12/26 Alley; PMPS 495 - Back on the juice

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Dan & Alley

Dan & Alley

Member Since 2016
I should have seen it coming the past few weeks... Greasy fur, dander, listless, champion pisser, and now loss of appetite. After 18 months at the falls, Alley is back on the juice.

Crap.

When she was first diagnosed in March 2016, Alley had dropped from 17 down to 11 pounds and was all but dead. This time she's only down to 15.5 pounds from 17 pounds, so her return from the falls is rather recent. Six weeks ago, she tested in the 120's. In her first year off the juice, Alley was a picture of consistency with BG in the 70's. Over the past half year, she'd gone up to the 120's, nothing to get in a wad about, but worrisome... now she's back over the top 400's and 500's.

So anyway... to old friends and others here I don't recognize, she's back!

Crap.
 
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Well darn!!! (can't say what I'd like to say)......Welcome back?? Wish you weren't here??

At least you caught it early and knew where to come for support....that's a good place to start!

Have you had Alley's teeth checked? Any sign of a UTI? Those are the top two reasons for cats coming out of remission
 
Chris, I'd not considered reasons for Alley coming out of remission but those are good to know about. I'll have to have Alley checked out for those.

One thing I just now considered is that Sophie started on a fish based dog food in the past 6 weeks. Alley never had the least bit of interest in Sophie's food in the past, but she's been caught stealing a kibble or two of Sophie's Six Fish Orijen on occasion. The carbs are low glycemic and only 18%, but Alley has had ZERO carbs for the past 18 months and maybe it's a far bigger problem with Alley stealing Sophie's food than I'd realized. It's probably time to go back to the dog food varieties for which Alley has no interest. Shame because Miss Sophie really loves the fish formula.
 
OH poop! I am so sorry that Alley is back! With the weight loss, excess peeing, dander and loss of appy, and high numbers I'd say she definitely needs some insulin support . Had you caught the dog food stealing early and she spiked a few higher numbers, I'd try just removing the contraband and see if Alley's numbers come down, but, I think you were wise to start her back on the juice.

She's in good company as Bubba is back and doing his 4th rodeo with the juice. :rolleyes: And there are others that just can't stay away too.......
 
I agree with Chris about getting Alley in to see your vet for a check-up. The need for a dental is one of the most frequent causes for a kitty to fall out of remission. I also suspect Alley chowing down on 18% carb puppy food is like her sitting down to eating cookies and ice cream. Let's see what happens when she stays out of the dog's food and you make sure she doesn't have anything else going on.

 
I agree about not allowing access to the doggy food. In the past, we always kept the dog dish filled, but after a few times of catching Rex (and the other 3 cats) stealing a few pieces, I decided to switch the dog to 2x a day feeding schedule and he no longer grazes. I hope there are no big health issues... well, maybe if there are and you can get them taken care of... :D
 
Sienne and Gabby (GA) said:
I agree with Chris about getting Alley in to see your vet for a check-up. The need for a dental is one of the most frequent causes for a kitty to fall out of remission. I also suspect Alley chowing down on 18% carb puppy food is like her sitting down to eating cookies and ice cream. Let's see what happens when she stays out of the dog's food and you make sure she doesn't have anything else going on.
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I’ve heard that a lot re the dental. If a kitty already in insulin gets a dental - will that spike the numbers? Is it due to the anesthetic and/or pain meds? My two 11 year olds not yet had a dental but at last checkup vet said teeth weren’t too bad. Oh and made me buy a dental dry food!
 
Alley, silly girl eating the droolers food!

Dan, I see you gave her 3u last night and 2.5u this morning. Pretty sure both are too high of a starting dose. With TR, starting dose is .25u pet Kg. If Alley is 13.5 lbs that’s 6.1kg so starting dose would be 1.5u. You’ll also need to hold that dose for 6-10 cycles to let the depot fill unless she goes below 50.

Tagging @Marje and Gracie and @Wendy&Neko to make sure I’m accurate. Maybe @Sienne and Gabby (GA) will see this too.
 
Remember that we dose Lantus by the low numbers, not the highs. Last year's SS shows that Alley never got more than 2.25 units, so I wouldn't have started as high as you did. I know you are probably impatient to get her back in good numbers, but going too fast is not the way to go. Since Alley is not new to insulin and is returning to the juice, you could start a bit higher dose that the TR starting dose, if you can monitor, but less than you did. I would get her into a vet ASAP - I hope the office is open this week.

Low carb wet or raw is also good for droolers.
 
If you do the math, starting your kitty at 3.0u isn't that off. A different option may be to start out at a lower dose than the 3.0u and if necessary, we can fast track the dose up. I tend to think it's easer on the caregiver's nerves to not be worried that their kitty's numbers may plummet when they're not home. If you're comfortable with the 2.5u dose, just monitor as closely as you can.



 
Thanks all.

Alley is at 15.6 pounds, so at 0.25U/Kg, that would indicate a starting dose of 1.75U. So 3.0U is aggressive, as was 2.5U. Actually, I should have looked up the old spreadsheet because 3.0 is what I remembered, incorrectly, thus the immediate drop to 2.5 once I looked up the old numbers.

Alley just gave a PMPS of 106 so I'm swinging to the conservative side at 1.0U. Fortunately, I've got the week off, so I can deal with any potential low numbers. So... how much of this is relapse and how much of this is Alley sampling Sophie's dinner?

Anyone who has dealt with Alley and me knows that I'm impatient to an alarming degree. On my first rodeo, I would ask for advice but not necessarily follow it. Sometimes I would, sometimes I wouldn't. Not that I don't appreciate all the advice, but there's a lot to "know your cat". I do tend toward the aggressive side of treatment, especially when I have the time to pay close attention to Alley's numbers. I can sometimes frustrate folks here who tend to stick to chapter and verse on TR, but the aggressive has worked for me and it has worked for Alley.

The rapid drop to 106 tells me slow down and try some of that patience thing I've heard about.
 
Pet Health Dental Month is in February...if you can hold out, you might get a discount on a dental. Pretty sure that it would help Alley to have one, to get rid of her dog breath (ha). Good luck keeping her out of the dog food! You've done the dance before, so at least you can feel comfortable advocating for Alley. As a new FD parent, I felt like a teenage girl buying my first car, believing everything the salesman (i.e. the vet) told me because I didn't know any different and didn't have the experience to ask the right questions. Good luck!
 
Marniepaul, the trip to the vet was more of the old routine. I asked for general bloodwork (I wish I'd also asked for urine analysis for UTI) and frustosamine. The vet brought in the results and I started reading them off... "BUN holding steady at 60 from last time, creatinine still around 2.0... her kidneys are still holding up. Fructosamine 560 so she's not well controlled over the past several weeks, I'd prefer to see it under 400, certainly under 500, but 560 is just bad. I'll need a script for a Lantus vial and a pile of U100 syringes". The vet who I'd not seen before at the office I take Alley to just looked at me and said, "I'd tell you what I think, but you just about covered it".

If Alley's kidneys were going, I'd be looking at multiple organ system problems and perhaps a hard decision, but her creatinine has been 2.0 - 2.2 for the past two years solid.
 
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Hi Dan

Sorry to see you all back here. Let’s hope you can get Alley back into remission fast.

We usually recommend that for kitties returning from the Falls, that the CG be a little more aggressive. It’s harder to get them back to remission the second time and the CG is more experienced.

Good luck!
 
Thanks Marje,

No problem with the more aggressive thing! It's interesting that while Alley has been poorly controlled for the past several weeks (via fructosamine lab), that she only lost her appetite back on Christmas. I'm finding it more than a little interesting that after 3 shots (3.0U, 2.5U, 1.0U), she's bleeding up green numbers. This could be ALL about Alley stealing from Sophie's bowl. I started Sophie on the fish recipe on November 18th and there's been 6 weeks for Alley to commit her daily crime... so it very possible that we're not looking at a diabetic relapse at all, but rather the consequence of a zero carb falls kitty finding her way into a daily dose of illicit carbs.
 
It’s possible but she’s always going to be diabetic. She just might get back to being exogenous insulin independent.

But it’s a good lesson for all to see....how dry food can potentially affect the BG.
 
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