11/21 Minner AMPS 227 +5 213 PMPS 152 - can’t stop yellow

MinnerPip

Member Since 2024
Nov 12th - last post

Since our last post, I have increased Minner’s dose from 5.75 to 6 to 6.25, back down to 6.125. I recognize this is too much change. Ugh. I admire Seth’s ability to stick so tightly to protocol with Bell. I keep watching her sheet to learn. Meanwhile, I am an erratic, overly anxious disaster. I think Minner’s IAA is wreaking some havoc as well. I discussed her entire situation with ChatGPT and was very impressed with the feedback. I’ll copy that dialog into a file and share on Google drive for anyone interested.

I took Minner back to vet on 11/17 to recheck her mouth. The gum tissue where her molars were smoothed down and a gum flap stitch done look good. However, she still has red line along gum where she does have teeth and vet said that should have resolved with dental so recently, so he wonders if she might be developing touch of stomatitis. That is horrifying to me, her mom had full mouth extraction at Texas A&M in 2021 when we lived in Austin, to deal with very bad caudal stomatitis. Her mom was 3 yrs old at time. We would not be able to manage this with Minner and her diabetes too so we can only hope this does not progress to stomatitis. She seems to be eating well and has nice big yawns, both of which go away with severe stomatitis. She also has/had what may have been an abscess under her chin. I thought it was a bit of chin acne and had tried to clean it and also lanced it and it bled. The vet seemed to get it fully “out” so I think that is on the mend. He gave her a convenia injection.

Note that after increasing to 6.25, we got 4 cycles of no yellow, but I chickened out b/c it was a feeding frenzy. Look at my notes and how much she ate on 11/18. So I tweaked back to 6.125 and during 2nd cycle at 6.125 we returned to yellow and yellow has appeared/stayed in all 5 cycles at 6.125 since. Also note the big difference in AM and PM cycles. There seems to be strong insulin resistance in AM cycle followed by a late cycle release and drop. Then the PM cycle seems very active (which may be an overlap of AM late cycle action), so I think I may be over-carbing her … ??? I have introduced this 9% weruva gravy food that she loves, and it lifts her when we start going low in early PM cycles, but maybe this is contributing to her bouncing back up into yellow going into AM cycle.

Arrgggghhhh. Where is the Minner instruction manual??

I am going to try to keep away from that 9% unless she gets in danger … so I say now.

Maybe I need to tweak her back up to 6.25 since that did get us out of yellow, and see if we can move past feeding frenzy.

It’s wild that 0.125 of a unit at this high of a dose can be a tipping point, but it sure looks that way.

I appreciate feedback.
 
Nov 12th - last post

Since our last post, I have increased Minner’s dose from 5.75 to 6 to 6.25, back down to 6.125. I recognize this is too much change. Ugh. I admire Seth’s ability to stick so tightly to protocol with Bell. I keep watching her sheet to learn. Meanwhile, I am an erratic, overly anxious disaster. I think Minner’s IAA is wreaking some havoc as well. I discussed her entire situation with ChatGPT and was very impressed with the feedback. I’ll copy that dialog into a file and share on Google drive for anyone interested.

I took Minner back to vet on 11/17 to recheck her mouth. The gum tissue where her molars were smoothed down and a gum flap stitch done look good. However, she still has red line along gum where she does have teeth and vet said that should have resolved with dental so recently, so he wonders if she might be developing touch of stomatitis. That is horrifying to me, her mom had full mouth extraction at Texas A&M in 2021 when we lived in Austin, to deal with very bad caudal stomatitis. Her mom was 3 yrs old at time. We would not be able to manage this with Minner and her diabetes too so we can only hope this does not progress to stomatitis. She seems to be eating well and has nice big yawns, both of which go away with severe stomatitis. She also has/had what may have been an abscess under her chin. I thought it was a bit of chin acne and had tried to clean it and also lanced it and it bled. The vet seemed to get it fully “out” so I think that is on the mend. He gave her a convenia injection.

Note that after increasing to 6.25, we got 4 cycles of no yellow, but I chickened out b/c it was a feeding frenzy. Look at my notes and how much she ate on 11/18. So I tweaked back to 6.125 and during 2nd cycle at 6.125 we returned to yellow and yellow has appeared/stayed in all 5 cycles at 6.125 since. Also note the big difference in AM and PM cycles. There seems to be strong insulin resistance in AM cycle followed by a late cycle release and drop. Then the PM cycle seems very active (which may be an overlap of AM late cycle action), so I think I may be over-carbing her … ??? I have introduced this 9% weruva gravy food that she loves, and it lifts her when we start going low in early PM cycles, but maybe this is contributing to her bouncing back up into yellow going into AM cycle.

Arrgggghhhh. Where is the Minner instruction manual??

I am going to try to keep away from that 9% unless she gets in danger … so I say now.

Maybe I need to tweak her back up to 6.25 since that did get us out of yellow, and see if we can move past feeding frenzy.

It’s wild that 0.125 of a unit at this high of a dose can be a tipping point, but it sure looks that way.

I appreciate feedback.
Hi Laura, I hope you get some feedback on your dosing decision. It IS wild that such a small variation in dose is the difference between yellows and too low. In looking at Minner's sheet, my question is, when do you sleep :oops: No, seriously, I'm glad to hear her mouth is healing, but I hate for stomatitis to be in the mix. In truth, I understand nothing about stomatitis, so you're sending me to Dr. Google to investigate, but if you say it's something that isn't manageable alongside FD, it's BAD. Jude had a dental in February, and when the vet checked his mouth the other day, he said Jude needs another one. Another dentist that we've seen in the between times since he's been having either an FIC flare or UTI mentioned stomatitis to me, but, again, I know nothing, so I'm going to educate myself. Is Minner gaining weight with all of the "feeding frenzy" activity??
 
Hi Laura, I hope you get some feedback on your dosing decision. It IS wild that such a small variation in dose is the difference between yellows and too low. In looking at Minner's sheet, my question is, when do you sleep :oops: No, seriously, I'm glad to hear her mouth is healing, but I hate for stomatitis to be in the mix. In truth, I understand nothing about stomatitis, so you're sending me to Dr. Google to investigate, but if you say it's something that isn't manageable alongside FD, it's BAD. Jude had a dental in February, and when the vet checked his mouth the other day, he said Jude needs another one. Another dentist that we've seen in the between times since he's been having either an FIC flare or UTI mentioned stomatitis to me, but, again, I know nothing, so I'm going to educate myself. Is Minner gaining weight with all of the "feeding frenzy" activity??
Hey Mary! I ended up NOT increasing back to 6.25 b/c I was able to keep her out of yellow in PM cycle yesterday mainly by feeding only 1% and 2%. But then her AM overnight cycle, which we are in now, despite eating only 1% and 0% and starting in low blue, she jumped back into yellow. It’s like her IAA is super strong in AM cycle and insulin is so much less effective. This makes it even stranger to manage b/c she needs more insulin for AM cycle but not the PM cycle, so have to use food to manage the difference.

She is up in weight. She was 15lbs at diagnosis last June. She’s never been less than 15 since, she’s currently 16.3 lbs.

Mama Pip was Minner’s mom. We lost her in 2023. She had all kinds of challenges. Minner was csection, her 2 siblings died on day 1&3. Mama Pip had pelvic fracture so opening was about 1/4 normal size. Babies wont fit thru, and pooping issues the whole time we had her. Hypercalcemic. Then the stomatitis, had to do feeding tube even b4 the surgery to extract all teeth and for weeks after. That was challenging with a super accommodating kitty, it would be near impossible with Minner. I would not put her (or us) thru all of that. We lost Mama PiP when her colon eventually quit. Evacuating her colon under anesthesia every 5 days just not sustainable. Sigh.

Anyway, I think there are milder forms of stomatitis, but they are all auto immune reaction to bacteria on teeth. Get rid of the teeth and in most cases it resolves. Mama Pip’s resolved and we got almost 2 more years with her. We kept her on low dose pred too. Caudal stomatitis is when the reaction causes inflammation all in back of mouth. One vet said it looked like hamburger meat. They stop yawning b/c that is too painful and eating(swallowing) is too painful. Many will starve to death.

So Jude’s dental was 9 months ago and needs another! And you use those cloth finger wipes on his teeth daily? I am sorry about his FIC. How do you manage that? It looks like it can be idiopathic. I know pred can cause diabetes but if you already have diabetes and pred can reduce inflammation from other things I wonder if it can be appropriate course of action.

I now wonder if 6.25 is going to do the job for Minner. Or will it no longer be enough either. I’m going to go to 6.25 and hold for at least 6 cycles and re-evaluate. Will do an 11/22 post to document.
 
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