12/31 Leo♡ AMPS 269 +2.25 539 +6.7 491 PMPS 515 +4.75 366

Hi Joni- glad to see he’s eating this morning. I was curious what your usual feeding schedule is and what % carbs you typically feed and when. I appreciate that with his appy issues you have to try and find foods that he is interested in eating.

I saw from your SS that you had a vet appointment a couple of weeks ago. Did the vet say anything specifically about his weight loss or anything out of the ordinary in Leo’s lab work? Also, the vomiting and occasional appy issues, is that new or has that been going on for a while? Do you notice when he doesn’t want to eat that he is licking his lips?
 
Christie & Maverick said:
usual feeding schedule is and what % carbs you typically feed
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AM & PM: Test~Feed~Shoot
Usually, FF Classic pates, 1-3% carb, splits 3 oz can with Andy (non-diabetic kitty, four years younger). He usually eats a good amount of of 1.5 oz, but not all. Goes back to eat more shortly after he stops, but 30-45 min before +1.

+1: Depending on PS BG, provide/encourage to eat, and he usually does. Quite often, he shows up on his own to get food. Though he doesn't eat all the food provided from the bowl, he seeks a higher carb.

Then he has wet food available throughout the day as I add new food to bowl(s). Andy has annoying habit of eating Leo's food, even though he has the same thing.

After BG checks, Leo gets Pure Bites freeze-dried chicken and/or some Young Again Zero Mature pellets.

LC food Leo does not like:
Weruva Cats in the Kitchen,
Wellness Core pate, there are others, but my brain is not quite awake.

Leo will eat Friskies pate, like this morning; 5% carb.
 
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Christie & Maverick said:
Did the vet say anything specifically about his weight loss or anything out of the ordinary in Leo’s lab work?
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She did mention the weight-loss, but look at his glucose level. It was high. This is when I felt I needed a script refill as the Pens seem to lose their viability. 2023s Glargine from Costco is a different manufacturer than 2022, and I notice a difference much sooner than before, in that his BGs go higher than with the 2022 script. OR maybe he getting insulin resistant?? IDK

Vet authorized a refill script.
After various discussion on FDMB & FB the Pen was likely good and after I started a new Pen, I went back to that original Pen I suspected was bad, and Leo's numbers went bad again. :mad:
 
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I guess I was wondering more so whether there were some lab values out of range that could be indications of some other issues going on, in addition to the diabetes. So, as far as feeding then taking for example the last 3-4 days, the MC and 33% HC was given as you’ve noted in your SS? Ie. not something you feed regularly otherwise?
 
Christie & Maverick said:
anything out of the ordinary in Leo’s lab work? Also, the vomiting and occasional appy issues, is that new or has that been going on for a while? Do you notice when he doesn’t want to eat that he is licking his lips?
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Leo’s glucose was high, for sure. I just realized I never added the last labs to the Labs portion of the SS. Looks like his platelets have dropped below the average. Hmmm. Will you check it out? A different vet called to tell me his labs are normal, except glucose, but Leo's actual vet called to talk to me, but it was when we were heading to the hospital, 12/22, right before my step-mom passed after life support was removed. I really need to follow-up with her, but the crazy holiday schedule... :stop:

The vomiting only occurs when BG is high; the recent appy issues are new and so extreme. I do not notice any lip licking. What does this mean if they do?
 
Christie & Maverick said:
So, as far as feeding then taking for example the last 3-4 days, the MC and 33% HC was given as you’ve noted in your SS? Ie. not something you feed regularly otherwise?
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Looked over SS to see when the HC, 33%, appeared. It must be when I stopped updating the SS for awhile this year. The higher carb has always been used to slow down a drop after the shot, +1, if needed, either 10%, 15%, or 20%. Then I found a 33%.

The higher carb is only used to slow the drop or keep him from going under 50. Relying/using this as a means to control lower BGs seemed a case to become insulin resistant.?? IDK
There were times, HC was used and not needed, after all, when the +2 or so revealed a high BG. Then if I didn't use the higher carb, he would drop under 50. Dammed if I do, damned if I don't.
 
La-La Leo said:
Looks like his platelets have dropped below the average. Hmmm. Will you check it out?
The vomiting only occurs when BG is high; the recent appy issues are new and so extreme. I do not notice any lip licking. What does this mean if they do?
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low platelets are not usually a concern, often that’s due to clumping, do your labs show that comment? Sometimes lip licking can be a sign of nausea and also just eating a few bites then walking away.

I might suggest keeping a closer eye on what Leo is eating, since if I understand correctly after +1 you typically add a little food and it might be possible that he’s just not getting enough calories through the day. For a little while at least, especially since he needs to gain weight, I’d be monitoring the calories he eats more closely.

I have to admit I don’t think I have seen too many cats here where such a high carb (33%) is routinely used and I do wonder if that is contributing to the high bounces. How much are you feeding, is it like a couple of teaspoons at a time, less, or more?

Yes, when you are seeing a quick and significant drop to onset it’s ok to try and prop up the numbers and depending on how carb sensitive he is, it may be that going into a a higher LC or MC might do the trick. If he needs HC I would see whether 15-20% carbs work. With Mav when he was on Lantus, I’d often go into a higher LC (like a 6-9%) first and if that didn’t do the trick to slow the drop, then I tried something in the 11-14% range and saved the HC for under 50. The tricky thing is that with Leo on Dec 28th, the green preshot in the PM cycle led to a quick drop.

Since you are already feeding a little at +1, it might be worth doing a +1 test for a while especially when you get green preshots or where you think a bounce is breaking, and let that test guide you in whether to feed higher LC or perhaps MC if he doesn’t appear to be getting much of a food bump from his preshot meal. In the evening cycle of Dec. 28th, by the time you got to +2 Leo was already under 50 and then as you know, once you get into an active cycle so early and need to feed HC it can be a game of catch up, since you can get above 50 briefly, but then since the HC wears off quickly, you need to give more HC to bring him back up over 50. The amount of difficulty you had in continuing to have to feed 33% and some syrup to keep him above 50 suggests to me that he would have earned a reduction without that level of HC intervention.

Yesterday’s cycle is an example of how Leo showed that he was breaking his bounce from the previous greens. He had started the bounce on Dec. 29th then stayed high in the pm cycle, but came down to red then continued his drop to preshot.

Just few observations for you to think about.
 
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@Christie & Maverick, I'll get to the rest of your inquiry after the kids leave. Leo is throwing up again this afternoon and had a terribly smelly poopy. He ate this morning, but that was it really. What in the world?
He did play with the flying bird toy this morning with my husband.
 
Forgot to mention our other kitty is not as voracious as usual. Another thing, our daughter got the kitties new feeding bowls at Christmas. Maybe this is part of it. Hmmmm...
 
Christie & Maverick said:
Oh hon, I’m sorry, take your time, even over the next few days I realize you have a lot going on. I don’t want to add more to your plate.
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No apology necessary. I am thankful for your insight and help. ♡♡♥︎♡♡♡♡♡♡♥︎♡♡♡♡♡♥︎♡♡♡♡♡♥︎♡♥︎♡♡♡♡♡♡
 
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