7/8 Henry WC. AMPS 270 +2 275 +4 132 +5 86 +8 345 +11 293 PMPS 238 +4 190 +5.5 68

John & Henry

Member Since 2022
previous: https://felinediabetes.com/FDMB/thr...53-6-5-75-7-5-80-8-63-9-5-37-pmps-144.265524/

Henry spent last cycle in the yellow/pink but has came down again to the greens again this afternoon. The libre alarm went off alerting me he had hit 70 and he was ravenously hungry and scarfed down about 3/4 cups of enzymed food. I'm starting to wonder how well the enzyme pills work vs mixing it in the food. I did the pills on Wednesday and Thursday and last night I wasn't impressed with the color of his poos. They certainly look better than they did, but the color is lighter than I would like, so last night we went back to putting the enzymes in the food instead of using the gel caps.

I wonder what his numbers have in store for us today. I'm going to surmise based on what we've seen with the last 5 cycles we'll see a bunch of green again today. All the good numbers recently make me wonder if now that he's getting nutrients into his system if that isn't somehow starting to get the diabetes under control? It's gotta be hard for a system (body) to function properly with the correct raw materials.

I've been reading academic research papers about EPI and it's extremely rare in cats. So rare there have only ever been about a dozen papers written on the topic and half of those were written in the last 10 years. Just to give you an idea, from March 2008 to January 2010 TAMU (afaik, the only lab to perform EPI testing) received serum from 46,529 cats of which 1,095 tested positive for EPI (2.4%). With an estimated 95 million cats in the US that would mean about .00057% test positive per year. Now granted the number is much higher than that as not everyone will have their cat tested or even be suspected by a vet. But even if the number is 100 times larger, that's still only a .057% chance of getting EPI in any given year. I'm thinking about making a post on the feline health board with everything I've learned so far for when this happens to someone else.

I'm not sure if it's just wishful thinking, but I almost think I can feel a little bit more meat between his ribs than a week ago.
 
Be careful about reading older research papers. It used to be acromegaly was so rare that most vets were taught "this is acromegaly, you will never see it". A 2015 study on a large number of diabetic cats found it was more like 1 in 4 diabetic cats. Just saying that because we have seen EPI cats here. A lot of the blood sent to TAMU is for full panel GI blood work to test B12, folate, or SpecfPL levels too. The more interesting question is "of blood work sent specifically to test for EPI, how many were positive". The person who wrote the article on EPI on the IBD Kitties website has had 4 cats with EPI. Seems like she'd have to have had a huge amount of cats to get 4 positive according the rate you quoted.

Reducing systemic inflammation or issues with the system is going to reduce insulin resistance. I hope the next weigh in gives happy news.
 
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The person who wrote the article on EPI on the IBD Kitties website has had 4 cats with IBD.
I think you meant to type EPI instead of IBD? If that's the case, it's pretty crazy one person would have 4 cats with it! (edit: Just remembered I've read all the EPI information on IBD kitties, so I'm pretty sure you meant EPI. Makes me wonder if there isn't some environmental factor causing it in this case. That's some pretty crazy luck to get 4 EPI kitties)

Maybe a lot of the low numbers is from under diagnosing due to lack of suspicion on the part of the clinician. The paper (Xenoulis, et al., 2016) I've been referencing did state that since many of the symptoms were non-specific (diarrhea, increased appetite, lethargy, weight loss, poor coat) and don't always hold to a specific pattern which was once thought to be required to consider EPI (yellow diarrhea, mid to old age) it just isn't being considered very frequently by vets resulting in the low numbers of diagnosis.

The number of diagnosis is certainly on the rise. This 2014 paper from Steiner, et al. points out the sharp increase in the number of diagnosis:

Disorders of the exocrine pancreas, and especially EPI, have traditionally been thought to occur less frequently in the cat than in dogs or humans. However, since the introduction of a new assay for the diagnosis of feline EPI, feline trypsin-like immunoreactivity (fTLI) in 1995, feline EPI is now diagnosed much more frequently than before. For example, of 180,648 cats entered into the Veterinary Medical Databases (VMDB), then at Purdue University, over a ten year period (from the early eighties to the early nineties), only 11 of those cats (0.006%) were reported to have been diagnosed with exocrine pancreatic insufficiency. In sharp contrast, in 2010, 775 cats were diagnosed with EPI through a severely decreased serum fTLI concentration measured at the GI Lab at Texas A&M University. This was up from 476 in 2008, 225 in 2004, and 23 cats in 2002. These data clearly show that EPI occurs with considerable frequency in cats, and also point to the fact that the recognition of EPI is still increasing.​

Reducing systemic inflammation or issues with the system is going to reduce insulin resistance. I hope the next weigh in gives happy news.

Me too! I'm counting the days til the next weigh in.
 
Uh oh, I think I made a mistake. I got this "Go! Solutions" limited ingredient duck pate which I swear I thought was low carb, but after feeding him half a cups worth (and him eating the whole thing) his BG rocketed from 70 to 345 (and rising still), which made me go back and look up the carb count. Their website lists the carbs in 4 different places as 24%, 24%, 7% and 31%:

go-duck-pate.jpg


Well, looks like I finally found a good HC novel protein which I've been on the lookout for. He ate another 6.3oz of this last night in 2 different sittings, so I'm guessing this may be responsible for last nights pinks/reds too. Ugh. Live and learn I guess..
 

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Have to say, yours is the coolest looking SS I've seen! I can't even focus on his numbers because I get caught up in the artistry. And those icons are just so darn cute! Hoping he works his way back to the green. :cat::D:cat:
 
Have to say, yours is the coolest looking SS I've seen! I can't even focus on his numbers because I get caught up in the artistry. And those icons are just so darn cute! Hoping he works his way back to the green. :cat::D:cat:
haha. Thanks! I wondered if other people did that too. I figured I needed to keep track of how often he was eating (and how much -- if he eats a lot he gets the double burger emoji). I figured, why not a little honey emoji for the syrup. Took me a little bit to figure out how to make them bigger than the text in the rest of the cell so you could actually tell what they were. I figured the icons would be easier to visualize when things happened rather than just putting it in the comments. That HC food rocket sent him up to 365, but he's on his way back down now. Hopefully in the next couple hours he'll be back in the blues or greens.
 
Nope, meant what I said. The ibdkitties website article on EPI.https://www.ibdkitties.net/epi/

I think the high numbers are from bouncing, not the food. The good news is he's getting over the bounces quickly. As for the Go Duck pate, we want %calories from carbs, not the straight %carbs. Information on how to calculate is here: Calculating % Calories from Carbohydrates
I get that you meant ibdkitties website and I've read the article but you said:
The person who wrote the article on EPI on the IBD Kitties website has had 4 cats with IBD. Seems like she'd have to have had a huge amount of cats to get 4 positive according the rate you quoted.
The article about EPI on ibdkitties talks about the 4 cats she's had that EPI, not IBD. Unless they had both and that's what you meant.

edit: Thanks for the link on calculating calories from carbs. I'll read up
 
Well here we go again. Hypo incoming. Libre alarm just went off at 68 (probably lower on the nova).

While I can't be sure the 1/2 cup of 24% food I accidentally gave him at AMPS +5 was responsible for the meteoric rise and fall, it circumstantially looks that way on the graph from the libre: (you can even see the little bump he got from some LC @ ~11pm)

Screenshot_20220709-015657.jpg

(this picture was taken about an hour ago before he hit the 68)

He just had a small snack hopefully that will bring it up a bit. Waiting for the enzymes to incubate to give him a meal.

edit: Just gave him his meal. Last libre reading before meal was 63

edit2: It's been 2 hours since the 63 and his meal. Right now at PMPS +6.75 we're going sideways at 91. Paws crossed we don't get a drop and I get to sleep for awhile
 

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