8/31 Ella amps 311 +3.5= 270 +5.5=245 "ticking time bomb"

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tpr

tpr

Member Since 2012
http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=78099
Hello,

We're still having network problems here. The phone call to the company has been made so hopefully we'll get a decent connection soon. I have tried posting from my smart phone but it's so frustrating as I can't type quickly on the flat screen and there are so many typos to fix that I'd rather wait until I'm on my computer.

I raised Ella to 1.50 yesterday morning and of course after I shot her it appeared that it was a breaking of the bounce day. Unfortunately I had to go to work so I couldn't get the tests I needed to see how low she got before bouncing again. I suspect she hit the blues and shot up as I was back within four hours and she was in the pinks again. She is scheduled for her dental on Wednesday so perhaps she may see some good numbers betwenn now and then. It was suuggested that I give Ella half her dose of insulin on the day of the procedure but I may not give it to her if I feel it might be a breaking of the bounce day. They will be monitroing closely but I'm worried if it is a bounce breaking day that she will dive and I'd rather not complicate matters while she's under on the surgery table.

I hope everyone has been well.
 
Re: 8/31 Ella amps 311 +3.5= 270

Hi Tamara, no wonder I have not been able to find your condo and so sorry about all the network problems. Thanks so much for all your support with Maggie. Good luck with the dosecrease for Ella. She has a nice slide and hoping for a nice surf. Have a nice day.
 
Re: 8/31 Ella amps 311 +3.5= 270 +5.5=245 "ticking time bomb

SO...the vet/dental specialist just called me, and as mentioned at our consultation, she showed Ella's file and SS to the internist that works closely with them in their practice. Both of them combed through her file and the internist feels that Ella is a ticking time bomb! :shock: They say that Ella shouldn't take this long to regulate and the internist feels that she may have smoldering pancreatitis. They believe that her pancreatitis was a combination of GI issues coupled with the Depo-shot she got for suspected allergies last December. I personally don't think she's had GI issues as the only time she's ever had diarrhea is when she's been on antibiotics and when I mentioned this to the doctor, she told me there were other times in her file when she presented with diarrhea but didn't tell me when. At the present moment Ella is eating well, pooping well and to my knowledge, isn't showing any signs of pancreatitis. I have never had an US done on her but have had the blood work done which has come back negative. They are suggesting that she would benefit from a US and a tailored treatment plan to help regulate her diabetes. This would probably involve putting her on specialized food and following their protocol. The vet mentioned that Ella would most likely be on long term pred for allergies but isn't that harmful for her liver? I feel more confused as ever as I feel she's been doing pretty well despite her high numbers. Looking at her SS, does it seem like she should have been regulated long ago? When I look at other spreadsheets, I see other cats bouncing around as well. Lately I've been increasing her dosage but her liver won't let her go below blue before bouncing. I just don't know what to think.
 
Re: 8/31 Ella amps 311 +3.5= 270 +5.5=245 "ticking time bomb

Hey, Tamara -

I don't know how long it should take to regulate a kitty. Initially, my vet asked us to bring Hershey in for an overnight stay (or two nights maybe) to start him on insulin and get him 'regulated.' As we talked, I learned that meant 300's. She didn't give me much hope of him being below the upper 200's even after some time on the insulin. As I've read more, I think we have different ideas about what 'regulated' even means.

I'm not saying you shouldn't utilize every tool to take care of Ella (US, whatever). But, you're right. Kitties are bouncing all over the place. Hershey has been on insulin since January and bounces whenever he pleases. Sometimes you have to look at the whole kitty picture and go with your gut. You love Ella and are with her day in and day out. You know her and will continue to do what's best for her.

BIG HUG -

Libby (& Hershey, too!)
 
Re: 8/31 Ella amps 311 +3.5= 270 +5.5=245 "ticking time bomb

Hi Tamara,

Racci took forever to regulate! She's pretty much regulated now. I think you would know if she had stomach issues but isn't that FPL Spec test the definitive one? I'm going to take a look at your ss. I'll be back.

Hugs,
Melanie & Racci
 
Re: 8/31 Ella amps 311 +3.5= 270 +5.5=245 "ticking time bomb

Hi Tamara, :YMHUG: :YMHUG:

I'm with Libby on wondering what the vet means by regulated. When Neko was first on Caninsulin, the vet was happy when she tested just over 10 (180 is US numbers) at nadir and thought that was good enough. Ella has seen a lot of days with much better numbers than that. You've also had occasions where you've had to lower to dose to work around school and vacation and she's gone higher as expected. Just before you went on vacation her SS was looking really pretty. As I've heard may times, it's a marathon not a sprint. And if your vet thinks Ella bounces, she should take a look at Neko's or Rupert's SS or Rosy or Mocha or .... Lots of bouncers out there. Dental issues can cause higher numbers and I've seen big changes in cats SS once that has been done.

Is Ella showing signs of allergies now? Just wondering why they think pred long term.
 
Re: 8/31 Ella amps 311 +3.5= 270 +5.5=245 "ticking time bomb

Thank you for the visits Ann, Roni and Libby :-D

I'm still struck by the words ticking time bomb! Ella is chasing a toy around as we speak! She's got energy and is licking her plate clean these days. Could she do this if she had smoldering pancreatitis?
Also, I haven't exactly followed protocol for a number of reasons (vacation, fear of her going low when I'm not home) so perhaps it's premature to say that the protocol she's currently on isn't working. I just don't know. I do believe she has allergies of some sort as she itches her eyes,nose and ears but this has been since we moved in to our new home so perhaps there is something here she is allergic of?!

Off to a freind's b-day dinner but will check back later. Turns out our connector to the cable was busted and now it is fixed..yay!
 
Re: 8/31 Ella amps 311 +3.5= 270 +5.5=245 "ticking time bomb

and thanks for the visits to Wendy and Melanie too:)

Wendy: I addressed allergies in the last post:) Thank you all for your concern :-D
 
Re: 8/31 Ella amps 311 +3.5= 270 +5.5=245 "ticking time bomb

I'd like to see Ella in less pink numbers. That said, rather than put Ella through more aggravation, there's what I'd suggest. Get the dental. Give her a month or two to see how her numbers are before you do anything else. If teeth are the issue, problem solved!

What tests were run for pancreatitis? If the vet is basing a diagnosis on amylase and lipase numbers, they are unreliable in cats for diagnosing pancreatitis. The blood test that needs to be done is a spec fPL. Getting the blood test will be far less expensive than an ultrasound. If the vet is going to run pre-dental labs, then have him send blood off for the spec fPL.

Dietary intervention for pancreatitis is "old school" thinking. It works for dogs. It's not necessary for cats. Ella is already on an insulin protocol. She's on a protocol that has research to support it. What protocol are they talking about and do they have data to indicate it's more successful than the TR Protocol you're using? Can they give you the citation in the research literature because I'll be more than happy to track it down. It doesn't matter what protocol Ella is on, she will bounce. Until she starts spending more time in lower numbers, she will bounce. Her liver needs to get comfy with blues and greens.

There are any number of cats that have been on pred for a long time for allergies, IBD, etc. I don't know if it has a long term effect on the liver. It's a good question to ask on Health. However, if Ella needs the pred to help keep her comfortable, we work her insulin dose around the steroid.
 
Re: 8/31 Ella amps 311 +3.5= 270 +5.5=245 "ticking time bomb

Tamara,

Most vets seem to think of regulated as in the yellows without bouncing. We are not satisfied with that. Most vets do not try for remission which is why they are satisfied with those numbers whereas we know it is not only possible but likely in a healthy cat treated properly from the very beginning. Our cats bounce because we push them towards remission and there is nothing wrong with bouncing. Their livers just aren't used to being in low numbers. The bounces may put them in high numbers but the reason for that is that their livers are getting used to low numbers which are normal! This is a good thing in my eyes!

I just looked over your ss and I see decreases that should not have been done and that probably slowed you down but other than that, his numbers are yellow & pink, not red and black, so not that bad. It hasn't been that long since February. It took Racci more than a year to regulate.

What does Ella eat, snacks, what is the spacing for her meals? does she drink a lot of water?There are a lot of factors that can keep her from getting regulated.

Melanie & Racci
 
Re: 8/31 Ella amps 311 +3.5= 270 +5.5=245 "ticking time bomb

I just want to throw in my two cents that mocha was never regulated UNTIL she went nearly straight into her OTJ trial .. for nearly two years we dealt with highs and lows .. and lots of frustrations .. and then one day she said, No .. I'm done with direbeasties :lol: and within a few weeks not only was she regulated, she was on trial .. not every cat get's regulated in a few weeks or a few months .. some cats are never regulated .. but so long as they are happy and healthy and well taken care of, sometimes that is the best we can do for them, you know?
 
Re: 8/31 Ella amps 311 +3.5= 270 +5.5=245 "ticking time bomb

Hi Tamara,
I fully agree with what the others have said. Bouncing is a normal part of getting better regulation. Some cats bounce for a long, long, time and they are none the worse for it. ECID. Our protocol works because it doesn't take chances and does things in small steps. It is a safe protocol.

Sienne's suggestion to have the vet send out the bloodwork to IDEXX Labs for the spec fPL at the same time that he does the pre-dental bloodwork is a great idea. That way you will know if Ella has pancreatitis, and if she does, you will know how mild or how serious it is (there is a numerical scale) (There is also an IDEXX snap fPL test for pancreatitis that vets with the IDEXX equipment can do "in house". However, this test only tells you if the cat does or does not have pancreatitis: it does not tell you how mild or serious it is. When Rusty had pancreatitis he got the snap fPL, but if he should have another flare-up I will insist on the spec fPL so that I will have a baseline number.) Since Ella is acting fine and eating fine, it doesn't seem that she has pancreatitis.

I think that Sienne's advice to have the dental surgery done and then wait until Ella's mouth heals before proceeding to a "next step", if any, is the way to go. Just my opinion, but why undertake so many procedures, strange protocols, expensive vet diets, etc. etc. all at once? There will just be too many variables to deal with.

Have a good evening and a good weekend, and try not to freak out over such un-professional "terminology" as "ticking time bomb"!! :shock:

Hugs from us,
Ella & Rusty

Hi Ella! I hope I'll see you at the Full Blue Moon Party tonight.
Rusty
 
Re: 8/31 Ella amps 311 +3.5= 270 +5.5=245 "ticking time bomb

Thanks for visiting everyone. I really appreciate all of your thoughts and encouragement on this matter. Ella has already had her blood work done for the dental, twice actually. The first one was over a month ago at my previous vet but I needed to do another one when we decided to change vets as Ella had a week where she wasn't feeling that well so they wanted to make sure she was good to go. We just did the basic test (CBC). I guess it's probably better to get the pancreatitis blood test done prior to the dental as she might be at risk when she's under?! I feel so poorly for Ella. She's been back and fourth to three different vets in the last month being poked and prodded.
Ella, I don't think highly of the term either and although I appreciate honesty, there are much more sensitive ways that information could be shared with a caregiver. Perhaps there is something going on that needs to be addressed but I feel so anxious about things now.
I will be writing an email to the vet outlining a few of my concerns and then proceed from there. Paws crossed that Ella is alright.
 
Re: 8/31 Ella amps 311 +3.5= 270 +5.5=245 "ticking time bomb

Tamara, I agree with Sienne. Get the dental and see what happens. Zener's numbers got a LOT better after his dental and I know others have said the same thing. I also agree with Ella (the bean): very unprofessional teminology. Around here, the bean usually has a strong suspicion that something is not quite right with the cat, because we watch them so closely. I am skeptical that the vet knows Ella better than you.
Liz
ETA: Your profile link didn't work for me.
 
Re: 8/31 Ella amps 311 +3.5= 270 +5.5=245 "ticking time bomb

marje did some research on the Spec fPL test and i think it was Texas A & M told her that the cat has to fast for an accurate test. punkin hadn't fasted when he got tested, but i do think he had pancreatitis. it's not unreasonable to test her - it does sound like there is some possibility that diabetic cats can have chronic pancreatitis and that can affect them getting regulated. dental issues can also affect it.

i think the bouncing is normal. my experience is that vets are looking for cats to be around 200 and are very content with that. personally, i'd pass on those particular concerns - can't imagine what plan they've got that's going to make ella stop bouncing. we have a ton of experience here and if there was another plan besides following the protocol, no one would be hiding it. i like sienne's suggestions about getting the dental done and seeing if it makes a difference. i'd get the spec fPL test done when she's going under for the dental - that way she'll have fasted and you'll have an accurate result.

getting the dental done will give you some information. either it will help or it won't. getting the spec fPL test done will also give you information. then you'll be able to consider how you want to proceed.
 
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