? 10/31 Chewy AMPS 73 PMPS 102 Skiiping shot

Shannon & Chewy

Shannon & Chewy

Member Since 2022
https://www.felinediabetes.com/FDMB...63-4-91-7-5-169-pmps-134.270225/#post-3012750

I'm not sure what's going on with Chewy. In the past 6 days we have skipped 5 shots and dealt with low numbers. He has gone from 3.5U to .75U. Today at 73 he is ravenous. Not sure how a dose at this level is keeping him so low. His spreadsheet is up to date with tests and labs. Just some background for everyone, I am unable to do extensive testing with working 2 jobs and caring for sick parent.

I gave him some high carb food since I'm leaving for work now and he loved the Fancy Feast. I have someone to watch over Chewy every day (but she can't test him) and he has been acting fine and even seems back to himself with these lower numbers. I feel at a loss since his vet has not been helpful at all. Any help would be greatly appreciated.

@tiffmaxee
 
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Hi, I have not gone too far back in your condos. Was there a recent food change from a high carb food to a low carb one? I see Blue Buffalo Kidney dry food in your Signature. Any kind of infection/inflammation can also elevate numbers and treating that can bring down blood sugar.

You could try 0.5U or even 0.25U from tonight.
@tiffmaxee
 
I suspect that he went lower a lot before posting here. I would try .50 tonight if you can monitor. He might just be becoming food controlled. Have you stopped feeding the hc unless he's is low and you need to leave or to bring his bg up? With two skips there was no reason to feed hc. If you see this have your mom I think who is home to feed or whoever else feed only lc the rest of the day. If you can't test as much as needed tonight I would go down to .25.
 
Hi Elise - Thank you for helping me out. I'm on my lunch break and wanted to respond. I fed the hc food (1 can of Fancy Feast Beef gravy) this morning and my mom reports that Chewy is very playful and acting normal. Since his diabetes was diagnosed, he eats twice a day (unless we see a low number). I left dry food out when I left this morning but my mom took it away about an hour ago. To answer your previous questions, Chewy is still eating Blue Buffalo kidney diet dry + Weruva can (under 10% carb/200 PHOS). His last diet change was on 9/18 (moving from Blue Buffalo wet food to Weruva can). He has been eating less of the dry since his numbers have gone lower. Generally, when his numbers are between 80 and 250 he eats half his wet food and then grazes on dry. Over 250, he eats all of his wet food and eats dry more quickly (i.e., he does not graze). Under 75, he is extremely hungry and eats for a good 30 minutes whatever is put in front of him.

I have three cats and Chewy is the only one who eats can. I tried to get him to only eat wet food but he typically eats wet food for awhile and then refuses to eat that can and will only eat dry. I do want to get to a better dry food (maybe Crave) if Chewy's creatinine & BUN improve.

I will be home to test Chewy's PMPS and can only get a +2 before I leave for work this evening. I think based on your guidance, I will take dose to .25. I do have calipers and a magnify glasses but I have to admit the .75 was challenging so the .25 should be interesting.

I talked with the vet earlier today and he is giving me a prescription for the Freestyle Libra & we will get that placed in the next week or so. At that time, he will keep Chewy for the day if he does not have a full bladder. He said he is not sure what is going on with Chewy but thought it could be a partial remission. My vet is extremely responsive but he does not know much about diabetic cats. I would like to think of this stage of treatment as a reset.

Btw - are there any good resources to figure out how much to feed a diabetic cat? Chewy is 14 lbs 10 ounces. I've had him for 6 years and he is really picky when it comes to can food. He will eat is good for awhile and then stop altogether. He is not as picky about dry food. I have tried a homemade diet (with kidney supplements) and that did not work out.
 
Hi there. I’m glad you are going to have his urine tested. You need to check his USG (specific gravity) to get a more full-orbed picture of what his going on with his kidneys. His bloodwork shows kidney function is impaired. I would strongly encourage you to not feed dry food as a regular diet - and I am not just talking about from a diabetic standpoint. He needs hydration because of his kidneys. Dry food is inherently dehydrating and leaves cats in a constant state of dehydration. This is awful for the kidneys. Cats cannot make up the deficit of water just by drinking. At some point in the disease process chronic kidney disease, subcutaneous fluids (usually given daily) are necessary to maintain hydration and quality of life for the cat. You can potentially slow that process down by giving wet food and lower phosphorus food. Right now, Chewy’s blood phosphorus levels are okay, but feeding lower phosphorus foods such as many of the Weruva BFF PLAY foods can reduce the workload on his kidneys and help them in that way. If possible, I would transition all of your cats to wet food. It will greatly benefit all of them now and in the future. CKD cats are already prone to constipation because the body does such a good job of reclaiming every bit of moisture for use (so leaving the stool very dry and hard.). This constipation can be a constant struggle and can even have life threatening consequences. Sorry, that sounds so dire but it’s true. I know you are not at that point yet, but the wet food can be a game changer for all of your cats. For dry treats or a small “wet food topper,” I like Dr. Elsey’s Clean Protein, which is also lower in carbs. The Crave you mentioned is too high in carbs. In addition, there is a link between heart disease in cats and feeding peas/pea protein (both of which are in Crave) in cats as well as dogs. I was recently urged by a Board Certified Veterinary Cardiologist to NOT feed any cat food containing peas, lentils or garbanzo beans (chick peas). I was not previously aware of this link in cats. Fortunately, none of my cat food bas any of these ingredients since I feed Weruva BFF PLAY canned foods to all of my cats at this point. Peas/pea protein are used in cat food to bump up the protein numbers in the cat food - in lieu of meat protein. Vegetable protein can be put to good use by people, but cats need meat protein.

Sorry that was so long! As to Chewy’s dose, it would be better for Chewy if you select a consistent dose of .25 or .5 depending on how much testing/monitoring can be done - like Bhooma and Elise have recommended. This way you should not have to skip doses and hopefully will see smoothing out of the curve. A consistent dose is important when using Lantus. Then hold the dose for seven days before reevaluating the dose — unless a reduction is warranted based on numbers, of course.

Having said all that, you have a lot on your plate. And I really admire how you are trying to help Chewy with diabetes!
 
@Shannon & Chewy
I found this posted by one of our members
I don't know if the BFF play weruva pate is on the list your looking at or not. I wrote down the protein carbs & phosphorus #s in a notebook.
BFF play chicken Checkmate
Protein 31%
Carbs 5%
Phosphorus 129%
BFF play chicken & turkey topsy turvy
Protein 32%
Carbs 5%
Phosphorus 129%
BFF play chicken cherish
Protein 31%
Carbs 5%
Phosphorus 135%
BFF chicken & turkey tiptoe
Protein 31%
Carbs 5%
Phosphorus 136%
BFF chicken duck & turkey take a chance
Protein 32%
Carbs 5%
Phosphorus 149%
BFF play chicken & lamb laugh out loud
Protein 31%
Carbs 5%
Phosphorus 154%
BFF play chicken & duck destiny
Protein 32%
Carbs 5%
Phosphorus 165%
BFF play chicken & beef best buds
Protein 33%
Carbs 5%
Phosphorus 171%
 
Shannon & Chewy said:
do have calipers and a magnify glasses but I have to admit the .75 was challenging so the .25 should be interesting
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Just in case you haven't seen this
49822973683_0559ae843a_o.jpg
 
You need to order them online
Dr Elseys you can buy on chewey site they are about 5 or 6% carbs
https://www.chewy.com/dr-elseys-cleanprotein-chicken/dp/146269?utm_source=google-product&utm_medium=cpc&utm_campaign=12791446238&utm_content=Dr. Elsey's&utm_term=&show-search=1&gclid=EAIaIQobChMI0PvU2Zj79wIVRIdbCh3JawEkEAQYASABEgIInfD_BwE
Amazon sells it too

Or you can get freeze dried treats to sprinkle on the wet food
Look at this post #64 there is a whole list
Post numbers are to the right
https://felinediabetes.com/FDMB/threads/new-to-this-i-need-advice.269452/#post-3007262
 
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Thank you, everyone! I lost another cat to kidney disease and definitely understand how bad dry food can be. Back in April, I switched my cats to cans only and they all went on a hunger strike within a few days. I ended up caving out of fear of fatty liver. I'm sure I gave in too quickly. On September 18, I switched to Weruva cans (all of the cans are on the good list for carbs/phosphorous) based on earlier recommendations I found on this site. Chewy was eating the Cats in the Kitchen Fowl Ball really well until recently. He will lick at the gravy ones but does not eat them as well. I end up spoon-feeding him the can food to get him to eat more of that to limit the dry food intake. I will order some Dr. Elseys and look around for tips to entice cats to eat wet food. I will definitely stay away from the Crave brand.

I did some math based on Diane's post of 20 calories per pound and think Chewy needs 280 calories a day. The Fowl ball can is 129 calories which would leave approximately 1/3 cup of Blue Buffalo dry (for now until I switch). I don't think Chewy is eating that much dry food presently. The Weruva chicken and beef gravy is 206 calories per can (plus 1/5 cup dry). I will try my best to replace the dry food but it helps to know how much he should eat.

I'm crossing my fingers his BUN + creatinine will improve with the antibiotics.
 
I thought we'd see higher PMPS numbers than 102 with no insulin for 24 hours. He is acting normal but not very interested in food. He gets two pill pockets with antibiotic 1.5 hrs ago. I wonder if that's also messing with his appetite. I will keep food out for 2 hours to see if I can get him to eat more. He usually grazes at the lower numbers. I'm planning to skip dose since I have to work tonight.
 
Shannon & Chewy said:
I thought we'd see higher PMPS numbers than 102 with no insulin for 24 hours. He is acting normal but not very interested in food. He gets two pill pockets with antibiotic 1.5 hrs ago. I wonder if that's also messing with his appetite. I will keep food out for 2 hours to see if I can get him to eat more. He usually grazes at the lower numbers. I'm planning to skip dose since I have to work tonight.
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What is the antibiotic for? I think I probably als would have skipped if he was at 102 with no insulin for 24 hours and I was going to be working away from home. Let us know how he does.
 
Hi Shannon, I hope you find the right diet that works for Chewy. I wonder if some of the more experienced members could address whether more frequent feedings than twice a day would be recommended? I would think spacing meals out more could help keep bg from dropping too much throughout the day.
 
Suzanne & Darcy said:
What is the antibiotic for? I think I probably als would have skipped if he was at 102 with no insulin for 24 hours and I was going to be working away from home. Let us know how he does.
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Hi Suzanne I read in Shannon's previous post she said

Chewy's first low number came during routine bloodwork last week. Since then he has been on an antibiotic for a possible UTI. I say possible because we have not gotten urine from Chewy in a long time. I have plans to get urine tested soon but I wonder if the medication has helped with a UTI and that is making him more sensitive to insulin.
I'm a bit frustrated that the vet did not insist on a urine sample before starting treatment.
@Suzanne & Darcy
 
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Yes. I was going to mention that feeding multiple small meals throughout the day is really the best way to feed a diabetic cat. It helps stabilize blood sugar. We often recommend not feeding after kitty’s typical nadir because that can shorten duration of insulin an, of course, don’t feed for two hours prior to shot time so that the AMPS and PMPS numbers will not be elevated by food. Doesn’t your mother give him snacks?
 
Diane Tyler's Mom said:
Some members sprinkle Parmesan cheese on the wet food or
bonito flakes[/QUOT
I do. My cats love Bonita Flakes. I buy the bag of the human bonita flakes from Japan (at The Fresh Market.) Most of my cats love Parmesan cheese too. Forti Flori is good (but expensive for every day use). What really seems to make my cats happy as a food topper is to take Pure Bites Chicken Freeze Dried treats and crush them up and sprinkle them over the wet food. They go crazy for my "Magic Chicken Dust." Pure Bites Freeze Dried Treats are a great low carb snack, by the way, to give at each ear prick test).
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Diane Tyler's Mom said:
Hi Suzanne I read in Shannon's previous post she said

Chewy's first low number came during routine bloodwork last week. Since then he has been on an antibiotic for a possible UTI. I say possible because we have not gotten urine from Chewy in a long time. I have plans to get urine tested soon but I wonder if the medication has helped with a UTI and that is making him more sensitive to insulin.
I'm a bit frustrated that the vet did not insist on a urine sample before starting treatment.
@Suzanne & Darcy
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Thanks. Last night, I finally had time to go over a few of Shannon's previous threads. I found the one that mentioned the suspected UTI. I'm okay with it, although I still think he needs a urinalysis. There's not much point in doing a urinalysis though until he's been finished with the antibiotics for a week to ten days. That way you will know if he has any bacteria in there or not and the antibiotic will not interfere with any of the results. It may be that he had a UTI and the antibiotics are clearing it and so his BG numbers have gotten better. Infection and inflammation do raise BG. This would be wonderful it it were happening!
 
Suzanne & Darcy said:
Yes. I was going to mention that feeding multiple small meals throughout the day is really the best way to feed a diabetic cat. It helps stabilize blood sugar. We often recommend not feeding after kitty’s typical nadir because that can shorten duration of insulin an, of course, don’t feed for two hours prior to shot time so that the AMPS and PMPS numbers will not be elevated by food. Doesn’t your mother give him snacks?
Click to expand...

Hi Suzanne - thanks for all of the advice. Chewy was 71 this morning and very hungry which is typical at this number. I did order some Bonita flakes that I hope will help all my cats transition to can. They do love fish. What do you suggest for a feeding schedule? When he started insulin vet told me to feed twice a day. He has not been getting snacks. I did buy some low carb freeze dried chicken snacks but he did not like it.
 
Suzanne & Darcy said:
Thanks. Last night, I finally had time to go over a few of Shannon's previous threads. I found the one that mentioned the suspected UTI. I'm okay with it, although I still think he needs a urinalysis. There's not much point in doing a urinalysis though until he's been finished with the antibiotics for a week to ten days. That way you will know if he has any bacteria in there or not and the antibiotic will not interfere with any of the results. It may be that he had a UTI and the antibiotics are clearing it and so his BG numbers have gotten better. Infection and inflammation do raise BG. This would be wonderful it it were happening!
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Based on this info, I will wait to do the urinalysis. Vet originally wanted to see him 3 weeks from date he started the 2-week antibiotic.
 
It looks like he would benefit from snacks by +2 and +4 at least. You can play around with it and see how it affects his BG. It almost looks like feeding a teaspoon at +1 might help because sometimes he has a big drop already by +2. So these can be just small snacks to support the BG in the early part of the cycle, in particular. Although if he's super hungry, just feed him and don't stress about it (unless it's within that 2 hour pre-shot window.) You are doing amazing, by the way. Looking at his spreadsheet I can't even tell that you work two jobs! Did you say you were going to get a Libre sensor put on? I can't remember now if it was you who said this or a different person (sorry.)
 
Suzanne & Darcy said:
It looks like he would benefit from snacks by +2 and +4 at least. You can play around with it and see how it affects his BG. It almost looks like feeding a teaspoon at +1 might help because sometimes he has a big drop already by +2. So these can be just small snacks to support the BG in the early part of the cycle, in particular. Although if he's super hungry, just feed him and don't stress about it (unless it's within that 2 hour pre-shot window.) You are doing amazing, by the way. Looking at his spreadsheet I can't even tell that you work two jobs! Did you say you were going to get a Libre sensor put on? I can't remember now if it was you who said this or a different person (sorry.)
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Much appreciation for your advice and thank you for saying I'm doing a good job. I feel terrible I cannot test more. I generally work 16 hours a day Mon - Fri and then a few hours over the weekend. My jobs are close by so I can swing home during breaks to test. Everyone on here is so kind to devote their free time to helping our furbabies. Do you have suggestions for +2 and +4? I did just order some Vita Essential freeze dried snacks that were recommended by Dianne. Chewy did not like the Pure Bites freeze dried chicken so I'm hoping some other flavors will entice him. As far as the Freestyle Libre, I am going to try that out. I need to pick up the script from vet and schedule a time to do it. Chewy does have hyperesthesia (back crawling) so we are not sure how well he will tolerate it.
 
Shannon & Chewy said:
Much appreciation for your advice and thank you for saying I'm doing a good job. I feel terrible I cannot test more. I generally work 16 hours a day Mon - Fri and then a few hours over the weekend. My jobs are close by so I can swing home during breaks to test. Everyone on here is so kind to devote their free time to helping our furbabies. Do you have suggestions for +2 and +4? I did just order some Vita Essential freeze dried snacks that were recommended by Dianne. Chewy did not like the Pure Bites freeze dried chicken so I'm hoping some other flavors will entice him. As far as the Freestyle Libre, I am going to try that out. I need to pick up the script from vet and schedule a time to do it. Chewy does have hyperesthesia (back crawling) so we are not sure how well he will tolerate it.
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I understand. I have a kitty with what I describe as mild hyperesthesia. It definitely bothers him at times, but he isn’t so bad that he tears himself up like some cats will do. Normally, I would say to feed spoonsful of low carb carb wet food for snacks, but just feed whatever low/lowish carb stuff he will eat for the time being. You already know to give medium or high carb if you need to bring his numbers up.
 
Also, I know it’s not a perfect world and we do what we can with regard to what our cats will eat. I admire you for trying. A lot of people don’t bother to try to transition their cays to low carb wet food. It’s especially hard with multiple cats. I know!
 
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