1/7 Ivy Amps 400, +3 222, +3.10 112, +5 151, +7 142, +9 248, Pmps 400, +2 343, +3 247 Libre

Staci & Ivy

Staci & Ivy

Member Since 2022
https://www.felinediabetes.com/FDMB...10-130-pmps-134-2-59-3-48-5-116-libre.285343/
Good morning All,
Amps 400
Big bounce from Ivy’s lovely dip down to nicer bgs last night early in her cycle.
She had an active cycle while I was out to dinner. In addition to her feeder hourly snacks, my son gave her a tsp of 12.5% around +2.5 & 1 tsp of 9.25% at +3. She was dropping down to 48, 55 on Libre over the evening.
I wanted her to stay high enough while I was out so no issues.
When I got home she stayed lower, so the added higher carbs don’t seem to have affected her cycle. She eventually went up to a safer number around +5.5 when I went to bed.

Today began in the red, 400 or higher, but already coming down at +2 she’s 262 on Libre.
Giving hourly 6% snacks, as usual +1,2,3.

Regarding her itchiness, I’ve been thinking about it and I realized that we added 1/16 tsp freeze dried beef liver (for her anemia and lower HCT levels) to her diet on October 11, 2023 two times a day. I went back through my notes and it seems I started commenting, more and more about her itchiness.

While we are waiting to meet with the nutritionist on 1/22, I’m going to eliminate that beef liver and just see if the itchiness calms down at all.
Maybe she’s having an allergic reaction to that. She was itching before I added that, but maybe there’s a correlation and it’s gotten worse?
Who knows but I’ll try that starting tonight, (eliminating it) and see if there’s any change.

Have a good day everyone. :cat:
 
112 on Libre at +3.10
Fed 1/2 tsp 9.25% per Marje’s suggestion. Trying to slow her fast drops. She’s picking up steam suddenly.
Problem is her fast drops then lead to bounces (up to 400 on Libre) later.
Cycles keep repeating lately. High bounces, then drops, repeat. Ivy clears bounces fast, next cycle, but the extreme highs then lows need to be tamed. @Marje and Gracie
Tagging you here so not to hijack Alicia’s condo further. :)
 
Good meowning Staci and Ivy!

Very similar pattern to yesterday. She loves 400s for her AMPS. Luckily she's already on her way down. Just a quick purrrrrformance on her trampoline and meow time to relax.

Have a nice amd peaceful day.

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Staci & Ivy said:
112 on Libre at +3.10
Fed 1/2 tsp 9.25% per Marje’s suggestion. Trying to slow her fast drops. She’s picking up steam suddenly.
Problem is her fast drops then lead to bounces (up to 400 on Libre) later.
Cycles keep repeating lately. High bounces, then drops, repeat. Ivy clears bounces fast, next cycle, but the extreme highs then lows need to be tamed. @Marje and Gracie
Tagging you here so not to hijack Alicia’s condo further. :)
Click to expand...
I’ll move your question from Kit’s condo over here shortly and respond. I appreciate your patience…..it’s my cats’ morning routine time and patient they are not :smuggrin::rolleyes:
 
Well done Sherlock Staci :joyful: It does sound like you're on to something. I hope you've discovered the source. If it's a food allergy I'll assume you'll see a difference rather quickly.
She's had a really nice streak of green in the past couple of nights. She does seem to like her morning red.
Ivy, it's the blue pill not the red :p
It's wonderful that she comes down more quickly from her highs.
I find it also interesting that you've had her on this dose for nearly three weeks now and she's actually giving you some good greens and short bounces. I wonder of the itchiness adds stress that kicks her bg.
I hope you're having a lovely day :bighug::bighug::bighug:
 
Hi Staci!
Ivy seems to be responsive to insulin much more lately!
Even though some of the preshots are high, she's come down nicely!

And wow, good thinking about beef liver! Hope that's the answer and you don't have to keep buying 50lb of baby clothes every week :p

Hope you and Ivy are having nice relaxing Sunday :bighug::bighug::bighug:
 
Alicia & Kit cat said:
Cat's? Not patient? :eek::eek::joyful::joyful:
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:p My world revolves around them by demand....but also because they are so stinkin’ cute and sweet that I can’t help it.

Jason - Kona's Dad said:
Has Marje recommended Nutriscan yet? ;) https://hemopet.org/nutriscan/ Wondering if it'll help with figuring out the itch? and the suspicion of beef liver?
Click to expand...

I hadn’t, but thank you, Jason, for doing so. I was focused on the curve issue. However, @Staci & Ivy, this was money well spent on both our cats. It does not address food “allergies” as Dr. Dodds tries to address them before they get to that point.....so while they are still food sensitivities. One thing I learned is that when a cat doesn’t want to eat a specific food, perhaps it is not being picky but it knows it causes them issues. As humans, if we know a specific food upsets our tummy, we avoid it. I thought my boy, Tobey, was just being picky by not eating his raw balanced chicken. However, I did know that chicken is one of the most suspect meats in causing food/tummy/allergy issues but he was not clinical for any of that. The Nutriscan revealed that he does have a mild sensitivity to chicken so I stopped it before it got to be more than that. The good thing is now, with the Nutriscan results, I know if they don’t gobble it down, they are being picky. Gotcha, little ones!!

I think it’s smart of you to stop the beef liver treats and see what happens but be sure you don’t change anything else or you won’t know. Because she likely has regenerative anemia, have you considered an iron supplement?

I’m curious why you think she is in CKD, Stage I-II? Nothing in her labs indicates this. She is really concentrating her urine nicely at 1.040, her creatinine is 1.4, and her BUN is 34. Keep in mind, as well, that raw fed cats generally have a higher creatinine due to the amount of protein. For example, both my cats (13 and 7) have been raw fed since kitten hood. The 13 year old is a larger male and his creatinine runs about 1.9 but he concentrates the heck out of his urine and his SDMA is 12. My younger one is a tiny girl but her creatinine is always about 1.4, again with very concentrated urine and SDMA about 11.

Ivy's potassium, calcium, and phosphorus are all normal although her phosphorus could be lower. I like to keep my healthy cats’ P at about 4-4.5 max. However, CKD is not diagnosed based on P anyway. I am very curious why you are giving her a phosphorus binder and what is the amount of P in the food you give her? A binder is not usually done unless a cat has CKD and the P is over 6. Has she been diagnosed with hyperphosphatemia due to some other problem (which would be really uncommon especially with a normal calcium level).

I’ve had four CKD cats, two of which lived a very long time and never progressed past Stage III; both passed from a non-related CKD comorbidity. I’ve also been a members of the CKD group associated with Tanya’s website and another one for decades. So unless you have more recent labs than Sep, 23, I’m not seeing CKD.

Staci & Ivy said:
Hi Marje, I just read this response. (Sorry to hijack your post, Alicia.)
Ivy is not very carb sensitive and her regular 6% diet doesn’t do much if she’s dropping. And yes, I’ve been told many times to let her drop so she gets used to lower green healing numbers.
Problem is when she drops in the first 3 hours of a cycle, it can be very extreme. She can go from 400 down to under 100 within 3 hours. Sometimes drops over 100 points in an hour or less. (I watch her drops on her Libre sensor).
Then I check with an ear prick to verify on a handheld meter if she goes to very low numbers.
Then of course later in the cycle she can bounce back up to 400 again (highest number the Libre 3 reads). And the cycle repeats.
You can see these cycles on her SS.
All that said, would you suggest using 9% or 12.5% frequently if I see these big drops early in her cycle before and at onset? (I make her food so that’s the carbs I have to use in my recipes).
Thank you @Marje and Gracie :)
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Little Miss Ivy does have some interesting curves and I don’t mean physically, although she is quite adorable. I think you are doing a pretty good job but she has thrown some interesting situations out there like on the evening of 1/5. Up at +1 and way down at +2. I’m assuming she wasn’t fed or didn’t get into anything at PMPS different from usual that would have caused that spike at +1 (I don’t see anything on her SS....thanks for the GREAT notes, BTW).

By the time 2015 came around with Gracie and she had been diabetic 5 years, I was able to feed more in the 3-6% carbs range as, by and large, she had stopped that crazy dropping. What I found, though, when I was experimenting, was that I had to be consistent with the 9-10% food. I couldn’t give her 6% at AMPS when she was at 200 and think it was going to help when she onset. So if I was feeding LC on the higher end, I had to do it even when the BG was higher than I wished it was if it was early in the cycle before she onset. Does that make sense? By +3 or +4, if she had flattened out, I could give her the 3-6% but if you are trying to slow the early drops, you have to feed the 9-10% early even if your gut is saying, “she’s at 300!” unless you know her so well that you know she’s bouncing and is absolutely not going to clear a bounce that cycle.

But what I’m seeing every PM cycle since 1/1 except for 1/2 and also the AM cycle of 1/3 is that she’s losing duration. Most people can’t tell the onset of a bounce from loss of duration but if the BG absolutely zooms up within an hour, it’s loss of duration. THEN you might see a bounce on top of that and so you see her getting into the 400s. I also think her drops, when she does drop, are pretty mild. Gracie could drop 70-100 mg/dL in an hour until she got into greens....which didn’t take long at that rate.

Let’s look at PM 1/5 closer. She dropped a good deal from +1 to +2 which looks like a food spike drop plus onset. That’s why I was asking if she could have eaten something else that spiked her like that as, more often than not (but not always), she drops at +1. At any rate, you did not feed any more than 6% that evening but she still lost duration by +6. I have to question what role her snacks are playing in that especially if you are giving them through +5 and even if they are ultra LC?

If ivy were my cat, I would worry less about those occasional drops you are seeing, like PM cycle 1/5, and stick with your 6% lamb especially if she has sensitivities. I think you’ve been doing a great job!!!

Let me know your questions and if there is something specific you see that I’m missing, I’m all ears.
 
Marje and Gracie said:
I’m curious why you think she is in CKD, Stage I-II? Nothing in her labs indicates this.
Click to expand...
Hi Marje, thanks so much for the insight. I’m so confused. Ivy has been diagnosed and treated for Ckd for 5-6 years. Discovered when she had a dental done. Been treating as such ever since. Seen multiple vets and 3 internal medicine vets, 2 nutritionists. None has said she’s not a ckd cat. So I’m floored with your assessment and love what you’re suggesting.
Yes 9/23 labs are the most current.

The beef liver is what my vet suggested to help with the anemia In October 2023. She couldn’t come up with another suggestion to try to help raise the HCT levels, which have suffered the past several years. (The internal med vet thought the anemia level was fine. Regular vet disagreed. )
Is there an iron supplement you like instead?

I give 1/4 tsp phosphorus binder in am and 1/2 tsp in evening. I use Thriving Pets binder.
 
Marje and Gracie said:
like on the evening of 1/5. Up at +1 and way down at +2. I’m assuming she wasn’t fed or didn’t get into anything at PMPS different from usual that would have caused that spike at +1 (I don’t see anything on her SS..
Click to expand...
No Ivy has no way to access any food other than what I feed her. She’s an only pet and not near food scraps. She’s not a Hoover anyway, never was.
 
Marje and Gracie said:
By +3 or +4, if she had flattened out, I could give her the 3-6% but if you are trying to slow the early drops, you have to feed the 9-10% early even if your gut is saying, “she’s at 300!” unless you know her so well that you know she’s bouncing and is absolutely not
Click to expand...
So are you suggesting I try feeding her 9% as her constant food (which would help with duration?) instead of 6%?
It does seem that Ivy consistently drops as soon as +1 anywhere to +3 and beyond. Even until +5 at times.
She’s not carb sensitive so I have to give her higher carbs if I want to temper or slow her drops.

As I mentioned before I’ve been advised to give her only 6% and only use higher carbs if she’s under 50 on a handheld meter. So I’ve been trying to follow that but she really dives hard.
I do think she may need a little more carbs to combat the power of the insulin.
But since she’s on 6% only, her bg is somewhat lower. (But she bounces so high after she’s so low….). I had no idea it was a duration issue. Just thought it was a bounce as I’ve been told that so many times.
 
Marje and Gracie said:
:p My world revolves around them by demand....but also because they are so stinkin’ cute and sweet that I can’t help it.



I hadn’t, but thank you, Jason, for doing so. I was focused on the curve issue. However, @Staci & Ivy, this was money well spent on both our cats. It does not address food “allergies” as Dr. Dodds tries to address them before they get to that point.....so while they are still food sensitivities. One thing I learned is that when a cat doesn’t want to eat a specific food, perhaps it is not being picky but it knows it causes them issues. As humans, if we know a specific food upsets our tummy, we avoid it. I thought my boy, Tobey, was just being picky by not eating his raw balanced chicken. However, I did know that chicken is one of the most suspect meats in causing food/tummy/allergy issues but he was not clinical for any of that. The Nutriscan revealed that he does have a mild sensitivity to chicken so I stopped it before it got to be more than that. The good thing is now, with the Nutriscan results, I know if they don’t gobble it down, they are being picky. Gotcha, little ones!!

I think it’s smart of you to stop the beef liver treats and see what happens but be sure you don’t change anything else or you won’t know. Because she likely has regenerative anemia, have you considered an iron supplement?

I’m curious why you think she is in CKD, Stage I-II? Nothing in her labs indicates this. She is really concentrating her urine nicely at 1.040, her creatinine is 1.4, and her BUN is 34. Keep in mind, as well, that raw fed cats generally have a higher creatinine due to the amount of protein. For example, both my cats (13 and 7) have been raw fed since kitten hood. The 13 year old is a larger male and his creatinine runs about 1.9 but he concentrates the heck out of his urine and his SDMA is 12. My younger one is a tiny girl but her creatinine is always about 1.4, again with very concentrated urine and SDMA about 11.

Ivy's potassium, calcium, and phosphorus are all normal although her phosphorus could be lower. I like to keep my healthy cats’ P at about 4-4.5 max. However, CKD is not diagnosed based on P anyway. I am very curious why you are giving her a phosphorus binder and what is the amount of P in the food you give her? A binder is not usually done unless a cat has CKD and the P is over 6. Has she been diagnosed with hyperphosphatemia due to some other problem (which would be really uncommon especially with a normal calcium level).

I’ve had four CKD cats, two of which lived a very long time and never progressed past Stage III; both passed from a non-related CKD comorbidity. I’ve also been a members of the CKD group associated with Tanya’s website and another one for decades. So unless you have more recent labs than Sep, 23, I’m not seeing CKD.


Little Miss Ivy does have some interesting curves and I don’t mean physically, although she is quite adorable. I think you are doing a pretty good job but she has thrown some interesting situations out there like on the evening of 1/5. Up at +1 and way down at +2. I’m assuming she wasn’t fed or didn’t get into anything at PMPS different from usual that would have caused that spike at +1 (I don’t see anything on her SS....thanks for the GREAT notes, BTW).

By the time 2015 came around with Gracie and she had been diabetic 5 years, I was able to feed more in the 3-6% carbs range as, by and large, she had stopped that crazy dropping. What I found, though, when I was experimenting, was that I had to be consistent with the 9-10% food. I couldn’t give her 6% at AMPS when she was at 200 and think it was going to help when she onset. So if I was feeding LC on the higher end, I had to do it even when the BG was higher than I wished it was if it was early in the cycle before she onset. Does that make sense? By +3 or +4, if she had flattened out, I could give her the 3-6% but if you are trying to slow the early drops, you have to feed the 9-10% early even if your gut is saying, “she’s at 300!” unless you know her so well that you know she’s bouncing and is absolutely not going to clear a bounce that cycle.

But what I’m seeing every PM cycle since 1/1 except for 1/2 and also the AM cycle of 1/3 is that she’s losing duration. Most people can’t tell the onset of a bounce from loss of duration but if the BG absolutely zooms up within an hour, it’s loss of duration. THEN you might see a bounce on top of that and so you see her getting into the 400s. I also think her drops, when she does drop, are pretty mild. Gracie could drop 70-100 mg/dL in an hour until she got into greens....which didn’t take long at that rate.

Let’s look at PM 1/5 closer. She dropped a good deal from +1 to +2 which looks like a food spike drop plus onset. That’s why I was asking if she could have eaten something else that spiked her like that as, more often than not (but not always), she drops at +1. At any rate, you did not feed any more than 6% that evening but she still lost duration by +6. I have to question what role her snacks are playing in that especially if you are giving them through +5 and even if they are ultra LC?

If ivy were my cat, I would worry less about those occasional drops you are seeing, like PM cycle 1/5, and stick with your 6% lamb especially if she has sensitivities. I think you’ve been doing a great job!!!

Let me know your questions and if there is something specific you see that I’m missing, I’m all ears.
Click to expand...
Marje and Gracie said:
Let’s look at PM 1/5 closer. She dropped a good deal from +1 to +2 which looks like a food spike drop plus onset. That’s why I was asking if she could have eaten something else that spiked her like that as, more often than not (but not always), she drops at +1. At any rate, you did not feed any more than 6% that evening but she still lost duration by +6. I have to question what role her snacks are playing in that especially if you are giving them through +5 and even if they are ultra LC?

If ivy were my cat, I would worry less about those occasional drops you are seeing, like PM cycle 1/5, and stick with your 6% lamb especially if she has sensitivities. I think you’ve been doing a great job!!!
Click to expand...
Do you think that snacks I’m giving in the pm cycle through +6 are shortening her duration? (They are basically 2 tablespoons of her 6% diet per hour.)

I’m feeling really confused about what I should be doing at this point to move her to better overall bg and reduce these bounce or duration issues.

Plus the itching is another ball of wax :(
We originally fed her a homemade diet of chicken and lamb then they felt she has some ibd issues. So we went to a novel protein being lamb a few years ago. Now we are about to have a turkey recipe possibly formulated for me to cook (her diet is cooked, not raw).
 
Staci & Ivy said:
Ivy has been diagnosed and treated for Ckd for 5-6 years
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Treating how besides the phosphorus binder? Have you ever looked at Tanya’s CKD site? One of the references states:

"Grauer GF Today's Veterinary Practice5(2) pp36-41 says 'Note that this staging system suggests that azotemia in cats begins with serum creatinine concentrations of 1.6 mg/dL or greater. However, serum creatinine concentrations must always be interpreted in light of the patient’s muscle mass, urine specific gravity (USG), and physical examination findings in order to rule out pre- and postrenal causes of azotemia.’"

The bold is mine. While the IRIS Staging chart shows Stage I as being 1.6 or below, it’s not so simple as to only look at creatinine and there is no lower limit to that Stage which has been an issue for a long time. The IRIS system does state if a cat has no symptoms or other tests which indicate CKD, they should just be monitored.

Also, on urine specific gravity:
  • "The typical range for hydrated cats is around 1.035 to 1.060.
  • A cat with a USG below 1.035-1.040 is generally considered to have a problem of some kind.
  • In a cat with normal bloodwork, it may be an early warning sign that CKD is developing.
  • Most CKD cats have a much lower USG of between 1.008 and 1.012.”

CKD cats can’t concentrate their urine. When I look at her USG, her lowest is is 1.036 which is great.

I’m not a vet but it shocks me that she has been diagnosed with CKD. Her creatinine was 1.1 last May!

Staci & Ivy said:
Is there an iron supplement you like instead?
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IF a cat has non-regenerative anemia caused by CKD, beef liver treats won’t touch it. They need vitamin B12 in the form of methylcobalamin and a multi B vitamin. You can read more about anemia associated with CKD here. I’m surprised none of these vets have checked her SDMA. Before that test, the first indicator of CKD was not the creatinine but the USG. If the USG started creeping down below 1.035, it was an early indicator of CKD.

The best advice is for you to join Tanya’s CKD forum and show them her labs and let them tell you what they think. But, as I’ve said, I’ve been in these groups a very long time and had my own CKD cats and I’m not seeing it. But never say never.

Staci & Ivy said:
So are you suggesting I try feeding her 9% as her constant food (which would help with duration?) instead of 6%?
It does seem that Ivy consistently drops as soon as +1 anywhere to +3 and beyond. Even until +5 at times.
She’s not carb sensitive so I have to give her higher carbs if I want to temper or slow her drops.

As I mentioned before I’ve been advised to give her only 6% and only use higher carbs if she’s under 50 on a handheld meter. So I’ve been trying to follow that but she really dives hard.
I do think she may need a little more carbs to combat the power of the insulin.
But since she’s on 6% only, her bg is somewhat lower. (But she bounces so high after she’s so low….). I had no idea it was a duration issue. Just thought it was a bounce as I’ve been told that so many times.
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I’m sorry I confused you. I as talking in generalities. If she were mine, I would continue the 6% food as you have been and if you see a cycle where you feel pretty certain she’s going to clear a bounce and drop down, you can up the ante at PS. I’m saying this because I don’t think her drops are as bad as you do. They are fairly gradual for the most part. The other reason I’m saying this for her is because she does seem to be diet-limited. You have to be a little more careful with IBD cats (was she diagnosed by biopsy?). Being a raw feeder myself, it’s hard to get those carbs up using raw food and I definitely think the raw or raw cooked is a better diet for an IBD cat than any commercial cat food. Does all that make sense?

Staci & Ivy said:
Do you think that snacks I’m giving in the pm cycle through +6 are shortening her duration? (They are basically 2 tablespoons of her 6% diet per hour.)
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First, tell me if you are talking “snacks” or “minimeals”. There is a difference. A minimeal is fed every hour or so for the 2-4 hours of the cycle to flatten the curve and work with the insulin. A snack is extra. For example, I always gave Gracie a very small boiled chicken snack later in the cycle once she developed IBD because it helped keep the tummy acid down. That’s a snack. If you are talking minimeals, for a cat on Lantus, they shouldn’t really need more than PS, +1, +2 and +3 minimeals. By feeding all the way to +5, it could be shortening her duration. That’s just one of those things you have to experiment with and see because you know the saying “ECID”.

Staci & Ivy said:
I’m feeling really confused about what I should be doing at this point to move her to better overall bg and reduce these bounce or duration issues.
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You aren’t going to like the answer but it is “patience, Grasshopper”. They bounce until they don’t. I’ve seen cats here bounce for three years, then the liver snaps, they went into remission and stayed there for years. My Gracie bounced for 5.5 years although she had times when I could keep her in the 50-199 range for quite a long time. We all hate bouncing but it’s just a fact of FD. I honestly believe you are doing a really good job of addressing it especially considering all the other things going on with her. Scroll through her 2023 SS and see how far she has come!!
 
Marje and Gracie said:
oncentrating her urine nicely at 1.040, her creatinine is 1.4, and her BUN is 34. Keep in mind, as well, that raw fed cats generally have a higher creatinine due to the amount of protein. For example, both my cats (13 and 7) have been raw fed since kitten hood. The 13 year old is a larger male and his creatinine runs about 1.9 but he concentrates the heck out of his urine and his SDMA is 12. My younger one is a tiny girl but her creatinine is always about 1.4, again with very concentrated urine and SDMA about 11.

Ivy's potassium, calcium, and phosphorus are all normal although her phosphorus could be lower. I like to keep my healthy cats’ P at about 4-4.5 max
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So interesting to read this! Fistuk was diagnosed with early CKD in October. According to your numbers (if I understand correctly) Fistuk doesn't have CKD...
 
Marje and Gracie said:
I am very curious why you are giving her a phosphorus binder and what is the amount of P in the food you give her? A binder is not usually done unless a cat has CKD and the P is over 6. Has she been diagnosed with hyperphosphatemia due to some other problem (which would be really uncommon especially with a normal calcium level).
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No she’s not been diagnosed with hyperphosphatemia. I’m not sure if the phosphorus level in her food offhand, but it was formulated by a veterinarian nutritionist who understood she was considered a CKD cat.
Also, below is her Libre graph to show you the extreme highs and lows. Not a gentle Lantus curve.
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Staci & Ivy said:
No she’s not been diagnosed with hyperphosphatemia. I’m not sure if the phosphorus level in her food offhand, but it was formulated by a veterinarian nutritionist who understood she was considered a CKD cat.
Also, below is her Libre graph to show you the extreme highs and lows. Not a gentle Lantus curve.
View attachment 68711
Click to expand...
No but there are not alot of cats who have that flat curve. Again, I think one reason she is shooting up so high is she is losing duration and then she’s bouncing on top of it. There are probably only three people in this forum that understand what loss of duration looks like: Sienne, Wendy, and me and I’m probably the one who recognizes it the most because it happened to Gracie. After nadir, the BG should gradually increase even in a cat that’s going to bounce.

The best thing, if you are really wanting to try it, is to try and find an acceptable 9 or 10% food and she how she does with it with her IBD. It will likely bring the overall curve up and you’ll have to raise the dose. But sometimes, I think we get a little too aggressive with a cat that has other things going on. Having experience with IBD (diagnosed by biopsy), I had to change up what I was feeding Gracie and make it work with her curve even if we lost some ground. If you look at her SS, after she was dx, she started bouncing alot more again because I was limited on what I could feed her.
 
Marje and Gracie said:
IF a cat has non-regenerative anemia caused by CKD, beef liver treats won’t touch it. They need vitamin B12 in the form of methylcobalamin and a multi B vitamin. You can read more about anemia associated with CKD here. I’m surprised none of these vets have checked her SDMA. Before that test, the first indicator of CKD was not the creatinine but the USG. If the USG started creeping down below 1.035, it was an early indicator of CKD.
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Ivy had been taking methylcobalamin for several years but when I put her on Zobaline last year for neuropathy (hadn’t yet helped) they said she didn’t need 2 b12 and to stop the methylcobalamin. I don’t have her on a Vitamin B. (Do you like any in particular?)
The vet thought the iron in the liver could help but it sounds like not the best idea.
 
Marje and Gracie said:
Treating how besides the phosphorus binder? Have you ever looked at Tanya’s CKD site? One of the references states:
Click to expand...
Yes I’ve looked at Tanya’s site before.
Ivy also takes other supplements for Ckd: Standard Process Renal Support, Vetri Science Renal Chews and a homeopathic (drops) Futureplex Antioxidant Kdny-drn. (Among other supplements).
I mentioned before her prior diet was chicken and salmon… (then we switched to lamb only). They saw some thickening on an ultrasound and said IBD. She had also had a few bouts of diarrhea. (However she hasn’t had that in years, so maybe the diet change did help).
She did not have a biopsy for a diagnosis of IBD.
 
Marje and Gracie said:
The best thing, if you are really wanting to try it, is to try and find an acceptable 9 or 10% food and she how she does with it with her IBD. It will likely bring the overall curve up and you’ll have to raise the dose. But sometimes, I think we get a little too aggressive with a cat that has other things going on. Having experience with IBD (diagnosed by biopsy), I had to change up what I was feeding Gracie and make it work with her curve even if we lost some ground. If you look at her SS, after she was dx, she started bouncing alot more again because I was limited on what I could feed her.
Click to expand...
The 9.25% Lamb food I already use is the recipe I have from the nutritionist.
Do you feel Ivy would do better on a little higher carb recipe than 6% or would you leave it alone with 6%?
It’s hard for me to know when she’s going to break a bounce, I wouldn’t know when would be the right cycle to feel a higher carb at PS.
(How could I tell in advance?)

I can eliminate the mini-meals of 2 tbsp of her 6% lamb (past +3 in pm cycle) to see how she does.
(I added those extra snacks since she was going lower over night for a while.)
We were trying to have more carbs onboard to keep her going against the insulin. But it seems like maybe it’s causing a duration of insulin issue and maybe causing more bouncing, if I’m understanding.
 
Staci & Ivy said:
Ivy had been taking methylcobalamin for several years but when I put her on Zobaline last year for neuropathy (hadn’t yet helped) they said she didn’t need 2 b12 and to stop the methylcobalamin. I don’t have her on a Vitamin B. (Do you like any in particular?)
The vet thought the iron in the liver could help but it sounds like not the best idea.
Click to expand...
Another area where vets just don’t get it. Yes, methylcobalamin helps with neuropathy but it’s also very good for non-regenerative anemia combined with a multiB. All you ever wanted to know about B vitamins for cats with CKD is here. The ones I used which are still preferred by that group are Jarrows Bright multi B complex and Vita Cost’s methylcobalamin 500 mg. I used to get #3 gel caps and put the required dose of each in them together. However, another option is if you can syringe feed her, you can mix the doses in with some baby food and syringe it to her.

Staci & Ivy said:
They saw some thickening on an ultrasound and said IBD.
Click to expand...
While this is “possible”, anyone who has dealt with IBD will tell you the diagnosis cannot be confirmed without a biopsy. Having said that, many members of the IBD group on FB do not go the biopsy route and treat based on an assumption of IBD with the ultrasound and symptoms. I had a biopsy done on Gracie and while we would have never known she also had SCL without it, I wish I had just treated based on symptoms. Long story.

Staci & Ivy said:
Do you feel Ivy would do better on a little higher carb recipe than 6% or would you leave it alone with 6%?
Click to expand...
Honestly, I don’t know the answer to that question and no one here no matter their experience would know either. The only way to know is to try it. It’s frustrating, I know, but cats have very different responses to carbs. Our incredible moderator, Jill (RIP), had a kitty, Alex, who got a BG bump off freeze dried chicken that was basically 0% carbs. I know my own frustration when Jill told me “it’s trial and error so do what you think is best” but I found out she was right.

By answering the original question, I was just passing on the institutional knowledge. Does every cat need it? No. But some cats benefit from the higher LC food and it helps to flatten out some curves and increase the insulin dose. Will it work for Ivy? We just won’t know unless you try. However, that doesn’t mean you have to try. If everything is pretty stable with her health wise and the bouncing is just bothering you, it is probably not worth it. Change doesn’t happen overnight. But it just comes down to your decision.

Staci & Ivy said:
(How could I tell in advance?)
Click to expand...
Some cats get a “high before the break”. However, I don’t really see that Ivy has done it as of late and I looked back to late 2023. But what it looks like is a bounce starts and then it appears the BGs start to come down, maybe to blue, and then they go up much higher before coming down, usually into green. It takes a really practiced eye to see it on a SS.

Staci & Ivy said:
I can eliminate the mini-meals of 2 tbsp of her 6% lamb (past +3 in pm cycle) to see how she does.
(I added those extra snacks since she was going lower over night for a while.)
We were trying to have more carbs onboard to keep her going against the insulin. But it seems like maybe it’s causing a duration of insulin issue and maybe causing more bouncing, if I’m understanding
Click to expand...
You can always give her some freeze dried treats if you need to if she’s hungry. But once you hit around +5 or +6, you can start working against the insulin.

Loss of duration and bouncing are two separate things. If a kitty loses duration but doesn’t bounce you would see a pattern like this just as an example. See how the BG fast the BG went up in the AM cycle and came back down in the PM cycle?

AMPS 200
+2 167
+4 120
+6 75
+7 180
+10 275
PMPS 325
+2 300
+4 200
+6 170

Loss of duration with a bounce might look like this (example):
AMPS 200
+2 167
+4 120
+6 75
+7 180
+10 275
PMPS 325
+2 350
+4 375
+6 425

Of course, the BGs might not be that high but you can see the difference in the patterns.
 
Marje and Gracie said:
You can always give her some freeze dried treats if you need to if she’s hungry. But once you hit around +5 or +6, you can start working against the insulin.
Click to expand...
I see what you are saying. My concern with less pm cycle food after + 3 is that she often continues to drop, sometimes steeply, until +4 or +5. If she does keep dropping, would I then give her some food if she was dropping as needed?

She’s not a snacker. Doesn’t ask for food. Isn’t really interested in freeze dried food. (She is happy to eat her regular food at any time I offer it, however).
 
Marje and Gracie said:
Another area where vets just don’t get it. Yes, methylcobalamin helps with neuropathy but it’s also very good for non-regenerative anemia combined with a multiB. All you ever wanted to know about B vitamins for cats with CKD is here. The ones I used which are still preferred by that group are Jarrows Bright multi B complex and Vita Cost’s methylcobalamin 500 mg. I used to get #3 gel caps and put the required dose of each in them together. However, another option is if you can syringe feed her, you can mix the doses in with some baby food and syringe it to her.
Click to expand...
So right now I just crush the zobaline in her food. I add most supplements directly to her food. Would it be ok to add the Jarrows Bright into her food as well?

It sounds like the Zobaline and Jarrows would suffice for the B12 and multi B vitamins combo, is that correct?

The less I have to put down her mouth the better. (I do have to pill her with A Denamaren pill once a day and I try to limit that process). She’s tough to handle.
 
Marje and Gracie said:
By answering the original question, I was just passing on the institutional knowledge. Does every cat need it? No. But some cats benefit from the higher LC food and it helps to flatten out some curves and increase the insulin dose. Will it work for Ivy? We just won’t know unless you try. However, that doesn’t mean you have to try. If everything is pretty stable with her health wise and the bouncing is just bothering you, it is probably not worth it. Change doesn’t happen overnight. But it just comes down to your decision.
Click to expand...
I had tried to feed 12% for a while last summer, but her bg was higher. So it was advised that I take her back to a lower 6%, which was done in October.
Overall, as you mentioned earlier, her SS looks much better over time than it did earlier last year in 2023.
I would love to flatten out her curves, so she doesn’t have the extreme highs and extreme lows that I see. And I don’t love having to intervene with carbs when she starts a fast drop.
I have noticed that if she’s been flat yellow all day, she will usually head into a pretty fast drop after pmps. That can last for 1-5 or 6 hours of a very active cycle.
I don’t notice too many very high bgs and l then a drop to low (as you said).
It’s so hard to figure out what to do. I feel I’ve tried so many options but nothing has really flattened her curve in a successful manner. :(
I really do appreciate your trying to help me. :)
 
Staci & Ivy said:
So right now I just crush the zobaline in her food. I add most supplements directly to her food. Would it be ok to add the Jarrows Bright into her food as well?

It sounds like the Zobaline and Jarrows would suffice for the B12 and multi B vitamins combo, is that correct?

The less I have to put down her mouth the better. (I do have to pill her with A Denamaren pill once a day and I try to limit that process). She’s tough to handle.
Click to expand...
Stacy

I’m sorry....we’ve had guests tonight and it’s late so I hope you don’t mind if I respond tomorrow. I appreciate your patience.
 
Staci & Ivy said:
Of course, Marje. I’m sorry to take up so much of your time. No problem at all :)
Click to expand...
Please no apologies. You aren’t taking up my time.

Staci & Ivy said:
I see what you are saying. My concern with less pm cycle food after + 3 is that she often continues to drop, sometimes steeply, until +4 or +5. If she does keep dropping, would I then give her some food if she was dropping as needed?
Click to expand...
Yes, of course IF she is dropping fast or she’s getting into lower numbers. How we react to the BG coming down is a little different in the before nadir part of the cycle than the after nadir. After nadir, unless she is clearing a bounce, the BG should start to gradually increase so we want to be careful how much we feed when and especially when it comes to carbs. Let’s say she is clearing a bounce and she’s down to 70 at +8 and that makes you nervous. You wouldn’t want to feed HC that late in the cycle when a tsp of LC might let her flatten out (or bring her up).

Staci & Ivy said:
So right now I just crush the zobaline in her food. I add most supplements directly to her food. Would it be ok to add the Jarrows Bright into her food as well?
Click to expand...
You might check the dose on the Zobaline as I think it is more than is needed for CKD plus it’s alot more expensive. Of course, if she still has neuropathy, then she would still need the zobaline. I have heard the Bright doesn’t taste that great but ECID. If she will eat it in her food, yes, you can do that. Just be sure you read the dosing on both of those for CKD.

Staci & Ivy said:
The less I have to put down her mouth the better. (I do have to pill her with A Denamaren pill once a day and I try to limit that process). She’s tough to handle.
Click to expand...
Just curious why she is on Denamarin? It’s been quite a while since her ALT was elevated and that was so, so mild. Barely even above normal. Even elevations into the 300s are mild on ALT. I know this from Gracie often popping up into the 300s on ALT and my little one now always runs about 125 on ALT. If you just want to give liver support, a great product is Adored Beast’s Liver Tonic. It’s drops and so much easier to give and an excellent product. It’s what I give to my Livvie just to give her some liver support.

Staci & Ivy said:
I had tried to feed 12% for a while last summer, but her bg was higher. So it was advised that I take her back to a lower 6%, which was done in October.
Overall, as you mentioned earlier, her SS looks much better over time than it did earlier last year in 2023.
I would love to flatten out her curves, so she doesn’t have the extreme highs and extreme lows that I see. And I don’t love having to intervene with carbs when she starts a fast drop.
I have noticed that if she’s been flat yellow all day, she will usually head into a pretty fast drop after pmps. That can last for 1-5 or 6 hours of a very active cycle.
I don’t notice too many very high bgs and l then a drop to low (as you said).
It’s so hard to figure out what to do. I feel I’ve tried so many options but nothing has really flattened her curve in a successful manner. :(
I really do appreciate your trying to help me. :)
Click to expand...
You have two options:
1. leave it as it is considering her health issues and ride it out. Follow SLGS as written (or TR??) and try not to worry so much about it.
2. Try the 9% and see how it goes. It’s not written in stone that you have to stick with it. Just experiment. If you don’t like the results on the BG, go back to 6%.

I understand the stress having had a very bouncy little girl for a long time. But, in hindsight, if I was doing this dance over again, I’d take a very different approach. Sometimes it’s very hard to see the forest for the trees, KWIM? We are so anxious for them to do well and to not have all this bounciness, up/down. But I’ve seen cats live for over a decade with FD with alot worse looking SS than hers; that’s not to say you should not do what you are able to to help her but we need to also try and keep our own stress levels down. After Gracie passed away, it took me TWO years to get my adrenal glands functioning properly again because I had allowed myself to become so overstressed and exhausted. Our health is important to so we do the very best we can for them but we try to not be so stressed every time we look at the meter.

Does any of that help?

Jason - Kona's Dad said:
ohhhh, I have a bookmark for that one. I wanted to do that too.

Man, I'm not going to have a retirement fund at this rate. These cats..
Click to expand...
Do you mean Animal Biome? I also did that and I don’t think it was worth the $$$. Yes, if your cat has IBD and all the symptoms that come with it like vomiting and diarrhea. But they are almost ALWAYS going to recommend the fecal transplant pills. I ran the test on my Tobey just to see if some of his respiratory issues he’s had since kittenhood were the result of gut inflammation. His gut biome looked pretty good but they still tried to talk me into the fecal transplant. My vet, who recommended we do the test, was against the pills for him. Instead, I increased his Saccharomyces boulardi to balance out the one imbalance he had and started him on PEA from Dr. Judy. It’s made a world of difference as PEA is a great anti-inflammatory.

Animal Biome will not identify food sensitivities or allergies. It will just tell you if the gut bacteria is good, bad, needs improvement, etc.
 
Last edited:
Marje and Gracie said:
Please no apologies. You aren’t taking up my time.


Yes, of course IF she is dropping fast or she’s getting into lower numbers. How we react to the BG coming down is a little different in the before nadir part of the cycle than the after nadir. After nadir, unless she is clearing a bounce, the BG should start to gradually increase so we want to be careful how much we feed when and especially when it comes to carbs. Let’s say she is clearing a bounce and she’s down to 70 at +8 and that makes you nervous. You wouldn’t want to feed HC that late in the cycle when a tsp of LC might let her flatten out (or bring her up).

I understand to use less carbs later in the cycle, my main concern is more around +5 or +6, she still can drop mighty low am or pm.

You might check the dose on the Zobaline as I think it is more than is needed for CKD plus it’s alot more expensive. Of course, if she still has neuropathy, then she would still need the zibeline. I have heard the Bright doesn’t taste that great but ECID. If she will eat it in her food, yes, you can do that. Just be sure you read the dosing on both of those for CKD.

I may switch to the Vitacost B12 methylcobalamin, many people her use it. Not sure on dosing. I use Zobaline 2 x daily (it has folic acid in it as well).

Where do you think dosing suggestions on these meds would be noted for CKD cats?

Just curious why she is on Denamarin? It’s been quite a while since her ALT was elevated and that was so, so mild. Barely even above normal. Even elevations into the 300s are mild on ALT. I know this from Gracie often popping up into the 300s on ALT and my little one now always runs about 125 on ALT. If you just want to give liver support, a great product is Adored Beast’s Liver Tonic. It’s drops and so much easier to give and an excellent product. It’s what I give to my Livvie just to give her some liver support.

She's been on Denamarin for years. It seems once they put her on these items, they don't tend to remove them. I suppose they feel the numbers they were concerned with seem better, so let's not remove the supplement or it could go back to unwanted values? (I'm guessing on this)

You have two options:
1. leave it as it is considering her health issues and ride it out. Follow SLGS as written (or TR??) and try not to worry so much about it.
2. Try the 9% and see how it goes. It’s not written in stone that you have to stick with it. Just experiment. If you don’t like the results on the BG, go back to 6%.

Ok, I will give it thought about the carb % to use. I suppose I can always use 9% or 12% if she's dropping if I am feeding 6% as her main diet (which is what I do now).

I understand the stress having had a very bouncy little girl for a long time. But, in hindsight, if I was doing this dance over again, I’d take a very different approach. Sometimes it’s very hard to see the forest for the trees, KWIM? We are so anxious for them to do well and to not have all this bounciness, up/down. But I’ve seen cats live for over a decade with FD with alot worse looking SS than hers; that’s not to say you should not do what you are able to to help her but we need to also try and keep our own stress levels down. After Gracie passed away, it took me TWO years to get my adrenal glands functioning properly again because I had allowed myself to become so overstressed and exhausted. Our health is important to so we do the very best we can for them but we try to not be so stressed every time we look at the meter.

Yes, the stress is REAL. I've spent way too many nights on the basement couch watching her meter. Functioning on 4-5 hours of sleep at best. It's the most stressful thing I've been through. (I don't remember being this sleep deprived with the human children!)
I'm sorry you has such difficult health issues as a result. It's one of my biggest fears, since I am Ivy's sole caregiver.

Does any of that help?
Yes, it does help:)

Do you mean Animal Biome? I also did that and I don’t think it was worth the $$$. Yes, if your cat has IBD and all the symptoms that come with it like vomiting and diarrhea. But they are almost ALWAYS going to recommend the fecal transplant pills. I ran the test on my Tobey just to see if some of his respiratory issues he’s had since kittenhood were the result of gut inflammation. His gut biome looked pretty good but they still tried to talk me into the fecal transplant. My vet, who recommended we do the test, was against the pills for him. Instead, I increased his Saccharomyces boulardi to balance out the one imbalance he had and started him on PEA from Dr. Judy. It’s made a world of difference as PEA is a great anti-inflammatory.

Yes, I meant Animal Biome. I already paid for the test, so I will send it in for analysis. I don't think I will want to do the fecal transplant either. I really just want to see the report. She doesn't have ongoing vomiting or diarrhea.
I'm mostly concerned with this itching and want to see if the gut health will shed some light on that situation.
What is the PEA for?

Animal Biome will not identify food sensitivities or allergies. It will just tell you if the gut bacteria is good, bad, needs improvement, etc.
Click to expand...
Marje and Gracie said:
You might check the dose on the Zobaline as I think it is more than is needed for CKD plus it’s alot more expensive. Of course, if she still has neuropathy, then she would still need the zibeline. I have heard the Bright doesn’t taste that great but ECID. If she will eat it in her food, yes, you can do that. Just be sure you read the dosing on both of those for CKD.
Click to expand...

Where do you think dosing suggestions on these meds would be noted for CKD cats?
Thanks, Marje :)
 
Marje and Gracie said:
Yes, of course IF she is dropping fast or she’s getting into lower numbers. How we react to the BG coming down is a little different in the before nadir part of the cycle than the after nadir. After nadir, unless she is clearing a bounce, the BG should start to gradually increase so we want to be careful how much we feed when and especially when it comes to carbs. Let’s say she is clearing a bounce and she’s down to 70 at +8 and that makes you nervous. You wouldn’t want to feed HC that late in the cycle when a tsp of LC might let her flatten out (or bring her up).
Click to expand...
Yes, I understand about not giving high carbs late in the cycle. My concern is around +5 and +6, she still drops sharply at that time, both cycles, sometimes even +7.
 
Marje and Gracie said:
You have two options:
1. leave it as it is considering her health issues and ride it out. Follow SLGS as written (or TR??) and try not to worry so much about it.
2. Try the 9% and see how it goes. It’s not written in stone that you have to stick with it. Just experiment. If you don’t like the results on the BG, go back to 6%.

I understand the stress having had a very bouncy little girl for a long time. But, in hindsight, if I was doing this dance over again, I’d take a very different approach. Sometimes it’s very hard to see the forest for the trees, KWIM? We are so anxious for them to do well and to not have all this bounciness, up/down. But I’ve seen cats live for over a decade with FD with alot worse looking SS than hers; that’s not to say you should not do what you are able to to help her but we need to also try and keep our own stress levels down. After Gracie passed away, it took me TWO years to get my adrenal glands functioning properly again because I had allowed myself to become so overstressed and exhausted. Our health is important to so we do the very best we can for them but we try to not be so stressed every time we look at the meter.

Does any of that help?
Click to expand...
Yes it does help :)
I guess I have to try different strategies. Right now using 6% as her base food, I use 9 & 12% if I need to give her higher carbs to slow her down in the first few hours when the insulin is kicking in and kicking her butt.

It's very stressful, I am sorry you had such a difficult time with your health.
I have spent more nights sleeping on the floor or couch near Ivy when she's very low overnight. Not good for my health, 4 hours sleep.
(I don't recall having a human newborn being so tiring or being so sleep deprived!)
 
Marje and Gracie said:
Just curious why she is on Denamarin? It’s been quite a while since her ALT was elevated and that was so, so mild. Barely even above normal. Even elevations into the 300s are mild on ALT. I know this from Gracie often popping up into the 300s on ALT and my little one now always runs about 125 on ALT. If you just want to give liver support, a great product is Adored Beast’s Liver Tonic. It’s drops and so much easier to give and an excellent product. It’s what I give to my Livvie just to give her some liver support.
Click to expand...
I think once they add supplements they seem to leave them in place. I can only assume they feel that the meds are keeping her where the values are desired, so let's not rock the boat. Just a guess.
 
Marje and Gracie said:
Do you mean Animal Biome? I also did that and I don’t think it was worth the $$$. Yes, if your cat has IBD and all the symptoms that come with it like vomiting and diarrhea. But they are almost ALWAYS going to recommend the fecal transplant pills. I ran the test on my Tobey just to see if some of his respiratory issues he’s had since kittenhood were the result of gut inflammation. His gut biome looked pretty good but they still tried to talk me into the fecal transplant. My vet, who recommended we do the test, was against the pills for him. Instead, I increased his Saccharomyces boulardi to balance out the one imbalance he had and started him on PEA from Dr. Judy. It’s made a world of difference as PEA is a great anti-inflammatory.

Animal Biome will not identify food sensitivities or allergies. It will just tell you if the gut bacteria is good, bad, needs improvement, etc.
Click to expand...
Yes, that's the test I have to send off. I already paid for it.
I really want the report to learn what is going on with her gut and if it is somehow impacting her with this itchiness that is driving her and me crazy.
I don't think I would want to do the fecal transplant, she doesn't have ongoing diarrhea or vomiting. I will share the report with her vet and see what she has to say. I am sure they will try to sell the gut restore pills, it's their business model after all ;)
 
Marje and Gracie said:
If you just want to give liver support, a great product is Adored Beast’s Liver Tonic. It’s drops and so much easier to give and an excellent product. It’s what I give to my Livvie just to give her some liver support.
Click to expand...
I will check out this product, thanks for the suggestion!
 
Staci & Ivy said:
Where do you think dosing suggestions on these meds would be noted for CKD cats?
Click to expand...
Dosing is in this link I left in a post above:
"All you ever wanted to know about B vitamins for cats with CKD is here.”

Staci & Ivy said:
My concern is around +5 and +6, she still drops sharply at that time, both cycles, sometimes even +7.
Click to expand...
My comment was a general one since alot of people read but don’t post. But also, if you decide to try 9% to prevent early drops, you might want to use your 6% for the later ones to minimize the impact to duration. See what works.

Staci & Ivy said:
Yes, that's the test I have to send off. I already paid for it.
I really want the report to learn what is going on with her gut and if it is somehow impacting her with this itchiness that is driving her and me crazy.
I don't think I would want to do the fecal transplant, she doesn't have ongoing diarrhea or vomiting. I will share the report with her vet and see what she has to say. I am sure they will try to sell the gut restore pills, it's their business model after all ;)
Click to expand...
Good. Just wanted you to be aware. As you know, gut inflammation can cause alot of issues, not necessarily related to the gut so it’s reasonable to think if there is a good bacteria she needs or a bad one she needs to get rid of, there are ways to do it besides the fecal transplant pills.

Staci & Ivy said:
I will check out this product, thanks for the suggestion!
Click to expand...
It’s really good. Animal Essentials also has a good one for the liver BUT it has glycerin in it and I don’t like my cats to have glycerin. They also don’t like it; it’s too sweet. I also note the immunity product from Animal Essentials you linked has glycerin in it.

Here is the link to Dr. Judy’s PEA. It’s a great product for the immune system. I did a webinar of a week-long of presentations from different renowned holistic vets (my vet also listened in) and Dr. Judy was on there. We were both impressed with her information about PEA and I really think it’s made a big difference for our boy.
 
Marje and Gracie said:
Dosing is in this link I left in a post above:
"All you ever wanted to know about B vitamins for cats with CKD is here.”


My comment was a general one since alot of people read but don’t post. But also, if you decide to try 9% to prevent early drops, you might want to use your 6% for the later ones to minimize the impact to duration. See what works.


Good. Just wanted you to be aware. As you know, gut inflammation can cause alot of issues, not necessarily related to the gut so it’s reasonable to think if there is a good bacteria she needs or a bad one she needs to get rid of, there are ways to do it besides the fecal transplant pills.


It’s really good. Animal Essentials also has a good one for the liver BUT it has glycerin in it and I don’t like my cats to have glycerin. They also don’t like it; it’s too sweet. I also note the immunity product from Animal Essentials you linked has glycerin in it.

Here is the link to Dr. Judy’s PEA. It’s a great product for the immune system. I did a webinar of a week-long of presentations from different renowned holistic vets (my vet also listened in) and Dr. Judy was on there. We were both impressed with her information about PEA and I really think it’s made a big difference for our boy.
Click to expand...
What don’t you like about the glycerine?
Ivy has been on the Animal Essentials immune as well as their Seasonal Allergy drops too. I’m sure they also have the glycerine in them.
I will try the PEA if you feel it’s so good. What do you feel it’s done for your boy?
Thanks again for the suggestion.

As for the 9% carbs, I always try to use them minimally, and if possible before nadir (although sometimes it’s hard to know if she’s gone as low as she’s going to go in a given cycle).

I will check out the link on dosing for clarity.

One last question for now. Ivy has been on this current dose of 3 units since 12/17. She has nadirs under 149. But not every day. Her SS is listed as Freestyle Libre sensor values (unless I cross check her with a handheld Contour Next meter. (The Libre reads lower than a handheld meter, especially in low numbers I have found since I check with an ear prick when she dips down very low on the Libre. She’s fractions, it’s why use the Libre )

Would you think I hold this dose or change it?

Thanks again for everything, Marje. :bighug:
 
Staci & Ivy said:
What don’t you like about the glycerine?
Click to expand...
It’s a sugar alcohol and has more calories in it than sugar although it is not the same as glucose. While it doesn’t raise the BG, it’s can act as a diuretic and can also cause allergic reactions.


Staci & Ivy said:
Ivy has been on the Animal Essentials immune as well as their Seasonal Allergy drops too. I’m sure they also have the glycerine in them.
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I believe they do. The Seasonal Allergy also has alcohol in it but the Nettle doesn’t even though it has glycerin. Nettle is great for allergies, too. But, if something is working for her like this, I wouldn’t change that up. I do, however, change up the liver support I give Liv. Sometimes, I give her Herbsmith milk thistle powder from Chewys. I mostly use the Adored Beast but every six months, switch it up for a couple months and then go back to the AB.

My Tobey has herpes which he contracted at the vet’s office where he was neutered. We had gone there a long time but, between that and the recommendations for how to treat Gracie’s diabetes (all of which happened at the same time), we left that clinic. Over the years, he has bouts of getting kind of snuffly and because he is a Scottish Fold and already has a flat face, he doesn’t need to have that going on. I used L-Lysine for years until the webinar with Dr. Morgan where she went into the great benefits to the immune system from PEA which is relatively new. Because my vet listened to the same webinar, she talked to Dr. Morgan, and then told me she thought it would benefit him. And it has!

Here’s the thing…I have a great relationship with my holistic vet and we email back and forth a lot. She does nutritional response testing (NRT) so she energy tests the cats to see what works best for them. That’s a bit of an oversimplification as there is more to it than just energy testing but I don’t put them on anything she hasn’t tested them for under NRT. It’s not like I’m just adding things to their supplements without veterinary concurrence. If I find something I want to try, I have Holly do NRT on them to see if it will work for them.

I mention all that so you can discuss these things with your vet. Of course, if your vet is not a holistic vet or doesn’t take the time to look into things as Holly does for me, then it’s up to you on what you use. Some things work for some cats and not for others. I’m not trying to discourage you but I am not a vet and I don’t know Ivy’s full supplement and/or medication list.


Staci & Ivy said:
One last question for now. Ivy has been on this current dose of 3 units since 12/17. She has nadirs under 149. But not every day. Her SS is listed as Freestyle Libre sensor values (unless I cross check her with a handheld Contour Next meter. (The Libre reads lower than a handheld meter, especially in low numbers I have found since I check with an ear prick when she dips down very low on the Libre. She’s fractions, it’s why use the Libre )
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One thing I will mention first is that if you are using 70 as a reduction point, you aren’t doing SLGS; you are custom dosing and that would be a better label on her SS and your signature block. The reduction point for SLGS is 90; thus, if you aren’t using 90, it’s not SLGS.

Having said that, SLGS and TR are where we start where we are learning; once we get a lot of data, understand our cat’s pattern, can read the SS, and have a solid knowledge of FD, then we can customize a dosing method. But, until then, we should be using the dosing method as written. Ivy has been diabetic well over a year and you have a lot of data. You ask pertinent questions and seem to understand her curves so changing her reduction point might be warranted. However, as I said before, then it’s custom dosing :)

The one downside to custom dosing is getting advice. Under SLGS, you should have reduced her dose with those low numbers on 1/4 PM cycle. I understand the Libre runs low at low numbers but do you think a 44 on a Libre would have been above 90 on your Contour and is there a correlation between the two that is constant? I do see where you recorded a “lo” on the Libre was a 100 on the Contour. That is a substantial difference. My knowledge of meters tells me that just because a Lo on a Libre might, for example, be 100 on a Contour once, it won’t be the same every time. I understand she’s fractious with ear pokes but you’ve held a dose assuming all those 40-somethings were above 70 on the Contour. That’s not a criticism….just an observation.

I am sure you’ve addressed this before so please forgive me for asking but she’s not eating dry food so why not TR? Even if those lows were accurate, she wouldn’t have earned a reduction and I might feel a little better at telling you could increase if you were going to be there to test her and catch the lows. But I’m not comfortable saying that with SLGS or custom dosing with a reduction point of 70.

Questions?
 
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