5/26 Copernicus AMPS 341 +3 279 +6 275 (alphatrak)

[Krista & Copernicus]

Copernicus has had a few good days! I had to move mountains and pay an arm and a leg for a bag of fluid, but I know it made a difference. Before fluids, his numbers were higher and he was just laying behind the TV not moving. Today, he took a bath on the sofa. In the words of his vet school vet “ I don’t treat diabetic cats with fluids.” Huh?! I am also still watching what food does to his BGs. He loves the Koha rabbit, but I may need to go even lower carb with him. Although, I did see his BGs start to travel up even before I fed him the last couple of days. He has has more trouble with regulation at night. It looks like an increase to 8? I left him with my husband for 5 minutes while I changed my shirt, so Copernicus took the opportunity to take his Libre off once again. The cat can reach every part of his body with his teeth. He doesn’t move much with a onesie on and gets very depressed, so I am going to order some different shirts for him. Hope all your kitties are doing great! PS The alphatrak reads about 30 points lower than the libre.

 

[Staci & Ivy]

Thank you for the update, Krista!
I am so happy to see Copernicus having a bath

The vet who said that about fluids is an id#$t is all I can say
We are treating dehydration....not diabetes per se. It's not insulin and fluids to treat diabetes for God's sake!

Seems he may possibly need an increase, but I will let others who are more experienced with dosing advice provide that suggestion.
It's great to see some yellow on his spreadsheet, thanks for updating that!

Has he seen any lower values on the Libre (before he yanked it off?)

Glad the fluids have helped, I wish one of your vets would prescribe more if you should need them so it's not a scramble and forces you to pay a fortune to get just one bag at a time!
Are the starred values on the spreadsheet from the Alphatrack or another meter?
If so, I would indicate what that means at the top of the spreadsheet so we can tell.

I hope you can get him situated with a food he likes and works well with his IBD (and maybe CKD?)

Give him lots of hugs from me, please

 

[Krista & Copernicus]

The * is AlphaTrak and I put it in the comments but I can also add it up top. He got to about 275 on Libre yesterday at +2. See attached.

 

[Wendy&Neko]

Here is the link to your previous post: 5/22 Copernicus AMPS 397 which we include so people can easily go back and see the history.

I give the vet a little slack on the fluids comment, but not for the reasons you state. Yes, fluids are for dehydration, but..... Cats that have acromegaly often have or develop heart conditions. One quarter of diabetics have acromegaly. Not sure if the vet has detected a heart murmur. At 7.5 units, some other secondary endocrine condition is most likely present. With certain heart condition, fluids are definitely contraindicated. Neko was getting fluids for her kidneys, which caused her to go into heart failure. Her cardiologist had less than a year prior said her heart was fine. But something changed leading up to the fluids. Neko did get over the heart failure that time, but it set her on a downward path. The vet school vet may just be cautious.

I wouldn't blame the Koha rabbit for the upward trend in numbers. It's something that happens with cats with conditions (IAA or acromegaly) that make a cat harder to regulate, especially when in higher numbers. Plus, I see some yellow numbers today!

 

[Krista & Copernicus]

Good warning about the heart condition with Neko (poor baby), but he was laying flat on his side and not doing well at all pre-fluids. He did have a negative proBNP and they don't think his murmur needs follow up. I don't blame that food for his increase, I definitely saw his BGs climb before I fed him sometimes. But it has been reported that Koha has variable carbs. He seems very sensitive bc if he is trending down and I feed him, I can see the decline turn to an incline. Also if I feed him too much his BG shoots up. Just observations. I also suspect inflammation in his esophagus. I have reported hard swallowing for years and he has some sleep apnea. But I can't get anyone to investigate that. Yes,
Yellow is good!

 

[Krista & Copernicus]

Here is the link to your previous post: 5/22 Copernicus AMPS 397 which we include so people can easily go back and see the history.

I give the vet a little slack on the fluids comment, but not for the reasons you state. Yes, fluids are for dehydration, but..... Cats that have acromegaly often have or develop heart conditions. One quarter of diabetics have acromegaly. Not sure if the vet has detected a heart murmur. At 7.5 units, some other secondary endocrine condition is most likely present. With certain heart condition, fluids are definitely contraindicated. Neko was getting fluids for her kidneys, which caused her to go into heart failure. Her cardiologist had less than a year prior said her heart was fine. But something changed leading up to the fluids. Neko did get over the heart failure that time, but it set her on a downward path. The vet school vet may just be cautious.

I wouldn't blame the Koha rabbit for the upward trend in numbers. It's something that happens with cats with conditions (IAA or acromegaly) that make a cat harder to regulate, especially when in higher numbers. Plus, I see some yellow numbers today!

Actually, I've been meaning to ask you about his patterns. To me, a depot is the numbers progressively drop as you increase the dose no matter how long it takes. So 500 to 400 to 300 etc. I've noticed he does well on some doses and then if I increase he does terrible and I have to start all over from HI. This is not typical for Lantus correct? Thoughts?

 

[Wendy&Neko]

Insulin is a hormone, not a drug. You don't always see a better numbers with each dose increase. (not the depot) You just have to keep increasing until you see the numbers you want. But on top of that, is whatever is causing insulin resistance. With Neko's IAA, I could see green on a dose, then nothing close for the next two dose increases.

There are other things you can see when you first increase, a common one being New Dose Wonkiness as we call it. Which causes temporary higher numbers after that increase. That is a common response with Lantus.

• New Dose Wonkiness (NDW) and failed reductions