1/31 Champ PMPS 329, +2.75 207, +4 141, +5 96

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Patty & Champ

Patty & Champ

Member Since 2011
Yesterday

I'm really getting frustrated wth this whole process, to be quite honest. I tried like hell to get Champ up last night, but he just got a lot of extra food with no rise. He has never been a cat to bounce after a run of blues yet that now sets him off. He used to be very carb sensitive, but now that doesn't seem to be the case. I sometimes just want to drop him back down to 1u, get rid of the bouncing, and slowly start increasing him again. I know that's not the answer, but it is tempting. I'm going to have to find a way to keep him in the 200s because he obviously doesn't like the 100s. And I need to do this without added food because he needs to lose weight, not gain. And I need to do this while still being able to sleep because I really do like to do that. Gaaahhhh. I'm a little frustrated right now...can you tell? ohmygod_smile :lol: :lol:

I need some guidance from the guru's. At what number do I start carbing him to keep him in the low 200's? And should I be trying to keep him in the low 200's? I want to stop the bouncing before I worry about hitting the 100's and below.

From anyone's experience, have you found that one 10% carb food will work better than another? I've been trying Wellness Chicken & Lobster which is 11%, but it doesn't do a thing for Champ, or maybe he would drop lower if he wasn't eating it...who knows!! I've got some Wellnes Sardines, Shrimp, & Crab that's suppose to be 16% so I'll try that next time. Maybe I'll try some FF Elegant Medleys. Does anyone here use those to raise BGs?

I've been here for a year and the questions never end!!

Have a great day everyone!! I have another hellacious day at work so I'll be back in a few hours.
 
Re: 1/31 Champ AMPS 218, +2 307, +4 318 - ??'s FOR THE GURU'

So sorry on the bouncy kitty! Tarragon has been doing the same thing since Sept. It was really out of control for awhile with red and blacks. Yuck. I did the whole drop him back down and start slowly back up, but it didn't work and I was worried about DKA since he has had that before. I kept raising his dose until we were all the way up to 3.75, which is way higher than T had ever been on. That was the only time I finally got a breakthrough. We are on our way back down again and are now at 2.5 and the bounces are finally getting shorter and smaller.

You might ask Anne & Liz (Zener) what they are doing. They were trying to manage Zener's large drops with food to lessen the bouncing.

Hugs to you dear friend. Hang in there! :YMHUG: :YMHUG: :YMHUG:
 
Re: 1/31 Champ AMPS 218, +2 307, +4 318 - ??'s FOR THE GURU'

I'm sure you'll get answers, but not from me. I'm just here to lend support. Oh yeah, if you figure out the sleep thing, please let me know.
 
Re: 1/31 Champ AMPS 218, +2 307, +4 318 - ??'s FOR THE GURU'

Sorry to hear about your frustrations Patty, :YMHUG: I have always used the FF elegant medleys to bring Leo up, except for 2 weeks ago when it didn't do squat until i added karo to the mix. I use the white meat chicken florentine or the yellowfin tuna florentine to bring Leo up and he loves it, i think i read somewhere that they are 15% but i'm not completely sure. They work pretty well IMHO, it usually brings him up from <50 to around 90-100.

I hope this gets easier for you and Champ, i hate to see you so frustrated.

Hope you have a better day!
 
Re: 1/31 Champ AMPS 218, +2 307, +4 318 - ??'s FOR THE GURU'

i'm not a guru, but i'm not really following your logic, patty. is your goal to stop the bouncing, even if it leaves him in higher numbers? i'm thinking that's what you're saying.

personally, i'd be more worried about a constant level of higher BGs than i would the bouncing to the occasional high numbers. a couple of weeks ago i spent 3 days straight over the weekend reading on glucose toxicity from the body being in higher numbers. that scared me more than the lows or the higher bounces. if you want to aim at 100, would that be high enough for your comfort zone? the trouble with aiming at 200 is that higher than that isn't good for any sustained length of time.

i saw on champ's ss that you fed him last night several times with his shot and in the first 3 or so hours after. he was flat for several hours - do you think that helped? i'm trying to remember if you have a timed feeder.

what did you think of the idea of changing him to levemir to see if that eliminates the bouncing?
 
Re: 1/31 Champ AMPS 218, +2 307, +4 318 - ??'s FOR THE GURU'

He's bouncing when he gets in the 100's, which he never used to do. That's why I was thinking of trying to get him to stay low 200's and then work our way down from there. Also, his bounces are getting harder and lasting longer which I may have to attribute to food. I think I may try only honey to see if the bounces are less hard and shorter. It may be the 11% Wellness that's causing him to bounce so bad...and the fact it doesn't work to bring up his BG makes it kinda dumb of me to keep trying it!!
 
Re: 1/31 Champ AMPS 218, +2 307, +4 318 - ??'s FOR THE GURU'

Like Julie, I'm not sure why you would want to run Champ in the 200s. For many cats, that means they will be above renal threshold and you are risking kidney damage. I don't think letting Champ run in higher numbers is the answer with regard to bouncing.

If you are looking to use food and insulin to manipulate Champ's curve, the goal is blue at pre-shot and green mid-cycle. You are going to need to give food manipulation some time to work. You also need to feed based on Champ's Lantus onset and nadir as a means of preventing the fast drops. That does not always mean feeding HC. Often what I will do with Gabby is split up her meal at, for example +2. So, I feed LC at +2 and at +2.5 but it's the +2 mini-meal that I've divided in half. It may not be clear on Gabby's SS, but often when I'm testing, I'm giving some LC to smooth things out. (You might also want to go back and take a look at Blackie/Angela's condo. Jill and I were providing info on using food to manipulate the curve.)

The blues last night were lovely. Champ's not bouncing off of the blue -- the bounce is from dropping from 261 to 131 in an hour.
 
Re: 1/31 Champ AMPS 218, +2 307, +4 318 - ??'s FOR THE GURU'

:YMHUG: :YMHUG: extra hugs being sent your way .. I can tell you are really frustrated .. Don't feel bad about asking questions, even a year later .. I was asking them two years later! Then I would go off and pout cause no one gave me the one answer I really wanted .. you know, the one that told me exactly what to do and when to do it to make everything perfect .. I don't have any advice for you, about dosing or feeding .. But I can say I understand your frustration, and I can say I really feel for you .. Just hang in there!
 
Re: 1/31 Champ AMPS 218, +2 307, +4 318 - ??'s FOR THE GURU'

If I could figure out onset and nadir, I don't think my frustration level would be quite so high. Unfortunately, the pattern is very different every day. If the drop from 261 to 131 last night caused this bounce, then what caused the bounce yesterday morning? Because the night before there was no big drop. In fact, he had a really nice, relatively flat PM cycle. I'm confused.
 
Re: 1/31 Champ AMPS 218, +2 307, +4 318 - ??'s FOR THE GURU'

hi patty. i haven't been around because i'm sicker than a dog, but wanted to pop in to comment...

the food manipulation method that was suggested is not about using food to stop kitty's bouncing. we use insulin to stop the bouncing by gradually increasing the dose enough to flatten out the curve. food is only used to prevent kitty from going too low.

there's nothing wrong with letting champ drop into greens. i wouldn't prop him up in the 200s. i'd prop him up so he doesn't fall below 50 and earn a dose reduction. if he earns a dose reduction, there's less insulin available to pull down those higher numbers on either side of his nadir.

when you prop up nadirs it'll allow you to add more insulin into the picture safely.

make sense?

by the way, i've seen many lantus/levemir users try to eliminate bounces by reducing the dose. initially the results don't look too bad, but eventually you'll see the caretaker having to take the dose right back up. when i look at those spreadsheets, all i see is months of wasted effort and expense. sigh...
 
Re: 1/31 Champ AMPS 218, +2 307, +4 318 - ??'s FOR THE GURU'

Thank you, Sienne & Alex, for making me start thinking again. I seriously think my brain took a vacation. For some reason, I had it in my head that I didn't want Champ to go into the greens because it would trigger a bounce. I just went back a few condos to when we talked about all this and I realize that I had twisted all this in my head...thinking I'm trying to prevent bouncing with the food when, in fact, I'm just trying to control his descent and keep him from earing a decrease. Increasing his dose every six cycles will lessen the bouncing (in time). Okie dokie...I'm on board again. I got this!! I'm going to stop my "oh my god oh my god i need to panic" routine and realize this, ALL TOGETHER NOW, is a marathon, not a race. I will repeat this mantra every day......

Peter, Tracy, Linda, and Melissa...thanks for the support. I know you've all dealt, or been dealing, with your own bouncing kitties. It really helps to be reminded that I'm not alone in this.

Jill, I hope you feel better!! Thank you so much for taking the time to stop in when I know you have so much on your plate!!

Sienne, as usual, you're my voice of reason and the slap across the head I need from time to time!!!

Julie, I'm glad you mentioned glucose toxicity. I just did a goggle search and got some education!!! Thank you!!
 
Re: 1/31 Champ AMPS 218, +2 307, +4 318 - ??'s FOR THE GURU'

And I'm sure that Jill's Alex appreciates that "thank you" but I'm sure Alex would like a treat even more!! Jill, on the other hand, is most likely appreciative of your brain coming back on line.
 
Re: 1/31 Champ AMPS 218, +2 307, +4 318 - ??'s FOR THE GURU'

:lol: :lol: :lol: I haven't called anyone by their cat's name since I first started on this board!!!!

Sorry JILL!!!!
 
Re: 1/31 Champ AMPS 218, +2 307, +4 318, +8 296

Well, Champers, I'm glad you got this sorted out :lol: :lol: :lol: :lol:

Much love from Gracie.

Oh wait...I meant Patty... and Marje. Oops.

Gotta laugh...we gotta laugh. :lol: :lol: :lol: :lol: :lol:
 
Re: 1/31 Champ AMPS 218, +2 307, +4 318, +8 296

We completely understand your frustration and the "where did my brain go" phenomenon. Zener is consistently inconsistent and we have been trying to use food to manipulate his early cycle dives which cause bounces. It is complicated by his frequent bouts of poor appy. We have used fancy feast chicken florentine - 11% with some success. And until recently, we were using high carb fancy feast turkey & gravy - 17%. It is so hard to get him eating lower carbs after these higher carb meals, we are now trying to stay with two foods he will eat - 5% fancy feast chicken and 11% purina pro plan chicken mixed together for 8% - and add honey or karo if he is diving. Honey was too slow getting in his system so now we are using karo, though it requires frequent monitoring as the bump is short lived. We have still been unsuccessful in getting him to eat any of the good low carb foods. If you can wade through Zener's SS, we put what he eats on there. Hope this helps!
 
Re: 1/31 Champ AMPS 218, +2 307, +4 318, +8 296

hi patty - not too much I can add to what hasn't already been said. I too am one that will manage things with food, to manipulate the curve. it did even Mannie out alot, but took time to get there - it didn't happen over night. we still get bounces, but he doesn't dive like he used to. Wish you luck!

Come on down to the blues Champ - it's a great floor!
 
Re: 1/31 Champ AMPS 218, +2 307, +4 318, +8 296

Hi Patty, you know by now, that I have nothing intelligent to say about bouncing kitties. :-D
I'm sending along support, and sitting here, soaking up whatever advice you get from the gurus.
Thanks for asking the questions, so I don't have to. *grin*
 
Re: 1/31 Champ PMPS 329

Wow...what a condo. Lots of great info in here, and I'm glad you've gotten things figured out for Champ - or at least they're as figured out as possible when your talking about a cat :lol: ! I know you guys will get back to that flatter, lower curve again, just by sheer determination!

Have a great evening!
 
Re: 1/31 Champ PMPS 329

For a little light reading if you can't sleep in the middle of the night tonight, here's my understanding of hyperglycemia and the related articles/links:


in a non-diabetic cat, the pancreas' beta cells produce insulin and amylin. According to Dr. E Hodgkins and Dr J Rand (Rand/Roomp Protocol) too high of blood sugar suppresses the insulin secretion from the beta cells. after just 3-7 days at 540 mg/dL Dr Rand found only minimal insulin secretion from the beta cells.

if the hyperglycemia lasts only a short time the pancreas's beta cells may either heal, or some may die, but enough of them may remain that the cat can go OTJ. if it lasts for a long period of time, the beta cells will die.

when the beta cells stop producing insulin, they continue to produce amylin in response to high blood sugar. the high blood sugar then causes the amylin to be disrupted in its normal folding process and it clogs the islets of the pancreas. when that happens the beta cells will die and are unrecoverable. if enough of the islets are covered and the beta cells blocked/dead, remission in that cat is no longer possible.

When a diabetic animal is hyperglycemic for long enough, the animal's damaged tissues may start having trouble using insulin. This in turn means that even a well-dosed animal may continue to have high blood sugar, leading to even more insulin resistance.



here are some of the links that i pulled all of the above from. all of these do make me think that there is a limited amount of time for getting a cat off of insulin - but it's related to the amount of time the cat spends in higher numbers, perhaps, more than the overall amount of time being diabetic. specifically, the last article in this email is about amyloidosis - the plaques that develop and cover the islets in the pancreas, killing beta cells.

this is pretty disjointed because i've gone back and forth, added information, and pulled out excerpts that seemed relevant, but here it is . . .

http://clinical.diabetesjournals.org/content/23/1/44.full
the case study was about a man, but the part that interested me was at the end in the "clinical pearls" specifically #2 below.
Clinical Pearls

Glucose toxicity occurs frequently in type 2 diabetes. When profound hyperglycemia (blood glucose > 300 mg/dl) is persistently present, pancreatic β-cell insulin release is downregulated. In the presence of underlying insulin resistance, this contributes to progressly greater hyperglycemia and may lead to ketosis.

Glucose toxicity can be reversed by aggressive treatment of severe hyperglycemia with insulin. The goal is to return blood glucose to near-normal values for several days or weeks to allow restoration of islet-cell insulin production. When this occurs, then diet, exercise, and oral antidiabetic medications may be sufficient to allow the patient to maintain near-normalization of blood glucose for extended periods of time.



http://www.medscape.com/viewarticle/428857 Management of New Onset Type 2 Diabetes

When a patient presents with severe hyperglycemia, glucose toxicity may be a major issue affecting the course of treatment. Often these patients have been hyperglycemic for weeks or months prior to presenting with the usual symptoms of polyuria and polydipsia. During this time, the pancreatic beta cells are desensitized to glucose-stimulated insulin secretion due to the persistently high ambient glucose concentrations,[1] resulting in insufficient insulin production and availability.

However, glucose toxicity is at least partially reversible, and this has major implications in the choice of an initial treatment. Many patients with severe glucose toxicity are best managed by insulin therapy because of their relative lack of endogenous insulin secretion and underlying insulin resistance that is exacerbated by glucose toxicity. As the effects of glucose toxicity are reduced over the first few weeks of treatment, the insulin dose can be tapered and oral medications may be successfully introduced.

Unfortunately, severe hyperglycemia does not provide an accurate estimate of the 2 major underlying factors in type 2 diabetes, which are insulin resistance and beta-cell reserve. In a nondiabetic person, insulin stimulates glucose uptake in skeletal muscle. In type 2 diabetes, skeletal muscle is resistant to the effects of insulin. Therefore, over time, pancreatic beta cells secrete greater and greater amounts of insulin to overcome insulin resistance. Eventually beta-cell exhaustion occurs and hyperglycemia develops.

The amount of insulin resistance and beta-cell reserve is highly variable from patient to patient at presentation. Once glucose toxicity is reduced, patients often have enough residual beta-cell function for oral agents to be effective. Measuring C-peptide levels can help determine the level of beta-cell reserve, as C-peptide is only produced if insulin is secreted by the beta cell.[2] However, this is not always a reliable test because glucose toxicity may suppress C-peptide levels. In addition, tests can be done to determine if the patient develops late-onset type 1 diabetes due to an underlying autoimmune destruction of beta cells.



http://www.jbc.org/content/279/41/42351.full
Chronic Oxidative Stress as a Central Mechanism for Glucose Toxicity in Pancreatic Islet Beta Cells in Diabetes*
Journal of Biomedical Chemistry

however, the basic point is that antioxidants may have a role in preserving those beta cells or helping them recover.


http://petdiabetes.wikia.com/wiki/Glucose_toxicity and so interesting that in the links at the bottom of the article are some to FDMB Think Tank discussions! one of the options at the end of this paragraph about jump-starting or pushing through insulin resistance by using a more potent insulin sounds like our use of R on FDMB.


http://petdiabetes.wikia.com/wiki/Amyloidosis
this article talks about amyloidosis and how it figures into a cat not being able to go into remission after a period of time. this would be directly relevant for any cat in too-high numbers for too long. i thought it was interesting.

basically it's saying that amylin is produced in the beta cells, along with insulin, in response to high blood sugar. if the beta cells aren't producing insulin they still continue producing amylin in response to high blood sugar. the high blood sugar then causes the amylin to be disrupted in its normal folding process and it clogs the islets. when that happens the beta cells die and are unrecoverable. if enough of the islets are covered and the beta cells blocked/dead, remission in that cat is no longer possible.
 
Re: 1/31 Champ PMPS 329

i know patty - i thought the same thing about punkin. i'm pretty sure we caught the diabetes within a week or so because he had such a dramatic decline, but after his acro diagnosis, i listened to the people who said acros shouldn't go under 100 and i let him be too high for months. now i think they were wrong on that - i've looked at a bunch of ss of acro cats from more than a couple of years ago before this notion came about, and they all let their cats go into greens. no problems. unfortunately, i think by listening i have wrecked punkin's chances of going OTJ even with the SRT. as you said, it's not the end of the world if they remain diabetic but if i had only known then what i know now . . . hindsight has painful clarity sometimes, doesn't it?
 
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