? 18/03 Maggie AMPS 360 / +3 270 / +5 270

[hellen_maggie]

? - 15/03 Maggie, AMPS 326 / +2 168 / +3 66 / +3.5 72 / +4.5 79 / +6 96 / +10 312 / Reduction earned

Hi everyone,
I’m really not happy with Maggie’s numbers since we reduced the dose to 0.50u. We are now on day 4 of the reduction, but it seems quite clear, at least to me, that this dose is not keeping her in good ranges.
I understand that according to the protocol I should hold the dose for a full week before making any changes, but it’s very discouraging to see her in these higher numbers all day long. I’m also worried that staying this high might not be good for her health...
Would it be reasonable to consider going back up to 0.75u before the end of the week, or should I be more patient and hold the dose a bit longer? I would really appreciate another opinion.

Tagging for more eyes

 

[Allie & Gen]

I've been in your position, back when we were still on SLGS, and I remember how frustrating it was. I also remember that the advice I was given every time was to stick to the protocol, because it was developed that way for a reason based on lots of experience (which I believe). The range Maggie's in isn't ideal, but also is unlikely to do her any harm if she stays there fore a few more days. Are you testing for ketones? How's she doing with food? Are you still working on a transition? I can't remember if you decided to stop/change that plan after she was vomiting so much awhile back. I may have missed some posts.

(For what it's worth, my vet and most of the literature out there--I've been reading up recently--would agree on waiting as well.)

I'm not giving direct advice because I don't feel competent to do it with my current grasp of the SLGS method, Maggie's situation, etc; just explaining what I do know. Best of luck, and much sympathy!

Tagging a few veteran users who may have more to add: @Wendy&Neko @Christie & Maverick @tiffmaxee @Sienne and Gabby (GA)

 

[hellen_maggie]

I've been in your position, back when we were still on SLGS, and I remember how frustrating it was. I also remember that the advice I was given every time was to stick to the protocol, because it was developed that way for a reason based on lots of experience (which I believe). The range Maggie's in isn't ideal, but also is unlikely to do her any harm if she stays there fore a few more days. Are you testing for ketones? How's she doing with food? Are you still working on a transition? I can't remember if you decided to stop/change that plan after she was vomiting so much awhile back. I may have missed some posts.

(For what it's worth, my vet and most of the literature out there--I've been reading up recently--would agree on waiting as well.)

I'm not giving direct advice because I don't feel competent to do it with my current grasp of the SLGS method, Maggie's situation, etc; just explaining what I do know. Best of luck, and much sympathy!

Tagging a few veteran users who may have more to add: @Wendy&Neko @Christie & Maverick @tiffmaxee @Sienne and Gabby (GA)

Hi Allie,
Sorry for the delayed reply, yesterday was a really chaotic day at the office
Unfortunately, we’re still a bit stuck with the food transition. We’re still only at around 20% of the new food at the moment. After the last vomiting episodes, I got so scared, so I decided to slow things down and give her more time before pushing the transition further.
Honestly, I feel like food is the hardest part for us to manage. It’s quite discouraging… I really want to move her to a low-carb diet and give her the best chance with Tight Regulation, but no matter how much I try, I don’t seem to be getting there.
At the same time, her numbers are still so high. Today, at AMPS cycle, her drop at +3 is even smaller than yesterday, which was already high so that’s also worrying me. I’m really looking forward to increasing the dose again so we can (hopefully!) get her back into blue and green and help Maggie feel better too.


Thank you so much for your support

 

[Allie & Gen]

Hi Allie,
Sorry for the delayed reply, yesterday was a really chaotic day at the office
Unfortunately, we’re still a bit stuck with the food transition. We’re still only at around 20% of the new food at the moment. After the last vomiting episodes, I got so scared, so I decided to slow things down and give her more time before pushing the transition further.
Honestly, I feel like food is the hardest part for us to manage. It’s quite discouraging… I really want to move her to a low-carb diet and give her the best chance with Tight Regulation, but no matter how much I try, I don’t seem to be getting there.
At the same time, her numbers are still so high. Today, at AMPS cycle, her drop at +3 is even smaller than yesterday, which was already high so that’s also worrying me. I’m really looking forward to increasing the dose again so we can (hopefully!) get her back into blue and green and help Maggie feel better too.


Thank you so much for your support

No need to apologize, I've been having some chaotic times at work myself! It's making it harder for me to find time to keep up with folks here as much as I'd like. We do have to live our whole lives, though.

I wish I had useful advice on the food transition thing, but given that Gen just had his huge bout of scary inappetence right when I was about to start trying to do one for him, I'm not in a particularly good position for that. (I think it was bad timing, not the food itself in his case, but regardless ... the vets want us to hold off on it and focus on the new med for a few weeks, so.) I can understand your worry. If she's still eating the new food, though, even only 20%, that seems like a good sign - like maybe the vomiting wasn't because she necessarily can't tolerate it?

I know veterinary resources are somewhat limited in your country; do you know if there are any veterinary dietary specialists at all? If not, I wonder if there might be any internationally who could do a virtual consultation ... it might be pretty expensive, and that would certainly be a major issue for me, but in Maggie's case I wonder if getting expert advice tailored to her (with as much information as you have about the things she's reacted to and any related circumstances) might be helpful. (This may have come up before; apologies if I'm retreading old ground.)

Much sympathy on the high numbers; I'm very stressed about them myself right now, even though I know that they're not necessarily dangerous in any immediate way.

 

[hellen_maggie]

No need to apologize, I've been having some chaotic times at work myself! It's making it harder for me to find time to keep up with folks here as much as I'd like. We do have to live our whole lives, though.

I wish I had useful advice on the food transition thing, but given that Gen just had his huge bout of scary inappetence right when I was about to start trying to do one for him, I'm not in a particularly good position for that. (I think it was bad timing, not the food itself in his case, but regardless ... the vets want us to hold off on it and focus on the new med for a few weeks, so.) I can understand your worry. If she's still eating the new food, though, even only 20%, that seems like a good sign - like maybe the vomiting wasn't because she necessarily can't tolerate it?

I know veterinary resources are somewhat limited in your country; do you know if there are any veterinary dietary specialists at all? If not, I wonder if there might be any internationally who could do a virtual consultation ... it might be pretty expensive, and that would certainly be a major issue for me, but in Maggie's case I wonder if getting expert advice tailored to her (with as much information as you have about the things she's reacted to and any related circumstances) might be helpful. (This may have come up before; apologies if I'm retreading old ground.)

Much sympathy on the high numbers; I'm very stressed about them myself right now, even though I know that they're not necessarily dangerous in any immediate way.

Allie, to be completely honest, this period has been incredibly chaotic for me, and I’m trying (not very successfully) to keep up with everything (work, taking care of Maggie, my mental state, the exhaustion, the lack of sleep, and the disappointment with how things have been going over the past few days). You probably understand better than many how hard this is…
On top of that, I also have to deal with people around me (both colleagues and others) who keep asking what’s wrong because I’m not my usual cheerful self. And when I explain that it’s because of Maggie’s illness, they look at me as if I’m from another planet!
I’ve reached out to many vets asking about a feline nutrition specialist, but I get the same reaction. After months of research, I’ve come to the conclusion that this specialty essentially doesn’t exist in Greece. Even those who present themselves as “nutritionists” don’t seem to know much more than what I’ve already learned through my own research.
At this point, the most important thing is for Maggie to have further testing (including for IBD). However, based on my vet’s advice, we’re waiting until her glucose is better regulated first. He doesn’t want to put her through sedation and additional stress while she’s still so vulnerable. I should also mention that even for routine blood tests, we have to sedate her because she becomes extremely aggressive, she even tries to attack me at the vet, let alone the vet himself. The whole situation is incredibly stressful for me.
I really believe that in order to properly address her food issues, we first need to rule out certain conditions through testing, and then we can find the right approach.
For now, I’m planning over the next few days to slowly try again to increase her low-carb food, hopefully with better results this time. You’re right, the vomiting may not necessarily be related to the food transition. Honestly, I just don’t know at this point!!!
As for the high numbers, I think I will increase the dose tomorrow morning. I don’t feel comfortable letting her spend so many hours in such high ranges..I’m really worried about her health. Thankfully, we checked ketones earlier and they were negative.
I just wish I could wake up one morning and realize this has all been a bad dream, and have my Maggie healthy and happy again like she used to be… I truly hope our little ones win this fight and stay by our side for many, many years to come

 

[Sienne and Gabby (GA)]

Hellen -
Cornell University is one of the top veterinary schools in the US. They have a cat clinic and they do consultations. They may be a resource. Lisa Pierson, DVM is the author of a feline nutrition website that we use -- it's where one of the food charts comes from. She has done consultations, as well.

If you can provide more information on what you've been doing with Maggie's food, we can try to offer some guidance. Like you, work has been more than busy and I've not been checking on the Board as much as I'd like. We're truly here to help.

 

[hellen_maggie]

Hellen -
Cornell University is one of the top veterinary schools in the US. They have a cat clinic and they do consultations. They may be a resource. Lisa Pierson, DVM is the author of a feline nutrition website that we use -- it's where one of the food charts comes from. She has done consultations, as well.

If you can provide more information on what you've been doing with Maggie's food, we can try to offer some guidance. Like you, work has been more than busy and I've not been checking on the Board as much as I'd like. We're truly here to help.

Dear Sienne,
Your message came at exactly the right moment. I was feeling really discouraged and wondering whether it would be the right decision to increase Maggie’s dose back to 0.75u, since things have not been going well at all after the reduction. We are now on day 4 of the 0.50u dose, but it’s very upsetting to feel like we’ve taken ten steps backwards. Over the past two days, Maggie has started urinating large amounts again, drinking a lot of water, and generally sleeping more. I feel like I need to help her somehow… I would really appreciate it if you could take a look at her spreadsheet and share your experienced opinion.

Regarding her food
I’ve been trying for the past 4 months to transition her to a low-carb diet. Maggie has eaten dry food her entire life. When she was diagnosed with diabetes, I switched her (following my vet’s advice) to Royal Canin Diabetic dry food.
After finding this forum and learning that dry food is not good at all, I tried transitioning her to wet food (Pro Plan Diabetic, chicken-based). I did it very slowly, increasing by about one teaspoon every two days (especially since I remembered she had vomited during a previous attempt a few years ago), and I followed Lisa Pierson’s guidelines for a slow transition (I think I’ve read all of her articles on feline nutrition).
Despite the very gradual transition, after a few days she started vomiting. Repeatedly and quite severely. We ended up going to the vet for fluids and anti-nausea treatment for two consecutive days. I thought it might have been a coincidence, so after she fully recovered, I tried again. The same thing happened, only this time with severe diarrhea as well. Again, fluids and anti-nausea treatment.
At some point (I’m sorry, I don’t remember if it was you or Wendy), I was asked whether Maggie had ever been tested for IBD. I looked into it and, based on her symptoms, I started to suspect it might be a possibility.
So I began trying limited-ingredient, novel protein wet foods. I tried 3–4 different ones (Lucky Lou Supermono Lamb / Granatapet Delicatessen Pur Venison / ND Quinoa skin & coat Venison) but the result was always the same. That’s when I gave up on wet food, because I just cannot bear to see her suffer like that. The last time she had that reaction, I truly thought I might lose her. She was completely lethargic, unresponsive, and didn’t eat for two full days. I was terrified.
So my only option was to look for a low-carb alternative to dry food. After a lot of research, I found Ziwi Peak air-dried (venison), and I’ve been trying to transition her to that since we started Lantus.
Right now we’re only at about 20% Ziwi, with the remaining 80% still Royal Canin Diabetic. Every time I try to go above that percentage, her stools become soft, and I get really scared that we’ll end up in the same situation again. I honestly can’t go through that again.
I feel completely overwhelmed and discouraged. I’m trying so hard, and the only progress I’ve managed is reaching 20%...

Thank you so much for your help, and I’m sorry for the long message,I just wanted to give you the full picture.