3/6 Shooter AMPS 250

So I'm feeling like a complete failure as a mom. Apparently Shooter has severe arthritis, severe neuropathy, really bad teeth, very unregulated diabetes, possible high blood pressure, they're doing a fructosamine and acro test. She wants to put on the libre for a TRUE CURVE "because I would have to test every 20 min to get a true nadir." She might want him to switch to a different insulin. I have to look it up now. It's a stronger, longer lasting called Toujeo. She gave him a shot of solensia for his arthritis and wants to do a blood pressure recheck on Friday. I feel bad his mouth must hurt so bad but she said we need to deal with his regulation, neuropathy and arthritis then his possible heart issues then his teeth. I feel so defeated. :(

@Bandit's Mom
@tiffmaxee
@Marje and Gracie
@Wendy&Neko
 
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I also don’t think you are a bad mom and I’m not sure the insulin is the issue.

He does need a 0.25u increase, though. I’m not a fan of SLGS because if a cat needs more insulin, it takes so long to get there so it looks like the insulin isn’t working.

Don’t do a fructosamine test; it’s a waste of your money. You have plenty of real-time data. We also don’t recommend that you test for acro and/or IAA until the dose hits 6u bid. He also doesn’t have very unregulated diabetes. Here are the definitions regarding regulation:
  • Not treated [blood glucose typically above 300 mg/dl (16.7 mmol/L), poor clinical signs]
  • Treated but not regulated [often above 300 (16.7) and rarely near 100 (5.6), poor clinical signs]
  • Regulated [generally below 300 (16.7) with glucose nadir near 100 (5.6), good clinical signs, no hypoglycemia]
  • Well regulated [generally below 200-250 (11.1-13.9) and often near 100 (5.6), no hypoglycemia]
  • Tightly regulated [generally below 150 (8.3) and usually in the 60-120 (3.3-6.7) range, no hypoglycemia, still receiving insulin]
  • Normalized [60-120 (3.3-6.7) except perhaps directly after meals -- usually not receiving insulin]
I would say he fits under “regulated”.
 
Marje and Gracie said:
I also don’t think you are a bad mom and I’m not sure the insulin is the issue.

He does need a 0.25u increase, though. I’m not a fan of SLGS because if a cat needs more insulin, it takes so long to get there so it looks like the insulin isn’t working.

Don’t do a fructosamine test; it’s a waste of your money. You have plenty of real-time data. We also don’t recommend that you test for acro and/or IAA until the dose hits 6u bid. He also doesn’t have very unregulated diabetes. Here are the definitions regarding regulation:
  • Not treated [blood glucose typically above 300 mg/dl (16.7 mmol/L), poor clinical signs]
  • Treated but not regulated [often above 300 (16.7) and rarely near 100 (5.6), poor clinical signs]
  • Regulated [generally below 300 (16.7) with glucose nadir near 100 (5.6), good clinical signs, no hypoglycemia]
  • Well regulated [generally below 200-250 (11.1-13.9) and often near 100 (5.6), no hypoglycemia]
  • Tightly regulated [generally below 150 (8.3) and usually in the 60-120 (3.3-6.7) range, no hypoglycemia, still receiving insulin]
  • Normalized [60-120 (3.3-6.7) except perhaps directly after meals -- usually not receiving insulin]
I would say he fits under “regulated”.
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Well crap! I feel like I just spent $616 for dumb reasons. :arghh: I didn't think I needed a fructosamine either because I test so often but she sure was adamant. She just about got me to do the libre too because it's a true curve... unlike my home testing... The acro I wasn't sure about either because he doesn't have the outward signs but she said it doesn't always show that way. o_O She said it's not the teeth or arthritis causing him to be insulin resistant and that there must be something more.

She did give him a Solensia shot for his arthritis and said there are no risks but then I got online and people are saying their cats died from it! :nailbiting: She was really upset about his neuropathy but then didn't mention anything to help it. She said she would never put him under anesthesia for his teeth or to remove the growth on his head in front of his ear until his diabetes is more regulated and they figure out more about his heart murmur. He also has Stage 2 CKD.

He is TR protocol and Bhooma mentioned that from now (5u) to 10u I go up .5u at a time. So tomorrow morning I should give him 5.5u? :eek:
 
You aren't a bad mom at all! :bighug::bighug::bighug:

It's good she gave him the Solensia shot. It's supposed to be really helpful for arthritis and I'm sure it will make him feel better. Pain also elevates numbers. Is the initial course an injection a week? Or once a month?

For neuropathy, try and see if methylcobalamin B12 helps. Although what really helps is getting his BG regulated.
https://www.felinediabetes.com/FDMB/threads/feline-diabetic-neuropathy-weak-back-legs.178252/
https://www.amazon.com/Vitamin-B12-Methylcobalamin-5000-mcg/dp/B08154TKT8/?tag=felinediabetesfdmb-20
https://www.vitacost.com/vitacost-vitamin-b-12-methylcobalamin-5000-mcg-100-capsules-6

Bandit had a dental today - she has never been a regulated cat since she eats only HC dry. She's also CKD stage 2/3. I know many vets insist on BG regulation before a dental but dental issues can affect BG regulation. Not sure what is that way out of that Catch-22 situation!

Just keep what you're doing on the dosing front. Great to see that green BG!! :D After that green you want to hold the dose a little longer.
 
Bandit's Mom said:
You aren't a bad mom at all! :bighug::bighug::bighug:

It's good she gave him the Solensia shot. It's supposed to be really helpful for arthritis and I'm sure it will make him feel better. Pain also elevates numbers. Is the initial course an injection a week? Or once a month?

For neuropathy, try and see if methylcobalamin B12 helps. Although what really helps is getting his BG regulated.
https://www.felinediabetes.com/FDMB/threads/feline-diabetic-neuropathy-weak-back-legs.178252/
https://www.amazon.com/Vitamin-B12-Methylcobalamin-5000-mcg/dp/B08154TKT8/?tag=felinediabetesfdmb-20
https://www.vitacost.com/vitacost-vitamin-b-12-methylcobalamin-5000-mcg-100-capsules-6

Bandit had a dental today - she has never been a regulated cat since she eats only HC dry. She's also CKD stage 2/3. I know many vets insist on BG regulation before a dental but dental issues can affect BG regulation. Not sure what is that way out of that Catch-22 situation!

Just keep what you're doing on the dosing front. Great to see that green BG!! :D After that green you want to hold the dose a little longer.
Click to expand...

Ok, thank you so much! I had a feeling he was gonna go down just a little more so I rechecked at +9 (because regardless of what the vet says I KNOW he almost always nadirs around +8/+9) and he was at 77 so I did hold the dose this morning.

I'll look into the B-12 for sure. Thank you. She wants to give the Solensia once a month. Man is it expensive! But if it helps him, I'll do it. I wonder why the vets feel so strongly about regulation before a dental. Especially if bad teeth can increase bg. Are they more prone to die under anesthesia?
 
Heather82372 said:
Ok, thank you so much! I had a feeling he was gonna go down just a little more so I rechecked at +9 (because regardless of what the vet says I KNOW he almost always nadirs around +8/+9) and he was at 77 so I did hold the dose this morning.

I'll look into the B-12 for sure. Thank you. She wants to give the Solensia once a month. Man is it expensive! But if it helps him, I'll do it. I wonder why the vets feel so strongly about regulation before a dental. Especially if bad teeth can increase bg. Are they more prone to die under anesthesia?
Click to expand...
We’ve had many, many cats here receive dentals. Bad teeth could be contributing to his BG. An FD cat is not more prone to die provided the vet follows a protocol for dentals on FD cats. You’ll find info here. The biggest danger, specific to FD cats, is if they don’t monitor the BG closely and it goes low. Many members give either no insulin the day of the dental or a half dose. Shooter should be the first patient of the day.
 
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