8/11 Toeby - AMPS 140, +2 94, +4 50, +4.5 50, +5 49, 56, +6 67, PMPS 169, +2.5 122, +4 104.

[Laurasboyz]

Last post on Saturday Aug 7: https://www.felinediabetes.com/FDMB...4-72-5-88-pmps-175-2-185.251008/#post-2831774

I heard from the vet today and they will be re-ordering the 0.5mg Budensonide from the pharmacy and would like me to keep giving it to him on an every other day schedule.
I learned today that it is primarily intended to treat suspected cancer, not just IBD, and stopping it or reducing it could trigger a rapid growth of the cancer.
I always knew intestinal cancer was a possibility for him, but I didn't know that budesonide helps keep cancer in check.

It's been suggested I could try giving him a small dose of insulin on the days he gets his steroid, or try going off it altogether and see what happens with his blood sugar, as he MIGHT be going into remission.
I'm wondering if anyone has any experience with a dosing schedule other than daily?

I do feel that, given his track record this past week, 0.2 units of insulin is still too much on the day following his "skip the Budesonide day" - he went low on me again this morning, and it seems to be getting harder to get him back UP once he goes low.

 

[Bron and Sheba (GA)]

I would go down to 0.1 which looks like you did this cycle then down to a drop. You want a strong remission. You are nearly there. But we would like to see some more green BGs.
Are you still feeding during the cycles?
Try feeding a +9 snack both cycles to see if that helps bring down the preshots.
I’ll tag @Wendy&Neko as she has experience with giving budensodine. She may not be around for a few more days though. If she doesn’t see this tag within a week, tag her again and ask her.

 

[Katherine&Ruby]

Hi Laura, sorry Toeby keeps dropping on you. Ruby is on prednisolone for her lymphoma (cancer) and her gastrointestinal symptoms have improved a lot. Her oncologist has not prescribed chlorambucil (chemo pill) unless her symptoms don't improve, so it sounds like you have a very good vet. On the IBD kitties Facebook group I belong to, many of the caregivers do give chlorambucil if the cats don't respond well to steroids, as in the case of diabetic cats. The admins of the FB group are really good, and they might be able to address some of your questions, though not with regards to diabetes. Because Lantus is a depot insulin, I don't know that giving insulin one day and not another will work very well.

I don't know of other kitties here on budesonide. Wendy is the best person to ask when she comes back from vacation.

My other thought is for you to keep Toeby on the lowest dose of insulin needed to keep him below 200 (renal threshold) and above 50. .1 unit dose might work for that, and Bron's advice to feed him at +9 in each cycle is a really good one.

 

[Laurasboyz]

Are you still feeding during the cycles?
Try feeding a +9 snack both cycles to see if that helps bring down the preshots.

Hi Bron, nice to hear from you - I hope you are well?
I do still feed during the cycles - primarily when I am testing him in the mornings and earlier evenings, as he sleeps most of the afternoons away, and I try to sleep at night (I am NOT a good sleeper).
Both he and his brother snooze more as they age.
I am not sure I will always be around the house or awake to get him a snack at +9, but I will try.
We always go to bed with food down for them to eat during the night.

 

[Bron and Sheba (GA)]

We are fine here thanks except we are in lockdown because of the delta virus.
Have you thought of getting an automatic timed feeder. They are great for when you can’t be there. Petsafe 5 is good.

 

[Laurasboyz]

...so it sounds like you have a very good vet.

Hi Katherine,
I agree!
She is stepping into his case part way through, however the vet who we had been working with (who is off on maternity leave for a year) discussed his case with her before she left, which I think is great.
I don't think she's quite on the same page as people here on everything, but that's okay.
Her #1 concern is that Toeby not be put into danger, and that is common ground any one can agree on.

 

[Laurasboyz]

We are fine here thanks except we are in lockdown because of the delta virus.
Have you thought of getting an automatic timed feeder. They are great for when you can’t be there. Petsafe 5 is good.

Bron, I have a crappy timed feeder I used to use years ago for if we went away just overnight.
I'll have a look at your recommendation for a better one.
They do have food down during the day, that we take up 2 hours before shot time...

Oh, and edited to add, I am sorry you're still under lockdown...
I find it hard to realize we're OUT of lockdown now... the border to the USA just opened today, I think... I'll soon see license plates from visitors not just from outside the province, but from the USA too...

 

[Sienne and Gabby (GA)]

I do have one thought. Given that Toeby likes to drop closer to nadir but the pre-shots are higher than normal range, there are two options right off the top of my head. Giving a snack at +9 or there about may result in lower pre-shot numbers,. The food may stimulate your kitty's pancreas to produce some insulin and lower the numbers. (A timed feeder would be helpful!)

Another strategy is to try to prevent a dose reduction. when you seen numbers edging down, feed some low carb (or MC) to prop the numbers up. Overall, Toeby isn't ready to stop insulin despite some of the lime green numbers. Preventing the reduction and keeping him surfing in numbers above 50 may help.

 

[Laurasboyz]

[QUOTE="Sienne and Gabby (GA), post: 2834545, member: 95" when you seen numbers edging down, feed some low carb (or MC) to prop the numbers up.[/QUOTE]

Thanks Sienne
There is food available all day for he and his brother except for 2 hours before his PM shot, and at night we put food down before bed, but I do not get up to take up whatever might make it to 4:45 am, as I get up at 6:45 am to give his insulin by 7am.
It still surprises me that he eats snacks for me - it is usually because I mix warm water in it and make a fuss over it, I think.
He will eat a snack from me this way, even when he eats the food in his bowl.
So I'm not sure how big a difference a timed feeder would make, but I am reading all these comments and considering everything, for sure.