Getting Wilbur inline and on track with Vetsulin

Status
Not open for further replies.
johnt

johnt

Member Since 2016
At the request of @Kris & Teasel I'm starting a new thread:

Looks like the 3u worked well. AMPS is 245.

I assume stick with 3?

Also, to make it fit better on the cells, I removed the extra text on the +2.5 times and added a note to the cell. cleaner. that OK?
 
johnt said:
At the request of @Kris & Teasel I'm starting a new thread:

Looks like the 3u worked well. AMPS is 245.

I assume stick with 3?

Also, to make it fit better on the cells, I removed the extra text on the +2.5 times and added a note to the cell. cleaner. that OK?
Click to expand...
Yes, try 3 u. It can go up if today's data shows it's necessary. Yes, you can add notes to cells as you did.

Is he eating canned food right now? What type? I know you're whittling away at the Temptations.

Thanks for the new thread. :)
 
Kris & Teasel said:
Yes, try 3 u. It can go up if today's data shows it's necessary. Yes, you can add notes to cells as you did.

Is he eating canned food right now? What type? I know you're whittling away at the Temptations.

Thanks for the new thread. :)
Click to expand...

Dosed 3
I withheld the temptations almost completely yesterday. I also fed him more tuna to compensate, making sure he ate the simple servings. I also reintroduced the Dr Elsey's Salmon hard food and he actually ate it! This will now replace the temptations completely, while still giving me an option for treats during dosing. I would switch him for food, but it seems awful expensive. However, if we can get him to level at 3 it will save enough from the Insulin cost alone to make it viable.

I will admit though, i did give him just a tiny bit of temptations again this morning. I put tuna out for him, he gobbled it up, then some of the whitefish and tuna simple servings (wet) and he kept crying. So i gave him 6. That satisfied him. I don't plan on giving him more today
 
I saw your note about Wilbur getting into the kibble - and he blessed you with a pink number. :confused: High carb food can actually abort the insulin action for the remainder of the cycle. Maybe increase to 3.25 u tomorrow AM.
 
Kris & Teasel said:
I saw your note about Wilbur getting into the kibble - and he blessed you with a pink number. :confused: High carb food can actually abort the insulin action for the remainder of the cycle. Maybe increase to 3.25 u tomorrow AM.
Click to expand...
OK. i'm TRYING to get him off the temptations completely too, but he will sit and cry for 30 minutes and he is extremely loud. i'm a wimp and he knows it :)

I'll get him.

I'll increase, but i assume if he stays at those low to mid 100s i should got back to 3 when i can keep him off the kibble and temptations.

I'm ordering the Dr Elsey's food tomorrow. That will replace the temptations immediately. when he turned and liked it he gobbles them up now.

Wish I could use it for all grazing food. But i need to see about the other cats. If I can get him and him ONLY to eat it, I can get him off the Hills Prescription Diet and everything he'll have then is low carb. I bet I can drop to 3 or lower when I get him there
 
You can try another day at 3 u if you want. No rush - especially if you get good nadir numbers. The eventual goal is to see some high dark greens on his SS.
 
Kris & Teasel said:
You can try another day at 3 u if you want. No rush - especially if you get good nadir numbers. The eventual goal is to see some high dark greens on his SS.
Click to expand...
Forgive me if You answered this already. what again is nadir?

We've gone back and forth so many times you likely already answered so i'm sorry for asking again. i believe you're talking about the readings that are blue right now? at the lower point of the curve?
 
johnt said:
Forgive me if You answered this already. what again is nadir?

We've gone back and forth so many times you likely already answered so i'm sorry for asking again. i believe you're talking about the readings that are blue right now? at the lower point of the curve?
Click to expand...
Yes, the lowest part of the curve, ususally around +4 to +6 for Vetsulin.
 
Kris & Teasel said:
Yes, the lowest part of the curve, ususally around +4 to +6 for Vetsulin.
Click to expand...
OK thanks. I have an early breakfast today (it's 5:10am here right now) and I'll be out. but i'll get his AMPS, then check him later. any thoughts on when I should check again? i'm going to 3.25 today.

I had to give him a few temptations at dosing time, but have refused him this morning (not to his preference). I was figuring i'd get +4 and +6 today to get a better idea on his nadir with the dose change. that's considering my work schedule allows me breaks at those times, but i should be ok. as long as I don't get too embedded in a task (i lose track of time when that happens)
 
Game plan: give 3.25 u tonight and both AM and PM tomorrow. If mid cycle is still yellow or high blue increase to 3.5 u on Sunday.
 
ok. he's starting to go back in and sneak the other cats food whenever i refuse him the temptations. until i get the new cat food i'm stuck. i either give him temptations or he's going to eat the other cat's food
 
@Kris & Teasel I got a little lazy since I'm sick. i did the tests and dosing just didn't get it logged.

I raised him to 3.5 this morning. I can't wait to get the new food and replace his treats and kibble needs. this should be really good!
 
johnt said:
I'm starting to think he's going to need to sit around 4.5 to 4.75 based on his charts. 3.5 doesn't seem to be enough until I can get the new food here.
Click to expand...
That’s possible but I’d give it another day at 3.5 u before increasing. General rule: keep a dose 3 - 4 cycles before changing it.
 
Kris & Teasel said:
That’s possible but I’d give it another day at 3.5 u before increasing. General rule: keep a dose 3 - 4 cycles before changing it.
Click to expand...
ahh ok. great to know. hey honestly, at least I know he's controlled and not lethargic from way overdosing him.

I feel so much better, and since I've been withdrawing the temptations, he lost a tiny bit of weight and was able to clean his back feet yesterday.

I bought some rinseless shampoo (foam) in the meantime to try helping him out. poor ole guy

EDIT: i noticed I forgot to put his +6 in, i jusdt did but it's pretty much inline with +4
 
@Kris & Teasel (or anyone that knows), I keep trying to look for food, but even on the site for the CleanProtein I don't see any direct info on carbs. How do you determine a hard foot (any food really) to be low/high in carbs?
 
Kris & Teasel said:
Nice AMPS! It'll be interesting to see what the increased dose does today. :)
Click to expand...
I'm going to try a +4 and +6 today if I'm feeling better. i finished my work but boy am I not feeling well. I'll try.

I can actually see that he's lost a tiny bit of weight. That makes me feel really good. Since he's able to at least try to clean his bits (he can't reach them yet but he's close) and he cleaned his feet it's a good sign.

I've struggled keeping him from begging. Today to circumvent the crying, I went to bed late and woke up 15 minutes before his AMPS so i could be assured he didn't eat +2 from dosing.

its harder at night, but i'm getting there. Since I can already see he's moving better it's encouraging.
 
Kris & Teasel said:
Good yellow PS today. Try for one between +4 and +6 if you feel up to it. Really good progress!
Click to expand...

he's been crying a Lot but i've been witholding the temptations as much as possible. it's helping. I am sure he's going to start losing weight too.

I'll get a +6. His +4 is 156
 
johnt said:
he's been crying a Lot but i've been witholding the temptations as much as possible. it's helping. I am sure he's going to start losing weight too.

I'll get a +6. His +4 is 156
Click to expand...
Any luck with the Young Again Zero or Dr. Elsey's kibble?
 
Kris & Teasel said:
Up to 4 u tomorrow AM. The hard work testing and increased food policing is paying off. :smuggrin:
Click to expand...


This is frustrating. my doctor called me today asking how Wilbur was doing (the vet). I gave him a link to the spreadsheet.

He came back and told me I should be only giving him 2u twice per day because raising his insulin is causing his cortisol to go up, because his body is fighting against the higher level of insulin. and that's causing the higher numbers. he said that's also how Wilbur survived those 10u doses, because his body kept producing more cortisol to fight it

It's like he doesn't understand that the food is influencing this.

it's really disappointing working so hard to fix him to have the doctor tell you to go the other way
 
johnt said:
This is frustrating. my doctor called me today asking how Wilbur was doing (the vet). I gave him a link to the spreadsheet.

He came back and told me I should be only giving him 2u twice per day because raising his insulin is causing his cortisol to go up, because his body is fighting against the higher level of insulin. and that's causing the higher numbers. he said that's also how Wilbur survived those 10u doses, because his body kept producing more cortisol to fight it

It's like he doesn't understand that the food is influencing this.

it's really disappointing working so hard to fix him to have the doctor tell you to go the other way
Click to expand...

We all at some point had to go against our vet's advice to get better treatment results. I know I did. It's your call of course but I truly don't understand what your vet means. Wilbur's SS is showing definite progress according to the BG evidence. You weren't testing or keeping a spreadsheet when he was on those crazy high doses and, yes, it was probably extreme rebound that saved his goose, along with lots of high carb food.

I'd have to do some research to see where cortisol fits into the biochemistry behind the phenomenon we call bouncing. Bouncing is the result of a mobilization of glycogen in the liver which can be converted to glucose to prop up BG when it drops too low because of an insulin dose that's too high. Cortisol might be part of the pathway and that might be what your vet is talking about. For what it's worth, I see no evidence of bouncing on your SS right now. Rather, I see an insulin dose that's working quite well but needs to go up a little.
 
Here are some questions for you - and I don't mean to be rude or snarky: in all the time since Wilbur's diabetes diagnosis do you feel this vet or others you might have had have been on the ball with his treatment and have given you good direction wrt diet, dosing, etc. Were you given a clear explanation of why he had those seizures and why you got up to those 10 u doses? Were you given good advice on how to get his weight down safely?

If you can answer yes to all those questions then you can follow his advice with confidence.
 
Yep! That's what he's referring to. Here's an article:
https://dtc.ucsf.edu/types-of-diabe...y-processes-sugar/blood-sugar-other-hormones/

So he's talking essentially about bouncing and his take on it is that you're overdosing Wilbur and driving his BG too high. The only BG numbers that support a lower dose are those at 1 u on Feb 20. That's where the dose was dropped because of a low PS. If you want to satisfy yourself on this issue you can drop Wilbur down to 2 u tomorrow AM and leave him there for 4 cycles or so to see what happens. Try to keep the food as low carb as you can. You might feel better after trying this. If it works, great! If it doesn't you can go up in dose again.

BTW - I said I see no evidence of bouncing right now because his BG data if plotted on a graph would give the typical smile shaped curve of Vetsulin. Bouncing usually inflates PSs a lot and often pushes them into high flat numbers for the whole cycle. That's not happening.
 
Kris & Teasel said:
Here are some questions for you - and I don't mean to be rude or snarky: in all the time since Wilbur's diabetes diagnosis do you feel this vet or others you might have had have been on the ball with his treatment and have given you good direction wrt diet, dosing, etc. Were you given a clear explanation of why he had those seizures and why you got up to those 10 u doses? Were you given good advice on how to get his weight down safely?

If you can answer yes to all those questions then you can follow his advice with confidence.
Click to expand...
I should have been more clear.

1. I like this vet a million times more than the one I had previously. I feel like he does care. Shoot how often does a vet call a patient's owner a month after the visit just to check up? it wasn't a secretary etc, it was the same Doc that saw him. So i feel good that he cares.
2. I think his advice is likely correct given the technical aspects..... but
3. I don't think he has a full picture of what Wilbur is going through. he didn't ask about food, etc. I think he's basing his opinion as though all of those tests are based on the same diet each day.
4. I am not going to follow his advice, and although i know you aren't a vet, I feel you and I have a much more sound grip on the whole picture and we will get better results this way.
5. Some things irritate me. I have always followed my vet's advice. When i first arrived he requested a fructosamine, even though i asked for a glucose curve since I couldn't test him then. Just so happens a fructosamine costs me about $300 since it includes blood draw and lab work, whereas a glucose curve just means testing every hour etc and costs less than half.

His numbers were good according to the doc, saying he came in around 300 which I have no clue what that means.

this was Oct 2016. He never had a glucose curve done.

Last month, when this fiasco started, I had been having growing concern since I couldn't test wilbur and I felt i was giving him too much. The day i was able to test him is when I was worried, and he was lethargic, stopped eating etc and it worried me about him becoming hypoglycemic (i think that's the right one), and at that time I had Karo Syrup in my hand incase something happened. it didn't, but that's when i was finally able to test him with low resistance and I started that crude spreadsheet before talking to you. You evaluated it, persevered through my panic and lack of understanding and got me on the right path.

At this point i took Wilbur in that day before being able to check him. HIs blood sugar then was 375. The doc said he was not hypoglycemic. I did his recommended blood work again which included another fructosamine which came back at 290.

He never did a curve, and now I have another $600 vet bill with zero answers. The answers i did get came from you. Although I didn't get answers, at least I am sur3e now his kidneys are working right, his pancreas and all organs came back good under that blood check

So would I follow his advice or yours? i think common sense answers that without question. I think he has good intentions and obviously the knowledge, but i do not believe he has the whole picture or really understands in depth what's been happening.

This is why i'm so appreciative of your help (and all of the others that have stepped in)
 
Kris & Teasel said:
Yep! That's what he's referring to. Here's an article:
https://dtc.ucsf.edu/types-of-diabe...y-processes-sugar/blood-sugar-other-hormones/

So he's talking essentially about bouncing and his take on it is that you're overdosing Wilbur and driving his BG too high. The only BG numbers that support a lower dose are those at 1 u on Feb 20. That's where the dose was dropped because of a low PS. If you want to satisfy yourself on this issue you can drop Wilbur down to 2 u tomorrow AM and leave him there for 4 cycles or so to see what happens. Try to keep the food as low carb as you can. You might feel better after trying this. If it works, great! If it doesn't you can go up in dose again.

BTW - I said I see no evidence of bouncing right now because his BG data if plotted on a graph would give the typical smile shaped curve of Vetsulin. Bouncing usually inflates PSs a lot and often pushes them into high flat numbers for the whole cycle. That's not happening.
Click to expand...
you don't need to convince me at all. I would have stayed with your advice either way. you'll see in my reply above,
 
Well, you've thought this through really well and it seems you know what you want to do. I'm here to help. I certainly can't claim I know everything but I've learned quite a bit in my time here on FDMB and am always willing to research something or defer to someone with more knowledge or experience. The numbers speak for themselves! :)
 
Status
Not open for further replies.
Back
Top