9/27 Fred AMPS 384 It's been a while

[Purrberry]

Hi everyone.

I haven't posted for quite a while, but thank you to @Suzanne & Darcy for checking in on us!

Fred and I soldier on. It's not an easy road-Fred has remained a champion bouncer in spite of all my very best efforts. He can take some crazy rides, which is why my dosing sometimes looks a little wacky. (please note, I use Alphatack, as well as custom dosing) As Fred's daily reaction to insulin can vary greatly, you will find me always erring on the side of caution, as I live in fear of hypos. I'm getting braver, though.

We are fighting against some worsening neuropathy; I have doubled his Zobaline which actually seems to have helped a bit. But it breaks my heart to see my big, strong, happy cat become a dulled-down version of himself. I have been encouraged as of late to see some lower PMPS, but Fred's pattern is that he gets down by day, and bounces by night. (though if it has to happen, I'm very happy it's not the other way around!!)

We're now about 9.5 months in, and I have pretty much given up hope he will become regulated. But I will continue to do everything I can for my boy.

Best to all the kitties and caregivers out there.

 

[tiffmaxee]

I’m sorry you are having trouble getting Fred regulated but as I see it your need to figure out how to get rid of your fear of a hypo and follow your method as written. It will also help to ditch the dry. I only see two line green tests and it came right up. You test more than enough to keep Fred safe. I think if you even follow SLGS you will be able to get him regulated. If you post when the bg is scary for you someone very likely will be able to stay with you and help you feed the curve. This will help the kidneys as well.

 

[Sue and Luci]

It looks like Fred could use some more insulin. I'm not familiar with your 'custom dosing method' except for simply observing the SS. Appears Fred is in need of some help (in the form of insulin) because his pancreas is taking a break.

Best of luck to you.

 

[Purrberry]

Hi @tiffmaxee and @Sue and Luci. Thanks for responding.

Oh, our fears! They can be mighty and mighty hard to overcome. My worst fear (well, one of them) is that someday I will come home/wake up and Fred will be seizing or comatose or worse due to a hypo. Or, that he starts to fall too low, and I cannot bring him back up, leading to the above. The first and worst experience I had with this, @Bron and Sheba (GA) was AMAZING in helping me through it, staying with me through a very long night. But I really thought I was going to lose him, and well, it really kind of scarred me. I now much better know the tricks and tools of the trade, but I also know that Fred is not very carb sensitive in the short term, and Karo will bring only him up around 8 points. So when I see it happen, I am so flooded with anxiety and fear that I can hardly see straight.

Conversely is the guilt that those fears are preventing him from getting to where he needs to be. But then added into the mess is the fact that Fred DOES go all over the place, and nothing is ever predictable. (like today. What??) It becomes a vicious cycle.

It will also help to ditch the dry.

Because Fred is such a gentle giant, he puts up with all my testing and feeding routines and hovering, etc. But he draws the line at not getting any dry. ;-) I've cut way back and changed to very low carb, but he WILL have it, or there will be a seriously angry feline.

I'm not familiar with your 'custom dosing method'

That just means I don't 100% follow any method, but I am closest to SLGS, which is what I always tried to follow in the past. However, since I do vary here and there, I thought it better to say "custom dosing", in case anyone was looking at his sheet.

@Sue and Luci I know you tried Tresiba, but ultimately switched back to Lev. I've long thought about Tresiba for Fred, as sometimes, it seems his issue is not only bouncing but duration. But there are so few people who have tried it; I'm afraid I'd really feel alone. Plus..there's my old hypo fear, and I think the risk is higher on Tresiba?

 

[tiffmaxee]

The trick will be a dose that keeps Fred in mostly yellow and blue. I’m sorry about your bad intro.

 

[Sue and Luci]

Hi @tiffmaxee and @Sue and Luci. Thanks for responding.

Oh, our fears! They can be mighty and mighty hard to overcome. My worst fear (well, one of them) is that someday I will come home/wake up and Fred will be seizing or comatose or worse due to a hypo. Or, that he starts to fall too low, and I cannot bring him back up, leading to the above. The first and worst experience I had with this, @Bron and Sheba (GA) was AMAZING in helping me through it, staying with me through a very long night. But I really thought I was going to lose him, and well, it really kind of scarred me. I now much better know the tricks and tools of the trade, but I also know that Fred is not very carb sensitive in the short term, and Karo will bring only him up around 8 points. So when I see it happen, I am so flooded with anxiety and fear that I can hardly see straight.

Conversely is the guilt that those fears are preventing him from getting to where he needs to be. But then added into the mess is the fact that Fred DOES go all over the place, and nothing is ever predictable. (like today. What??) It becomes a vicious cycle.


Because Fred is such a gentle giant, he puts up with all my testing and feeding routines and hovering, etc. But he draws the line at not getting any dry. ;-) I've cut way back and changed to very low carb, but he WILL have it, or there will be a seriously angry feline.


That just means I don't 100% follow any method, but I am closest to SLGS, which is what I always tried to follow in the past. However, since I do vary here and there, I thought it better to say "custom dosing", in case anyone was looking at his sheet.

@Sue and Luci I know you tried Tresiba, but ultimately switched back to Lev. I've long thought about Tresiba for Fred, as sometimes, it seems his issue is not only bouncing but duration. But there are so few people who have tried it; I'm afraid I'd really feel alone. Plus..there's my old hypo fear, and I think the risk is higher on Tresiba?

Hi again, I think you might benefit from reading the comments on the Tresiba forum: https://www.felinediabetes.com/FDMB/forums/tresiba-degludec.42/

Actually in my reading there, I found that lower numbers were more tolerated without harm. So I too was attempting to get a longer duration and supposedly Tresiba is better for that. I ordered one pen and wanted to give Luci a fair chance to see if it would help her. After what I thought was a decent trial I decided that her numbers overall didn't look much better than the numbers she was getting on Lev, so we went back to that.

Have you tried Young Again and/or Dr. Elsey's dry as a sub for the dry food? Luci was always a dry food girl until I found out she had diabetes and I tossed it all out. She would get an occasional can of wet food as a treat over the years and she thought she'd gone to heaven with the round the clock feeding of wet food. Although she thought she needed Temptations, we found other treats that she seems to enjoy just as well - freeze dried chicken and salmon; Orejin makes a great chewy treat and there are a variety of other freeze dried meats on Chewy - we've tried a variety of them - she's always thrilled with something new in the mix.

I'd give it a try and leave the wet in his bowl - only a little dab at a time...I think he might find himself just hungry enough to sample it...and perhaps he'll find a brand or flavor that he's really crazy about. I feed Luci a nice variety - Blue Wilderness, Purina One, Friskies, Tiny Tiger (from Chewy) and there are others - she didn't like Tiki - although other people rave about it - so keep looking and trying different flavors and brands until you find one that he likes a lot - and tell him that he can't get angry over not getting dry food, it's not good for him. I've told Luci that about many foods that she feels she needs to have - like ice cream and other human foods - she's a pretty bad kitty when it comes to raiding the counter top for contraband. I had to give up all candy in bowls around the house because Luci would help herself - and yes, it was wrapped candies like Hershey's Kisses or Halloween candy - she'd rip open the wrappers and eat the candy...such a bad kitty!

When you increase and can get him back to better numbers - watch the trends - are the numbers going down? If so, then it's time to test more frequently and feed accordingly - some cats respond better to different things - honey vs karo vs maple syrup vs ice cream! Anything with sugar and carbs will send those numbers soaring - you've just got to hit the right combo for Fred. Someone advised me once to try rice flour - carby stuff - Luci didn't like it at all...so there are other carb loaded options that Fred might enjoy and one of those options might be just the right one for Fred. Gravy style foods may not have the right combo of ingredients in it for Fred - keep trying different ones. I know there's one from Fancy Feast that has cheddar cheese in it - sends Luci's numbers soaring. I don't have to use it often but it's there for an emergency.

Try not to be so frightened of a potential hypo - I know you had a bad experience but you guys pulled through - and now you know there is so much more to it than what happened in the beginning...(I can't see an older SS, so I don't know what the numbers were at that time or even when it happened)...

Fred isn't feeling well because his blood glucose is too high...he needs a break from all that soon. I hope you can work up your courage to increase him....try some different foods and hopefully he'll start to feel like his old self soon.

 

[Wendy&Neko]

Sorry to hear Fred's neuropathy is getting worse. Zobaline plus getting him better regulated is the answer.

Unfortunately, getting him better regulated means him spending more time in better numbers, which seems to be a problem for you. Try not giving MC when he's over 200, and just do LC instead. You want to slow him down, not stop him in his tracks. Higher carbs when he doesn't need it will shorten duration too.

The link to your last post here: https://felinediabetes.com/FDMB/threads/8-17-18-fred-pmps-506-1-5-542-5-265-6-354.251604/

 

[Purrberry]

@Sue and Luci Thanks so much for all the great info on food. Fred actually DOES eat a homemade, raw diet for his wet food/main meals. The dry, which is a 75/25 mix of Young Again and Dr. Elsey's chicken, is the dry he gets for snacks and in his auto timers. He is a major snob when it comes to commercial wet...won't touch anything. ;-) And thank you for the info on hypo remedies; maybe we need to find something that will work better than the Karo!

The trick will be a dose that keeps Fred in mostly yellow and blue

Ah, my kingdom for this. It's really hard with him b/c he's such a bouncer. I'm going to very cautiously and anti-jinx say that I think we *might* be getting somewhere with leveling out. His blues now do not automatically result in a black, as was generally the case in the past. It's more one cycle good, the next cycle higher, then it repeats.

Try not giving MC when he's over 200, and just do LC instead. You want to slow him down, not stop him in his tracks. Higher carbs when he doesn't need it will shorten duration too.

Yes, I think I will definitely try that when he's over 200. When I see him falling fast, especially during the day when I'm around, I give the food to try and prevent a bounce, and less b/c I don't want him getting down. In the middle of the night, it's harder to be calm about it.

We're in a dance between 4.25, 4.5, and 4.75. Whenever we go up to 4.75, he swings more wildly, and we see blacks. Then it seems after a few days, we'll see a lime or a reduction point, and back down we go.

I'm also getting worried about his eyes and cataracts. :-/ They look a bit weird to me. We have a vet appointment on Friday.

 

[NyCatMom]

When is his last vet visit? Many years ago I had a cat who had hind leg weakness and it was related to some heart disease. I’d be curious to see his labs, I’d also ask for some B12 shots to boost his levels if his heart sounds good.

 

[Purrberry]

When is his last vet visit? Many years ago I had a cat who had hind leg weakness and it was related to some heart disease. I’d be curious to see his labs, I’d also ask for some B12 shots to boost his levels if his heart sounds good.

We last saw the vet in mid June, and we're going on Friday. I just want another check-up and labs. I know things can change rapidly, so I'm very nervous!

I'm almost 100% sure his weakness is due to neuropathy, but we can never know for sure. I did have a cardiac panel done back in April and all was well. But again, things change so quickly, especially when he's not regulated. My very first cat died suddenly of a saddle thrombosis, so I do have a great fear of those.

 

[NyCatMom]

I lost the cat I mentioned to saddle thrombosis too. She had just been diagnosed with mild cardiomyopathy and then the hind end weakness started. The blood clot came on quickly and I rushed her to the Er. Better to be safe than sorry and have the vets give him a good exam since he’s going on anyway. Good luck on Friday.