8/19 Martha FollowUp

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Hosanna

Hosanna

Member Since 2012
Martha has been doing well. Here is her recap:
This morning, BG was 229. No insulin last night!
The past 3 days of 200+ AMPS--each morning it has dropped just a little.
Remember, these are BGs with NO INSULIN the night before.
Friday--261
Saturday--245
Today--229
I really believe she is on her way! :-D
 
From the standpoint of how Lantus works best, it would make more sense to reduce Martha's dose so you can shoot twice a day. What you are doing is very hard on her pancreas and not giving it the maximum opportunity to heal. I would decrease to either 0.5u or 0.75u so you can shoot consistently.
 
looks great, and it's good to hear that her heart is doing better now too. :smile: It can be challenging to manage multiple health conditions in the same cat.

Since you have basically been giving 1 unit once a day, you might find that her numbers will level out nicely if you change to giving 0.5 units twice a day. Lantus is long-acting in cats, but rarely does it last a full 24 hours. Usually we find that giving shots every 12 hours yields much smoother results. Maybe give 0.5 units a try starting tonight or tomorrow morning?

Of my two diabetic cats, one was just diabetic and I wanted to aim for remission for her. I followed the tight regulation protocol and my goal was to get her under 120 all the time. She eventually went off insulin. My other cat had other health issues and I didn't want to push her as hard. My goal for her was to get her numbers under renal threshhold 24/7. For her, it was very obvious that she felt best when she was under 200, so that was where I tried to keep her. Martha is *almost* there and I think giving smaller shots twice a day might help her get there.

I'm so glad you reduced her dose from the 4 units!
 
One thing Sienne has said before that makes a lot of sense to me is that cat metabolism is about twice as fast as a humans. So they need 2 insulin shots per day while humans just need one.
Liz
 
I gave her 1 unit this morning and will be more than happy to split this into two shots. Thank you for that information!
My question now is: What if she tests low enough this evening not to need a shot?
This would be my understanding:
Below 175, no shot.
175-200-- .5 unit
over 200 - 1 unit.
Would I give .5 unit if she does not need a shot?
 
FOOD

Martha has not had any dry food at all for several days. I forget the last day, but it's been awhile. (Correlation between this and her good numbers? Probably, considering the importance of diet.) She has been doing well, because when she started begging for her "fix" of dry food, I'd bring out the Fancy Feast and Friskies and all the good stuff she's been denied the past few years. And she'd dig in and enjoy it and we're all better off and further down the road.
HOWEVER, today, she won't leave me alone. She is PITIFUL the way she's begging for dry food. I broke down a few hours ago and gave her 10 little pieces of 15% kibble. She acted like she'd arrived in heaven.
Any suggestions to make this easier on us all? I'm doing a lot of self-talk about how it's GOOD for her, etc. etc. :YMSIGH:
 
Here is the link to yesterday's condo. Please include that.

Martha is doing great! Dry food is addictive. It took Zener about a year to like wet food. There is a powder called Fortiflora that has the same flavoring as dry food. You can get it at the vet or at amazon.com for much cheaper. You can sprinkle it on the wet food. It has probiotics so it's actually good for the cat's digestive system. Maybe that will help Martha transition to wet feed. It's ok to give her a few pieces of kibble to help in the transition but give her as few as possible.

Martha is responding well to lantus. There is a possibility that she could go into remission and not need insulin shots. That is the objective of the tight regulation protocol. The protocol is very strict in that you need to give 2 shots, 12 hours apart, and the dosing must be consistent. You also need to test, at a minimum, 4 times per day: at the preshot and a midcycle test. If you get a pre-shot number less than 175, you should stall: don't feed and re-test in 20 mins until you get a rising number, then shoot. The next shot is 12 hours later. You can gradually move the shot back to the time that you want. This pre-shot value is gradually lowered until you are shooting green numbers. It sounds scary, but it's how you get the cat's BGs down to the normal range all the time (50-120).

I would go with the 0.5u as Sienne and Libby have suggested. They are dosing experts and give great advice.
Liz
 
Is Martha your only kitty? What I would do is take that bag of dry food and give it away or dispose of it and never look back. As long as she is eating good low carb canned food, and she's eating enough of it, you really have no use for the dry food. Even small amounts can boost her BGs. I was pretty lucky because Bob didn't really miss it when I got rid of it. Neither did Mullet, my civvie. But I'm quite certain that if I put it in a bowl right now, even after a year without it, that both of my guys would scarf it down (and Bob would probably end up needing insulin again eventually).
If you really think she just needs "crunchies" occasionally, get some good zero-carb freeze dried treats that you can give her a few of as snacks. From what I've read other people say here, as long as dry food is in the house, no matter how well you think you have it hidden, at some point, kitty will find it. It really messes up their numbers, and it seems to always happen right when they've been making real progress.

Carl
 
No, I have another kitty. He's 2 years old this week, and causes all kinds of problems with Martha and her food. Always stealing it. I can put them both down a dish of good fresh food. He sniffs his, then makes a bee line for hers. I have to stand guard till she's finished. Also have to keep her from his, because she has stolen his from time to time. (Dry)--I can't separate them, or put one away in his own room. Morelli, my guy cat, has done things like vomit underneath the door and chew/claw the carpet down to the wood. So I am having to learn how to manage the two of them and their eating.
Morelli does eat Digestive Care dry food but I've even been pulling him back off of that. I like the idea of getting every bit of dry out of the house. I have almost TONS of unopened dry food bags (prescription diet) in the house, which I plan to try to take back to PetSmart for credit.
Liz, I use Fortiflora and you're right--it does make them dig right in. My question about FortiFlora is, could it make them constipated? I notice it is primarily for diarrhea, so just wondering because they've both started heading in the direction of constipation. I give each of them 1/8th tsp Miralax daily to ward it off.
Carl, I have used the freeze dried chicken for a couple of years and they love it. I grind it up into a powder and sprinkle like FortiFlora. I have been afraid to give it as crunchies because Martha could get choked on it. There's no way she could chew it into something soft. I use the Whole Foods brand. Wish i could find a freeze dried not so hard.
 
A good no-carb treat that isn't overly crunchy is Pure Bites freeze dried shrimps (Bob's favorite). I get them at Petsmart.

Carl
 
What a little rascal! He must be adorable. :-D I would get them both off the dry food as soon as possible. It's really bad for Martha and bad for the 2 year old. Our civie Tillie eats wet food now because of Zener. She has never been healthier (12 years old). She's had itchy skin and feline acne almost her whole life and that is pretty much gone, just a little flare now and then.

How much Fortiflora do you use? Miralax is good stuff.
Liz
 
There are several brands of freeze dried chicken. Halo is one but it's pricier than others. Purebites is another brand that's available. If you are able to feed both cats the same canned food it will make your life considerably simpler. Some cats can become constipated from FortiFlora. However, if all you're using is a pinch or two (vs. an entire packet), I suspect it won't make a difference. It only takes a little bit to have the smell get a cat's interest.

We don't do a sliding scale with regard to dose -- at least not routinely. With Lantus, if you are still new and gathering data, we suggest not shooting if you have a pre-shot value of 150. We suggest you post and we can walk you through the alternatives. Libby wrote a post on how to deal with low pre-shot numbers that you may find useful. The alternatives involve skipping the shot altogether, stallling (without feeding), or shooting a reduced dose.

I think with what we're suggesting (i.e., 0.5u twice a day), Martha's numbers should be fine. If your goal is to get Martha tightly regulated or in remission, it will serve your purpose to become comfortable with shooting progressively lower numbers.
 
Getting rid of the dry food completely will help a lot. If you can get your cats eating the same food, that will make things much simpler for you. We have 4 cats, all grazers, and over the years have tried but never been able to establish feeding them different foods. Jasper is diabetic, Pixie is allergic to chicken, Pearl with bladder stones, Pepper eats all foods she can reach. Now we look for any foods they can all eat. Not a lot to choose from, but cats don't need variety and free feeding preserves peace and sanity. At first our cats rejected wet food and they have since come around. I believe the low carb wet food has helped Jasper a lot and even our vet now endorse wet food despite the possible effects on cats teeth. Of course he will provide more dental care, so win-win for all involved!
 
For Martha, you could also re-hydrate the freeze dried to make it softer for her.

My cat loves the PureBites Shrimp and I sometimes put a few in a couple of drops of water and it makes them even more attractive.

It sounds like your other cat likes Martha's canned food. You should just get them all on it for their own sake. And it would be so
much easier for you.
 
Rhiannon, they usually both eat Fancy Feast, so that's not it. They can have the very, exact food in their dishes but he high tails it to hers. I will try putting the dehydrated chicken in some water and see what happens. Will also try the shrimp.
Leslie--your Jasper looks exactly like Martha! My husband thought it was!
Liz--I just sprinkle some on top of their food. The trouble is, when that's gone, they lose interest. But Morelli has found a way to get to the Fortiflora during the night. I have NO idea how or where. I keep it in the box in an upper cabinet behind a closed door. But I'll come in in the morning and find little packages all chewed up, in numerous pieces. Morelli will "kill" for that stuff.
 
OH NO--!!!!!
Martha just tested at 291--!!!! I couldn't believe my eyes. So I again tested her, on my own meter, and it was 244 on that one. So I guess I'll have to go with 291, sticking with the same meter. She had those 10 little pieces of kibble early afternoon. But has starved ever since. And she has been hungry!
This blows all my theories! nailbite_smile
 
it might have been the kibble. Some cats are so sensitive to it that any amount is too much. Of course, it's possible that this is the effect of all the skipped shots catching up to her, or it could be some combination of the two things.

If I were you, I would shoot 0.5 units tonight, then see where that leaves her in the morning.
 
Feline diabetes is a tough disease. Cats are really hard to regulate. One thing about Lantus is the dosing is based on the nadir, not the pre-shot. So even though you got a higher than expected reading tonight, you should have shot the 0.5u as Sienne and Libby suggested. I would strongly recommend that you be prepared to test at least at +2, +4 and maybe +6 depending on the numbers. Sienne likes to point out how Gabby was 400+ at preshot one time and went to 40 in that cycle. Rupert did that recently too. Do you have plenty of strips, high carb canned food and karo/honey in case Martha decides to crash?
Liz
 
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