8/28 Mačka AMPS 741 +3 621 +6 436 +10 566 :(

Just to give you some perspective, Sebastian is at 7u right now. So 2.75u isn't really that bad. And yeah the BG numbers are really high but I see that you're also checking ketones so as long as those are staying negative, it's not the end of the world. As far as I can tell, you're doing a great job. You're getting a lot of readings, feeding LC wet food, making a ton of notes on food, behavior, litter box. All really good stuff. Just keep doing what you're doing and stick to the TR guide. Looks like he's coming off an infection too and that'll bump the BG up and there's not a lot you can do except wait it out.

I see you're back up on the dosage after the vet suggested a decrease. Personally I wouldn't decrease unless you actually earn the reduction, regardless of what the vet says. Yeah, BG might drop once the infection clears and you get low and need to steer back up with some high carb food, but the alternative is the BG doesn't drop and you've set back your dosing progress.
 
Justin & Sebastian said:
Don't be discouraged by that, it happens. The only way the higher BG would be the result of a higher dose is if the dose was bringing the BG low enough to trigger a bounce and it doesn't look like that's what is happening here.
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Thank you so much for your words. He's been high for so long that even a purple triggers a bounce now I believe. I think that yesterday he went into high yellows (but I missed it), which could explain a bounce, maybe?
 
Have they checked for pancreatitis?
Penelope and Mačka said:
He's been high for so long that even a purple triggers a bounce now I believe. I think that yesterday he went into high yellows (but I missed it), which could explain a bounce, maybe?
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It's tough to say. As far as I know we still don't have really good research on what triggers the bounce, at least I haven't seen any. It is entirely possible that even dipping down to the yellows would cause it, since that's not a "normal" number. Like when that happened on 8/24, that was a 300 point drop from the AMPS which is a lot.

Now that you mention though, I can see a case for it being bouncing. The low 300s that you're hitting could be the trigger, since he seems to shoot right up afterwards and that would explain the increased number of blacks. In any case it doesn't really change the treatment plan that much. Only thing you might want to adjust is how quickly you increase the dose but it looks like you're already at about an 8 cycle interval which I would say is pretty good. He'll eventually get used to the lower numbers and bounce less. It's very hectic, believe me I know, Sebastian loves to bounce, but like I said it looks like you're doing great so just keep on with it and you'll make the breakthrough eventually.
 
Penelope, don't get discouraged remember its a marathon not a sprint. I know how hard it is to see all of those reds and blacks but you will get there. I've read somewhere here that steroids can affect BG negatively so you may see a difference once you have tapered off of those. Be ready though as if he's clearing a bounce and steroid use you may see an significant drop in BG.

It takes time and patience really... so deep breath and chin up.:bighug::bighug::bighug::bighug::bighug:a few encouraging hugs from me to you.
 
Penelope and Mačka said:
I know! The problem is, we’re leavjng town soon and I really don’t want any drop to happen while the pet sitter is here!!
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Are you able to get a trained tech to stop by? We've got a cruise planned for December and that's what we wound up setting up. We'll have someone here 24/7 for normal pet sitting, doing the food and litter and just generally keeping an eye out, but then we've got one of our vet techs stopping by twice a day to give the insulin and take some readings.
 
Justin & Sebastian said:
Have they checked for pancreatitis?
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Not recently, last time was 1 month ago and his levels were fine.
Justin & Sebastian said:
Are you able to get a trained tech to stop by? We've got a cruise planned for December and that's what we wound up setting up. We'll have someone here 24/7 for normal pet sitting, doing the food and litter and just generally keeping an eye out, but then we've got one of our vet techs stopping by twice a day to give the insulin and take some readings.
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The pet sitter is a professional (that's her business), and she was recommended to me by my vet tech, saying she would trust her with her own cats. She knows how to give insulin (had a diabetic cat before) but not BG tests (I know, crazy), which I can show her.
I believe she has the resources in case anything happens, since it's her business to sit pets. She also has training in pet CPR or something like that.
But of course, I am ultra worried since it will be the first time we're leaving, since Macka's diabetes. He used to stay outdoor for days, with a little bed in the garage, and neighbors feeding him x2 day, when we would go on holidays. What a change! Now I'm scared of leaving him one hour.
 
Never lose Hope! Take a look at my Ravan's SS from 2018 I think we all go thru the miserable Red & black #'s. Just have Patience. It will get better.

Why was Macka taking steroids? That can affect his readings. Steroids can cause a spike in blood sugar levels. Prednisone and other steroids can cause a spike in blood sugar levels by making the liver resistant to insulin.Mar 28, 2019

Once he gets off the steroids his BG should come down.
images
 
+6 436, either a curve (high but still), or clearing a bounce perhaps?
JoyBee&Ravan said:
Why was Macka taking steroids? That can affect his readings. Steroids can cause a spike in blood sugar levels. Prednisone and other steroids can cause a spike in blood sugar levels by making the liver resistant to insulin
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He was taking steroids because vet though he had IBD or small cell lymphoma. She saw a thickened small intestine on the ultra sounds. So she put him on Budosenide right away. I was told that budosenide doesn't pass through the liver and as such, his BG shouldn't spike. But honestly, who knows? I decided to stop them gradually because apart from that ultrasound, he NEVER had IBD symptoms in his life. I don't like the idea of Macka taking so many medications, and I want to protect his kidneys as much as I can. When she told me that he would take these steroids for life, I got nervous. Honestly, he wasn't eating and had nausea and diarrhea recently because of UTI, pancreatitis, DKA (all in the same week of course). So we're giving it a try. I give him probiotics, bone broth, raw now and feel like he's already looking better despite the high numbers.
 
I know these high numbers are frustrating, but remember Macka is more than his numbers. How is he feeling?

Cats can bounce from getting into numbers lower than they are used to, which can include pink. Hang in there.
 
Penelope and Mačka said:
budosenide doesn't pass through the liver and as such
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This info is from a Veterinary Web site. You can read more https://veterinarypartner.vin.com/default.aspx?pid=19239&catId=102894&id=4952315


Budesonide is a strong corticosteroid, about fifteen times stronger than prednisone. This means that even the minimal amount that does get absorbed can be significant.Experience with this drug in small animals is still limited.
Budesonide is absorbed from the intestine but removed virtually immediately by the liver.
 
Glucose toxicity is a bear. What I said last time
2.75 wasn’t enough before hand, so you will probably need to increase beyond that.
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You have been keeping Macka in high numbers for a very long time, his body is used to it. He needs more insulin.

And yes, cats can bounce from yellows if they aren't used to it. The good news is that you can increase tomorrow night. If he doesn't see any yellow before then, you could increase by 0.5 units. That's what I would do. Those ugly high numbers are hurting him.

The majority of cats here who took budesonide, including my Neko, did not see an impact on blood sugar. And yes, budesonide is stronger, that's why you have a much smaller dose of it. It was a teeny, tiny pill. More to the point, when Macka started budesonide on 7/23, I do not see any significant change on his spreadsheet. I don't expect you'll see any significant change when you stop them. He just plain needs more insulin.
 
JoyBee&Ravan said:
This info is from a Veterinary Web site. You can read more https://veterinarypartner.vin.com/default.aspx?pid=19239&catId=102894&id=4952315


Budesonide is a strong corticosteroid, about fifteen times stronger than prednisone. This means that even the minimal amount that does get absorbed can be significant.Experience with this drug in small animals is still limited.
Budesonide is absorbed from the intestine but removed virtually immediately by the liver.
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Thanks for sharing, yes, that's exactly why he needs to get off this steroids. I can't say ASAP, because it has to be very gradual . :(

I hope to see better colors once he's off. I can't believe I let her give him steroids, even though I asked about diabetes etc!!!!
 
Wendy&Neko said:
And yes, cats can bounce from yellows if they aren't used to it. The good news is that you can increase tomorrow night. If he doesn't see any yellow before then, you could increase by 0.5 units. That's what I would do. Those ugly high numbers are hurting him.
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He likes to bounce for sure. I don't know if I'm ready to increase by 0.5, right before we leave town.
Wendy&Neko said:
The majority of cats here who took budesonide, including my Neko, did not see an impact on blood sugar. And yes, budesonide is stronger, that's why you have a much smaller dose of it.
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Wendy, do you know a good method to wean him off? The vet told me to cut his dose (0.5ml) in half (0.25) for then days. Then stop. When researching online, I read that Budosenide should be tapered very gradually, over 8-12 weeks. So I decided to cut the pear in half (French expression), and presently reducing by a 1/4 every week.

Edit: Sorry if I am repeating myself, maybe you already answered that question before, my apologies!
 
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Hi there! You have a week before you leave according to the SS. I would give an increase as he needs more insulin.

Is the pet sitter only coming in twice a day to test, feed ,and shoot? At this point, there is a lot of wiggle room for more insulin and you can reduce a bit before you leave for a vacation dose ( 4 cycles before). But until then, I would want to get him out of these blacks and reds.

And yes, that yellow could be enough to bounce him up.
 
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Bobbie And Bubba said:
Hi there! You have a week before you leave according to the SS. I would give an increase as he needs more insulin.

Is the pet sitter only coming in twice a day to test, feed ,and shoot? At this point, there is a lot of wiggle room for more insulin and you can reduce a bit before you leave for a vacation dose . 4 cycles before). But until then, I would want to get him out of these blacks and reds.

And yes, that yellow could be enough to bounce him up.
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She's going to stay at night, but I believe she has to go see other cats during the day. I have to teach her how to test though.
 
Penelope and Mačka said:
Wendy, do you know a good method to wean him off?
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Follow the guidelines your vet gave you, that is the safest method. Do not create your own method to wean him off. Listen to your vet, not Dr. Google.
Penelope and Mačka said:
I can't believe I let her give him steroids, even though I asked about diabetes etc!!!!
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Sometimes cats get conditions that require steroids, in order to save their life or improve quality of life. Budesonide is a much better option than prednisolone and it did not seem to impact his blood sugar. Your vet did the right thing. As much as I dislike steroids, there is a place for them. If the steroid impacts the blood sugar, and prednisolone does, then you just work the dose around the steroid. If a cat has thickened bowels from either IBD or small cell lymphoma, they should get some treatment or it will just get worse. Fortunately kitties with IBD can really be helped with the appropriate diet. Moving to raw food was a good idea if Macka has IBD. Probiotics will also help.
 
Bobbie And Bubba said:
Do you have an auto feeder that she can use to help steer him?
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Yes! but I also have another cat.... and millions of ants, so the auto-feeder didn't do too well in this house :facepalm:
A moat with water and ice in a plate works better than the feeder, if the other cat is locked with us in the bedroom. I just don't know how it will go with the pet sitter... those two cats just do NOT get along.
 
Penelope and Mačka said:
Yes! but I also have another cat.... and millions of ants, so the auto-feeder didn't do too well in this house :facepalm:
A moat with water and ice in a plate works better than the feeder, if the other cat is locked with us in the bedroom. I just don't know how it will go with the pet sitter... those two cats just do NOT get along.
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Have you tried sitting the feeder on a large baking tray with water ? We had ant issue one summer too and did that and it helped, the ants drowned in the water moat.
 
Regarding the needed dose increase - if Macka went too low on any dose you give before leaving town, you would still have time to decrease before leaving, with no risk of the previous higher dose causing a low.
Does that make sense?!
 
Tina Marie and Jan said:
So many people want Macka in healthier numbers, and we need you to trust this system and the educated volunteers who are trying to help. Relax girl:). You came here to get help, and you have it:bighug::bighug::bighug:
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Thank you!!! If I hadn't this trip coming up, I'd be less concerned, as I'm slowly getting used to the new life and pace (there's tons of room for improvement though).
I study hard other cats' spreadsheets everyday and can see that this forum helped hundreds of them go into remission, it's impressive, fabulous and hopeful.
All I want is the same for Macka. I'm always second guessing myself because of my past with my other babies and things I feel guilty about and should have done better. I lost confidence. Sorry if I drive you all crazy here! I drive my husband crazy already :p
 
Just for some more perspective, someone told me that they've never seen a hypo event in all the years the board has been active. Not to downplay the seriousness of it, because it is life threatening if it does happen, but the amount of attention and info that's given about it is maybe a bit disproportional to the likelihood of it actually happening. I think you've got plenty of time to figure out an appropriate dose before you leave and even if there are a couple low dips, and keep in mind the bounce is the body's natural defense against hypo so it's not like you're flying without a net.
 
Justin & Sebastian said:
Just for some more perspective, someone told me that they've never seen a hypo event in all the years the board has been active. Not to downplay the seriousness of it, because it is life threatening if it does happen, but the amount of attention and info that's given about it is maybe a bit disproportional to the likelihood of it actually happening. I think you've got plenty of time to figure out an appropriate dose before you leave and even if there are a couple low dips, and keep in mind the bounce is the body's natural defense against hypo so it's not like you're flying without a net.
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Thank you Justin for your wise words and for reassuring me. You're right, there were hypos, but not seizures if I remember what Jill told me the other day.
 
Penelope and Mačka said:
He likes to bounce for sure. I don't know if I'm ready to increase by 0.5, right before we leave town.
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Maybe you could try to think of it this way... you still have time to make some progress before you leave! :)

Anecdotally... I accidentally increased from 1 unit straight to 1.5 units back on 7/30 and in retrospect I'm glad I did it (although I was mortified when I figured out my mistake... I was sleep deprived :facepalm:). Figaro was in pink, red, and black numbers at the time and he still needed several increases after that. I feel like I got a bit of a jumpstart.. maybe from my subconscious mind... :p
 
Figaro's Liz said:
Maybe you could try to think of it this way... you still have time to make some progress before you leave! :)

Anecdotally... I accidentally increased from 1 unit straight to 1.5 units back on 7/30 and in retrospect I'm glad I did it (although I was mortified when I figured out my mistake... I was sleep deprived :facepalm:). Figaro was in pink, red, and black numbers at the time and he still needed several increases after that. I feel like I got a bit of a jumpstart.. maybe from my subconscious mind... :p
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Oh yes I remember! You helped him break a bounce too! Figaro is looking VERY good these days, even better with the human meter. I'm so happy for you :cat: What's the next move?
 
Penelope and Mačka said:
Oh yes I remember! You helped him break a bounce too! Figaro is looking VERY good these days, even better with the human meter. I'm so happy for you :cat: What's the next move?
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Thank you!! The human meter does help the numbers, and it also makes me feel less confused about what to do. It is still a roller-coaster emotionally (I worry a lot also!), but I am starting to feel more in control. I had to be brave and keep increasing, as you are doing now... I know how hard that is... and I may well need to increase Fig's dose again at some point, maybe even soon! But I'm trying to take it one day at a time.. I'll see what happens tonight and tomorrow, then decide. :) :bighug:
 
I completely understand being nervous about leaving Macka, I was a nervous wreck about having to leave Scooter last fall, but he did just fine.

I agree with everyone else about continuing to stick with TR and increase him accordingly. I started on SLGS, but got nowhere. When I changed to TR I started to see some progress. Scooter was up to 9.5 units before we “broke through” and earned a reducie. He is now down to 1.25!
 
Jill & Scooter said:
I completely understand being nervous about leaving Macka, I was a nervous wreck about having to leave Scooter last fall, but he did just fine.

I agree with everyone else about continuing to stick with TR and increase him accordingly. I started on SLGS, but got nowhere. When I changed to TR I started to see some progress. Scooter was up to 9.5 units before we “broke through” and earned a reducie. He is now down to 1.25!
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Wow @Jill & Scooter, Scooter's journey is incredible! Another inspiring kitty... :) You test a lot during the night, how can you sustain such a pace with life, work, etc?
 
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