Howie: Post-1 year diagnosis dosing protocol

I am almost 1 year since Howie’s FD diagnosis, and, like all of you, my life is forever changed! There is absolutely NO WAY I could have survived this adventure (compounded with eventual IAA and acro diagnoses later) without all of you! He seems happy and healthy for what I think is a 12 YO fur baby. I was gifted him after his former person passed away in Feb 2020 so we’re not sure how old he is. He’s been on Cabergoline for 4 months and I’m still not seeing the drastic dosing decreases that many of you have. But he’s been hanging out in the 27-30 unit BID neighborhood, so maybe it’s helping to keep him out of the 50+ unit BID doses he saw this winter. I hate to take him off it to see if it is having an effect.

I know that there is different TR dosing protocol for cats who have been diagnosed for more than a year but can’t find the info. I’m also not sure how that different protocol works with IAA and acro diagnoses. I’ve been using 70 BG as my automatic reduction number per Wendy because of the Cabergoline. I’m not sure if I should still use that number or if I should go back to 50? I’ve been lucky that he hangs out in greens and low to mid-blues so don’t even think I’m following TR correctly with dose increases, holds, and reductions. I would REALLY appreciate some honest feedback on my SS and where I haven’t been doing things correctly and incorrectly. Also, I appreciate insights/recommendations I should follow now that he’s getting to be a long-term diabetic. I know ECID and cats need what they need. Howie seems to defy a lot of “normal”. THANKS!
@Wendy&Neko

 

I ignored the TR long term diabetic guidelines with Neko. If she earned a reduction, it held. But that was me experimenting with my cat, to see what worked for her. Whether you change the reduction point, is based on whether you think Howie holds his reductions. Know Thy Cat is doubly true for acro/IAA cats. Another thing for you to keep in mind, at some point, around the year time frame, the IAA can break. When that happens, you can get quick drops in doses. For that reason, I wouldn't keep him on a dose that keeps him in numbers with no margin for error.

The goal with acros is not to get them to the level to force reductions but by being tightly regulated, but rather to try to keep them in good numbers (preferably under renal threshold) as much as possible. With experimenting, I found nadirs of 70's were a good dose for Neko.

As far as Howie goes, I think you are doing a great job. He is really flat. At this current dose you haven't seen anything above 130. My one comment, I would periodically set an alarm for somewhere in the +8 neighbourhood at night. Many cats go lower at night and the SS is a blank slate there.

 

Thank you so much, Wendy! I appreciate your feedback and time of looking at his data. I feel more comfortable just doing what I’m doing than trying to change it up as he is doing good. I’m just so happy he is flat for the most part and doesn’t fluctuate as much as some other kitties I follow on the L/L forum. His IAA anniversary is end of Sept so I have a ways to go with that one.

Another quick question: Howie’s food manufacturer is changing their formula which means some of the carb %s are going up on some flavors. When we say that food should be 7-10% carbs (or less), is that %DMB, %ME, or %As Fed/Guaranteed Analysis? I can’t find a definitive answer. I really appreciate YOU!

 

Less than 10% on Dr. Lisa's chart on the catinfo website. Which is %carb on As Fed values. Definitely not guaranteed analysis.

 

His food isn’t on her chart and he just spiked up to 165 at PM +3 as I’m mixing in a new flavor today. I finally found the right article of hers tonight and her chart is %ME based in typical nutrient analysis (not As Fed or Guaranteed Analysis). I have a chart of As Fed and DMB values from Dr. Elseys, but they don’t seem to work with her equations to figure out %ME. So I have another email into them. Using their current info (that doesn’t make total sense), the carbs should be under 10%. But I’m questioning that given that 165 BG at PM+3.as I’m writing this, I just did +5, and he’s up to 178. He’s not been this high since April. I’m guessing I should stop this new food immediately? Nothing else has changed to explain this HUGE bump in #s. I’m going to bed so am not giving any midcycle R. I may regret that in the AM but I’m working from home and can deal with it then. He’s really getting bored with the pork flavor food and so was happy to finally be able to try a new flavor. I guess I’m out $45 since Amazon probably won’t take an open case of food back

 

If you can get the As Fed values from the manufacturer, you can use this post to calculate the %carbs. Calculating % Calories from Carbohydrates

 

Thanks, Wendy! That post you linked was much easier to follow than Dr. Lisa’s info! I do have the As Fed values, but they add up to over 100 so I can’t figure out the carb info as you can’t go negative. We’ll see what their next email says as he really likes this new flavor. I’m guessing that it is higher carb than his current food (even if it is under 10% in the end), so that is why the bump in numbers ? I wonder if I keep feeding it if his body will eventually normalize or if it will continue to treat it is maybe a MC food? I know this isn’t the topic of my original post but plays into everything I’m dealing with with my long-term diabetic and trying to figure out how to keep him healthy and engaged!

 

I would ask the manufacturer about the As Fed numbers, cause they shouldn't add to more than 100 what they give you.