10/21 Max AMPS 571 +2 535

[Max & Lori]

I knew Max would not handle this much of a reduction very well and I told the vet what was recommended here. She gave me a long discussion about SRT and hypoglycemia and strongly advised that I follow directions. Knowing Wendy was right, I was so upset about the vets dose, but he is being seen there next week so I listened against my better judgement. Now Max is stuck up in these high numbers again. I’ve just sent in another message to the vet asking again if I can go to 8. After he gets this follow up next week, I’m taking him to his new local vet who is more willing to work with me. I don’t know why everything always has to be so hard. I have practically given up my life trying to take care of Max and I always seem to find myself running into a brick wall. I just don’t know what else to say. Thank you @Wendy&Neko as always, for trying to help. Last post https://felinediabetes.com/FDMB/thr...106-6-96-113-8-136-9-312.254408/#post-2867203

 

[carfurby (GA)]

 

[Max & Lori]

@Wendy&Neko do you still recommend 8 units. This is getting out of hand. I will just have to be lectured to on Tuesday, this is not working. I tried to tell them.

 

[Wendy&Neko]

I know it's hard to do, but I stopped listening to my vet on dosing. I handed her a copy of the TR protocol paper and initially at least, gave her weekly updates on the spreadsheet. My vet was fantastic on everything else, but insulin dosing was my territory. It got to the point her involvement was just to ask the current dose when we visited. The methodology and spreadsheets showed her she could trust my decisions on that. Tell the vet on Tuesday that you tried it their way for a few days, but it wasn't working and you couldn't stand seeing Max miserable in high numbers. After all, you hold the syringe, not them, not me. The decision is yours. You test enough to keep him safe.

Max needs more insulin, I would try 8 units. It may be too much of a reduction, but maybe not. Let's get his depot built at 8 units and see where to go from there.

Yes, cats can hypo after SRT, but so can non acro cats without SRT. That's why we home test and follow a dosing methodology. And why I suggested moving the reduction point to under 70, to give you some margin of safety. SRT changes typically do not happen that quickly. At it's most active, I would see two reductions a week, doing reductions of the size recommended by TR. Doing the odd BCS (big chicken shot) or partial dose to drain the depot is also a technique you can try when he earns a reduction. I personally didn't do that, because Neko was guaranteed to bounce to the moon after earning a reduction. Some cats are flatter than she was.

 

[Max & Lori]

Thank you for being patient with me Wendy. I’ve been lectured to so many times it makes my head spin. I’ve showed my spreadsheet to them also. I think most vets are just reading from a textbook and it just doesn’t work. I’ve told them about TR and showed them everything. I had just sent her an email telling her that it wasn’t working, Max is feeling terrible and he’s going to get sick again if we continue this. I can’t do it anymore. I sent her the spreadsheet AGAIN so she could see what a mess we’ve made. This is what she replied “Thanks for sharing the spreadsheet. that was helpful. I think you're fine to try 8IU tonight but we just need to be careful in changing his insulin around so fast so we will probably need to hold tight at the 8 IU for a few days before making any drastic changes after that unless of course he gets hypoglycemic again.”
I don’t know why she didn’t listen to me to start with. Anyway, you’ve always given me good advice so I’m sticking with you from now on. That’s it. I may end up getting that freestyle libre though. Do you think that’s okay, accurate? I’ve got to get back to spending more time with my grandchildren or they are going to forget who I am lol.
Going forward, if he does become hypo again, he will not eat the fancy feast high carb foods. If he does he vomits. He only likes the pates and they are low carb. What else can I do if he becomes hypo again? I know you said put syrup on his regular food right? Thank you Wendy!

 

[Wendy&Neko]

I think it's fine if you want to try the Libre for a while. You still do have to download the data of course, and if it looks like he's dropping in a cycle you might have to intervene. Do make sure you double test with a hand held meter if you get a low number, but otherwise the numbers should be enough to tell you the trends of his blood sugar.

Neko stopped being able to eat the Fancy Feast gravy foods - turns out she couldn't handle wheat. So I searched around for high carb foods that were higher carb due to potatoes or potato flour. Most of the ones I know are chunky (Weruva Grandma's Chicken Soup was one, or the Cats in the Kitchen pouches), so he might not eat them. But you can absolutely add a drop or two of karo/syrup/honey to his regular LC to make it higher carb. I found it handy to print off this Sticky Note: Don't Panic! or How to Handle Low Numbers Handy to have a print out in case the power goes off.

 

[Max & Lori]

I’m wondering if that’s what’s happened to Max with the gravy foods. He probably won’t eat the Weruva but I can try it. He just doesn’t like the texture of the chunky or shredded foods. I will have to use the syrup in the food if it happens again. I know y’all don’t recommend using the dry kibble but that’s what I had to give him the other day.

 

[Wendy&Neko]

Dry kibble will get the numbers up, but will last longer in the system to keep his numbers up, that's why it's better to find alternatives in wet food. If you can get any of the First Mate foods, they are high carb with potatoes, and pate.

 

[Max & Lori]

I will have to check online. I haven’t seen that at Petsmart or any of the grocery stores. He may like that if it’s pate though!

 

[Wendy&Neko]

More likely something you can get at a specialty pet store. Their headquarters is very close to where I live. Also sold on Chewy, but I'm sure you'd like to try one can first instead of a case.

 

[Max & Lori]

I saw it on Chewy but yes I hate to buy all that without him trying it. I’ve wasted so much money on cat food. He will either eat fancy feast pate or he loves the homemade food with the EZ premix. That’s all I give him. He normally doesn’t eat kibble but that’s all I had that I knew was high carb. Thank you!