6/20 Ruby AMPS 109/+3 116/+5.5 125/+9.5 250/PMPS 216/+3 159

PerfumedCatMom said:
Yesterday on The Ruby Saga. :cat:

Cleaned her bowl at breakfast. ✅
Sat in my lap to nap and purr last night. ✅
Nice low blue start to the day. ✅

Today is Ruby's 10th day on prednisolone.

Healing thoughts for all of the sick kitties and hugs all around. Have a beautiful Sunday, and for those celebrating, happy Father's Day. :bighug::bighug::bighug:
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Good morning Katherine. So glad Ruby ate and her numbers look good. Have a great day. :bighug::bighug::bighug::bighug:
 
Our Dolly Girl said:
Good morning Katherine. So glad Ruby ate and her numbers look good. Have a great day. :bighug::bighug::bighug::bighug:
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Thanks, Adrienne! Hope you got some needed sleep last night and DH enjoys the festivities today.

I think the 116 might be from the fact that Ruby hasn't had a BM in a few days. Poor girl. I added extra Miralax to her food this morning (1/4 tsp). Please send poop prayers. :(
 
PerfumedCatMom said:
Thanks, Adrienne! Hope you got some needed sleep last night and DH enjoys the festivities today.

I think the 116 might be from the fact that Ruby hasn't had a BM in a few days. Poor girl. I added extra Miralax to her food this morning (1/4 tsp). Please send poop prayers. :(
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Hi Katherine. Absolutely, Dolly has special poop and tummy vibes she sends out to ailing kitties. :cat::cat::cat: Now I need someone to get Dolly to eat today. She always eats :facepalm:. Maybe my stress and having family over, a rarity since Covid. Too much commotion for her. Have you heard any updates on Darcy? Too many sick kitties lately. Have a wonderful Sunday. Hope Ruby gets the Dolly vibes :cat::cat::cat:. Sending loving prayers to you both. Ruby’s numbers not too bad. :bighug::bighug::bighug::bighug:
 
+9.5 = 250. @Wendy&Neko I don't know what to do. Her greens have been few and far between but significant ones. I'm not sure the pred at +3 is working very well. I might start moving it slowly a few hours ahead during the day so that it's at PMPS to see what happens then. Feel defeated right now by the pred but I don't want to let it win.
 
You've been on this dose long enough and she's creeping up. I would increase. I think pred earlier was better. Ideally you want to time the time when pred impacts the BG with when the insulin is strongest. Another thing to consider, when/how pred impacts a cat seems ECID. We had one member who gave pred in the AM because she had to work every day out of the house, and the pred then kept her safe while she was gone. What works for one person, may or may not work for another person's situation.
 
Wendy&Neko said:
You've been on this dose long enough and she's creeping up. I would increase. I think pred earlier was better. Ideally you want to time the time when pred impacts the BG with when the insulin is strongest. Another thing to consider, when/how pred impacts a cat seems ECID. We had one member who gave pred in the AM because she had to work every day out of the house, and the pred then kept her safe while she was gone. What works for one person, may or may not work for another person's situation.
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Ok, I will increase her dose tonight to .5. And yes, earlier with the pred seemed better. Ruby has seemed more susceptible to daytime lows rather than nighttime, so that may be the best time to give it when the insulin is strongest. Thank you!
 
Know that there are alternative dosing strategies to manage cats being given Prednisolone if you run into issues with your attempts using the protocols here. The protocols being used here were created to try to help cats go into remission vs being a means of managing every cat &/or cats with special needs such as a cat with DM being treated with Prednisolone. The problem is there is the increase in insulin resistance, and as you are seeing, more so during the cycle with the Prednisolone vs the cycle without it. Many times, attempts to manage the glucose end up being very limited if using the protocols used here—because the dosing is the same for both cycles. You end up having to stop short of maximizing the dosing for the cycle with the Pred because you then end up with lows in the cycle where Pred is not given.

The other option that has been used in the past to make it simple is to do split dosing with the Pred so that someone can use the same doses of insulin each cycle, but the issue is that this approach often results in the cat spending more time in higher #s overall and across 2 cycles vs only 1 cycle because even with the higher doses of insulin, there are still some limitations to how much of the spike you can control from day to day. Again, some days it can be better than others.

In the end, the goal is obviously to find dosing that is able to manage the insulin resistance so that the cat spends as many hours as possible with good glucose control. Often, with cats being given Prednisolone, alternative dosing is the best way to accomplish this.

If you need to or decided to do this, the Libre will help as would a consult with an endo. Just wanted to throw this out there so that if you run into issues, you know there are some options….you aren’t stuck :bighug::bighug:. Best with the increase in dose!
 
Tomlin said:
Know that there are alternative dosing strategies to manage cats being given Prednisolone if you run into issues with your attempts using the protocols here. The protocols being used here were created to try to help cats go into remission vs being a means of managing every cat &/or cats with special needs such as a cat with DM being treated with Prednisolone. The problem is there is the increase in insulin resistance, and as you are seeing, more so during the cycle with the Prednisolone vs the cycle without it. Many times, attempts to manage the glucose end up being very limited if using the protocols used here—because the dosing is the same for both cycles. You end up having to stop short of maximizing the dosing for the cycle with the Pred because you then end up with lows in the cycle where Pred is not given.

The other option that has been used in the past to make it simple is to do split dosing with the Pred so that someone can use the same doses of insulin each cycle, but the issue is that this approach often results in the cat spending more time in higher #s overall and across 2 cycles vs only 1 cycle because even with the higher doses of insulin, there are still some limitations to how much of the spike you can control from day to day. Again, some days it can be better than others.

In the end, the goal is obviously to find dosing that is able to manage the insulin resistance so that the cat spends as many hours as possible with good glucose control. Often, with cats being given Prednisolone, alternative dosing is the best way to accomplish this.

If you need to or decided to do this, the Libre will help as would a consult with an endo. Just wanted to throw this out there so that if you run into issues, you know there are some options….you aren’t stuck :bighug::bighug:. Best with the increase in dose!
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Thanks, Amy! This makes sense to me now that I've seen how the steroids affect the BGs. I'll talk to her oncologist about this when we see her and find out if she has a referral for an endocrinologist within AMC.
 
PerfumedCatMom said:
Ok, I will increase her dose tonight to .5. And yes, earlier with the pred seemed better. Ruby has seemed more susceptible to daytime lows rather than nighttime, so that may be the best time to give it when the insulin is strongest. Thank you!
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PerfumedCatMom said:
Thanks, Amy! This makes sense to me now that I've seen how the steroids affect the BGs. I'll talk to her oncologist about this when we see her and find out if she has a referral for an endocrinologist within AMC.
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Sending prayers for poop and lower numbers. You must be so concerned Katherine. Hugs:bighug::bighug:
 
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