2/2 Shakes - ADVICE PLEASE
- Thread starter dmartini4
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Kathy and Kitty
Member Since 2009
I'm not an expert, but it doesn't look like anything's amiss on Shakes' SS. What in particular is your concern? Maybe someone smarter will come along! Specifics are helpful.
Kathy and Kitty
Member Since 2009
I see this in the protocol about increasing:
Increasing the dose...
Hold the dose for 3 - 5 days (6 - 10 cycles) if nadirs are less than 200 before increasing the dose.
After 3 consecutive days (6 cycles)... if nadirs are greater than 200, but less than 300 increase the dose by 0.25 unit.
After 3 consecutive days (6 cycles)... if nadirs are greater than 300 increase the dose by 0.5 unit.
Looks like you went up .5 with nadirs that were under 300, so the protocol might have been an increase to 2.25 instead of 2.5. But I'm not sure you needed to reduce. Did you do a shave this morning for some reason, or did you mean to decrease?
Someone wise will come along soon. Hang in there!
Increasing the dose...
Hold the dose for 3 - 5 days (6 - 10 cycles) if nadirs are less than 200 before increasing the dose.
After 3 consecutive days (6 cycles)... if nadirs are greater than 200, but less than 300 increase the dose by 0.25 unit.
After 3 consecutive days (6 cycles)... if nadirs are greater than 300 increase the dose by 0.5 unit.
Looks like you went up .5 with nadirs that were under 300, so the protocol might have been an increase to 2.25 instead of 2.5. But I'm not sure you needed to reduce. Did you do a shave this morning for some reason, or did you mean to decrease?
Someone wise will come along soon. Hang in there!
dmartini4
Member Since 2010
I meant to decrease because I thought the numbers were too high with the 2.5, so I decreased and his numbers were a little better.
I am desperately trying to get his numbers under control because I am scared that he doesnt have long to live.
His neuropathy is getting so bad, I give him the metho... every day and he gets an injection once a week to help him to walk but he is really struggling
I cant imagine losing him so I think I am panicking.
I think I will keep him at the 2.25 for the next week and see what his numbers are
I am desperately trying to get his numbers under control because I am scared that he doesnt have long to live.
His neuropathy is getting so bad, I give him the metho... every day and he gets an injection once a week to help him to walk but he is really struggling
I cant imagine losing him so I think I am panicking.
I think I will keep him at the 2.25 for the next week and see what his numbers are
Jen & Squeak
Member Since 2009
Ok, with the caveat that I don't remember your history, on paper, those numbers aren't terrible and I've never heard of a cat dying from such numbers.
That said, if he has other symptoms and they aren't getting any better, you may need to dig further and see if something else is going on. For example, is it really neuropathy or low potassium or ?????
Jen
That said, if he has other symptoms and they aren't getting any better, you may need to dig further and see if something else is going on. For example, is it really neuropathy or low potassium or ?????
Jen
Let me ask the question in a different way: What are you expecting to see with respect to Shakes response to Lantus?
Like Kathy noted (and I think I mentioned this at the time), according to the protocol, Shakes would have been increased by 0.25u vs. .5u. However, his numbers were fine after that increase. He didn't plummet into low numbers. Rather than dropping his dose back, I would have suggesting increasing his dose to 2.75u. You want him to be seeing more of those blue numbers.
You're giving Shakes methyl-B12 (methylcobalamine)? Most of us give this as an oral supplement that is added to food. This is a link to a brand that is formulated for cats -- it doesn't contain any sugar. (It looks like Amazon sells it cheaper.) Could you check whether you're giving Shakes B12 or methyl-B12? Also, regardless of whether it's a shot or a powder, it can take a while to see improvement -- like a month or two.
Why do you think he doesn't have long to live?
Like Kathy noted (and I think I mentioned this at the time), according to the protocol, Shakes would have been increased by 0.25u vs. .5u. However, his numbers were fine after that increase. He didn't plummet into low numbers. Rather than dropping his dose back, I would have suggesting increasing his dose to 2.75u. You want him to be seeing more of those blue numbers.
You're giving Shakes methyl-B12 (methylcobalamine)? Most of us give this as an oral supplement that is added to food. This is a link to a brand that is formulated for cats -- it doesn't contain any sugar. (It looks like Amazon sells it cheaper.) Could you check whether you're giving Shakes B12 or methyl-B12? Also, regardless of whether it's a shot or a powder, it can take a while to see improvement -- like a month or two.
Why do you think he doesn't have long to live?
dmartini4
Member Since 2010
my vet suggested going to 2.5 units.
its methyl B12 and he has been on it since October
His neuropathy started 2 weeks after he started the insulin and is getting so bad he can barely get up
his potassium and everything else they say is fine,
the vet says i need to get better control of his numbers then the neuropathy
will get better, but that is not happeneing
when it gets to the point that he can no longer get up we will have to put him down
its methyl B12 and he has been on it since October
His neuropathy started 2 weeks after he started the insulin and is getting so bad he can barely get up
his potassium and everything else they say is fine,
the vet says i need to get better control of his numbers then the neuropathy
will get better, but that is not happeneing
when it gets to the point that he can no longer get up we will have to put him down
Nicole & Baby
Member Since 2009
(((Shakes))) please don't put the kitty down.. insulin takes time to work & does not happen overnight.. it does not look like Lantus has been given long at all.
Kathy and Kitty
Member Since 2009
My Kitty could barely stand. He is now fine. It takes time.
If he can't get to the litter box, figure out a short-term solution -- because it will improve if you get the numbers under control.
It is so hard to have patience when you feel your furbaby is doing badly, but this takes time. I think it is important to follow the protocol - it works. My own Kitty is proof.
Ask Sienne and other more experienced people what they think, but I think I would treat this morning's dose as a fluke, and go back to 2.5. Give the Lantus time to work.
If he can't get to the litter box, figure out a short-term solution -- because it will improve if you get the numbers under control.
It is so hard to have patience when you feel your furbaby is doing badly, but this takes time. I think it is important to follow the protocol - it works. My own Kitty is proof.
Ask Sienne and other more experienced people what they think, but I think I would treat this morning's dose as a fluke, and go back to 2.5. Give the Lantus time to work.
Lacie
Member Since 2010
OK, take a couple of deep breaths. (1....2....there...)
You wrote: I meant to decrease because I thought the numbers were too high with the 2.5, so I decreased and his numbers were a little better.
INcreasing will bring his numbers down, if he's earned an increase under the protocol. I don't have enough experience to tell you whether he has, but definitely a DEcrease isn't what you want if his numbers are too high.
Shakes spreadsheet looks a lot like my kitty Leo, if anything a bit better (Leo hasn't hit any blue yet), and Leo's dose is twice as high as Shakes. I was feeling like you, thinking this is a lost cause, he's going to die, and someone stepped into my condo and told me her kitty was going red and pink every day, Lantus dosage went up to 4u, then 5 u, and then at 5.75 he dove down to the 60s and a month later he was OTJ. After I read her story, I've decided I'm a soldier, this is a war, and I'm in it to win. You just don't know what Shakes is going to do until he does it.
Lantus likes things smooth. Try not to pay too much attention to the preshot numbers - it's the nadirs that count. I had to force myself to learn this - I still hate those reds and pinks before the shots, but our midcycles are looking better and better. So are yours.
If the neuropathy is really bad, make sure you have the right kind of B-12. The correct formula is Methylcobalamin, and it should have no added sweetener. The two I had recommended to me on this board are:
http://www.lifelinknet.com/siteResource ... baline.asp
Zobaline is a pill, so if you'd rather not pill Shakes, you can try this:
http://www.vitacost.com/NSI-Vitamin-B-1 ... lcobalamin
which is a capsule that you can sprinkle on his food. Both of these formulas are a large enough dosage that he'll get the B-12 he needs. He needs a minimum of 3mg a day. The 5mg is fine too - the overdose threshold for B12 is high, possibly nonexistent.
Give it time to work - a month to two months. In the meantime, make him comfortable. If he's having litter box trouble, section off a room or part of a room in your house where he can get there easily. Choose a litter box with very low sides. Carry him when he needs to be carried. He's your patient and needs your care.
He'll come around. Although it's awful to watch a kitty who can't walk, the neuropathy will resolve if you hang in there and give it time.
You wrote: I meant to decrease because I thought the numbers were too high with the 2.5, so I decreased and his numbers were a little better.
INcreasing will bring his numbers down, if he's earned an increase under the protocol. I don't have enough experience to tell you whether he has, but definitely a DEcrease isn't what you want if his numbers are too high.
Shakes spreadsheet looks a lot like my kitty Leo, if anything a bit better (Leo hasn't hit any blue yet), and Leo's dose is twice as high as Shakes. I was feeling like you, thinking this is a lost cause, he's going to die, and someone stepped into my condo and told me her kitty was going red and pink every day, Lantus dosage went up to 4u, then 5 u, and then at 5.75 he dove down to the 60s and a month later he was OTJ. After I read her story, I've decided I'm a soldier, this is a war, and I'm in it to win. You just don't know what Shakes is going to do until he does it.
Lantus likes things smooth. Try not to pay too much attention to the preshot numbers - it's the nadirs that count. I had to force myself to learn this - I still hate those reds and pinks before the shots, but our midcycles are looking better and better. So are yours.
If the neuropathy is really bad, make sure you have the right kind of B-12. The correct formula is Methylcobalamin, and it should have no added sweetener. The two I had recommended to me on this board are:
http://www.lifelinknet.com/siteResource ... baline.asp
Zobaline is a pill, so if you'd rather not pill Shakes, you can try this:
http://www.vitacost.com/NSI-Vitamin-B-1 ... lcobalamin
which is a capsule that you can sprinkle on his food. Both of these formulas are a large enough dosage that he'll get the B-12 he needs. He needs a minimum of 3mg a day. The 5mg is fine too - the overdose threshold for B12 is high, possibly nonexistent.
Give it time to work - a month to two months. In the meantime, make him comfortable. If he's having litter box trouble, section off a room or part of a room in your house where he can get there easily. Choose a litter box with very low sides. Carry him when he needs to be carried. He's your patient and needs your care.
He'll come around. Although it's awful to watch a kitty who can't walk, the neuropathy will resolve if you hang in there and give it time.
Kathy and Kitty
Member Since 2009
I just want to add that Kitty also couldn't get into his regular box, so we got a new box with 4 inch sides. He sat down to rest every four steps, and he would sit next to the litter box after he got out. It was so hard to watch.
But his mobility came back. He walks, he jumps, he runs!
It's a wonderful thing that cats' bodies do!
And Kitty was also in pinks and reds. His turn-around dose was also around 5.5 units. Now he's in remission.
There's debate about whether it's the Methyl B12 that helps or getting the numbers under control. Maybe it's both; most of us did both at the same time.
Follow the protocol. Post here. Shakes and you can do this.
But his mobility came back. He walks, he jumps, he runs!
It's a wonderful thing that cats' bodies do! And Kitty was also in pinks and reds. His turn-around dose was also around 5.5 units. Now he's in remission.
There's debate about whether it's the Methyl B12 that helps or getting the numbers under control. Maybe it's both; most of us did both at the same time.
Follow the protocol. Post here. Shakes and you can do this.
dmartini4
Member Since 2010
thanks, but with shakes it seems that when he gets too much insulin his numbers go up
I took his blood 1.5 after the 2.25 shot tonight and he was at 174.
As for the MethB-12, I have the correct pills and the vet gave me the pure injectable kind that he gets once a week.
I bought a new very low litter box for him but he cant even stand to pee anymore.Believe me the last thing I will do is put him down, unless he is completely unable to stand or get up
I am doing everything I can for him, I dont sleep anymore, I stay up all night a carry him back and forth to the box and to the food, I sleep when I can on the floor with him or put him on a cushion and I sleep on the floor.
the bottom of his feet are hurting him and I cant stand to see him in pain.
dont worry though, I am continuing the fight with him, jsut so afraid
I took his blood 1.5 after the 2.25 shot tonight and he was at 174.
As for the MethB-12, I have the correct pills and the vet gave me the pure injectable kind that he gets once a week.
I bought a new very low litter box for him but he cant even stand to pee anymore.Believe me the last thing I will do is put him down, unless he is completely unable to stand or get up
I am doing everything I can for him, I dont sleep anymore, I stay up all night a carry him back and forth to the box and to the food, I sleep when I can on the floor with him or put him on a cushion and I sleep on the floor.
the bottom of his feet are hurting him and I cant stand to see him in pain.
dont worry though, I am continuing the fight with him, jsut so afraid
Kathy and Kitty
Member Since 2009
I am so sorry you are hurting.
For what it's worth, many people have discussed neuropathy here, and it's not clear that they feel strong pain from this. Of course, we don't know, but maybe that will give you some relief.
It is strange that his numbers appear to go up when he gets more insulin. Are you saying that because Shakes' numbers are now in the pink, compared with yellows in mid-January at 2 units?
I'm sorry I don't know more about Shakes' history. Can you refresh us? I see your spreadsheet starts in January. Is that when you began giving insulin, or was there a prior experience? I see also that you started at 2.5 units, then bobbled around a bit. What was happening?
I hope also you can get some rest.
For what it's worth, many people have discussed neuropathy here, and it's not clear that they feel strong pain from this. Of course, we don't know, but maybe that will give you some relief.
It is strange that his numbers appear to go up when he gets more insulin. Are you saying that because Shakes' numbers are now in the pink, compared with yellows in mid-January at 2 units?
I'm sorry I don't know more about Shakes' history. Can you refresh us? I see your spreadsheet starts in January. Is that when you began giving insulin, or was there a prior experience? I see also that you started at 2.5 units, then bobbled around a bit. What was happening?
I hope also you can get some rest.
Lacie
Member Since 2010
It's so hard. They can't talk; if they could, they could tell us how they're feeling and we wouldn't have to wonder if we're doing the right thing for them.
You love your kitty, that much is clear. Keep the "ADVICE PLEASE" in your header and sometime tonight someone experienced will be here to help you out with Shakes' spreadsheet numbers. It's been a crazy day with the board down until late afternoon, so sit tight - help is on the way.
You love your kitty, that much is clear. Keep the "ADVICE PLEASE" in your header and sometime tonight someone experienced will be here to help you out with Shakes' spreadsheet numbers. It's been a crazy day with the board down until late afternoon, so sit tight - help is on the way.
dmartini4
Member Since 2010
thanks Kathy,
Here is our story (short version)
In May 2010 I took him to a new vet for recurring blood in urine.
He tested his sugars, which was 126, told me he was pre diabetes and put him on a special diet (high carb, please keep in mind this is way before I found this site)
so for 3 months I fed him this high carb diet, but that is when he starting losing weight, drinking a lot of water. I took him back in August and he said his number was 300 and started him on humilin, 2 units, 2x a day.
we wwent back and forth to the vet(before I knew about home testing) and he kept raising his insulin,(I found out in December that his numbers will go up 200times what he really is from stress of the vet. He was a bottle fed baby, I found him at 3 days old)
anyway, the vet up and downed and we hypoed and it was ugly
I found this website I think in November and switched vets and insulins. The new vet put him on Lantus, 3 units 2 x a day (which was too much)
but the weird thing was that the first week on Lantus his legs started working again and he was doing better until the Lantus kicked in about a week later. hencce his legs went very bad again.
I just cant help thinking that he maybe was not really diabetic and we are on a roller coaster ride that we should not be on. Not sure where to go from here, we are just trying to hang in there and get his numbers down
thanks everyone for all your input
Here is our story (short version)
In May 2010 I took him to a new vet for recurring blood in urine.
He tested his sugars, which was 126, told me he was pre diabetes and put him on a special diet (high carb, please keep in mind this is way before I found this site)
so for 3 months I fed him this high carb diet, but that is when he starting losing weight, drinking a lot of water. I took him back in August and he said his number was 300 and started him on humilin, 2 units, 2x a day.
we wwent back and forth to the vet(before I knew about home testing) and he kept raising his insulin,(I found out in December that his numbers will go up 200times what he really is from stress of the vet. He was a bottle fed baby, I found him at 3 days old)
anyway, the vet up and downed and we hypoed and it was ugly
I found this website I think in November and switched vets and insulins. The new vet put him on Lantus, 3 units 2 x a day (which was too much)
but the weird thing was that the first week on Lantus his legs started working again and he was doing better until the Lantus kicked in about a week later. hencce his legs went very bad again.
I just cant help thinking that he maybe was not really diabetic and we are on a roller coaster ride that we should not be on. Not sure where to go from here, we are just trying to hang in there and get his numbers down
thanks everyone for all your input
drjsiems
Member Since 2010
Please be patient. It takes a while for numbers to go down. It can also take several months after that for the neuropathy to go away. It took nine months for Jake's numbers to come into to regulation and then he went into remission about two weeks later. The last time he had insulin was insulin was in April 2010. It took a little longer for the neuropathy to go completely away - about two or three months. I don't think the neuropathy caused him pain - just made him wobble. So hang in there; it is worth the wait. Jake is almost 19 now and is the healthiest he has been in a long, long time.
Judy
Judy
Kathy and Kitty
Member Since 2009
I would want to throttle that first vet. What a story. To put a "pre-diabetic" cat on a high carb diet is bad.
I really get it. We had a similar experience, with a vet that raised the dose way too quickly -- 10 units once a day (But we are in remission now!!! )
I see why you feel that the numbers go up with a higher dose. I know my Kitty couldn't stabilize on what was too high a dose.
It's hard to think about starting over at a lower dose, because of the neuropathy. I wonder if a consultation with a specialist vet would help you. People here know some good, experienced vets who do phone consultations.
I really get it. We had a similar experience, with a vet that raised the dose way too quickly -- 10 units once a day (But we are in remission now!!!
)I see why you feel that the numbers go up with a higher dose. I know my Kitty couldn't stabilize on what was too high a dose.
It's hard to think about starting over at a lower dose, because of the neuropathy. I wonder if a consultation with a specialist vet would help you. People here know some good, experienced vets who do phone consultations.
Throttling that first vet sounds like it could have been very satisfying. But, that's not going to happen so let's work from where Shakes is now.
One factor you are probably not aware of is what we term, "new dose wonkiness (NDW)". There's not logical explanation that I know of, but in some instances, when you raise a dose, rather than seeing the numbers initially going down, they go up. This may be a partial explanation for what's going on.
While it's possible that Shakes should have been started on a lower dose when he was first diagnosed, I'm not seeing that his dose is too high now. I do think you are holding on to a dose for too long, though. If you stick with a dose and Shakes stays in the higher ranges, his body will get used to being in those yellow or pink numbers and start to acclimate to those numbers as "normal." When this happens, all you can really do is keep pushing the dose in order to break through that barrier until the numbers start to come down. I would suggest that you stick with your current dose for between 2 - 3 days. If you don't see more blues and/or greens, we increase the dose based on the protocol.
Does that make sense? We all want to see Shakes in lower numbers.
BTW, you may want to double check on the ingredients in the oral methyl-B12 you're using. Many of the available brands contain some form of starch or sugar. The brands that Lacie and I linked are both diabetes friendly.
One factor you are probably not aware of is what we term, "new dose wonkiness (NDW)". There's not logical explanation that I know of, but in some instances, when you raise a dose, rather than seeing the numbers initially going down, they go up. This may be a partial explanation for what's going on.
While it's possible that Shakes should have been started on a lower dose when he was first diagnosed, I'm not seeing that his dose is too high now. I do think you are holding on to a dose for too long, though. If you stick with a dose and Shakes stays in the higher ranges, his body will get used to being in those yellow or pink numbers and start to acclimate to those numbers as "normal." When this happens, all you can really do is keep pushing the dose in order to break through that barrier until the numbers start to come down. I would suggest that you stick with your current dose for between 2 - 3 days. If you don't see more blues and/or greens, we increase the dose based on the protocol.
Does that make sense? We all want to see Shakes in lower numbers.
BTW, you may want to double check on the ingredients in the oral methyl-B12 you're using. Many of the available brands contain some form of starch or sugar. The brands that Lacie and I linked are both diabetes friendly.
mybuddybinks
Member Since 2010
for what it's worth, binks had reached the point where he could barely walk due to the neuropathy...and he was really ill...but none of the research i can find can clarify whether or not feline neuropathy is painful as it is for humans.
what i take as my indicator is his response to the massage therapy i give him daily...and it doesnt cause him pain.
and at this point, he is better regulated, and runs, jumps, plays, beats up his adopted sisters, and rarely ever hock-walks any more.
don't know if this helps you...but much as i hoped for him to get better, deep inside i NEVER expected him to reach this level of good health and mobility...
hoping that will be true for Shakes, also. i give the MB12...but i feel the better numbers have been the bigger factor in his improvement.
what i take as my indicator is his response to the massage therapy i give him daily...and it doesnt cause him pain.
and at this point, he is better regulated, and runs, jumps, plays, beats up his adopted sisters, and rarely ever hock-walks any more.
don't know if this helps you...but much as i hoped for him to get better, deep inside i NEVER expected him to reach this level of good health and mobility...
hoping that will be true for Shakes, also. i give the MB12...but i feel the better numbers have been the bigger factor in his improvement.
Cheryl & Whiskers (GA)
Member Since 2010
Hello,
I don't have experiance with this. Our hearts go out to you. Keep posting and hang in there, you are doing such a good job, spending so much time with Shakes. I'm sure he know how much you love him and how hard you are trying to help him feel better.
I don't have experiance with this. Our hearts go out to you. Keep posting and hang in there, you are doing such a good job, spending so much time with Shakes. I'm sure he know how much you love him and how hard you are trying to help him feel better.
Lisa and Do Lou (GA)
Member Since 2010
(((((HUGS)))) hang in there its not easy and getting regulated takes time for the cat to start to feel better it took my cat months to start to feel better and he is still far from regulation but much closer then he was 1 year ago and he feels better he can play and he no longer urinates and drinks too much but it took time and I know ECID sending feel better vines for Shakes you are at the right place this board is a lifesaver they (not my vet) are who turned Do Lou's life around in March of 2010 with the protocol on this board
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