10/8 Olive PMPS 521/ Insulin increase of 1/8th. Update on Cindy's Appt.

O

OlivesMom

Member Since 2020
https://www.felinediabetes.com/FDMB...oing-much-better-tonight.236511/#post-2652460

The PM cycle will begin cycle 15 since her earned reduction so it's just a matter of how much to increase it. Taking her to .75 dropped her a bit too much a week ago but she is on slightly more carbs now that we are slowly switching her to DM. She gets a 60/40 mix to the DM side for the first half of the cycle and 2/3 raw to 1/3 DM for the last half of the cycle. We are working both ratios up towards the DM side slowly with the end goal being all DM for both cycles. I was of the mind that by feeding her less carbs starting at +6 when levels naturally begin to rise that this would help keep her BG down. The vet said it didn't work that way and she needs the same amount of carbs to keep a steady continuation of glucose levels throughout because with the proper carbs/fat/protein ratio the insulin will begin to work towards stabilization better. I remain totally confused by foods it's not even funny. If I could get her on a higher calorie raw food, that would provide a bit more carbs and the calories she needs, but she won't touch anything but turkey and it HAS to be pate. Tried some cooked chicken and she puts it in her mouth and drops it after. She's not into shreds at all. All I know is she needs stability and I'm so confused by what's best to feed her that she's not getting stability at all. So it was either feed all raw or feed all DM and at this point, until we can find something healthy that meets the DM's ratios, it's going to have to be an all DM diet. See if this works to stabilize her in conjunction with the insulin increase and then we can move forward from there.
Any thoughts on how much I should increase her insulin? Until we can get Cindy back to full health I'm going to delay trying TR with Olive. It's just too much to deal with right now.

Cindy is doing well today. Definitely better than she was yesterday. She did start in with the vocalizing at the exact same time at 3:30am and I was like "No way. Not again," but it only lasted a few minutes and not 7 hours! Her appetite is there. She really wants to eat and wolf her food down, it's just that her eating is being effected by her tooth hurting so she's weary. So I'm trying to feed her far more often since she's only eating a little at a time before she calls it quits due to the pain. I'm pretty certain it's just a tooth issue but the thought of her having a dental worries me at her age. She's about 15 or 16. Yet, I know at this point we don't have a choice. She's got to get this fixed. Vets tie my stomach in knots worrying what they'll tell me. This whole year has been nothing but bad news at every turn. Praying for some good news today.
 
Is there a vet dentist you could go to for the dental? I’m wondering if you should take a 1/8 increase instead of 1/4. See what others say. Poor Cindy. :bighug:
 
tiffmaxee said:
Is there a vet dentist you could go to for the dental? I’m wondering if you should take a 1/8 increase instead of 1/4. See what others say. Poor Cindy.
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No vet dentists. I live at least an hour away from any major city. I've never heard of a vet dentist in this area and Cindy doesn't travel well. She'll be screaming the whole way. When prior to being adopted she'd been at the shelter for almost a year and developed extreme claustrophobia. So we don't like to take her anywhere unless absolutely needed, like now.
tiffmaxee said:
1/8 increase instead of 1/4
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For the insulin you mean? The caliper is set at .67 On average I got 1.06 for a whole unit. She was getting .53 starting the PM cycle on September 23rd and got the tad increase starting on the PM on the 28/ AM on the 29th for which at the time I was eye-balling. So I thought it went closer to the .75 then but I wasn't sure. Hubby thought it looked more to the light side of .75 but definitely in that range. That's when she went too low and got the .25 reduction on the PM cycle on the 29th. Stuck with the original eye-balled dose of that tad/hair fat 0.5 and as of Oct 1st started having issues with air bubbles after air bubbles and tried compensating and before I knew it 9 more cycles had gone by at that eye-balled Fat 0.5. That's when I bit the bullet, wanting to know exactly what she was getting instead of eye-balling, and changed the caliper settings to what I "thought" was that fat 0.5 for those last 9 cycles which ended up being .67 on the caliper. I've been sticking with that caliper setting since. But her numbers just won't come down so she needs an increase. So by my calculations if she were to go back to that .75 then that's a 0.78 setting on the caliper.

I tried (AGAIN) to get her some nutritional advice from the holistic vet, even agreeing to pay the huge phone consultation fees) but the tech said she won't give nutritional advice without seeing Olive hands on first. Ugh. I wish hubby hadn't cancelled her first appointment back in September because I'm so frazzled over this. I went ahead and made another appointment for her dietary needs but it's not until the 29th. In the meantime the tech said she doesn't think the vet is going to like the fact Olive is on DM. Ugh! So what do I do in the meantime?? :confused: I don't want to have to go back to food transitioning her back to the raw diet that I know she's going to move towards once she sees Olive. I want to pull my hair out! Hubby just called and said he'd stick with the original 50/50 mix and not just for the first cycle but for the second as well. Just keep her on something stable until that vet visit. no more messing around. Increase her insulin a bit and see what happens over the next week. I just need to get her numbers down...she's staying too high all the time.
 
By my calculations if we increase her insulin by the 1/8 unit instead of the 1/4 unit( a 0.24 increase would take her to the .75 unit which dropped her too low before) that should make the new caliper setting 0.72 so that's what I'm going to set it for the PM cycle 4 hours from now. Any thoughts on this?
 
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Many go up and down over and over. What didn’t worked before may or may not work now. We have gone through this with Gideon and Blue. The other night I managed to keep Blue surfing green and not earning a reduction and so far he’s holding. The trick was testing and feeding every 1/2 hour for several hours.
 
I wish there was a magic rule book to go by. I don't mind trying to go up to by the quarter unit again as I test every 3 hours no matter what. I just don't want to have to stick with high numbers for another week if the 1/8th increase isn't enough. I've got to get ready to take Cindy to the vet. Later guys....
 
I'm trying to catch up on your history, since I think this is the first time I have stopped by. Maybe I am missing something, while I see that there were some iffy (fats/tad fat) doses, 0.5u isn't cutting it. I'd personally go up a full 1/4u. The thing is, she's getting too comfy now in higher numbers, which looks to me like glucose toxicity has set in. It sounds worse than it is, just means you need to get them back to lower numbers, and 1/8u to me won't do it. Usually when people here are getting close to a good dose, they tweak it in smaller increments(fats and skinnies) but Olive really isn't anywhere near that yet. Remember, SLGS is a method to help guide you, you have a lot of test data (more than SLGS would actually call for) to see how this dose is working, and haven't seen greens in 9 days, and there are far too many high numbers and no nadirs under 150 in sight. If it were me, I'd be going up 1/4u and see if that gets her back into better numbers.
 
I'm back. I'm exhausted though. We were at the vet's office with Cindy for 3 hours!! And ended up getting home late because of it and Olive's insulin was delayed by a half hour due to it. Although I won't get the lab results until late tomorrow or possibly even Saturday to confirm the docs thoughts, there's a lot to update you guys on. The doc agrees her teeth are terrible, she's in pain and discomfort because of it and she needs to have the dental work, but that's only one of her many issues going on. His suspicions were confirmed by feeling what he's called a benign tumor in her thyroid. She has hyperthyroidism which is why she wants to eat, but even when she has eaten she continues to not gain any weight. I told you she was very skinny and my husband and I have been trying for months now to get the weight back on her to no avail. We suspected she needed another dental but really wanted to get some weight on her first. We even switched her recently to half raw and half another kind of food hoping it had more calories and fat to add to her diet. So this is why no matter what we did we couldn't get her to gain. We just thought she was eating less due to her bad tooth. But it turns out after doing some quick research while there, that raw food is actually the best food for cats with hyperthyroidism. And Cindy loves her raw food, so that's great. He hasn't started her on the meds yet until the lab work confirms it, but he said she'll be on pills twice a day for the rest of her life. And the other issue he found he believes is directly linked to the first...cardiomyopathy. (probably spelled that wrong. He said it was a thickening of the heart muscles and she actually has a double beat going on. More often times than not he said once the thyroid issue is resolved and animals get on meds, then the heart issue clears itself up too. Then there's the third thing he's not sure about yet just wanted to test and make sure, but that too is part of the chain reaction he's suspicious of due to the other two things and that's her kidneys since kidneys don't like the high blood pressure from the heart issue that's being created by the thyroid issue. Whew! He was very good with our girl. Thank you guys for your thoughts and prayers and if you can keep those going that the lab work will actually be better than he thinks, that would be awesome too. Cindy was so terrified today and especially since it took over 2 1/2 hours before we were even seen, that she held her mouth wide open panting like a dog. It was really concerning us so we kept grabbing the techs that went by and telling them she needed seen NOW. After doing that 3 times and telling them too we didn't think when we made the appointment that they'd keep us waiting for over 2 hours at that point and we HAD to get home to our diabetic cat who needed her insulin at a certain time, they got her in before a lot of others. Today's problem was they "accidentally" triple booked every single person. Yes, triple booked. But we were just so grateful she got seen and the steps are taken now to get her to feeling better. Because of her heart issue it depends on the lab work first as to what can be done about the dental. If that comes back okay he wants an EKG done just before she goes into surgery so he knows she'll be ok. Very good vet. He really seemed to care. Because of Covid we couldn't go inside or be with Cindy so the doc was on the phone with me the whole time. Nice! Too bad this hospital is so far away. The trip was torture for Cindy. I'd never seen her so upset that she panted before. She was still doing it during the exam and when he questioned it I told him it was only due to her being so scared for so long...long car ride and then having to wait over 2 1/2 hours in the car before even being seen. She has severe claustrophobia. He said his cat was the same way.
Olive & Paula said:
What about puree the raw add in some water to make it soft like pate.
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That's exactly what I did. Now that we know it's not diet, we let her have her full amount of raw when we got home and added a lot of water. She lapped it up, even though it was clearly still hurting her. I always warm her food in a warm water bath first.
Christie & Maverick said:
Maybe I am missing something, while I see that there were some iffy (fats/tad fat) doses, 0.5u isn't cutting it. I'd personally go up a full 1/4u. The thing is, she's getting too comfy now in higher numbers, which looks to me like glucose toxicity has set in. It sounds worse than it is, just means you need to get them back to lower numbers, and 1/8u to me won't do it. Usually when people here are getting close to a good dose, they tweak it in smaller increments(fats and skinnies) but Olive really isn't anywhere near that yet.
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I know she is.:( I increased the dose tonight by 1/8th but like you, I think she needs a quarter dose increase even though it didn't work last time. Seeing her in the black is eating at me. She's there tonight and isn't a happy camper by any means. Hubby thought it best to stick at the 1/8th increase because of last time so that's what I did, but my gut tells me she's never going to come down unless I force her to by a little more drastic measure than simply upping her amount by something so small. Even though she got the slight increase tonight there's no point in testing her until much later as she's still in the black.

We also thought it best to stop trying to figure out what to feed her and to simply leave it at a 50/50 ratio of raw to DM all day long, not worrying about changing that ratio for the last half of the cycles like I've been doing, and just allowing her body to experience something totally steady for a change. That, and increasing the insulin, even though I know she needs more, and we'll wait things out for the rest of the 3 weeks until she sees the holistic vet. Only then will we have our answers to her dietary needs. She's a holistic vet but also mainstream for those who wish to go the traditional route. So we'll have the best of both worlds. The 29th can't come soon enough. Everybody is just so booked due to covid.

Okay, I'm off to bed. Olive will get a break from testing if her numbers are still high right before I head off. She'll love that. Good night!
 
Sound like a plan. You can also give kitten food as snacks. It's higher calorie. Add some powdered egg white for extra protein and few extra calories.
 
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