7/23 Chloe AMPS 216 +4 74 +5 79 +9 139 PMBG 101 +15 182

Randi & Max (GA)

Randi & Max (GA)

Member Since 2009
Yesterday's Condo

Good morning.
Chloe seems to be feeling better today. Took her to the vet and gave her a shot of Cerenia to help with the vomiting and some B12 to make her feel good.
No vomit the rest of the day.

Yet again she was low last night so could not shoot. Even 15 hours after insulin she was still only at 86.

Today I reduced the dose so that I could hopefully get 2 shots in a day because once a day is not the way Lantus should be working. So that was fun reducing from a .25. So I measured to .5 on the syringe. Slowly turned the plunger and counted how many drops made up the .5, keeping the drops very close in size. Then when I had that amount I knew I wanted to shoot .1, which is 20% of .5. I got 14 drops out of the .5 so I measured again a new .5, released 11 drops and 3 drops should have remained and that's what I gave her.
The plunger was just barely at the zero mark.

If anyone has another way to measure a micro dose I am open to suggestions. I do not have a caliper.
Have a great day.
 
On 3 drops this morning Chloe dropped to 74 at +4. How often should I be testing to make sure she doesn't hypo. I just can't figure anything out.
 
That was a bit of a fast drop but she's surfing pretty now!

Chloe....settle down girl....you're driving your mama a little bonkers!!

Glad she's at least feeling better today though! That's important!
 
Chris & China (GA) said:
That was a bit of a fast drop but she's surfing pretty now!

Chloe....settle down girl....you're driving your mama a little bonkers!!

Glad she's at least feeling better today though! That's important!
Click to expand...
Very bonkers and tomorrow I really need to go to my office. Can only work from home for so long.
Testing every hour for now since she is now to drop late in the cycle. I will still worry about shooting tonight though
 
I think you can take a break from testing...maybe get a +8 or +9 and a +11.5 so you have a little time to make a decision on PMPS

I'd give her a snack to help encourage her to surf
 
Randi, I have a thought. It's rather unorthodox... and yet we have seen it happen every once in a great while.

I'm seriously wondering if Chloe needs insulin. I'm wondering if the change in diet to low carb was enough. I'm wondering if these fast drops caused by exogenous insulin are creating bounces evidenced by the high numbers we're seeing in between shots. Lots of wondering.

There's only one way to test the theory. You'd have to commit to withholding insulin for a minimum of three days (6 cycles)... maybe a couple more. Has she ever thrown ketones, that you know of? If you decide to try this experiment, you'll have to put the insulin away and sit on your hands no matter what numbers you're seeing... which won't be easy. I'd also test for ketones at least once a day.

If this doesn't pan out, there's still insulin in the fridge. It hasn't gone anywhere. Other options include feeding higher carb foods, shooting on an 'as needed' basis, shooting SID, or trying Levemir.

Think about it. You don't have to make any changes at all if you don't want to.


@Wendy&Neko
@Marje and Gracie
@Sienne and Gabby (GA)
Thoughts, ladies?
 
I would agree with Jill. It’s been a while since I’ve seen a kitty bouncing like this on such a low dose. The hardest part is sitting on your hands for six cycles if you see the BG going up. Been there, done that :blackeye:

If she does go back up and it’s clear she needs some insulin, as Jill said, we have some methods that might help. We have had other members that shot SID or when a little support was needed when the dose got really low but the cat didn’t look remission ready.

ETA: I might also suggest that either way you go, you try a feeding trial. If you continue insulin, you might want to do it at +9 by feeding a small LC meal and see if her PS drops. If you stop insulin, test and feed at your normal shot times and then test again three hours later. I know this might be a challenge with your work schedule but just thought I’d throw it out there. It would give us an idea if, in fact, her pancreas is doing the work.
 
Marje and Gracie said:
ETA: I might also suggest that either way you go, you try a feeding trial. If you continue insulin, you might want to do it at +9 by feeding a small LC meal and see if her PS drops. If you stop insulin, test and feed at your normal shot times and then test again three hours later. I know this might be a challenge with your work schedule but just thought I’d throw it out there. It would give us an idea if, in fact, her pancreas is doing the work.
Click to expand...
Yes!
 
Jill & Alex (GA) said:
Randi, I have a thought. It's rather unorthodox... and yet we have seen it happen every once in a great while.

I'm seriously wondering if Chloe needs insulin. I'm wondering if the change in diet to low carb was enough. I'm wondering if these fast drops caused by exogenous insulin are creating bounces evidenced by the high numbers we're seeing in between shots. Lots of wondering.

There's only one way to test the theory. You'd have to commit to withholding insulin for a minimum of three days (6 cycles)... maybe a couple more. Has she ever thrown ketones, that you know of? If you decide to try this experiment, you'll have to put the insulin away and sit on your hands no matter what numbers you're seeing... which won't be easy. I'd also test for ketones at least once a day.

If this doesn't pan out, there's still insulin in the fridge. It hasn't gone anywhere. Other options include feeding higher carb foods, shooting on an 'as needed' basis, shooting SID, or trying Levemir.

Think about it. You don't have to make any changes at all if you don't want to.


@Wendy&Neko
@Marje and Gracie
@Sienne and Gabby (GA)
Thoughts, ladies?
Click to expand...

Very interesting idea. Although she has been on what I thought lower carb food I think there was too much potato and pea flour in what she had been eating and gums as well. I am now paying closer attention to the ingredients.
I have never tested her for ketones until the day she was diagnosed and there were none. I have brand new sticks. I did not find a blood meter to test. I think very expensive?? Are ketostic still okay to use? Ketones were a major concern of mine and the vet seemed to feel that if she was eating well and looks good then not be as scared as I was. I certainly can attempt to get tests. She mostly pees out of the litter box anyways by the way she stands in it.
SO if I feed her higher carb foods that would probably make her need the insulin. Higher carb foods would be lower in protein so would be better for kidneys. So many choices as to what I need to treat. I would like her off insulin, not that it matters what I would like.

I am not opposed to sitting on my hands for the next few days, continue testing.
I gave you Max with his crazy high dose. And you all worked Magic for me then. Now I give you his sister with her crazy low dose.
 
Randi & Max (GA) said:
I am not opposed to sitting on my hands for the next few days, continue testing.
I gave you Max with his crazy high dose. And you all worked Magic for me then. Now I give you his sister with her crazy low dose.
Click to expand...
Haha! I was thinking the same thing this morning, but I wasn't going to bring it up.

Whatever you want to do, Randi. You know you have our support. At this point, I just think we need to try something because while Chloe would make for a cute accessory, the two of you can't be chained to each other indefinitely.
 
Marje and Gracie said:
I would agree with Jill. It’s been a while since I’ve seen a kitty bouncing like this on such a low dose. The hardest part is sitting on your hands for six cycles if you see the BG going up. Been there, done that :blackeye:

If she does go back up and it’s clear she needs some insulin, as Jill said, we have some methods that might help. We have had other members that shot SID or when a little support was needed when the dose got really low but the cat didn’t look remission ready.

ETA: I might also suggest that either way you go, you try a feeding trial. If you continue insulin, you might want to do it at +9 by feeding a small LC meal and see if her PS drops. If you stop insulin, test and feed at your normal shot times and then test again three hours later. I know this might be a challenge with your work schedule but just thought I’d throw it out there. It would give us an idea if, in fact, her pancreas is doing the work.
Click to expand...

Okay so I like the feeding trial idea. But I want to understand it Marje as I was not sure what you meant at the +9 comment. I am okay to try no insulin so if you want to tell me exactly what to do I shall
 
Randi & Max (GA) said:
Very interesting idea. Although she has been on what I thought lower carb food I think there was too much potato and pea flour in what she had been eating and gums as well. I am now paying closer attention to the ingredients.
I have never tested her for ketones until the day she was diagnosed and there were none. I have brand new sticks. I did not find a blood meter to test. I think very expensive?? Are ketostic still okay to use? Ketones were a major concern of mine and the vet seemed to feel that if she was eating well and looks good then not be as scared as I was. I certainly can attempt to get tests. She mostly pees out of the litter box anyways by the way she stands in it.
SO if I feed her higher carb foods that would probably make her need the insulin. Higher carb foods would be lower in protein so would be better for kidneys. So many choices as to what I need to treat. I would like her off insulin, not that it matters what I would like.

I am not opposed to sitting on my hands for the next few days, continue testing.
I gave you Max with his crazy high dose. And you all worked Magic for me then. Now I give you his sister with her crazy low dose.
Click to expand...


I recently bought a Keto-Mojo meter @ GNC Nutrition on a BOGO deal. I then had them apply a 20% coupon I found online. I bought it at the store, not online.
 
Marje was headed out...
  • if you continue insulin --- when cats get down to those tiny doses... feeding at around +9 may stimulate the pancreas enough to pull preshot numbers down
  • if you withhold insulin --- test and feed at normal shot times. retest 3-4 hours later to see if she's producing enough of her own insulin to pull her numbers down without endogenous insulin
Make sense?


ETA: when withholding insulin, use food like you would insulin. test, feed, retest 3-4 hours later
 
Randi & Max (GA) said:
Are ketostic still okay to use? Ketones were a major concern of mine and the vet seemed to feel that if she was eating well and looks good then not be as scared as I was.
Click to expand...
Ketostix are fine.
I agree with your vet. If she's eating well and appears well, there's less chance of ketones developing. That said, I'd test for ketones if you withhold insulin.
 
Jill & Alex (GA) said:
Marje was headed out...
  • if you continue insulin --- when cats get down to those tiny doses... feeding at around +9 may stimulate the pancreas enough to pull preshot numbers down
  • if you withhold insulin --- test and feed at normal shot times. retest 3-4 hours later to see if she's producing enough of her own insulin to pull her numbers down without endogenous insulin
Make sense?


ETA: when withholding insulin, use food like you would insulin. test, feed, retest 3-4 hours later
Click to expand...
But wouldn't feeding at +9 and possibly bringing PS number down will cause me to have a lower number and then not be able to shoot. I guess that's what I am not understanding.
 
Jill & Alex (GA) said:
And if it was too low you wouldn't shoot, BUT we'd know her pancreas is doing at least some, if not all of the work.
Click to expand...
Alright I think I will try the no insulin for 6 cycles, feed and the same times, watch for ketones and go from there. The stress in her going hypo when I sleep or if i need to be out of the house on such a low dose is killing me.You give me blessing for that?
It is also a bit easier for me as I cannot guarantee a +9 feeding unless I was home.No one would be here at that time and the next couple of days I nee to get to my office.
 
Randi & Max (GA) said:
Alright I think I will try the no insulin for 6 cycles, feed and the same times, watch for ketones and go from there. The stress in her going hypo when I sleep or if i need to be out of the house on such a low dose is killing me.You give me blessing for that?
Click to expand...
Absolutely.
Remember, test, but ignore the high numbers. Don't shoot. What we're doing is withholding insulin while we're waiting for the bounce to clear. Once the bounce clears and the depot is drained, we'll get a baseline on her... and go from there.
 
Jill & Alex (GA) said:
Absolutely.
Remember, test, but ignore the high numbers. Don't shoot. What we're doing is withholding insulin while we're waiting for the bounce to clear. Once the bounce clears and the depot is drained, we'll get a baseline on her... and go from there.
Click to expand...
Alright, but if you like one plan over the other let me know. You have more experience than I do. But I will have problems monitoring feeding at a +9 religiously for the next few anyways
 
Randi & Max (GA) said:
Alright, but if you like one plan over the other let me know. You have more experience than I do. But I will have problems monitoring feeding at a +9 religiously for the next few anyways
Click to expand...
If I were in your shoes and given the circumstances, I'd withhold insulin.

If you're withholding insulin, test and feed at normal shot times. Retest 3-4 hours later to see if she's producing enough of her own insulin to pull her numbers down without endogenous insulin. If you normally feed mini-meals during the cycle, that's ok. Feed normally.
 
Jill & Alex (GA) said:
If I were in your shoes and given the circumstances, I'd withhold insulin.

If you're withholding insulin, test and feed at normal shot times. Retest 3-4 hours later to see if she's producing enough of her own insulin to pull her numbers down without endogenous insulin. If you normally feed mini-meals during the cycle, that's ok. Feed normally.
Click to expand...
That;s the plan. testing and feeding without the insulin. Starting tonight. 6 cycles!!!
 
Wendy&Neko said:
Out of curiosity, at what time is the pred given relative to preshot time?
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The same time.
I always give her pred at breakfast so I don’t forget and now that I started insulin I shoot her while she eats.
Was that a bad thing? Vet never asked orbdiscussed the timing of the 2.
What are you thinking Wendy
 
It isn’t a bad thing, just wondering. I have seen a lot of ECID on when pred seems to start impacting BG and for how long. Wondering if there was a pattern that could be explained by Chloe's numbers.
 
Wendy&Neko said:
It isn’t a bad thing, just wondering. I have seen a lot of ECID on when pred seems to start impacting BG and for how long. Wondering if there was a pattern that could be explained by Chloe's numbers.
Click to expand...
It has been a year since she is taking the pred in liquid form religiously. Withvyhe pills itbwwsnt consistent and she would spit them of.
I’m open to hearing any opinions.
I knew in the back of my head that long term steroid use could result in this but that was the choisenin dealing with the ibd.
 
Jill & Alex (GA) said:
Marje was headed out...
  • if you continue insulin --- when cats get down to those tiny doses... feeding at around +9 may stimulate the pancreas enough to pull preshot numbers down
  • if you withhold insulin --- test and feed at normal shot times. retest 3-4 hours later to see if she's producing enough of her own insulin to pull her numbers down without endogenous insulin
Make sense?

ETA: when withholding insulin, use food like you would insulin. test, feed, retest 3-4 hours later
Click to expand...
Thank you for “picking up the ball” and explaining it for Randi since I had to leave.

Randi & Max (GA) said:
It has been a year since she is taking the pred in liquid form religiously. Withvyhe pills itbwwsnt consistent and she would spit them of.
I’m open to hearing any opinions.
I knew in the back of my head that long term steroid use could result in this but that was the choisenin dealing with the ibd.
Click to expand...
Have you ever thought about discussing using budesonide for the IBD with your vet? The systemic effects are minimized and si it’s less likely it will impact the BG. It’s widely used for IBD over prednisilone.

Paws crossed! Good luck with the trial! Patience pants ready :p:p:joyful:
 
Marje and Gracie said:
Thank you for “picking up the ball” and explaining it for Randi since I had to leave.


Have you ever thought about discussing using budesonide for the IBD with your vet? The systemic effects are minimized and si it’s less likely it will impact the BG. It’s widely used for IBD over prednisilone.

Paws crossed! Good luck with the trial! Patience pants ready :p:p:joyful:
Click to expand...
Hey Marje
Actually I did last week because I read that as well. I was surprised that she didn’t know what it was.
Maybe I didn’t pronounce it correctly.i told the vet I saw yesterday and she did know but she is not my normal vet and i have not seen her since my Sasha was alive. Like 17 years ago. It’s vacation time here so everyone is rotating. I’ll make a call tomorrow for the vet that put Chloe on the pred and see what she thinks. Although just spent $100 on a new bottle of it.
And yes I will try and keep my patience.
And thanks for the help.
 
Not uncommon for vets to be less familiar with budesonide for cats. That has been my experience too. Neko was prescribed budesonide over pred for her suspected small cell lymphoma because her heart could not take pred. The bonus was that it didn’t impact her blood sugar.
 
Randi & Max (GA) said:
Hey Marje
Actually I did last week because I read that as well. I was surprised that she didn’t know what it was.
Maybe I didn’t pronounce it correctly.i told the vet I saw yesterday and she did know but she is not my normal vet and i have not seen her since my Sasha was alive. Like 17 years ago. It’s vacation time here so everyone is rotating. I’ll make a call tomorrow for the vet that put Chloe on the pred and see what she thinks. Although just spent $100 on a new bottle of it.
And yes I will try and keep my patience.
And thanks for the help.
Click to expand...
Another friend of mine had the same issue. She finally took enough info in on it that the vet prescribed it and her kitty is doing very well on it. I was worried that with the age of the kitty and her other issues, pred was one more push towards diabetes.

Hmmm...yeah no one wants to toss a $100 bottle of meds. :eek::eek:
 
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