly thereafter. Usually that is the Hills md wet food. Today he refused to eat it, so I put out a different food which he enthusiastically gobbled up and which turned out to be far lower in carbs. When we tested him at +4, his BG was 3.7, way lower than most of our readings so far and a bit white knuckle territory. But what this suggests is that we may be able to get some better control over the BG with food and use a lower insulin dose. I hope anyway!
 
Sergei said:
Hi Jeanne, your hypothesis that the Hills may have too many carbs for Sergei is very interesting. I always give Sergei a snack at +2, just to buffer him against the steep Caninsulin BG drops that start shortly thereafter. Usually that is the Hills md wet food. Today he refused to eat it, so I put out a different food which he enthusiastically gobbled up and which turned out to be far lower in carbs. When we tested him at +4, his BG was 3.7, way lower than most of our readings so far and a bit white knuckle territory. But what this suggests is that we may be able to get some better control over the BG with food and use a lower insulin dose. I hope anyway!
Click to expand...
:eek: Is Sergei ok? sigh...whenever you make a food switch make it slowly. Add a little more low carb while a little less high carb. Its a GOOD thing you are testing otherwise he could have crashed. This is dangerous Scott. You must be a nervous wreck.Which Hills wet were you feeding?
 
jt and trouble (GA) said:
:eek: Is Sergei ok? sigh...whenever you make a food switch make it slowly. Add a little more low carb while a little less high carb. Its a GOOD thing you are testing otherwise he could have crashed. This is dangerous Scott. You must be a nervous wreck.Which Hills wet were you feeding?
Click to expand...
Thanks, indeed. Luckily we are both home most of the time due to partial lockdown here, so he’s got at least one set of eyes on him all of the time, it not two. Sergei seems to be doing pretty well generally and he seems happy tonight.

The Hills in question is the wet md / Diabetes. We feed him only about 2-3 Tbsps (30g) of it as snack at +2. Last night he did not eat much of it and today he shunned it completely, which is how I ended up giving him the Almo food instead. I think the particular type of Almo I chose is fairly low in carbs. The 11 at PMPS really surprised ptnr and me.
 
I've just had a quick look at Sergei's spreadsheet. I think you should speak with your vet about decreasing the dose: nadirs in the 60s are quite on the low side for a Caninsulin cat. I think the black preshot BGs you're catching are bounces from low numbers mid-cycle.

Do you mind if I ask why you don't take AMPS readings and only take very few PMPS readings?


Mogs
.
 
Critter Mom said:
I've just had a quick look at Sergei's spreadsheet. I think you should speak with your vet about decreasing the dose: nadirs in the 60s are quite on the low side for a Caninsulin cat. I think the black preshot BGs you're catching are bounces from low numbers mid-cycle.

Do you mind if I ask why you don't take AMPS readings and only take very few PMPS readings?


Mogs
.
Click to expand...
Hi Mogs, Thanks for your feedback about Sergei's dose. Partner and I completely agree and we plan to speak to the vet about it.

We did an AMPS this morning (24,7 is obviously high, but still lower than we expected at 24 hours without insulin). We judged it safe to shoot but we reduced his dose by 0.5 until we can further talk over the situation with the vet.

In an ideal world we'd do AMPS every day. At the moment it's not part of our routine and mostly that's just owing to practicality and the rigours of Sergei's food and insulin schedule. Adding AMPS would mean operating not just on a reduced sleep schedule but on a pretty severe sleep deficit (this is so we can monitor him through BG nadir on the night time cycle). We do PMPS when our nadir numbers during the day dip below values we are comfortable with. So a 6 or lower at nadir usually means a test at PMPS (This is not a recommendation for anyone else, it is just our method).
 
Last edited:
Status
Not open for further replies.
Back
Top