Freya's ProZinc Saga, Vol. II

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So... weird AM cycle o_O with a good PMPS. The random rise mid-AM surprised me. Unless she's suddenly developed an issue with that particular variety of food, I don't think it's a food spike. She's had a few times before where she's randomly "spiked" after eating a food she usually continues to drop on, for no apparent reason other than maybe her weird regulation issues and unpredictable cycles. It may be that, but I'll keep watching just to make sure.

Fingers crossed for good stuff tonight... :nailbiting:
 
Glad I got that +6 last night, because between that and this morning's strangely nice AMPS, I'm assuming she may have had one of her trademarked delayed/"long" cycles last night. Given that, I wouldn't be surprised if she ends up rising for the first part of this AM. It's good to see she at least hit blue last night. Now, if she could just do that some more...

She's got 100 more test strips on the way since we're blowing through them lately. I'm trying to be relatively conservative if I can until they arrive, just to be safe. (Pretty sure I'm keeping some London guy on eBay in business.) And I ordered more MAC's food last night to add back into the mix. Just the usual Duck/Turkey/Chicken and Turkey/Blueberry, plus their Mono Sensitive Turkey to try for the first time. New foods are always a bit scary, but with her being as sensitive as she is, I feel like I really need to learn which ones are okay in case an issue ever arises with one of her regular varieties, or something goes out of stock. It's like 1% carb, so I just hope the minuscule amount of carrot doesn't disagree with her. :rolleyes: The blueberry in the other kind doesn't seem to.

...Anyway, I feel like I want to sit down with some popcorn as I wait on the edge of my seat for how this cycle unfolds. :p
 
Blair & Freya said:
Glad I got that +6 last night, because between that and this morning's strangely nice AMPS, I'm assuming she may have had one of her trademarked delayed/"long" cycles last night. Given that, I wouldn't be surprised if she ends up rising for the first part of this AM. It's good to see she at least hit blue last night. Now, if she could just do that some more...

She's got 100 more test strips on the way since we're blowing through them lately. I'm trying to be relatively conservative if I can until they arrive, just to be safe. (Pretty sure I'm keeping some London guy on eBay in business.) And I ordered more MAC's food last night to add back into the mix. Just the usual Duck/Turkey/Chicken and Turkey/Blueberry, plus their Mono Sensitive Turkey to try for the first time. New foods are always a bit scary, but with her being as sensitive as she is, I feel like I really need to learn which ones are okay in case an issue ever arises with one of her regular varieties, or something goes out of stock. It's like 1% carb, so I just hope the minuscule amount of carrot doesn't disagree with her. :rolleyes: The blueberry in the other kind doesn't seem to.

...Anyway, I feel like I want to sit down with some popcorn as I wait on the edge of my seat for how this cycle unfolds. :p
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I think you're getting close to her "good dose". She's given you some nice numbers with 4.75 u but I think you'll be at 5 u soon. Tricky/bouncy cats tend to bobble and wobble a bit when they're dancing around the good dose. I speak from entirely too much experience! :confused::)
 
Kris & Teasel said:
I think you're getting close to her "good dose". She's given you some nice numbers with 4.75 u but I think you'll be at 5 u soon. Tricky/bouncy cats tend to bobble and wobble a bit when they're dancing around the good dose. I speak from entirely too much experience! :confused::)
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Yeah I agree. What in the world is going on today though? She's gone from 11.2 at AMPS to 19.1 at +4. Ugh.

(Corrected +3 to +4. Typo!)
 
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Yeah, I just don't think I've ever seen anything quite like that from her before. It's like an upside-down curve. :eek: I'd like to see if she stabilises a little first, but I wonder when I should bump her to 5u.

Edit: And whoops, I realise now that in my post, I accidentally wrote that the spike was at +3, but it was in fact at +4 like the sheet indicates. Dumb fingers.
 
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Hm... part of me wonders what's going on after those PM +6s the past few nights. She's clearly getting some time in blues overnight, but I wonder if they've been typical cycles or some of the strange ones lately where she keeps dropping at various times past +6. I think the latter may have been the case on the 9th. I'm encouraged to see she's not staying all yellow, in any case.

I was trying to let any prolonged bounce to clear, but do you guys think I should go ahead and try 5u within the next few days?
 
Generally people around here say that a bounce can take up to six cycles to clear, although I was looking at a spreadsheet the other day that had eight cycles to clear the bounces. So an argument could be made for waiting a couple more cycles. However, given Freya's inclination toward sticking, I think I'd lean toward making the increase. That being said, I agree with Kris' earlier comments that you seem to be getting closer to a good dose, so you may start to see greater volatility in the next increase or two.
 
Teasel has taken longer than 6 cycles to clear a bounce before. He clears them faster when he's at a better dose. Another thing about long cycles: they can happen when a bounce is clearing. Teasel shows this pattern sometimes - BG continues to drop right up to the end of the cycle.

I'd take a chance on 5 u today if it was my Sticky Kitty. :)
 
Djamila said:
Generally people around here say that a bounce can take up to six cycles to clear, although I was looking at a spreadsheet the other day that had eight cycles to clear the bounces. So an argument could be made for waiting a couple more cycles. However, given Freya's inclination toward sticking, I think I'd lean toward making the increase. That being said, I agree with Kris' earlier comments that you seem to be getting closer to a good dose, so you may start to see greater volatility in the next increase or two.
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Kris & Teasel said:
Teasel has taken longer than 6 cycles to clear a bounce before. He clears them faster when he's at a better dose. Another thing about long cycles: they can happen when a bounce is clearing. Teasel shows this pattern sometimes - BG continues to drop right up to the end of the cycle.

I'd take a chance on 5 u today if it was my Sticky Kitty. :)
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Yong said:
If you'll be around to monitor her as usual, I agree you could try 5.0U today :cat:
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She'd already had her AM shot by the time of the posts, but I gave her 5u for her PM just now and will monitor through the night. I've taken to sleeping on the couch between cat-check phone alarms when I have to. ;) I was shocked, she actually slept through her test/food/shot alarm tonight and didn't even hear it go off. Normally she starts bugging/staring at/pawing me an hour before. There was a look of panic on her face once I'd woken her and let her hear the ringtone. :D
 
Not too pleased so far after two cycles on 5u. :( Maybe tonight will be a bit better. I've noticed that a lower than usual pre-shot usually means she'll either have a flatter cycle than usual or climb higher. So today's AM wasn't entirely unexpected.
 
Isn't it comforting to start to see the patterns? It helps give a better idea of what to expect and how to dose going forward. You're doing such a great job!!!

Sam used to do that too. A higher PS meant a nice drop, and a lower PS meant a flat cycle. It's a good feeling to have enough data to feel like we are making an educated guess instead of a reckless gamble.
 
Once I have her new test strips, I'll increase to 5.25u if nothing interesting happens. I think I should have them by tomorrow or Wednesday at the latest.

Her MAC's delivery arrived a bit ago. I was stacking the cans in the cabinet using little cardboard pallets, and I looked over and saw this...

JpQylfj.png


...How did my cat suddenly become a box cat?! She never used to be, but between this and her box fort, I'm starting to think it's some innate thing and she was a late bloomer... :cat:

Oh, if you look at her chest just beside her white patch, you can see where her fur grew back in red after the vet shaved it during her diagnosis. I read this was because of mineral deficiency or something? :( There are a few other places with a slighter reddish tint, but that spot is extremely obvious in person. I haven't noticed any more recent reddish growth further down on the hair shaft as that spot grows out, but her fur is grey further down. I wonder if only the black part would be affected.
 
Similar thing happened to Maury after his last lion cut, some of his black fur grew back more brownish/rust. Also his striped furs are taking longer to come in, past month or so I noticed more stripes again :). We had a black cat that adopted us, she had to have been abused by previous owners :mad:, but she had fur that grew back the same reddish tint as Freya once we started taking care of her.
 
Blair & Freya said:
Once I have her new test strips, I'll increase to 5.25u if nothing interesting happens. I think I should have them by tomorrow or Wednesday at the latest.

Her MAC's delivery arrived a bit ago. I was stacking the cans in the cabinet using little cardboard pallets, and I looked over and saw this...

JpQylfj.png


...How did my cat suddenly become a box cat?! She never used to be, but between this and her box fort, I'm starting to think it's some innate thing and she was a late bloomer... :cat:

Oh, if you look at her chest just beside her white patch, you can see where her fur grew back in red after the vet shaved it during her diagnosis. I read this was because of mineral deficiency or something? :( There are a few other places with a slighter reddish tint, but that spot is extremely obvious in person. I haven't noticed any more recent reddish growth further down on the hair shaft as that spot grows out, but her fur is grey further down. I wonder if only the black part would be affected.
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What a beauty she is! Her eyes are gorgeous! :D
 
Yong said:
Similar thing happened to Maury after his last lion cut, some of his black fur grew back more brownish/rust. Also his striped furs are taking longer to come in, past month or so I noticed more stripes again :). We had a black cat that adopted us, she had to have been abused by previous owners :mad:, but she had fur that grew back the same reddish tint as Freya once we started taking care of her.
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Interesting. It's very weird to look at, especially in the sun: black cat with red patches. :confused: From what I've read, it can be deficiencies in minerals or amino acids which affect the melanin or whatever. I also recall reading somewhere that it can happen in cats with liver damage, and I know her enzymes were out of whack at the last test. :( That's pretty typical of diabetes though, isn't it? I'd like to get her organ functions tested again, but not sure how often stuff like that should be done. I guess she might be going in for some tests soon anyway if her dose keeps increasing as it has been...

Her test strips actually arrived unexpectedly today, but I remembered I won't be home in the AM tomorrow, so I'll hold off on the increase until I can be there for her. Really not liking the look of this 5u.
 
Figures she has what starts out to be a better looking AM cycle when no one will be home... argh! I hope she'll be alright. I've put the cat-cam on so will check in on her via webcam while out. Good news is MAC's Mono Sensitive Turkey doesn't seem to spike her, so that's one more thing she can eat. :cat:

Rachel said:
If I fits, I sits....



tiger.jpg
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Hahah that's great. She spent several hours last night curled up in her MAC's box. She fits perfectly for shipping. :D
 
I've been preoccupied so haven't been around here as much, but well, looks like Freya is going to be starting 6u soon. :( Just no luck with anything. Her dose just climbs and climbs, and this insulin is getting expensive. I'm already about halfway through the second vial of ProZinc that I just opened not that long ago. I really need to see if it's something that can be treated and remedied because this is on its way to becoming a financial burden, as well as being worried about her.

I'd like to take her to the vet and get her checked out. I am not even sure if they'll be able to test for things like acromegaly or IAA here; I know not everywhere can. What other things should I try to eliminate? Are there any infections or other issues I should be looking for, and if so, what would be the symptoms?
 
I'm so sorry she's getting to such a high dose! That is expensive. Is Lantus/Levimir any more affordable where you live? I just ordered from a pharmacy in Canada and it is less expensive than Prozinc.

There are tons of things that can cause high BG, but I think one of the more common is dental issues just because cats hide them so well. Until it gets really bad, they often won't show any symptoms at all. But really any infection or inflammation can keep their numbers elevated. That might be a good question to post in the main forum, or to search for in the main forum.

There is also a short acting insulin called "R" that is sometimes given to higher dose kitties to give them a boost when the regular insulin doesn't have much impact. I don't know anything about cost, and it isn't widely used, but the couple of people I've seen try it have had some success with it. If the vet rules out infections or other health issues, that might be worth researching a bit. I've only seen it used over in the Lantus forum, so once other health issues are cleared, you might post/search there to learn more about it.

A couple of things to consider: Freya's numbers have come down overall in the past two months, and your notes indicate that her symptoms are somewhat better as well. She is making progress. It's slow and not to the level we'd all like, but her numbers really aren't terrible, and she's feeling better, so what you're doing really is working.
 
It's interesting, because she sure is headed up that dosing scale, yet she is getting good numbers. I think, if she was mine, I'd schedule a vet visit for a checkup. Have them look at her teeth to see if she needs a dental, check for any infections, and just a general overall check. If you find anything there, get it handled and see if that helps. If not, ask about the tests for acro and IAA I know @Sharon14 has an acro cat and could maybe give you more info about that.

Most people with high dose cats switch to Lantus or Lev...I think Lev is most common as it's thought to sting less at higher levels, but not every cat seems to notice any sting. I'm not sure if Freya is high dose or not...I seem to remember high dose cats having worse numbers, but I admit that I don't really know much about it.
 
Hi Blair, Freya is beautiful!!! I love black kitties! We do usually recommend testing for acromegaly and IAA when a cat gets to 6u. I'm not sure how it works where you are, although I've seen posts here about the RVC doing research on acro, so maybe you can get testing info from them. If you want to know more about it, maybe start a new post(this ones getting long) and I'll tag Wendy, our acro/IAA expert to come answer any questions you have.
 
Yong said:
Hey! How are you and Freya? :cat:
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Probably better not to ask. Life has been pretty crap lately, and now all this on top of it. I was waiting to post until after today since she had a vet visit, so let me tell you A Thing.

She hit 6u, and eventually 6.5u, so I called a cat clinic across town to have her seen, thinking maybe it would be a better experience than her usual vet. It was not. This place was far away and we don't have a car, so I took a taxi way over there. The vet then tells me:
  • They literally NEVER advise glucose curves on cats. Ever. Because "stress."
  • To cease all home testing of her immediately because of "overanalysis", even though in my experience, I am more cautious and conservative in my approach to dose increases than the vet was.
  • To cease all home testing of her immediately because the "stress" of it is partially to blame for her hyperglycaemia and insulin resistance. When I pointed out that Freya literally sleeps through her tests half the time, the response was that it's "stressful even if it doesn't seem like it." Even if she's not bothered enough to wake up because she's used to it and doesn't give a crap?!
  • To instead rely solely on fructosamine tests at their office.
  • To drop her dose down to 6u and not increase for at least a week or two.
  • To absolutely not test her ever, unless I suspect she's "too low," in which case I should just bring her to them and not even attempt to address it myself. (I know how to steer.)
  • Stuff about "overswing" despite the fact that I have an abundance of detailed data showing that it's extremely unlikely she's ever been low enough to have a true hypoglycaemic episode to the point that this would be some overarching issue.
They attempted to draw blood for a test, but she got extremely aggressive and was hissing and drooling and trying to bite, and she ended up peeing and pooping all over the table. So she had to have a bath immediately once getting home.

Anyway, I'm completely out of ideas. I can't get any veterinary support here, and I don't know what I'm supposed to do now. I'm seriously so frustrated and angry I could cry. Is this a UK thing? I ask that legitimately, not to be mean. I cannot imagine my extremely proactive and enthusiastic US vet who loves a challenge EVER saying these things, but it seems like this is old textbook information they continue to spout over here or something. Every experience I've had with a UK vet has been this way so far, and most of what I've read online from others seems to be in keeping with this trend. I'm seriously so baffled and feel like I'm living in the Twilight Zone of complacency. Where are the proactive vets? If anyone has heard about a good FD vet in the Edinburgh area of Scotland, I'd sure love to hear about them.

And if anyone has any advice for me on how to continue on my own, I could really use it and the support. I really feel so lost and just want to do what's best for her. I'll be picking up a new vial of ProZinc from her usual vet tomorrow because she's nearly done with the other one already.

Sharon14 said:
Hi Blair, Freya is beautiful!!! I love black kitties! We do usually recommend testing for acromegaly and IAA when a cat gets to 6u. I'm not sure how it works where you are, although I've seen posts here about the RVC doing research on acro, so maybe you can get testing info from them. If you want to know more about it, maybe start a new post(this ones getting long) and I'll tag Wendy, our acro/IAA expert to come answer any questions you have.
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I think getting the tests is going to be a real struggle for me, if it's even possible at all. :( They don't want to do anything until she's over 9u, but as you can see from my above rant, I don't feel I have much reason to be confident in them.
 
:bighug: So sorry you're being treated this way! I don't bring my cat to the vet anymore for his diabetes. I home test and get help here if needed. As for the acro tests, I know several people on this forum that are in the US have been in contact with the RVC via email, so I would think you could too. They could maybe give you some info and might even have vet suggestions. I'll go ahead and tag @Wendy&Neko to give some ideas and I think @saltycat and @Bronx's dad have spoken with someone at RVC?
 
So sorry you have an out of date vet. :bighug: Mine didn't want to do the tests until we were over 10 units - never got that high. I asked the vet to humour me as I was paying the bill. Guess who was more surprised than me at the results. :rolleyes:

The Royal Veterinary Clinic is where blood is sent to be sampled for acromegaly. They have recent papers showing that one in four diabetic cats has acromegaly. This paper is one of their more recent ones, we have a lot more information on acromegaly listed in this thread on acromegaly. I don't know if your vet would be any more amenable to doing the blood draw and sending in the tests if you showed them the recent paper. It sounds like they currently have their head firmly in the sand when it comes to diabetes. :banghead: To their credit, vets used to be taught "this is acromegaly, it is rare, you will never see it". More recently graduated vets or those who keep current should know better.

If you want to contact the RVC, here is the email address for the Feline Diabetes Remission Clinic at RVC. drc@rvc.ac.uk
If you do find out Freya has acromegaly, the RVC are offering the world wide gold standard in treatment. If nothing else, they are a great resource and have answered several emails from me and others here.
 
Sorry to hear what you had to deal with Blair :bighug::bighug::bighug:. I don't think it's just a UK thing but similar to US, the good Vet to old school Vet's is very in proportionate. Try not to feel like you are continuing alone, we are still here for you and Freya! Even with finding a better Vet for my boy, he's still only going to go if there's some other issue like recently. I'll gladly share some knowledge with her as she does seem open about it and admires what I'm doing but sticking here for any diabetic related questions. Sounds like RVC is a helpful place though. Remember, you can always vent here :)
 
So sorry you're feeling defeated, Blair. :bighug: You don't have to deal with FD on your own - we're all here to help and there are owners of high dose kitties for that part of it. I suspect that the vast majority of members here are doing the FD thing on their own.
 
Dang, that's terrible, Blair! I despise it when a vet tries to tell me not to do things that I KNOW I need to do. It just makes me furious!

Please do remember you always have us. We've been there and we can help you, even if the darn vet won't! I would contact RVC yourself if you can...and if not, I'd probably just call the vet and explain that you want this test, you will be paying for it, and they need to just go with it. Nicely, of course, but firmly.
 
I guess what bothers me most is that they don't even seem to want to do the testing I'm asking for. Like, I wanted to have her tested for any possible infections, have her teeth and ears checked, test for high-dose conditions, and it was just totally dismissed. To me that's a step beyond just being out of touch about the benefits of home testing. What reason can there possibly be to not run tests? I can manage dosing on my own, but I can't do things like labs and bloodwork, you know?

As I took her PMPS tonight, I observed how incredibly "stressed" she was. She was so "stressed" and under such duress that she was excited as usual when her test time alarm went off, because she knows it means food. She was in such a state of anguish that I'm sure it made her BG rise by at least 100 points in the 30 seconds it takes to give the tiniest pin prick to her ear. How can I put my cat through such torment??? :rolleyes: How ridiculous does that sound, seriously?! If I don't immediately get up when her alarm goes off, she comes and chases me down meowing and trying to lead me to the kitchen. But, you know, she's just so stressed by the whole ordeal...

And thanks, everyone. I'll have to do some investigating into the RVC thing and see what's doable. Urgh.

Edit to continue the rant: Oh, do you think it would blow their minds if I told them she often purrs happily for her morning tests, because she's still all sleepy and cuddly and enjoys being wrapped up in the blanket when I do it? So stressful.
 
LOL....it's not very often that sarcasm comes across quite that clearly in a post! :)

I'm so so sorry you had to go through all of that today! What a terrible experience. Others have already said it, but please know that you are not alone. We are all here to walk through this journey with you. You're right though - we can't run lab tests. Can you call around a bit and just ask upfront if they will do the tests you need before traveling all over the country talking to old fuddy-duddy vets?!

Is it possible for you to get Lantus? If you're running out of Prozinc anyway, I'm wondering if it might be worth giving it a try if you can?
 
Yong said:
Compliments to Kris, Maury has his own piddle spoon too :D. My issue is he doesn't seem to keep a consistent schedule so a week flies by between ketone testing :woot:
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My vet told me for ketone tests, it ok to just take the pee with the litter and add a bit of water as ketone test is look for a specific chemical I guess, it won't dilute the results. If you were testing urine for bacteria, then that would not work.... My kitty makes it easy for me, pees on floor on regular basis. lol
 
Wendy&Neko said:
f you do find out Freya has acromegaly, the RVC are offering the world wide gold standard in treatment. If nothing else, they are a great resource and have answered several emails from me and others here.
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I can vouch for RVC as I recently reached out for help, as my cat was diagnosed with acromegaly about a month ago. I reached out to one of the researchers and have exchanged emails, and my kitty is now on an experimental drug that may help. My vet was very willing to help me, as when I went to the internist here, I had a bad experience too. I was pretty sure he was an acro cat, he was at 6U, was mostly flat all the time in mid 20s, he also had most of the symptoms of acromegaly, the internist wanted to do all the test in the world first, my vet had been doing regular tests, but they want to redo, would have been over 2,000.00 just for tests. they convinced me that I should let him go, as if I couldn't do the test, I could afford to help him. Well, thank god I vented on here, as Wendy, Sharon, Kris and so many others encouraged me to hold on. And funny enough, the day after that visit at the internist Marvin gave me his first low number... think he was also telling to not give up....

I worked it out with my own vet, and we simply did the acromegaly test which I could afford. the way she saw it, there is nothing to lose, and she is also very supportive with the experimental drug. It's been an emotional road, I am so glad I haven't given up. He is doing a lot better than last month. It too bad that you are having a hard time, as UK has the top researcher for diabetes in the world.
 
Marvin's Mom - Nat said:
My vet told me for ketone tests, it ok to just take the pee with the litter and add a bit of water as ketone test is look for a specific chemical I guess, it won't dilute the results. If you were testing urine for bacteria, then that would not work.... My kitty makes it easy for me, pees on floor on regular basis. lol
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I didn't know this. :)
 
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