Charlie's vet's thoughts on his high numbers

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Charliemeow

Charliemeow

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#1: maybe find a lower carb food
#2: change dose less frequently, every 5 days
#3: test less often, just get several tests on like the 4th day of the dose(she thinks I'm just driving myself crazy looking for better numbers that don't exist yet)
#4: get fructosamine test. Maybe Charlie is functioning at a level that his body considers good.
#5: since he has no symptoms of diabetes and he has gained back most of his lost weight and is now holding steady, maybe we assume these numbers are good enough.
#6: acro/insulin resistance tests unnecessary at this time
because of points in #5

Any thoughts?

Edit: I see her point on a few of these. I told her that I'm not going to stop testing, though, especially at ps's. But I sooo don't want to just accept that these numbers may just be as good as it's gonna get. That breaks my heart!
 
Disagree with:
3,4,5,6

3) It's not her place to decide how crazy you are. So she's a psychologist too now? Gha!

4) No need for frutosamine test when you are testing. There is some discussions around about being able to convert from BG values over time to frutosamine numbers??? That's what frutosamine DOES - it's like and average over time. Vets can use frutosamine to make sure owners are complying with giving insulin and to make more money.

5) No symptoms? Have you had a urinalysis done lately? Was there any glucose in the urine? You can test for glucose in the urine at home with strips too. No "clinical symptoms" does not address the potential organ damage from unregulated diabetes.

6) Tests are not going to hurt anything besides your pocket book a little. Probably as much as the frutosamine test. I'd put the frutosamine test $$ towards the acro/iaa test. Besides she's wrong about #5 IMHO. :smile:

just my $0.02
 
#1: maybe find a lower carb food
ok

#2: change dose less frequently, every 5 days
ok

#3: test less often, just get several tests on like the 4th day of the dose(she thinks I'm just driving myself crazy looking for better numbers that don't exist yet)
riduculous since you won't know when he hits the jackpot and then gone to far....that is not a good idea at all. by the 4th day you may have been 'there' and now rebounding and we'd never know.


#4: get fructosamine test. Maybe Charlie is functioning at a level that his body considers
good.
don't know about this.

#5: since he has no symptoms of diabetes and he has gained back most of his lost weight and is now holding steady, maybe we assume these numbers are good enough.
huh???? is she really a vet??? yep let's just give up and let him have 300-400 bg's from now on!

#6: acro/insulin resistance tests unnecessary at this time
because of points in #5
don't know about this.
 
Charliemeow said:
#1: maybe find a lower carb food
#2: change dose less frequently, every 5 days
#3: test less often, just get several tests on like the 4th day of the dose(she thinks I'm just driving myself crazy looking for better numbers that don't exist yet)
#4: get fructosamine test. Maybe Charlie is functioning at a level that his body considers good.
#5: since he has no symptoms of diabetes and he has gained back most of his lost weight and is now holding steady, maybe we assume these numbers are good enough.
#6: acro/insulin resistance tests unnecessary at this time
because of points in #5
Click to expand...

Is the food you are using below 10% carb. and more protein than fats?

Change dose less frequently. IF, if we were seeing numbers below renal threshold...that might be acceptable. You are nowhere near there.

Test less often. If you weren't testing you would not know things are not working.

Fructosamine test at this time is worthless. His numbers are bad and the test is only going to show that, something you already know.

Resolved symptoms. For many, many uneducated owners this is acceptable and for a really long time was the "standard." That is all old news and old standards.

Acro test. I sort of understand what is being said here as we don't have a true big gulper dose here yet. Key...yet. up to 5 units isn't high dose. IMHO. 5u is kinda scary...but it isn't high dose outside of these forums.

Were you able to get a few test syringes of the PZ?
 
some cats are uber carb sensitive. my friend marjorie and gracie are like that...i think she feeds under 5 carbs. why don't i ask her to pop in and let us know what she's feeding?
 
well i just posted to her and i know she'll come right on over as soon as she see it.
her kitty is sooooooooooooooo carb sensitive.
 
Morning.....DH called me at work and said Lori was looking for low carb cat food info. Yes, Lori is right...Gracie is uber carb sensitive and I try to keep her below 3% unless she's dropping quickly; if I get a number that shows me she may be dropping, I'll give her 4% to slow her down a bit; even when she's below 50, I can't give her more than 9% to bring her up or she skyrockets from the carbs.

Here's what I feed LC and these are more expensive because I won't feed her anything with byproducts and I try to stay away from anything that has fish as the MAIN ingredient and avoid grains:
Merrick Before Grain Chicken: 2%
Merrick Before Grain Turkey: 2%
Merrick Before Grain Beef: 1%
Merrick Surf n Turf: 3%
Evo 95% Beef: 4%
Evo 95% chick/turk: 2%
Wellness Chicken: 4%
Blue Wilderness Chicken: 3%
Blue Wilderness Turkey: 3%

There are tons of reasonably priced low carb foods, for example:
9 lives Flaked Tuna in Sauce: 2%
Sophisticat:
Beef/Liver: 1%
Country Style: 1%
Liver/Chicken: 1%
Mariners Catch: 0%
Mixed Grill: 0%
Salmon: 3%
Sophisticat Supreme:
Fish/Shrimp: 0%
Chopped Grill: 1%
Ocean whitefish/tuna: 2%
Seafood: 1%
Sophisticat Pouches:
beef/gravy: 2%
mixed grill/grave: 2%
tuna in sauce: 2%

You can also take a look at Janet and Binky's Charts (link below) as they have these and many others which have low %calories from carbs.

http://binkyspage.tripod.com/CanFoodNew.html

I hope that helps!!!

eta: You're welcome Lori!!! I thought Tom was on a raw diet? There are some that are very low carb but some that are not...
 
#1: maybe find a lower carb food

yes, if you are feeding a higher one perhaps

#2: change dose less frequently, every 5 days

yes.

#3: test less often, just get several tests on like the 4th day of the dose(she thinks I'm just driving myself crazy looking for better numbers that don't exist yet)

perhaps. if you are testing as you are and it's not driving you nuts and you don't find yourself obsessing over the numbers, then keep at it. some people do get obsessive over the numbers and trying to race to remission and if that's the case, then maybe cut back some here and there.

in the beginning, because of my vet being who she was, i became very obsessed with the numbers and within a couple months or less, would test, see the number and get very frustrated, sometimes even crying over it. to the point that i considered asking her if she would take Mousie and treat her diabetes because clearly i wasn't doing a good job so i thought. then people here made me realize Mousie is my cat, she's not a number and to be honest, i backed off, from testing and from even thinking about it and get this, Mousie's numbers actually got better.

#4: get fructosamine test. Maybe Charlie is functioning at a level that his body considers good.

wasteful spending. won't repeat what others have said cause they've pretty much said it. :-)

#5: since he has no symptoms of diabetes and he has gained back most of his lost weight and is now holding steady, maybe we assume these numbers are good enough.

agree with others. yeah, kitty may be alive and breathing but these numbers over time are going to cause other complications so i don't agree with the vet on this one either.

#6: acro/insulin resistance tests unnecessary at this time because of points in #5

not sure really if they're called for or not here just yet. i'm not too familiar with what patterns you would see in the numbers and doses to say if a kitty may be acro or not. i'd probably see if you could get some input from the acro forum on that one. i would possibly consider giving each dose more time to work before changing it before i'd run off and get that testing done, if this were me. we used pzi, not prozinc, so not sure if it really applies but in my experience, constantly varying the dose was what was keeping Mousie all haywire. once we settled on consistent dosing, twice a day instead of three times, and gave it a week or so between changes, she went to under 200 BG levels 90% of the time (her BG reacts to stress so if my doorbell rings, her BG flies)
 
Thanks Marjorie for the food info! I appreciate it! I'll look for the sophisticate and 9lives ones, and do a gradual change-over just in case that drops his numbers.

Gator, Cindy, blue and Lori- thanks for you input! Gator- I use ketodiastix at home, and they always turn darker than the darkest shade on the bottle for sugar level. So obviously his levels are higher than they should be, eh? Vet made it sound like the f'mine test would somehow be cat-specific in regards to his good functioning sugar level. I think I eithermisunderstood or was misled.

Thanks again!!!
Claudia and charlie
 
claudia i just went out and got tom some of the cans on that list. i want to see if it helps his numbers.
don't give too many seafood meals. it's not good for them. maybe 2 or 3 a week? if you can.
 
Charlie is YOUR cat, yes? Based on Charlie being your kitty, here are my thoughts on those 'points'.
#1: maybe find a lower carb food
- You are feeding low carb so you could try some lower ones from Binky's list and the suggestions from others, but that's not the problem here.

#2: change dose less frequently, every 5 days
- I can't comment on this insulin as we use Lantus and Lev, so I'll leave it to the experts here who use that insulin.

#3: test less often, just get several tests on like the 4th day of the dose(she thinks I'm just driving myself crazy looking for better numbers that don't exist yet)
- LOL, spoken like a true vet. You know that if you did not test, you would not know how high Charlie's numbers are at shot times and through the cycles. Test as often as you want.

#4: get fructosamine test. Maybe Charlie is functioning at a level that his body considers good.
- Ah yes, money for the vet's bank account. You don't need to get that test done. You can just add up your home test results and get yourself a free average. While you may not save money, I certainly think that home testing is a life saver for many cats; fructo test is not.

#5: since he has no symptoms of diabetes and he has gained back most of his lost weight and is now holding steady, maybe we assume these numbers are good enough.
- Big deal he does not show symptoms! Does the vet want to wait till Charlie is so sick that he can't stand and THEN ... oh yeah, I guess we better do something. My Oliver does not have any symptoms but I am still giving him 17.5u BID at the moment. Should I stop giving my cat insulin cuz I see no symptoms? Want to know how fast I'll see rising numbers? What a silly statement!

#6: acro/insulin resistance tests unnecessary at this time
because of points in #5
- while I don't know about the insulin you are giving, a dose of 5u is not really an indication of acro/ IAA, but they could be. There have been others who have been getting higher doses and one I know (Randi/Max) who is currently OTJ and he was up to around 7u or so.
I would suggest that you see if a bit more insulin will finally kick in and give you some good numbers. While 5u may be higher than most others, it does not mean there is resistance. Charlie may just be a thirsty fellow!
If the time comes when the dose is getting up there, and you are not seeing any improvement in the numbers, just TELL you vet that you want the test done.
Charlie is YOUR cat, and it's YOUR money. Who cares what your vet says! It's nothing more than a blood draw that is shipped off to MSU for the tests!
My vet office dragged their collective feet and I wanted my Shadoe tested. She was up to 9uBID and they did not want to draw for the test because 'she did not look acro'. Well the test came back positive and they were shocked.
Please remember who is the boss: YOU on Charlie's behalf.

Try the lower carb thing; my Shadoe is very carb sensitive, so Charlie may do better on some of the way low carb canned foods.
Continue with the dose increases, as is proper for this insulin you are using, and see if maybe Charlie just needs a wee bit more insulin.

Good luck with Charlie and don't give up your control to the vet.
 
Claudia,
I just wanted to mention that BOTH of my cats have had fructo tests and they always show that their diabetes is in the good/very good range.
That one number does squat to help me from day to day in telling me when I need to increase or decrease doses... it's the home testing we do that matter, but I know you can see that yourself by seeing Charlie's numbers!

You're doing a great job Claudia - you know that by how well Charlie is doing.
 
On your relion glucometer:

Press the on button:

First number that comes up is your last reading,
Press the on button again,
7-day average

Press the arrow button pointing to the left
14- day average
Press it again
30- day average

Page 36 in the instruction manual.

Interesting reading and comparison as to why we might say averages and fructosemine tests tell us less about what is really happening: http://www.diabetesselfmanagement.com/A ... be_fooled/

When might you request a fruct. test?

So Attie saw the new vet today too. I did request a fruct. test for him to help establish a baseline for the new vet. Plus he bounces all over the dang place. I suspect his fruct. test will come back actually lower than my averages and he is doing better than it first appears.
 
Thanks for the advice Gayle! I will lower the carbs in his food. Maybe that'll help. Otherwise, keep increasing and testing.
Blue- I hope Attie's numbers come back looking good! I also hope you both like the new vet.
 
1) one thing I have noticed about the various foods (since I use a measuring cup to space out Cody's food). 9 lives and Special Kitty have a lot more liquid, and a lot less pate in the can, than Friskies, so even though they may be cheaper, and all contain "5.5 ounces" its not the same quantity of actual food. I can get three 1/4 cup meals out of a can of Friskies, but only two+ out of a can of 9 lives. I always drain all liquid as I figure a lot of the gravy carbs may be lurking there. I wonder if the quantity of food in "1/2 can" has anything to do with the improved numbers....

2) if you want to stay the same for 5 days, increase by 1/2 units. Take a look at Jan + feb on Cody's ss to see our ramp up and how long it took. after 5 months I still hadn't quite gotten to the dose he needed, but as it turns out I was probably close, and his current lev dose hovers around 15u most of the time. Once you start getting closer you can go back to fine tuning attempts.

3) your cat, your finances, your peace of mind, I do hope you are using a meter with less expensive strips. I thrive on the data. without it there can be quite divergent explanations for why the numbers are high at preshot ( and the resulting second guessing) On the other hand- cats generally survive despite us and testing does become obsessive... your call

4) no advantage and not cheap. Unless you suspect a bad meter- forget it.
Useful for initial diagnosis to distinquish vet stress vs FD

5) it is not uncommon for acros to gain weight even with lousy unregulated numbers. They don't feel as good as they could with high numbers- he's counting on you to bring him down. He wants to feel better...
Cats are resilient to high numbers, but over time, kidney failure, blindness, megacolon, rear leg neuropathy/weakness, frequent UTI, and URI, feeling chronic cell "starvation". I doubt she'd advise her Mom to live with it.
 
6) no point in the acro test at this time....
I may actually agree with her on this one, given your circumstances. Heck, I balked a long time, and my DH has a job. The best use of your resources now would be on insulin and good food.

Sure it would be awesome to know, and it would affect how I suggest you ramp up, but even if you don't KNOW he's acro, you do know he needs more insulin.

There have been several families that have been unable to get a diagnosis, but obviously are acro. One bean lives in remote Canada, one local vet( who already thinks she's crazy), and shipping the blood to the US through customs...overnight.... well lets just say not a good use of her teacher's salary. Her Kitty has been up and down from 28u of lev 2x/day, obviously acro, and lived with terrible numbers, and increasing misery for a long time, with a vet that said "dont change from vetsulin, don't give more than 10u. He's now on Lev (no rx needed in Canada so she could ignore the vet), and feeling more like his old self, although still with a residual rear leg weakness. I believe she did get the vet to agree eventually- not actually sure though

I've said it before, don't worry about that now, lets just keep giving him increasing (lifesaving ) doses until he shows us some relief from those numbers.
 
My 2 cents.

#1: maybe find a lower carb food

Can't hurt. It might be a coincidence but Harley's bg's improved with a lower carb food.

#2: change dose less frequently, every 5 days

I agree.

#3: test less often, just get several tests on like the 4th day of the dose(she thinks I'm just driving myself crazy looking for better numbers that don't exist yet)

I disagree, for reasons already stated by others.

#4: get fructosamine test. Maybe Charlie is functioning at a level that his body considers good.

I disagree, for reasons already stated by others. Take the money you save on this test and put it towards your food change experiment.

#5: since he has no symptoms of diabetes and he has gained back most of his lost weight and is now holding steady, maybe we assume these numbers are good enough.

Wrong.

#6: acro/insulin resistance tests unnecessary at this time because of points in #5

If they are willing to take your money for the F-test why won't they take your money for this test and get it over with.
 
I know I am late to the party here, but I just wanted to add something about the possibility that the numbers you are seeing now might be ok. No offense, but did your vet have a bowl of crazy for breakfast that morning?!? I would never, ever, ever think that 400s are ok for a maintenance number for a kitty. There is no question that that number is above the renal threshold. AND you are seeing evidence of that from the sugar level on the ketostixs you are using.

I just want to give you another vote of confidence to keep doing what you are doing! Many vets aren't used to seeing good results and tight regulation because they don't often give their patients the tools to get there. It is a catch 22 - don't suggest the protocol to get tight regulation - don't see tight regulation - don't expect tight regulation so don't suggest the protocol........ After years of this, there is no wonder many give up in a sense and are pleased with higher numbers than we personally would like to see.
 
Hi Kelly- thanks for stopping by. I don't think my vet is very up-to-date on fd. I like that clinic for everything else, but I feel like they think I'm asking too many questions and questioning her opinions too much. She always sounds exasperated when she talks to me, like I'm an annoying child who keeps asking "but why?". I may switch vets when our money situation improves, but I'm stuck there for now. I wouldn't even know where to go. Maybe they would do free consultations like pediatricians and midwives do so you can see if you click before you pay them. It's worth asking, I suppose.
.
 
I have thought of finding another vet, and maybe sometime in the future I will, but for now, my vet office is good for some things.
One vet there is awesome for everything dental; she does all dental at the office, and none of the other vets even consider it.
Actually she does all the important surgery, and I just adore her and how she treats the animals. She freely admits that she knows next to nothing about FD. She knows her a/b's and all other meds, and knows how to get things done fast and well. A fantastic diagnostician is what she is. All my cats just love her. Unfortunately, she's not the main vet for my two acros.
There is another vet that I don't like much but she's OK. She's finally willing to listen to me and do as I ask so I stay because of the other vet even though my cats' vet is not great on the FD matters.
There are so many vets that really don't know alot about FD, but they may be very good in other areas. You probably know more about FD now than your vet and more than some others too, so if your vet is good with 'the other stuff', maybe you can work with her, but go your own way on the FD issues.
 
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