10.28 Charlie AMPS 128 +2 158 +4 65 +5 82 +6 67 +7 90 PMPS 82 (stall 88) +2 119

Link to previous post:
https://www.felinediabetes.com/FDMB...-8-124-9-119-pmps-187-dosing-question.282981/

Going to tag a few senior members for their inputs on his high triglycerides. It would be a shame to keep him on the Purina OM if it were not required. He is already responding to the removal of pred. Switching him to a low carb diet (if possible), would help with BG regulation ever more.

Btw, from Dr. Lisa's food list, Purina OM is 33% fat and 21% carbs. I cam see several other options on the list with fat less than 33% and which are low carb.
https://catinfo.org/chart/index.php

@Wendy&Neko
@Sienne and Gabby (GA)
 
Thanks, @Bandit's Mom
I know, I don't get it, other than more fiber could be useful, but it's also possible to add psyllium husk to the foods he was eating that were 15%-18% fat and 0 carbs.

I would appreciate some more guidance. He was 65 on his +4. I just gave him some of the OM food. But I think we'll have another anxious afternoon making sure he stays over 50.

I think I want to drop him a full half unit tonight and not a quarter. He's flying through reductions like crazy right now and like clearly it's more insulin than he needs, even on this higher-carb food.
 
He won't eat the Tiki cat chicken... there was a more mousse/pate version he would eat but they discontinued it. There are some chicken Weurva flavors he'll eat. Finding something without fish seems challenging. Likewise some of the thickeners... my sense of all the foods we've tried, fish is a problem, and possibly some of the thickeners.
 
We navigated his nadir with some snacks and he's decided that it's warm enough down here to lay next to me. He had been curled up in my bed with the Tiny Cat TM, who spends all day curled up in the blankets.
 
This is an article on triglycerides. It's a bit dense!

The take away is that there can be a number of reasons for elevated triglycerides. The first thing that comes to mind is whether Charlie was fasting when the vet drew labs. Steroids can also have an effect on triglyceride levels as can diabetes. If Charlie had a recent bout of pancreatitis, that can also contribute.
 
Thanks @Sienne and Gabby (GA) ... That article is not nearly as dense as the research in vet journals I read... I am a vet's worst nightmare, I'm not a scientist but I have access to a university library (I'm an education professor at our state uni)

The first test was not fasted that was in the 4000s
The second test was pretty fasted, he had a small meal with his shot and then they drew blood about 11 hours after. That test is here: https://drive.google.com/file/d/1BKLyFeSM_AG8fdLGZYg4UqNCd6rxTZrY/view?usp=drive_link

The last pancreatitis bout was in July. I've been holding my breath because he's flared every 3 months since last November. But he seems fine so far.

His regular vet did a test where they let the blood settle for 12 hours and looked at how the fats separate out and she said there was both dietary fat and fat that his body was producing. That test, he had fasted overnight and had a small meal with his shot. Possibly not ideal but given their hours and having to fast him, it is hard.

No one would be keener to put him back on low-carb food than me. If his triglycerides look better in two weeks (no idea how we navigate fasting at the moment with his numbers dipping so low but he will be at the vet for his fast again... unfortunately the tech with the diabetic cat doesn't seem to work mornings, because I think he would get it if I explained exactly when they should test him. He loved the spreadsheet and apparently went off and did some reading when I insisted they use my blood ketone meter, he gets it, but the other techs are like talking to a wall), I'm going to suggest we slowly transition him back to homecooked chicken and keep the Omega 3 supplement and the chitosan and recheck in a month. Given how things are going, could we get him off insulin... maybe? I mean, yesterday he hit 42 with 21% carb food,

I feel like we're in a weird half-TR-half-SLGS place... I cannot do this much testing every day. Next Monday, for example, I will be out of the house in the middle of the day and will only get to check him once in the later afternoon before I have to go back out. I will close him in a room with the autofeeder, but I can't be doing this test, feed dance. Next Monday, I'll be gone from 8:30 straight through 4 pm. I haven't had to do too much travel lately, but its coming. I've read the how to TR with a job, but I don't have a regular job with regular hours so it doesn't help. I'm so bad at sleeping that getting up and testing in the middle of the night means I just won't sleep. All of which is why I decided not to do it to begin with.
 
@Bandit's Mom up in Mumbai yet?
@Sienne and Gabby (GA) ?

Charlie' PMPS was 82. I'm gonna stall for 15 and see if he's heading up but that's under 90.

I did shoot an 84 a couple weeks back, he stayed flat and then bounced.

More recently, I shot a 111 and he dropped into the 70's and I was up for hours feeding and testing.
 
His second test was 88. I fed him and gave him 2u. Was planning to drop to 2.5 tonight. But my anxiety cannot take this. And I cannot take the sleep deprivation. I was looking at someone's spreadsheet who does TR and I was just like when do you sleep?
 
Sarah & Charlie-cat said:
I was looking at someone's spreadsheet who does TR and I was just like when do you sleep?
Click to expand...
You learn your cat's patterns on insulin, and when you need to test, and when you don't. I think you test more with SLGS than I did on TR. Of course it helped that Neko got a bit more predictable on Levemir than she was on Lantus.

The 3.5 unit depot from a couple days ago was still influencing today's cycle as well as the 3.25 units. The 2 units tonight should help drain that depot.

I remember one other kitty here (Ming) with high triglycerides. I think her vet said her cat's blood looked pink it was so bad. He got pancreatitis frequently and was on steroids too, and got to a high dose. Which came down quite a bit when the pred was reduced.

Did some searching, and I found a place where Jill (former moderator Jill & Alex) mentions taurine powder as something that reduces triglycerides.
 
I was testing less when he was more predictable... when he was always 240-350, not a whole lot of interest going on, although I did have to prove to several vets that these high numbers were not bounces, he was just high and flat.

I probably could have done 2.5. I just wimped out.

I think Charlie's blood was basically sludge... 2000 is like 200x the high end of normal.
 
@Bandit's Mom, I don't think so. I've been trying to give him smaller meals so he'll eat again at +1. He didn't eat all of that or all of his +1. He ate a bit of Friskies gravy but not his food. Not even with fortiflora, duck heart or freeze dried chicken. I hope his pancreatitis isn't about to flare
 
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I am a vet's worst nightmare, I'm not a scientist but I have access to a university library (I'm an education professor at our state uni)
Click to expand...
I can relate. I have access to both our university library system and the medical/vet school libraries and I'm on faculty on the med school side. (I actually faced off with a new vet at the practice for not understanding informed consent.)

Wendy's point is well taken. With glargine, it helps to remember that everything is influenced by the depot. You don't often get the immediate response you're expecting. It can take a cycle or several for the depot to adjust to a change in dose. As far as testing, for either TR or SLGS, the minimum number of tests is 4 -- the two pre-shot tests and at least one test each cycle. If numbers are dropping, you need to test more to make sure Charlie is in safe numbers.

I'd also point out that if you're sleep deprived, you're not going to be in a good place to manage your cat's FD. It's important to take care of yourself. (I've also posted to people that when Gabby was alive, I'd decided that sleep was highly overrated!)
 
@Sienne and Gabby (GA) I can't even imagine having a better understanding of the science and trying to interact with vets

Definitely taken on the sleep deprivation. My ADHD goes into overdrive without enough sleep. I feel like I'm a danger to myself and others if I don't sleep enough.

I wouldn't be testing this much except he's been having much lower than normal numbers since getting off pred.

He woke me up for food around 5 and ate well just now. He was 145 this morning. I would imagine as the depot drains his numbers will come up. I was still up late with him because he wasn't eating great and I didn't want to leave him going down without food.
 
Sometimes it's a good thing (i.e., my vet saying she wanted to get a pro-BNP on my cat and I looked at her and said, "You can do that for cats?" Her response was, "You know what that test is?"). Sometimes, it's not such a good thing -- I can know just enough to be dangerous.

Do you have a timed feeder for Charlie? I found having one was helpful. It may allow you to get more sleep.
 
I do have a timed feeder. I have tried it in the past but it's not great with five other cats. Which wasn't as bad when two were closed up at night but now they've not (long story). When he was unregulated and always hangry, he would just stand next to it and scream until I advanced it for him. He won't stay in a room by himself all night. He will scratch at it with incredible, unwaivering conviction that it must be open. Ditto the little black cat who likes to sleep in my bed.

I would like to try again, especially since we plan to be away for a week in December. I have used it more when I'm away, having the cat sitter fill it up.

I wish they made something that combined chip feeder and autofeeder. We did use a chip feeder before he was diagnosed because he was always screaming he was hungry (now I know why!)
 
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