The ballad of Olivia, part 3... now with added K/D?

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mosi_yazhi

mosi_yazhi

Member Since 2021
Part 1

Part 2

(Continuing in this thread because the last one was getting pretty lengthy.)

The 411:

Me:
Wendy.
32 years old.
United States.

The cat in question:
Olivia
18 years old, female, calico
Indoors cat
Diagnosed April 22, 2021
Started insulin April 27, 2021
Vetsulin (1 unit?? 2X a day???)
Accu-check Guide Me
Vet says she might need to have teeth pulled?

---

So Olivia had a vet visit yesterday at her usual place.

(The place that diagnosed her diabetes was a different vet, due to her usual place being booked at the time she was having issues.)

I got the doctor up to speed on all that had happened recently, gave over her records from the previous place, and a copy of the spreadsheet where I've been tracking her BG.

Doc decided that we should run some more tests, just to be sure the UTI had cleared up, and reassess what Olivia's care might be going forward, given the good numbers on the spreadsheet. She commented that Olivia's BG was super high at the start when Olivia was first diagnosed (around 600?!), but it seems like she's self-regulating better because of the new diet, and she MIGHT actually be about to go into remission? Also confirmed that Olivia had some teeth that definitely needed to be pulled, and that once they're gone her BG might drop even more.

She also looked at the records from the previous place and was like 'So... it looks like her kidney values were a little elevated this day they tested her. That could be because the UTI and that her BG was so high at the time of diagnosis. Did they tell you this?"

And I was like, "WTF, no?"

She told me it was nothing to freak out about just yet, and that elevated kidney values were kind of on par with what you would expect for an older cat anyway.

Because Olivia didn't have a whole lot of urine in her bladder, Doc decided to keep her for a few hours just so Olivia could 'generate' some more pee to test.

When I returned, Doc had done the tests, and determined that Olivia's UTI was still kinda there, and she would need more Clavamox... but also that her kidney values were still high, and that she wanted to keep her for a few days just to administer fluids and for observation.

Doc said I might have to start giving subcutaneous fluids at home once (or twice?) a week, and Olivia would have to go on a special kidney diet to help.

I asked her where she thought Olivia was in this whole journey, like, did she just start having these issues? Is she at the beginning? Doc said if she had to guess, she's about in the middle of the disease progression, whatever that means.

She also said that Olivia's bad teeth will have to stay in for the time being. She wants to make sure her kidneys are stable and hold their own for a while before we attempt to take them out, given the anesthesia risks.

Anyway. Suffice it to say, it's been a super emotional 24 hours. Not going to lie, I cried more than a couple times. The original diabetes diagnosis was scary, but I knew that there was the possibility of remission. This just seems so... resolute and final. It's overwhelming to think that this might be the thing that eventually takes Olivia from me, but I decided that it can't have her without a fight.

So - advice?

I had told the doctor I wanted a copy of Olivia's charts from this visit, and she said she would email them to me. She hasn't yet, but I'm going to poke her about sending them again here in a little bit. I've now got a copy of the records from the place that diagnosed her, and I can try to upload them (preferably just to send over private message, since it's got identifying info in them)

As far as my research tells me, the special kidney foods the Doc wants me to start are heavy in carbs. Just from my own research, it looks like the NEW name of the game is finding stuff that is low-carb but ALSO low in phosphorus (and possibly protein?). Anyone got any recommendations? Hopefully something that doesn't break the bank too badly.

Ideas? Thoughts?

EDIT:

Also, commiserate with me for a moment, for just a day prior to this, I had bought a TON of Fancy Feast and Sheba, and it now looks like it might be too high in phosphorus to feed to Olivia? Fml.

The other cat will eat it, so it wont go to waste. When Oliva had to switch to low-carb, it wasn't a big deal to give it to BOTH of them, but now I need to figure out a way to keep them from swapping bowls half way through their meal times since Olivia will be eating something (presumably) a little more expensive. Sigh.
 
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Weruva slide and serve pate foods Family Food (.97 phosphorus and 0 carb). Also Jeopurrdy Chicken (0.97 P 6.1 carb)
What a Crock 0.71 phosphorus and 8 carb lots of gravy so she loves it.
Goody stew shoes 0.71 phosphorus, 8.5 carb. This one is a big hit

Weruva Steak Frites (0.57 phosphorus 5.5 carb although I take out any big pieces of potatoes to try to limit the carbs just a bit)

Weruva LA isla Bonita - phosphorus 0.77 carb 4.5 (used to like, not a favorite anymore)
Glam and punk 1% carb, 0.93 phosphorous.

Weruva paw lickin chicken 3.3 carb 0.82 p and
Press your lunch 5.9 carb. 0.82 phosphorous
Bff play Laugh Out Loud chicken and lamb 7.7 carb, 0.82 phosphorous
BFF play destiny (chicken and duck) 0.87 phosphorus 7.7 carb
Bff play chicken cherish 0.71 phosphorus 7.6 carb
Bff play best buds chicken and beef 7.9 carb 0.9 phosphorus
Bff play chicken Checkmate. 7.7 carb 0.7 phos
New favorite On the Cat Wok 3.8 carb 0.74 phosphos

A lot of members feed these for kidney disease
 
Diane Tyler's Mom said:
She you get the labs could you post it
Click to expand...

OK, here it is - hopefully this shows up properly!

Thank you SO SO MUCH for the food recommendations! Let me know if you have any particular recs now that you're seeing what we're working with (percentages to stay under, etc)

EDIT:

Doc called just after I sent this reply.

Olivia's doing good. Eating, and has calmed down (she hates the vet)

She seems to be responding positively to the subcutaneous fluids, and her BUN and CREA levels have gone down a bit.

I asked for the updated (today) results, so hopefully she'll send those soon.
 
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They sent today's results, so I updated the file.

It now shows yesterday's numbers on page 1 (May 25)
And today's numbers on page 2 (May 26)
 
Breathe! It's not a death sentence by any means. Olivia definitely is very close to remission by Vetsulin standards. The trouble being that if the underlying issues aren't resolved/managed, it might not be a strong remission.

@PerfumedCatMom you're the first that comes to mind with a CKD cat - can you help? I think there's a forum for kidney cats too? And a lot of you use phos binders?

Tagging @Suzanne & Darcy as well. I know Darcy is giving you a hard time lately, but you always seem to have the knowledge!
 
I completely commiserate with you. Ruby was diagnosed with diabetes in September 2020, then CKD in January 2021, with IBD/SCL in the mix as well. Diabetes and kidney disease often go hand in hand, in humans as well as kitties. When hyperglycemia happens, sugar gets excreted through the kidneys and causes damage. CKD is also one of the most common ailments of older kitties. That being said, it looks like your feline overlord :p doesn't have too bad of a case of diabetes. You might want to try a really low dose of Lantus (Diabetic Cats in Need can help you get some free pens and syringes to tide you over for a bit: https://dcin.dreamhosters.com/), like a drop dose as @FrostD has been advising, so you can get those blue numbers down to green ones to get her into a strong remission. If you can get your hands on Lantus, please post on the Lantus forum for switching from Vetsulin to Lantus and to get dosing advice.

@Diane Tyler's Mom has already provided you with a list of low phos, low carb foods. I was feeding Ruby Weruva foods before her IBD flare ups, and now I feed her a raw diet that has been the best thing for her kidney values. I use raw boneless (bones have phos, so bad for CKD) ground meat and mix it with EZ Complete, a meal completer mix that has vitamins and other yummy stuff to make the meat nutritionally balanced. The company that makes EZ Complete has a fantastic website on raw feeding in general for kitties: foodfurlife.com.

Here's a good discussion about making food at home for your CKD kitty: https://www.felinediabetes.com/FDMB/threads/home-prepared-diet-of-crd-cats.150441/.

If you want to avoid raw, that's cool, but whatever low phos, low carb canned/pouched option you choose, add water to the bowl and mix it up with the food. CKD kitties need lots of hydration. I do a 2:1 ratio of food to water, so if I'm feeding 1 ounce of food, I add .5 ounces of water. Some caregivers do a 2:1 ratio of water to food. It really depends on how soupy Olivia prefers her food to be.

Melissa mentioned phosphorus binders, but it looks like Olivia's phosphorus levels are normal, so you don't have to worry about that right now. But in case the phos levels do start to creep up, you can buy phosphorus binders to add to the food and it helps to prevent it from being absorbed by the kitty's body: https://www.thrivingpets.com/thrivingpets-aluminum-hydroxide-powder-usp-50g-jar.html. Phosphorus can really do a number on the kidneys.

It seems Olivia is responding well in the hospital to the fluids she's getting there. The initial blood tests showed her to be in IRIS Stage 3, which means she can probably do well with subcutaneous fluids administered at home several times a week. Check with her vet about this. It's not terribly expensive to get set up at home (cheaper than doing it at the vet) and would help flush out the toxins in her blood that the kidneys can no longer filter. Here is a great video that shows you how to administer them to your kitty: https://www.felinediabetes.com/FDMB/threads/how-to-give-subcutaneous-fluids-video.75933/.

Hope I didn't overwhelm you! Please feel free to pick our brains for any more helpful tidbits. Olivia can live many more happy and healthy years with CKD.

Resources:
Tanya's Comprehensive Guide to Feline Kidney Disease (felinecrf.org): an AMAZING site. Has all of the stuff I say above and then some. Everything you ever wanted to know.
Feline Chronic Kidney Disease FB group: https://www.facebook.com/groups/felinecrf/. Nice group of people, lots of knowledge, good CKD nutrition files.

:bighug::bighug::bighug:
 
PS: The low protein diet isn't recommended anymore to deal with kidney disease. In fact, it causes more problems because CKD kitties are already prone to muscle wastage. The important factors here are low phosphorus and low carb (less than 5% if you can swing that).
 
PerfumedCatMom said:
I completely commiserate with you. Ruby was diagnosed with diabetes in September 2020, then CKD in January 2021, with IBD/SCL in the mix as well. Diabetes and kidney disease often go hand in hand, in humans as well as kitties. When hyperglycemia happens, sugar gets excreted through the kidneys and causes damage. CKD is also one of the most common ailments of older kitties. That being said, it looks like your feline overlord :p doesn't have too bad of a case of diabetes. You might want to try a really low dose of Lantus (Diabetic Cats in Need can help you get some free pens and syringes to tide you over for a bit: https://dcin.dreamhosters.com/), like a drop dose as @FrostD has been advising, so you can get those blue numbers down to green ones to get her into a strong remission. If you can get your hands on Lantus, please post on the Lantus forum for switching from Vetsulin to Lantus and to get dosing advice.

@Diane Tyler's Mom has already provided you with a list of low phos, low carb foods. I was feeding Ruby Weruva foods before her IBD flare ups, and now I feed her a raw diet that has been the best thing for her kidney values. I use raw boneless (bones have phos, so bad for CKD) ground meat and mix it with EZ Complete, a meal completer mix that has vitamins and other yummy stuff to make the meat nutritionally balanced. The company that makes EZ Complete has a fantastic website on raw feeding in general for kitties: foodfurlife.com.

Here's a good discussion about making food at home for your CKD kitty: https://www.felinediabetes.com/FDMB/threads/home-prepared-diet-of-crd-cats.150441/.

If you want to avoid raw, that's cool, but whatever low phos, low carb canned/pouched option you choose, add water to the bowl and mix it up with the food. CKD kitties need lots of hydration. I do a 2:1 ratio of food to water, so if I'm feeding 1 ounce of food, I add .5 ounces of water. Some caregivers do a 2:1 ratio of water to food. It really depends on how soupy Olivia prefers her food to be.

Melissa mentioned phosphorus binders, but it looks like Olivia's phosphorus levels are normal, so you don't have to worry about that right now. But in case the phos levels do start to creep up, you can buy phosphorus binders to add to the food and it helps to prevent it from being absorbed by the kitty's body: https://www.thrivingpets.com/thrivingpets-aluminum-hydroxide-powder-usp-50g-jar.html. Phosphorus can really do a number on the kidneys.

It seems Olivia is responding well in the hospital to the fluids she's getting there. The initial blood tests showed her to be in IRIS Stage 3, which means she can probably do well with subcutaneous fluids administered at home several times a week. Check with her vet about this. It's not terribly expensive to get set up at home (cheaper than doing it at the vet) and would help flush out the toxins in her blood that the kidneys can no longer filter. Here is a great video that shows you how to administer them to your kitty: https://www.felinediabetes.com/FDMB/threads/how-to-give-subcutaneous-fluids-video.75933/.

Hope I didn't overwhelm you! Please feel free to pick our brains for any more helpful tidbits. Olivia can live many more happy and healthy years with CKD.

Resources:
Tanya's Comprehensive Guide to Feline Kidney Disease (felinecrf.org): an AMAZING site. Has all of the stuff I say above and then some. Everything you ever wanted to know.
Feline Chronic Kidney Disease FB group: https://www.facebook.com/groups/felinecrf/. Nice group of people, lots of knowledge, good CKD nutrition files.

:bighug::bighug::bighug:
Click to expand...
Hi Kathetine, I'm glad you can make out the labs, I can't they are all blurry
 
I agree with @PerfumedCatMom about maybe trying Lantus

Thru
Diabetic Cats in Need can help you get some free pens and syringes to tide you over for a bit: https://dcin.dreamhosters.com/), like a drop dose as@@FrostD has been advising, so you can get those blue numbers down to green ones to get her into a strong remission. If you can get your hands on Lantus, please post on the Lantus forum for switching from Vetsulin to Lantus and to get dosing advic

Or we have a supply closet ,I see some members have the lantus pens for sale, you can check it out, ask them for the expiration dates

You would need U -100 syringes for lantus with half unit markings
You would insert the syringe into the gray rubber stopper iand draw the insulin from there.
We use syringes rather than the needles that are used with the pens because you can only increase or decrease with the pens
With using syringes you can increase or decrease by 0.25 units
If you decide to switch to lantus let us know and we can tell you where to buy the U-100 syringes
 
PerfumedCatMom said:
I completely commiserate with you. Ruby was diagnosed with diabetes in September 2020, then CKD in January 2021, with IBD/SCL in the mix as well. Diabetes and kidney disease often go hand in hand, in humans as well as kitties. When hyperglycemia happens, sugar gets excreted through the kidneys and causes damage. CKD is also one of the most common ailments of older kitties. That being said, it looks like your feline overlord :p doesn't have too bad of a case of diabetes. You might want to try a really low dose of Lantus (Diabetic Cats in Need can help you get some free pens and syringes to tide you over for a bit: https://dcin.dreamhosters.com/), like a drop dose as @FrostD has been advising, so you can get those blue numbers down to green ones to get her into a strong remission. If you can get your hands on Lantus, please post on the Lantus forum for switching from Vetsulin to Lantus and to get dosing advice.

@Diane Tyler's Mom has already provided you with a list of low phos, low carb foods. I was feeding Ruby Weruva foods before her IBD flare ups, and now I feed her a raw diet that has been the best thing for her kidney values. I use raw boneless (bones have phos, so bad for CKD) ground meat and mix it with EZ Complete, a meal completer mix that has vitamins and other yummy stuff to make the meat nutritionally balanced. The company that makes EZ Complete has a fantastic website on raw feeding in general for kitties: foodfurlife.com.

Here's a good discussion about making food at home for your CKD kitty: https://www.felinediabetes.com/FDMB/threads/home-prepared-diet-of-crd-cats.150441/.

If you want to avoid raw, that's cool, but whatever low phos, low carb canned/pouched option you choose, add water to the bowl and mix it up with the food. CKD kitties need lots of hydration. I do a 2:1 ratio of food to water, so if I'm feeding 1 ounce of food, I add .5 ounces of water. Some caregivers do a 2:1 ratio of water to food. It really depends on how soupy Olivia prefers her food to be.

Melissa mentioned phosphorus binders, but it looks like Olivia's phosphorus levels are normal, so you don't have to worry about that right now. But in case the phos levels do start to creep up, you can buy phosphorus binders to add to the food and it helps to prevent it from being absorbed by the kitty's body: https://www.thrivingpets.com/thrivingpets-aluminum-hydroxide-powder-usp-50g-jar.html. Phosphorus can really do a number on the kidneys.

It seems Olivia is responding well in the hospital to the fluids she's getting there. The initial blood tests showed her to be in IRIS Stage 3, which means she can probably do well with subcutaneous fluids administered at home several times a week. Check with her vet about this. It's not terribly expensive to get set up at home (cheaper than doing it at the vet) and would help flush out the toxins in her blood that the kidneys can no longer filter. Here is a great video that shows you how to administer them to your kitty: https://www.felinediabetes.com/FDMB/threads/how-to-give-subcutaneous-fluids-video.75933/.

Hope I didn't overwhelm you! Please feel free to pick our brains for any more helpful tidbits. Olivia can live many more happy and healthy years with CKD.

Resources:
Tanya's Comprehensive Guide to Feline Kidney Disease (felinecrf.org): an AMAZING site. Has all of the stuff I say above and then some. Everything you ever wanted to know.
Feline Chronic Kidney Disease FB group: https://www.facebook.com/groups/felinecrf/. Nice group of people, lots of knowledge, good CKD nutrition files.

:bighug::bighug::bighug:
Click to expand...

PerfumedCatMom said:
PS: The low protein diet isn't recommended anymore to deal with kidney disease. In fact, it causes more problems because CKD kitties are already prone to muscle wastage. The important factors here are low phosphorus and low carb (less than 5% if you can swing that).
Click to expand...

THANK YOU SO SO SO MUCH for all the information! :bighug: omg

I had said in a previous thread that I'm using THIS CHART to help me make my low-carb food choices, and thankfully I'm now seeing that it has phosphorus values, as well as carb, fat, proteins, etc. (I know that this file is from 2017, but I'm hoping that these companies haven't radically changed their food formulations in the years since.)

Is there a certain amount of phosphorus that I need to stay under? I think I read something like 200 at one point -- is that a good ball park, considering what Olivia's specific kidney values look like at this point in time? Or do you think I need to try to stay even lower?

I definitely will want to pick your brain about raw feeding at some point -- I kinda want to try, but was always hesitant about how fussy it seems to be, making sure she got all the vitamins and nutrients she needs. The EZ Complete looks like a game changer. For now, I want to try the Weruva just for ease of feeding and until I figure out how to try to keep my two cats separated while they're eating so they don't swap bowls.

The vet said she would set me up with subq fluids and teach me how to do it, but she said Olivia would only need it once or twice a week -- does that seem like enough times a week? Like, how often do you think I would need to do this, if she's at Stage 3?

Also, how does this play with her insulin shots, while she still needs them? Like, I'm guessing I should give them both within the same hour. Which should come first, and how long would I wait between them?

Just applied to DCIN last night, so hopefully I'll be accepted and get my hands on some Lantus soon-ish.
 
Diane Tyler's Mom said:
I agree with @PerfumedCatMom about maybe trying Lantus

Thru
Diabetic Cats in Need can help you get some free pens and syringes to tide you over for a bit: https://dcin.dreamhosters.com/), like a drop dose as@@FrostD has been advising, so you can get those blue numbers down to green ones to get her into a strong remission. If you can get your hands on Lantus, please post on the Lantus forum for switching from Vetsulin to Lantus and to get dosing advic

Or we have a supply closet, I see some members have the lantus pens for sale, you can check it out, ask them for the expiration dates

You would need U -100 syringes for lantus with half unit markings
You would insert the syringe into the gray rubber stopper iand draw the insulin from there.
We use syringes rather than the needles that are used with the pens because you can only increase or decrease with the pens
With using syringes you can increase or decrease by 0.25 units
If you decide to switch to lantus let us know and we can tell you where to buy the U-100 syringes
Click to expand...
Diane Tyler's Mom said:
https://felinediabetes.com/FDMB/forums/supply-closet-for-sale-or-free.15/

Here is the link for the supply, one pen can last you 6 months are longer
Click to expand...

Yes, thank you! I just completed my application to DCIN last night, waiting for a reply.

I had poked my nose into the Supply Closet, but things seemed slow-moving/things were already getting claimed, but I'll make sure I keep a better eye on it!

I didn't know that you could use your own syringes with the pens! My mother used to use the pens, and I always just saw her use the pen to inject - I didn't know you could draw it out of the pen and administer that way! I think she was using Levemir, but had to recently-ish switch to a different insulin. I saw an unused pen in the fridge, but didn't think anything of it because I knew you could only inject whole units with it. But if I can draw the insulin out myself, maybe I can put it to use since my mom herself can't use it anymore.

I'll take a look at it. Hopefully it's not expired yet! Would the Levemir be on-par with the Lantus in helping her manage her sugars better without crashing her too harshly like the Vetsulin?
 
FrostD said:
Breathe! It's not a death sentence by any means. Olivia definitely is very close to remission by Vetsulin standards. The trouble being that if the underlying issues aren't resolved/managed, it might not be a strong remission.
Click to expand...

Ok, thank you. Sometimes it's easy to not see the forest for the trees and fall into 'the sky is falling' mode. It's just my lack of knowledge, combined with the hellscape that's been the last year that has frayed my nerves, I think.

I appreciate you telling me to calm down and giving me advice and likewise knowing who to tag for THEIR advice. :bighug:
 
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ALSO, I made this last night, so I could showcase to you all just what a magnificent floof Olivia is!

The grainy profile picture doesnt really do her justice, afterall. (Also featuring my other civvie cat, Sophie.)

I also got some good news - I got the job I interviewed for last week! I'm not sure when my start date will be since the job site is still technically closed due to covid, but hopefully in a couple weeks here since cases are falling! So relieved to have some footing, and I don't have to worry as much about stacking vet bills and more expensive cat food since theres SOME light at the end of the tunnel.
 
mosi_yazhi said:
ALSO, I made this last night, so I could showcase to you all just what a magnificent floof Olivia is!

The grainy profile picture doesnt really do her justice, afterall. (Also featuring my other civvie cat, Sophie.)

I also got some good news - I got the job I interviewed for last week! I'm not sure when my start date will be since the job site is still technically closed due to covid, but hopefully in a couple weeks here since cases are falling! So relieved to have some footing, and I don't have to worry as much about stacking vet bills and more expensive cat food since theres SOME light at the end of the tunnel.
Click to expand...
Awesome!!

Edit: beautiful cat! I brought home a calico kitten from the woods once, my mom wasn't thrilled, but she somehow became my mom's cat lol
 
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mosi_yazhi said:
I'm hoping that these companies haven't radically changed their food formulations in the years since.
Click to expand...
A more up to date chart of foods with phosphorus levels is on that Tanya's CKD site I shared with you. If you follow THAT chart, you want to keep below 1% phos on a dry matter basis. If following the chart from catinfo.org, you want 250 or below.

mosi_yazhi said:
The EZ Complete looks like a game changer.
Click to expand...
It was a game changer for me too. I was totally intimidated by raw feeding until I discovered EZC, and my cats LOVE it. I had Ruby on Weruva and my civvie was eating FF with some dry food and I transitioned both over and now they cry for the raw food. As I said, Ruby's kidney values went down substantially in the three months I had her eating boneless ground meat. I have mine shipped from Hare Today and Raw Feeding Miami since I'm on the East Coast and they have a lot of selection in terms of boneless meats. Even with the shipping and the cost of EZC, I find that if you stick to inexpensive meats like turkey, chicken or beef, it can be cheaper than feeding Weruva long term and the health benefits are huge. Their coats are shiny and they don't throw up as much, only an occasional hairball maybe once a month. I spend about 45 minutes mixing and portioning 10 days of food (my freezer has limited space), but it's worth my while knowing exactly what is going in their food.

mosi_yazhi said:
Would the Levemir be on-par with the Lantus in helping her manage her sugars better without crashing her too harshly like the Vetsulin?
Click to expand...
I'm tagging @SashaV here to help you answer that question, as her kitty Mauer is currently on Levemir after switching from Lantus and Vetsulin before that, I believe.

mosi_yazhi said:
vet said she would set me up with subq fluids and teach me how to do it, but she said Olivia would only need it once or twice a week -- does that seem like enough times a week? Like, how often do you think I would need to do this, if she's at Stage 3?
Click to expand...
I would start with what your vet suggests, and if you see her acting poorly, like low appetite, dehydrated (tacky gums are a sign, or you can pick up her scruff and see how well it bounces back), then giving it to her more often can perk her up. I've been told to give subQ a few hours apart from the insulin, as it can drive numbers lower.
 
I started on Caninsulin, your Vetsulin.
Then levemir, without understanding how it worked so only used that about a month.
Then prozinc that didn't do enough... and then back to Levemir. Now I understand how it works, it works for Mauer too. But it doesn't hit hard, it lasts longer.. just look at my spreadsheet.
If your mom have a pen, not used and stored in the fridge, do it.

I believe I've said it before, but you probably won't need much so one pen will get you a looooooooong way. Mine is on 3U twice a day, and one pen lasts me one and a half month.
 
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Ok, Olivia's back from her stay at the vet!

She's definitely happy to be home, and is trotting around the house, making sure we didnt mess with how she left things while she was gone :p

I managed to snag some Tikicat Puka Puka Luau (0% carb, 154 phos) from the crunchy hippy co-op in town, so hopefully that should last until I can place an order for some Weruva. She seems to like it, so maybe I'll snag a crate of it as well.

Her bg is at 279(!!!!)

Some of it I'm sure is stress, but also I'm sure they were feeding her the HC k/d food.

I think I'm going to shoot her a drop of the Vetsulin and monitor for a while, just because I have a better idea of what that will do to her --- not willing to experiment with the Levemir tonight since shes had a rough couple days and she doesnt need me poking her every few hours to see where her sugars are at all through the night.

That sound reasonable, @FrostD ?
 
mosi_yazhi said:
Ok, Olivia's back from her stay at the vet!

She's definitely happy to be home, and is trotting around the house, making sure we didnt mess with how she left things while she was gone :p

I managed to snag some Tikicat Puka Puka Luau (0% carb, 154 phos) from the crunchy hippy co-op in town, so hopefully that should last until I can place an order for some Weruva. She seems to like it, so maybe I'll snag a crate of it as well.

Her bg is at 279(!!!!)

Some of it I'm sure is stress, but also I'm sure they were feeding her the HC k/d food.

I think I'm going to shoot her a drop of the Vetsulin and monitor for a while, just because I have a better idea of what that will do to her --- not willing to experiment with the Levemir tonight since shes had a rough couple days and she doesnt need me poking her every few hours to see where her sugars are at all through the night.

That sound reasonable, @FrostD ?
Click to expand...
Sounds good!

I'd suggest giving her maybe another two days or so on Vetsulin drop doses to settle down/even out. If that k/d was dry it might take some time for her to come back down. Once she seems a little more back in a pattern, then try the Levemir switch. If you have spare time, read the stickies in the Lantus/Levemir forums, those insulins work differently than Vetsulin.

By tomorrow PM if she's still a bit high you might consider zapping her with a 0.1-0.25U dose of Vetsulin to hopefully bring her back down.
 
I likely won't be around tomorrow, vet appointment in AM and a date with the couch for some binging in the PM. When in doubt err on the side of caution!
 
FrostD said:
Sounds good!

I'd suggest giving her maybe another two days or so on Vetsulin drop doses to settle down/even out. If that k/d was dry it might take some time for her to come back down. Once she seems a little more back in a pattern, then try the Levemir switch. If you have spare time, read the stickies in the Lantus/Levemir forums, those insulins work differently than Vetsulin.

By tomorrow PM if she's still a bit high you might consider zapping her with a 0.1-0.25U dose of Vetsulin to hopefully bring her back down.
Click to expand...

FrostD said:
I likely won't be around tomorrow, vet appointment in AM and a date with the couch for some binging in the PM. When in doubt err on the side of caution!
Click to expand...

Ok! Will do! o7

Hope the vet visit goes well, and enjoy your time off! <3
 
Ok, after that first initial drop dose of Vetsulin after her trip to the vet on Thursday, she came down pretty drastically

279 > 113@+5

Which is pretty yikes... but shes also kind of returned to her normal ballpark of low blues, so I haven't been giving the Vetsulin.

Shes a little high this morning (148) and I gave her a more carb-ier breakfast (8%) than what she normally gets, so I'm going to try the Levemir today.

Should preface this by saying I know Levemir uses the u100 syringes, but I've only got 40u. I figure since I'm just drop dosing, it shouldn't be too big a problem, right?

@FrostD @SashaV @Diane Tyler's Mom (or anyone else) wanna weigh in? Good idea, bad idea?

(Melissa, I know you said you're not usually on during the day, but tagging you so you'll see this when you get on, I suppose.)

EDIT: ALSO: I know Levemir is longer-acting than Vetsulin - should I check her numbers every 2 hours, instead of every 1 hour?
 
If you are going to use levemir, please do get the U 100 3/10 30 or 31 gauge 6 or 8mm insulin syringes. DO NOT USE THE U40 syringe EVEN FOR A DROP DOSE

Levemir is a different insulin to vetsulin. Levemir is a much more suitable insulin for cats.
Levemir is a depot insulin and a longer lasting insulin. The depot needs to fill initially and stabilise for the full effect to be seen. You can still see action as the depot is filling, but not the full effect.
So you hold the starting dose for 5 to 7 days, unless the BG drops under 50 for TR and 90 for SLGS.
I suggest reading the yellow stickies at the top of the Lantus page on Lantus and Levemir dosing before starting.

I would recommend you get at least one test in during every cycle to see how low the dose is taking your kitty. Just getting preshot BGs is not giving us nearly enough information. Levemir dosing is based on the nadir not the preshot number.

Looking at the SS your kitty does still need insulin if you want a strong remission.
I would suggest trying a drop of Levemir but only if you have the correct syringes and are able to monitor the cycles and get tests in during the cycles.
 
Hi Wendy,

Since you have the Levemir, no harm in trying it. It's definitely a better insulin for cats than Vetsulin. And Olivia does look like she needs some insulin. You could try a starting dose of 0.25U.
Let's see what @Bron and Sheba (GA) and @tiffmaxee think.

You could get the Relion brand u100 syringes with half unit marks at Walmart. All their 30cc(unit) syringes come with half unit markings.
 
Bron and Sheba (GA) said:
If you are going to use levemir, please do get the U 100 3/10 30 or 31 gauge 6 or 8mm insulin syringes. DO NOT USE THE U40 syringe EVEN FOR A DROP DOSE

Levemir is a different insulin to vetsulin. Levemir is a much more suitable insulin for cats.
Levemir is a depot insulin and a longer lasting insulin. The depot needs to fill initially and stabilise for the full effect to be seen. You can still see action as the depot is filling, but not the full effect.
So you hold the starting dose for 5 to 7 days, unless the BG drops under 50 for TR and 90 for SLGS.
I suggest reading the yellow stickies at the top of the Lantus page on Lantus and Levemir dosing before starting.

I would recommend you get at least one test in during every cycle to see how low the dose is taking your kitty. Just getting preshot BGs is not giving us nearly enough information. Levemir dosing is based on the nadir not the preshot number.

Looking at the SS your kitty does still need insulin if you want a strong remission.
I would suggest trying a drop of Levemir but only if you have the correct syringes and are able to monitor the cycles and get tests in during the cycles.
Click to expand...

Hi! Ok, wont be giving the Levemir today, then, thank you!

I know she needs some insulin, yes, it's just that the Vetsulin is too harsh for her and drops her too hard and fast from even a single drop, and I cant afford a better, suitable insulin right now.

The Levemir is just 'leftovers' from when my mother was using that insulin. It's a pen, she never opened it, and it's been sitting in the fridge for a few months, so that's why I dont have the correct supplies for it (it's not expired yet, dont worry). But I'll make sure I get the u100 before I try the drop of Levemir.

Bandit's Mom said:
Hi Wendy,

Since you have the Levemir, no harm in trying it. It's definitely a better insulin for cats than Vetsulin. And Olivia does look like she needs some insulin. You could try a starting dose of 0.25U.
Let's see what @Bron and Sheba (GA) and @tiffmaxee think.

You could get the Relion brand u100 syringes with half unit marks at Walmart. All their 30cc(unit) syringes come with half unit markings.
Click to expand...

Ok, I'll add that to my list!

I live SUPER rurally, and the nearest shops are an hour away. If I left home right now (8:30am), I wouldn't be back until 11am, which is a little late for a starting time.

If her pmps is a high, I'll give her drop of her usual Vetsulin tho.
 
mosi_yazhi said:
I live SUPER rurally, and the nearest shops are an hour away. If I left home right now (8:30am), I wouldn't be back until 11am, which is a little late for a starting time.
Click to expand...
You can start tomorrow or whenever you get the syringes. Makes sense to try Levemir when you have it (and can't afford it otherwise).
Once you decide to start, you can post on the Lantus / Basaglar (glargine) and Levemir (detemir) forum for dosing help.

The Relion syringes are $12.58 for a box of 100. You can buy syringes online as well at www.adwdiabetes.com but they would take longer to get to you and you'd also need to pay for shipping.
Looking forward to seeing you on the LBL forum soon :-)

187012378_10219026602323260_3968692681995309298_n.jpg
188348278_10219026599283184_6551822536842039758_n.jpg


 
Bandit's Mom said:
You can start tomorrow or whenever you get the syringes. Makes sense to try Levemir when you have it (and can't afford it otherwise).
Once you decide to start, you can post on the Lantus / Basaglar (glargine) and Levemir (detemir) forum for dosing help.

The Relion syringes are $12.58 for a box of 100. You can buy syringes online as well at www.adwdiabetes.com but they would take longer to get to you and you'd also need to pay for shipping.
Looking forward to seeing you on the LBL forum soon :)

187012378_10219026602323260_3968692681995309298_n.jpg
188348278_10219026599283184_6551822536842039758_n.jpg

Click to expand...

Yesssss, I LOVE picture references of what I should be getting! Thank you!

DUDE, I'm SO excited to be getting her off the Vetsulin omfg, you dont even know. Everytime I give her the Vetsulin, I feel like I have to mentally prepare myself for a rollercoaster the next few hours since it dips her so low so quickly. It's a little terrifying tbh. I know the longer acting insulins have their own pitfalls, but I'm still optimistic it will be a good switch.

She has a vet appointment tomorrow, I'll see if I can get an official script for the Lantus or Levemir. The place that diagnosed her was willing to write a Lantus script, but I've heard that some vets are weird about it? Idk.
 
mosi_yazhi said:
She has a vet appointment tomorrow, I'll see if I can get an official script for the Lantus or Levemir. The place that diagnosed her was willing to write a Lantus script, but I've heard that some vets are weird about it? Idk
Click to expand...
Since you already have the Levemir, do you need to struggle for a script?
 
Welcome. Lantus and Levemir are used mostly for cats so you should not have a problem getting an RX. Since yours has not been opened it should be fine until the expiration date stored in the fridge.
 
Bandit's Mom said:
Since you already have the Levemir, do you need to struggle for a script?
Click to expand...
I just want the paper saying I can buy it, not a whole other pen/vial of Levemir.

The Levemir I have expires this November.

It looks like she's on the cusp of remission, we theorize that it's her bad teeth keeping her bg high, but with the recent ckd diagnosis, she has to keep the teeth for a while longer until her kidneys are more stable to be anesthetized for extractions.

Doc said it could be a few months. I just want to have my bases covered in case this extends past November... Plus, never hurts to have a backup plan in case something unfortunate happens and I need to quickly scramble to buy another pen/vial.
 
mosi_yazhi said:
Yesssss, I LOVE picture references of what I should be getting! Thank you!

DUDE, I'm SO excited to be getting her off the Vetsulin omfg, you dont even know. Everytime I give her the Vetsulin, I feel like I have to mentally prepare myself for a rollercoaster the next few hours since it dips her so low so quickly. It's a little terrifying tbh. I know the longer acting insulins have their own pitfalls, but I'm still optimistic it will be a good switch.

She has a vet appointment tomorrow, I'll see if I can get an official script for the Lantus or Levemir. The place that diagnosed her was willing to write a Lantus script, but I've heard that some vets are weird about it? Idk.
Click to expand...
I get your feelings! It takes balls to do Vetsulin! I couldn't do it again, and I advice against it every chance I get...
 
mosi_yazhi said:
Was able to get u100 syringes from Walgreens yesterday! She was at 146 this morning, so I gave her the drop of Levemir.

Gearing up for a day of ear pokes! Fingers crossed, y'all!

@Bron and Sheba (GA) @SashaV @Bandit's Mom @FrostD
Click to expand...
I see you switched to Levemir
On your spreadsheet make a line above the day you switched stating

Switched to Levemir so members know
Also on your SS in the upper left hand corner where it says insulin

Did you get the syringes with half unit markings?

@mosi_yazhi
 
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What is your feeding schedule? Btw, your signature doesn't say what food she eats. Could you add that please?
How are you measuring the drop?
 
Now isn't exactly the time, but you'll want to pick a dosing method. Reason I say that, is that it determines what food to give when this happens because each method has a different reduction threshold.

No harm in HC right now, just might be counterproductive.
 
Bandit's Mom said:
What is your feeding schedule? Btw, your signature doesn't say what food she eats. Could you add that please?
How are you measuring the drop?
Click to expand...

Her bg gets taken at 6:30, and then food immediately after.
At 7:00, she gets her shot.

I try to keep her food under 6%, but the recent CKD DX threw us for a loop, and I'm trying to find something she likes. She had some 8% carb this morning for breakfast.

What do you mean, how am I measuring the drop?
 
Does it take her nearly half an hour to eat? We usually test, feed, shoot in 15 mins or so.

What stage CKD is she at? Till later stages of CKD, you can continue to feed low carb food. You need to watch the phosphorous levels in the food, though. Try and keep it under 0.5% DMB.

I see that she's lower even after 24% carbs! :eek:

How are you measuring/drawing the drop dose of Levemir in the syringe?
 
Bandit's Mom said:
Does it take her nearly half an hour to eat? We usually test, feed, shoot in 15 mins or so.

What stage CKD is she at? Till later stages of CKD, you can continue to feed low carb food. You need to watch the phosphorous levels in the food, though. Try and keep it under 0.5% DMB.

I see that she's lower even after 24% carbs! :eek:

How are you measuring/drawing the drop dose of Levemir in the syringe?
Click to expand...

Before all this, she was free fed on kibble. She's a grazer by nature, and it's been hard to get her to eat the bulk of her meals in one sitting. She only ever eats like half when I first give it to her, and then nibbles on it for a few more hours. I can usually cox her into eating a good amount within 1/2 an hour, though. Sometime all, sometimes 2/3

Vet didnt give me a definitive answer on what stage shes at, but @PerfumedCatMom reckons she's at stage 3, looking at her charts, which is upthread.

I take the syringe out of the package, pump the plunger to get it unstuck, then push and hold it down. Insert into vial/pen. Release plunger to let it suck up what it will, I dont pull on it. Insert needle into cat, push plunger down, and hold for 10 seconds until I remove it.
 
mosi_yazhi said:
Before all this, she was free fed on kibble. She's a grazer by nature, and it's been hard to get her to eat the bulk of her meals in one sitting. She only ever eats like half when I first give it to her, and then nibbles on it for a few more hours. I can usually cox her into eating a good amount within 1/2 an hour, though. Sometime all, sometimes 2/3
Click to expand...
Eating all the food at shot time makes more sense for insulins like Vetsulin. With gentler depot insulins like Lantus and Levemir, you can space out the food into several smaller meals through the cycle. Looks like Olivia may do well with her breakfast broken into mini-meals fed at PS, +1, +2

mosi_yazhi said:
Vet didnt give me a definitive answer on what stage shes at, but @PerfumedCatMom reckons she's at stage 3, looking at her charts, which is upthread.
Click to expand...
Yup Stage 3. Looks like Katherine has that covered including Tanya's site. :-)

mosi_yazhi said:
I take the syringe out of the package, pump the plunger to get it unstuck, then push and hold it down. Insert into vial/pen. Release plunger to let it suck up what it will, I dont pull on it. Insert needle into cat, push plunger down, and hold for 10 seconds until I remove it.
Click to expand...
You got it right.
 
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