13/08 - Djoko - amps HI; +8.5 = 224; pmps 295; +2.5 = 304

I'm sorry Djoko is on the moon right now. You'll get him under control. Keep your head up:)
Come on Djoko work that juice PLEASE:cat: Purty cat please:)
 
Yes I hope he will go down :S. When he starts the day at HI or in the high blacks, he sometimes does not drop a lot. I find he has two types of cycles. It is rare when he starts in the black that he gets into the blue. It happened last week and then bounced in the red...When should I test him today? Is it worth it during his day cycle? Thanks!
 
Marj & Djoko said:
When should I test him today? Is it worth it during his day cycle?
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High PS #s don't always indicate they're going to stay there....you know because you've seen it. Djoko does like to nadir around +6 or just before. If you want to get a test, I'd try for just around nadir time or a little before. Even though his #s may not come down, it's good to check just to be sure. I'm a big fan of +2 testing. It's an early indicator of how a cycle will unfold. You already know this though;) If you look at my SSs, when beginning Lantus, I started getting the +2. My boys were droppers in the first 2-3 hours of the cycle. It was imperative to get that test to ensure my boys were safe. I'm a very data driven person. The more #s you can get on that SS in different scenarios, will help to paint the big picture. Use your best judgement on when you think an appropriate mid-cycle test would be for Djoko.
 
I used to get a test around +2.5. It’s always suggested to get a +1 and +2 with a dose increase but Max would onset between +2 and 3. I know you haven’t put all your info in the ss. Try and update it with every test. You need to catch him when he is starting to come down to control the descent and keep him in middle blues. He’s not dropping from high to low within an hour. Even if food is available you need to coax him to eat just a little as he slides down to prevent him going too low which for him is green right now.
 
I think a test at +2.5 when he is in the yellow is the thing to do. Not sure when he is in the black though. I am wondering if he is sick. He seems fine and eats well but why that high in the last 24hours!
Do you think I should get a +2.5 also when he starts the day/night in the black?
 
The diet change for his other issues is high carb. So insulin needs to be adjusted for that. I’m also concerned that he won’t eat it with the supplement. .
 
tiffmaxee said:
I’m also concerned that he won’t eat it with the supplement. .
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What should I do? I seringed it and waiting for the vet to come back with a new plan re supplement but he is on holidays. What I am worried about is that 2 days ago, he went low (and maybe lower ) with the higher carbs diet, if I increase the dose, is it going to be fine or is he going to go into hypo? He was at 3.7 on AT2 and 2.5 on human meter (not the best human meter. I ay use a contour one shortly that my mother used to use during cancer treatments - she is fine now!).
3.7 = 67
2.5 = 45.
 
Lemme ask also, I'm not sure if it's just me but, does data disappear when going from the world SS to US for anyone else?
 
I think you need to talk to your vet about your cat not eating the food with the supplements and see what you should do. You are definitely right that you can’t up the dose of Lantus if he’s not eating.
 
Yes I have more data on the world one. I have just tested him and he is at 13.9 on human meter. Will he bounce from that? This morning he was at HI so pretty big drop.
The 3.7 happened on the 10 so 3 days ago.
 
tiffmaxee said:
I think you need to talk to your vet about your cat not eating the food with the supplements and see what you should do. You are definitely right that you can’t up the dose of Lantus if he’s not eating.
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He eats the food because I don't put the supplement in it. The supplement smeels terrible. I would not eat it either.
 
He needs 3 drops under 68 if pet meter or under 50 if human meter to earn a reduction. I only see one recently of 67. You use both which confuses me. Are those pet meter or human?
 
The numbers in the SS are pet meter unless mentioned otherwise (e.g when I have the libre).
It is because my vet told me to use the AT2 when he is going low (on human meter and Libre) to make sure he is not getting into hypo. So I tested with AT2. This human meter is not reliable. I use it to have a sense only just for my own knowledge. I will try another one.
 
Marj & Djoko said:
I use it to have a sense only just for my own knowledge. I will try another one.
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It's great to have a comparison using both human and AT2. Most peeps just use a good 'ole human meter and back up with the AT2. Some Vets prefer to see #s supplied by the AT2 when reviewing curves you provide. AT2 strips are expensive, especially for how much testing we tend to do. I like my good Walmart cheapy Relion Prime. Strips are very affordable too.
Some members found when they switched from the AT2 to a human meter for regular testing, they were able to steer the curves more efficiently. Human meters show the low #s better. Helps us to avoid them dropping too fast and TRY to prevent bouncing. I'm happy you're going to try another one.
When posting on the board and using the AT2.....if you run into lower #s and feel like you just need some peer support....be sure to include in your title that you're using AT2. A lot of members are not familiar with the AT2 differing # scale. Djoko may need some guidance and you get overlooked accidentally. To us using human meters mid 50s and 60s are wonderful. For Djoko it's a serious situation
 
I can read your World numbers - just takes a little longer multiplying by 18 at a decent pace;) At least the colors are helpful!

Hoping Djoko starts ditching those black and red numbers, AND I wanted to tell you how adorable he is - makes me want to kiss his little white muzzle:cat:
 
Hi Marj
I’m replying to your question on yesterday’s thread about the food and the supplements.
It is really important if you are feeding a homemade diet to Djoko, that it is a balanced diet with all the nutrients that he need. Otherwise you will run into other big problems down the track.

Can you tell us what the supplements you have at the moment and he doesn’t like are called please? A photo would be good as well.
Who suggested that diet you have him on now and is it for the CRD, IBD or both?

You live somewhere on the continent don’t you? So I’m not sure what supplements are available to you but I’m sure there must be some which you can add that he will not refuse to eat.

It is really important that he gets calcium and taurine as well as other Supplements. An excellent calcium supplement for cats with CRD is egg shell powder as it has no phosphorus in it at all.

I’m going to tag @Marje and Gracie to have a look at your lab results to see what stage the CRD is at.
Are the May labs the last ones you have had done?
 
Hello Bron,
It is for all but I think mainly for IBD and CKD as I was able to find suitable diets with low carbs with commercial diets.
The vet/nutrionist made me buy a supplment called Feline K from Balance It in California: https://secure.balanceit.com/marketplace2.3/home/14-balance-it-feline-k.html
He told me to add the suppement at week 3 which is now.

He was at advanced stage 2 in May. I will get blood test in a month and see how it has progressed and if he needs phosphorus binders.

I am sure there are other options but wanted to have the vet/nutrionist's opinions because that's his expertise. I hope he will find an alternative.
He eats 70g of horse meat, 56 g of brown rice, veggies (sometimes), 1/4 tea spoon of safflower oil, a bit of salt and the supplement. Of course, vitamines are contained in the supplement so we need an alternative because Djoko is not a fan..

I have just added labs results from June 17 (renal profile only). I was told to do another renal profile within 2-3 months to see the evolution. Good thing to do?
 
Djoko on his yoga mat (eating spot)
 

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Bron and Sheba (GA) said:
Hi Marj
I’m replying to your question on yesterday’s thread about the food and the supplements.
It is really important if you are feeding a homemade diet to Djoko, that it is a balanced diet with all the nutrients that he need. Otherwise you will run into other big problems down the track.

Can you tell us what the supplements you have at the moment and he doesn’t like are called please? A photo would be good as well.
Who suggested that diet you have him on now and is it for the CRD, IBD or both?

You live somewhere on the continent don’t you? So I’m not sure what supplements are available to you but I’m sure there must be some which you can add that he will not refuse to eat.

It is really important that he gets calcium and taurine as well as other Supplements. An excellent calcium supplement for cats with CRD is egg shell powder as it has no phosphorus in it at all.

I’m going to tag @Marje and Gracie to have a look at your lab results to see what stage the CRD is at.
Are the May labs the last ones you have had done?
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Was suggested by internist and prepared by a a vet who has a specialization in nutrition.
 
Balance It is the only one I think most vets in the US choose to use. They work with the vets here. I inquired but they are opposed to a raw diet.
 
He is at 304 at +2.5. Do I need to test again or OK to sleep? If so, when should I test. I can take a +4 or nothing. He hates the supplement by seringe. It looks like animal cruelty.
 
I know. Vet/nutrionist is back on the Aug 17th. I know I have to give it to him until then by seringe. He is traumatized though and pouting right now!
 
If Djoko is at stage 2 CRD you shouldn’t need to reduce the amount of protein in his diet yet and have him eating all that rice. That is old thinking. Reducing the protein will cause muscle wasting and with a phosphorus level of 1.4 (I am assuming that is the international testing level), it is in the normal range.....so you don’t need to be reducing the meat content. I assume they put him onto horse meat because it was a novel protein for the IBD.
Lets see what Marje thinks
 
Goal was to calm the inflamed organs because of IBD so that diabetes could be better regulated with less problems with chronic pancreatitis.
I will give it a try and see if it works. If it does not. I will go back with commercial diets. I have to admit that he has not vomited or had diarrhea since on this diet.
As per his BG, he was bouncing before eating brown rice so ...I will give it a chance and we can always go back to commercial diets.
Thanks
 
Bron and Sheba (GA) said:
If Djoko is at stage 2 CRD you shouldn’t need to reduce the amount of protein in his diet yet and have him eating all that rice. That is old thinking. Reducing the protein will cause muscle wasting and with a phosphorus level of 1.4 (I am assuming that is the international testing level), it is in the normal range.....so you don’t need to be reducing the meat content. I assume they put him onto horse meat because it was a novel protein for the IBD.
Lets see what Marje thinks
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Yes exactly. He used to vomit and have diarhee every 2 weeks.
 
Bron and Sheba (GA) said:
If Djoko is at stage 2 CRD you shouldn’t need to reduce the amount of protein in his diet yet and have him eating all that rice. That is old thinking. Reducing the protein will cause muscle wasting and with a phosphorus level of 1.4 (I am assuming that is the international testing level), it is in the normal range.....so you don’t need to be reducing the meat content. I assume they put him onto horse meat because it was a novel protein for the IBD.
Lets see what Marje thinks
Click to expand...
Also, he was at stage 3 and then was retrograded to stage 2 advanced. It depends...I want to believe they know what they do?
 
Bron and Sheba (GA) said:
I agree Elise. You can continue with a novel protein without the rice content and use a supplement that uses egg shell powder as the calcium content. That would address both IBD and CRD
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Do you have an article I could refer to/send him? I don't want to tell a doctor in nutrition for pets how he should prepare his diet so that could help! I also told him I was sceptikal with the amount of rice at the beginning and said we would reajust later with BG curves. He seemed open to the idea at least. Thanks!
 
Marj & Djoko said:
Do you have an article I could refer to/send him? I don't want to tell a doctor in nutrition for pets how he should prepare his diet so that could help! I also told him I was sceptikal with the amount of rice at the beginning and said we would reajust later with BG curves. He seemed open to the idea at least. Thanks!
Click to expand...
Adding carbs to the diet and reducing protein in a CRD kitty that is not in the late stages of CRD is now considered old thinking.
Now they think the most important thing is to reduce the amount of phosphorus in the diet. This can be done without compromising the protein amounts and having to add carbs
Have you read Tanya's Comprehensive Guide to Feline Chronic Kidney Disease?
Also here is a link to a discussion here on FDMB about the diet for a CRD kitty
https://www.felinediabetes.com/FDMB/threads/home-prepared-diet-of-crd-cats.150441/
 
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