diabetic 3 years~high dose (NANCY and CODY)

[Nancy and Cody]

Cody was diagnosed with FD about 3 years ago. He was on Vetsulin for a long time, and gradually increased to 12 units, 2x/day, still never really getting under BG of 220. Since Vetsulin is going off the market, we switched to compounded PZI (which was great), and now to Prozinc (2 weeks), which is brand new and manufactured for cats only. He's on 4 units and so far it seems his curves are much smoother than I saw on Vetsulin. The jury is still out because its hard to get a real curve during the holidays. Cody does have other issues, heart trouble, megacolon, pancreatitis, and is on a variety of meds, fluids, enemas.

Cody is on wet DM 3/4 can, 2x /day. We went through a long period of trying different foods and went back to wet DM. They recently changed the formulation of DM and it is much better- (flavor, carbs and ingredients) (similar to Fancy Feast pate) Unfortunately, Cody is always hungry and will eat anything he can get into. (4 AM last night he found and ate 1 1/2 beefsteak tomatoes!) Cody has a brother who is a slow eater, so we have to stand quard or separate them at meal time, and I have to sneak food to Tenderfoot midday so he doesn't waste away! I switched to dog water bowls and put them in 3-4 different rooms so its always available. As for the peeing on the carpet, I put out extra litter boxes and use Petzyme to clean up the "accidents"

Good luck - I am brand new to the message board also, but have read posts from time to time over the years. It helps knowing your not alone.

nancy i split your first post on this board off to your own thread so that there was not 2 different people on one thread to welcome to the board, especailly since your post was flagged by the high dose group to come take a look at. i hope i have not confused you and that you find this easily in the morning.
~moderator.

 

[Carolyn and Spot]

Hi Nancy

Cody was diagnosed with FD about 3 years ago. He was on Vetsulin for a long time, and gradually increased to 12 units, 2x/day, still never really getting under BG of 220. Since Vetsulin is going off the market, we switched to compounded PZI (which was great), and now to Prozinc (2 weeks), which is brand new and manufactured for cats only. He's on 4 units and so far it seems his curves are much smoother than I saw on Vetsulin. The jury is still out because its hard to get a real curve during the holidays. Cody does have other issues, heart trouble, megacolon, pancreatitis, and is on a variety of meds, fluids, enemas.

Cody is on wet DM 3/4 can, 2x /day. We went through a long period of trying different foods and went back to wet DM. They recently changed the formulation of DM and it is much better- (flavor, carbs and ingredients) (similar to Fancy Feast pate) Unfortunately, Cody is always hungry and will eat anything he can get into. (4 AM last night he found and ate 1 1/2 beefsteak tomatoes!) Cody has a brother who is a slow eater, so we have to stand quard or separate them at meal time, and I have to sneak food to Tenderfoot midday so he doesn't waste away! I switched to dog water bowls and put them in 3-4 different rooms so its always available. As for the peeing on the carpet, I put out extra litter boxes and use Petzyme to clean up the "accidents"

Good luck - I am brand new to the message board also, but have read posts from time to time over the years. It helps knowing your not alone.

Hi Nancy, nice to meet you I see you are feeding canned food and have a higher dose cat. With lots of medical issues going on, it's not a surprise, however I was wondering if you're hometesting or having the vet do the curves?

Honestly, you don't have to stick with DM for food. Friskies (believe it or not) is actually a higher quality product with many of their flavors. As a rule of thumb, I do not buy anything "in sauce" or "with gravy" and I also read the ingredients, staying away from anything that is a grain if at all possible. I just took a trip over to Purina's site and I am sad to see their ingredients are still not up to snuff. With cats, it's important not to feed too much liver, and according to their site, liver is still the highest quantity ingredient in the can, with no muscle meat evidently used:

Ingredients (Canned)

Liver, poultry by-products, meat by-products, water sufficient for processing, chicken, salmon, oat fiber, salmon meal, guar gum, potassium chloride, carrageenan, salt, Vitamin E supplement, calcium phosphate, taurine, thiamine mononitrate, zinc sulfate, ferrous sulfate, niacin, calcium pantothenate, copper sulfate, Vitamin A supplement, manganese sulfate, menadione sodium bisulfite complex (source of Vitamin K activity), pyridoxine hydrochloride, riboflavin supplement, Vitamin B-12 supplement, biotin, folic acid, Vitamin D-3 supplement, potassium iodide. H-4573
DM is unfortunately a low-quality, high priced food, with quite a few fillers in use. Nothing magical in that can.

In comparison, here is Friskies Poultry Platter:

Turkey, poultry by-products, water sufficient for processing, meat by-products, liver, fish, brewers rice, natural and artificial flavors, guar gum, potassium chloride, salt, carrageenan, taurine, Vitamin E supplement, thiamine mononitrate, ferrous sulfate, zinc sulfate, manganese sulfate, Vitamin A supplement, copper sulfate, pyridoxine hydrochloride, dicalcium phosphate, niacin, calcium pantothenate, riboflavin supplement, cobalt carbonate, Vitamin D-3 supplement, Vitamin B-12 supplement, menadione sodium bisulfite complex (source of Vitamin K activity), folic acid, potassium iodide, biotin.

See how liver is 5th on the list? I was a bit stumped to figure out why Friskies started adding brewers rice to all their flavors, but I have not noticed it affecting Leo's bg at all, and my diet controlled cat is completely unaffected as well.

Back to your dosing and noting your long history and the previous 12u on Vetsulin, I feel compelled to ask.. Is he a very big boy, or heavy set? Eating tomatoes is a good sign of a desperate kitty, no? :lol: I would like to learn more about him and his history because I am curious if he has ever been tested for Acromegaly. "Acrocats" have many various and not necessarily clear-cut symptoms, and some have no symptoms other than slightly high dose.. some of the things we have noticed are almost considered universal and they would include enlarged organs, heart problems, large size, incredible appetites, insulin resistance and loud breathing, just to name a few. There are many of us with acrocats here and often we find the higher dosed cats have stressed owners who don't post because they feel badly about the doses their cats are getting. I don't want to put the cart before the horse, because I don't know that I have enough information to make the call that he should be tested for it. For instance, when he was getting 12u BID, was he on dry food at the time, or canned?

(((hugs))) good to meet you and Cody!

 

[Spacey & Ella]

Re: Newly Diagnosed 4 units vetsulin BID

Hi Nancy,

Hello and welcome.

My cat Spacey is on Vetsulin (aka Caninsulin) as well. My vet gave first a shot of 5 units and then we had her on 2.5 units twice a day.
Now, she's on somewhere in between 0.5 and 1.
So.. things can change as soon as you go to wet only feeding.
You really need to test a lot.
My advice: do get a meter that not only tests glucose but also ketones. I didn't do that and now I have two meters lying around.

Good luck and keep in touch!

 

[jojo and bunny]

Re: diabetic 3 years~high dose

hi nancy and cody!
welcome to FDMB.
i cannot tell from your post (hey it is 4:30 am, maybe i'm just missing it :roll: ) if you are home testing or not? mentioning 'curves' rather than pre-shot numbers though makes me think that maybe the vet is getting the BG's? and it sounds like you were never very happy with the numbers those 3 years on vetsulin? was your boy eating canned food when he was on that 12 units of vetsulin? what are his numbers like now on 4 units of prozinc? has he ever had any hypoglycemic episodes in those 3 years?

basically what i'm digging around for is more information about what the response was/is like on the larger doses your cat is on. 3 years is a long time and if your cat was on low carb canned food and you are hometesting and the numbers were always still high, never any low numbers or hypos then i also strongly suggest that you get him tested for acro. it is a far more common condition than most vets realize. there are so many people out there that have never found this board, never heard of acromegaly, and wondering why their cat seems to need more insulin than other cats, and have always had this nagging suspicion that something else was going on. the test is a simple blood test, not expensive, and might answer questions that you have always had.
link for the IGF-1 test for feline acromegaly: http://www.animalhealth.msu.edu/Bin/Cat ... st&Id=1401

i hope you stop back in morning with more info!

 

[Patti and Merlin]

Hi Nancy and of course Cody,
I won't repeat all that the others have offered.

Could I just ask one more question - how old is Cody and how much does he weigh? Just something else that would help us help you and your boy.

We're anxiously waiting to hear back from you

 

[Nancy and Cody]

Wow, I am kind of lost on this site but here I am, found my way back! hurray

Cody and his brother Tenderfoot(TF) came from a shelter 13 3/4 years ago. We got them about 4 months old, and they had been bottle fed then adopted by another mom because their mom died. They have been spoiled rotten their whole lives by all 4 of us, and are sweet boys. They have had all the proper vet care and blood testing and vaccines etc. For the first 10 years Cody was the healthy one. Cody's weight has stayed pretty constant in the 10-12 lb range his whole life. At his PE, spring of 2007, his sugar was "a little high" my vet thought it was stress and told me to recheck later. Retesting in the summer we found out it wasn't just vet stress....

Pre diagnosis, I had always fed canned Friskies everyday and dry Purina One for grazing, but after diagnosis switched to DM, and eventually after browsing the site I tossed the dry DM and for years have only fed canned food. One attempt at raw was a disaster. I tried several of the others suggested on the site but never saw any real benefit in the BG readings, they were expensive, and / or he hated them. At least DM is consistant. TF now gets Fancy Feast (no gravy).

I think I started with Humulin N, then something else, then vetsulin, then compounded PZI and now Prozinc. I have been home testing all along and do curves from time to time especially when changing doses. My vet is totally supportive of home testing. Cody is fine with testing unless its meal time. I use a Freestyle meter and spend a fortune on strips. On any type or dose of insulin I have never seen a reading lower than about 160- 170 and that would be very unusual. He usually stays in the 200's or low 300's, but the day he scarfed the pecan pie or the soapy cake pan in the sink put him closer to 500. (Tonight I was rinsing coffee grounds out of his mouth when he dumped a sealed coffee can off the counter). PZI and prozinc seem very similar with really flat curves.

Somewhere during all this Cody developed bad megacolon which has given the vet and I fits more than the sugar. His stomach used to feel like he had multiple whole bananas inside. We tried pumpkin, vaseline, B12, extra water, and several meds. For a good year I struggled with this. Now he gets lactulose mixed in food, 150 ml subcutaneous lactated ringers everyday, and a warm water enema whenever his intestines get big again; and yes I do all of this myself. The vet thinks this is from unregulated sugar leading to decreased motility/intestinal blood supply.

This summer he had a bad colon spell when I took my daughter to school, which ended with anesthesia to remove the impaction, and an US ($350) which showed pancreatitis and both sides of his heart enlarged. Now he is on enelapril 2x/day for BP, and aspirin 2x/week to thin his blood, and Baytril every other day to ward off infection. He's actually doing pretty well now.

Do I win the prize for crazy cat woman of the week? I just wish I knew why he doesn't react more to insulin, I have never heard of ... whatever the last post mentioned (Im afraid to go back to check and lose this novel). tell me more

 

[Spacey & Ella]

Do I win the prize for crazy cat woman of the week? I just wish I knew why he doesn't react more to insulin, I have never heard of ... whatever the last post mentioned (Im afraid to go back to check and lose this novel). tell me more

Yes, you totally do!

 

[Carolyn and Spot]

Hi Again Nancy

Just getting back to the computer after a while.. you have been through the ringer with Cody eh? Ok so you've been doing everything you can to be doing as far as hometesting, wet food and following the ideas and tips from here and as you say, he's still insulin resistant.. There are a few things that are known contributors to insulin resistance, the top 3 being Acromegaly, Insulin Auto Antibody (IAA) and Cushings. There are tests you can have done for both acromegaly and IAA which will help you in discerning if he has either. The cushings testing is a little more involved, and you can read up in the link I'm about to post and decide for yourself whether you want to partake in that. For IAA and Acro, the blood will need to be shipped overnight but the total cost for me to have Leo tested for both IAA and Acro was around $100, including draw and shipping. He turned out positive for acro and negative for IAA, so we dumped the extended cushings testing.

Here is a link with lots of information about acro/iaa/cushings and where you can get the blood sent for testing: http://felinediabetes.com/FDMB/viewtopic.php?f=12&t=375

Now I didn't see if he is heavy, does he seem heavy to you? One physical trait that often separates acro's from other diabetics is their sheer size and weight. Some acro's are not large but still have a potbellied appearance.

You are more than welcome to visit with the High Dose group in the insulin support groups and share your experiences with us. Whether Cody is IAA/Acro/Cushings or none of the above, he's still a "big gulper" and we'd love to visit with you. We have a wide variety of cats in our small group, on multiple insulins, some at incredibly high doses, some at more manageable doses. My own boy is on the higher end (but not the highest ) at 26u BID of Levemir but he was once at 40u so I consider this an improvement LOL

 

[Nancy and Cody]

I just weighed him and he is 10 1/2 lbs, which is a little light for him I think, especially considering his intestines are feeling full again today. He's not "big" but he does have the pot belly, especially, when he needs to poop! maybe that's why he seems a bit more desperate recently.

Unfortunately when I increase the food, the megacolon gets worse, which requires more lactulose, which is bad for diabetic cats I think because it dehydrates more, so he needs more fluids, but that might increase his blood pressure and he has an enlarged heart.....bla bla bla.

the best thing we finally came across for the megacolon is the home enema, which sounds worse than it is, and the sub Q fluids (ditto)
The worst thing about it all is being so tied to his care 24/7/365

40 UNITS BID... WOW. that would be scary and expensive.

I may need help trying to find the high dose group and how to post some of his BG readings.

I am trying to go slowly so he adjusts to the lower BG, but hoping that a bit more insulin will gradually bring him down to a flat curve in the 150-250 range.

 

[laur+danny+horde]

Re: Hi Again Nancy

There are a few things that are known contributors to insulin resistance, the top 3 being Acromegaly, Insulin Auto Antibody (IAA) and Cushings. There are tests you can have done for both acromegaly and IAA which will help you in discerning if he has either.

Nancy,

I also recommend you get the Acro and IAA tests. Don't let your vet dissuade you! I have really struggled with regulating my second diabetic, Cole. My vet pooh-poohed the idea the first two times I asked for the tests since Cole didn't show the textbook signs, and she didn't want me to waste money due to large vet bills with my other animals. But to me Cole did show some signs, such as a potbelly (even considering her obesity), difficulty in losing weight, and difficulty in regulation. I knew that with the support of the board, I should be seeing better results with Cole. Finally I just said, look, I don't care if it's unlikely and I don't care about the money -- I want you to do the tests. The vet shrugged and did them.

Bingo. Cole has both acromegaly and IAA. I wish I had insisted a lot sooner. I would have saved myself a lot of second guessing and worry about Cole's frequent dosage swings.

ETA: have you tried Miralax? I have a cat with spinal nerve injury so Coco is unable to voluntarily poop. The surgeon told me to expect megacolon with him, since he was having major constipation problems. I tried lactulose which worked okay, but then others kept raving about Miralax so I tried that. Wow! So much easier to give and Coke never even notices it in his food. It works by absorbing moisture without adding bulk, so the poop is just much softer and easier to pass. I give him soupy wet food to make sure he has plenty liquids.

When he was having real trouble with constipation, I would also grease just inside his hiney with a couple cc's of KY jelly so the poop would soften and glide out easier once it got down that far, since he can't push. He was very tolerant of the insertion, since he had little sensation back there -- you may not be so lucky to have cooperation. Another thing that helped was Bethanecol, which as far as I can tell doesn't have some of the negatives of Cisapride. But since he's been on Miralax, everything has been great!

Good luck,
laur

 

[Patti and Merlin]

Hi Nancy and Cody,
So glad to see you found your way back! :thumbup

Here is a link to make your way to the hi dose section:
viewforum.php?f=12

Again I won't repeat all that Carolyn and Laur have said so very well.

I did want to tell you that you can order Freestyle test strips much cheaper thru Hocks.com. If you click on this link:
http://www.felinediabetes.com/pet-supplies.htm
At the bottom of the page you will see the link to Hocks. I ordered all my freestyle strips thru it when we tested Merlin. The more you buy the cheaper it is. It was the best deal thru them for those strips. And it supports the FDMB too.

 

[Carolyn and Spot]

I just weighed him and he is 10 1/2 lbs, which is a little light for him I think, especially considering his intestines are feeling full again today. He's not "big" but he does have the pot belly, especially, when he needs to poop! maybe that's why he seems a bit more desperate recently.

Unfortunately when I increase the food, the megacolon gets worse, which requires more lactulose, which is bad for diabetic cats I think because it dehydrates more, so he needs more fluids, but that might increase his blood pressure and he has an enlarged heart.....bla bla bla.

the best thing we finally came across for the megacolon is the home enema, which sounds worse than it is, and the sub Q fluids (ditto)
The worst thing about it all is being so tied to his care 24/7/265

Yeah, I hear ya. I don't have megacolon going on here but I do have a suddenly constipation-prone cat, and if it gets bad, it's real bad. It all started with a trip to NY to help my grandma, and I had to take him with me because he is on so many medications and I feel I need to be able to keep eyes on him at all times. He's been constipated about 5 times in the last 2 months which is unusual for him. My fiance can test and shoot, but.... you know, I had to bring him.

Would you say Cody's body weight is normal, heavy for his frame or on the thin side? I am continually asking you the same question not because I want to annoy you but because when a cat is resistant to insulin, or has difficulty achieving regulation, they should theoretically be thin. We have found the acro's tend to not have that happen, even if they are consistently very high in bg's. It can happen though, and when I got Leo, he'd been a stray and was only 7 lbs when he was found and very very sick. He gained 2 lbs in a week of treatment from his foster home and when I got him he gained 10lbs in about 3 months. A year later, he is well over 20lbs and on the too-heavy side, but he is what we would consider regulated.. in other words he stays within the 120-250 range normally. Some acro's get very heavy, some are just a little heavy, and some show absolutely no physical sign of being acro.

While Cody has some things that have caught my attention as an acro owner, I am entirely convinced he is one yet, and only a test will truly determine that. He does have some characteristics of acro, but they could be attributable to other medical conditions. Something is definitely going on with him requiring so much insulin in the past, and again, that may be attributable to his medical status. Regardless, he needs the insulin, and therefore we can definitely help you if you need help, and we can be there for you if you just need a friend.

40 UNITS BID... WOW. that would be scary and expensive.

LOL yep it was a new vial every other week on unemployment pay. I received a lot of help from this board though, and he's worth it.

I may need help trying to find the high dose group and how to post some of his BG readings.

Here's the group link, which you can navigate to by going to Insulin Support Groups from the forum index. The group is called High Dose and is 4th down on the list: http://felinediabetes.com/FDMB/viewforum.php?f=12

Look forward to seeing you soon!

 

[Carolyn and Spot]

Laur - great post!

I should have mentioned that too, and I'm sure glad you did. I use a lot of Miralax as well because Leo's poops are so huge that I have worried about megacolon becoming a problem for him since I got him. I was using just 1/8tsp twice a day but I've had to drastically up his dosing as the constipation has become a problem. (((hugs))) you're such a great mama-bean!

 

[Nancy and Cody]

Wow somehow I just lost my last reply, so here I go again, sorry if its a repeat!

Hocks .com WOW I just won the lottery , Strips are HALF the price I paid at Sams. Just ordered 150 wuppeeeee

Miralax sounds like a good option. Im surprised I haven't tried it. Is it available over the counter? Anyone using it on a diabetic?
Lactulose also works by drawing water into the colon but it has warnings for use in diabetics. This might be part of our "high dose" problem. I'll have to be careful cutting back. I'll run it past the vet

The acro, cushings and IAA sound interesting. I'll do some research.

Caroline, he has always been the "little brother" 9-12 pounds. He was gradually losing weight (muscle and fat) but it was hard to see because his belly was so distended. He started feeling like skin on bones, with a fat tummy. After we started treating his heart, dropped the cisapride, added daily sub Q fluids, up ing the insulin and getting the colon better, he has gotten more sub q fat, and seems happier.

Unfortunatley Cody was diagnosed about the time they stopped making IDEAX? and we started on insulins that were not the best for him and this aggravated his other issues. It may be a slow road back , but I am hopeful about the Prozinc. Recently I havent seen 300+ even after his meals; and yesterdays 12 hour prefood, preshot was 225, so ... maybe if I can get his sugar down he wont be such a sneaky scavenger!

Thanks for all the great tips! I found the high dose forum so I guess ill learn some more over there.

 

[laur+danny+horde]

Miralax sounds like a good option. Im surprised I haven't tried it. Is it available over the counter? Anyone using it on a diabetic? Lactulose also works by drawing water into the colon but it has warnings for use in diabetics. This might be part of our "high dose" problem. I'll have to be careful cutting back. I'll run it past the vet.

Many people here use it on their diabetics, that's how I heard so many good things about Miralax. It's available OTC at any pharmacy. It's a dry powder which you sprinkle on the soupy wet food. Coco doesn't notice it and neither do any of the other cats (they all swap dishes). The ingredient wouldn't have any effect on BG.

Dr Lisa very recently wrote up a post about constipation and comparing the two, but I can't find it. There is a difference in how they work, as I recall. At any rate, she recommended the miralax. Can anyone provide a link?

laur

 

[Nancy and Cody]

thanks I look for it

Sometimes I think I should write a book called the Misadventures of Cody! tonight he found the unfinished dog food. Hard to believe but we all try to be SOOO careful, but he outsmarts us all the time. At least it was food, last week he ate 3 inches of styrofoam leftover container out of the covered trash can. He threw some of it up a week later.... in perfect condition.

Maybe I should have him tested!

Its interesting that acro is caused by a tumor of a gland. His brother (Tenderfoot) had a benign Parathyroid tumor removed a few years back. The pathology report said it was rare.

 

[Carolyn and Spot]

thanks I look for it

Sometimes I think I should write a book called the Misadventures of Cody! tonight he found the unfinished dog food. Hard to believe but we all try to be SOOO careful, but he outsmarts us all the time. At least it was food, last week he ate 3 inches of styrofoam leftover container out of the covered trash can. He threw some of it up a week later.... in perfect condition.

Maybe I should have him tested!

Its interesting that acro is caused by a tumor of a gland. His brother (Tenderfoot) had a benign Parathyroid tumor removed a few years back. The pathology report said it was rare.

That is interesting Nancy, and might be even more interesting if Cody does turn out to be acro, because I don't think we have a lot of data on sibling health when it comes to this. As you can see, not much is officially known about acro, as it's mostly anecdotal from the owners who choose to treat, and are lucky enough to get these tests done.

I hope the Miralax will help, and I wonder if you can successfully use it in conjunction with Lactulose. I recommend you start a new thread on Health asking about Miralax/Lactulose/Megacolon and constipation. People with more experience can weigh in, and maybe someone can reference that post Laur is talking about. I did a google search looking for it and came up empty.. not sure if we can use the search function on the old board and I'm scared to crash it LOL

 

[Nancy and Cody]

We have an appt for tomorrow to discuss miralax, acromegally, and to bring in home BG curves and spot checks on the ProZinc.

Last curve was going well until.... yesterday while cleaning out the fridge from too much holiday sweet junk, my back turned for a moment, head in the fridge, and Cody jumps on the counter, QUIETLY of course, and scarfs 4 inches of chocolate frosting off a cake I was about to toss; all in about 4 seconds. So much for his BG .... absolutely exasperating! Anybody want a Cody lion? , kidding
As much as he cost me in $ and effort, I cried my eyes out when the vet told me how sick he was last summer, part of the family. He just really tests my otherwise good self esteem...constantly outsmarted by a mini-lion.

 

[Carolyn and Spot]

We have an appt for tomorrow to discuss miralax, acromegally, and to bring in home BG curves and spot checks on the ProZinc.

Last curve was going well until.... yesterday while cleaning out the fridge from too much holiday sweet junk, my back turned for a moment, head in the fridge, and Cody jumps on the counter, QUIETLY of course, and scarfs 4 inches of chocolate frosting off a cake I was about to toss; all in about 4 seconds. So much for his BG .... absolutely exasperating! Anybody want a Cody lion? , kidding
As much as he cost me in $ and effort, I cried my eyes out when the vet told me how sick he was last summer, part of the family. He just really tests my otherwise good self esteem...constantly outsmarted by a mini-lion.

Nancy, I hope you will not hate me, but I did laugh when I read your post. You have such a way of wording his little.. misbehaviors LOL

Fingers crossed for a great vet visit tomorrow! We'll look forward to hearing how it went

PS What were you thinking, throwing out perfectly good chocolate cake????? :lol:

 

[Nancy and Cody]

southern grandmother's live to cook ... every time the holidays are over, and she goes back home, it's purge time. Just don't have the heart to tell her not to bring sweets, and my DH and I gain 5 lbs. Besides Cody really loves the pecan pie and chocolate cake... (Havent figured out the smilies yet) but I did sign up for the usergroup

 

[Carolyn and Spot]

I'm glad you joined the usergroup, and don't hesitate to start a topic there and introduce yourselves! Cody is a total riot, though I imagine you are not quite seeing things that way LOL dancing_cat

To do a smiley, just click on the one you want to use on the right and it will insert itself into your post.

And maybe next time can you save some cake for me?

 

[Nancy and Cody]

Ok so we went in today for a follow up / check up to discuss progress on Prozinc, possible acromegally, miralax vs lactulose, his food, all his other meds (aspirin, enelapril, Baytril), his daily lactated ringers and the water I add to his food. So much to tell, we spent awhile together. FYI I printed previous chats and delivered them yesterday so she could do some research before our appt, which was very helpful.

Prozinc: She is happy with the BG data and really appreciates home testing. She wants me to continue 1 more week on 4 units to see if we can stabilize a bit more now that the hectic, sweet ridden holidays are past. She said to increase to 5 units if things stay the same. His best nadir now is ~212. and she would like to see 150-250 ranges, instead of 212- 300+

Acromegally- she is willing to test and will research the cost, but is very doubtful that he fits the bill. He is average sized and his internal organs are not big, his pancreas is no longer big, his kidneys are perfect size, his liver is not big. The enlarged heart and appetite have other explanations. And he did lose weight as a result of diabetes. I mentioned the doses ( 13 on vetsulin) and she said no telling how long the vetsulin recall "irregularity" was an issue, and he was pretty sick with pancreatitis/ cardiac / megacolon part of that time.

She asked about his quality of life: pretty good for a 13 3/4 yo diabetic cat, EXCEPT for the desperate hunger. He has lost significant weight again since November and this might explain the increased hunger. She said i could increase the food gradually to 1 1/4 can BID. This will require more laxative and more insulin. (We were so excited we cracked a can of FF when we got home )

As for the food, I like the fact that DM is the same everyday, and that 7 of the first 9 ingredients are animal protein or water. I think quar gum is slightly laxative which is good. I am changing other things right now (insulin and miralax), so I'm keeping the food as it is for now. If/when we go over 1 can/feeding I will add 1/2 can fancy feast, I guess.

She researched Miralax and said its fine to switch if I want to. Lactulose never bothered me because I just squirt it in his food and he eats ANYTHING; but at least it removes the small possibility that lactulose is affecting his BG. Both are cheap. (if anybody uses Lactulose , get the quart bottle online.~$12)

As for his heart meds (enelapril 2.5 bid and baby aspirin 2x/week) she asked if he had any fainting, (no) so we are keeping that the same.

She had me giving 150 ml SQ lact ringers everyday when he went home with pancreatitis last summer, and it helped the megacolon so much that I never stopped. She was surprised that he gets fluid everyday, but since he still makes the tent with his skin, so she said I should continue and could increase to 200ml/day if sugar or colon indicated. She said the water I add to his food primarily stays in the colon, so is not an problem for his heart. Ditto for the enemas.

Overall, it was a good appt but I'm sure the extra food will play havoc with BG, so I can almost guarantee we are headed back to higher doses. Acro testing is still out there. it would be interesting and i will probably do it, but I've gotta weigh the cost/benefit. We're well over $4000 this past year.

I spent 2 days figuring out the avatar,(aren't they cute? ) and now would like to add the BG chart to a signature.

 

[Nancy and Cody]

an update on the Miralax... I gradually decreased the lactulose and increased the Miralax over 3 days and then went to miralax alone yesterday, up to 3/8 tsp BID the past 3 meals. His stomach doesn't really feel hard, but it sure is big. I figured he may have a "dam" plugging up the works, so I tried an enema last night and only got 1 little ball. I'm waiting to find a PILE anytime now, but...

:?: Anybody else use 3/8 tsp BID? :?:

Nobody mentioned more than 1/4 tsp, but I haven't seen poop in days. Interestingly, his sugar numbers were great yesterday, that is until he raided the groceries we were unloading and ate bread

I got my spreadsheet and profile up, check it out

and thanks for ALL the great info earlier, its very helpful! :razz:

 

[Nancy and Cody]

an update on the Miralax... I gradually decreased the lactulose and increased the Miralax over 3 days and then went to miralax alone yesterday, up to 3/8 tsp BID the past 3 meals. His stomach doesn't really feel hard, but it sure is big. I figured he may have a "dam" plugging up the works, so I tried an enema last night and only got 1 little ball. I'm waiting to find a PILE anytime now, but...

:?: Anybody else use 3/8 tsp BID? :?:

Nobody mentioned more than 1/4 tsp, but I haven't seen poop in days. Interestingly, his sugar numbers were great yesterday, that is until he raided the groceries we were unloading and ate bread

I got my spreadsheet and profile up, check it out

and thanks for ALL the great info earlier, its very helpful! :razz:

 

[Carolyn and Spot]

an update on the Miralax... I gradually decreased the lactulose and increased the Miralax over 3 days and then went to miralax alone yesterday, up to 3/8 tsp BID the past 3 meals. His stomach doesn't really feel hard, but it sure is big. I figured he may have a "dam" plugging up the works, so I tried an enema last night and only got 1 little ball. I'm waiting to find a PILE anytime now, but...

:?: Anybody else use 3/8 tsp BID? :?:

Nobody mentioned more than 1/4 tsp, but I haven't seen poop in days. Interestingly, his sugar numbers were great yesterday, that is until he raided the groceries we were unloading and ate bread

I got my spreadsheet and profile up, check it out

and thanks for ALL the great info earlier, its very helpful! :razz:

Hi Nancy

I actually use 1/2tsp BID for Leo because less than that really doesn't soften things up enough. The not pooping is cause for alarm to me, not sure what your normalcy is there, since he megacolon. Miralax is not a laxative in the same sense as lactulose, and you may have to reintroduce lactulose until you can get him moving again.

I just checked out your SS.. excellent work! I am concerned by his flat cycles, and think he has room to grow on his dose.. I might pop it 1/2u and see if you can get some curving going. What do you think about that?

 

[Nancy and Cody]

ya, that 0 reaction (prebread) yesterday was really strange. I figured i'm going to have to go up from 4, I just felt so excited to see post food numbers so low. Im sorry I didn't get a prefood number.

as for the constipation, I can do another enema if things don't shake loose today. It's not really too strange for him.

You really do have great info and I appreciate it.

gotta go to church so... more later
:razz: Nancy

 

[Patti and Merlin]

Hi Nancy
So glad to see you posting again.

I've no experience with the Miralax - lucky I guess that none of my kitties have yet to need it! ;-)

But I would agree with Carolyn - you might think about increasing your dose a little more.

It's great that you have such a wonderful vet to work with.

If you think about it - you also might want to try posting in hi dose where we can find you a little easier too - Health is great too - but we'll look for you there as well!

 

[laur+danny+horde]

as for the constipation, I can do another enema if things don't shake loose today. It's not really too strange for him.

Definitely keep an eye on this, and go for the enema if he doesn't poop really soon. As far as I know, neither lactulose nor miralax can do anything to affect poop already in the system. So I can't see how re-introducing lactulose would help. If he's gotten impacted, the vet will need to unblock him.

Once he's going, you probably will have to go through 'too much' miralax (very loose poo) then you'll be able to reduce to get it just right. My Coco only needs a little sprinkle of it these days.

thanks for the updates,
laur

 

[Nancy and Cody]

Ok, so he's gotten to the point of really loose smelly poop so I'm backing off slowly. His tummy seemed almost fluffy, I think it's gas because I keep searching for messes I can't find. I hope this gas problem goes away as I back off the dose! this morning he got <1/4t miralax in his 5.5 ounces of food.

His sugar just doesn't want to budge below 200. I really don't want to change it again until this bowel thing is stable. I wish there was a way of knowing if the insulin was damaged from dropping it without buying another bottle. (do I spend the next $100 on acro testing or a new bottle?)

When he was on vetsulin, even at 13 units his numbers were still usually between 200-400 with a lot more jumping around than he has now. I feel like he's been "used" to 250 as normal for so long that his body is trying to maintain that. Am I crazy? Any human diabetics out there with a thought on this? He seems perfectly happy at 250...

I know, its time to start a new thread, Where do I start? :-| . I've finally gotten the profile up so I wouldn't have to repeat everything ... I also can't decide if I belong in PZI or high dose.
Nancy cat_pet_icon

 

[Carolyn and Spot]

Hi Nancy, I'm running out the door, but I got an email that this thread had been posted to.. I would copy and paste this whole post to HD group. Your dose *is* considered "high" so you'll be more than welcome there, and there are multiple PZI current and past HD'ers over there. Patti is one of them

Very glad to hear his poops are going more smoothly! Yes, they can get stuck in a range, I doubt there's anything at all wrong with your insulin since he is not 400+ every test, so I'd not worry too much about that. Leo prefers to be in the 150-250 range and gets very uncomfortable under 150.

Anyway I'm late so I gotta run, but ((((hugs)))) and glad to see you again

 

[Nancy and Cody]

Ohhhh and I almost forgot, I borrowed a mini thermometer from my dear parents and put it into the box I have taped inside my fridge to hold the insulin bottles from getting jiggled around. It tested right about 36-37, so I wonder if I've been letting it get too cold all these years. It rises instantly as I take it out to look at it, so who knows if its hitting <36 overnight with the door shut...

So I bumped it up a notch and now it reads 38-39. Interesting eh?

Nancy