? Bouncy numbers - Do I Need a dose reduction?

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MeltyCat

MeltyCat

Member Since 2015
Good Morning FDMB. :)

I hope all the kitty parents, sugar kitties, and civies are doing well today.

I'm still having a bit of bouncing with Melty's numbers, but he seems to be holding steady at 0.50u insulin. I gave .75 last night and he went a bit lower than I'd like, so I've fallen back to .5 this morning.

He is still peeing A LOT, and I'm not sure why this is. Diarrhea still seems pretty rough, but his manner is good other than being a little lethargic (I am not usually home at this time of the day, so this could be pretty normal).

Any ideas as to what I can do to keep his numbers a bit more flat? I'm already feeding into the curve with small meals at +2.
 
I'm not able to help in fact been feeling pretty helpless these days. We had an emergency vet visit last week as we can't seem to get my boy leveled. We're now seeing an internal medicine/nutrition specialist. They changed his insulin from Vetsulin to Lantus (holy cow on the price difference!) Although he's been more active and alert this week than in a while. Today we're going back, I need to learn how to do glucose checks at home and I'm really nervous! He also is taking anti nausea meds so we're upto 3 shots a day. One challenge has been changing his diet from dry to wet and only feeding 2 times a day. The specialist is now advising it's ok if he only eats a little wet food and allows him to graze on DM dry food. On top of this now he's being tested for digestive Lymphoma and Inflammatory Bowl Disease. They both look the same unless you do an endoscopy. How much can these babies take? So sad.....how long has Melty been diabetic? We're only 2 months into this.....
 
Nikki,

Just a thought about that higher AMPS this AM....perhaps Melty went lower last night than he is now used to, given the .75 rather and .5 dose the last night. Melty went really low the other day and his body might just be kicking in to make sure that doesn't happen again.

I'd try to keep him on the same dose for a few cycles and see what he does unless of course he's going too low at nadir. He's really doing great so Kudos to you both!:D
 
I concur with Linda's suggestion to stick at the 0.5 unit dose for a few cycles (or less if he gets low nadirs on the 0.5). It does take their bodies several cycles to adjust to a particular dose.

How's the food transition going?
.
 
I just feel the need to comment on @Doodles post. Lantus, three times a day? And he needs to be off the dry food. And the specialist said dry was ok? And as far as only feeding twice a day, a number of us use auto-feeders to feed wet food throughout the day.
 
@Doodles - I'm so sorry to hear about your trip to the Emergency vet! I know that stress and upset, as Melty and I had to go about two weeks ago when he went hypo at 11pm. It's very scary, but I promise once you get home testing and have an idea of where his numbers go throughout his cycle, things will get so so much easier. This Forum is a great place, and there are lots of experienced sugar kitty parents to help you along the way. Melty was diagnosed about 2 months ago, and even though his numbers still swing a bit from time to time, his quality of life really is much better, and I even have a chance to relax sometimes ;)

@MrWorfMen's Mom - I didn't think of that. You may be on to something there. I feel bad for upping his dose, but I hate to see him in the 20s. I know it can't be good for him and I feel a bit guilty.

@Critter Mom - Hi Aine :)
Food transition is going. He generally gets more wet food than dry now, and he seems to really like it, doesn't always eat it all, but certainly makes his best effort. He is still peeing a LOT and has pretty bad diarrhea though. Sometimes I can tell by his mood that he's not feeling great, but other times he fantastic. He hasn't thrown up at all though, so I'm hoping it will get better. I've tried pumpkin and FortiFlora, but it doesn't seem to be making a huge difference. :/
 
Nadir was 5.8 last night and trending even lower tonight. Should I be reducing his dose even more?
 
Hi Nikki,

I've just been looking at Melty's spreadsheet notes. I don't think giving the Temptations to slow the drop is helping any, because those carbs will be knocking around in Melty's system when the Caninsulin dose wears off. High carb stuff can muck up a kitty's BG for several cycles. It could be painting a false picture of how much insulin Melty needs. Ideally with Caninsulin you need to give Melty the bulk of his 12-hour food allowance before the injection is given (to give the Caninsulin something to get its teeth into).

Can you post details of Melty's typical feeding schedule (times and percentage of food allowance for each meal). That would be a help. Also, did you acquire any U100 syringes?
 
@Doodles - Following on from @Shiloh & Rhonda's earlier post, are you giving Lantus twice and another injection of something else each day? Or are you giving Lantus 3 times a day?

I'd appreciate it if you could let us know as soon as possible.
 
Nikki, I want to reassure you that, for this stage of the game, you're doing really well. :cat:

The SS is showing a pretty consistent pattern over the last three days. That's great! OK, the numbers could come down a bit more, and flatten out too, but given that Melty was only diagnosed a couple of months ago this is pretty good.

I'm not convinced that what you're seeing at the moment is bouncing (although it might be...). It 'feels' to me as though it's more likely that the insulin simply isn't lasting long enough in Melty's system. If it is the latter then you may find that the duration extends over time. As Melty's pancreas heals he may be able to hold the numbers down for longer.

Another option - for those who have the time - is to try 3 insulin shots a day ('TID'). This can sometimes be a useful technique with the shorter-acting insulins. (Basically, you can start out by dividing the total day's dosage by 3 instead of 2, and giving those shots every 8 hours). That way, the preshot number doesn't have a chance to rise so high, and the numbers tend to flatten out.
It is time consuming though, and is only feasible for those folks whose schedules allow for them to be home quite a bit. (I did this with Bertie for quite a long time, giving shots at 5am, 1pm and 9pm.) There have also been folks here who gave shots on a TID schedule at the weekends when they were home more, and then shot twice a day ('BID') during the week.

As Aine asked, can you clarify what it is that you are feeding Melty? And what the feeding schedule is?
Are you consistently feeding foods with a similar percentage of calories from carbs? Or does it vary?

And regarding those Temptation treats, there are kitties on the forum whose BG will skyrocket with just a few of those....(cats vary in their carb-sensitivity)... And the effect they have can stay in the system for quite a while. So if you are giving Melty those they may well be skewing the picture.
(Do keep a close eye on Melty's BG if/when you remove these from his diet.)
Are there other treats that Melty likes? Freeze dried meat treats? Small pieces of plain cooked chicken..?

Have you seen the FDMB user guide for Caninsulin/Vetsulin? You may find that it contains some helpful info:
Vetsulin/Caninsulin user guide

BTW, you are sure to come across comments on the forum saying that Caninsulin doesn't work so well for cats. And it is true that its quicker onset and shorter duration can make it more challenging to work with; and some cats really don't do well on it. However, some cats here have done just fine on it. (And there have been kitties going into remission (becoming diet-controlled) with Caninsulin just recently...)

Eliz
 
Good Morning @Critter Mom and @Elizabeth and Bertie,

Thanks for getting back to me. Here's an idea of what Melty's schedule looks like:

6:15-6:30am - Test. Followed by wet meal. (about 1/2 can Merricks Pate or Wellness Core with 1/2 pack FortiFlora and water)
7:00am - Insulin dose given.
8:00am - +1 BG check, followed by small wet meal (usually about 1/4 can with water)
8:30am - Usually check BG again just to make sure he isn't dropping too fast, then put about 1/3 cup dry (Orijen Cat & Kitten) in dish for both kitties to nibble throughout the day while I'm at work.

*sometimes during his night cycle he gets the second wet meal at +2 (if he's not dropping too hard) and the dry at about +3 before I start to settle in and think about going to bed.

Merrick's Pates are between 2% and 5% carbs depending on which flavor.
Wellness Core is 2% to 3% carbs (again depending on flavor)
Orijen Cat and Kitten Dry is 17% with a low glycemic index (but he eats very little of this)

He is very picky about food. Not interested in any brands other than Merricks and Wellness Core so far (but the civie loves the FF so it still gets eaten). He only likes the pates, and likes them watered down to the point where they are more gravy than anything else.
I feel bad, but sometimes the temptations are all I can get him to eat. I try to be sneaky and mix a couple into wet food (this usually works).
I bought four different flavors of freeze dried snacks for him yesterday, and so far two of the three are not to his taste. (Again, Aggie loves everything ever and will clean these up for us).

I do not have the U100 syringes yet, but will pick some up tonight. I'm fairly confident with my .50 dose now on the U40 syringes, but if I have to go down to .40, it will be a complete shot in the dark.

I could probably re-arrange my schedule to accommodate three doses a day, but I wouldn't be able to monitor his levels very well. Phil has been lovely enough to check his levels throughout the day for me, and give him insulin/food if I'm going to be late home from work, but he works at a sod farm, and is not in the office 100% of the time.

Thanks Elizabeth for the words of encouragement! They really do help.
 
MeltyCat said:
I feel bad, but sometimes the temptations are all I can get him to eat.
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Sooner that than a hypo, Nikki.

Have you tried warming Melty's wet food a little? Just to the point where it's lukewarm to the touch. It can release more aroma and make it more palatable.

I note that Eliz has mentioned TID (3x per day) dosing. In Melty's case, he has shown a very strong response to Caninsulin, but as Eliz says, it doesn't last as long as some other insulins in most cats. I really wouldn't recommend the TID route for Melty on safety grounds. If he were my cat on those numbers, I would not feel safe giving 3 doses. He gets really steep drops just on the 2 doses a day, plus you are out at work. I know that Phil is able to pop in for tests while you're working, but I still think such a strategy is too risky: things can change very quickly and unexpectedly sometimes. All it might take is for Melty's healing pancreas to give a sputter of life or maybe for him to eat a little less/throw up on a particular cycle and his numbers could drop him from his 'typical' OK nadir into hypo territory. If it were to be the case that Melty can't get 'all the way' on Caninsulin BID dosing, if he were my cat I'd then look to switching him to one of the longer-acting L or P insulins. But that's for further down the road. Marathon, not sprint. ;)

As Eliz says, it's early days. All the time that Melty's in lower numbers is going to give his pancreas a chance to heal. My suggestion for now would be to persist with the food transition and doing all you can to help Melty get used to the taste. Things like adding a little tuna water, grated parmesan or (when you find one Melty likes) some crumbled freeze-dried treats on top of the food might help. Or maybe try crumbling some of the Orijen kibble on top of the wet food instead of the Temptations.

Front-loading the cycle with the greatest number of carbs is usually the best way to work with Caninsulin. Next day you are at home, I'd suggest trying to swap the order of the second wet meal and the Orijen Cat & Kitten dry. Split Melty's daily food allowance in two - 50% for each cycle - and aim to have him eat 50% of his carb allowance for the cycle at injection time or as close as possible thereafter. I do understand that balancing insulin with food finnickiness ain't easy (been there). Sometimes anything a kitty will eat is the right thing to give them. :rolleyes: However, with a bit of work (and acclimatisation to new food from Melty's end) you may be able to optimise the curve at the 0.5IU dose. Then you could look again at tweaking the dose. On Melty's numbers at the moment - and with the food schedule and carb load he is currently on - he might be able to do a 0.6BID dose, but I'd recommend only edging it up when you have a couple of days to test him at a higher dose. The other option might be to stick with what you're doing now and focus on eliminating the higher carb food altogether and then seeing what Melty's dosing requirements are (obviously lowering the dose if required as the food transition progresses).

Re the U100 syringes, it's actually easiest to measure 0.2, 0.4, 0.6, etc. of a U40 insulin on them.

BTW, what on God's green earth is a sod farm?
 
Critter Mom said:
Sooner that than a hypo, Nikki.
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^^^ This is pretty much where my head is at. That being said, I do try not to give him too many. I'll let him sniff the bag and then mix a couple into his wet food to try to get him to eat it, and it usually works.

Does anyone have any other carb-friendly cat food treat recommendations? I can try a little cooked chicken, but he generally isn't too interested in human food.

It's a bit of a relief to hear that TID dosing may not be essential. While I could certainly arrange it and make sure he got his shots every day, I would not be able to monitor him the same way without staying up ridiculously late daily, and during the day I'd hate to Phil or Darilyn to have to shut up shop every hour to come over and check in on him. The vet has said that if we can't get him totally regulated on the Caninsulin, that we could switch to Glargine (Lantus). I don't want to jump ship on one insulin, especially with so many things changing and he's still not used to the new diet.

Hmmm parmesan. I have a giant bag of freshly grated in my fridge, conveniently. I could give that a try, and perhaps give his food a 15 second zap in the microwave to warm it up. I will try these suggestions tonight. :) (How much parmesan would you suggest giving with 1/2 can?)

It's a grass farm, hahaha. He's usually working the office, but sometimes they send him out on deliveries or harvesting, so it's not 100% guaranteed that he'll be able to test/monitor consistently.
 
Critter Mom said:
Front-loading the cycle with the greatest number of carbs is usually the best way to work with Caninsulin. Next day you are at home, I'd suggest trying to swap the order of the second wet meal and the Orijen Cat & Kitten dry. Split Melty's daily food allowance in two - 50% for each cycle - and aim to have him eat 50% of his carb allowance for the cycle at injection time or as close as possible thereafter.
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I'm no expert and in fact I feel like I'm lost a great deal of the time.... but in the last few days I've been experimenting with "front-loading" the cycle. I don't think I've got it figured out by any means, but I do have categories of FF in the cupboard now according to carb content. My method is to feed higher carbs at the beginning of the cycle and lower carb food later in the cycle. I can't tell you really if this method is working for Radar because I've been dropping Radar's dose so much recently that I don't know what is causing what. But maybe it would be a good thing to try??

@Critter Mom, could you take a peek at Radar's chart and tell me what you think about the recent numbers. I would really appreciate it. :)

I have an appointment with the vet this morning at +3 because there is suspicion that my AlphaTrak readings are inaccurate. The numbers I've been getting say that Radar is really low but his behavior says that he's fine. He's barking at the birds, chasing his ping pong ball or washing his leg in his favorite sunny window.
 
MeltyCat said:
It's a bit of a relief to hear that TID dosing may not be essential.
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It's not essential at all, Nikki.
It's just a useful technique to try for some cats who have a short duration on an insulin.
I suggested it as an option because you were asking about ways of levelling out the numbers, and this is one technique that can be used to try to achieve that.
(But just FYI (and for anyone else reading this in the future), the total amount of insulin given in a day can be the same as when giving two shots. It's just split between 3 doses so the the drop in numbers isn't so great/fast/, and the preshot doesn't rise so high because the cat has insulin in it's system for more of the time; that is how it can level things out.)
It works well for some cats (but is tough on the caregivers long term, especially if they desire sleeeeeep. ;) )

It would be good if we could get some experienced 'eyes' to look at Melty's SS to see if they can give other ideas. Gonna tag BJ @BJM to see if she's able to take a peek.

Eliz
 
Jan Radar said:
The numbers I've been getting say that Radar is really low but his behavior says that he's fine.
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Hi Jan @Jan Radar ,
Some cats have a greater tolerance for low numbers than others, so it may not be that your meter is working incorrectly (are you going to compare with the vet's meter today?)

If your Alphatrak meter is reading correctly then some of those numbers you've got are potentially hypoglycemic numbers.
Be aware that some cats show symptoms in the early stages of hypo (often seen as increased hunger); some cats show symptoms when a hypo is moderately advanced (disorientation, staring into corners, dilated pupils for example (the symptoms are many and varied)); and some cats do not show symptoms until the hypo is advanced. A cat can seem fine one minute and be having a seizure the next. It has happened to people on this forum. Absence of symptoms does not mean absence of hypo. When numbers are very low it is safer to give food/syrup as necessary to bring them up rather than assume that all is OK because the cat looks fine. (Bertie has had several hypos and, trust me, it's a lot easier to deal with the situation before symptoms occur... ;) )

Here is the link to the FDMB Hypo document. It contains a lot of useful info. I'd suggest reading it through and then printing it out and keeping it with your hypo kit in case of emergencies:
How to treat HYPOS - THEY CAN KILL! Print this Out!!
The blood glucose numbers in the above document are from readings on a human meter. An Alphatrak meter will read higher than a human meter. As a rough guide (there are no absolutes in this), the Alphatrak may read 18 points (1 mmol) higher than a human meter at low numbers. So it is necessary to allow for this. You may need to deduct 18 points (1 mmol) from any Alphatrak readings to get an (approximate) idea of a human meter equivalent.

It looks like you may have a pattern of bouncing going on, although the bounce (if it is a bounce) seems pretty mild - not too high, and not persisting very long.
It could be worth sticking with that lower (2 unit) dose for a few cycles to see how the numbers are when they settle out. (Let's see what others think.)

Incidentally, does Radar have any history of ketones?

Do let us know what the vet says about the accuracy (or otherwise) of your meter.

Eliz
 
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@MeltyCat - just a tiny sprinkle of finely-grated parmesan over the surface of the meal should be enough. Usually once you get them going with 'seasoning' they'll finish the rest under their own steam. :)
 
Jan Radar said:
I'm no expert and in fact I feel like I'm lost a great deal of the time.... but in the last few days I've been experimenting with "front-loading" the cycle. I don't think I've got it figured out by any means, but I do have categories of FF in the cupboard now according to carb content. My method is to feed higher carbs at the beginning of the cycle and lower carb food later in the cycle. I can't tell you really if this method is working for Radar because I've been dropping Radar's dose so much recently that I don't know what is causing what. But maybe it would be a good thing to try??

@Critter Mom, could you take a peek at Radar's chart and tell me what you think about the recent numbers. I would really appreciate it. :)

I have an appointment with the vet this morning at +3 because there is suspicion that my AlphaTrak readings are inaccurate. The numbers I've been getting say that Radar is really low but his behavior says that he's fine. He's barking at the birds, chasing his ping pong ball or washing his leg in his favorite sunny window.
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Just had a look at Radar's spreadsheet and he looks to be doing really well with the food transition. His numbers are getting better by the day and the improvements in his general clinical signs are very encouraging: all that playing and grooming means that Radar's feeling much more like himself! :)

I'm a little concerned that you did not reduce the dose quickly enough on some previous days: some of those lows really are way too low. So ...

  • Alphatrak hypo threshold is 68.

Any time this number is reached (or if BG goes any lower), you need to reduce the dose. I recommend keeping a written note of this number writ large somewhere prominent at your testing station. (Note: It's easy to get confused about this because most of what you see written on FDMB refers to the hypo threshold as 50, but that is only for human meters. You need to use the Alphatrak value.)

Have a look at the column headers on Saoirse's spreadsheet. I've customised the reference ranges for an Alphatrak meter (both US and international values). It might be helpful for you to make a note of the reference numbers there to give you a better idea of where Radar's at BG-wise at any given time.

Your feeding schedule sounds well thought out. Vets normally recommend that you split a cat's daily food allowance in 2 and give half before the morning dose and the other half before evening dose. Some cats can't tolerate long fasts like that (they may vomit when their tums are empty for too long due to acid build-up). In such cases, it can help to split the food allowance for a cycle into smaller meals. The general recommendation here for cats on intermediate insulins such as Caninsulin/Vetsulin is not to feed after about +8 in the cycle so that there aren't too many carbs knocking around when the Caninsulin dose runs out of steam, with the aim of preventing the BG getting too high before the next dose is due. That said, every cat is different and the idea is to use the 'standard' approach as a guide and tweak it to meet the individual cat's needs. For example, when Saoirse was on Caninsulin her pancreatitis was very bad. She could not tolerate having an empty stomach - the acid would induce painful vomiting bouts. Therefore I used the following schedule:

Measure out half of daily food allowance for each cycle. Then spread the allowance for the cycle as follows:

Pre-injection feed: 50%
+3 feed: 20%
+6 feed: 20%
+9 feed: 10%

Note: This was for one type of food, so the % carb load at each meal correlated with the % of food served.

Needless to say if your cat starts really looking for food at any point in a cycle, test straight away and feed/steer numbers as required since it is most often a signal that BG is dropping.

I see in your spreadsheet notes for 22 July that Radar asked for food at +3.5 and +8 on one of the cycles. The first hunger pangs were probably due to the amorphous insulin reaching peak effect, and it's very possible that at +8 he's getting a boost from the crystalline fraction reaching its peak effect. If that's his pattern, then a small meal at +8 might be a good plan. It also gives a hint that his numbers may be holding in the lower ranges that far along in the cycle, which is good.
 
We are back from the vets office and this is what we've learned.
1. We are adjusting his dose to 2 units. :) she said my decision this morning to adjust down again based on my BG reading preshot was a good one. Better high than low!
2. My AlphaTrak is reading 13 below the vets special machine. We tested blood side by side to reach this conclusion. She says this variation is common in her experience. She also said that when the BG numbers are low this variation matters more.
3.. She wants me to provide some Rx kibble for him to graze on (he eats maybe 10 bites of the kibble in a whole day these days as he strongly prefers wet now) so I bought a tiny bag of kibble and we'll see if he'll eat it. If not I will return it and find something else that he can graze on.
4. Now that he's switched to wet food I understand that the feeding every day must be consistent with a focus on low carbs instead of feeding a crisis which is what I've had to do recently because of all the low numbers. We compared the Rx wet to FF and she was glad to see that they are basically the same in terms of P,F and C content.

I would like to stop changing the dose every day or so and I would also really really really like to stop these low numbers every single day.

To answer your questions @Elizabeth and Bertie No. Radar has no history of ketones and I think very recent bloodwork would have showed a problem if there was one?? Right?
Thanks for the reminders about hypo readings and behavior. :) We have been on high alert for about 10 days here stalking the cat and constantly checking, ready to spring into action. Rest assured, my hypo kit is well stocked and ready and more importantly all low readings we get are followed with honey and food followed by testing until the numbers are safe again.

If there's one thing I've learned recently it's that dealing with this disease is just like cooking. You assemble the ingredients, mix it all up and bake and sometimes when you open the oven instead of the cookies you expected to be making there's a duck in there instead. I'm just learning to cook... And as a work in progress there will be good days with more cookies and "ducky days"...
 
Thank you Aine, @Critter Mom. I appreciate the time you took to look over Radars ss. Your suggestions are welcome ingredients to my recipe. :)

@MeltyCat, I didn't mean to distract attention away from your original post... I realize now that I should've done a separate post. Sorry. I hope you aren't feeling offended or ?? However perhaps some of this information will be useful to you as you "cook" for your kitty??? I certainly hope so.
 
I think adjusting the dose back to 2 is a good move. Are you able to regularly test for a few days on the lower dose before introducing the Rx carby kibble (which one?)? That way you would be able to determine whether 2IU is safe. Leaving kibbles out to graze might skew things. Of course, if safety is an issue and you're not able to test throughout the cycle, then go with the extra grub. :)

Really like the cooking analogy. Saoirse and I have been having a lot of 'ducky days' lately. :(
 
Jan Radar said:
If there's one thing I've learned recently it's that dealing with this disease is just like cooking. You assemble the ingredients, mix it all up and bake and sometimes when you open the oven instead of the cookies you expected to be making there's a duck in there instead. I'm just learning to cook... And as a work in progress there will be good days with more cookies and "ducky days"...
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Yep, sounds about right, Jan..... ;):)
 
Jan Radar said:
@MeltyCat, I didn't mean to distract attention away from your original post... I realize now that I should've done a separa
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I was going to ask you to create a new thread before I posted my reply to you, but I elected against it because I felt that the 'feeding schedule' stuff would be helpful and relevant to both yourself and Nikki. (Nikki, I hope that's OK with you.)
 
The carby kibble is Royal Canine glycobalance which I find funny as the suggestion to feed a cat. Lol. It's breakdown is 46% P 29%F and 25% C. It does have better numbers than the Hills w/d with 39% P 24% F and a whopping 37% C.

Yes I can test as much as needed until I have to drag myself back over to the elementary school in mid August where I will be enslaved for the next 9 months.

Sorry about your "ducky days"... I'm such an optimist that I always think this time there will be cookies...
 
No problem at all. :)

I go through and read threads all the time that I'm not even posting in.
I feel as though you can never have too much information, and I often find something that applies to my situation.

@Critter Mom

I will take your advice and try giving dry food at +2 instead of wet, then leaving out a small wet meal when I decide to finally curl up for the night. I'm wondering if him having lower numbers at night has something to do with him eating less. He usually licks his bowl clean in the morning, but he almost never finishes an evening meal. I also don't think he touches the evening wet food until about 3am the next morning haha. Once I get batteries for his automatic feeder I can set it to close at about 4am to make sure he isn't spiking his AMPS by pigging out right before I get up!

Melty coughed up two massive hairballs today (I am assuming they are his since the hair is black) and seems to be feeling pretty great. Haven't checked the litter box yet though, wish me luck lol.
 
Know what you mean about picking up nuggets of wisdom across many threads, Nikki. Sometimes something will crop up after a couple of months, and it's great to have had some exposure in advance to possible solutions.

MeltyCat said:
I will take your advice and try giving dry food at +2 instead of wet, then leaving out a small wet meal when I decide to finally curl up for the night. I'm wondering if him having lower numbers at night has something to do with him eating less. He usually licks his bowl clean in the morning, but he almost never finishes an evening meal. I also don't think he touches the evening wet food until about 3am the next morning haha. Once I get batteries for his automatic feeder I can set it to close at about 4am to make sure he isn't spiking his AMPS by pigging out right before I get up!
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I'd suggest first trying the re-jig of the feeding schedule during a daytime cycle where you can monitor clinical signs and test/intervene if things don't go as expected. Indeed, my approach is always to trial new stuff on monitored daytime cycles - it's safer.
 
That's a good suggestion.
I can't guarantee that he'll even eat the +2 meal tonight, and if he doesn't he may end up even lower than normal.
I'll try the change on Sunday morning (as I'll be here to monitor numbers all day)

I really appreciate all the advice Aine :)
 
I'm only too pleased to try to do something to help a fellow Sugar Mama. I remember how swamped I felt this time last year, and many times since. :) As it is, I'm fighting a bit of a battle to get Saoirse to manage food with her phosphorus binder in it. It's not going well... :(
 
Jan Radar said:
If there's one thing I've learned recently it's that dealing with this disease is just like cooking. You assemble the ingredients, mix it all up and bake and sometimes when you open the oven instead of the cookies you expected to be making there's a duck in there instead.
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That was hilarious Jan...I actually laughed out loud. My DH was looking at me like I was crazy. But so accurate!
 
:eek:
MeltyCat said:
Melty coughed up two massive hairballs today (I am assuming they are his since the hair is black) and seems to be feeling pretty great
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That is such a coincidence Nikki. Genghis coughed up 2 today as well and she has never, ever had hairball issues - I mean not even one hairball- in the 13 years she has been with me.:eek:

I have read elsewhere of folks having huge shedding bouts after starting treatment. I have been brushing Genghis a lot more lately and got a massive pile of fur out of her tonight. Since feeling better she has been grooming a lot more (how did I miss that she hadn't been??? :(). I think these two things combine are a "recipe" for yakking up surprises - since we are on the cooking theme :rolleyes:

Has Melty had hairball issues before?
 
Brashworks said:
I have read elsewhere of folks having huge shedding bouts after starting treatment.
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Saoirse's never been a sheddy cat, but her fur started coming out like there was no tomorrow after she started insulin treatment.

The increased grooming is a very positive sign. Like you, I had missed that my little one wasn't preening as much as she should be.
 
Critter Mom said:
Critter Mom now running round the place like some demented óinseach with a giant, specially-adapted, vibe-catching butterfly net... )
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I had to go look up "óinseach" - what a great word! Funnier because it simply doesn't suit!

Critter Mom said:
Saoirse's never been a sheddy cat, but her fur started coming out like there was no tomorrow after she started insulin treatment.

The increased grooming is a very positive sign. Like you, I had missed that my little one wasn't preening as much as she should be.
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This is very good to know and makes me feel much better. Thank you, as always! :bighug:
 
The óinseach cap is a good fit: trust me. :oops::rolleyes:

Forgot to mention that shortly after the shedding Saoirse's hair grew back very well - and soft and shiny, too. :) It was a big relief, because she ended up in a rather ropey state when the shedding was at its zenith.
 
@Brashworks

He is a prince among felines, and has always groomed himself often. So he's had hairballs before, but the ones I found today were HUGE (and pretty gross haha).
He is definitely shedding more than usual, I didn't think about brushing him. I'll have to get one to try to cut down on the amount of cat hair now blowing around my house!

I hope Genghis is feeling better after the purge? Melty's attitude is 100% this evening. I miss him like this. :)
 
Critter Mom said:
I'm fighting a bit of a battle to get Saoirse to manage food with her phosphorus binder in it. It's not going well... :(
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Aine, which binder are you using? Are you using aluminium hydroxide? I tried several different binders with my CKD kitty and this was the only one he'd tolerate (it seems to have no taste). If you've not tried it (and would like to) then I can send you some if you wish. Just PM me your address if you're interested.

Apologies, Nikki, for briefly interrupting your thread.... :bighug:
 
@Elizabeth and Bertie - Ipakitine was a no-no because of her soy sensitivity (reacted negatively on second dose - annoying because she didn't object to the taste/texture). Currently on Pronefra - got a few doses down but with much coaxing and some tuna juice. I'm not confident she'll stick with it. I took the precaution of ordering some Alu-caps to have ready should she struggle with the Pronefra (thank you for offer of a sample, though!). I'm going to keep on with the Pronefra for the next few days to see it things might improve (worried about her GI transit times on it as well :rolleyes:). If not, then it's a pow-wow with the vetty bean about the AlOH.

We now return you to your scheduled programme.

(Sorry for the mini frankenthread, Nikki! :oops:)

.
 
Hi Critter Mom - sorry for the delayed response. It's been a challenging few weeks. We were on Vetsulin twice a day and now we've switched to Lantus twice a day. We are now able to test at home which is relief although it was scary at first. We've since done 2 curves trying to get him regulated. The new specialist switched us to Purina Pro Vet DM dry food with some Fancy Feast at each meal. We tried getting him off dry food altogether but he was barely eating. So she is fine with the combination of wet/dry just as long as he eats. So my next question is...any opinion on DM vs. Evo? We just moved to 2 units of Lantus this morning and will do another curve next week.
 
Doodles said:
Hi Critter Mom - sorry for the delayed response. It's been a challenging few weeks. We were on Vetsulin twice a day and now we've switched to Lantus twice a day. We are now able to test at home which is relief although it was scary at first. We've since done 2 curves trying to get him regulated. The new specialist switched us to Purina Pro Vet DM dry food with some Fancy Feast at each meal. We tried getting him off dry food altogether but he was barely eating. So she is fine with the combination of wet/dry just as long as he eats. So my next question is...any opinion on DM vs. Evo? We just moved to 2 units of Lantus this morning and will do another curve next week.
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Hi - Could you please start a new thread for Doodles and re-post both this and your earlier post/first post that you'd done here? As the thread you're posting on now is about Melty Cat's situation --- & we really need to give you individual attention on a thread all your own. Thanks! - Robin (Then I'll provide you some more info on the D/M dry, which is too high in carbs.)
 
Hi Robin - I must have read your mind. I just reposted "Dry Food". I'm still getting use to this site and definitely need to be on more often. Thank You!
 
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