Help with dose for newly diagnosed cat | Page 2 | Feline Diabetes Message Board - FDMB

Help with dose for newly diagnosed cat

RoroB said:
think it looks like his nadirs are around +7/+8 on daytime?
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It does look like they may be a little later (nadirs) so.. good for Bub. He gets to eat longer.

I understand about the closed doors. With my underweight cats who need to be fed more, I frequently have to either feed one of them in a separate room so the others won’t steal their food, or I have to put the food thieves away in another room.
 
Suzanne & Darcy said:
It does look like they may be a little later (nadirs) so.. good for Bub. He gets to eat longer.

I understand about the closed doors. With my underweight cats who need to be fed more, I frequently have to either feed one of them in a separate room so the others won’t steal their food, or I have to put the food thieves away in another room.
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Yes to having little food stealing gremlins!

His PMPS was so close tonight. 11.5 a bit scary for me as it's the lowest I've shot. Going to stay up late and set alarms to keep a close eye on him overnight. Removing food a few hours earlier seems to have made a massive difference, he was really stropping by dinner time though.
 
And it came today (the blue!). I was just checking the spreadsheets of cats I haven’t heard from in a while :cat: and what do I see but a blue on Bub’s spreadsheet. I laughed because that was the last thing I said on September 30. I hope you two are both doing well.
 
Yes I was very happy 🥰 we're getting there, thanks for checking in. Bubs doing well I think we've worked out one of his new low carb foods was spiking his BG. But there's a couple others that everyone seems to like so food seems mostly sorted which felt like a daunting part to begin with.
 
Sometimes different food ingredients will raise BG in some cats — either certain proteins or particular ingredients— even if the overall profile is low carb.

If his numbers stay similar and his nadirs are higher blues, you can go to 2 units on 15 October.
 
Sorry just saw your messages, he's been off the last few days I was thinking I had triggered his pancreatitis with a too high fat food again- but he's done the most enormous poo this morning so I'm hoping that was it. I was doing a curve yesterday for the vet and his numbers were higher than I was expecting maybe caused by his not feeling well/constipated? Seems brighter today anyway.

Yes I'm using the food list shared here for, UK members as a guide, and the food that I think was causing a spike has a warning on there. As while it is overall low carb it does have 'various sugars'.

I've made a spreadsheet myself now that does the maths just from the product data, so I can easily input in the shop on my phone, I'm going to make a new post and share it. Should make my life easier and may help others who are new and struggling

Spreadsheet for calculating food values
 
Constipation can cause higher BG numbers.

It really looks like he needs that increase to 2 units.

When he is having a pancreatitis flare up, how does he act? Does he not want to eat? Can you tell that he is uncomfortable/in pain? Does he seem nauseated? What do you give him to help him?
 
Yes I think he needs to increase his dose.

So even when he had his initial bad pancreatitis he still ate, but less than normal. He also sat near food in the quesy kitty loaf position. He didn't throw up, he did have a major fever. He generally was weak and sad and was completely glued to me.

Since then he's had what I think are a few low level bouts of pancreatitis. Because he still eats and drinks I mostly just let him do what he wants and gave him doses of metacam for a few days. I've not given him metacam since his diabetes diagnosis because I'm not sure he can have it. I'm seeing the vet on friday so I can ask then.

How he was this last few days- subdued, still eating, stomach slightly potbellied, didn't see him sit in quesy kitty loaf position, felt warm not feverish (but this has been a symptom for months and heat intolerance was really what made me initially think he was ill)- so something probably has bunged him up and this wasn't pancreatitis in this case. Although he is still feeling fairly warm, again not to the point of fever.

I'm going to speak to the vet about his temperature again on friday. As the weather cools down and he is still having to seek out the cool kitchen floor it's becoming more and more odd. Whether he has chronic pancreatitis that's presenting oddly, an infection nestled somewhere causing mildly raised temperature, his diabetes is actually caused by agro and that's raising his temp ( seems to do that is some humans, haven't read it as a symptom in cats?), hyperthyroid- doesn't have any other symptoms or something else it just doesn't seem right.

I think I'm going to ask for a longer course of antibiotics for a start and then maybe blood tests after that. Also will ask about painkillers although now I'm monitoring his food so strictly I'm hoping there won't be any more pancreatitis
 
Yes Bubs doing ok, and I thought he was due a dose increase thanks for the confirmation.

I'm frustrated- vets was a bust. He doesn't want to regularly see nadirs below 10, so that just sets up a situation where I have to be very sparing with what I tell them/lie. Just makes it harder. No idea on why Bub is so heat intolerant just brushed past it.

Although having read around more it is a possible side affect of neuropathy. And when his bs has been mostly in range for a few days it does seem to be better- so maybe it's that, or just a food intolerance.

Anyway slowly slowly getting him into better numbers
 
RoroB said:
He doesn't want to regularly see nadirs below 10, so that just sets up a situation where I have to be very sparing with what I tell them/lie
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Many times it is better to just manage the diabetes on your own and not share too much information with the vets. Many members on this Board do that. Vets are afraid of owners letting their cats go into hypoglycemia, so they just tell you to keep them in higher blood glucose numbers to prevent that. I don’t think they have a clue about people who are actively tracking their cat’s BG at home and who are very familiar with all of their cat’s patterns (and who move slowly and carefully with dose increases.) I wonder how many cats are prevented from going into remission because of this? Or who are just prevented from achieving good BG regulation.

Does Bub currently have trouble walking or jumping due to diabetic neuropathy? Is he getting a methylcobalamin supplement for that (if he has neuropathy?)
 
I read through enough threads early on to know about issues with vets, with one member being banned from multiple vets! So I wasn't going to argue much, just agree and get out, but it's frustrating.

They are scientitsts or they should be, neither me or the cat are stressed by regular testing. But they only want me doing tests for curves maybe once a month- no other testing. Which means to them he has to sit at a much high bs to keep him safe from hypo's. It's fine, it's not going to change anything I'm doing with Bub but means I have to doublethink when I'm with them which is harder.

Yes his gait is off- both front and back leg ankle/wrists are sitting a bit low and he's a bit uneven and needing to rest a lot.
Something I brought up with the vet and you'll be unsuprised to hear was also brushed off. I've started him on the b12 advised here- the methyl? type
 
@Suzanne & Darcy afternoon Suzanne, when you have a minute would you mind having a look at Bubs spreadsheet?

I'm not sure what I'm doing wrong but he doesn't seem to be making any real progress. If I look at his numbers from the very start - even from before the vets diagnosed him and he started insulin - his numbers just don't look that different. In fact I see more reds/ blacks in the last week or so.

If he's having bounces I'm not managing to catch any of the lows they're happening from. I've been trying to get more tests overnight but I sleep through the alarm half the time.

Is there anything else I should be doing?
 
It is kind of depressing. There’s not a huge difference between now and when he first began. I think it sounds like you are doing everything possible for him. It also looks like you aren’t getting much sleep. I do not see that he is bouncing so I doubt it’s that.

I do have some ProZinc cats who need higher doses than others. I don’t think we have reached a breakthrough dose for Bub yet. The only other things I can think of are tooth problems and the pancreatitis. Hopefully there’s no other cause and we need to just keep on top of the increases.

I am sorry that I don’t have a really great answer. My own cat needed over 40 units at one point, but he had a “high dose condition” (acromegaly) but it’s likely Bub has nothing like that. I just understand the frustration and feeling like nothing you do (including increasing insulin) is making a difference.
 
No that's fine thank you I just wanted someone more knowledgeable to have a look and check I wasn't missing something.

I don't think his pancreas is bothering him right now. His teeth look pretty good, the vet did check those. But he did have raised infection markers in his bloods at dx, along with his non fever overheating issue I do wonder if he has an infection hiding somewhere. His urine was clear - so not there. He has also had a 7 day course already so it would presumably need to be something harder to get rid of.

But if it is that I'm going to need the vet to give me the antibiotics and I've lost hope with them.

They completely ignored me about his overheating. Just checked his temp and confirmed he had no fever which I knew.

I guess I keep increasing the dose and hope we just aren't at that breakthrough dose yet.
 
As a positive his overall bs must be better than before starting insulin as his urine dipsticks are showing less sugar. Still some but not off the chart anymore
 
Robo & B said:
No that's fine thank you I just wanted someone more knowledgeable to have a look and check I wasn't missing something.

I don't think his pancreas is bothering him right now. His teeth look pretty good, the vet did check those. But he did have raised infection markers in his bloods at dx, along with his non fever overheating issue I do wonder if he has an infection hiding somewhere. His urine was clear - so not there. He has also had a 7 day course already so it would presumably need to be something harder to get rid of.

But if it is that I'm going to need the vet to give me the antibiotics and I've lost hope with them.

They completely ignored me about his overheating. Just checked his temp and confirmed he had no fever which I knew.

I guess I keep increasing the dose and hope we just aren't at that breakthrough dose yet.
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Does he pant when he’s overheating?
 
Suzanne & Darcy said:
Is his thyroid level good?

Diabetes can cause heat intolerance. Maybe it is just that.
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I don't think they tested it, but he's not showing any symptoms.

Yes maybe it is - do you know if that is independent of bs level? I know I'm grabbing at straws for explanations. I'm just struggling with the not knowing and lack of much response to the insulin.
 
Since he is 12, a blood test of T4 would be
appropriate to make sure thyroid levels are okay. Maybe if you check your copy of hos bloodwork you will see it. Or if you don’t have a copy then you could call and ask them to check and see of it was included in any past/recent bloodwork.

There are some other more rare things that also cause heat intolerance, but it’s probably just his diabetes.

Does he feel hot to you when he does this? (Ears hot?). Body hot?
 
I got a copy of his test results it wasn't included.

Yes ears and toe beans very warm and can feel heat radiating off him. But not feverish level hot. Just a cat that wishes he could take his jumper off- even when it's not warm and all the other cats in the house are curled up on heated blankets
 
Had a seemingly all pink day yesterday, but I tried a different food which in theory meets all requirements. He really liked it- everyone seemed to like it. Bub ate way too much, so I'm not sure if the pinks are just because he overate.
He's mostly good though - his legs which seemed much worse in the week after the blacks are looking better again and I'm hoping they continue to improve.

We've had the odd blue but still don't seem to be able to hold onto them. I'm really leaning towards that black weekend being because of the carny food. In theory it should have been fine, but I've been too much of a wuss to give him a small trial of it again to confirm - those big blacks (and how off he was that morning) really scared me.

I suspect there is an ingredient that doesn't agree with him that I'm missing. It might not even be beef or the fat content. The food he is primarily eating at the moment does have a small amount of beef in which is why I'm trying to find something else. I know we've talked about foods before and you have also struggled with everything having beef in it! Hope your kitty is doing better
 
Robo & B said:
I did this morning. I had ended up giving dose increases in the evening which I didn't like so waited an extra 12 hours and shifted it to the morning a few dose changes ago :)
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Good. My policy was generally to do dose increases in the morning as well. It made better sense for me, even though I could set alarms for testing in the evening.
 
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