08/21 Mami Cat | PMPS 95 | Feeding the curve question

[Clarice & Mami Cat]

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Good evening to all

So many things are happening at the same time with Mami Cat’s health. She is always so sweet, cooperative and affectionate, but she is going through several things at once.. I am trying to balance everything, solve as much as I can, and organize things step by step. The renal situation and the phosphorus binder have worried me a lot this week. This is also because she eats several small meals throughout the day and has a voracious appetite right now, as she is recovering from anemia and Mycoplasma. That part of her recovery is going well.

The current state of BG things...

• I have to find a balance between LC food and renal wet food with low phosphorus. I am trying to solve this equation, but my options are still very limited. I am considering looking into the possibility of a low-phosphorus homemade diet. For now, I am continuing with the LC food I use to manage her BG. Its phosphorus level is acceptable, but not especially low, and she is taking a phosphorus binder. I restarted another binder from a different brand today.
  
  
• Yesterday, for the first time ever, I had a PMPS below 100 while using 1 drop, and I was really scared to give the dose. I didn’t. I decided to stall and monitor her, because this had never happened before. She was at 84 and still dropping. I could have given the dose an hour later, when she reached around 116, but at that point, the whole issue of shifting the schedule, together with how exhausted I was, made me decide to simply observe. Her numbers stayed below 130 throughout the entire night.
  
  
• Today, her PMPS was 95, but I took a deep breath and found the courage to give the dose, based on what I observed yesterday. Her nighttime cycle is very different from her daytime cycle, which drops very steeply during the first two hours. (Now I’m wondering if she actually got the drop!)
  
  
• Mami Cat continues to have that sudden BG rise in the early morning, just before AMPS. This has been happening for a long time. What has changed is that, since I started feeding her at +9 again, the rise is happening much later, but it is still happening. If it weren’t for this morning rise, I honestly don’t know how I would manage the AMPS dose, because her curve drops so dramatically early in the cycle.
  
  
• I wake up at +9 to feed her, but I am feeling very tired. I do it with so much love, but I feel tired. Sometimes I just can't.
  
  
• One piece of good news: I have largely overcome my fear of pricking her ear. Today I did it by myself at home: using the valuable tips you all gave me, I managed to prick her ear and see the blood. The main issue is that I still haven’t been able to get enough blood and properly learn the “milking” technique. But I overcame the fear, and that feels like a big step for me. She wasn’t bothered by the sound and didn’t seem to feel any pain at all.
  
  

• Yes or it could be 50 or 60, in which case I wouldn't increase.

• I also did a BG measurement at the clinic, comparing the Libre with the handheld meter, in the morning. Wendy, the Libre 1 was 55 and the handheld was 53! It was so good to do this cross-check and see that the sensor (for the moment) is accurate. You were absolutely right.
  
  
• To be able to give the morning dose when her AMPS gets lower, I would need to give her some food with higher carbs. I can do that with the renal wet food I have, but it is HC, not medium carb. I simply cannot find a MC option with lower phosphorus here. Since Mami Cat is such a diver during the first two hours after AMPS, I will need to think carefully about a strategy to continue with the drop as her AMPS gets lower. Otherwise, I may not be able to give the dose.
  
  Do you have any ideas? When a kitty drops this much, I imagine the only way to safely continue with the drop is through the “feed the curve” strategy.

Thank you all so much for all your help and support so far.

Wishing everyone a lovely weekend and lots of safe surfs !

 

[Marje and Gracie]

Hi Clarice

I would stop the +9 feedings. They aren’t helping her as we had hoped and are likely causing her duration to diminish.

Can you get phosphorus binders there like aluminum hydroxide or epakitin? These can be added to her food to bring the P levels n the food down as it binds the P. Also, feeding cooked egg whites mixed in with her food can bring down P levels.

Perhaps give her less of the HC renal food at AMPS and +1 and see what that does? Would that help?

 

[Clarice & Mami Cat]

Hi Marje! Good to read from you.

When I don't feed her at +9, her AMPS gets really higher... (the pink AMPS numbers some days ago, for instance).

I gave her aluminium and her stools got extremely dry. I started Pronefra, from Virbac, today - but it is meant to be used only twice a day. However, she eats many times a day... so I am wondering how it will really work. It is a liquid one and they like the taste of it.

I didn't know about the cooked egg whites. So nice. I will try it too!

For the moment she is not eating the renal food and she dives super quick after AMPS. The idea would be to give her a bit of MC or HC food to try to avoid this and be able to give her the AMPS dose (when her AMPS number gets lower, I mean). All renal food around here seems to be HC.

 

[Staci & Ivy]

Hi Clarice, just checking in. Glad to see your post. I’m so glad you’re having some success with ear pokes. It does take time.
It’s good you could verify the similarities between the 2 meters.

It’s so great that she’s such a good girl and so sweet and cooperative. That makes it much easier for both of you.

I’m sending you lots of hugs and many prayers for Mami to continue to heal and feel much better. Please take care of yourself too!