New Member Blandine & Fénix

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Blandine & Fénix

Blandine & Fénix

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I’m Blandine from France, and I'm Fénix's mom. He’s a 14-year-old neutered male who’s been dealing with diabetes for about a year now. Despite our best efforts, we haven’t seen significant progress, and we’re struggling with issues that seem to be recurring without resolution.

I’ve been following a treatment protocol inspired by Roomp and Rand’s guidelines, recommended by a French group. I’m hometesting with a human blood glucose meter, and my spreadsheet for tracking Fénix’s data is in French, though it uses the same format and structure you’re all familiar with. His current insulin is Levemir; I started with Caninsulin but switched as we tried to improve his control. Fénix eats kibble freely (Virbac hpm Senior), as he’s picky about food and won’t touch pâté.

The main reason I'm here is because of the rebound patterns we keep experiencing, which never seem to improve despite adjustments. Increasing the insulin dose doesn’t resolve these spikes, and lowering the dose after lower readings hasn’t worked either. This pattern has been ongoing for a year, and I feel quite stuck without knowing what to try next.

I’d appreciate any advice or feedback, especially if anyone has had a similar experience with slower progress or found any treatment adjustments helpful in similar cases. I’m here to learn and connect with other caregivers who may have gone through something like this.

I’ve spent quite a bit of time reading the forum, trying to absorb as much as I can, but I’m not very comfortable with English. I’m relying on translators to help me understand and communicate, so I’ll try to be as clear as possible, but please bear with me if I make any mistakes or if something isn’t clear. Your patience is greatly appreciated!

Thank you so much for your support!
 
Blandine & Fénix said:
I’m Blandine from France, and I'm Fénix's mom. He’s a 14-year-old neutered male who’s been dealing with diabetes for about a year now. Despite our best efforts, we haven’t seen significant progress, and we’re struggling with issues that seem to be recurring without resolution.

I’ve been following a treatment protocol inspired by Roomp and Rand’s guidelines, recommended by a French group. I’m hometesting with a human blood glucose meter, and my spreadsheet for tracking Fénix’s data is in French, though it uses the same format and structure you’re all familiar with. His current insulin is Levemir; I started with Caninsulin but switched as we tried to improve his control. Fénix eats kibble freely (Virbac hpm Senior), as he’s picky about food and won’t touch pâté.

The main reason I'm here is because of the rebound patterns we keep experiencing, which never seem to improve despite adjustments. Increasing the insulin dose doesn’t resolve these spikes, and lowering the dose after lower readings hasn’t worked either. This pattern has been ongoing for a year, and I feel quite stuck without knowing what to try next.

I’d appreciate any advice or feedback, especially if anyone has had a similar experience with slower progress or found any treatment adjustments helpful in similar cases. I’m here to learn and connect with other caregivers who may have gone through something like this.

I’ve spent quite a bit of time reading the forum, trying to absorb as much as I can, but I’m not very comfortable with English. I’m relying on translators to help me understand and communicate, so I’ll try to be as clear as possible, but please bear with me if I make any mistakes or if something isn’t clear. Your patience is greatly appreciated!

Thank you so much for your support!
Click to expand...
Welcome Blandine and Fenix, I first have to congratulation for being so way ahead of me from when I started this Forum, I had no idea about Feline Diabetes, or what to do, I am no expert on insulins, so I will tag someone that can help you with that, right off what caught my attention as of why
Fenix cannot regulate his Glucose numbers is his diet, diabetic cats need a low carb wet food diet between 0-10% carbs, the kibbles you are feeding, and freely, have from 25-35% carbs, even "prescribed" foods are just as bad, I do not know what brand of foods are available in France, but to give you an idea below is a Dr's Food list where you will find the % in carbs in the third column, it is at times difficult to transition from kibbles to wet food, but it is a process, a slow process at times, but it can be done, if you want Fenix to have a healthy pancreas, see cats cannot digest carbs, so the pancreas compensates, and as you know they poop quite a lot, because the food is not digested, unlike wet foods, if and when you transition to wet food you should have what is called a HYPO KIT this should contain some medium carb foods between 11-15% and some High carb foods between 16-24 as well as some Honey or Karo Syrup, and his glucose should be checked regularly once this transition starts, since his numbers might get lower in the process, we are here for you, no concern is a small concern:bighug::cat::cat:
@Wendy&Neko
@Sienne and Gabby (GA)
https://www.felinediabetes.com/FDMB...r-more-than-just-carbohydrate-content.175004/
https://www.felinediabetes.com/FDMB/threads/dr-pierson-new-food-chart.174147/
 
Welcome to FDMB!

In looking at Fenix's data, there are a few things that stood out. Earlier in the year, you weren't taking dose reductions at points where they were warranted. With Roomp & Rand's Tight Regulation Protocol, you want to reduce the dose whenever the numbers are below 50 (during the first year from diagnosis) and once a cat is more than a year past diagnosis, the dose is reduced if numbers drop below 40. If you are following the published protocol, doses are held for 3 days. It looks like you're holding doses considerably longer. Holding the doses for too long may make it harder to get the dose into a more desirable range. Your cat's body become accustomed to being in higher numbers. I'd also suggest that when you need to reduce the dose, you reduce by 0.25u.

Please let us know if you have more questions. I'm trying to see if we have any members who speak French fluently so be can be of greater help.
 
@Blandine & Fénix
Welcome
Can you please set up your signature
Information we need about Fenix
It's at the end of everyone's post in gray letters
Please be sure to add you are from France
If you can add it in the English language that would be great

This is where you can set up what we call your signature, it's at the end of everyone's post in gray letters. Just tap on your name up top then tap on signature and add this information. You will link it to your spreadsheet

  • Add info we need to help you:
    • Caregiver & kitty's name
    • DX: Date
    • Name of Insulin (do not include dose or frequency)
    • Name of your meter
    • Diet: "LC wet" or "dry food" or "combo"
    • Dosing: TR or SLGS or Custom (if applicable)
    • DKA or other recent health issue (if applicable)
    • Bexacat or Senvelgo (if applicable) and dates
    • Acro, IAA, or Cushings (if applicable)
    • Spreadsheet link. Please put the signature link on the bottom line of your signature information, on its own, so it is easy to find.
    • Please do not put any information about your location in the signature for security reasons. If you wish to add your country location, please add it to your profile.
Be sure to click the 'Save Changes' button at the bottom. If you need help urgently it is important we know these things at a glance. We don’t want to waste valuable time finding out information.
Can you put in your signature that your kitty was on Caninsulin and switched to Levimer and the date you switched

Take a look here might have low carb wet foods
that you can get and are not too expensive

https://docs.google.com/spreadsheets/u/1/d/1J5JpMe6TDXrHq_aTl9hUtHy6Gs9oRBqlz4nPGKxtySA/pubhtml

If you have to post some things in French we can use Google Translate and add it under what you posted in English

Or you can post in French and go to Google Translate yourself and copy and paste it in English

French
English






Translation
 
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Blandine & Fénix said:
I’ve spent quite a bit of time reading the forum, trying to absorb as much as I can, but I’m not very comfortable with English. I’m relying on translators to help me understand and communicate, so I’ll try to be as clear as possible, but please bear with me if I make any mistakes or if something isn’t clear. Your patience is greatly appreciated!

Thank you so much for your support!
Click to expand...
@cecile & bella
Hi Cecile I know you are French ,so is this new member , do you speak French ? If she need help with anything
 
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Blandine & Fénix said:
I’m Blandine from France, and I'm Fénix's mom. He’s a 14-year-old neutered male who’s been dealing with diabetes for about a year now. Despite our best efforts, we haven’t seen significant progress, and we’re struggling with issues that seem to be recurring without resolution.

I’ve been following a treatment protocol inspired by Roomp and Rand’s guidelines, recommended by a French group. I’m hometesting with a human blood glucose meter, and my spreadsheet for tracking Fénix’s data is in French, though it uses the same format and structure you’re all familiar with. His current insulin is Levemir; I started with Caninsulin but switched as we tried to improve his control. Fénix eats kibble freely (Virbac hpm Senior), as he’s picky about food and won’t touch pâté.

The main reason I'm here is because of the rebound patterns we keep experiencing, which never seem to improve despite adjustments. Increasing the insulin dose doesn’t resolve these spikes, and lowering the dose after lower readings hasn’t worked either. This pattern has been ongoing for a year, and I feel quite stuck without knowing what to try next.

I’d appreciate any advice or feedback, especially if anyone has had a similar experience with slower progress or found any treatment adjustments helpful in similar cases. I’m here to learn and connect with other caregivers who may have gone through something like this.

I’ve spent quite a bit of time reading the forum, trying to absorb as much as I can, but I’m not very comfortable with English. I’m relying on translators to help me understand and communicate, so I’ll try to be as clear as possible, but please bear with me if I make any mistakes or if something isn’t clear. Your patience is greatly appreciated!

Thank you so much for your support!
Click to expand...
@Suzanne & Darcy
Whenever you get a minute can you please take a look at her Spreadsheet
Thank you
 
Hello and thank you everyone!

@Diane Tyler's Mom GA I can't write everything on my signature, you can see more details on my personal details.

I realize there is a strong preference here for low-carb or grain-free diets to help stabilize blood glucose, but I’m facing a bit of a dilemma with Fénix’s specific needs.
In the French group I follow, grain-free diets (dry food only) are often discouraged, especially for older cats, because they might be less protective for the kidneys. Fénix is currently on Virbac HPM Senior, which isn’t specifically formulated for diabetes but is designed to support kidney health in older cats. Before his diabetes diagnosis, he was on Orijen (a grain-free food), and he still developed diabetes, which is why I switched to Virbac shortly after his diagnosis.
Additionally, feeding only wet food is also recommended in France, but despite my efforts, Fénix refuses it and has a history of anorexia. I’m concerned about forcing him on a diet he won’t accept, especially given the risks with his condition.
There is also a list of recommended wet foods and kibbles in the French group, created based on the research of a feline nutrition specialist : https://docs.google.com/spreadsheets/d/14WLRLwdKXKIFSv3_d8DuWvuLQLankalTk_CnhWNIx4I/edit?usp=sharing
I’m feeling a bit lost between these recommendations and the focus on low-carb options.

At the beginning, I was torn between the French group’s recommendation of increasing the dose every 2–3 days and my vet’s advice to hold each dose for 20 days. My initial understanding of the protocol was shaky, and then an early hypoglycemic event with symptoms led to an emergency vet visit. This experience left me with a lingering fear of hypos, which has influenced my choices since.
In response to that fear, I often ended up lowering the dose too much, skipping injections, or switching to 18-hour cycles. Holding doses longer than recommended seemed to help somewhat in the late spring, but ultimately, it wasn’t effective, and I struggled to reach stable numbers over the summer. In France, the reduction threshold is 50, not 40, and injecting down to 50 was the reason Fénix ended up in a symptomatic hypo. That experience made it difficult to stick to the protocol completely. Be sure I have my complete hypoglycemia kit!

@cecile & bella Bonjour ! J'ai juste une question concernant le fonctionnement du forum : j'ai cru lire qu'il fallait changer de publication tous les jours, est-ce que j'ai bien compris ? Est-ce que là j'aurais dû ouvrir un autre topic pour répondre à tout le monde (mais avec quel titre ?) ? C'est le fonctionnement qu'on a sur le groupe en France, mais c'est un groupe facebook ; sur un forum ça me choque un peu plus (surtout que je n'ai pas le même fuseau horaire que la majorité des gens ici du coup). Merci :)
 
Bonjour Blandine,
Je suis aussi francophone, et non, il n’y a pas besoin de changer de publication tous les jours. Dans la partie du forum qui est spécifique à l’insuline de longue durée (Lantus, Levemir& Biosimilar) on poste les résultats journaliers du glucose sanguin, mais sinon, si un thread dépasse les 50 réponses, il est demandé d’en faire un autre en mettant le lien du précédent. Le titre peut être tout simplement quelque chose dans le genre “continued thread etc… nom du chat”.

Merci beaucoup pour la liste détaillée des aliments qu’on trouve en Europe! On a tellement moins de choix ici, c’est très frustrant, et super utile de trouver ce type de listes!

Je vois que Fénix a de l’hypertension, est-ce qu’il est traité pour ça à l’amlodipine? En France c’est le médicament vétérinaire Amodip. C’est très important que l’hypertension soit traitée.

Bienvenue sur ce forum!
 
We use two approaches to dosing -- Tight Regulation which you're already familiar with and a method that was developed here, Start Low Go Slow (SLGS). With a cat that is eating a dry food diet, you should not be using Tight Regulation. It's too aggressive and that information was in the original Roomp & Rand publication. I'm linking our post on dosing methods for you to review. SLGS will give you what I'm guessing will be a more comfortable set of guidelines.

I don't know if the group in France considers recommending a raw food diet or if that would be a choice that would appeal to Fenix. That may also be an option. However, you need to add supplements to raw food to ensure it is nutritionally complete.
 
Sienne and Gabby (GA) said:
We use two approaches to dosing -- Tight Regulation which you're already familiar with and a method that was developed here, Start Low Go Slow (SLGS). With a cat that is eating a dry food diet, you should not be using Tight Regulation. It's too aggressive and that information was in the original Roomp & Rand publication. I'm linking our post on dosing methods for you to review. SLGS will give you what I'm guessing will be a more comfortable set of guidelines.

I don't know if the group in France considers recommending a raw food diet or if that would be a choice that would appeal to Fenix. That may also be an option. However, you need to add supplements to raw food to ensure it is nutritionally complete.
Click to expand...

Sorry for the cross-post!

I reviewed the SLGS method yesterday—it's new to me, and it seems like a safer approach. After a year of managing Fenix’s diabetes, my goal is less about remission at any cost and more about ensuring he’s comfortable and stable.

In France, the issue of dry food with the Roomp & Rand protocol isn’t typically discussed, though there’s a strong recommendation for a wet-only diet. However, the emphasis remains on ensuring the cat eats, even if it’s only kibble. A homemade diet (raw) is, on the other hand, strongly discouraged.

@Daphne and Aida
Bonjour !
Merci pour la précision, j'aurais fait une bêtise du coup ^^'
Pas de soucis pour la liste, c'est toujours chouette de pouvoir comparer !

Oui, il est traité pour l'hypertension avec Amodip. En fait, ça fait un an que je sais qu'il a de l'hypertension (au diagnostique du diabète on a fait un point complet), mais sa véto d'alors ne voulait pas le traiter pour ça avant de stabiliser le diabète. Comme je n'ai jamais pu le stabiliser... ben j'ai changé de véto fin septembre, qui n'est toujours pas bon pour le diabète, mais au moins j'ai un traitement pour son hypertension (qui apparemment crevait le plafond). Il a aussi une petite hypokaliémie sans symptômes, il est complémenté avec K for cat, la prochaine pds pour vérifier pour tout ça est fin novembre.

Honnêtement je suis un peu perdue avec toutes les infos qui peuvent être contradictoires entre les groupes français, anglais, et allemand (oui, j'ai même regardé du côté allemand, je crois qu'ils sont les pionniers du genre). Entre ça et le véto qui me dit que le seuil rénal c'est 300, qu'un chat non diabétique est aux environs de 200... Et mon premier véto qui voulait que je fasse qu'une seule piqûre de levemir par jour, je me sens un peu seule pour tout gérer !
 
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Blandine & Fénix said:
@cecile & bella Bonjour ! J'ai juste une question concernant le fonctionnement du forum : j'ai cru lire qu'il fallait changer de publication tous les jours, est-ce que j'ai bien compris ? Est-ce que là j'aurais dû ouvrir un autre topic pour répondre à tout le monde (mais avec quel titre ?) ? C'est le fonctionnement qu'on a sur le groupe en France, mais c'est un groupe facebook ; sur un forum ça me choque un peu plus (surtout que je n'ai pas le même fuseau horaire que la majorité des gens ici du coup). Merci :)
Click to expand...
Oui, tu as bien compris. Pour ce post, ici, tu peux continuer de répondre sans en ouvrir de nouveau. mais une fois que tu vas commencer à poster dans le forum Lantus, il faut faire un nouveau post chaque jour, avec la date, le nom de ton chat, puis les valeurs de glycémie avec les heures. C'est tout expliqué ici: https://www.felinediabetes.com/FDMB/threads/posting-guidelines-please-read.231511/
De cette façon, c'est beaucoup plus facile pour les membres qui veulent aider de lire tout le post. On ajoute le lien vers le post précédent en haut du premier message pour pouvoir lire plus de deetails si besoin. peu importe le fuseau horaire, ce qui compte c'est les "heures" par rapport à l'heure d'injection: AMPS c'est la glycémie juste avant l'injection du matin, puis on note les valeurs suivantes comme sur la feuille de données, +1, +3, etc, jusqu'à PMPS pour celle du soir. Il y a des membres un. peu partout, en Amérique, Europe, Asie, etc. Ce qui est bien c'est que cela veut dire qu'il y a tujours quelqu'un potentiellement réveillé et qui peut répondre en cas de problème.
J'ai regardé la liste de nourritures que tu as postée. On conseillerait beaucoup des pâtées qui sont dans les deux dernières listes. Rien qu'une nourriture basse en glucides permet souvent de faire baisser les besoins en insuline, parfois même d'obtenir une rémission. Si Fenix ne veut vraiment pas manger de pâtée, il faut suivre l'autre protocole, SLGS, que je connais moins.
Personnellement maintenant. Bella était très difficile à contrôler tant que je suivais les conseils de la vétérinaire, qui ressemblaient un peu à ceux que tu as eu du tien. J'ai trouvé le forum après un épisode d'hypo où j'ai réalisé que je n'avais aucune instruction logique de sa part. je suis médecin, j'ai quelques idées sur ce qui est dangereux avec l'insuline mais j'aurais aimé avoir bien plus de marches à suivre. En farfouillant sur internet j'ai trouvé ce forum. Si tu regardes la fiche de Bella, c'est assez frappant: à partir du moment où j'ai suivi le protocole ici et écouté ce que les membres expérimentés me conseillaient (j'avais du mal au début :) ), ses chiffres se sont normalisés très vite.
ma vétérinaire voulait aussi que j'arrête la nourriture crue, que je lui donne des pâtées "prescription"... le taux de glucides était 22%, c'est énorme! Bella a en général entre 0 et 4%, sauf en cas de chiffre bas, là je monte jusqu'à 10 et en général elle remonte bien.
Les valeurs en-dessous desquelles on peut faire l'injection varient. Pour un chat diagnostiqué récemment, tant que tu n'as pas une bonne idée de comment il va réagir à l'insuline et à la nourriture, le chiffre est plus haut. Quand ça fait longtemps met que tu connais ton chat, c'est different. J'ai déjà donné une dose normale à Bella avec un taux pre-injection dans les 50, parce que je sais comment elle réagit à la nourriture, si c'est un jour où je suis à la maison, que je peux surveiller sa glycémie, etc.
Je te conseille de poster dans le forum Lantus, dès que tu seras prête, tu auras beaucoup plus de conseils pour ton cas particulier.

For non-French speaking members:
Yes, that's correct. You can keep adding to this post, but once you start posting in the Lantus forum, it is better to open a new post every day, with a title including the date, name of your cat, and BG with times. It's all exlained in details here: https://www.felinediabetes.com/FDMB/threads/posting-guidelines-please-read.231511/
This way, it is a lot easier for members who want to help you to read the whole post. We also link the previous day's post at the top of the day, so we can read more details if needed.
The time zone where you are is not important, what counts is the number of hours since shot time: AMPS is BG just before morning injection, then we indicate the times as on your spreadsheet: +1, +_2, etc. up to PMPS, for night time shot, and then same for the night.
There are members from everywhere in the world. The great thing with that is that there will always be someone who is awake if you need help.
I looked at the list of foods you linked. Here we would advise you to use some of the wet food on the last 2 lists. Often, feeding a low-carb diet can be enough to dramatically lower the needs in insulin, and sometimes even getting a cat into remission. If Fenix refuses to eat any wet food, then you would need to follow the SLGS protocol, which I know a lot less about.
My cat, Bella, was very difficult to contro;l as log as I was following our vet's advice, which were very similar to what you are saying about yours. I found this forum after a hypo scare, when i realized I had no steps to follow and did not know what was safe. i am a physician and have some notions of what is dangerous with insulin but not in cats, and I wanted a more precise and logical protocol. If you look at Bella's SS, it's amazing what happened after I started following advice fom experimented members here, her numbers got lower very fast and she is now regulated.
My vet also stringly advised against keeping her raw diet, and feed her prscription food. Those had a glucose content of 22%, which is huge. Bella typically eats foods wth between 0 and 4% of glucose, I go up to 10 and for her in general it's enough to bring her up.
The BG values that are safe to inject vary. For a newly diagnosed cat, when you don't know how the cat will react to insulin and food, we use a higher number. After a long time, when you know your cat very well, it's different. Shooting in the 50s is fine once you know your cat, the way he will rcat to food, and you know you will be there to test and watch him, etc.
I think you should start posting in the Lantus specific forum, where you will get a lot more advice for your specific situation.
 
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Blandine & Fénix said:
I’m Blandine from France, and I'm Fénix's mom. He’s a 14-year-old neutered male who’s been dealing with diabetes for about a year now. Despite our best efforts, we haven’t seen significant progress, and we’re struggling with issues that seem to be recurring without resolution.

I’ve been following a treatment protocol inspired by Roomp and Rand’s guidelines, recommended by a French group. I’m hometesting with a human blood glucose meter, and my spreadsheet for tracking Fénix’s data is in French, though it uses the same format and structure you’re all familiar with. His current insulin is Levemir; I started with Caninsulin but switched as we tried to improve his control. Fénix eats kibble freely (Virbac hpm Senior), as he’s picky about food and won’t touch pâté.

The main reason I'm here is because of the rebound patterns we keep experiencing, which never seem to improve despite adjustments. Increasing the insulin dose doesn’t resolve these spikes, and lowering the dose after lower readings hasn’t worked either. This pattern has been ongoing for a year, and I feel quite stuck without knowing what to try next.

I’d appreciate any advice or feedback, especially if anyone has had a similar experience with slower progress or found any treatment adjustments helpful in similar cases. I’m here to learn and connect with other caregivers who may have gone through something like this.

I’ve spent quite a bit of time reading the forum, trying to absorb as much as I can, but I’m not very comfortable with English. I’m relying on translators to help me understand and communicate, so I’ll try to be as clear as possible, but please bear with me if I make any mistakes or if something isn’t clear. Your patience is greatly appreciated!

Thank you so much for your support!
Click to expand...
Blandine & Fénix said:
Sorry for the cross-post!

I reviewed the SLGS method yesterday—it's new to me, and it seems like a safer approach. After a year of managing Fenix’s diabetes, my goal is less about remission at any cost and more about ensuring he’s comfortable and stable.

In France, the issue of dry food with the Roomp & Rand protocol isn’t typically discussed, though there’s a strong recommendation for a wet-only diet. However, the emphasis remains on ensuring the cat eats, even if it’s only kibble. A homemade diet (raw) is, on the other hand, strongly discouraged.

@Daphne and Aida
Bonjour !
Merci pour la précision, j'aurais fait une bêtise du coup ^^'
Pas de soucis pour la liste, c'est toujours chouette de pouvoir comparer !

Oui, il est traité pour l'hypertension avec Amodip. En fait, ça fait un an que je sais qu'il a de l'hypertension (au diagnostique du diabète on a fait un point complet), mais sa véto d'alors ne voulait pas le traiter pour ça avant de stabiliser le diabète. Comme je n'ai jamais pu le stabiliser... ben j'ai changé de véto fin septembre, qui n'est toujours pas bon pour le diabète, mais au moins j'ai un traitement pour son hypertension (qui apparemment crevait le plafond). Il a aussi une petite hypokaliémie sans symptômes, il est complémenté avec K for cat, la prochaine pds pour vérifier pour tout ça est fin novembre.

Honnêtement je suis un peu perdue avec toutes les infos qui peuvent être contradictoires entre les groupes français, anglais, et allemand (oui, j'ai même regardé du côté allemand, je crois qu'ils sont les pionniers du genre). Entre ça et le véto qui me dit que le seuil rénal c'est 300, qu'un chat non diabétique est aux environs de 200... Et mon premier véto qui voulait que je fasse qu'une seule piqûre de levemir par jour, je me sens un peu seule pour tout gérer !
Click to expand...

This is why I love this Forum, everyone anywhere in the world can get assistance, it gives me goose bumps to see so many dedicated members helping each other, you are in great hands. just trust the advise and Fenix will be on better numbers on no time, I spoke wrote and read French, but since I have not used it in 20 years, is totally forgotten, I can read it some though if I really try hard, but I still understand it when spoken.:bighug::bighug::cat::cat:
 
Blandine & Fénix said:
Diane Tyler's Mom GA I can't write everything on my signature, you can see more details on my personal details.
Click to expand...
@Blandine & Fénix
Can you just fit in your signature SLGS since you are feeding dry food


Pouvez-vous simplement mettre votre SLGS signature puisque vous donnez de la nourriture sèche




In case any members want to see more information Fenix it's in her profile page where it says informatio
 
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Thank you everyone!
@Diane Tyler's Mom GA no need to translate in french, I just have difficulties to speak correct english (Deepl is my friend :D )
I can't change my signature. I have an error message "spam". Most of the informations are on my speadsheet, you can also see blood test results.

@CORKY You're better than I am! I can't speak or write properly in anything but my own language :p

@cecile & bella I dreaded the diagnosis of diabetes because I myself have an endocrine disease (Hashimoto's disease). I know how hard it is to deal with hormone issues and find the right doctor to listen...

I'm going to try wet food again, I still have cans from the last time I tried it. You never know! And I'm going to increase the insulin by 0.25, I haven't seen any improvement in a week.
 
Bonjour Blandine- je comprends le français parce que je l’ai étudié ici au Canada comme deuxième langue :).

Since you are able to understand English well, I will continue in English, but am happy to correspond with you also in French if you prefer.

I am not sure what information you have been given in the past on other forums, but yes, there are certainly some differences in suggested dosing methods elsewhere out there. Sienne has already shared the dosing methods we follow here on this forum in post #11.

I would like to offer a few observations from my experience since I have been using Levemir for the last several years. In looking at your spreadsheet for Fénix, I see some patterns that are very common for cats who are on Levemir. In many cases, cats on Levemir typically onset at +4 and nadir around +8 but sometimes you will find that the nadir is actually the next preshot or sometimes a little after. I’ve had more than a few cycles where my cat’s nadir carries into +14 or +15.

This is important to note because it influences how one thinks about feeding. While it is true with Lantus that many caregivers choose to feed only in the first half of the cycle, this is because cats on Lantus tend to onset earlier and nadir earlier so feeding after nadir would tend to put the brakes on whatever remaining duration the insulin dose has for the rest of the cycle. Those of us who use Levemir need to consider that onsets and nadirs can happen later than typical for Lantus which means needing to feed later in the cycle as a result.

I agree with you on the increase; however, if you are planning to make an immediate change from the higher carb dry food to wet food, I would only do one or the other, not both at the same time. I would hold off on the increase if you are changing food now, and see how his blood glucose numbers are for several days, since we often find kitties will need less insulin when the dry food is removed.

Questions?
 
Christie & Maverick said:
Bonjour Blandine- je comprends le français parce que je l’ai étudié ici au Canada comme deuxième langue :).

Since you are able to understand English well, I will continue in English, but am happy to correspond with you also in French if you prefer.

I am not sure what information you have been given in the past on other forums, but yes, there are certainly some differences in suggested dosing methods elsewhere out there. Sienne has already shared the dosing methods we follow here on this forum in post #11.

I would like to offer a few observations from my experience since I have been using Levemir for the last several years. In looking at your spreadsheet for Fénix, I see some patterns that are very common for cats who are on Levemir. In many cases, cats on Levemir typically onset at +4 and nadir around +8 but sometimes you will find that the nadir is actually the next preshot or sometimes a little after. I’ve had more than a few cycles where my cat’s nadir carries into +14 or +15.

This is important to note because it influences how one thinks about feeding. While it is true with Lantus that many caregivers choose to feed only in the first half of the cycle, this is because cats on Lantus tend to onset earlier and nadir earlier so feeding after nadir would tend to put the brakes on whatever remaining duration the insulin dose has for the rest of the cycle. Those of us who use Levemir need to consider that onsets and nadirs can happen later than typical for Lantus which means needing to feed later in the cycle as a result.

I agree with you on the increase; however, if you are planning to make an immediate change from the higher carb dry food to wet food, I would only do one or the other, not both at the same time. I would hold off on the increase if you are changing food now, and see how his blood glucose numbers are for several days, since we often find kitties will need less insulin when the dry food is removed.

Questions?
Click to expand...

Can't agree more! The French group obviously talks about nadir, but I've never seen a detailed hour-by-hour effect (I've seen the sticky that talks about it and I think it's fabulous). I always thought that a higher value at +3 or +4 than the preshot was a rebound, but not necessarily! I am so agree for the nadir timing and I think it's a part of my problem. I tried to convince my vet to switch to Lantus to avoid this problem, but my vet was so happy with BG values (late september in my spreadsheet) that he refused.

My cat has all-you-can-eat kibble. His bowl is never empty, and he eats when he wants and needs to, making several small meals throughout the day on his own. I think this is the right way for a cat to eat (apart from dry food) and I wouldn't want to break it by imposing schedules on him. On the other hand, I can sometimes encourage him to eat by hand-feeding him kibbles. I've already done this when I thought his blood sugar was too low at the start of the night and was in danger of going even lower.
I'm not going to switch from dry to wet food right away, and it will be extremely gradual.
He'd had wet food in the morning in previous years until this spring, when he just stopped eating it. I didn't see any particular effect on his blood sugar levels, but at least I stopped throwing away cans that had barely been eaten!
Oh, and important information: my cat goes outside, in a neighborhood full of cats and cat lovers, he can probably find food somewhere other than my place and I can't control that (my apartment is too small to lock him up and he meows continuously when he's locked up).

I finished a cartridge of insulin this morning, I'll start a new one tonight with 2.75 and then tomorrow I'll increase it to 3.

For questions... I would have liked to know what makes insulin decreases never hold. What could I have done better? What do I need to do better now?
For exemple, see 30/29/2024 on my spreadsheet: PMPS 159, I injected 3 like other cycles. At +3 (92) it was the effect (nadir or almost nadir) of the morning shot? At +5 (47), the low BG was caused by the combined effects of morning shot and evening shot? I gave him lots of sugar (sweetened condensed milk, nutrigel, crappy cat treats) and it took me 2 hours to get his blood sugar level to a safe level. I really need to understand everything so that I can manage...

Merci ! J'espère que mon anglais n'est pas trop mauvais et que tout est compréhensible.


@Diane Tyler's Mom GA Problem solved! I think I just changed my signature too many times, I have to wait to change again.
 
I think you mean 9/26? It's hard to tell because you don't have numbers for the AM cycle, so maybe he was already going down. He might have eaten less that day, or just the dose was working a little too well :-)
You decreased the following day, whoch was the right thing to do.He went low again that night (9/27) and I think I would have skipped the shot as well. Then he went high, that was a bounce caused by a reaction from his body to the lower levels he is not used to.
With time, he will get used to lower levels and the bounces should be smaller.
It's hard to know in his case, if he has access to food and you cannot control, that can have an effect too, and make it difficult to predict.
 
@cecile & bella
Yes, sorry, it's 09/25 (I have trouble with dates written backwards for me huhu)

@Daphne and Aida
I answer you in french on #12: Yes, he's being treated for hypertension with Amodip. In fact, I've known for a year that he has hypertension (when the diabetes was diagnosed, we did a complete check-up), but his vet at the time didn't want to treat him for it until the diabetes was stabilized. Since I was never able to stabilize him... well, I changed vets at the end of September, who still isn't good for diabetes, but at least I've got treatment for his hypertension (which apparently was going through the roof). He also has a small hypokalemia without symptoms, he is supplemented with K for cat, the next pds to check for all this is late November.

I'm having display bugs on my spreadsheet, I'm having trouble editing pages other than the first one, so it's not quite up to date (but I've updated my signature).
 
I have a few thoughts in response to your question regarding the dose reduction not holding and using the data from Sept. 25.

Levemir is a depot insulin. What this means is that you may not get an immediate response to a change in dose. It's why doses are held at the same amount for 3 days with Tight Regulation or a week with SLGS. The other thing that we often see is what we refer to as a "bounce." If a cat's blood glucose level drops low, drops fast, or simply drops into a range the cat isn't used to, there can be a relatively rapid rise in blood glucose numbers. This is the result of the liver and pancreas releasing a stored form of glucose along with counterregulatory hormones. The higher levels can last for several days. What I think happened with Fenix was that his depot was over filled. He dropped into 40s on the 25th and it's likely he was in lower numbers over the AM cycle the next day and you skipped his PM shot since his numbers were in the 70s. Skipping the shot depleted the depot and in addition, you reduced the dose by 0.5u. It likely would have been better if you had reduced by 0.25u since from that point forward, his numbers have mostly been in the 200s. You've also held the 2.5u dose for a long time! As I mentioned previously, holding a dose that isn't brining numbers into a normal range can make it harder too your cat to return to better numbers.

I hope that explanation makes sense.
 
Blandine & Fénix said:
@Daphne and Aida
I answer you in french on #12: Yes, he's being treated for hypertension with Amodip. In fact, I've known for a year that he has hypertension (when the diabetes was diagnosed, we did a complete check-up), but his vet at the time didn't want to treat him for it until the diabetes was stabilized. Since I was never able to stabilize him... well, I changed vets at the end of September, who still isn't good for diabetes, but at least I've got treatment for his hypertension (which apparently was going through the roof). He also has a small hypokalemia without symptoms, he is supplemented with K for cat, the next pds to check for all this is late November.

I'm having display bugs on my spreadsheet, I'm having trouble editing pages other than the first one, so it's not quite up to date (but I've updated my signature).
Click to expand...
Sorry I missed it!
I’m reassured, I had to explicitly ask my vet at the time to get my other cat treated for his hypertension, I really don’t know why they think it’s not so important to treat such a serious issue… maybe because the pills sold in France under the name Amodip are huge, and the vets believe that few of us would ever get our cats to swallow them?
Amodip and amlodipine do have an impact on potassium levels by lowering it a bit. Maybe by the next check-up you’ll see that you have to increase it a bit. The ideal range is 4.2 to 5.5, and you don’t want it to drop below 4.

En français:
Ah je suis rassurée! J’ai dû pratiquement courir après la vétérinaire où j’amenais mes chats à l’époque pour lui demander de me donner une ordonnance pour traiter l’hypertension de mon autre chat, elle s'apprêtait à nous lâcher sans rien! Je ne sais pas pourquoi autant de vétos choisissent de ne pas traiter ça, alors même que c’est très sérieux… Je pense que ça doit être lié à la taille des comprimés de l’Amodip, ils sont 5 fois plus gros que le comprimé pour humain, et ils doivent penser que peu d’entre nous seraient capable de donner ces monstres de cachets à nos chats tous les jours…
L’Amodip et la molécule le composant amlodipine ont un impact sur le potassium, c’est possible que tu vois au prochain contrôle qu’il faut augmenter un peu l’apport en K. L’idéal est entre 4.2 et 5.5, si c’est en dessous de 4 il faut augmenter la supplémentation. Même si les labos ont comme fourchette 3.5 comme minimum, si c’est sous 4, c’est le signe que le corps n’en a pas assez, et qu’il commence à en puiser dans les cellules pour l’amener au cœur.
 
Bonjour et Bien venue
Blandine &Fénix..

I can speak s little french, but I'm going to respond in English, as I think your English is much better than my french. Lol

I live in Spain, so I'm familiar with the different foods available in Europe.

I checked out the components of the kibble that Fénix is getting, it's 22%. That's going to make it difficult to achieve regulation.

Ideally he would be on a low carb wet diet, which incidentally is a prerequisite for following the romp rand protocol (which we call TR), I'm sorry that he had a symptomatic hypo, but that is the risk when using kibble and following TR. Anyhow, as others have said that's not a problem, we can still help you and Fénix, here we use SLGS, when we have kitties who are kibble addicts or if CG isn't able to monitor closely enough for TR., it's a less aggressive approach, which is safer for our kibble addicted kitties.

That said and thinking of fenix addiction to dry food, there are lower carb options (below 10%) dry food available, a lower carb kibble may allow you to achieve regulation, I hear you on that he's an older cat, and we are all told that a low protein diet is necessary to protect kidneys, but the way I see it is when we have a diabetic cat, feeding them carbs and having their Blood sugars run above the renal threshold is the greater risk to their kidneys

For what it's worth George was diagnosed when he was 16, I swapped him to a low carb high protein diet, he went into remission., I fed him good quality protein, added water to his food, and chose food that was relatively low in Phosphorus and carb, he remained in remission, whilst on his high protein diet until passing away at the age of 24, just about 6months ago.

I'm leaving you a link below of a SS with low carb foods, at the bottom there are some dry foods that are below 10% perhaps some of those might be suitable for Fénix, with his hyperkalemia. ???

It says UK but realistically most of it is European manufactured and available to us throughout Europe.

https://docs.google.com/spreadsheet...l9hUtHy6Gs9oRBqlz4nPGKxtySA/edit?usp=drivesdk

ETA

One last thing it's fine to free feed if that's what you prefer, but it would be advisable to restrict his access to food for the two hours prior to shot time. It helps you to know that the amps/pmps is not food influenced
 
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A request to everyone who has been helping Blandine in her native language...

Many of us either do not speak French or do not speak fluently. If you are responding to Blandine's questions in French, would you kindly provide an English summary of your note. One of the strengths of FDMB is that communications are in the public domain. As such, if someone provides misinformation, another member is able to make a correction. We are not able to provide that input if we don't speak the language.

Thanks to everyone who has gone to the effort to be helpful. It is even more appreciated if you would go the extra mile.
 
Sienne and Gabby (GA) said:
Levemir is a depot insulin. What this means is that you may not get an immediate response to a change in dose. It's why doses are held at the same amount for 3 days with Tight Regulation or a week with SLGS. The other thing that we often see is what we refer to as a "bounce." If a cat's blood glucose level drops low, drops fast, or simply drops into a range the cat isn't used to, there can be a relatively rapid rise in blood glucose numbers. This is the result of the liver and pancreas releasing a stored form of glucose along with counterregulatory hormones. The higher levels can last for several days.
Click to expand...

I know the deposit and the rebounds (we call them “kangouchats” = kangaroo cats).

Sienne and Gabby (GA) said:
What I think happened with Fenix was that his depot was over filled. He dropped into 40s on the 25th and it's likely he was in lower numbers over the AM cycle the next day and you skipped his PM shot since his numbers were in the 70s. Skipping the shot depleted the depot and in addition, you reduced the dose by 0.5u. It likely would have been better if you had reduced by 0.25u since from that point forward, his numbers have mostly been in the 200s. You've also held the 2.5u dose for a long time! As I mentioned previously, holding a dose that isn't brining numbers into a normal range can make it harder too your cat to return to better numbers.
Click to expand...

I agree, I've lowered the dose too much. I lowered it the second time because after the first time I had a non-injectable value. But it was too much.
I think that may be one of the reasons why I don't hold blue and green values (in addition, as you say, to staying too long at certain levels - when I see blue appear sporadically I stay at the dose so that it comes back, but it doesn't work like that).


Daphne and Aida said:
I’m reassured, I had to explicitly ask my vet at the time to get my other cat treated for his hypertension, I really don’t know why they think it’s not so important to treat such a serious issue… maybe because the pills sold in France under the name Amodip are huge, and the vets believe that few of us would ever get our cats to swallow them?
Amodip and amlodipine do have an impact on potassium levels by lowering it a bit. Maybe by the next check-up you’ll see that you have to increase it a bit. The ideal range is 4.2 to 5.5, and you don’t want it to drop below 4.
Click to expand...

Thanks for the warning! He has hypokalemia before taking amodip, I would be doubly careful. I'm familiar with the forks used by laboratories, which are more like rakes! (I don't know if it's an analogy used other than in French).
I don't think the pills are that big. In any case, they are crushed and given in a highly appetizing gel ("add one" I don't know if you have that - it's a game changer for me!).


Gill & George said:
I live in Spain, so I'm familiar with the different foods available in Europe.
Click to expand...

Hi neighbor! I live in the south of France.
I'm really sorry for your loss.

This is my personal opinion, but I don't think that when a cat goes without insulin because it's given a very, very low-carb food, it's really in remission. His pancreas still doesn't work properly. It's one way of treating his cat, of course, but I don't see the harm in giving him a little more sugar and insulin to help him. In the French group, some cats went into remission with the same kibbles as me.
It's still my personal opinion, but I think there's more danger for the kidneys with high levels of ash and phosphorus (which often happens with no-grain) than with relatively well-treated diabetes.
On the other hand, it gives me an idea because you've all really made me realize that the moment when Fenix eats is very important for interpreting his blood sugar. I can put a camera in front of his bowl to check when I'm not there or at night.
Thank you for the link (I don't know what EAT means).
 
Blandine & Fénix said:
I know the deposit and the rebounds (we call them “kangouchats” = kangaroo cats).
Thanks for the warning! He has hypokalemia before taking amodip, I would be doubly careful. I'm familiar with the forks used by laboratories, which are more like rakes! (I don't know if it's an analogy used other than in French).
I don't think the pills are that big. In any case, they are crushed and given in a highly appetizing gel ("add one" I don't know if you have that - it's a game changer for me!).
Click to expand...
I think I understand the forks/rakes analogy, it is really incredibly regulated and controlled in France, vets are not allowed to prescribe by law any human medicine if there is an animal analogous product - that of course costs at times 10 times more! So really, well done to have convinced your vet to give you a prescription for Levemir!
Regarding Amodip, I was only given the pill option. A former colleague crushes it and gives it in the food, but Feloro is easy to pill. Still, now that I’m in Greece and I can get the human version of amlodipine, the size of the Amodip pill simply makes no sense at all!
Here a pic to compare both, I hope it works:

upload_2024-10-31_10-54-45.jpeg


Blandine & Fénix said:
This is my personal opinion, but I don't think that when a cat goes without insulin because it's given a very, very low-carb food, it's really in remission. His pancreas still doesn't work properly. It's one way of treating his cat, of course, but I don't see the harm in giving him a little more sugar and insulin to help him. In the French group, some cats went into remission with the same kibbles as me.
It's still my personal opinion, but I think there's more danger for the kidneys with high levels of ash and phosphorus (which often happens with no-grain) than with relatively well-treated diabetes.
Click to expand...
I kind of agree with you on this one. The international guidelines state that Diabetes control takes precedence over Chronic Kidney Disease, and therefore the diet choice has to be made accordingly by selecting a food that is poor in carbs. But if the diabetes IS well controlled, I tend to rather watch out for too much phosphorus/calcium/sodium foods to spare the kidneys.
 

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In English it's a "range" and not a "fork", but I love the rake analogy! I am waiting for piano movers right now and was given such a large one that it's a rake, definitely!
ETA means "edited to add".
Where in the south are you? I grew up close to Orange :) now I'm in Minneapolis, very different climate here. It's snowing now.
As for foods, I personnally like the low-carb diet because it is closer to what a cat would eat naturally. i cannot say Bella is completely grain-free, she will steal break or cake or cereal if she has the opportunity, but let's say she is fed a grain-free diet. If a cat can go without insulin, that means his pancreas is working, whatever diet he is eating. I think the probability of healing is higher if they eat less carbs. it is comparable to type 2 diabetes in humans: you can normalize it with diet and exercise.
 
Daphne and Aida said:
vets are not allowed to prescribe by law any human medicine if there is an animal analogous product
Click to expand...
In France, vets are obliged to start with animal treatment, but if that doesn't work, they can switch to human treatment. I was lucky to be able to change so quickly.

Daphne and Aida said:
the size of the Amodip pill simply makes no sense at all!
Click to expand...
Yes, it's crazy to make such a big tablet for an animal when the human pill is so small...

cecile & bella said:
I am waiting for piano movers right now and was given such a large one that it's a rake, definitely!
Click to expand...
Precisely!

cecile & bella said:
Where in the south are you? I grew up close to Orange :) now I'm in Minneapolis, very different climate here. It's snowing now.
Click to expand...
I grew up in Arles bu I live in Montpellier now. Orange is not far away! Yesterday I took my friend to visit Fontvieille and the Moulin de Daudet. It was sunny, we were in t-shirts, and the temperature was easily 25°C (77°F). Not the same weather at all ;)

cecile & bella said:
If a cat can go without insulin, that means his pancreas is working, whatever diet he is eating. I think the probability of healing is higher if they eat less carbs. it is comparable to type 2 diabetes in humans: you can normalize it with diet and exercise.
Click to expand...
What I meant was that if a cat has normal blood sugar levels on a very, very low-sugar food, it's not necessarily because his pancreas is working properly and he's no longer diabetic. In fact, if you change his food for one with a slightly higher sugar content, he'll become diabetic again (because he never stopped being diabetic). To me, this is different from a complete recovery, where no matter how much sugar is in the food, the pancreas is able to deal with it properly.
It's like someone who's allergic to nuts. If he doesn't eat them, he's not sick, but he's not cured. At least that's how I see it (and that's a right way to treat a cat!).
 
I understand what you mean, but a cat should not be on a high-carb diet, diabetic or not. If he can go without insulin, whatever the diet he is eating, it means his pancreas is working and he is considered in remission. There is no "cured" from diabetes. If his pancreas is not working, you will not be able to stop the insulin, even if the diet is completely low-carb.
My cat became diabetic while eating a low-carb diet. She was obese, I tried for years to have her lose weight (I adopted her as an adult obese cat). She still needs insulin, but a lot less tha she used to, and she still eats the same diet of low-carb raw food. It is more complicated than just food. In some rare cases, yes, stopping the kibble and changing the diet for low-carb is enough to control the diabetes, but that is far from being the norm.
 
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