9/5 - Alphyne - AMPS @ 348, +3 @ 316, +6 @ 382 - curve day

[bobjoh]

(previous) 8/31 - Alphyne - PMPS @ 405; +3 @ 286; +6 @ 227 - no pattern? | Feline Diabetes Message Board - FDMB

Well, sadly, Alphyne didn't come out of the last bounce. She's still on her upward trend, so today is curve day. Based on the +3, I can already tell she's going to need an increase. Boo!

This will be the first time I've done an 18 hour curve; I thought I'd try it this time, in case it shows me something the 12 hour curve didn't, but it looks like I'm going to get the same results regardless.

I hope everyone has a nice Sunday!

 

[Wendy&Neko]

Ugh! Looks like a little bit of a bounce today. I suspect your guess on the curve results and increase is right.

 

[bobjoh]

Ugh! I suspect your guess on the curve results and increase is right.

My poor girl. I'm still suspecting something underlying...her numbers weren't even this high (consistently) back when we started insulin in January. She was doing so good until April, and then BANG...numbers just keep increasing.

I love my home state, but HATE the lack of services and specialists we have here. Hard to get a definitive diagnosis when none of the vets can do any of the tests.

Hopefully an increased dose can at least get her in the 200s. Fingers crossed!

 

[Wendy&Neko]

When was the last time she was in at the vet? You could always get a senior panel blood work and have the vet look in her mouth at her teeth. Anything besides the higher numbers making you suspicious? Hmm, I see frequent vomiting list on the spreadsheet. An ultrasound might be worth it too. If they can't do that, add a GI panel to the blood work, to test for B12 and folate. Some places (like my vet) have a roving ultrasound vet specialist that comes into the clinic periodically.

 

[bobjoh]

When was the last time she was in at the vet?

She's been in a lot recently. I forgot to add her latest labs (blood and urine) to my spreadsheet, but I just did.

The pottying outside the box was the first clue something else was going on, but that seems to have 'mostly' resolved with the diet change and the famotadine. My vet keeps saying the vomiting could be related to the higher glucose numbers, and that's true, but it never happened before, so my gut tells me that's not it.

The numbers in the Google sheet for labs are a bit different than my vet ranges, but beside the glucose, everything was pretty normal. She was due for a dental; she has light tartar, nothing concerning (per the vet), but of course they don't want to do the dental until her numbers are stable. I made the appointment in April when she was doing so well, and we've cancelled it twice since then. I try to get my cats in every 3-5 years, unless they have something obvious needing to be taken care of. All of their visits have been a standard light cleaning, nothing else has needed to be done.

I think the GI panel is a good idea. We did that for Gryphen and that's how we found her IBD. Bad part is they want the cat to fast for 10 hours, and that's almost impossible with a diabetic cat. I'll have to see what the other options are.

When she was in and got the Cerenia injection in July, the vet (on call) thought she noticed some thickening in the intestinal walls, and that's when she mentioned the C word. However, my regular vet is hesitant to do the ultrasound, since she doesn't feel she will be able to 'see' anything unless it's really obvious, like a tumor or something. We do not have any specialists or travelers here. My vet office is building a new facility and hopes to bring in a traveling cardiac specialist on occasion, but that's for the future, and doesn't help my girls, anyway.

Thanks for the ideas; I'll see about getting some of those things scheduled!

 

[Wendy&Neko]

For Neko's GI panel, we didn't fast quite as long as they wanted. I got the last appointment of the day, so still had 6 hours of fasting.

As for ultrasound, you really do want a specialist to do it, sorry you don't have one nearby. Have you tried Alphyne on a novel protein diet to see if that makes a difference? Fatomadine usually isn't a good solution for cats with GI issues. A good probiotic like Proviable or Visbiome might help. Vomiting as much as she does is not due to high blood sugar.

A lot of the blood work does look better.

 

[bobjoh]

Fatomadine usually isn't a good solution for cats with GI issues. A good probiotic like Proviable or Visbiome might help. Vomiting as much as she does is not due to high blood sugar.

I have both her and Gryphen on FortiFlora. The vet nutrition specialist at the U of M recommended it when we switched Gryphen to the specialized renal food, because it's hydrolyzed. Luckily, they both also like the way it smells/tastes, so that helps.

I'll ask about the Proviable for Alphyne, in case it's a better fit. I'll also ask about the novel protein diet. We were thinking of going that route with Gryphen originally, but the U of M vet nixed it, as she said most commercial novel protein diets are contaminated (and Gryphen hates people food).

I'll ask again about the famotadine, too. It was supposed to be a temporary thing, for both her and Gryphen, and I'm to wean them both off of it when they stop throwing up for a week or so. Sadly, we've never been able to get to a week for either of them, so I have to keep filling the prescription.

Thanks again, so much, for the suggestions. I wish pets could talk, and tell us how they are feeling. It's such a guessing game, especially with limited vet resources.

Appreciate the assistance!!

 

[Wendy&Neko]

Fortiflora's not a great probiotic, it's only one strain. More useful as a flavour enhancer than as a probiotic.

she said most commercial novel protein diets are contaminated

I wonder what she means by that? Perhaps she gets more profit from selling vet food? I think there would be a lot of press if commercial foods were in fact "contaminated". I have an IBD kitty doing just fine on commercially available novel protein. Hydrolyzed food tends to be high in carbs.

You don't need a prescription for fatomadine - regular Pepcid AC will do. See here for more details.

 

[bobjoh]

Fortiflora's not a great probiotic, it's only one strain. More useful as a flavour enhancer than as a probiotic.

I wonder what she means by that? Perhaps she gets more profit from selling vet food? I think there would be a lot of press if commercial foods were in fact "contaminated". I have an IBD kitty doing just fine on commercially available novel protein. Hydrolyzed food tends to be high in carbs.

You don't need a prescription for fatomadine - regular Pepcid AC will do. See here for more details.

Proviable was discussed prior to the U of M consult, but it contains maltodextrin, which the U of M vet said isn't ideal for a diabetic cat. But the kicker was the FortiFlora being hydrolyzed. Gryphen needed that. The renal/hydrolyzed food Gryphen is on is higher in carbs, but her BG remains stable at about 125-135 on the AlphaTrak. That's about 90-95 on the human meter (as far as I could tell from running side by side tests). Getting her tummy under control was the key with her. I'd like her BG to be lower, but it's in the normal range, and too low for insulin. Since she has diabetes, CKD, IBD, and food sensitivities, I'm counting my blessings that anything is working.

The U of M vet wanted to try a homemade diet, but like I said, Gryphen hates people food. I was trying Dr. Elsey's Rabbit for a while, and various duck wet foods, but she mentioned that if those foods are tested, there is almost always protein found in them other than the novel protein. She wasn't trying to get me to use a prescription food; that's the route I chose of the options given because Gryphen is soooooooo picky. I tried several of the options before settling on the hydrolyzed. She hates most wet cat food (and trust me, I tried them all), and she's the only pet I've ever had that will snub every single people food you try to give her. I have another cat that will climb up your chest to rip a taco out of your mouth, but not Gryphen.

I get transdermal famotadine since Gryphen is ridiculously hard to pill, and was vomiting up the liquid. Alphyne is using up the rest of Gryphen's liquid prescription at present.

I'm still going to ask about the things we talked about. Alphyne is obviously different than Gryphen, and is going to lead me down a much different path.

As we always say, every cat is different. My girls definitely put that adage to the test!

 

[bobjoh]

Ugh! Looks like a little bit of a bounce today. I suspect your guess on the curve results and increase is right.

Of course, I just tested her at PMPS +3, and she's at 151. There is no rhyme or reason to her numbers at all. Do you think I should hold or raise her dose?

Edit: I tested again 15 minutes later, just in case. She's at 136. I guess I will hold the dose. My goodness; these numbers make no sense!

I think I need to stick with the 2 hour curve. Her numbers rise and fall too fast.