10/14 Bubby AMBG 106 PM+3 82

[knolet]

viewtopic.php?f=9&t=126921

Hi all,

Bubby seems to be doing OK, but he is not eating very well. The vet emailed that he would like to start Mirtazapine at least until we can find a food that he will love. Looks like we need to stray from the venison that we were trying to stick with. Then he said that he would be happy with numbers between 120-280. I so hope that top number must be a typo? Isn't renal threshold 250?

That does make me wonder though... When talking about my meter -relion ultima- and comparing it to an Alphatrac, it was very close, only about 2 - 18 points different when I did a curve and compared the two.... But I know that I've read the AT is 30 points higher on average. So I guess my question is what range should I aim for? I used 60-120 as the normal range with Zeus, but should I aim for 90-150 instead?

Thanks for any thoughts. Hugs and prayers to all that need them.

Kathie

 

[julie & punkin (ga)]

Re: 10/14 Bubby AMBG 106 PM+3 82 question

hi kathie!

i'd aim for 50-120 - which are normal numbers for a cat on insulin. Cats that are not on insulin might be in the 30's or 40's, but having the low threshold at 50 gives you a safety margin to raise Bubby's BGs when he goes below 50 before he gets too low.

I wouldn't compare meters - it can make a person crazy. Just go with the ultima and that will let you compare from one test to another.

from the TR Protocol link:

Phase 5: Remission

"14 days without insulin and normal blood glucose values. Most remission cats are able to stay in the normal range all of the time (50 to 80 mg/dl), although there are a few cases of sporadic higher and lower BGs. Don't stop feeding low-carb and try to avoid cortisone if possible. Test the cat's BGs once per month.

We know that cats who have their blood sugar held in normal numbers (50-120, which is considered tightly regulated) as soon as possible after diagnosis have the best chance of their pancreas healing and beginning to put out insulin again. The stats for cats who become tightly regulated in the first month is over 90% can heal and become diet-controlled. The stats lessen as time goes on because damage occurs to the pancreas that cannot be healed. If I were you, I'd be aggressive in following the protocol and trying to get Bubby tightly regulated as quickly as possible. The chances are greatest early on, although we've had cats go OTJ after 3 years (Trixie being one), but that's unusual.

I'd guess the numbers the vet gave you would apply to someone who isn't hometesting and isn't working towards remission. A vet who does a curve and determines the dose would probably aim for that range to keep the cat high enough that hypogycemia isn't a constant concern in a cat not being monitored. You, on the other hand, know how to hometest and are monitoring.

Can I suggest, however, that you step up the testing and record your dosage information in the ss? If you need help, all of the data that's going to be needed is pretty lacking right now. If you're going to run him in green numbers, you really want to monitor and test more so that you are confident he is safe. We can't be sure what his nadirs are on this dose. It looks at a cursory glance like he's responding well to the insulin, but you're going to want to catch him when he goes under 50 so you can reduce his dose and help guide him safely OTJ. Looks like that's a good possibility for him - you just want to keep him safe on the way there. Pretty exciting!

I would try sprinkling on fortiflora before resorting to Mirtz or another appy stimulant.

 

[knolet]

Re: 10/14 Bubby AMBG 106 PM+3 82 question

Hi Julie,

Thanks so much for dropping in, and all of the info... Just to clarify though, we haven't started insulin yet.... The vet wanted to stop the steroid first and work on a diet change. He said we should wait a month, I disagreed, and he said he wouldn't fight me. Anyway, that is why there are only a couple of tests per day and no dosage listed. I'm just getting random tests as we can.

You are right about comparing meters and driving oneself crazy. :YMSIGH:

Unfortunately Bubby never did like the fortiflora when I tried that. He is being super stubborn about his food, little stinka.

Thanks again Julie

 

[julie & punkin (ga)]

oh sorry! i didn't realize you hadn't restarted yet. in that case, he's looking pretty great.

if not fortiflora, how about freeze dried meat flakes? a lot of kitties like FD chicken. that might tempt him.

 

[phlika29]

Hi Julie

It looks like the switch to low carb food and coming off the steroids is working for your little boy. Will keep my fingers crossed for him.

With regards not eating well if you think he is nauseous (lip licking, walking up to food but walking away) you might like to discuss ondansetron with your vet. Many tablets taste really horrible I use an empty gelatine capsule size 4 and put all of remi's tablets in in one go. That way it is smooth, doesn't taste and so my remi doesn't react in the same way. I always follow the capsule with at least 3 ml of water gently syringes into his mouth (to ensure it doesn't get stuck in his throat). Over the last couple of years they helped tremendously and I have put up to four tablets in just one capsule.

Best wishes

Sarah