8/19 Freya, struggling to get her regulated

[Tim & Freya]

Previous Thread

I know it numbers can be a bit wonky at first when starting treatment, but I feel like something's not right with how things are going. Last week with her vet, we upped her dose to 1.5U. Next day she went from 368 AMPS down to a 161 nadir at +6 and I thought we were going to finally start seeing progress. However, the last few days her numbers actually have been going up through +6 after her dose. She's almost never below a 200 reading. She also started drinking more water and she's having incontinence again, which she hadn't had since we first started insulin. I'll be taking her into the vet again to check for a UTI (they're probably sick of seeing me so often at this point).

I'm not sure if we need to start being more aggressive with her treatment or keep hoping it starts to kick in better. The other issue is she's still not eating very much. I've been trying every single low-carb wet food I can and the best we usually get is a few licks/nibbles and she'll walk away. I'm avoiding giving her the old higher carb food as much as I can, but I can't have her eating nothing at all since that'll be even worse.

 

[Staci & Ivy]

Previous Thread

I know it numbers can be a bit wonky at first when starting treatment, but I feel like something's not right with how things are going. Last week with her vet, we upped her dose to 1.5U. Next day she went from 368 AMPS down to a 161 nadir at +6 and I thought we were going to finally start seeing progress. However, the last few days her numbers actually have been going up through +6 after her dose. She's almost never below a 200 reading. She also started drinking more water and she's having incontinence again, which she hadn't had since we first started insulin. I'll be taking her into the vet again to check for a UTI (they're probably sick of seeing me so often at this point).

I'm not sure if we need to start being more aggressive with her treatment or keep hoping it starts to kick in better. The other issue is she's still not eating very much. I've been trying every single low-carb wet food I can and the best we usually get is a few licks/nibbles and she'll walk away. I'm avoiding giving her the old higher carb food as much as I can, but I can't have her eating nothing at all since that'll be even worse.

Hi Tim, I know all of this is so new and we want instant changes and regulation. But the reality is Freya was probably diabetic before you even knew she was (same iwth all of our cats).
So it takes time to have their systems get used to changes and using insulin to help with their glucose.
Think of this process as a marathon (slow) and not a sprint (fast). You will see that mentioned a lot around here as it's very true.

We come here expecting quick changes and course correction. Some kitties respond rather quickly, while others take more time.
We have to be patient, as hard as it is for us!

You've only been at this about one month. And it feels like forever.

If you want to switch to TR (tight regulation) you can think about that but you need to be able to monitor her and (does she eat wet food only as that's a requirement) get a few more tests each day.
With TR you can give increases faster than with SLGS, but again, you must be able to monitor her.

Just some things to think about. Let is know if you have more questions.
More info on Tight Regulation below in the link:

Sticky - Dosing Methods: Start Low, Go Slow (SLGS) & Tight Regulation (TR)

 

[Wendy&Neko]

Staci is right, this is still very early in Freya's journey. Her body had to learn how to use this new hormone (glargine insulin) and it does take some time.

One thing I'd recommend strongly, is adding a second test in the PM cycle, at least 2-3 hours after the PM shot. Cats often go lower at night and we determine how to change the dose based on how low the dose is taking the cat. It is possible she is going lower at night, then bouncing during the day. Also, with our dosing methods, and especially since you did see some numbers under 200 on 1.0 units, we would have had you increase to 1.25 units, not 1.5.

her numbers actually have been going up through +6 after her dose.

Yes, probably bouncing.

What food are you feeding now? Just wondering if we can give you some ideas of other foods to try. What was she eating before her diabetes diagnosis?

 

[Tim & Freya]

Staci is right, this is still very early in Freya's journey. Her body had to learn how to use this new hormone (glargine insulin) and it does take some time.

One thing I'd recommend strongly, is adding a second test in the PM cycle, at least 2-3 hours after the PM shot. Cats often go lower at night and we determine how to change the dose based on how low the dose is taking the cat. It is possible she is going lower at night, then bouncing during the day. Also, with our dosing methods, and especially since you did see some numbers under 200 on 1.0 units, we would have had you increase to 1.25 units, not 1.5.


Yes, probably bouncing.

What food are you feeding now? Just wondering if we can give you some ideas of other foods to try. What was she eating before her diabetes diagnosis?

I'm usually asleep for testing after the PM shot, but I should be able to do the +2 at least. When I had the libre on she was usually higher during the night than during the day.

Before the diagnosis, it was primarily the Fancy Feast Gravy Lovers (non-pate) and the Creamy Delights Chicken/Tuna. I've got the pate version of the Gravy Lovers now and she'll sometimes eat a bit of it at least. Tried all of the FF classic pates, FF flaked, Friskies pates, various Weruva/Tiki Cat that are lower carb and she turns her nose up at them all.

I'm also leaving out the Dr Elsey's CleanProtein dry food, she will eat some of that, but I don't think she loves it either.

She may very well have had diabetes longer than known. She stopped jumping up on the couch maybe 6 months ago and climbs up now instead. The vet at the time thought it was arthritis, and she did have full bloodwork done that was all normal.

Ketone tests seem ok yesterday, so I don't think she's got DKA at least. I'm just worried we're sliding backwards with the incontinence. Need to catch a sample for the vet tomorrow just to be sure no UTI.