? Bouncy Boy SugarLou

[Lynda and Louis]

Hi friends.
Long back story...
http://www.felinediabetes.com/FDMB/threads/im-exhausted-trying-to-figure-this-out.227878/

So here I am doing SLGS since April 3rd. I guess I need reassurance....

Louis continues to bounce at AMPS/PMPS. I've been following 6 cycle rule but as of this am, I'm back to 3.75 uI PZI, and getting close to the dose he was getting when I reached out a few weeks back. Maybe I need somebody to tell me to be patient again. Should I be waiting more than 6 cycles?

Gonna tag @Deb & Wink and @Sienne and Gabby (GA), as you guys have helped me before,
Anybody else, chime in.

Thanks in Advance for all you do.
Lynda and Louis

Oh and PS: His neuropathy seems to be getting WORSE!!! I increased Zobalink to 9mg daily on 4/14/20

 

[Ale & Bobo & Minnie (GA)]

Hi friends.
Long back story...
http://www.felinediabetes.com/FDMB/threads/im-exhausted-trying-to-figure-this-out.227878/

So here I am doing SLGS since April 3rd. I guess I need reassurance....

Louis continues to bounce at AMPS/PMPS. I've been following 6 cycle rule but as of this am, I'm back to 3.75 uI PZI, and getting close to the dose he was getting when I reached out a few weeks back. Maybe I need somebody to tell me to be patient again. Should I be waiting more than 6 cycles?

Gonna tag @Deb & Wink and @Sienne and Gabby (GA), as you guys have helped me before,
Anybody else, chime in.

Thanks in Advance for all you do.
Lynda and Louis

Oh and PS: His neuropathy seems to be getting WORSE!!! I increased Zobalink to 9mg daily on 4/14/20

Hi Lynda,

I can’t speak for much other then the neruropathy. Increasing to 9mg a day won’t make much of a difference as his body will get rid of the excess when he pees. I’d suggest staying at 6 because the b12 will start to work once his BG levels are more stable. When you say worse, how bad is it? Can you describe it? Minnie’s was so bad she could barely take 2-3 steps without resting, could not use the litter box and it started affecting her front legs as well. She’s 90% better going up and down stairs, jumping, so it’s reversible. The other thing that a lot of people agree can help is gabapentin since it’s an anti-inflammatory and also helps with arthritis. You might want to ask your vet about it as you’ll need a prescription for it. Lastly, Minnie was also on Thorne small animal antioxidant as it helps combat the oxidation caused by the excess BG.

Hang in there!

 

[Deb & Wink]

Taking a look at the SS. Back soon with more.

 

[Deb & Wink]

Ok, took a look at Louis's SS.
He's bouncing some.

But I think it's time to increase the dose again, to 3.75U of Prozinc. Which I see you already did for this morning, 4/24/20.

Reminder about getting at least one test in the nighttime cycle, before you go to bed. Otherwise, we are only seeing half the picture as to what is going on.

Agree with Aleluia, increasing the zobaline will not help Louis. We need to get those BG levels down first and foremost.

 

[Lynda and Louis]

Hi Lynda,

I can’t speak for much other then the neruropathy. Increasing to 9mg a day won’t make much of a difference as his body will get rid of the excess when he pees. I’d suggest staying at 6 because the b12 will start to work once his BG levels are more stable. When you say worse, how bad is it? Can you describe it? Minnie’s was so bad she could barely take 2-3 steps without resting, could not use the litter box and it started affecting her front legs as well. She’s 90% better going up and down stairs, jumping, so it’s reversible. The other thing that a lot of people agree can help is gabapentin since it’s an anti-inflammatory and also helps with arthritis. You might want to ask your vet about it as you’ll need a prescription for it. Lastly, Minnie was also on Thorne small animal antioxidant as it helps combat the oxidation caused by the excess BG.

Hang in there!

Thanks so much.
So here's what he's doing. At first it was just the back legs and the sitting down into "meatloaf" position (front paws curled under). Then pretty fast I noticed the front paws going down. Now his back legs are totally "duck like" and his back is hunched up with he walks. And the front paws are almost down to a wrist position when walking. Kills me.

Some questions on the supplements you suggest:

1. Should I start with one and see how he does? If so, which one?
2. If I start with Anti-oxidant, how many per day. It's pretty expensive on Amazon and I cannot see the dosage anywhere. They are capsules so sprinkle on food is probably best, but how many per day?
3. What type/brand of gabapentin do you get? I'm thinking the liquid might be better to give Lou. But IDK.
4. With these two and the Zobaline, I'll be giving him stuff all the time. Kinda daunting. How do you do it?? Do you mostly give something with every meal and rotate it? (Oh, and I'm gonna reduce the Zobaline per yours and Deb's suggestions)

Thanks again!
L&L

 

[Lynda and Louis]

Ok, took a look at Louis's SS.
He's bouncing some.

But I think it's time to increase the dose again, to 3.75U of Prozinc. Which I see you already did for this morning, 4/24/20.

Reminder about getting at least one test in the nighttime cycle, before you go to bed. Otherwise, we are only seeing half the picture as to what is going on.

Agree with Aleluia, increasing the zobaline will not help Louis. We need to get those BG levels down first and foremost.

Thanks Deb. I'm glad the increase was the right thing. I've been trying to do a +3 in the evenings, but some nights I'm just so tired. Last night I just weenied out on it and went to bed. I think it's a physiological thing with me. All the testing. (Whining here).... I just feel so bad for him and even tho I found the Magic Bullet with my people turkey from the deli (and he purrs the whole time), I just hate the damn testing. There I said it. I will now get over my pity-party and do it. Thanks for listening.

 

[Deb & Wink]

The gabapentin is a prescription drug. You will have to get that prescription from your vet, before you can order it.

Not sure if the liquid form would have some sort of sugars in it. Gabapentin is very bitter, so you need to either get it in a pill form, or a capsule that you split into smaller doses, and put part of the dose in one of those empty gel caps, for pilling cats. Cats can "foam at the mouth" when you give it to them, and drool like crazy. I've used it for a cat with oral cancer, in concert with buprenorphine for major pain management.

I just hate the damn testing. There I said it. I will now get over my pity-party and do it.

I know you do. I know you hate to test, I know you don't want to hurt your Louis anymore than you already are with giving him the shots. But he needs you to test him, so you know where the BG levels are in the PM cycle. So we can get his BG levels down and help his neuropathy.

If I had a sugarcat right now, I'd probably have to shoot at 5 am and 5 pm, since I need to go to sleep so early.

 

[Ale & Bobo & Minnie (GA)]

The gabapentin is a prescription drug. You will have to get that prescription from your vet, before you can order it.

Not sure if the liquid form would have some sort of sugars in it. Gabapentin is very bitter, so you need to either get it in a pill form, or a capsule that you split into smaller doses, and put part of the dose in one of those empty gel caps, for pilling cats. Cats can "foam at the mouth" when you give it to them, and drool like crazy. I've used it for a cat with oral cancer, in concert with buprenorphine for major pain management.


I know you do. I know you hate to test, I know you don't want to hurt your Louis anymore than you already are with giving him the shots. But he needs you to test him, so you know where the BG levels are in the PM cycle. So we can get his BG levels down and help his neuropathy.

If I had a sugarcat right now, I'd probably have to shoot at 5 am and 5 pm, since I need to go to sleep so early.

yes prescription so not a brand type thing. I actually get it at my human pharmacy CVS. I don’t really recommend the liquid. Minnie hated it and it was a struggle then she’d be nauseated after plus it had a vanilla flavor/scent and her whole face smelled like it because it would go everywhere. This is a pain and yes I’m a neurotic pet owner so it’s what I do. I get the 100mg capsules, open them up and fill empty capsules with half each since she’s taking 50mg at a time. I don’t know any other way to do it and if anyone else here has a better “technique” please let us know! I put the capsule into a pill pocket because she will eat anything I put in those. I actually don’t use Zobaline. I use the cheaper Vitacost b12 methyl version that some folks here also use. I think personally, works just as well but it comes in capsules too! The good news is b12 is flavorless and odorless so I open the capsule and mix it with her food. Then guess what? I reuse those empty capsules, because they’re pretty small, for the gabapentin! Oey vey I’m getting tired just explaining it all lol. It’s a lot I know. I’d keep the b12 and add the gabapentin for now. Wait on the antioxidant till his numbers are regulated. Minnie is not taking that anymore because she’s recovered well and if I remember correctly it’s $70 a bottle? One a day is all they need per my nutritionist. I think you get 120 so it lasts a while. I would also use a pill pocket if that works for you guys because I find all those herb probiotic like things do have a slight scent and taste and when I try to mix it with food, Minnie can smell it and won’t eat it. But inside a capsule inside a pill pocket, no smell. I’ll add this to your reply above as well.

 

[Ale & Bobo & Minnie (GA)]

Thanks Deb. I'm glad the increase was the right thing. I've been trying to do a +3 in the evenings, but some nights I'm just so tired. Last night I just weenied out on it and went to bed. I think it's a physiological thing with me. All the testing. (Whining here).... I just feel so bad for him and even tho I found the Magic Bullet with my people turkey from the deli (and he purrs the whole time), I just hate the damn testing. There I said it. I will now get over my pity-party and do it. Thanks for listening.

Let’s all say it! I hate testing too!!! I watch the clock dreading as the time to do it nears it and I take deep breaths and I say I’m sorry a lot. But we have no other choice. I’ll come to your pity party if you come to mine. But we become nurses for the ones we love and as I tell my friends, nursing my cats prepared me for nursing my mom when she had multiple strokes. So there’s a reason for everything even if we don’t see it at the time. Sending you positive thoughts and strength

 

[Ale & Bobo & Minnie (GA)]

Thanks so much.
So here's what he's doing. At first it was just the back legs and the sitting down into "meatloaf" position (front paws curled under). Then pretty fast I noticed the front paws going down. Now his back legs are totally "duck like" and his back is hunched up with he walks. And the front paws are almost down to a wrist position when walking. Kills me.

Some questions on the supplements you suggest:

1. Should I start with one and see how he does? If so, which one?
2. If I start with Anti-oxidant, how many per day. It's pretty expensive on Amazon and I cannot see the dosage anywhere. They are capsules so sprinkle on food is probably best, but how many per day?
3. What type/brand of gabapentin do you get? I'm thinking the liquid might be better to give Lou. But IDK.
4. With these two and the Zobaline, I'll be giving him stuff all the time. Kinda daunting. How do you do it?? Do you mostly give something with every meal and rotate it? (Oh, and I'm gonna reduce the Zobaline per yours and Deb's suggestions)

Thanks again!
L&L

1. I’d stick to the b12 you already have Louis on and add the gabapentin for now

2. I’d wait on the antioxidant till BG is regulated. One a day and I use a pill pocket because Minnie won’t eat the food if it’s mixed in. I used to get it from Thorne directly. I think you get a 10% discount from them

3. Again, liquid didn’t work for Minnie but if you think you can put it in a syringe and give it to him orally twice a day... it stressed me out too much so filling the capsules and using a pill pocket worked best. Even thought it’s a lot of work for me

4. It is totally daunting! I printed a cheat sheet and put it on the fridge and even then, sometimes I still forget one. Mind you Minnie is also on ondansetron, probiotics (2 kinds) and Pepcid so I give Minnie 3 feedings in the am. First with nothing because I need to make sure she eats for the insulin shot. I add the b12 to the second feeding, probiotics to the third and gabapentin in a pill pocket as a treat after. Then I repeat the process at night.

 

[Sienne and Gabby (GA)]

One suggestion right off the top is to not feed Louis at least 2 hours prior to your shot time. Giving food too close to shot time will influence your pre-shot number. While that may not be so much of an issue at the moment, once his numbers start coming down, it can give you a sense of false confidence.

I agree with Deb, a dose increase is warranted. I also think you may not see much of an effect on the neuropathy until you can get Louis' numbers into a better range. It's usually the combination of methyl-B12 and a reduction in numbers that starts to chip away at the neuropathy.

Gabapentin is NOT an anti-inflammatory. It's an anti-seizure drug that also has an effect on neuropathic pain. I would suggest a vet visit to make sure what you're seeing is diabetic neuropathy vs arthritis.

What kind of B12 do you have at home? Most generic B12 is cyanocobalamin. It is not as effective as methylcobalamin (methyl B12) in treating neuropathy.

I also want to plant a seed. I don't know if Louis is getting the duration you would want with Prozinc. Some of what you're seeing is clearly bouncing. I don't know that this is entirely the case. Prozinc is a longer acting insulin but ultimately, it may be worth thinking about if a switch to Lantus or Levemir may be a consideration. Both of these are depot-types of insulin which is a difference between how they work vs Prozinc.

 

[Lynda and Louis]

One suggestion right off the top is to not feed Louis at least 2 hours prior to your shot time. Giving food too close to shot time will influence your pre-shot number. While that may not be so much of an issue at the moment, once his numbers start coming down, it can give you a sense of false confidence.

I agree with Deb, a dose increase is warranted. I also think you may not see much of an effect on the neuropathy until you can get Louis' numbers into a better range. It's usually the combination of methyl-B12 and a reduction in numbers that starts to chip away at the neuropathy.

Gabapentin is NOT an anti-inflammatory. It's an anti-seizure drug that also has an effect on neuropathic pain. I would suggest a vet visit to make sure what you're seeing is diabetic neuropathy vs arthritis.

What kind of B12 do you have at home? Most generic B12 is cyanocobalamin. It is not as effective as methylcobalamin (methyl B12) in treating neuropathy.

I also want to plant a seed. I don't know if Louis is getting the duration you would want with Prozinc. Some of what you're seeing is clearly bouncing. I don't know that this is entirely the case. Prozinc is a longer acting insulin but ultimately, it may be worth thinking about if a switch to Lantus or Levemir may be a consideration. Both of these are depot-types of insulin which is a difference between how they work vs Prozinc.

Thanks for the advice on trying a new insulin. I had been thinking of this. Right now I am sort of in between vets. I was ready to make an appt with a new one I found that only treats cats when the virus hit. I'm going to call this week tho and see if they will take me and Lou.

Can you take a look at Lou's spreadsheet today? Also gonna tag Deb as well. Yesterday was a wild ride and I think I should have lowered the AM dose more. I read and re-read the dosing instructions, then I panicked when he hit 64 and I may have given too many Greenies which caused the giant bounce. I have lever had my meter give me that "too high to give a number" reading. Ugh.
@Deb & Wink

 

[Deb & Wink]

It's pretty typical to want to feed whatever high carb foods you have on hand, to bring those lower BG readings back up. Particularly, if the low BG results are early in the cycle, like at +4.

So next time, you know you don't have to give him so many greenies, to bring his BG levels back up. In fact, you should reach for his regular low carb food first 1 teaspoon, then retest in 20 minutes, if still not coming up, maybe another teaspoon of low carb food, then the medium carb food, retest, then the high carb food, retest. Lather, rinse, repeat as we say here.

Louis was bouncing from that low of 125 on 4/24/20. He cleared the bounce on 4/26/20 AM, with that 195 BG at AMPS.

Louis earned himself a reduction, with that 64 yesterday, 4/25/20. You need to hold that lower dose, back to 3.5U for a week since you are using SLGS. Unless of course, Louis "earns" another reduction, by dropping below 90 mg/dL again.