Cierra” Story please help

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Looking at Cierra's spreadsheet (SS), she needs more insulin. If you're planning on following SLGS, you would increase the dose by 0.25u.

Is there a reason you're opting to follow SLGS vs Tight Regulation (TR)? You're testing enough to consider TR and with TR, if the nadirs are generally over 300, you can increase by 0.5u. TR is more aggressive but Cierra has been sitting in high numbers for a while and a more aggressive approach at least in the short term may be helpful. It's at least something for you to consider.
 
Sienne and Gabby (GA) said:
Looking at Cierra's spreadsheet (SS), she needs more insulin. If you're planning on following SLGS, you would increase the dose by 0.25u.

Is there a reason you're opting to follow SLGS vs Tight Regulation (TR)? You're testing enough to consider TR and with TR, if the nadirs are generally over 300, you can increase by 0.5u. TR is more aggressive but Cierra has been sitting in high numbers for a while and a more aggressive approach at least in the short term may be helpful. It's at least something for you to consider.
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Hi Sienna, apologies if I’m wrong I thought SLGS mean giving two shot per day . Is it meaning something else ?
 
Sienne and Gabby (GA) said:
Looking at Cierra's spreadsheet (SS), she needs more insulin. If you're planning on following SLGS, you would increase the dose by 0.25u.

Is there a reason you're opting to follow SLGS vs Tight Regulation (TR)? You're testing enough to consider TR and with TR, if the nadirs are generally over 300, you can increase by 0.5u. TR is more aggressive but Cierra has been sitting in high numbers for a while and a more aggressive approach at least in the short term may be helpful. It's at least something for you to consider.
Click to expand...


Found it . START LOW GO SLOW.
 
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Din said:
regarding carbs still I'am confuse .

It should be under 10%
is that mean if one can mentioned 2% carb I can give her 5 cans per 24 hours( Per day.)
so 2 times 5 = 10
is that correct.
please help me to 0 % carb food because Cierra is always hungry and every day I have to give her more than 10% carb / or more than 5 cans.
Click to expand...

Hi Din, if you are still confused about carbs, then think of it this way: an example:

You go to doctor about the food you eat, you tell him all the things you eat in one day.
-you eat lots of meat each day (50% of your food is meat) ~1/2 protein and fat
-you eat lots of potatoes each day (25% of your food is Starch) similar to ~1/4 Carbs
-you do not eat many fruits and vegetables ( 25% of your food is fibre, moisture, nutrients, vitamins)
Doctor says "No, no, this is not good!! ... TOOOO many potatoes!! (Too many Carbs) Eat more fruits and vegetables every day!!!! Eat less potatoes please!

Your new healthy diet from Doctor is 25% meat, 5% potatoes (Carbs), and 70% fruit and veg. And this always adds to 100% (everything you eat)
Same idea with different cat foods (it is just all in one can).... 2 or 20 or 50 cans of 4% Carb food is still 4% carbs

Another example may help:
Ciera eats 1 can of 4% carb in morning
Ciera eats 1 can of 6% carb in the evening
She eats half of each type (4% and 6%)
Math: We take an average of these two, so she is getting 5% carbs in her total daily diet
 
Sienne and Gabby (GA) said:
Looking at Cierra's spreadsheet (SS), she needs more insulin. If you're planning on following SLGS, you would increase the dose by 0.25u.

Is there a reason you're opting to follow SLGS vs Tight Regulation (TR)? You're testing enough to consider TR and with TR, if the nadirs are generally over 300, you can increase by 0.5u. TR is more aggressive but Cierra has been sitting in high numbers for a while and a more aggressive approach at least in the short term may be helpful. It's at least something for you to consider.
Click to expand...


Found it . START LAW GO SLOW.
Melinda and Kitkat said:
Hi Din, if you are still confused about carbs, then think of it this way: an example:

You go to doctor about the food you eat, you tell him all the things you eat in one day.
-you eat lots of meat each day (50% of your food is meat) ~1/2 protein and fat
-you eat lots of potatoes each day (25% of your food is Starch) similar to ~1/4 Carbs
-you do not eat many fruits and vegetables ( 25% of your food is fibre, moisture, nutrients, vitamins)
Doctor says "No, no, this is not good!! ... TOOOO many potatoes!! (Too many Carbs) Eat more fruits and vegetables every day!!!! Eat less potatoes please!

Your new healthy diet from Doctor is 25% meat, 5% potatoes (Carbs), and 70% fruit and veg. And this always adds to 100% (everything you eat)
Same idea with different cat foods (it is just all in one can).... 2 or 20 or 50 cans of 4% Carb food is still 4% carbs

Another example may help:
Ciera eats 1 can of 4% carb in morning
Ciera eats 1 can of 6% carb in the evening
She eats half of each type (4% and 6%)
Math: We take an average of these two, so she is getting 5% carbs in her total daily diet
Click to expand...


Hi Melinda thank you so so much for taking time to explain this. I really really appreciate. I understood it very clearly …..!!!!!!!!
 
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Bron and Sheba (GA) said:
If you are saying the PMPS is 17 i would give the usual dose of insulin
Is the libre working again
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@Bron and Sheba (GA)

yes it’s working but sensor stopping sometimes as it’s last 24 hours. I bought another but later appointment is Saturday to attach it. I’m thinking to do it by our self next time as currently we are having financial issues.
 
Din said:
I have to buy one to use situation like this. ( number are low and sensor not working) but I’m afraid to use it . It might be really hurt ? Isn’t it ?
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No, you will find cats don’t really mind having their ears tested.
A good meter is the ReliOn premier which is $9 and 100 test strips is $17.88
You will also need a box of lancets…make sure you get size 26 or 28 gauge lancets.
And some cotton rounds to help behind the ear.
Have a look at the link below
HOMETESTING HINTS AND LINKS
 
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Bron and Sheba (GA) said:
No, you will find cats don’t really mind having their ears tested.
A good meter is the ReliOn premier which is $9 and 100 test strips is $17.88
You will also need a box of lancets…make sure you get size 26 or 28 gauge lancets.
And some cotton rounds to help behind the ear.
Have a look at the link below
HOMETESTING HINTS AND LINKS
Click to expand...
@Bron and Sheba (GA)

Thank you Bron , I have to try then, I’m thinking to give low carb fancy feast from Saturday. My plan is give 12 % carb first few days then reduce 4-6 % carb gradually . I calculate carb on Royal canine DIABETES cat wet food nutrition chart , according to that it does have 15 % carbs and also contain sugar 1.3%.

I’m checking her BG on every hour day and night unless i falling deep sleep.

do you think I should do change her diet?
 
I would change to fancy feast. But do it slowly. It is cheaper than the prescription food.
I gave you the wrong information about the test meter. I was forgetting you live in Australia and I gave you Us information.
You won’t be able to buy the meter I mentioned post 63 in Australia.
The accuchek or the Abbott freestyle Optium are both good meters. You can get them online or from pharmacies in Australia

I don’t think you need to check the BG every hour during the night. You will get exhausted. I would drop it to every 2 or 3 hours if the BGs are yellow or pink and see how that goes.
 
Bron and Sheba (GA) said:
I would change to fancy feast. But do it slowly. It is cheaper than the prescription food.
I gave you the wrong information about the test meter. I was forgetting you live in Australia and I gave you Us information.
You won’t be able to buy the meter I mentioned post 63 in Australia.
The accuchek or the Abbott freestyle Optium are both good meters. You can get them online or from pharmacies in Australia

I don’t think you need to check the BG every hour during the night. You will get exhausted. I would drop it to every 2 or 3 hours if the BGs are yellow or pink and see how that goes.
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@Bron and Sheba (GA)

Apologies for late reply Bron, 4 days to due and I was doing my final shopping and getting ready with hospital bag..


I changed her food gradually and today we started feeding Fancy feast chichen Chuncky which is only 6 Carb.
I can see her numbers are getting drop. Hopefully not too low. :). I have ready with hypo box. honey/ Kibbles and 12 carb gravy fancy feast too.
 
I hope all goes well with the birth!
Who is looking after her while you are in hospital?
Do you have another libre attached or are you testing yourself?
 
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Bron and Sheba (GA) said:
I hope all goes well with the birth!
Who is looking after her while you are in hospital?
Do you have another libre attached or are you testing yourself?
Click to expand...


Thank you Bron,

Yes we attached another libre to her yesterday. Vet is really kind and save her last time when Cierra was sick, but unfortunatly they do not know much about diebetic cats. ones they said Cierra is experiment for them. I felt so sooooo bad. But here ( regional area) there is no other option for me. Their only advise give 8 units in the afternoon and only two meals per day.

After attached libre we started giving less carb (under 10%) today.
Untill Thursday 15 Carbs
Thursday night /Friday /Saturday - 12 Carbs
Sunday morning - Fancy feast Chicken Chunky When calculate its come as 8 % carb. But on the list is says 4 carbs.

My husband is looking after Our pur babies all the time. but I gave insulin to Cierra. So now I have to show him tricks how to do it.:woot:
He knows how to give it but time to time I had to change the way I give it. because Cierra act so smart and she knows that after her breakfirst and dinner I,m doing something to her :woot: therefore she try to hide.

We have to learn how to reduce the dose accorting to the BG level. I try to find it but could not.
Please teach me that Bron...
 
I don't think at the moment the insulin needs to be reduced. I think if it is still the same when you come out of hospital, you will need to increase the dose 0.25 units twice a day. That doesn't mean it won't eventually come back down again but at the moment she is needing more insulin.
 
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Bron and Sheba (GA) said:
I don't think at the moment the insulin needs to be reduced. I think if it is still the same when you come out of hospital, you will need to increase the dose 0.25 units twice a day. That doesn't mean it won't eventually come back down again but at the moment she is needing more insulin.
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Okay Bron Thank you , I will increase .25 units when I come back from hospital.
 
Din said:
We have to learn how to reduce the dose accorting to the BG level. I try to find it but could not.
Click to expand...
Hi Din, you will find some general information in the "Stickys" and links but you will NOT find a "Simple Guide to Dosing".
The experts here will always help decide a dosage change, and they must consider many, many things (not just BG) before they make a recommendation. They have years of experience with Feline Diabetes and every cat has a unique requirement. You are correct.... always ask before you change the dose :p:D:joyful:
 
Melinda and Kitkat said:
Hi Din, you will find some general information in the "Stickys" and links but you will NOT find a "Simple Guide to Dosing".
The experts here will always help decide a dosage change, and they must consider many, many things (not just BG) before they make a recommendation. They have years of experience with Feline Diabetes and every cat has a unique requirement. You are correct.... always ask before you change the dose :p:D:joyful:
Click to expand...


@Melinda and Kitkat .
Thank you Melinda, definitely I’ll ask before do any changes again. I wish I found this forum earlier….thank you again
 
Hi Everyone,

@Bron and Sheba (GA)
@Ale & Minnie (GA)


after one month I’m back. Had a really hard time. I need your advice please.

Cierra is vomiting since this morning. Vomited 6 times. Last two weeks she doesn’t have senser attached to her body.

Since 17th of Feb Her AM and PM Was around 14 then my husband dropped her dose from 4 units to 3 units ( I was in hospital on that week I could not ask your advice) .

since 17th of Feb she is getting morning- 3 units and evening-3 units.

food Fancy feast chicken chunky 4cans.

She is gaining weight and after I come home I slowly reduce her food from 4 cans to 3and 1/2.

Now my biggest fear she is vomiting since this morning and 6 times. Firstly vomited food now water.
Please advise should I run to Vet emergency?????

I make an appointment for tomorrow.
Please help.

please forgive me if I’m late to reply. Having hard time with 20 days newborn baby.
 
Congratulations on the new baby.
I don’t suppose you have any cerenia or ondansetron tablets for nausea at home?
You may need to take Cierra to the vet for an injection to stop the vomiting.
Does she seem unwell apart from the vomitinga. Is she lethargic? Is she wanting to eat?
Have you tested for ketones? You would need a bottle of Ketostix from a pharmacy and collect a urine sample from Cierra.
 
Thank you Bron,

I don’t have that tablet.she is not seems unwell or lethargic. But does not want to eat now. Change my vet appointment to this evening. Check keton day before day. I’ll collect urine from her. Thank you Bron
 
Bron is that tablet just coming for Cats ? Can I buy it from chemist warehouse?
 
See what the vet says about a blood test.
He may want to do a test for pancreatitis which is a separate test to the normal blood tests….ask for a fPLspec OR a fPL snap
 
If your vet can do an ultrasound, that would be good too. I’ve been going through the same thing with Bobo for almost 2 weeks now. He’s on both ondansetron and Cerenia, metroclopramide and also budesonide but that’s because the pancreatitis test was negative so the assumption is IBD.
 
I call my vet. He said let’s do a blood test? Is Blood test can find out it ?

is your purr baby gain weight?

cierra gain weight. I thought reason is kcal.
she ate sometime 4 - 5 cans got 90* 5 Kcal.
 
Her pancreatitis number is 5000 +
Dehydrated because of vomiting
Glucose 25
Kidney
Vet said I have to hospitalise her.
 
I hospitalised her yesterday. On fluids/ antibiotics/ medication

vomited whole day. I told not to give insulin, but nurse gave her insulin last night and her Glucose got dropped 3.9.
I don’t know what to say . Please keep my Cierra on your prayers ......
 
I’m very glad to hear Cierra is getting treatment in hospital. It’s the best place for her at the moment.
I think they did the right thing giving some insulin last night. Diabetic cats need insulin, especially when they are unwell as other things can go wrong if they don’t get the insulin they need.
Please let us know how she is getting along:bighug:
 
Bron and Sheba (GA) said:
I’m very glad to hear Cierra is getting treatment in hospital. It’s the best place for her at the moment.

I think they did the right thing giving some insulin last night. Diabetic cats need insulin, especially when they are unwell as other things can go wrong if they don’t get the insulin they need.
Please let us know how she is getting along:bighug:
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@Bron and Sheba (GA) @Ale & Minnie (GA) @Sienne and Gabby (GA) @Dyana
I just visited her.
vet asked me why I’m giving insulin morning and evening. And he said don’t give insulin morning and evening glargine is 24 hours one.

they decided to give one shot per day and because vet don’t want to give insulin two times per day. Nurse gave 6 units last night. I already gave 3 units yesterday morning and total units per yesterday was 9 …… that’s toooo much
Morning and night staff has no proffer communication. Morning person has been ready to give 3 units insulin. But stoped because low blood sugar. I’m helpless…. ….don’t know what to say . I can see from nurses faces I’m just annoyed to them.

They taking blood from leg every hour to check blood sugar. Why not ear :arghh::arghh:

I gave them freestyle sensor. But they didn’t set it up. I’m dying inside.

Her pancreatitis going up 6000+ yesterday it was 5400+

vet said this happen because of I changed her food from diabetic to fancy feast.

pleeeeeeese help us please
 
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Oh my goodness!
Lantus is given every 12 hours. Humans have it every 24 hours. Cats have a faster metabolism than humans so need it every 12 hours. To give 6 units at once is dangerous and plain stupid. And they are negligent if they were going to give 3 units again this morning after 6 units last night.
Din said:
vet said this happen because of I changed her food from diabetic to fancy feast.
Click to expand...
That vet has no idea what he is talking about. I can promise you changing from their diabetic food to fancy feast did not, in any way, cause the current problem.
Is there any other vet you can take her to. I’m sorry to say those vets are totally incompetent and negligent.
I am so sorry this is happening to you and Cierra
 
Also I have not seen the numbers 6000+ or 5400+ used for pancreatitis before. Can you please ask the vet for a copy of the blood results. You are paying for them so they are yours. Don’t take no for an answer. Remember Cierra can not talk for herself. You must do it for her.
 
Bron and Sheba (GA) said:
Also I have not seen the numbers 6000+ or 5400+ used for pancreatitis before. Can you please ask the vet for a copy of the blood results. You are paying for them so they are yours. Don’t take no for an answer. Remember Cierra can not talk for herself. You must do it for her.
Click to expand...

I have a copy of her blood test.

it says LIPA 5638 U/L yesterday 4.49 Pm
They did another blood test at 9 pm
LIPA ( lipase ) is > 6000 U/L
it should be in between 100 to 1400
 
Bron and Sheba (GA) said:
Oh my goodness!
Lantus is given every 12 hours. Humans have it every 24 hours. Cats have a faster metabolism than humans so need it every 12 hours. To give 6 units at once is dangerous and plain stupid. And they are negligent if they were going to give 3 units again this morning after 6 units last night.

That vet has no idea what he is talking about. I can promise you changing from their diabetic food to fancy feast did not, in any way, cause the current problem.
Is there any other vet you can take her to. I’m sorry to say those vets are totally incompetent and negligent.
I am so sorry this is happening to you and Cierra
Click to expand...


I’m crying and crying but I’m helpless Bron. As I said on beginning of our story other vet place- vet said I have to sleep Cierra. But this vet recovered my girl. I’m in regional area NSW . We have 4 vet place. One is not Taking new patients. They are full. I can not trust any vet anymore…. They don’t love our babies. They just need money.
 
Din said:
I’m crying and crying but I’m helpless Bron. As I said on beginning of our story other vet place- vet said I have to sleep Cierra. But this vet recovered my girl. I’m in regional area NSW . We have 4 vet place. One is not Taking new patients. They are full. I can not trust any vet anymore…. They don’t love our babies. They just need money.
Click to expand...
Yes the are neglected. Just because of my girl got low sugar they didn’t give insulin this morning otherwise they going to give 3 units in the morning,

Yesterday 9 units total…..
they don’t even know how to use glargine pen. When I visited Cieera vet asked me to show how to use it. I don’t know what they doing to my poor girl
 
Where abouts in NSW? I am in Sydney.
Can you ask about what the 6000+ test is please. I have not heard of a result line that.
Also don’t let the nurses make you feel bad. Cierra is your cat and you are entitled to ask as many questions as you want to.
please tell them that cats have a faster metabolism than humans and need insulin every 12 hours. Can you show them your spreadsheet?
 
Bron and Sheba (GA) said:
Where abouts in NSW? I am in Sydney.
Can you ask about what the 6000+ test is please. I have not heard of a result line that.
Also don’t let the nurses make you feel bad. Cierra is your cat and you are entitled to ask as many questions as you want to.
please tell them that cats have a faster metabolism than humans and need insulin every 12 hours. Can you show them your spreadsheet?
Click to expand...


I did tell them Bron . I told the vet one of my friend is a vet and she said give insulin morning and night. Then vet said I should follow one vet advice. I was speechless. I’m in Dubbo. Can I upload a picture here ? I can not find that option. Then I can show you it .
 
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