3/8 Bonk PMPS 332 - An Introduction

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CanisLupus

Member Since 2014
Greetings all,

My name is Brian, and I joined this forum last week when I got the diagnosis of diabetes on my cat Bonk. I was invited to join the tight regulation forum, and it sounded like a good idea to me. For those who haven't seen it, my original posting can be viewed here:

viewtopic.php?f=28&t=114627

I'll start off with a status update. I started Bonk on 2 units last night (he was on 1.5). His preshot was 402, but his +4 spiked to 517, then he dropped back to 424 by morning. I don't quite get those numbers, but I'm wondering if he got into Faolan's dry food during those 4 hours. I think I will switch Faolan to a similar diet, it will be better for him anyway, and will stop these potential issues.

Now, a quick little history on my furry family. Bonk has been suffering chronic constipation for many years. Sadly, this has led to the diagnosis of Megacolon at the beginning of January. He had to be sedated, and my vet did a full clean-out. At the time, he was given a series of medications to take to manage the megacolon. Shortly after, I noticed he was drinking and urinating much more, and figured it was a side effect of the medication. But as the problem continued to worsen, I decided a trip to the vets was in order. So in the end of February, I got the diagnosis of Diabetes. It's been an up and down battle since with him between lethargy, inappetence, and me trying to learn home blood testing. But we're getting there.

Here is his current list of medications:
5ml Cisapride 3x per day
3ml Lactulose 3x per day
1/4 tsp Miralax 3x per day
2 units Lancet 2x per day

He was also put on the Royal Canin Fiber Response dry food. But as his diabetes got worse, he decided he didn't like it. Which is fine by me, as I am now transitioning him to an all canned diet with low carbs and low fiber. I picked up a small bag of Evo to help him transition, and as a low carb treat.

So now, let me introduce everyone. This is Bonk taken just a week or so ago, doing one of his favorite activities:
Bonk1.jpg


He is a rescued stray cat, in fact I rescued him right out of my back yard. The first time I met him, I didn't know he was homeless. He was in my driveway, and I stepped out there for something unrelated. I thought he was one of the neighbors cats. He ran as soon as I approached, right into the fence, bonking his head. He proceeded to run down the driveway a few feet, and bonked his head on the fence again. he did this several times before running up the street. Every time I saw him after that, I called him Bonk, and the name stuck. It wasn't long after that I realized he was a stray. I started to put out food for him, and lure him into my back yard. It took about six months to fully earn his trust, but it was well worth it. By this point, he was spending most of his time in my yard. I wanted to get him in my house, but since I had another cat living there, I wanted to make sure he was vaccinated, checked out, and neutered.

At the time, I didn't have the money to cover these costs, so I called on a local organization called the Stoneham Cat Society, who helped me through these expenses. I would never have been able to do everything I did at the time without their help. Ever since then, every Christmas, I use my Christmas display to raise donations for them to thank them for their help. In August of 2005, he came indoors, and has never looked back. Here is one of my favorite shots of Bonk, taken many years ago:
Bonk2.jpg


And this is me, taking a photo of Bonk through my back door. This is also the photo used in my avatar here:
Bonk3.jpg


Now we jump to last year. I got a phone call from someone at the earlier mentioned Stoneham Cat Society. She told me about a cat they just rescued, who was a little on the wild side, as it seemed he hasn't been in a home for a few years. They currently didn't have the foster facilities to take care of him, so if they couldn't find a home quickly, they would have to treat him like one of the feral cats, where they trap, neuter, and release. They didn't want to do that, and wanted to know if I would be willing to take him in. So of course, the softy that I am, said yes.

Now I love Wolves (as you can probably tell by my user name here.) When I saw a picture of this cat, his fur coloring made him look like a little wolf. Before I even met him, just going on the photo I was emailed, I did some internet research on names, and I found the irish name Faolan, which means literally, Little Wolf. I thought it was a great name, and it worked out better than expected, because Faolan is more like a dog than a cat. He follows me around everywhere I go, Sits at the Kitchen table and begs, and will even play catch (though he hasn't quite masted bringing the toy back so I can throw it again). When he was rescued, his fur was badly matted, so he was shaved. This is what he looked like the day he came into my house:
Faolan2.jpg


And this is what he looks like today:
Faolan1.jpg


He too was a long road to earn his trust. He spent the first couple months hiding in my closet. Slowly though, he learned to trust me. Now he is an absolute lap cat. He is also a challenge with food. He is on that classic "See Food" diet. Any food he sees, he wants to eat. Which is tough, as Bonk is a picky eater and likes to nibble, so I have to protect his food to make sure Faolan doesn't eat it for him. Faolan loves to help his older brother!

There is one more cat I want to introduce everyone to. He was my first cat. I brought him home as a kitten when I was 14, so I spent a good part of my life growing up with him. His name was Putz (my father started calling him that, and the name stuck. He wasn't thrilled at the time to me bringing home a cat. I did over the years, however, turn him into a cat person :lol: ) Anyway, a little over six years ago, just two weeks shy of his 15th birthday, I lost him to renal failure. I got the diagnosis of late stage renal failure just days before Christmas. I did everything I could for him, but in the end, just got two more months with him. He did teach me a lot though on caring for a sick cat, and fighting through the emotions to do what needs to be done. And though they are very different illnesses, these experiences have helped me greatly on dealing with Bonk's issues. Here is one of my favorite photos of Putz:
Putz.jpg


And that's my furry family, and where I am today. Starting another journey in my life.
 
Re: 3/8 Bonk AMPS 424 - An Introduction

Hi Brian,

I just wanted to welcome you to the board! My name is Shelly; my cat's name is Jersey. We're relatively new to the board ourselves, so I can't help you with dosing, interpreting numbers, etc. What I can tell you is that there are wonderful people here who can help you with all of those things. I'm sure they'll be along soon to welcome you, ask you questions (they're very inquisitive, which is good :-D ), and guide you through this process. In the meantime, I'll do what I can - give you encouragement and support.

Shelly
 
Re: 3/8 Bonk AMPS 424 - An Introduction

Welcome to LL Brian and super sweet Bonk :-D

What a wonderful introduction! You are obviously a very thorough and organized fella :-D I love how you are so willing to help those in need and have the patience and understanding to let them 'come around' in their own time. Bonk and Faolan are very lucky to have you! And thank you for sharing the great pics of your family. It's sweet that the name Putz stuck and your Dad became a 'cat person' :lol: I too recently lost a kitty, my Daril Girl , to renal failure. It's a horrible way for you to be crash tested into animal health care, and I'm seriously impressed with what it taught you in terms of setting aside emotion to get done what needs doing. I have no doubt at all that you did all you could, and Putz knew that too. :YMHUG:

Regarding Bonk's numbers, if it is at all possible he got into the contraband...he very well might have :? :lol: But also remember that Lantus is a depot insulin, so you may not see the results of the increase the same cycle as it is given (this also applies to decreases). We like to hold onto a dose for several cycles to see how it will respond. So wearing 'patience pants' is a MUST here :lol:

And as Shelly mentioned, ask lots of questions and expect the same from us :-D You're in good hands here my friend. The people are truly amazing :-D
 
Re: 3/8 Bonk AMPS 424 - An Introduction

Hey Brian!! Welcome to Lantus Land!!

Glad you came on over! The Health board is great for starting out, learning the basics and getting the spreadsheet up and running, but here you'll get the most experienced Lantus users watching over you and your precious Bonk! We don't have many roosters in our henhouse, but we're happy to have you!! ;-)

Love the stories! Bonk sure did show you his name didn't he? I'm a firm believer that cats know their names and will tell you what it is when they are good and ready. They may agree to come to something else that we named them, but that's just because we are the bringers of the fuds....LOL
If we wait long enough to name them though, they'll whisper their real name to us...or in Bonk's case, show you very clearly the first chance he got!!

You're on the right track with just changing Faolan over to the low carb wet too. Makes it much easier in a multi-cat household if everyone will just eat the same food, and knowing what we know now about feline nutrition, we know that Faolan will benefit from the lower carbs and extra water in the canned too, and may keep him from ever becoming diabetic....as well as a bunch of other benefits for his overall health. I feed China separately and first so I know exactly what she eats, and then move to the kitchen where my other 2 civvies get their meals.(It also gives her a chance to eat in peace with me "protecting" her so she doesn't get pushed away). Since I wanted to try a raw diet with China but couldn't really afford to feed everyone raw, they get Friskies pates (but they love them), and then when they're done with theirs, they'll come in and see if China left any little lickin's..and if China happens to want a little snack (and they left any), it's not going to hurt her if she gets an occasional taste of their Friskies.

It'd be great if you felt like doing a profile for your kitties! You can add the link to your signature just like your spreadsheet link with all the stories, pictures and details you'd like to share! Here are some Profile Instructions

Good luck with the dosecrease! Hopefully you'll see some better numbers soon!
 
Re: 3/8 Bonk AMPS 424 - An Introduction

Brian, welcome to the most wonderful place to learn how to take care of your sugar baby. You're off to a great start. What a lovely introduction to your family and might I add they are very beautiful. :smile:
As the others have stated the ladies here possess an untold wealth of experience and knowledge and just general support should you need it.
Kudos on changing your babies over to wet food. That's half the battle. ;-)
I hope you have wonderful day!
 
Re: 3/8 Bonk AMPS 424 - An Introduction

Hi Brian and Bonk and welcome to Lantus Land,

You have come to the right place to get help for your kitty. Your background stories on Bonk and Faolan are beautiful to read. And Putz's too (my brother-in-law had a foundling kitty that he called "Putz"). Feline Diabetes can be challenging. There is a lot to read and absorb, but it gets easier and begins to make more and more sense as you go along. The best place to start is by reading the "Stickies"--the informational posts at the top of the Lantus Forum. Begin with the one "New to the Group".
I see on Bonk's spreadsheet that you just increased his dose to 2 units yesterday. Don't worry that his numbers still are high. This is typical. Lantus is what we call a "depot" insulin, i.e, it leaves a depot, or storage shed, of itself in the cat's body. This is what enables it to control diabetes in a more-or-less stable way, without (hopefully) huge dips and spikes that are more often seen in insulins that do not have the depot effect. When you first begin Lantus, and every time you change your dose, it takes a few cycles for the depot, or shed, to get to a size that corresponds to the size of the dose. Until this happens you can often see high numbers that you do not expect. So the best thing to do--regardless of what you see on the meter or what your vet tells you--is to follow the TR protocol. It is a safe protocol and here we put the safety of the cats before anything else.

So ask any questions you have. There are many very experienced people on this board who can help with dosing, medications, etc.. There are also many of us who can give support. Switching both your cats to a canned, low-carb diet is probably the very best thing you can do for their overall health.

Welcome!

Ella & Rusty

p.s. your "Wolf" looks like he has a lot of Maine Coon in him!
 
Re: 3/8 Bonk AMPS 424 - An Introduction

hi Brian! just wanted to add my welcome to you, Bonk and Faolan. you have a wonderful family!

i'd encourage you to post here daily, or as often as you can, to learn how Lantus works in Bonk's body and how to best take care of him. Also, take a look at the yellowed starred sticky posts that are at the top of the daily threads in this forum. Starting with how to take care of your insulin is a good spot, then just move through them all. You don't have to memorize anything - we'll tell you as things come up, but it will be helpful if you at least get familiar with the info.

Ask questions as often as you want - we don't mind. we've been in your shoes. Use the ? post icon and edit the subject line of your first post in a thread, then add a "reply" to bump up your post. It helps us if you remove the ? when you've gotten an answer that satisfies you. you can keep editing that first subject line all day long to reflect anything happening that day that you want to ask about.

For now, hold your dose and try to get tests about every 3 hours during the day in addition to the preshots and one in the evening cycle. if you think you need to change the dose, it would be good to ask here and let us help you figure out if it's the right thing to do or not.

Glad to have you here! :-D
 
Re: 3/8 Bonk AMPS 424 - An Introduction

Hi Brian, I just wanted to stop by and welcome you, too. Ella & Rusty mentioned your condo to me, as my kitty, Maggie, also had Megacolon and diabetes. Maggie passed away just this past August 5 from a series of medical issues, mainly renal failure. She was on most of the same medications as Bonk for the Megacolon. Maggie had diabetes first and then Megacolon later. I had to take her in periodically for enemas. She was also a feral/stray, and it took some time for me to get her indoors. I'm so impressed with your furry family. Love the pic of Faolan and what lucky kitties to be rescued by you. If there's anything I can do to help with the Megacolon, let me know, but it sounds like your Vet is doing the same as mine did for Mags.
You're in the best place with so many experienced caregivers.
 
Re: 3/8 Bonk AMPS 424 - An Introduction

Welcome to Lantus Land!

I love your kitties' names and what a great intro! This community is truly the best place you never wanted to be.

I think you did the right thing by increasing Bonk's dose. Those are not lovely numbers. If contraband is a possibility, it may explain a lot. Having both of my kitties on the same food made my life much easier.

Was the reason your vet suggested the Royal Canin for the megacolon to increase the fiber in Bonk's diet? If so, you may want to think about adding either some canned pumpkin (not pumpkin pie filling) or squash baby food to Bonk's diet. Both will increase the fiber without all of the carbs in dry food.
 
Wow! Thanks for the wonderful welcome everyone! I am so glad I found this place. I don't think I'd be able to do this without the help I've gotten here. Anyway, Bonk has been much more active today than he has been in a couple weeks. And when I took his PMPS, I saw why. 332, the lowest reading I've seen yet. Hopefully, if I check a time or two more tonight, I'll see an even lower number.

I also got a call from my vet today (imagine, a vet who takes her time to call and check on patients herself, even on Saturdays. She happy with me home testing, and even said that after I've had him on the current dose for a few days to give him a curve test.

ForJersey said:
Hi Brian,

I just wanted to welcome you to the board!...

Hi Shelly! Thanks for the welcome! I have recived a tremendous amount of help from the folks on this board already. Though I will be honest, I wish I never had to be here (I'm sure everyone does) I am glad I'm here. Good luck with Jersey!

Kim & Twice said:
Welcome to LL Brian and super sweet Bonk :-D ....

Thanks Kim! Thanks for the comments on my introduction, though if you saw my apartment, you wouldn't think I'm all that organized. :) Sorry to hear about your kitty, I wouldn't wish what happened to my Putz on anyone. Of course, dealing with a sick cat was a lot harder for me the first time around.

Contraband, I like that! We'll see how his numbers do tonight, I'm starting to see changes in him as they drop today, so hopefully the trend continues.

Chris & China said:
Hey Brian!! Welcome to Lantus Land!!...,

Thank you Chris, and thanks for inviting me! I'm glad you enjoyed my stories, I'm sure I'll have quite a few more in the future. I usually don't find my pets, they find me. I like to adopt those who really need a home, even if it means I won't see them for two months while they hide in my closet. :lol: I did setup a wireless camera, so I could watch him when he came out to eat his food. At least I knew there was a cat there that way, and not a monster in my closet! :smile:

As for the food, yes, I want them on the same diet. I agree, it will be better for everyone. Though I hate to throw away food I've paid for, so I will probably let Faolan eat his way through that before I switch him entirely.

Thanks for the link on the profile. I'll make one soon.

Lauren&Tommy said:
Brian, welcome to the most wonderful place to learn how to take care of your sugar baby....

Thanks for the welcome Lauren!

Ella & Rusty & Stu(GA) said:
Hi Brian and Bonk and welcome to Lantus Land....

Thank you Ella! I'm glad you enjoyed the stories, and it's interesting to hear there was another Putz out there! :smile: I've been reading those stickies, and anything else my brain will absorb. I've learned a lot more about diabetes in the last two weeks and I have in my entire life. And yes, you are correct. Things are making more and more sense as I go. Thanks for the info on the numbers. It still takes some getting used to, but as I said, I'm seeing much better numbers tonight.

As for Faolan, yes, I do believe a large part of him is Maine Coon. From what I read about Maine Coons online, it explains a lot of his "dog like" personality. And it's nice to finally have a cat who will sit in my lap.

julie & punkin (ga) said:
hi Brian! just wanted to add my welcome to you, Bonk and Faolan....

Thank you Julie! I'm sure I will have all kinds of questions as we go along. I'll hold the dose per the protocol, and see how he is doing. I have authorization to go up to three units now as needed. Hopefully that won't be needed, but we will see.

Ann & Maggie11 said:
Hi Brian, I just wanted to stop by and welcome you, too....

Hi Ann, thank you for the welcome. I'm sorry to hear about your Maggie. Bonk has been in for many enemas over the last several years. I had things under control for over a year, until the end of last year. I'm suspecting diabetes was already starting to play a role, and that's why his condition worsened the way it did.

I do have one question for you, and that's about diet. Did you have Maggie on any diet for the megacolon? My vet wants Bonk on a high fiber diet, but from my research, a low fiber diet is much better for megacolon kitties, as the fiber causes things to bulk up in the colon and get stuck. So I'm wondering if you had any experience one way or the other. Thanks!

Sienne and Gabby said:
Welcome to Lantus Land!....

Thanks Sienne! I agree, the dose increase seems to be helping today. And contraband could very well be a problem right now.

And yes, the Royal Canin was prescribed for the fiber. But what is interesting is, as I said in my comments to Ann above, I'm being told by others online that Low Fiber is better for Megacolon kitties. So I have contridicting information. But I tend to lean towards the low fiber idea, mainly for the reason mentioned above on it bulking up in the colon. But the pumpkin and squash might be a very good idea, if Mr Picky will eat them. ;-)

That took me a while to get caught up on those comments. Thanks again everyone! I truly appreciate it!
 
The protocol has increases in either 0.25u or 0.5u increments. i'm not sure if the vet is suggesting increasing by an entire unit from 2.0 to 3.0, but you can miss a good dose by increasing in too large of increments. If you think that Bonk did get into high carb food (or dry food) then you want to hold the dose for at least 24 hrs after that to let it clear out of his system.

The reason we are careful in our increases is that a cat that is overdosed with a too-high dose of insulin can have a spreadsheet very similar to a cat that doesn't have enough insulin. The cat's body will produce hormones and release counter-regulatory hormones to keep up the blood sugar if they are given too much insulin, and the result can be constant high numbers.

The way we prevent that is to be methodical in our dose increases. Lantus builds a depot in the body and then slow-releases, so when you increase a dose you want to give it at least 6 cycles to settle in before considering another dose increase. In cats that have a history of ketones (has Bonk had them?) or who have particular circumstances, we sometimes have them increase after 4 cycles, but generally it is a minimum of 6 cycles.

Increasing the dose:
Hold the dose for 3 - 5 days (6 - 10 consecutive cycles) if nadirs are less than 200 before increasing the dose by 0.25 unit.
if your cat is new to numbers under 200, it is recommended to hold the dose for at least 8-10 cycles before increasing.

when your cat starts to see nadirs under 100, hold the dose for at least 10 cycles before increasing.

After 3 days (6 consecutive cycles)... if nadirs are greater than 200, but less than 300 increase the dose by 0.25 unit.

After 3 days (6 consecutive cycles)... if nadirs are greater than 300 increase the dose by 0.5 unit.

In Bonk's case, you'd want to give him til Monday to see what the 2.0u does, then look at the protocol above and decide based upon the nadirs (low point) the 2.0 dose is getting him to to decide what the increase might be, or if he should keep the same dose for a little longer.

by the way, you're doing a great job at getting enough tests in to see what the dose is doing. good job!
 
I do have one question for you, and that's about diet. Did you have Maggie on any diet for the megacolon? My vet wants Bonk on a high fiber diet, but from my research, a low fiber diet is much better for megacolon kitties, as the fiber causes things to bulk up in the colon and get stuck. So I'm wondering if you had any experience one way or the other. Thanks!

Hi Brian, nice to see Bonk slide down to that 332, way to go Bonk! That's good question about the fiber and Megacolon. My Vet never mentioned having Maggie on a high fiber diet. That was my thought exactly, that the fiber would cause even more problems with the colon. At the time Maggie was diagnosed with Megacolon, she also had the chronic renal disease, so I fed a low phosphorus diet. She ate Wellness Turkey and some of the other no grain wet foods, some FF Turkey & Giblets as a treat. I also tried the Royal Canin and some of the other prescription diet foods, but they were too high in carb and the insulin had to be increased plus cats just don't care for that food. There are some links and lists of food for the diabetic kitties from Dr. Lisa. I'll see if someone can send you the latest if you already don't have them. You're doing a good job with Bonk and juggling it all.

ETA Here is a great source of info on chronic constipation that Marje & Gracie gave me when Maggie was first diagnosed with Megacolon, if you don't already have it.
http://www.felineconstipation.org/whatgoeswrong.html
 
Hi Brian,

I wanted to welcome you! It's cute how Bonk got his name. I enjoyed the pictures and reading the background on the rest of your cats.

I have been using Lantus since September and the people here have been very helpful and warm. I was pretty overwhelmed in the beginning. So it is a great place for support and information.

Switch to a low carb canned food was a really good idea. It will help the numbers drop. It takes a little while at first for the Lantus to stabilize and show its full

effect.

Have a great day!

Catherine and Lovey
 
This is the link to Dr. Lisa's site (Lisa Pierson, DVM) that deals with feline nutrition. The food lists are linked on the right hand side of the site. She also has good information on a number of medical conditions, including diabetes.
 
julie & punkin (ga) said:
The protocol has increases in either 0.25u or 0.5u increments. i'm not sure if the vet is suggesting increasing by an entire unit from 2.0 to 3.0....

Thanks Julie, basically, I'm running everything by my vet as we go. So no, she isn't saying to go from 2 to 3 units, she is saying she is fine with me going up to 3 units as needed. I will be following the protocol as listed, and will go up .5 units if needed later in the week. Though I suspect it will be needed, the changes are working. Yesterday was the first full day all readings were under 500. Still not great, but it is an improvement.

Thanks again!

Ann & Maggie11 said:
Hi Brian, nice to see Bonk slide down to that 332, way to go Bonk! That's good question about the fiber and Megacolon.....

Thanks Ann, yes, you were dealing with the renal failure too. That must have been a hard diet to manage. Okay, so I will stick with my low fiber canned food plan then. I've been feeding him Weruva "Cats in the Kitchen" line, as well as Fancy Feast Classics. They are all low in fiber and carbs. I've been dealing with the chronic constepation for years, so I am quite familiar with that site, but I appreciate the link. I also have Dr. Lisa's food chart (in fact, I have a copy on my phone, so I have it with me when shopping for food). Thanks again.

lovey11 said:
Hi Brian,

I wanted to welcome you!...

Hi Catherine, thank you for the welcome! I'm glad you enjoyed the photos and stories. And yes, I'm starting to see the changes in numbers!

Sienne and Gabby said:
This is the link to Dr. Lisa's site (Lisa Pierson, DVM)....

Thanks for the link. I have it bookmarked already. I've been using it quite a bit as I adjust both Bonk and Faolan's diets.
 
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