07/11 Zorro AMPS 454 Dose increased.

Zorro's mom

Zorro's mom

Member Since 2019
Okay let's see how this goes with the increased dose.

@Wendy&Neko @Bobbie And Bubba Something that's been niggling at me: Zorro recently had a dental during which 6 teeth were extracted and an abscess or two were treated. We never suspected any dental issues up to that point (as incredible as that may sound) so I really expected his bg to at least settle in slightly lower numbers after that.

He also eats more raw these past few weeks than ever before.

Have you ever seen cats who's had these positive changes yet no improvement to their bg?
 
Zorro's mom said:
Have you ever seen cats who's had these positive changes yet no improvement to their bg?
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Yes, not uncommon. Although raw is better for them, it may not be a lot lower carb. Plus some cats do better with a little bit of carbs. I primarily used a manufactured raw product that had 3-4% carbs. Also, if a cat has glucose toxicty, you just have to keep increasing until you break through the toxicity. Did the vet do dental xrays to confirm all the bad teeth were removed? The dental should help, but they aren't alway sthe magic answer. He will feel better now because of it.
 
Hi Wendy, someone else has also suggested that I request dental x-rays so I'll get on that very soon, together with another urinalysis as a follow-up to the one he had just before switching to Levemir on 04/18.

How would one determine the carbs in raw food? The one I buy contains some egg and yoghurt, so would that be sufficient carbs without the need to add more by way of commercial canned food? Labelling in South Africa is not very detailed so the raw food does not specify carb content.
 
When Bubba had a couple of bad teeth, it really effected his numbers in a bad way. That was how I knew something was wrong and took him to the vets where it was discovered he was going to be losing at least one tooth to tooth resorbtion. His numbers were fairly good and then they went really high due to the pain. Once the bad tooth was removed, he came right back down again. So, yes, you might see his insulin needs getting less after you break though any insulin resistance . I am glad you he had a dental follow up after the extractions. Bubba's last extraction recently developed an infection and his numbers started going back up again which alerted me to have him seen again.

As far as the raw food and determining carbs with manufactured raw pet food, maybe you could call the company and have them break it down for you. I use raw turkey from a butcher which is 0% .

Hope this dose increase will start bringing him down again.
 
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@Bobbie And Bubba @Wendy&Neko Thank you. I am seeing the vet, who did Zorro's extractions, tomorrow to discuss any possible infections / issues that might make him so difficult to regulate.
Today I enquired about dental x-rays as part of tomorrow's second follow-up but she said they don't have a machine that's suitable for dental x-rays. She is of the opinion that they're not necessary...
Zorro's dental follow-up as noted on his SS was purely just her looking into his mouth 2 weeks post-op to assess whether the holes where teeth were extracted, had closed up nicely (apparently the gums were in such a state that not all could be sutured up). He was on a 2-week course of Clavet after the dental which I completed diligently. His ketone urine test strips test for heamoglobin as well and it always used to show some blood in his urine. After the antibiotics course it showed no more blood (from what I can see) in his urine so I do think the antibiotics did their job as far as possible infections go.

That brings me to my question again: How can a cat who's teeth were in the state Zorro's were apparently in, not show ány improvement in his bg after it's been dealt with? His insulin needs have not even decreased, in fact he is now on his highest dose since starting Levemir.
Have you ever seen a cat who bounced so drastically for so long? I know I jumped from protocol to protocol (and I have promised myself and my partner I'll stick to the FDMB TR this time) but Zorro still seems like an unusual situation to me. I just need to know if you've seen anything like this before or whether something else could be up.

I think that overall Zorro is still doing and looking much better than he did earlier this year, before I started searching online in Feb and started to home test, giving more insulin etc. Now that I know more about FD I just fear what is happening to his organs while he's in those ugly numbers (which he was probably in often on only 2 units Caninsulin twice a day - I just didn't know it before home testing) and I wonder if his system is so messed up from more than 18 months of bad "regulation" that there's no hope of getting him regulated.

And, on top of everything else, there's still this little worry I always have that he is now getting too much insulin and that thát is causing his constant bouncing. What does one look out for to rule out the possibility of a too high dose?

Sorry, that's a lot to respond to but I'm just getting some thoughts out. No rush to reply.

@Bellasmom where can one get those pants from? :)

@Sue and Luci I've mentioned in previous posts that you may have missed that I kept all Levemir data on Zorro's SS for the sake of completeness and to enable possible dosing assistance. However I only started to follow the FDMB TR from 06/26 - see the dates on the left, bottom few entries for the past +/- 2 weeks.

@Figaro's Liz and @AmandaE thank you so much :bighug: It does brighten one's day to receive these lovely messages of support.
 
Zorro's mom said:
@Bobbie And Bubba @Wendy&Neko Thank you. I am seeing the vet, who did Zorro's extractions, tomorrow to discuss any possible infections / issues that might make him so difficult to regulate.
Today I enquired about dental x-rays as part of tomorrow's second follow-up but she said they don't have a machine that's suitable for dental x-rays. She is of the opinion that they're not necessary...
Zorro's dental follow-up as noted on his SS was purely just her looking into his mouth 2 weeks post-op to assess whether the holes where teeth were extracted, had closed up nicely (apparently the gums were in such a state that not all could be sutured up). He was on a 2-week course of Clavet after the dental which I completed diligently. His ketone urine test strips test for heamoglobin as well and it always used to show some blood in his urine. After the antibiotics course it showed no more blood (from what I can see) in his urine so I do think the antibiotics did their job as far as possible infections go.

That brings me to my question again: How can a cat who's teeth were in the state Zorro's were apparently in, not show ány improvement in his bg after it's been dealt with? His insulin needs have not even decreased, in fact he is now on his highest dose since starting Levemir.
Have you ever seen a cat who bounced so drastically for so long? I know I jumped from protocol to protocol (and I have promised myself and my partner I'll stick to the FDMB TR this time) but Zorro still seems like an unusual situation to me. I just need to know if you've seen anything like this before or whether something else could be up.

I think that overall Zorro is still doing and looking much better than he did earlier this year, before I started searching online in Feb and started to home test, giving more insulin etc. Now that I know more about FD I just fear what is happening to his organs while he's in those ugly numbers (which he was probably in often on only 2 units Caninsulin twice a day - I just didn't know it before home testing) and I wonder if his system is so messed up from more than 18 months of bad "regulation" that there's no hope of getting him regulated.

And, on top of everything else, there's still this little worry I always have that he is now getting too much insulin and that thát is causing his constant bouncing. What does one look out for to rule out the possibility of a too high dose?

Sorry, that's a lot to respond to but I'm just getting some thoughts out. No rush to reply.

@Bellasmom where can one get those pants from? :)

@Sue and Luci I've mentioned in previous posts that you may have missed that I kept all Levemir data on Zorro's SS for the sake of completeness and to enable possible dosing assistance. However I only started to follow the FDMB TR from 06/26 - see the dates on the left, bottom few entries for the past +/- 2 weeks.

@Figaro's Liz and @AmandaE thank you so much :bighug: It does brighten one's day to receive these lovely messages of support.
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Screenshot_20190711-135716_Samsung Internet.jpg

Here ya go
 
Zorro's mom said:
That brings me to my question again: How can a cat who's teeth were in the state Zorro's were apparently in, not show ány improvement in his bg after it's been dealt with? His insulin needs have not even decreased, in fact he is now on his highest dose since starting Levemir.
Click to expand...
That is most likely due to insulin resistance. When they are in higher numbers for a while, that can happen. By following the protocol with increases, you will eventually get to a dose that starts to bring him down.

It’s worth a visit to have the extraction sites rechecked ; I would be surprised if he developed an infections since he was checked 2 weeks postoperative. But that said something could have been missed.
 
Zorro's mom said:
previous posts that you may have missed that I kept all Levemir data on Zorro's SS for the sake of completeness and to enable possible dosing assistance.
Click to expand...

You're right! I missed those posts - sorry! Now I see the correct info :)

I sure hope he starts to respond to the Lev soon - tell him we're rooting for him! Bring it on down Zorro - you've got 4 u now - work that juice :)
 
Zorro's mom said:
Have you ever seen a cat who bounced so drastically for so long?
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It took Neko a year to stop bouncing to red, then she still bounced. Mind you, she had a couple underlying secondary conditions that made it harder to regulate. Dyana’s JD still bounced to black at age 20 when he passed, after nine years on insulin. Some cats just like to bounce. Getting them to spend more time in green is how you make it better, so their bodies get used to normal numbers.
Zorro's mom said:
And, on top of everything else, there's still this little worry I always have that he is now getting too much insulin and that thát is causing his constant bouncing. What does one look out for to rule out the possibility of a too high dose?
Click to expand...
Been there, worried that. :bighug: Trust the protocol. A kitty started at a reasonable dose and increased safely, and your do test more than enough to catch any lows, it is not an issue. What I do see is a little glucose toxicity, which is what Bobbie describes above. It is a type of insulin resistance. The solution is to raise the dose until you break through. How is Zorro’s bloodwork? Been tested for hyperthyroid?
 
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I just mention HyperT for a couple reasons. One, it’s not uncommon in older cats so worth testing when they get to a certain age. Two, it’s one of a handful of conditions that can lead to having difficulty regulating. Not impossible, just not easy. Of course, there are usually clinical signs with it too.
 
I thought I might get a pair of these - but Luci might get the wrong idea - they're PJ's - might think she should keep me up half the night for a party!
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Zorro's mom said:
And, on top of everything else, there's still this little worry I always have that he is now getting too much insulin and that thát is causing his constant bouncing. What does one look out for to rule out the possibility of a too high dose?
Click to expand...

I feel the same. I don't think that bouncing is a good thing (for them, and also for us!) and I don't understand how it can help with regulation. Because it goes down yes, but then uuuuup again. It is still very unclear how insulin works.
Zorro and Macka have a very similar spreadsheet. I was wondering if Macka also had some dental issues, the vet mentioned it at some point, event though he had dental last year.
 
@Penelope and Mačka Bouncing is normal for cats. All newly diagnosed cats do it, and so do some who have been diabetic a while. Bouncing is a good thing. It is their bodies protective mechanism so that their blood sugar does not go lower than they are used to. Our job as caregivers, is to get them used to lower and lower numbers, until they are seeing normal blood sugar values often. That is when the bounce mechanism will recognize normal as good and stop or slow the bouncing. For most of us, we don't know when our cats first became diabetic and started having higher blood sugar numbers, so we don't know how long they have been used to higher blood sugar.

As much as I hated bouncing (and I think it's harder on us than them), it helped me to think of bouncing as a victory. I was finally getting Neko's blood sugar numbers down below what she was used to. The insulin was finally starting to do it's job.

The only part of the equation we can influence is bouncing due to fast drops. If your cat is one of those that like to drop fast, then learn when he drops, and try to slow the drops with food. This post is a good description of Manipulating the Curve with food.
 
Wendy&Neko said:
As much as I hated bouncing (and I think it's harder on us than them), it helped me to think of bouncing as a victory. I was finally getting Neko's blood sugar numbers down below what she was used to. The insulin was finally starting to do it's job.
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Thank you so much for the explanation and for offering this perspective. I will try to see it as positive instead of as a scary/worrying phenomenon. It just kills me to see him lethargic and grumpy due to the high sugar.

And thank you for sharing the link!
 
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