3/29 - Gryphen AMPS @ 207, Alphyne AMPS @ 120 / PMPS +4 @ 70 / +5 @ 74

Discussion in 'Lantus / Levemir / Biosimilars' started by bobjoh, Mar 29, 2021.

  1. bobjoh

    bobjoh Member

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    Jan 23, 2021
    previous(3/25 - Gryphen - curve shows hold dose/modified TR | Feline Diabetes Message Board - FDMB) and (overgrooming issues? | Feline Diabetes Message Board - FDMB)

    Good morning!

    The rollercoaster that is my furry family life continues!

    Both girls had a dose increase; one per my vet (Gryphen), the other per the SLGS method (Alphyne). Guess which one is showing results already? Yep, you guessed it, Alphyne. :facepalm:

    Plus, Gryphen seems to have developed allergies, and now has bald little front legs. She looks miserable. :( I hope her numbers are going up because of the allergies, and not because of the increase.

    Since I changed their diet almost at the same time we started insulin, I feel like a bad furmomma! I hope the FF is the culprit...I FINALLY got everyone to eat the Dr. Elsey's (including the non-diabetic cats). I do use the Young Again as treats, and ordered the LID Zero Mature yesterday instead of the regular Zero Mature, just in case. I don't know what I'll do if it turns out to be the Dr. Elsey's!

    I do have a call in to my vet clinic to see what we can do for the allergies; again, allergies is an assumption. I see testing coming. (I'm trying to get in to see a different vet...tricky situation...the one I want to see is the boss of my current vet, and he's not taking new clients. Technically, I'm not new, but I don't know if they will see it that way. Plus, my regular vet started in on the 'quality of life' that my girls will have since I test a lot, and told me to stop using calipers... We only have 4 vet clinics here between 2 cities, and 2 of the others do not have any experience with feline diabetes. I'm waiting for a call back from the other clinic.)

    I am going to pick up some different foods today. I have tried every single chicken/turkey flavor on Dr. Lisa's food chart that we have here in town (and some from online) that is under 10% carbs; I went with chicken/turkey since I know they like those. The only ones they would eat are the FF and Weruva Funk in the Trunk (which is higher @ 8%). So they got the Weruva this morning, in case the FF is the allergy trigger. I usually save that to slow the curve. Hopefully they will eat some of the duck flavors I was able to find; late night shopping.

    Anyway, that's my book for the morning. Just had to get it all down since I know the people here will understand the frustration and such that I'm having. It's a juggling act with the diabetes, and now the possible allergies, and finding a new food...bah! It's definitely a Monday!

    Hope everyone has a better day than I'm going to have! ;)
     
    Last edited: Mar 29, 2021
  2. Butters & Lyla

    Butters & Lyla Well-Known Member

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    May 30, 2020
    Definitely a lot of balls in the air at once. :bighug: I completely understand and am going through the same thing with Butters, who is currently going bald behind her ears and around her face from all the scratching....why...i have no idea yet.
    Hang in there. Hopefully with time and patience you’re figure out Gryphen’s allergy. Butters’s numbers have been a little higher (for her) lately too and I had been thinking it could the allergy and discomfort. Perhaps it is raising your girl’s numbers as well.
    Have a wonderful day! I hope it gets better.
     
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  3. Marina & Chico

    Marina & Chico Well-Known Member

    Joined:
    Jan 31, 2021
    it's nice to hear an update on Gryphen and Alphyne. So sorry for Gryphen having developed, what seems to be an allergy :( hope you find out as soon as possible what is it and manage it.

    Sometimes when i read people's experience with veterinarians i say that after all we are lucky to have had a completely clueless veterinarian in diabetes issues. At least he didn't tell us that what has worked for hundreds of other cats cannot work for ours. I just want to reassure you one more time that our kitties don't mind the testing. Our Chico is purring while we do it, he jumps on the table when he hears the microwave... it is a matter of habit + they get a treat after that so they have an overall positive experience with testing ;) and any vet that says that our kitties quality of life is somehow worsened by testing clearly has never seen home testing ;)

    Please don't take is as any pressure, i honestly do not intend it like that at all, i understand that all of us have different schedules and responsibilities. I just find it difficult to understand much of what is happening with your girls with only the preshots and i am sure i will not be the only one. The yellow preshot for Gryphen might mean an increase in her BG or it might mean that she is bouncing from a low yesterday in the night. An increase in insulin could be dangerous in case it is the second one. I understand that with 2 diabetic cats it would impossible to keep up with the multiple tests you were doing a couple of weeks ago. Maybe it would be possible to add at least one more test in the middle of the cycle like +4 or +6 to get a better understanding of where is this dose taking them, i believe it would be helpful for you to see what is going on.

    I am rooting for all three of you :bighug::bighug:
     
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  4. bobjoh

    bobjoh Member

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    Jan 23, 2021
    No pressure taken. The vet did honestly make me feel bad, though I'm mostly over that. That conversation strengthened my resolve to find a new vet, so I'm hoping I'm successful in that regard. I think that will go a long way toward calm for all of us. I did start with the additional testing for Alphy again today since her numbers are lower, but then Gryphen has the allergy thing, so I was trying not to stress her out. I know I need to get more tests in there. No one slept last night, since I had one eye open in case she started licking, so maybe I stressed her out, too. :( Everyone is acting normal, except for the licking, so I'm counting my blessings there. I appreciate the input!
     
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  5. Marina & Chico

    Marina & Chico Well-Known Member

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    Jan 31, 2021
    Honestly i believe the vet input into Chico's diabetes is completely unnecessary at this moment, i believe you can find a lot of better and more practical advice on this forum/ Most important that the advice on this forum comes from experience in dealing with a diabetic cat at home. You can bravely chose the best vet in the region disregarding their experience or inexperience to diabetes management.

    When we started testing i had this scared face on when approaching Chico and my husband kept on telling me that Chico is not stressed because of the testing but because of my scared eyes and shaking hand. I read a lot of similar ideas on the forum as well. So i started singing when testing him to make him think i wasn't stressed (of course i still was for another while though :D). It worked :) It is like with children, if you react with horrified eyes when they scratch themselves they will cry that much more

    When you wrote about licking it actually reminded me that Chico started licking his belly around 7 years ago (not that i forgot, i just didn't realize what you mean about her being allergic). Every time i would hear the licking noise i would jump off my chair in the attempt to make him stop. He never stopped completely, he just stopped doing it as intensively and he still has a half naked belly. The vet didn't think there is anything wrong with him but that it might have been related to stress (i had a lot of changes happening in my life at that time). Now i believe it is just a bad habit which intensifies whenever he has some new source of stress (he is very sensitive to stress, just like me hahaha). The last information we read about it is that the most important (if it is stress related licking) is not to increase the stress by trying to stop them. Exclude the source of stress and they might stop. I do not know if Gryphen is stress licker or it is really an allergy but i thought it might be useful to know that it doesn't have to be so dramatic. And to end this on a positive note, since we started treating him for diabetes (including ear pricking 15-20 times a day :D), he has a very strict diet, a stable routine and he gets a looot of attention, he is licking his belly much less than before :)
     
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  6. bobjoh

    bobjoh Member

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    Jan 23, 2021
    Gryphen really isn't a licker at all, which is why I think I'm more unnerved by her doing it now. She's the calm cat of the 4. Ha!! But, I suppose anyone can have their breaking point...I think I'm close to finding mine! :p

    I really do like my current vet, but some of her comments since the diagnosis have made me second guess the entire relationship.

    It's hard, too, living somewhere with limited options for vets, and prescriptions, and food...the internet can get a person a lot, but not everything. I know it will get better, and I appreciate all of you being willing to calm me down. :bighug::bighug:
     
  7. Christie & Maverick

    Christie & Maverick Well-Known Member

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    Aug 1, 2017
    Perhaps it is worth clarifying for anyone who may be lurking, and not posting, that adjustments even if you are modifying SLGS guidelines to use a lower reduction number, which I believe is what you have decided to do, does not mean that you increase the dose too quickly, and we would still recommend holding the dose if you are getting nadirs under 150.

    SLGS, even modified once you have enough data and experience with how your cat responds to insulin, is as the name says...start low, go slow. It's usually best not to try and rush the process along, especially when you don't have the data to support an increase. It has probably been mentioned before, but we dose based on how low the dose is taking the kitty, not preshots. Based on your curve, I would have suggested holding the dose. No worries if you want to follow your vet's advice about dosing decisions, but that isn't modifying SLGS.
     
    Last edited: Mar 30, 2021
    Reason for edit: spelling
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  8. bobjoh

    bobjoh Member

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    Jan 23, 2021
    I needed to find a middle ground, and that was the reason for the increase. You are right, the 'modified SLGS' comes in with the lower reduction point at the nadir, so she can maybe get to, and stay in, the greens longer. 150 on a human meter is over 200 on a pet meter, and that's the language my vet speaks. Gryphen only started in the high 200s (pet meter). My terminology is obviously bad; I just changed it so it's not confusing. Things get lost in translation. People here suggested holding the dose. But, I chose to listen to my vet. It's a learning curve.

    Hopefully anyone lurking can see the past threads and know they would absolutely not want to flip flop between the advice of the vet and the advice given here. I struggled with it, and am still struggling. We can see which advice is working, but it's a choice between someone I know and random people on the internet. I'm getting there! Every bit of wonderful advice I get here brings my girls one step closer to feeling so much better!!
     
  9. Christie & Maverick

    Christie & Maverick Well-Known Member

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    Aug 1, 2017
    All good, Bobbi, first of all, kudos for managing two diabetic cats at the same time. Second, it was more a point of clarification, and truly Gryphen is doing quite well, although I'm sorry to hear about the allergies, I hope the food change helps. There are a lot of different methods out there, and sometimes you need to go with what works for you. An occasional night time before bed test would give you a sense of how the new increased dose is working, especially now that she's been on the new dose for four days. She seems pretty flat, which is a good thing, but those spot checks can be very telling.
     
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  10. bobjoh

    bobjoh Member

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    Jan 23, 2021
    I was actually just testing now, and of course they want to keep me up all night...well, Alphyne does...again. :) ;)
     
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  11. Christie & Maverick

    Christie & Maverick Well-Known Member

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    Aug 1, 2017
    I don't know, Gryphen is doing some fancy moves herself ;), you know her best, but usually a lower number around +2-3 means the kitty has some plans.

    Looks like Alphyne is already there :D:D
     
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  12. bobjoh

    bobjoh Member

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    Jan 23, 2021
    Sleepless in North Dakota!! :p:p
     
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  13. bobjoh

    bobjoh Member

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    Jan 23, 2021
    Apparently, Alphy only likes to stay on a dose for 4 days. I know SLGS says to go down .25 (my reduction point is 80ish). But, we JUST increased from 1.5. Do I try something like 1.6, or go to the 1.5? Thank you!

    Note: I did feed some medium carb food to slow the drop.

    Double note: my girls apparently like cliff diving and not surfing.
     
    Last edited: Mar 29, 2021
  14. Bandit's Mom

    Bandit's Mom Well-Known Member

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    Oct 18, 2019
    When did you feed the MC? When you start the cycle with a lower number, it may make sense to get tests early (+2) and feed the curve.

    Do you think you would be comfortable with a lower reduction point with SLGS? Say 70? It will help keep her on a good dose. Plus you have buffer till the take-action number of 50.

    With SLGS you don't skinny or fatten doses.
     
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  15. bobjoh

    bobjoh Member

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    Jan 23, 2021
    I fed the MC at PMPS +4.

    Yes, I think I would be comfortable with a reduction point below 70. I will stick with 1.75 today, and then test earlier.

    Thank you so much! I think we will all feel better if she would hang out in 'good' numbers for a while before switching doses again! :bighug::bighug:
     
    Last edited: Mar 30, 2021
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  16. Christie & Maverick

    Christie & Maverick Well-Known Member

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    Aug 1, 2017
    Dose adjustments for people following SLGS generally are best done in 0.25u. I believe I've seen some SLGS folks who have a lot of data on how their cat responds to insulin and carbs over time make adjustments and try tweaking the dose, but this isn't something that is written into the SLGS guidelines any longer (it actually used to be when I first joined). FWIW, it seems to me that even some people who follow TR over-use the dose fattening/skinnying, when really they should be adjusting the dose in full 0.25u.
     
    Last edited: Mar 30, 2021
    Reason for edit: Added clarification
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  17. bobjoh

    bobjoh Member

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    Jan 23, 2021
    Thank you! With the up, then down, then up...it's confusing! Ha! I think we started too high, hence all the jumping around...some stability would be nice. ;)
     
  18. Christie & Maverick

    Christie & Maverick Well-Known Member

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    Aug 1, 2017
    Completely understandable :). If you feel you are at the point in terms of data and understanding of both your kitties in when they onset, nadir, how much duration they get, and how they generally respond to carbs, then you can certainly personalize things. Just be cautious how much you customize, since above all else, we want kitties to be safe. The risk of customizing too much is that you end up throwing out the safety measures that are built in the guideline. Perhaps add "custom dosing, do not copy" rather than SLGS so people know that you are doing things a little differently.
     
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