7/3 Henry WC. AMPS 242 +4 HI +5 HI +6 330

John & Henry

John & Henry

Member Since 2022
previous: https://felinediabetes.com/FDMB/thr...1-6-249-8-190-11-254-pmps-230-ket-0-2.265329/

Strange jump in BG around the time the nadir should have happened. Finally got some new syringes and boy oh boy, do they make a world of difference. I've had zero air bubbles, they have 1/2 unit markings making measuring way easier. Especially for the .25U and .1U doses. It slides easier, the plunger is flat and consistently lines up with the zero mark. I skipped the subQ fluids yesterday because hes been acting so much better and I don't want to use them all up in case he really needs them in the future. I'm wondering if they've perked him up so much in the past because he's not getting the electrolytes he needs via food due to the EPI and the fluids are providing them.

He's been a bit more subdued today, a bit less ravenous. I found the only store that has porcine pancreas enzymes locally is the vitamin shoppe, so I'm going to pick some up right now.

Wendy&Neko said:
I haven't seen today's post yet, but just wanted to say how pleased I am with that ketones number and the fact that you haven't had to give R for two cycles in a row. :)
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Thanks for your reply Wendy. Yes! I was thrilled the ketones came down so quickly, all the way to 0.2. You may have jinxed me on the R tho, because his BG shot up this morning so I gave him 0.1uR at AMPS +6. Hopefully we get a (little) drop soon.
 
Hi John, a few people have tagged me on your posts and I have just gotten back from a long trip and am reading up on your journey with Henry. You have been through the wringer. I wanted to relay to you my experience dealing with my Ruby’s SCL. She was diagnosed definitively via surgical endoscopy and we’ve been seeing an oncologist at the Animal Medical Center in New York for the past year. At Ruby’s diagnosis, the doctor opted to treat only with prednisolone. She was close to diabetic remission but the steroid knocked her out of it. I have been very happy nevertheless with how well Ruby’s been doing—eating like a champ, her nausea and vomiting gone, and 6 months after the SCL diagnosis her intestinal thickening was gone. We went up in insulin at a steady clip, plateaued around March of this year and now she seems to need less and less insulin. On Wednesday we’re doing another ultrasound and depending on the findings we are going to try to taper her off the steroid and then maybe she won’t need insulin. Ever since the diagnosis I have put both of my cats on a raw food diet made with raw meat and EZ Complete. I have been told by many people that treating SCL with prednisolone alone would not cure the lymphoma, that my doctor is wrong to not give Ruby chemo, but I have been thrilled with how well Ruby has been doing and hope she remains cancer free. Time will tell.

I am afraid I don’t have a lot of experience with EPI, but there’s some good info on the IBD kitties website. I used to be a member of their Facebook group but I found them to be hostile and impatient, unlike the wonderful people here whose patience and generosity seem endless.
 
Bobbi Kraham said:
What brand are these magical syringes?? :)
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So I'm new to this while thing and have only used a single brand before these new ones so ymmv. Strangely both the new and old ones are from vetrx, but that's where the similarities end. The old ones were utiliguard the new ones are utilicare U-100 3/10cc 31g 5/16 length with half unit markings. I've only drawn about 4 syringes worth since I've had them so maybe I just had good luck. Did catch an air bubble on this last draw but that was easily removed (had serious problems getting rid of bubbles with the old ones). There may be better out these, but these are far superior to the original ones I had.
 
So Henry has had his first 2 doses of porcine pancreas enzymes. The first 1/4 cup of wet food I started with just a half a pill mixed in, because I wanted him to eat it and not be immediately turned off and not want to touch it again. I also got a different flavor of wet food than he's used to because if he did get turned off, I didn't want him not to eat his "normal" food. The first plate was a complete success. He ate the whole thing and I gave him a little scoop of his normal food hoping to clear any enzyme tastes left in his mouth. An hour later I upped the ante to a whole pill per 1/4 cup and he ate about 2/3rds of it. Strangely when I gave him his "normal" unlaced food after to clear the taste he turned his nose up at it. He probably feels tricked.

The whole world of enzymes is a little confusing, especially converting between products and exactly how much is required to accomplish the goal. enzymediane.com under "emergency enzymes" states: "Pancreatin by The Vitamin Shoppe Sold at The Vitamin Shoppe. Porcine based 7-9 tablets or capsules crushed and sprinkled on the food with warm water will equal a teaspoon of Enzyme Diane® Pancreatin 6x in potency" OK. the standard dosing for "enzyme diane 6X" product (ED6X) is 1/2-1tsp per 1 cup of food (although the site says some use more and some use less). Let's say the conversion is 8 tablets per tsp ED6X and we start at the low recommendation of 1/2tsp per cup of food, that would be 4 pills per cup of food or 1 tablet per 1/4 cup of food. Seems easy enough. But when you look at the actual content of the enzymes measured in USP (the units enzymes are measured in) it would take between 12-23 tablets per tsp ED6X depending on which enzyme is used to do the conversion (protease, amylase or lipase) since they're all in different ratios between products I'm not sure which one you'd use to do the conversion. So it seems the answer is between 1 and 6 tablets per 1/4 cup of food depending on the calculation used. I think I'll just stick with the 1 tablet for now since I don't want to turn him off of it and he didn't finished eating the whole thing which is kinda strange for a ravenous cat. Maybe he's starting to actually absorb some of the nutrients and isn't feel as hungry anymore? Hard to tell. But his BG did shoot up within an hour of eating the first meal so I'll be keeping a close eye on him.

I'd be interested to hear anyones thoughts that has knowledge of EPI and/or how many enzymes they've used. There are different ways to calculate how much should be needed. I've seen sources that state exactly how much USP of enzymes is required to break down 1g of fat, 1g of protein, etc. and according to that and the fat/protein content of the food, 1/2 tablet per 1/4 cup should be more than enough to break it all down. Even 1/4 tablet may be enough. So that's a pretty broad conversion! Somewhere between 1/4 tablet to 6 tablets per 1/4 cup of food depending on your source. A little confusing. Further confounding the whole thing I've read 70% of the enzymes are destroyed in the stomach when they're needed in the intestine. So how does that play into the conversion? Guess I'm going to have to break down and use the EPI kitties group on (gasp) facebook!
 
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I ordered from Enzyme Diane too - very helpful and great service.

I never had to resort to the 'emergency enzymes'. It'll probably be a bit hard for you to gauge since you don't know his optimum dose yet.

It's been a few years for me, details are getting a little hazy. Have you come across the thread in Feline Health about Wenchie and her enzymes? I posted about about how much powder I used, how I incubated that worked for us and a better dose for Wenchie by looking at the ratios you mention
John & Henry said:
depending on which enzyme is used to do the conversion (protease, amylase or lipase) since they're all in different ratios between products I'm not sure which one you'd use to do the conversion.
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I looked at the Lipase and Protease ratios. Amylase (starch) seemed to be the highest ratio in most RX enzymes I came across - I'm guessing because EPI is (was?) more prevalent in dogs that eat more kibble.

Wenchie & her enzymes part 2
Wenchie & her enzymes part 3
 
Shelley & Jess said:
I ordered from Enzyme Diane too - very helpful and great service.

I never had to resort to the 'emergency enzymes'. It'll probably be a bit hard for you to gauge since you don't know his optimum dose yet.

It's been a few years for me, details are getting a little hazy. Have you come across the thread in Feline Health about Wenchie and her enzymes? I posted about about how much powder I used, how I incubated that worked for us and a better dose for Wenchie by looking at the ratios you mention


I looked at the Lipase and Protease ratios. Amylase (starch) seemed to be the highest ratio in most RX enzymes I came across - I'm guessing because EPI is (was?) more prevalent in dogs that eat more kibble.

Wenchie & her enzymes part 2
Wenchie & her enzymes part 3
Click to expand...
Yes, actually I had read all 3 of those threads night before last (sad ending tho:() But the chart you posted was the same one I used (and linked to in my post above) that told how much of each enzyme was needed to break down 1g of fat, 1g protein, etc. and that's how I came up with 1/2 tablet should be more than enough and really 1/4 tablet would probably work just as well. Really glad I had that info, thanks for posting it. I guess the best I can do now is wait for some poop and give it a good inspection :rolleyes:. So you only used the 1/8 tsp of the enzyme Diane per cup of food and it worked out fine? Was that your dose you used for a long time? (After you had done all your initial experiments?)

I just fed him his third meal with the 1/2 pill and he devoured the whole thing no problem. He even polished off what he hadn't eaten last night, so I guess the taste isn't bothering him too bad. I've noticed he'll drink a bunch of water right after (which I've never seen him do after he eats in the past) which is great -- get whatever enzymes are left in his mouth washed down which should help avoid any mouth injuries. I'm so glad I'm not going to have to syringe feed him or try or pill him before every meal!

Thanks for your reply Shelly. It really means a lot to hear from someone who has been there, done that.
 
Shelley & Jess said:
I ordered from Enzyme Diane too - very helpful and great service.

I never had to resort to the 'emergency enzymes'. It'll probably be a bit hard for you to gauge since you don't know his optimum dose yet.

It's been a few years for me, details are getting a little hazy. Have you come across the thread in Feline Health about Wenchie and her enzymes? I posted about about how much powder I used, how I incubated that worked for us and a better dose for Wenchie by looking at the ratios you mention


I looked at the Lipase and Protease ratios. Amylase (starch) seemed to be the highest ratio in most RX enzymes I came across - I'm guessing because EPI is (was?) more prevalent in dogs that eat more kibble.

Wenchie & her enzymes part 2
Wenchie & her enzymes part 3
Click to expand...
I wish I had never read through those threads. Very sad.
 
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