6/30 Toeby AMPS 176, PMPS 97, +2 68, +3 47, +3.33 67, +3.7 79, +4.5 119, +5 8.6.

PM +3 was a bit of a surprise - he is acting normally.
He had some LC pate with his +2 check.
I gave him some gravy FF and will check him again in 15-20 minutes.
 
Laurasboyz said:
PM +3 was a bit of a surprise - he is acting normally.
He had some LC pate with his +2 check.
I gave him some gravy FF and will check him again in 15-20 minutes.
Click to expand...
Looks like Toeby's had enough of that dose! Come on up!

Out of curiosity, when do you give the budesonide in the evening? Is it with his insulin? Looks like he didn't register last night's dose much, which is good.
 
PerfumedCatMom said:
Looks like Toeby's had enough of that dose! Come on up!
Out of curiosity, when do you give the budesonide in the evening? Is it with his insulin? Looks like he didn't register last night's dose much, which is good.
Click to expand...

PM +3.33 (20 minutes after his 47 at +3) and I gave him some FF Medleys Florentine Chicken, which I think is MC at 13%
He is still acting normally, and eating
I will keep checking closely

Katherine, I give him the Budesonide with his evening meal, and with his insulin, and yes, either he didn't register much today, or the new higher insulin dose is outweighing the steroid.
I am wondering if this dose is right - it feels kinda right, but he could have gone lime green yesterday and I missed it when I caught the 52, and he definitely was below 50 tonight.
I'm not nervous tonight, but I don't like to see the low numbers, of course.

His new Budesonide capsules are ready to pick up Friday but I heard from the vet who will be looking after him tonight, when she saw the capsules come in.
She thought the 0.5 was a mistake... I explained what I was thinking.
She told me that the reason I was told to give him a pill every other day, is that the body will become reliant on the steroids if not allowed to perform naturally.
That's why they like to wean cats off them.
That's why I was told to give him his dose every other day - that wasn't clear to me, I thought we were just tapering the dose in amount, with the 1 mg tablets I had on hand.
I didn't consider the time frame, or a day off being required.
She said my thinking, made sense from a BG control POV, but not from the systemic action of the steroid POV.
I sent her a copy of his spreadsheet, and asked her to give me direction based on what is best for him overall - our phone conversation was a bit muddled, with her trying to work with me, and me trying to work with her, to the point where I am a bit confused over what is best.
I am waiting to hear back from her before I do anything to his dosage.

My timer just went, so I am off to check him again.
Laura
 
+3.66 79
Gave him another bit of the FF Florentine and will keep checking him.
He normally is at his lowest by +5 - that lower reading this morning at +7 was weird.
 
Your vet's reasoning makes sense to me from what little I know/understand about the steroids by going every other day and then adding more days between as time goes on with the same dose. Have you seen Pearl's SS? @Margaret (and Pearl) was giving prednisolone every other day and now she skips 4 days. I suppose it depends on how well the cat does symptoms-wise on less frequent dosage. It still makes for spikes in BGs each time the steroid is administered, but as you can see from Pearl's SS, she's well regulated because of Margaret's careful management of her insulin doses and food. Pearl gets more insulin than Toeby does, so maybe that's what he needs? If you can manage his lower numbers so he doesn't drop that low or get overcarbed and go too high--maybe then he might learn to bounce less and you can get more insulin in him?
 
@PerfumedCatMom I did take a peek at Pearl's SS when you mentioned her here the other week.
I guess I made an assumption when my vet who was leaving for maternity leave said about reducing his dose.
I would really rather space the steroid out if that is best for his system.
I will talk again to his vet, I really came away from our conversation a little befuddled... I think she thought I was doing something whacky, and maybe I was.
She didn't want to tell me that, she understood what I was trying to do, but I feel if she knew me better, she'd say "WTF are you doing?" :)
Professionally, of course... LOL.
Or maybe she thought I might try to bail on paying for the capsules, seeing as I ordered them, and I won't, but she wouldn't know that.

I dunno Katherine, tonight I kinda feel down - I wonder what I am working towards.
Is there really a chance I can get him back into remission, or to what end is this all for?
I probably just need a kick in the pants, but this juggle of food and insulin is a pain... I want him to be in lower numbers, but I do not want to have to hand feed him every hour to stop him from hypo'ing or bouncing either.
As Bron would say, time to put on the patience pants.

Oh, +4.5 he's 119 so that's good.
Laura
 
Geez, there are bigger problems in this world than mine, for sure.
Wildfires have now broken out in Lytton BC, where we had record breaking high temperatures this week - 49.6 Celsius yesterday, or 121 Fahrenheit
They have evacuated the town as of 6 pm Pacific Time.
I hope Wendy is doing okay out there.
 
Hi Laura! Can you tell me what you're doing with the Budesonide now? You were on 1mg daily, now is it 1mg every other day? Or is it 0.5mg daily? I can give you some feedback on steroids. Budesonide really is the best steroid for IBD, but if in your weaning Toeby becomes symptomatic, you'll have to increase it again. And BTW I have used Budesonide on a LOT of cats with IBD, never heard about steroid dependence, wouldn't suggest worrying about it. It's all about what Toeby needs to survive, so you give the dose that is going to work the best for that. Love that you're testing out a new dose, and you will see how it goes.

Pearl takes the Pred for asthma. If she just had IBD (which she also has), then I would be using Budesonide. I know Budesonide has the fewest side effects for BG - so are you positive Toeby's FD is reacting to the steroids? When did you start the Budesonide?

Sorry for a million questions, lol. Just trying to come up to speed so I can offer some meaningfull suggestions.
 
Margaret (and Pearl) said:
Hi Laura! Can you tell me what you're doing with the Budesonide now?
Click to expand...

Hi Margaret!

I think his FD was caused by going on prednisolone in November of 2020.
We're not sure Toeby has IBD, we didn't do an ultrasound or a biopsy, but several vets in the past year have commented that he has "ropey" feeling intestines, and he has a long history of frequent vomiting.
Cancer or IBD were possible causes.
He has a heart murmur, and an enlarged heart on one side and I didn't want to put him under for tests.

His symptoms of vomiting became well controlled on the prednisolone, and continued well controlled after we switched to Budesonide.

His FD symptoms showed up in March and we started insulin therapy March 22.

Toeby started on Budesonide on April 5th, 1 mg (tablet OR flavoured chew) per day.

On May 31 his vet called me to check in before going off on a year's maternity leave.
She suggested going to every other day to wean him off and see how he did.
I skipped his dose that day, and then gave him 1 mg on June 1 and every other day ongoing.
He is still currently on 1 mg every other day.

It looked like he might be having higher BG's the morning after his dose, and better BG's the day after the night off,
I give his dose to him in the evening.
I thought going to 0.5 mgs every day might affect his BGs less, IF it was affecting them, rather than giving him 1mg one day, 0 the next.
The only way the compounding pharmacy could do up 0.5 mgs was in capsules, not tablets or chews.
I got the pharmacy staff at the vet to order me a small quantity to try.

Wednesday the vet who will be looking after us now called me when the capsules arrived at the clinic.
I guess the staff hadn't put any notes on his file for why I asked for 0.5 mg capsules.
She thought it was an order error.
I told her what I was thinking of doing.
She explained that when we are cutting back on steroids, he needs a day off, so his system doesn't get totally dependent on the action of the steroid.
She said that's why my vet said on May 31 to dose every other day.
When I got off the phone, I emailed her a link to his spread sheet and asked to clarify things.
I haven't heard from her, and probably won't until next week - I think she only works 3 days a week.

When I picked up the new 0.5 mg capsules this afternoon, I note that the bottle directs me to give him one 0.5 capsule daily for 2 weeks and then reduce dose to one every other day and call if issues arise.
The capsules are WAY bigger than the little tablets he was taking - I am not sure he will like taking them, and I may just forget about this whole experiment and stick to the tiny 1 mg tablets that I know he will take easily.
I think I should touch base with her before I make any changes.
Hopefully she will answer my email next week.

So I hope that answers your questions... NO, I am NOT positive that his FD is reacting to the budesonide.

He is 16, and as long as he has a quality life, I will do what I can for him.
I am very, very interested in your comments, especially on how you give the budesonide - I think you give it every 3 or 4 days??
Thanks so much for contacting me.
Laura
 
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