Blood panel answers - pancreatitis

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JenM

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JUST when I think we're getting somewhere...

Had a nice couple cycles on 7/20... but not so great since. This morning was rediculously high. I just dont get it. I HAD been shooting PM dose early, which seemed to be working - but thought I'd try to get him back on a 12/12 schedule to see if we could pull AMPS down a tad. THAT clearly didn't work - though I have no idea why. I wonder what it would have been this morning had I given his PM shot early - which would have made his AMPS at +14 rather than +12.

OYE.

I gave his shot this morning and did NOT feed right away - waited an hour (which I've been doing with his early PM shots) to let the insulin work a bit. It didn't seem to kick in yet at +1 (still 491) and I had to go to work, so I fed him at +1 and his timed feeder will feed him again at +5. I just dont know what else to TRY. This is nuts. It seems like every time we get anything close to a good cycle, his need for insulin jumps up again.

I think I'll try thowing in an early am (like 2am) feeding and see if that gets us anywhere. I just dont know how to divide half a can of food (daily ration) into FIVE servings. Tink's gonna eat me in my sleep - he already thinks I'm starving him. He eats his food in like five bites and then tries to steal everyone else's. I wonder if I smeared it around on his plate, if he'd have to savor it a little more...
 
Re: AMPS 561 ?!?!?! Going crazy over here. :(

Options to slow the ravenous eater:
- Smearing it across a wide plate
- Adding a tablespoon of water to increase the volume.
- Freezing part of it to be nibbled as it thaws

Note that the uncontrolled diabetic may need up to 50% more calories due to the inability to use what is eaten.
 
Re: AMPS 561 ?!?!?! Going crazy over here. :(

No chance of a fur shot? He was doing well. Although it is hard, don't get worried about one number. You'll get him back in good numbers.
 
Re: AMPS 561 ?!?!?! Going crazy over here. :(

We do understand your frustration.
But as Sue says, try not to worry about one number.

I wish I had a pound for every time my Bertie has thrown me a WTF number over the years...
There are lots of reasons for jumps in numbers, and sometimes we never know the reason why. (Is there any chance your kitty scavenged a high carb snack during the night...?)

Big reassuring (((hug))) to you,

Eliz
 
Re: AMPS 561 ?!?!?! Going crazy over here. :(

Thanks guys. It's hard to not focus on a number when it's SUCH a crazy number (and when more of them seem to be crazy than not)... but I get it.

I dont think it was a fur shot - though I'm tempted to shave a spot. He's got very long plush hair - so I always worry about that. But, I feel like he's lost so much dignity with the 4-6 pokes and two jabs per day regimen that I'm reluctant to add a bald spot. :lol: He sees me coming and just gets this look like "really??? again????"

His appetite is just insane. He literally tries to grab the plate from my hand - I'm just waiting for cat food to fly across the room. He's never been like that until the diabetes. However, he seems to be using most of his calories. Before he lost remission, he had continued to gain weight and was up to a lofty 13lb. I feel like his ideal weight is 12 - he had been a 14+ pounder before being diagnosed and loosing a bunch in the process. I can't imagine what high carb goody he could have scavenged, but it's always possible. We're diligent about picking up any snack plates or wrappers, rinsing off dishes in the sink, etc., so as not to tempt him. But it's hard. The dog kennel is in the living room and she eats kibble - so there's always the risk of a stray piece. I've purchased wall-mounted dishes, but it's still possible.

Now that he's not regulated, I've been watching his weight even more. He IS losing weight, but slowly (so far) and is still above 12 lb. so I've not increased his food with this loss of remission. We are due for another date with the scale, but last time I checked (roughly a week ago?) he was still over 12 lb. If he drops below 12, I'll certainly offer more food. I'm also checking for ketones weekly and we've had no reaction on the strips so far. That's the biggest thing that worries me about those crazy high numbers is knowing how sick he was initially and having dealt with DKA & hepatic lipidosis - I dont want to go back there!!! I can't afford to go back there.

Anyway... all I can do is keep going. I'll stick with the 2u awhile and see what we see. I'll also start smearing his food around on the plate - if it takes him longer than three seconds to eat his meal, maybe he'll feel a little fuller. May try the water idea too, but I'm pretty sure he wont tolerate that. Might try to get some large glass marbles or something to add in the PetSafe5 too, to slow down his eating. Though that will likely just result in trails of cat food across the floor, from them playing with the marbles. :roll:
 
Re: AMPS 561 ?!?!?! Going crazy over here. :(

Elizabeth and Bertie said:
I wish I had a pound for every time my Bertie has thrown me a WTF number over the years...

Took me a minute on this... I was like "why would you want to gain a pound every time... I'd be HUGE"...then I realized you're in the UK and that's your money!! HAHAHA :lol:
 
Re: AMPS 561 ?!?!?! Going crazy over here. :(

Go to you spreadsheet.
Zoom out until all you can see is the colors.

To me, it looks like as you've increased the dose over the past couple of weeks, the numbers have gotten worse. Maybe, just maybe, you need to reduce, not increase the dose.
 
Re: AMPS 561 ?!?!?! Going crazy over here. :(

I'm not sure I'm seeing what you're seeing. Where were the numbers ever good?? The dose kept getting bumped up because the numbers were staying high. We've just recently started getting more blues and even a couple greens. It was almost all pink & yellow before that...

I see a couple days at the end of June, on 1u, where it was almost all yellow with some blue... but those blues were too high. Although... I was also playing with feeding routine there too...

Do you think I should go back to that?? I just felt like we finally may have hit that ceiling with the 2u on 7/20... but who knows.
 
Re: AMPS 561 ?!?!?! Going crazy over here. :(

I didn't say they were good; I said they appeared to get even worse as you increased - from yellows to magentas, to a black, even. And I could be wrong, too.

The thing is, too much insulin can look like not enough insulin. If you give too much, compensatory hormones kick in and release stored glycogen which converts to glucose. This only works as long as there is stored glycogen. When there isn't enough stored, the cat may drop suddenly and crash.

Really, the only way to tell is to reduce and test (especially for ketones), then see if it gets better or not. And if you do not reduce and continue raising, be on the alert for a sudden drop into possible hypo.

Six of one, half a dozen of the other. It is completely up to you.
 
Re: AMPS 561 ?!?!?! Going crazy over here. :(

OYE! @-) Thanks... I did not know that.

What does it look like when a cat becomes insulin resistant??

I'm wondering if I'm going to HAVE to either figure out a way to do TID dosing, or move to a depot insulin. Though, without being able to nail down a dosage... neither is going to be easy.

This all just seems so weird. Every time I adjust, it's like it works for a day... then we're back to bad numbers.
 
Re: AMPS 561 ?!?!?! Going crazy over here. :(

OOOOKAY.... I may have found the culprit. Got home today and tested at +10, came out at 550. NOT what I was hoping for. Gave his 2u early and will feed at normal time, as we were doing the last few days (except yesterday). A few minutes later, while doing dishes, I realize the lid is off a pan that had couscous in it last night. Couscous that I instructed my teenager to put in the fridge so she could eat it later. :-x Since the lid was on the pan, I assumed she'd done it. Tonight, when I see the lid OFF the pan, and couscous still IN pan... I asked her about it. She says the lid was off this morning too, but she neglected to MENTION this to me. UGH! I THOUGHT she put it AWAY.

SO... Tink likely gorged himself on couscous (about as carb heavy as it gets) last night and again today.

I'm HIGHLY irritated that this happened. I KEEP telling her how important it is to keep ALL carbs (or all foods for that matter) cleaned up and out of his reach. But... things like this happen from time to time. We all forget. It just sucks when our forgetfulness results in potential health consequences for someone else!

On the BRIGHT SIDE... I'm hoping this is WHY we're seeing these crazy numbers. The 2u dose looked like it was working, till this. HOPEFULLY these carbs clear out and we get back to those pretty blues and greens we saw a couple days ago.
 
Re: AMPS 561 ?!?!?! Going crazy over here. :(

Aha. Well, I hope this is the explanation. Just imagine how much he enjoyed That forbidden couscous. :mrgreen:
 
Re: AMPS 561 ?!?!?! Going crazy over here. :(

Explanations help! You might tell her that kitchen privileges come with the responsibility to clean up! (Option, not a mandate :smile: )

If he is insulin resistant, you will see increasing doses and possibly shorter duration. Once you get up to 6 units or so, we suggest having tests for acromegaly and insulin auto-antibodies run. Info on those in the acro forum here. You're not there yet.

Be sure to have a hypo kit on hand, just in case he ever vomits for any reason after you've shot the insulin (Spitzer did that to me more than once; he developed IBD). You'll want a stash of high carb gravied food, Karo syrup, oral syringe, extra test strips, and locations and phone numbers of 24 hour vets. You may never need them, but having them ready to go if you do need them is worth it.
 
Re: AMPS 561 ?!?!?! Going crazy over here. :(

Oh this sounds sooo familiar! :roll: When Tommy throws an unusually high number, the first thing I do is check any dishes not washed, any bread bags left on the table/counter, and ask my DH if he forgot to put up the dog food! ohmygod_smile Tommy WILL find contraband food if anywhere, usually forgotten by DH (forgets...head injury). Even though Tink had a high number, at least it was from food and not a health issue. :mrgreen:
 
Re: AMPS 561 ?!?!?! Going crazy over here. :(

JenM said:
Elizabeth and Bertie said:
I wish I had a pound for every time my Bertie has thrown me a WTF number over the years...
Took me a minute on this... I was like "why would you want to gain a pound every time... I'd be HUGE"...then I realized you're in the UK and that's your money!! HAHAHA :lol:
Ha-ha-ha!!! :lol:

If your kitty's high numbers were due to a contraband snack, or indeed due to a fur shot, then at least that's something temporary.

Eliz
 
Re: AMPS 561 ?!?!?! Going crazy over here. :(

We were a bit lower this morning, but still very high. I would assume that it may take awhile for his numbers to stabilize, since even this morning was likely only about 12hrs since his last carb binge. :roll:

462 this morning - I gave 2u and waited an hour to feed. He was 420 when I fed at +1. Still very high... but better than yesterday or last night. Ugh. I double and triple checked that nothing is out for him to get into.

I do need to get a bread box though - although he's never shown interest YET. A few of the sweeter breads (hawaiian bread, etc) we have to keep in the cabinets as Tarzan the Pirrhana Kitty will chew holes in the bag and/or drag it to the floor where the dogs eat it. ohmygod_smile Dealing with cats' antics and dogs' antics is bad enough... but working together I'm pretty sure they could take over the world. :lol:

I did also add a 2am feeding starting last night. Of course, after getting a high number this morning, I realize I probably should have waited till the couscous numbers settled down before doing this. Now I dont know if he's still high from the couscous, or high because of the extra meal, or??? ohmygod_smile
 
Re: AMPS 379 - getting better

This morning's AMPS was still high (379)... but much better than we've seen the last couple days after Tink's couscous binge. PS#'s seem to be getting consistently lower.

Hoping things continue to trend downward and stabilize at a reasonable level.

Last night I continued with the new 2am feeding, but instead of an extra meal like he got the first night, I just split his last evening meal in half. Given the recent high #'s I doubt the calories from the extra meal hurt anything, but I dont think it's sustainable, since he was maintaining a bit too much "fluff" on his current amount of food.

I'm taking a long weekend (Fri-Mon) so will be able to get some good data and am hoping to get him in for some bloodwork as well. I would like the couscous #'s to work their way out prior to the vet visit though, as I dont want him being "artificially" high when tests happen. It'll be bad enough just BEING at the vet. The vet is open 7 days and dont charge any extra on weekends, so that's good at least.
 
Re: AMPS 379 - getting better

Well at least numbers are slowly going back down! And you know he enjoyed the couscous!
 
Re: AMPS 470 - ugh. Back up after beautiful cycle last nigh

angry(2)_cat

Yesterday's PM cycle was near perfect - reasonable PMPS (258), excellent nadir (83)... AND then a bounce. UGH.

AMPS 470 this morning (though admittedly, AMPS is at +14 due to giving his PM shot 2hr early), steadily going down, but now at +4 and still 333. I even broke his AM meal into two servings (one at AMPS & one at +2). I wanted to shoot and wait on his meal, but I took the day off and was looking forward to going back to bed and really wanted a full 2hrs of sleep. Probably would have been fine to let the insulin work that long before his meal, but didn't want to risk it.

Maybe I should have shot lower on the 258... but at +6 and a reading of 86, plus he eats at that time, it seemed like a perfect cycle.

So frustrating...

I might try TID dosing today (depending on what his +8 is) and see if that might help. I'm home until Monday (with a few things happening Saturday, but I will still be in and out all day and can test every 3-4 hrs at least). I guess it's a good time to try it. I can't do exactly every 8hrs, but I could do 7am, 4pm & 10pm pretty consistently. The 4pm would be the only real issue... if I need to grab groceries or anything after work I dont get home till closer to 5... but I think it'd be ok as long as I'm watching the dose.
 
Re: AMPS 470 - ugh. Back up after beautiful cycle last nigh

I think TID is a good idea to try, if just to see if it might work. Be sure to remember that you shoot every 8 hours, if the number is sure headed up. You don't want to shoot a falling number.
 
New TID dosing - helping, but still high #'s

TID seems to be helping, but we're still not there yet. Part of the problem is that I can't TRULY do TID - not every 8 hrs. I can shoot at 7am (though this morning he needed it at 6am) but can't shoot again until I get home from work at 4pm - 9hrs. Then I can shoot at 10pm when I got to bed - only 6hrs. I COULD get up at midnight to shoot... but that worries me (what if the alarm doesn't go off, etc) and that would make it so his AM shot would be only 7hrs out... I just dont know what to do. Plus, TID makes it THAT much more difficult to do anything in life outside of pet care. What about when I need groceries, or need to work late, etc. We're trying it for now... but it doesn't seem to be helping enough to be a sustainable approach.

Plus, even with the pretty-close-to-every 8hrs I was doing this long weekend (fri-mon), we were still getting high preshots in the morning, after only 9hrs (from 10pm to 7am) - which makes me think that's going to happen every day on his 4pm shot.

I need to figure out how to put this data on the SS, since it's not set up for TID dosing. I'll try to make it make sense. But, what I'm seeing (at least in the AM) is that the insulin doesn't "hit" for at least 2hrs. His crazy highs continue to climb even after insulin. Then around +2 or +3 he starts a slow descent until a nadir at around +7 (except days like 7/26 where he seemed to hit nadir at +4...). But THEN he seems to instantly shoot back up to the 400's.

I'm going to try to get to the vet tonight and get some bloodwork done to rule out anything else, and talk to him about maybe trying Lantus.

If we switch to Lantus... is it safe to just switch? I'm afraid of having him sit too long with high numbers. We've seen WAY too much pink/red in the last 2 months. At some point it's going to cause damage. He is losing weight, but not rapidly. Appetite is insatiable and thirst drive is still elevated, though maybe not as bad as it was when he first lost remission. He was stalking the dog this morning (a pug, with food aggression issues), trying to steal his kibble. :shock:
 
New TID dosing - helping, but still high #'s

Ok... SS is updated. PLEASE let me know if it makes sense and/or if there is a better way I can indicate my TID dosing.

I've basically made a line for each cycle (so each day is 3 lines) - but the "+" values dont jive except for the first cycle.

I'm not sure it's going to make sense to ya'll... I was having hard time even keeping up - and I did it! :) Does anyone else do TID dosing and have a better way to indicated things on the SS?? I tried shading in each day, just to help keep the days straight...but it seems to only shade cells with values in them. I am pretty good with excel, but know next to nothing about Google Docs or the new(er than Windows XP) excel versions. :(
 
Re: New TID dosing - helping, but still high #'s

BJ has helped people with TID spreadsheets ( I think she may have a template.) You could pm her (BJM)

I like yesterday's late cycle with those blues, but yes, it is hard to get a handle on any kind of pattern. I don't understand why he goes up right after the shot. Have you tried spreading out the food and feeding smaller amounts after that amps. Maybe the food hits then.

If you change to Lantus, you can just switch over. (It's harder to go the other way because Lantus has the shed.) Just be sure you read the stickies on the TR page. It is very different from ProZinc. You might pm Jen&Eddie. She likes to get into the science of this dance, and she switched to Lantus.

I am sorry this has been so hard. The first time he did so well, so fast!
 
Re: New TID dosing - helping, but still high #'s

Thanks. I don't understand why he goes up after a shot either. Especially that "HI" we got the other morning. I did retest when I got that, and got the same result. To go from mid 400s to 600+ 2hrs AFTER insulin WITHOUT any food... that's just crazy! I finally fed him even with the "HI" since the poor guy hadn't eaten since the tablespoon or so he got at 2am, and it was about 9am by then.

He has had some decent cycles with the TID - I just dont see why it jumps back up so fast. I understand it not lasting 12hrs... but to not last 7 or 8 hours?! I'd shoot higher, but he's had a few nadirs in the green, so I'm reluctant to go too fast. Today surprised me (in a good way for once)... I had to shoot at 6am as he was very high (I aim for 7am with the TID, so it doesn't mess everything up)... then I forgot I had to work late, so didn't get home till just now (5pm here)... I am planning to shoot at 4pm - which is still 9hrs from the 7am dose but it's the best I can do. So, he went 11hours and his number was actually lower than it has been. Go figure. But I'm not complaining. :) It was still high... but at least it wasn't "red". Of course, now that I didn't shoot till 5pm, that means I get to get up at midnight for the next dose.

I may just have to accept that for awhile - the getting up at midnight.

Also, since I forgot that I had to work late, I wasn't able to get to the vet tonight like I'd hoped. HOPEFULLY I can find time tomorrow to call during the day and get an evening appointment. At least once I know nothing else is at play here, I can focus on finding the right dosage and/or the right insulin. If BID isn't going to work with the ProZinc though, I dont know that I have any other long term options except to switch to a depot insulin. I just can't do midnight shots as a permanent solution - plus, I DO have to work late a few times per month and it would be WAY too stressful for him to go to work with me. I work in an office... but he's quite the homebody.

Anyway, I'm just glad he wasn't sky high tonight when I got home. Hopefully we're getting somewhere with this TID stuff.
 
Re: New TID dosing - helping, but still high #'s

TID spreadsheet here

Save to your Google account, or save to PC and then upload.
 
Re: New TID dosing - helping, but still high #'s

Thank you!!!

So, I'm finding out the obvious... TID dosing works best when it's actually given every 8hrs. LOL Sounds like a no brainer... but I was TRYING to make it work with my schedule and it just wasn't working. So... looks like I'll be giving midnight shots for awhile.

This morning at 6am (so, +6) he was 269 I think it was and an hour later at AMPS he was 299 I think (I say I think because the #s are at home and I'm at work). While I can force myself to get up at midnight and shoot, I cannot alter my afternoon availability, so his AM dose is going to have to last 9 hrs. Hopefully that won't be a huge deal. I'm thinking IF I can get him to STAY at least in yellow for awhile (without the pinks & reds), maybe his pancreas will start to kick in again... or maybe not... who knows.

I am working on transferring the TID stuff from the old SS into the new TID SS... so be patient with me. Google Docs is WAY outside my comfort zone. I'm not sure why it can't be more user friendly. I spend more time trying to figure out HOW to use it than actually using it. :) I'm pretty tech savvy... but sheesh! :oops:
 
Re: New TID dosing - helping, but still high #'s

The overnight dose can be skinny, since many cats go lower overnight. Likewise, the dose for the 9 hour period could be fat, so long as the nadirs were in a safe level.

That's an advantage to ProZinc - you can use the data you have to evaluate a pre-shot glucose and adjust the dose to accommodate that value based on historical response to a similar scenario.
(ie, you can shoot what you see with data to make the decision)
 
Re: New TID dosing - helping, but still high #'s

Ok... new TID SS up... I think. :) Could someone please test it out and make sure you can't change it?? The link looks slightly different than my old SS, which I had help with, so just want to make sure I did it right.

I'll have to update last night & this morning's data later as I dont have it with me.
 
Re: New TID dosing - helping, but still high #'s

Great, thanks! Last night/this morning's numbers look even better than what's on there so far... so hopefully we're moving in the right direction!
 
Re: New TID dosing - numbers looking much better

OK... TID SS is up to date as of now. We had a pretty low AMPS and a pretty decent set of cycles yesterday, though I wasn't able to test at nadirs. I was a bit nervous about this mornings dose on a 188... but I did reduce by .5u, fed him at AMPS, which usually spikes him quite a bit, and he will eat again at +4... so it should be fine. Also, my daughter is home until 12:30 or so and will call me if anything seems off.

My struggle is the timing. During the week, the closest I can get to 8/8/8 is 9/8/7. I leave for work at 7am and dont get home until 4 - IF I go straight home, which I've been doing. So, I've been testing at 6am (+6), then testing again at 7am for AMPS (so I know it's going up, not down) and feeding at AMPS.

But I wonder... since it's only 7hours instead of 8... would I be better off feeding him at 6am when I first test? Then shooting at 7? I just worry that feeding could make me think the number is up when it would have still been going down without food... What do you think?

I gave a skinny dose this morning... but I hate to do that since his AM dose is the one that needs to last longer than the others. I guess I could swap it out a little and do 9/7/8 - or 9/7.5/7.5... I normally go to bed at 10ish... so an 11:30 shot is certainly not ideal (I have a really hard time falling asleep if I know I have to get up within an hour or so) but I can do it if I have to. I just wish there was some way to give the 4pm dose earlier... but there isn't.
 
Re: New TID dosing - numbers looking much better

Yes, the 7 shot would be better if it were at a time when someone could monitor after it. We generally say you can usually shoot at +8. As you can imagine, the concern is that sometimes they are possibly still dropping at 7. (that can also look flat but isn't necessarily, if he has continually been coming down and you don't have those midcycle numbers).

It sounds like you have developed the best schedule possible for him and you. At some point, maybe you have to assume it will be fine. I know it is hard for you to give him the choice of eating if low without separating him, but maybe during the one part of the TID that worries you, you could do that? The hope is that this is temporary and once he gets into good consistent numbers, you will be able to switch back to BID. That is also the danger, if he is doing well with the TID and is continuing to drop overall and you are not there when he decides to really drop in a cycle.

Something to think about. Few cats here actually hypo to the point of dangerous - in the 30s with symptoms. We are cautious about them dropping to 50 and then below 40, so we err with dosing on the side of caution. If you have a way to offer him the choice of eating or having someone check on him, you could, more confidently, continue shooting earlier than ideal with that +7 cycle. You've been doing this awhile and have a good grasp on how he "works" .

It is still hard and there are, of course, no fool proof predictions about what he might do with a given dose.

No possible vacation time coming up? :mrgreen:
 
Re: New TID dosing - numbers looking much better

At least I can feel a little more confident knowing the insulin doesn't seem to "hit" for at least the first hour.... but every once in awhile it does hit fairly hard around +2... so even that isn't "for sure" (are there EVER any "for sures" here???).

As for leaving food out, it's not just that I can't leave food available without separating him... it's that even if separated, he would easily consume an entire can of food when I give it to him. He will eat it all when given and not leave any for later - unless I literally let him eat his fill - which I'm afraid would send him soaring (plus get him rather plump if done consistently) - not to mention, cost me an arm and a leg. He will scarf it all down the moment he has access. He was on the stove gnawing on a huge zucchini last night, right after eating! He's has NO self-control when it comes to anything edible (or not edible... he eats plastic bag handles too).

Now, I COULD offer it up to 4 times per day, via the PetSafe5, if I isolate him. So there's that. But simply leaving food available to him, wont work until his appetite is under control - and I'm not sure if it would work even then. He's always been quite the pig. He was the reason I had to stop free-feeding years ago. You know how they say a goldfish will eat until it explodes? He might be part goldfish. :lol:

I will try shooting at 11:30 tonight (+7.5), which would make his 7am dose also at +7.5. That might be the best. If his AMPS still hangs on the low side, I can make it 11pm and 7am, so at least he'll get the full 8 hours. It's just the darn workday that prevents a true 8/8/8. WHY do I have to work again?? Oh yeah... so I can AFFORD to have cats. ohmygod_smile


Oh... and I'm off a bit early on Friday, and dont work the weekend (and just picked up 100 more strips)... so I'll be able to get some better TID data after today. :) That'll be helpful. I should really consider renaming him "Pin-cushion" though. :YMSIGH:
 
Re: New TID dosing - numbers looking much better

You may slow him down some by adding some water to the food, spreading it thinly on a large plate, and placing obstacles he'll have to eat around, like large marbles too big for him to swallow.
 
Re: New TID dosing - numbers looking much better

I have started smearing the food onto the plate a bit, which has slowed him down quite a bit. Now the other cats can USUALLY finish their meals before he tries to eat it for them. :)

Still pretty confident that no matter how slow he were to eat, he wont let me "leave food available"... he'll just eat it all. But maybe with enough food and enough obstacles (I dont know, a bowl full of big marbles?) maybe he'd wear himself out before it was all gone?? I could try it at some point.

On the other hand... I gave last night's shot at 11:30 (+7.5, rather than the usual +7) and at 6am he was up to 334. By 7am (AMPS) he was 366 so I gave his regular 2u. His cycles looked a bit higher yesterday, so I'm glad that I'm off a little early today (should be able to give his next shot at 3pm (+8 for once), but more importantly, I'll be around to get some mid cycle data over the next couple days.

While I CAN do a true 8/8/8 during the weekends... I'm thinking it might be better to stick to my regular workday schedule for his shots, so that I can gather data related to that. I guess it doesn't do much good to gather data for 8/8/8 if that's not my reality during the week.
 
Re: New TID dosing - numbers looking much better

Re: my note yesterday - about him gnawing on a zucchini... I wonder where I might get some info about vegetables and cats. Part of me is thinking if he likes zucchini... that could be a GREAT way to help him feel full. So far as I know, zucchini is mostly water so would be good for hydration... and doesn't contain many calories. I wouldn't image there's much sugar in it given that it's fairly bland. Just a thought. If pumpkin is ok... it's sort of along the same lines... and since I garden, I have it coming out my ears. I could shred it and freeze it, or cube it and freeze it...

What do ya'll think?

Of course... if I actually WANT him to eat it... he may decide it isn't nearly as good as when it's forbidden fruit on the stovetop. ;)
 
Re: New TID dosing - numbers looking much better

Oh no, this was just a whole, HUGE zucchini I'd just picked. And he wasn't even eating the fruit part yet... he was gnawing on the stem and had about half of it gone! :lol: In fact, the reason I caught him was because some of it had fallen down into the stove grate and was making a racket trying to get into the stove grate!
 
Re: New TID dosing - numbers looking much better

So it looks like, per 100g of zucchini, it contains around 2.5g sugar and a little fiber, resulting in a total carb content of 3.1g (again, per 100g of zucchini). That seems like it would be good. It contains lots of vitamins and nutrients, and lots of water. 100g of zucchini is around 17 calories (are human calories different than cat calories?).

Seems like this could be a good filler if he'll eat it. Does it sound safe to you guys? I think Wellness does have zucchini in it... and I know it's SAFE... just wondering if it's a good idea to add to a diabetics diet or not?? It seems to be in the same family as pumpkin (according to wiki anyway) and I know that's used on here sometimes.

I wonder if it might fill whatever craving he's having too... he is constantly eating leaves off my orange tree and coffee plant. Neither of which are probably great for him. Maybe he needs something from the green leaves?? Although he also REALLY likes my contact lens solution - he tries to drink the drips out of the sink - I'm assuming because of the saltiness. So maybe he just has really weird taste.
 
Re: New TID dosing - numbers looking much better

Why don't you just go to a longer lasting insulin?
The TID dosing may look better to you but it's not great.
Talk to your vet about trying Levemir.

For the diet, water will be filling, so if you soup the water, equal parts water and food, it's going to keep him well hydrated, healthy, and eat a bit less.
When diabetic cats are craving food, it's for a reason. When there is no regulation in numbers, the cat may well need to be eating more food to extract what is needed.
My two cats were eating around 24oz and 30oz per day until regulated and they dropped down on their own to amounts of maybe 5oz and 10oz per day.
How many ounces of food are you feeding per day?

Gayle
 
Re: New TID dosing - numbers looking much better

He gets about 6oz a day. While OTJ, he was getting fat on this. But I know he may need more calories until he's regulated again. He's lost a bit of weight so far, but needed to. He's right at 12 now, where he should be... but if he starts dropping below I'll certainly feed more.

ProZinc is SUPPOSED to be a 12hr insulin. I like the dosing flexibility as I can't always shoot exactly when I'm supposed to. It worked great last time on him and got him regulated quickly. But yes, at this point it seems apparent that it's not going to work as well this time. We had a beautiful cycle this morning... but it seems that every time we see anything near 100, he bounces. I'm not sure if Levemir or Lantus will fix that or not. I'm already half way through my bottle of ProZinc and I'm fine with trying something else...
 
Re: Why do we bounce every time we get a decent nadir????

EVERY time we get anywhere close to 100, he bounces.

I am ready to try Lantus or Levemir... but isn't this going to be an issue no matter what insulin I'm using??? It's like his body doesn't believe that 105 is GOOD. @-)
 
Re: Why do we bounce every time we get a decent nadir????

Usually they bounce until they stop bouncing. :mrgreen: Regardless of insulin. You might check out Jen and Eddie's ss. They were on ProZinc Zinc and yes, he bounced. He is still bouncing but after several months on Lantus, his bounces don't last as long and he is gradually getting used to lower numbers overall. I don't know whether he would have done the same thing if he stayed on ProZinc. You might pm her and see what she thinks about changing. I'm sure she would have good insights since her circumstances are very similar to yours.
 
Re: Why do we bounce every time we get a decent nadir????

Thank you. Just sent her a PM. Looking at poor Eddie's SS makes me feel like I'm looking at Tink's!! OYE. At least I know I'm not alone... but sheesh. What is it with these sugarcats?? Do they just not want us to ever leave the house?!?!

Tink was in the low 200's this morning. I couldn't bring myself to shoot more than 1.5u as his 7am # was lower than his 6am#. I know it's not a good idea to shoot on a falling number... but he did get a meal with it and will have another meal at +4. I had to leave for work and didn't want to not shoot at all. He'll probably be flying by the time I get home. :sad: This roller coaster ride is getting old.
 
Re: Why do we bounce every time we get a decent nadir????

A roller coaster with your eyes closed so the drops are unexpected. :mrgreen: He is under the renal threshold quite a bit of the time, which is some kind of a silver lining?
 
Re: Why do we bounce every time we get a decent nadir????

Ok... got an appointment to get a full blood panel done tonight. I LOVE MY VET. The lady scheduling asked if I WANTED a full vet visit, or just the blood draw. HECK YES I just want the blood draw! Save me $50. The vet is going to call me with results anyway, and will talk with me forever... so why make Tink get poked and prodded again (well, more than necessary at least)? He just had a full exam right before I put him back on insulin, so it's just the bloodwork I want.

I did verify that this blood panel will rule out pancreatitis and she said it would. Are there other things I should be sure to ask about?
When he calls with the results, I'm going to ask him to provide an RX for Lantus and see how that goes. My Costco will sell a single pen. Hoping I can figure out how to get the insulin out of it. :) Also hoping the savings card actually works, but it sounds like others here have used it?

On my way to the Lantus group to read the protocol now...
 
Re: Why do we bounce every time we get a decent nadir????

Poor guy was SO stressed out going on a car ride. It was also in the mid 80's yesterday, which is unusually warm for us. But I had all the windows open and I was comfortable, so can't imagine he was too hot (he was sitting right next to me). It's less than a 10min drive, so by the time A/C would have cooled us down, we'd have been there... so I just went "au naturale". He was panting and even drooling a little bit, and meowing a LOT. Mostly just on the way there though, less so on the way home. I think going to the vet is pretty traumatizing to him now, since his little 11-day stint living there. I promise him I wont leave him there, but he is always much calmer when he's BACK in the crate after having seen the vet.

Should have results today. Part of me hopes SOMETHING is up with his bloodwork, something easily treatable that would bring him back off insulin once resolved... but that's probably wishful thinking. Everything SEEMS fine with him - other than his BGs.

Interestingly enough, rather than the stress causing his BG to spike or elevate, I got an oddly low preshot for his 11:30pm shot. Low enough that it really jacked up my sleep routine. :roll: I hate making shooting decisions in a groggy state. After staring at his sheet for awhile, I decided to shoot 1u on the 179 reading, knowing he'd eat in 2hrs. But once I DID that... I couldn't fall asleep because I was too busy worrying "what if he drops too fast"... then a random yapper dog started barking somewhere nearby... So, on the bright side, 30min later I was still awake, so I tested him again. LOL He was on the rise (195), and I managed to get some sleep knowing that.

I REALLY hope Lantus works better for us. @-)
 
Ok, finally got blood lab back. Thyroid was on the low side, but vet says that's to be expected with diabetes and... pancreatitis. :sad:

Yup, positive for pancreatitis, though vet's thinking mild at this point since there is no diarrhea and no obvious pain issues. He's going to give him bupronepherine (sp??) for pain for a few days and verified that I'm feeding an all-wet-food diet. He was also very supportive of switching to Lantus - said it's his usual choice for FD.

He did say that some other thing was elevated, which is usually a result of some blood loss in stool and asked if he'd been having diarrhea, which he has not. Not sure what else that could mean, but the vet wasn't too concerned about it. Said kidney and liver function both looked good, as did everything else.

I'll be picking up the meds and a paper copy of the lab results later today or tomorrow.

Does this tx sound right for pancreatitis? Just pain meds for a few days? Is there anything else I should ask or be doing with this new diagnosis? I'm thinking this COULD mean that once the pancreatitis flare-up is over, he could go OTJ again? Is that a reasonable suspicion? But then of course be prepared for the next relapse / flare-up?
 
No direct experience from me, Jen, but I can share some resources:

Marje put together this great primer:

http://www.felinediabetes.com/FDMB/viewtopic.php?f=14&t=83108



Good information on Pancreatitis:http://www.marvistavet.com/html/body_pancreatitis__feline_.html

Good vet article on pancreatitis:http://www.idexx.com/pubwebresource...ng-pancreatitis-and-concurrent-conditions.pdf

He doesn't seem to be off his food like most pancreatic cats are - or is he? That is often one of the big problems as they don't want to eat because they hurt. The pain meds do sound right.
 
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