? AMPS 588/PMPS 534 - Kaz

[Suzanne & Darcy]

Since COVID no one will board medical cats. Have no problem boarding the other one. Angel just had a whole new wing built and they have a hospital attached and they will not take medical boarding right now. Hoping this changes at some point but they have even said this makes it hard for people in my shoes to get any help.

I don't understand this. It is absolutely IDIOTIC. What, do they think they're going to get COVID from a cat? I doubt it, but I can't think of any rational explanation (unless it's just that they do not have staff.) Boy am I thankful that my vet still boards everybody (and I soon may have to take advantage of that this summer in July). And I do not live in a huge metropolitan area like Atlanta, although Macon, where my vet is, is one of the large cities in Georgia. Maybe by the time December rolls around the situation will have changed? (when you go to the UK again for a visit.) I hope your mother is well.

 

[Claire and Kaz]

http://www.felinediabetes.com/dictionary/cat-health-dictionary-fdmb.htm

Above is a link to a glossary for the FDMB

Thanks for the link on the dosing methods I have read the TR section its a lot to take in and understand all at once. I get about 80% of it but will have to come back and re read this.
I can also see that Kaz probably won't go into remission due to my trips and not being consistent with dosing which makes me sad.

 

[Claire and Kaz]

I don't understand this. It is absolutely IDIOTIC. What, do they think they're going to get COVID from a cat? I doubt it, but I can't think of any rational explanation (unless it's just that they do not have staff.) Boy am I thankful that my vet still boards everybody (and I soon may have to take advantage of that this summer in July). And I do not live in a huge metropolitan area like Atlanta, although Macon, where my vet is, is one of the large cities in Georgia. Maybe by the time December rolls around the situation will have changed? (when you go to the UK again for a visit.) I hope your mother is well.

I am with you it is idiotic and I do not think vets are understaffed as COVID caused a boom in the industry. I do know that boarding facility's are though and very few ever had a medical person on staff to begin with.

 

[Suzanne & Darcy]

So if this is correct unless you get multiple readings (curve) you would not be able to make an accurate prediction of what the true levels are.

So yes, it is helpful to have a lot of data to determine when your cat's nadir is. Although nadirs can move around a bit. It required a lot of testing to figure this out. If that's not an option during mid-cycles, then another option is to do curves and test every two hours when you're off work. Otherwise, it's good to get tests at different times on different days (+3, +6, +9 etc. on one or two days and maybe +4, +7, etc. on another day). The longer you are testing, the more data you will have and that makes dosing decisions much easier. The longer you go along you also get a better idea of things like how your cat responds to carbs (what you've already been learning) and how long kitty typically takes to clear a bounce.

 

[Claire and Kaz]

So yes, it is helpful to have a lot of data to determine when your cat's nadir is. Although nadirs can move around a bit. It required a lot of testing to figure this out. If that's not an option during mid-cycles, then another option is to do curves and test every two hours when you're off work. Otherwise, it's good to get tests at different times on different days (+3, +6, +9 etc. on one or two days and maybe +4, +7, etc. on another day). The longer you are testing, the more data you will have and that makes dosing decisions much easier. The longer you go along you also get a better idea of things like how your cat responds to carbs (what you've already been learning) and how long kitty typically takes to clear a bounce.

Thanks
Yes I am definitely beginning to understand about the food more than before. Today I deliberately gave him the 3% carb food versus the usual Tiki due to the lower number I got when I tested as I knew that the number could continue to drop as the insulin kicks in and peaks.
What I am not yet understanding is the increase part. I get that the dose has to keep going up by the .25 units as his numbers have not stabilized. However what my brain can't fathom is if the insulin keeps increasing how does a cat go into remission. Does the BG just suddenly stabalizes and then starts to drop and you then in turn decrease the insulin slowly to ween them off. Just stopping insulin is dangerous as far as I know.

The remission part is confusing but I know we are no where near that and may never make it.

I also realize through reading that if the cats BG is 200 (thought it was 150 but I keep seeing 200) then I should not give insulin at all and wait for the numbers to bounce back up. However if the insulin you are giving is at such a high dose is it not dangerous to stop altogether? Surly you would think that the dose should be halved or quartered but not stopped altogether.

So as you can see some of this is confusing.

 

[Suzanne & Darcy]

Thanks
Yes I am definitely beginning to understand about the food more than before. Today I deliberately gave him the 3% carb food versus the usual Tiki due to the lower number I got when I tested as I knew that the number could continue to drop as the insulin kicks in and peaks.
What I am not yet understanding is the increase part. I get that the dose has to keep going up by the .25 units as his numbers have not stabilized. However what my brain can't fathom is if the insulin keeps increasing how does a cat go into remission. Does the BG just suddenly stabalizes and then starts to drop and you then in turn decrease the insulin slowly to ween them off. Just stopping insulin is dangerous as far as I know.

The remission part is confusing but I know we are no where near that and may never make it.

I also realize through reading that if the cats BG is 200 (thought it was 150 but I keep seeing 200) then I should not give insulin at all and wait for the numbers to bounce back up. However if the insulin you are giving is at such a high dose is it not dangerous to stop altogether? Surly you would think that the dose should be halved or quartered but not stopped altogether.

So as you can see some of this is confusing.

Cats that go into remission gradually need less insulin and “earn” reductions by hitting a certain number. Then, over time, the cat’s dose is reduced down and reduced down until they’re on a tiny dose (like a drop dose) and when they stay in green numbers for a while on that tiny dose, you do what’s called an OTJ Trial (Off theJuice)where no insulin is given for two weeks. If they stay in normal numbers for two weeks, they are considered to be in remission (basically a diet controlled diabetic.). I’m describing a typical scenario here.

 

[Suzanne & Darcy]

About cats going into remission... I am linking today's post for a cat named Clyde who is on day 3 of his Off the Juice (OTJ) trial. Click on Clyde's spreadsheet in her signature at the bottom of the first post and take a look at Clyde's spreadsheet. You can see how he started out in pinks, reds and blacks and gradually his numbers came down. He was up to as much as 3.25 units of insulin at one time and gradually earned those reductions by hitting the low number that is the "reduction point" (this reduction point number, by the way, can be custom set for each cat for varying reasons). So Clyde's dose gradually was reduces as his insulin needs became lower and lower. He was on a dose of "one drop" for a week before starting the OTJ trial. He is looking good on zero insulin at this time. We will see if it holds for two weeks. Now, I admit that Clyde is one of the cats who went into remission very quickly. That's not really typical, but he was on my mind since I've been watching him go down in dose for the last month or so, until finally he got to the drop dose and was just doing so well.
https://felinediabetes.com/FDMB/threads/04-29-clyde-otj-trial-day-3-ambg-70.262613/

 

[Claire and Kaz]

About cats going into remission... I am linking today's post for a cat named Clyde who is on day 3 of his Off the Juice (OTJ) trial. Click on Clyde's spreadsheet in her signature at the bottom of the first post and take a look at Clyde's spreadsheet. You can see how he started out in pinks, reds and blacks and gradually his numbers came down. He was up to as much as 3.25 units of insulin at one time and gradually earned those reductions by hitting the low number that is the "reduction point" (this reduction point number, by the way, can be custom set for each cat for varying reasons). So Clyde's dose gradually was reduces as his insulin needs became lower and lower. He was on a dose of "one drop" for a week before starting the OTJ trial. He is looking good on zero insulin at this time. We will see if it holds for two weeks. Now, I admit that Clyde is one of the cats who went into remission very quickly. That's not really typical, but he was on my mind since I've been watching him go down in dose for the last month or so, until finally he got to the drop dose and was just doing so well.
https://felinediabetes.com/FDMB/threads/04-29-clyde-otj-trial-day-3-ambg-70.262613/

Thanks for sharing. Looks like Clyde went into the greens quickly he was never really in the blacks either which is good news for him. Hope he makes it seems hes been in the green area for a while.

 

[Bron and Sheba (GA)]

We are following TR with Kaz as he is a DKA kitty. We treat DKA slightly different because we sometimes have to increase the dose of insulin quicker than the protocol if there are ketones showing. That is why we always want to know if there are any ketones in the urine.
So I would go ahead and put TR in the signature and the SS please Claire. Thanks for explaining it Suzanne. SLGS is not the method we need to use for Katz at the moment as it isn’t flexible enough for us to make changes when needed.
You are doing a great job with him Claire. How far is Georgia from Boston? That would be a great solution if possible!

 

[Suzanne & Darcy]

We are following TR with Kaz as he is a DKA kitty. We treat DKA slightly different because we sometimes have to increase the dose of insulin quicker than the protocol if there are ketones showing. That is why we always want to know if there are any ketones in the urine.
So I would go ahead and put TR in the signature and the SS please Claire. Thanks for explaining it Suzanne. SLGS is not the method we need to use for Katz at the moment as it isn’t flexible enough for us to make changes when needed.
You are doing a great job with him Claire. How far is Georgia from Boston? That would be a great solution if possible!

Unfortunately, it’s an airplane ride away. I totally agree about the DKA and what you say about needing flexibility because of the DKA. My Darcy went DKA and was a high dose kitty with acromegaly - so I followed TR, but really it was a custom dosing because of his conditions and medications. This is why if you look at my signature it says that. People who only read on the board and don’t post meed to know that they should not follow my dosing.

 

[Claire and Kaz]

Thankyou both. I greatly appreciate any help I can get and appreciate having things explained to me. I find it slow going but I think I am beginning to slowly understand.

I think that one thing that does flummox me is that from diagnosis through 4/9/22 he was mainly in yellows and pinks with a few reds but then all of a sudden its all blacks and reds and a few sporadic pinks and yellows. I find this confusing did he somehow get worse from using the insulin. I have tried reading up on it but this is something that I have not yet understood.

 

[Claire and Kaz]

Hi Claire
Would you mind putting DKA in the signature please as it’s important that people helping you know that history…thanks.
Also in the Ss can you put TR as the dosing method please…..you aren’t feeding any dry food are you?
I would go up to the next dose of 2.5 units tomorrow morning.



When will you be going away and who is minding him?
Will they be able to test for ketones?
Do you think he will eat well for them when you are gone?

Hi Bron
I have had Kaz at 2.5 units for 4 cycles (2 days) and I have noticed that his numbers have dropped into the yellows all day today. This was more of a drop than I was expecting.
I need to know what number is the number where I do not administer insulin as if he was to continue dropping like this over the next day or so he is going to be under 200.
I have read not to administer under 150 but I also saw something about 200 so I need to understand when I SHOULD NOT be giving insulin and then if this was to happen with him getting 2.5 units what does that then mean over the next 12 hours as I am assuming that the next dose would be up again and insulin would be given.

Worried that his numbers will continue to drop over night and tomorrow I am back at work with early morning meetings.

Thanks Claire

 

[Bron and Sheba (GA)]

He’s looking pretty good with the 2.5 units. I would keep giving that for the next 24 hours and see where he is up to after that.
If he is under 200 at preshot I would stall, don’t feed and test again in 20 minutes to see if the BG is rising. And post and ask for help. You would need to change the subject line to let someone know you need help…..say..preshot xxx stalling need HELP.
Do you have time to stall in the mornings?
Once you move over to the Lantus forum….which I think you should do soon, you can shoot with a preshot of 150 after gradually moving down a bit each time. The Lantus forum has a lot of experienced users who can help you when I am not around.

 

[Claire and Kaz]

Kaz was back in high 500's this morning which I can not explain? I did give him a second small meal right after his shot as I am worried he may drop quickly during the day but had no choice I had to come into the office today.

The Meowspace has a defect so they are sending me a different model. Kaz understands how to get in and out so I am hoping that when the new door comes it should be an easy process so he can get food during day but till then he's on his own Monday-Thursday regarding food as the other cat is so greedy he will not let Kaz have any of it.

 

[Bron and Sheba (GA)]

Kaz was back in high 500's this morning which I can not explain? I

He may have dropped lower last night after the +3 and could be bouncing

did give him a second small meal right after his shot as I am worried he may drop quickly during the day but had no choice I had to come into the office today.

That’s fine. You have to do what you need to do to keep him safe.

The Meowspace has a defect so they are sending me a different model. Kaz understands how to get in and out so I am hoping that when the new door comes it should be an easy process so he can get food during day but till then he's on his own Monday-Thursday regarding food as the other cat is so greedy he will not let Kaz have any of it.

What a bummer it had a defect! I’m glad he understands how it works. That’s great!

 

[Bron and Sheba (GA)]

Maybe start a new thread tomorrow as this one is getting a bit long

 

[Claire and Kaz]

Maybe start a new thread tomorrow as this one is getting a bit long

Hi Bron

I started a new thread at link below. Kaz's numbers are all over the place. Been giving him food with carbs to help stabilize it versus the 0% Tiki????

https://felinediabetes.com/FDMB/threads/kaz-amps-533-pmps241.262834/