Hello! It’s been a while since I’ve posted about Emmett. Sorry, I’m currently on mobile so not sure how to link my previous threads on my phone. Anyway, I’m looking for some advice on Emmett and his numbers this past month. About a month ago, I moved with my cats. The stress, quite expectedly, caused Emmett to become completely disregulated. It took me a while to figure out what was going on with his numbers and whether I needed to be decreasing or increasing his dose (and I was too stubborn and sure Emmett would eventually stabilize so I didn’t ask for advice then). However, a month later, Emmett is feeling comfortable and not so stressed in this new place, but he’s still pretty disregulated. I can’t make any sense of what is happening with his preshot numbers. He seems to be constantly bouncing around. He has extremely high numbers followed by pretty low (for him) numbers. I don’t know if his nadir is changing or if his blood sugar is just bouncing mid cycle. Currently, his full dose is 3.25 units, but I’ve had to adjust that down with his lower preshot numbers. I’ve also not been able to test him during the day sometimes due to work. Aside from the move, nothing has changed about his routine or food. He still eats fancy feast pates (and sometimes merrick rabbit pate). He eats at +2, +4, and occasionally +6 (I’ve been skipping this meal more often lately, and he doesn’t seem to be begging for food as much since moving, but that could just be the result of him not feeling as comfortable yet). I would love some advice about what I should be doing with him/his dose. Thank you!!
Wow. Looking at his spreadsheet, he’s all over the place. I think it’s because his doses are constantly changing. He’s also very bouncy. On the days recently when he’s had a blue Amps, there are no tests during the cycle so we have no idea whether the reason he ended up in the black is because it just wasn’t enough insulin or because he dropped and then bounced. I think you need to find a dose that you can stick with pretty much all the time. And gradually increase or decrease On the days where there are no tests, are you gone all day?
Once you settle on a dose then you should run a curve testing every 2 hours so we can hopefully see what’s going on. Could there be anything else wrong like a dental problem or urinary tract infection or anything else you can think of?
yeah, I don’t like that how I’ve been changing his dose, but I know the full dose of 3.25 will be way too much with those blue preshot numbers. And I feel like he needs a higher dose with those higher preshot numbers, like how he was doing the month of April. But I can definitely find one dose I can stick with and see what’s going on. I think I’ve at least been consistent with his PM dose. And yes, unfortunately, and frustratingly, the days he’s had the blue AMPS I’ve had to be in the office for work. That’s why I was so conservative with his dose, to make sure he wasn’t getting too much when I couldn’t monitor him.
he still has a sore paw, likely the eosinophilic granuloma, but I have been wondering if I’m wrong about that and there is something else wrong like an infection. It might be time for a vet check.
I would check it with the vet, yes. Because he’s just got so much black and red on there. I know you hate that.
Thanks. I’m going to email the vet. I’m really hoping we can resolve this. When his blood sugar is relatively good he feels GREAT and will play all day, then it suddenly spikes and I can watch him just crash and have no energy. I feel so bad for him.
I understand. If only he would do this when you were home we would be able to gather some data to see if it’s too much or too little.
You could try a slight reduction to 3 units or 2.75 units and see if it’s something that you can shoot more consistently. Although if he has infection or inflammation it is going to be really hard to get him into more consistent numbers. I am sorry you’re having such a rough time of it. I know it is hard to see him feeling awful. Let’s work on it and see if we can do better for him.
My mom feeds the cats while I’m at work, and she’s getting more comfortable with testing him. Hopefully if this happens again in the future she can get at least one test in during the day
Okay, that’s a good idea. I will start doing that. I won’t be able to get him into the vet over the weekend of course. Fingers crossed we can figure out what’s going on with him.
It could even just be the inflammation from the eosinophilic granuloma… I mean it doesn’t necessarily have to be an infection, per se, but allergies are an inflammatory response so that could just be it. Have you tried Atopica?
Emmett is keeping me on my toes today! He had a great cycle, but these drastic differences in preshot numbers are stressful lol. I decided to try sticking with 2.75 and adjust from there. I’m going to monitor him really closely tonight.
Hi @Suzanne & Darcy I just wanted to say a big thank you to you for your advice. It was spot on as always. Turns out, Emmett just needed way less insulin. His numbers are way more stable over the past few days, and at least the bouncing numbers the past couple days make sense to me.
Those numbers do look better! I am very glad to see this! How’s his paw? What did the vet say? You reduced to 2.25 last night because of the greens? Just keep tracking his numbers and make sure you have not reduced too much or too quickly. Cats insulin needs can change over time (either up or down). His spreadsheet looks promising. If he can clear up any infection or irritation then he may need even less insulin. I bet he’s been feeling better a lot of the time!
The vet thought Atopica might not be the best choice for him (not sure why) but if this goes on any longer I’m not sure there’s a choice. I reduced because he looked like his blood sugar bounced up really quickly after the 4.8 at +4, when his nadir is typical +6. In the past that has been a sign that he needs an insulin reduction. So I wanted to give him a few days on 2.25 and see how he does. He’s definitely feeling better!
Okay. Then try to hold that dose for a while unless he drops low. We may want to keep him at this dose unless he drops below 70. I feel like he’s doing really well right now and it would benefit him to lower the reduction point. I will check back in on his spreadsheet later today.
Yeah, I agree. I normally wouldn’t have reduced him from the 2.5 units so quickly but I didn’t like the mid cycle bounce. I just tested him and at +4 he’s at 6.8/122 on the 2.25 units. Which seems to be really good, especially considering how high his AMPS was.
Also, I spoke to the vet and she is not concerned with his high preshot numbers. She manages diabetes more based on weight and other symptoms. Which is not necessarily the way I want to manage his diabetes. In terms of his paw, she wants to try an antibiotic and if that doesn’t work, Atopica. I will try that but I am skeptical of the antibiotic working (if it is just a granuloma and not an infection) as it didn’t really work he was given an antibiotic for his lip not too long ago.
Looking good so far. I hope the antibiotics will help. We have another member on this ProZinc forum whose cat was having severe skin problems and she took him to a dermatologist last week and they did a culture— it came back as a staph infection (so he is on antibiotics). If Emmett’s is truly eosinophilic granuloma then it won’t help, as you say — and he’s tried them before. So far I’ve only had it with non- diabetic cats who can get a steroid injection for eosinophilic granuloma.
Interesting! I would hate for him to have an infection that I’ve essentially ignored (or at least thought I’ve not been able to do anything about). The last time he had antibiotics, it was only his lip bothering him, not his paw, so who knows.
Emmett officially went under 70 on 2.25 units, which I expected to happen sooner rather than later, so I will be decreasing him to 2 units tonight.
It’s under 68 on an Alpha Trak, but he still made it! Good catch! Tell me what he ate and when. That kind of a drop from a pink AMPS to 67 in 4 hours is just too much. He should have eaten by +2 at least, and, if he already is doing that every day, then he is the kind of cat who needs more carbs (8/9) percent for his early cycle snacks and possibly 5/6/7 percent carbs at breakfast. We need to slow him down.
He eats fancy feast at +2 and +4. I can’t feed him chicken/poultry so my options are super limited with what I can give him. He likes Merrick rabbit, which I think is around 6% carbs, but rabbit is always hit or miss with stocking issues (we bought out all the pet stores in the area who carry it and it was like six cans total). I’ve tried lamb but he’s ambivalent about it. He loves the Purina DM (slices in gravy which is 10%) but unfortunately that’s chicken.
Oh that is a problem because he really needs to stop the diving. So no turkey either? Have you tried any pork options? Finding food is always so time consuming and so frustrating.
I will try to ration the rabbit so he gets it at +2 (I tend to give him it at insulin time so I know he’ll eat as he’s getting tired of his current food). He despises turkey. I think he likes pork but I don’t tend to see many options (mainly only in dry food). I’m in Canada where our cat food options are always so much more limited. I’m going to go to the pet store and look through the options more closely. Or maybe Chewy will have some options now that they ship to southern Ontario.
Hi @Suzanne & Darcy ! I’m wondering if you have any thoughts about Emmett’s recent numbers? The last couple days his pre shot numbers have been even higher than usual. Unfortunately today I was in the office so no mid cycle tests. I’ll get some in tomorrow though. Is he likely still bouncing? I’m hoping to see some better numbers tomorrow on 2 units; yesterday was promising. As an aside, he got an antibiotic shot yesterday to see if it’ll help with his paw. If this doesn’t work (and I suspect it won’t) then the next step is Atopica.
I don’t think he is bouncing because He saw blue yesterday. We don’t know what he did today. I think he was doing better on a higher dose. Unless we can control his early drops (with the slightly higher carbs) where he earns a reduction, he may bounce back and forth between doses. When I look at his SS, it really looks like he did better on the higher doses and his preshot numbers were lower. I know you are limited as to what you can feed him ( and you were going to try to save the rabbit for those snacks. I don’t like seeing the black on his spreadsheet (and I know you don’t either.)
Hmm okay. My mom ran out and found about eight small cans of the rabbit, which I’ll feed him at +2. Let’s see if that helps with the early drops.
Sorry. I don’t think you are liking my answer. But if everything else is pretty much the same, I just think his dose is too low. I so hope the antibiotic (Convenia, right?) will help him (although I am not a fan of Convenia). Is the paw really bothering him? Anyway, about the dose— I would wait and see if he gets any better numbers tonight before going back to 2.25. Will you be at home tomorrow?
No your answer is fine! I’m just really hoping to see Emmett level out again and thinking about what I need to be doing. yes, that’s what he got. He just holds his paw up a lot. It’s pretty swollen too. But he’ll sure ignore it and run around playing when he wants.
Yes. We will see if the 6 percent rabbit will help. It may not be enough. You may have to experiment with adding a tiny drop of corn syrup to his food or something…. I am just trying to think of something since he’s so limited on what he can eat. Sorry.
And yes, I will be home tomorrow. I’ll see how it does on 2 units tomorrow and then go back to 2.25 if he’s not improving.
Wow. He’s a tough guy. How old is he? Any chance it could be arthritic? Has it ever been x-rayed? Does the skin on the paw look broken or red or blistered? He’s had these skin problems for years?
No problem. I super appreciate all your help. I’ve been at a total loss for him. Especially since his vet doesn’t care about his preshot numbers. But I don’t see how him always in the red/black could possibly be good for him. I’ve got human diabetics in the family and can’t imagine NOT being concerned about constantly going into the 20s and 30s
He’ll be 4 on July 1st! It was x-rayed when the issue first appeared two years ago and there was nothing out of the ordinary. He hasn’t had any tests done on it since. Sometimes the paw pads look red and raw and crusty, but this time I’m not noticing anything unusual except it’s swollen. The issue first appeared two years ago, but we were going on a year without any major issue, until he got diabetes and started eating more chicken based food. Now it seems like it’s always his paw or his lip having problems.
I’m just thinking now, there are some brands of food like Nulo that have non poultry flavours he’ll eat, but I don’t see listed on the food spreadsheet. I’m not sure how many carbs are in those pates. I’ll have to look into options more on the weekend when I have more time.
