1/2 Herman amps 312, +3 299 +9 161

Amy & Herman

Member Since 2022
Herman has been hovering in the 300's last few days.

Aside from possible unconfirmed signs of nausea this morning (unconfirmed as he can also act similarly when he is anxious to go outside, I gave Ondansetron, but didn't get full dose into him) his energy, appetite and demeanor have been very good. Very playful and loving.

Happy to see some movement at +9 today. Am considering an increase in the morning, I am pretty concerned about the time he is spending in the 300's - we had come so far getting him regulated, not looking forward to his prolific bouncing again.

I have read the primer on pancreatitis. And continue to scour and read. How does one know if the pancreatitis is chronic or acute?

When I next meet with my vet I know they will want him on a new diet - do you prioritize diabetes or pancreatitis? Or are my fancy feast pate's suitable for both? (The ER vet was definitely not impressed that Herman ate fancy feast and not a diabetic food when they took our history).

I am very nervous of it happening again. Expense aside, the thought of another 3 days in ER for Herman breaks my heart. Can I catch it sooner and prevent it? Leading up to the Pancreatitis his numbers had been slowly rising, but other than that there were no other symptoms (was eating well, etc). Once I get him regulated (fingers crossed) do I take him to my regular vet any time I see a slight trend up in numbers? I had honestly planned to take Herman to my regular vet after Christmas anyway because of the rising numbers....but I guess I should have acted quicker. Would it have made a difference?

Alot of questions - I am not expecting answers - I will continue to read up. But for now I must sign off as sir Herman is here wanting some play time!
 
It looks like 2022 and 2203 SS are batched together, but for me at least, Google SS is telling me I need to ask for permission. I can’t see how long you have been on 1.25u but since you are seeing blues, if you only have been giving 1.25u for 3 cycles in 2024 I would say it is too early to increase yet.
 
Hi Amy :)
Happy to hear Herman is doing bit better. Very good news he's eating better.
Will you share with me what you're reading about pancreatitis? I'd be interested since Fistuk has that too.
I hope you were able to rest some over new year :bighug::bighug::bighug:
 
Hi Amy, I love seeing Herman wanted playtime amidst all the other stuff going on. Big hugs to both of you and happy New Year :bighug::bighug::bighug:
 
Hmm, if then that means that it has been 6 cycles on 1.25u, with mid blue at +9 I’d hold for a couple more cycles and see if there are greens on the horizon. Still can’t see the SS for 2022/2023 :)
 
Hmm, if then that means that it has been 6 cycles on 1.25u, with mid blue at +9 I’d hold for a couple more cycles and see if there are greens on the horizon. Still can’t see the SS for 2022/2023 :)
I know that we can't see the 2023 SS; Herman has been on 1.25 units for 7 cycles started on 12/30 PM cycle through 1/2 PM cycle, and the protocol would suggest she can increase. From the TR sticky (emphasis is mine):

"Increasing the dose:
  • Hold the dose for 3 - 5 days (6 - 10 consecutive cycles) if nadirs are less than 200 before increasing the dose by 0.25 unit.
    • if your cat is new to numbers under 200, it is recommended to hold the dose for at least 8-10 cycles before increasing.
    • when your cat starts to see nadirs under 100, hold the dose for at least 10 cycles before increasing."
Herman isn't new to blues and greens since coming out of remission.

You would still hold the dose?
 
It is based on the first point. Hold the dose for 6-10 consecutive cycles if nadirs are less than 200. I can’t see what happened before the first 3 cycles of 2024 and there is no data after the +9 161 which makes me wonder since numbers were trending down all day.

TR gives you a range of 6-10 consecutive cycles, even if cat is not new to blues. Can a CG increase after 6 cycles, sure. It is up to the CG to determine whether they want to increase after 6 cycles based on the data and what they know of their cat; I wouldn’t automatically say it is warranted after just 6 cycles. Could also be that the inflammation from the pancreatitis flare is subsiding.
 
From the TR sticky (emphasis is mine):

"Increasing the dose:
  • Hold the dose for 3 - 5 days (6 - 10 consecutive cycles) if nadirs are less than 200 before increasing the dose by 0.25 unit.
    • if your cat is new to numbers under 200, it is recommended to hold the dose for at least 8-10 cycles before increasing
I am glad also that you emphasized this point, because that does seem to be confusing for some members, and perhaps to clarify if you read further: if the cat is new to numbers under 200 it is recommended to hold the dose for at least 8-10 cycles, (emphasis mine) which indicates for those CGs they should not be considering increasing earlier than 8 and it might be longer than 10.

I agree that doesn’t apply to Amy and Herman.
 
@Amy & Herman, I can combine the two spreadsheets, if you'd like?

Tonight will be cycle 7 on this dose, Herman is not new to blues or greens and is a long term diabetic who has fallen out of remission. Depending on what he does tonight, I would increase tomorrow morning.
 
As I stated above, it is not a matter of whether Herman is new to blues, and yes, CGs who follow TR can increase after 6 cycles. I was just offering a few points of clarification, since I was asked why. :)
 
@Amy & Herman, I can combine the two spreadsheets, if you'd like?

Tonight will be cycle 7 on this dose, Herman is not new to blues or greens and is a long term diabetic who has fallen out of remission. Depending on what he does tonight, I would increase tomorrow morning.
Hi Bhooma, thanks for this. @Marje and Gracie set up my new spreadsheets for 2024 and helped make them so that it will convert from US to World (vs world to US) for me as I am now using a US Relion Meter and Strips but need to convert the numbers from US for my vet as we are in Canada. The $ savings by going to the US Walmart Relion vs my Canadian Contour Next is HUGE. I think that is why we needed a new spreadsheet for 2024. I just tried updating my signature. Hopefully now it links to my 2024 spreadsheet with a tab in my new sheet linking back to the precious spreadsheet. That said, I am having some issues with my new spreadsheet, it isn't updating colours when I enter a value, I copied and pasted from the line above and then it worked so I think I need to apply formatting to the whole sheet but am a little nervous of messing it up.
I agree and will increase Herman in the am unless something dramatic happens. Today he is hovering around 300 but his demeanor and appetite are good - I (think/hope) the pancreatitis flare is settling, now I need to get those numbers down.
 
I hate pancreatitis! It’s what caused Max to become diabetic as he had chronic pancreatitis for a couple of years before becoming diabetic and likely why he never went into remission. If it keeps reoccurring it’s chronic. Usually with acute episodes they get very sick but once recovered it doesn’t return. They can have both.

I knew an episode ended when I was able to remove all supportive meds and he was back to his normal. I did that one move at a time, either lowering a dose or removing a med one at a time and watched closely for several days for any symptoms returning. If any negative changes back the med came. Some cats need the support for a very long time and some not so much. This also varied by how sick he got.

Pancreatitis does not require a special diet. You just feed regular lc wet food. Some dint d well on a really high fat diet though. Max did fine on fancy feast and when he added ckd to his ailments some lower phosphorus canned foods. You don’t need a diabetic diet!

I would increase tomorrow as well unless he’s back to better numbers tonight. Max always reacted negatively to vet visits either with pancreatitis symptoms or higher bg.
 
it will convert from US to World (vs world to US) for me as I am now using a US Relion Meter and Strips but need to convert the numbers from US for my vet as we are in Canada. The $ savings by going to the US Walmart Relion vs my Canadian Contour Next is HUGE.
I did the same thing. I had a post box just across the border where I could get things shipped to. I used the spreadsheet as it comes out of the box. I just used the attached Excel file to convert the other way as I got the data.
 

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I did the same thing. I had a post box just across the border where I could get things shipped to. I used the spreadsheet as it comes out of the box. I just used the attached Excel file to convert the other way as I got the data.
I set up a special SS for her already that converts from US to World :):)
 
I hate pancreatitis! It’s what caused Max to become diabetic as he had chronic pancreatitis for a couple of years before becoming diabetic and likely why he never went into remission. If it keeps reoccurring it’s chronic. Usually with acute episodes they get very sick but once recovered it doesn’t return. They can have both.

I knew an episode ended when I was able to remove all supportive meds and he was back to his normal. I did that one move at a time, either lowering a dose or removing a med one at a time and watched closely for several days for any symptoms returning. If any negative changes back the med came. Some cats need the support for a very long time and some not so much. This also varied by how sick he got.

Pancreatitis does not require a special diet. You just feed regular lc wet food. Some dint d well on a really high fat diet though. Max did fine on fancy feast and when he added ckd to his ailments some lower phosphorus canned foods. You don’t need a diabetic diet!

I would increase tomorrow as well unless he’s back to better numbers tonight. Max always reacted negatively to vet visits either with pancreatitis symptoms or higher bg.
Thanks for this. I’ve weened him off the ondansetron and his appetite remains good, today I gave him a gabapentin at pmps as his number was so high and I was worried pain might have raised his BG, he was acting normal though. It’s a bit of a dance! Planning to increase in the morning.
 
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