HI, again, after 2years... :-)

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anson

Member Since 2012
hi, first of all, wish you all and your cats healthy and happy.

i am not entirely new here. i did join 2 and half years ago when my cat siujim (now age 19) was diagnosed diabetes and pancreatitis.
at that time, folks here help me a lot. siujim is still fine but with some problem recently.
i lost my password and so i re-registerted again.

a week ago, siujim had pain in the back leg and couldn't walk priorly and cry for pain. she has Arthritis which is common at her age.
vet treated with pain shot (temgesic) and cartrophen injection (i will go do it for 2 more weeks, one injection each week).
she is ok now walking again, but her BG is messed up. right after the two injection, on the second day -- last wed, her BG drops very low with 4 unit (her usual dose) of lantus.
she had a hypo (lowest 2.7) and i feed her sugar water for a few times. finally get her no. back to 7.
however, her numbers are all messed up.

i am now using half the insulin dose as suggested by vet to check if she is having rebound. but her BG is very high in the 2nd day of the new dose.
yet, we have to keep the half dose at least for 4-5 days and see how her body get used to it.
i will not bother you with the figures and i know home testing BG and urine test.

in this mail, i'd like to ask if anyone who has used the following supplements:
i. pet alive pancreas booster. as we are now testing a new low dose i am thinning perhaps good to use other natural supplement to help her out instead of relying on the insulin.
http://www.nativeremedies.com/petalive/ ... tment.html

ii. dr goodpet mobility support recommended by a friend who has a dog with terrible arthritis problem and now good in shape after using it.
http://goodpet.com/index.php?option=com ... ct=9378278

pls share your comments and experience, if you have used those products.

tbx a lot.
anson
 
Hi Anson! I don't have any experience with the supplements you reference, but I would caution you about the insulin. I cannot advise you on dosing amount but can tell you that in my observation on this board, cats who have a hypo incident often become very sensitive to the insulin, and their dosage must often be reduced dramatically - and some no longer need insulin at all! It is also not unusual that Siujim's blood glucose levels are running very high now or are unstable. It is my understanding that after a hypo incident, the cats body dumps "sugar" into the system to try to combat the low readings -- and it sends the blood glucose readings soaring. A high reading now does NOT necessarily mean you need more insulin, and in fact you may need a lot less. Even 2 units is a large amount of insulin to give after a hypo incident and you may want to reconsider that dose. Again, Siujim may not need any insulin at all anymore, or may need a greatly reduced amount.

What type of insulin are you using?

I would ask the more experienced members of the board to comment on a recommended plan for Anson and Siujim - whether or not he should discontinue the insulin for a few days to see where Siujim's blood glucose levels settle, and any other advice you might have for him.

Melanie
 
yes, thx for your reminder.

i used to use 4 units (lantus), so the vet suggests to cut it by half.
so we are doing 2.

in the first day, her BG curve is good, amps (259), +4 (92), +8 (130), pmps (265), but at pm, it starts to go very high again. pm +4 (296), +8 (351).
the vet suggests to keep the dose for 5-7 days, which i have doubts as usually it is 3-4 days. but i guess she is playing safe to make sure she will not have a hypo again.

today, her readings are very high amps (423), +3 (352), +8 (296), pmps (362)... and the vet said perhaps she has some inflammation as she had Arthritis last week (after that the BG is messed up, she has been stable for 1-2 years) on 4 units of lantus.

so i will closely monitor her.
she has lost a lot of weight, poor girl...

i guess her pancreas and body is very confused about the insulin intake and how to deal with sugar after i feed honey/sugar water on wed. and i didn't reduce the insulin right away after hypo, i used 3 units on thur after hypo and the reading was high, so i resumed 4 units on thur/fri for 2 more days before reducing it to 2 (cut by half) -- talking with the vet. it was my mistake. i feel very regretful.
the other thing is she has lost weight from 8p to 7.4p, she may need less insulin too. i will go on monitor her weight and talk to the vet two days later. as she just asked me to keep the dose first until sat...

this is why i am thinking to use some supplements to help her.
first on her mobility and Arthritis problem, and the pancreas support by natural herbs.

yes, pls if you have any comments about the dose, pls do let me know.

also, one more question. for the last two days, after insulin injection, she is very tried, breathing rate from around 22 up to 28-30 per min (still within normal range though) when still. is there some kind of sign?

thx. pls advise.
anson
 
anson said:
yes, thx for your reminder.

i used to use 4 units (lantus), so the vet suggests to cut it by half.
so we are doing 2.

in the first day, her BG curve is good, amps (259), +4 (92), +8 (130), pmps (265), but at pm, it starts to go very high again. pm +4 (296), +8 (351).
the vet suggests to keep the dose for 5-7 days, which i have doubts as usually it is 3-4 days. but i guess she is playing safe to make sure she will not have a hypo again.

today, her readings are very high amps (423), +3 (352), +8 (296), pmps (362)... and the vet said perhaps she has some inflammation as she had Arthritis last week (after that the BG is messed up, she has been stable for 1-2 years) on 4 units of lantus.

so i will closely monitor her.
she has lost a lot of weight, poor girl...

i guess her pancreas and body is very confused about the insulin intake and how to deal with sugar after i feed honey/sugar water on wed. and i didn't reduce the insulin right away after hypo, i used 3 units on thur after hypo and the reading was high, so i resumed 4 units on thur/fri for 2 more days before reducing it to 2 (cut by half) -- talking with the vet. it was my mistake. i feel very regretful.
the other thing is she has lost weight from 8p to 7.4p, she may need less insulin too. i will go on monitor her weight and talk to the vet two days later. as she just asked me to keep the dose first until sat...

this is why i am thinking to use some supplements to help her.
first on her mobility and Arthritis problem, and the pancreas support by natural herbs.

yes, pls if you have any comments about the dose, pls do let me know.

also, one more question. for the last two days, after insulin injection, she is very tried, breathing rate from around 22 up to 28-30 per min (still within normal range though) when still. is there some kind of sign?

thx. pls advise.
anson
Click to expand...

Hi Anson,
I remember you and your girl; it's good to hear from you, but sorry to hear your girl is having problems.
It does sound that you have a good vet, so I hope the treatments chosen help with the current issues.

The pain meds and also the cartrophen are great for pain and her joint issues, and you may find the you will benefit from continuing the cartrophen regularly now, with the temgesic(buprenex) on hand in case she has some flares of pain and for any pancreatitis attacks. If you are suspecting pancreatitis flare up, maybe you can talk to your vet about what would be best for an upset stomach.... many use Pepcid AC 10mg, giving a daily max of 5mg - by cutting the pill in 4, you can give 1/4 tab am and pm, and it should help her with the upset stomach/nausea that often come with pancreatitis.

I have heard a few people using the pancreas powders with now problems, so if your vet feels it can't harm and may be helpful, then give it a try.... you ca look up the ingredients of the powder and see what a seach says for them.

About the insulin, have you been giving her insulin all this time or did she go off insulin and you have just restarted it recently with a fresh container of insulin? If you have just restarted, I would agree with the vet to stick with the lower dose for 5 days or so, and keep doing your curves so that you know how the insulin is working. Keep in mind that if she is in pain or having a pancreatitis attack her numbers will be higher, then when the attack passes, and also the pain meds kick in, her BG numbers will become much lower and you will need less insulin. After 3days of the 2u dose, and her legs are giving her less pains, your curves will let you and your vet know how to adjust her dose of insulin.

If she is having problems with pancreatitis flares, you can also talk to your vet about giving her fluids as there are the 3 things normally given for pancreatitis:
pain meds like buprenex / temgesic is pancreatitis is painful
Pepcid AC or something for upset stomach
Sub Q fluids
My vet had me give my Shadoe weekly B12 shots at home, and after I started her shots, she had only one minor p-titis flare so it seemed to help her pancreas inflammation a great deal. Maybe you can ask your vet about starting B12 shots as well.

Hopefully, the pain meds will help your girl and you find a good dose of insulin for her as well.
 
thx thx thx thx for your advise. and thx for remembering siujim.
yes, she is 19 now... amazing!

she has been on lantus since dec 2009. the dose was up and down a bit until march 2010 (because of pancreatitis) we reached a dose of 5 units that best worked for her. yet, in 2011, i started to give her some chi herb and she did better and thus we could do 4units. she has been on 4 units for more than a year.

just last monday (a week ago), she couldn't walk properly, so we took her to vet on tue and with the treatment of pain medi and cartrophen injection, she got better. but on wed, she had a hypo and hence i feed her sugar water for 3 times -- in the beginning, i was not sure how much i could give. i tested again and the no. went on dropping until 49 which was at the edge of safety level so i feed her honey.
and on the next day after hypo, i gave her 3 units (instead of 4). and the BG jumped up so i resumed 4 unit on thur/fri (i didn't understand at that time). and after that, i realized something was wrong, so i went to the vet. and she suggested to cut the dose by half. we started on sunday for the new dose. and the vet said it is better to keep it for 7 days to play safe.

i will see how things go.
usually, it is better to monitor for 3-4 days. (6 cycles of a new dose). 7 days will be too long because i worry if her BG constantly are so high -- more than 370 (even 400, this am) at pre-shot and 290 at mid day, it will hurt her kidney. i am worried on this point.

should i convince the vet to re-consider rework the dose after 4-5 days, instead of 7 days?

thx very much.
anson
 
HI Anson, its nice to meet you on this forum. I don't have any experience with the supplements you asked about but for the arthritis there are a couple of things to try. One is a glucosamine/condroiten supplement - the two popular brands are Cosequin or the newer Dasuquin. These do take some time to kick in but can be very helpful with controlling joint inflammation. Another medication (which can be used in conjunction with the glucosamine/condrointen) is called Adequan. It was developed for arthritic race horses but is used very successfully in cats and dogs. Adequan is given subq under the skin - the main thing is getting it built up in the system. You should do 2 shots a week for four weeks then you can taper off to once a month maintenance. I hope you can get the pancreatitis under control and have your kitty feeling better soon. Jan
 
Hi Anson,
I think because you did not stop giving insulin, you do not need to wait the full 5-7days.
If you have been giving 4u BID and then she got sick, the meds you are giving her now may be helping her be better AND lower her insulin needs to less than 4u but maybe more than 2u....

what about following the general guidelines, or checking with your vet to try maybe 2.5u for a few days, or even 3u..... the thing is that you know that the 4u was too much, so you need something lower, but don't know how much less.... that's why it's good to step back to lower, like the 2u until you see how well it's working. I would give it 2 full days / 4 shots/cycles because you don't know if the higher numbers you are seeing due to a bounce from the low numbers or due to a too low dose. If you don't see a drop in the numbers at ps times, then maybe after 2 days, you can go up to 2.5u and hold for 2 days, then if still not enough, go to 3u for 2 days..... that way you are slowly moving up and closing in on her good dose, and at the same time, you are giving the meds time to heal whatever was making her sick...

Slowly raising her dose, and keeping an eye on her walking for improvement plus no crying from pain may be a good approach.

the general guidelines followed by many....

"General" Guidelines:
--- Hold the initial starting dose for 5 - 7 days (10 - 14 cycles) unless the numbers tell you otherwise. Kitties experiencing high flat curves or prone to ketones may want to increase the starting dose after 3 days (6 cycles).
--- Each subsequent dose is held for a minimum of 3 days (6 cycles) unless kitty earns a reduction (See: Reducing the dose...).
--- Adjustments to dose are based on nadirs with only some consideration given to preshot numbers.

Increasing the dose...
--- Hold the dose for 3 - 5 days (6 - 10 cycles) if nadirs are less than 200 before increasing the dose.
--- After 3 consecutive days (6 cycles)... if nadirs are greater than 200, but less than 300 increase the dose by 0.25 unit.
--- After 3 consecutive days (6 cycles)... if nadirs are greater than 300 increase the dose by 0.5 unit.

Reducing the dose...
--- If kitty drops below 40 (long term diabetic) or 50 (newly diagnosed diabetic) reduce the dose by 0.25 unit. If kitty has a history of not holding reductions well or if reductions are close together... sneak the dose down by shaving the dose rather than reducing by a full quarter unit. Alternatively, at each newly reduced dose... try to make sure kitty maintains numbers in the normal range for seven days before reducing the dose further.

You see how at the start, it talks about 5-7 days, but that's if the cat is new to Lantus, so that does not apply to you, right? I am sure that your vet would be OK with your slowly raising her dose after giving Lantus some time at each increase and that you are testing and have numbers to prove that she needs more.

Let's hope she feels better very soon and is good to stay at the lower dose!
 
thx. seems like Cosequin is a good choice as the main ingredients are glucosamine and MSM but without other things like Vit c or dehydrated goat milk whey which i am not sure if siujim, or other diabetic cats will be allergic to...

thx for your recommendation.
anson

nwnews said:
HI Anson, its nice to meet you on this forum. I don't have any experience with the supplements you asked about but for the arthritis there are a couple of things to try. One is a glucosamine/condroiten supplement - the two popular brands are Cosequin or the newer Dasuquin. These do take some time to kick in but can be very helpful with controlling joint inflammation. Another medication (which can be used in conjunction with the glucosamine/condrointen) is called Adequan. It was developed for arthritic race horses but is used very successfully in cats and dogs. Adequan is given subq under the skin - the main thing is getting it built up in the system. You should do 2 shots a week for four weeks then you can taper off to once a month maintenance. I hope you can get the pancreatitis under control and have your kitty feeling better soon. Jan
Click to expand...
 
thx a lot.
your suggestions are very good.
i will try.

hope siujim feels better soon.
she has lost quite some weight (from 8p to 7.4p within a week). and urine very often because of the high BG hence excessive drinking of water.
i really worry about her kidney.
4 years ago, she had an experience on a kidney problem. but later fixed by acupuncture and quitting dry food. lucky i only tried the western medi and vet-food for a few months. later quit them all...

again, thx very much.
anson

Gayle Shadoe & Oliver said:
Hi Anson,
I think because you did not stop giving insulin, you do not need to wait the full 5-7days.
If you have been giving 4u BID and then she got sick, the meds you are giving her now may be helping her be better AND lower her insulin needs to less than 4u but maybe more than 2u....

what about following the general guidelines, or checking with your vet to try maybe 2.5u for a few days, or even 3u..... the thing is that you know that the 4u was too much, so you need something lower, but don't know how much less.... that's why it's good to step back to lower, like the 2u until you see how well it's working. I would give it 2 full days / 4 shots/cycles because you don't know if the higher numbers you are seeing due to a bounce from the low numbers or due to a too low dose. If you don't see a drop in the numbers at ps times, then maybe after 2 days, you can go up to 2.5u and hold for 2 days, then if still not enough, go to 3u for 2 days..... that way you are slowly moving up and closing in on her good dose, and at the same time, you are giving the meds time to heal whatever was making her sick...

Slowly raising her dose, and keeping an eye on her walking for improvement plus no crying from pain may be a good approach.

the general guidelines followed by many....

"General" Guidelines:
--- Hold the initial starting dose for 5 - 7 days (10 - 14 cycles) unless the numbers tell you otherwise. Kitties experiencing high flat curves or prone to ketones may want to increase the starting dose after 3 days (6 cycles).
--- Each subsequent dose is held for a minimum of 3 days (6 cycles) unless kitty earns a reduction (See: Reducing the dose...).
--- Adjustments to dose are based on nadirs with only some consideration given to preshot numbers.

Increasing the dose...
--- Hold the dose for 3 - 5 days (6 - 10 cycles) if nadirs are less than 200 before increasing the dose.
--- After 3 consecutive days (6 cycles)... if nadirs are greater than 200, but less than 300 increase the dose by 0.25 unit.
--- After 3 consecutive days (6 cycles)... if nadirs are greater than 300 increase the dose by 0.5 unit.

Reducing the dose...
--- If kitty drops below 40 (long term diabetic) or 50 (newly diagnosed diabetic) reduce the dose by 0.25 unit. If kitty has a history of not holding reductions well or if reductions are close together... sneak the dose down by shaving the dose rather than reducing by a full quarter unit. Alternatively, at each newly reduced dose... try to make sure kitty maintains numbers in the normal range for seven days before reducing the dose further.

You see how at the start, it talks about 5-7 days, but that's if the cat is new to Lantus, so that does not apply to you, right? I am sure that your vet would be OK with your slowly raising her dose after giving Lantus some time at each increase and that you are testing and have numbers to prove that she needs more.

Let's hope she feels better very soon and is good to stay at the lower dose!
Click to expand...
 
ALSO, A BIT URGENT.
tonight, she was restless at first as she wanted to poopoo but failed. later drank a lot of water and be able to do it. i thought she should be able to relax.
however, later, she walked in circle without control. i had to stop her and put her to bed. then she was very restless and left the bed walked again in circles.
i understand this is one sign of hypo so i checked herBD right away and it was pm+2 (252). so it is fine. in fact, still high (this is the 6th shot of the new dose -- 2 unit), will talk to vet tomorrow and see how to adjust.

now, i could stop her walking and she is sleeping.
may i ask, do u know the reasons? i heard it is a sign before stroke?
what should i be careful of? as it is middle of the night. need to be alert... we need to drive 35-40mins to the 24hr clinic...

thx thx.
anson
 
How is your kitty doing? I dont have advice except to say, I think she needs to see the Vet ASAP.
Good luck will be waiting for an update,
jeanne

EDITED TO ADD...Sending prayers for Siujim.
 
she stopped walking in circle later (after 20-30mins)... sleeping right after that, i think she is very tried.
at present, it is already 2 hours later and she is ok. just ate her late dinner. pm+6 (230) as we are still adjusting the dose... BG no. not good but at least not too low.

but when she went to toilet, seems like she does not like to walk too much. will see.
she resumes her mobility today...
i did the cartrophen shot this morning (the second one, the first one, by vet last week in clinic). it is already 12 hrs ago... shouldn't be a side effect...

will call the vet tomorrow.

thx
anson
 
anson said:
she stopped walking in circle later (after 20-30mins)... sleeping right after that, i think she is very tried.
at present, it is already 2 hours later and she is ok. just ate her late dinner. pm+6 (230) as we are still adjusting the dose... BG no. not good but at least not too low.

but when she went to toilet, seems like she does not like to walk too much. will see.
she resumes her mobility today...
i did the cartrophen shot this morning (the second one, the first one, by vet last week in clinic). it is already 12 hrs ago... shouldn't be a side effect...

will call the vet tomorrow.

thx
anson
Click to expand...

Hi Anson,
I wanted to mention a couple things: circling and stool.

First, for the bowel movement issues.... Can you add lots of water into her food, and you can also get miralax or some sort of laxative powder from your pharmacy to mix into the foods. The miralax will pull water from your cat's body to soften the stool so you want to be sure to add more water into her wet foods, and don't rely on just her drinking alot more. If you don't add water, you will have softer stool but she will be dehydrated.

Next, for the circling issues ..... Can you go to the upper right of the screen and find Search. Type in 'circling' into the search box, then search those results for 'seizure'. You will come up with 8 posts I think.
There are many cats who circle as a sign of other conditions, and she could have had a seizure, so you may do well to mention what happened to your vet, and see what your vet thinks to do. What you can also do is to record on your camera / phone, if you see her have another incident. Many times, we think we are describing what happened and what's important, but a picture is worth a 1000 words.... just showing the video of the circling to your vet will say a great deal.

Even if it's been only the one time, and you don't see any others, and she seems just fine, I will still mention what happened to your vet so it's in her vet file.
 
hi, i have ordered Cosequin from US. it will take some time to arrive in hk.
i forgot to ask. is Cosequin totally safe for diabetic cats?

thx.
anson

nwnews said:
HI Anson, its nice to meet you on this forum. I don't have any experience with the supplements you asked about but for the arthritis there are a couple of things to try. One is a glucosamine/condroiten supplement - the two popular brands are Cosequin or the newer Dasuquin. These do take some time to kick in but can be very helpful with controlling joint inflammation. Another medication (which can be used in conjunction with the glucosamine/condrointen) is called Adequan. It was developed for arthritic race horses but is used very successfully in cats and dogs. Adequan is given subq under the skin - the main thing is getting it built up in the system. You should do 2 shots a week for four weeks then you can taper off to once a month maintenance. I hope you can get the pancreatitis under control and have your kitty feeling better soon. Jan
Click to expand...
[/quote]
 
hi, yes, talked to the vet. she said if situations get worse should bring her in asap. but she is ok today. so we will wait until sat (the appointment we made on the discussion of the dose adjustment), though quite drowsy after the pain medicine (temgsic). not responsive after using it. but her paws are painful again (as the weather is quite bad and changing all the time in hong kong in the last 2 weeks. hope the cartrohpne will help. did the second shot yesterday. and hope the Cosequin will arrive soon and can help her out.

in fact, if she has pain all the time, the BG will be unstable and hard to control...

i didn't want to burden her kidney too much on the temgsic but... you know it is hard not to use it for the time being. let's hope Cosequin will arrive soon...

thx.
anson
=================

Hi Anson,
I wanted to mention a couple things: circling and stool.

First, for the bowel movement issues.... Can you add lots of water into her food, and you can also get miralax or some sort of laxative powder from your pharmacy to mix into the foods. The miralax will pull water from your cat's body to soften the stool so you want to be sure to add more water into her wet foods, and don't rely on just her drinking alot more. If you don't add water, you will have softer stool but she will be dehydrated.

Next, for the circling issues ..... Can you go to the upper right of the screen and find Search. Type in 'circling' into the search box, then search those results for 'seizure'. You will come up with 8 posts I think.
There are many cats who circle as a sign of other conditions, and she could have had a seizure, so you may do well to mention what happened to your vet, and see what your vet thinks to do. What you can also do is to record on your camera / phone, if you see her have another incident. Many times, we think we are describing what happened and what's important, but a picture is worth a 1000 words.... just showing the video of the circling to your vet will say a great deal.

Even if it's been only the one time, and you don't see any others, and she seems just fine, I will still mention what happened to your vet so it's in her vet file.[/quote]
 
hi,

would like to ask for your advise.

siujim walks better after cartrophen injection (3 times), tomorrow will do the 4th time. can also quit temgmics.
and also started to have cosequin 3 days ago (use feral express and sent to HK from US)... wish it will help her in a long run.
she is 19...

however, for the insulin dose, vet insists to observe her for longer time.
at 2 unit (cut by half after hypo), the BG curve was very flat and mid-day is 300, then we raised it to 2.5 unit. and the vet insist to keep it for 7 days instead of 3 days. her argument is that the arthritis problem may affect her response to the insulin. she said if there is still some kind of inflammation (we check her unripe culture, there is no virus but the protein level is very high, 3times more than normal), it will affect her and it is dangerous to move the dose up too fast.

in the first few days of the 2.5unit, the mid day value goes down to (185-210). which is much better. but it went up again after 2-3 days.

the BG curve is still very flat (7th day of the 2.5unit)
11ST AUG:
amps (300)
+3 (315)
+6 (298)
+9 (278)
pmps (315)
+3 (351)
+6 (320))

i discussed with them yesterday, and they said it is better to keep the dose 2.5 unit for another week because the cartrophen treatment and also the possible inflammation of kidney is still there...

what is your advise?
do u think the vet's argument is valid?
i am afraid if it goes on, for 3 weeks already, her BG all day long mostly is over 250...

thx.
anson
 
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