Introducing Missy

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Maresydotes

Maresydotes

Member Since 2011
I am new to the Levemir forum andI would like to introduce myself and my sweet girl, Missy. Missy was originally dx'd with FD March 2011. After putting her on Lantus and transistioning her to wet food, she went OTJ in April 2011. She remained OTJ until early Aug 2011, when her BGs went up. We went back on Lantus at that time. I tried TR, but am unable to test as much as the TR forum for Lantus requires, due to health issues, so stopped posting. In the meantime, I have tried everything I can think of, but Missy remains unregulated. :cry: I have had her tested for acromegaly and IAA and she is negative. Ultrasound showed no evidence of IBD, cancer or pancreatitis (blood tests confirmed no pancreatitis) She has been tested for parasites, including Giardia and toxmoplasmosis...also negative. She had a dental in February of this year. The only thing Missy has tested positive for was Lyme disease. She is just off a 2 month course of doxycycline for the Lyme. (at which time her dose was decreasing) I tried the Hodgkins protocol, with 10 hour dosing. I tried TID dosing, I took her to an internal medicine specialist.
Missy's numbers are erratic and uncontrolled. We are hoping Levemir will help with that. Her daily routine is almost always the same, she is fed at the same times, fed the same food, so no variables there. She is indoor/outdoor, but she is in a 6 foot chain link 'gated community' with her civvie brother, Phoenix, so no contraband food involved. To the very best of my knowledge, there are no external variables in her life.
I just increased her dose from 5.5 units of Lev (9 cycles at this dose, with a curve done yesterday, only dipping in to yellows at +8.) to 5.75 units.
We are SO hoping that we can get Missy regulated with Lev.....and open to any and all suggestions!
Thanks.

Marilyn and Missy
 
So far, so good. When I transitioned from ProZinc to Lev, I didn't see much action until I reached the PZI dose, so it may just be a matter of time. Sounds like you've done all the right things, so just try to be patient while you gradually do your increase. I sure was pleased when I started seeing a response. Pretty sure you'll be too! Good luck!

Lu-Ann
 
Thanks, Lu-Ann! I sure hope Miss sees some action with Lev. How is your handsome boy doing today? I hope he continues with those nice numbers.
 
You have been very thorough in trying to eliminate a lot of the variables that could be the cause of the insulin resistance. Good job. :)

You talked in your profile about trying to get her weight down. As you know, that could be a big part of the reason (although you could point to the fact that she did go off insulin at one point when she was still over-weight.) I wonder what does your vet think her ideal weight should be?

Have you tried her on a raw food diet? The high protein will help build muscle mass and the fat may come off more easily. Also, if she is still having runny poo at times, this will help that too.

That is sad about Phoenix and her not getting along anymore. I wonder why? Seems odd. Cats always seem to have a reason for everything they do even if it doesn't always make sense to us. :(

Does your vet think the Lyme disease will come back or is she 'cured'?

ETA - she is very pretty! :)
 
Hi Pamela and Tigger!
Thanks for saying Miss is pretty......I am biased, but I think so, too. She has such pretty eyes.
I know that weight makes her more resistant to insulin. She is definitely overweight, but weighed more than this when she went OTJ. She also stopped losing weight when she went back on insulin. :sad: I have read it is common for humans to gain weight on insulin, so I guess it is not a surprise she has stopped losing. One good thing about Levemir, is that it apparently causes the least amount of weight gain, in humans, of all the insulins. Maybe this will help her to lose again.
The vet says she should weigh about 14 pounds (she is big-boned...really ;-) ) So, she needs to lose a significant amount still. Right now, I weigh her food and add pureed green beans for bulk, so she doesn't feel deprived
I have tried raw, but she is such a picky eater. Hard to believe such an overweight cat is picky, I know. Her and her brother only played with it, never ate. I suppose I could try it again, maybe use a different 'flavor'. I tried chicken and rabbit (Nature's Variety medallions).
I agree it is sad that she and Phoenix don't get along. They used to be so cute, grooming each other, sleeping together. He was always a little rough for her, but they got along. They had a falling out when we were remodeling our house. I think I saw on "My Cat from Hell" if cats see each other out of the expected context, they may not recognize each other and that an cause problems. I wonder if they didn't run in to each other in the yard, were already upset because of the work being done, and one scared the other. Or maybe Phoenix is just a bully. :sad: He is also part of her weight problem. She doesn't want to play if he is around, because he as to get involved, so she is more sedentary. I used to think about separate homes, but I couldn't part with either of them. I am retired, so playing referee is another job that I do these days.
I have to take her back in for another tick panel to check on the Lyme's disease. She(vet) wanted to wait a couple weeks after getting off the ab's, so I actually should schedule her for next week! I have seen where sometimes Lyme disease is chronic and they are on ab's for life. Hopefully that won't be the case for Missy.
Thanks for your encouragement and fingers and paws crossed Lev is the right insulin for my sweet kitty.
 
Hello Marilyn and Missy - welcome to lev.

I don't really have any suggestions about dosage, but I am surprised to see such a high dose on a cat that has tested negative for both acro and IAA. It is unusual is all. Has she ever been on a lower dose - like 1u? I see she was started at 3u in the beginning and when she went back on insulin so I just wonder about the higher dose causing some resistance.

With both of these insulins, dose consistency is key so you want to find a dose that doesn't cause a really low PS where you skip or wait on a shot followed by a high PS. Usually a small dose reduction (10-20%) will help to even the PS numbers. Since you are home during the day, when she has a low PS, I would try shooting a reduced dose right away - and then monitor (test) to see how she does. Obviously, don't shoot big doses on a 50 or 60. Another option you could try is shooting tid instead of bid, but the first thing to do is to see how she handles lev after several weeks.

I bet she went OTJ because she lost weight initially, but then the FD "caught up" with her again. My Jeddie went OTJ right after I got him, but he was really thin and was gaining back needed weight and ended up back on insulin in about 3 months. He was also a tough one to regulate. What I found, with him, was that he needed a long time to settle on a dose - at least 10 days.

Hopefully the lev with help her numbers to even out. It seems to be less prone than lantus to causing bounces in some cats. And maybe she will feel better on it (we have seen that as well) and start being friendly with Phoenix again.

She is very pretty - that patch of orange tabby on her face is so unusual. Very striking. Is that the only orange she has anywhere? The rest of her looks like a gray tabby. And Phoenix is cute too, but what orange tabby isn't?
 
Hi, Marilyn and Missy,
Just wanted to add my welcome to the others. Missy is a beautiful girl. You have done an amazing job ruling out the things that could have caused Missy to go back on the juice. I hope you can get her there again.
Marcy & Klinger
 
"I have tried raw, but she is such a picky eater. Hard to believe such an overweight cat is picky, I know. Her and her brother only played with it, never ate. I suppose I could try it again, maybe use a different 'flavor'. I tried chicken and rabbit (Nature's Variety medallions)"

Hmmm, those medallions aren't the greatest in my book, although I know a lot of people here do have success with them. Tigger is on Feline's Pride raw food and loves it, but won't touch those. As they say ECID. (link in my sig)

You might try getting a sample from Feline's Pride and give it a try. The Cornish Game Hen, Turkey, or Chicken are all Tigger's favorites. I heard they are quite generous about sending people samples. There might even be a distributor in the Seattle area.

Good advice from Sheila on the dose. :)
 
Guess I didn't mention this... I did a dose reduction when we were on ProZinc from 6u to 3u, and then to 2u. The nice thing about ProZinc is that if it had had a severe response, we could've gone right back up... but surprisingly, he did better on 3u, and again even better on 2u. Reductions on Lev are handled differently, so Gayle or someone else will have to advise.

If you should try a reduction, you need to stay on top of testing for ketones. They can pop up out of nowhere, and can be dangerous.... so be aware of them and test, test, test!!!

Lu-Ann
 
Thanks for the welcome, everybody!
Sheila, I am considering a dose reduction. That is what my vet wanted me to do, but I ran out of Lantus and had to start her on Lev while we had a houseguest and I was unable to watch her closely enough for trying that. I DID try doing that back in Dec. 2011 (on Lantus) but she showed ketones rather quickly, so I brought her back up. She was originally started on 3 units because of her weight. When I brought her down in Dec. I went to 1 unit. I know that she is my little enigma. Nothing about her makes sense ;-) She is a high dose girl with no apparent reason for it......other than her weight. She is mostly grey tabby with white hind feet and chest. Sprinkled throughout her body are patches of cream tabby marking. Not as 'showy' as her face, but subtly attractive. She is such a sweet girl.
And, yes, I love my orange boy, but OMG, he is an instigator. :-D. I told DH I think he is ADHD. When he was younger he started gnashing his teeth. Took him in and the vet did an exam...nothing wrong, maybe behavioral. So I started watching...and he did it when he was frustrated! Now he bangs the cupboard doors if he isn't getting what he wants, will turn the light on and off (touch controlled so he unses his nose) to get us out of bed. And, do NOT pet the belly when the tail is twitching! He will turn from a sweet boy to nothing but teeth and claws in a second. He is my brat cat.
Pamela, thanks for the thought on asking for samples. Think I will. That is why I stopped the raw experiment. It was kind of expensive to watch them bat them around and then throw out the bag. (couldn't find anybody who wanted the raw) But, if I can get samples, I am willing to try it again.
Lu-Ann, I guess I will have to work up to wrapping my head around the reduction. I would like to try it, since the internist my vet spoke to was thinking Somogyi, but she is really hard to catch at the litter box. She usually pees before I get up in the morning. I have the meter to check them, but Carolyn hates it for false positives, so not sure
about using it. I will have to mull it over for a while.
Thanks again for the warm welcome, everybody!
 
Marilyn -

My Moochie Pooch (cat) is did the same thing, knocking things off the counter, table, or any surface. Today he threw a light bulb on the floor (it didn't break)... until I stepped on it! He also frequently peed "inappropriately". I've had more tests run on him than anyone else in the house - everything came back normal (except he was dx FIV+ before he came in). He seems to be attention-starved. We concluded it was psychological. He's now on "happy pills". (Fluxetine 10 mg tabs - quatered). Because it makes him a little TOO quiet, I usually give it every other day.

As for the ketone testing... I have a meter that tests as well, and I purchased the strips for it. I was never completely confident in the accuracy of the meter tests - half the stips errored out, the other half seemed to give some wonky numbers. I used the bottle of Ketostix from WalMart or Walgreens with much more confidence. I moved a litter box up onto a card table in the dining room. Every time he got up there, I grabbed the bottle. He got to the point where he didn't even notice me there! I've said it many times, but that little $6 or $11 bottle is/was the best insurance I could've bought! Do what you need to do to get her to use the box. Most cats will jump at the opportunity to use a clean box, so scoop, even if there's nothing in it. Also, I mix 1 can of water with each can of food, so Grayson continues to have large pee pies. It also ensures that they use the box frequently.

Good luck... if I can offer anything further, I'll do my best!

Lu-Ann
 
Thanks, Lu-Ann.... I might have to look into the 'happy pills'. :-D I love Phoenix, but I think he contributes a lot to Missy's inactivity. He is a sweet boy at dinner time, tho. He will groom Miss then. That is the only time Miss puts up with him. :-D The belly wants what the belly wants. :-D
I am thinking that I will try the reduction when the weather here turns. It won't be long :sad: . I hate locking her indoors when it is nice outside. That is the biggest amount of activity she gets. But, she is a fair weather girl (unlike her brother who is a true Washingtonian and comes in, literally, dripping wet) and won't be spending much time outdoors...I will be able to get samples easier. We got a little bit of summer, unlike the rest of the country, and it is quickly turning to fall. My tomatoes (planted late) are just now ripening. Summer went too fast.
 
Maresydotes said:
Thanks for the welcome, everybody!
Sheila, I am considering a dose reduction. That is what my vet wanted me to do, but I ran out of Lantus and had to start her on Lev while we had a houseguest and I was unable to watch her closely enough for trying that. I DID try doing that back in Dec. 2011 (on Lantus) but she showed ketones rather quickly, so I brought her back up.
Click to expand...

But at the same time, you said in your SS that she was on DiaGel at the time which is for bacteria infections? I don't know (had to look it up), but it would seem that might also have contributed to the ketone buildup along with the lack of insulin? Your SS stops there so I am not sure. I am sorry. Not trying to contradict you, just trying to figure out why the ketones came on with the dose reduction. Usually there is an infection present, even one that is not always noticeable on the surface.

But yes, always testing while doing a dose reduction is a good idea and is usually recommended, as you already know. :)

Maresydotes said:
And, yes, I love my orange boy, but OMG, he is an instigator. :-D. I told DH I think he is ADHD. When he was younger he started gnashing his teeth. Took him in and the vet did an exam...nothing wrong, maybe behavioral. So I started watching...and he did it when he was frustrated! Now he bangs the cupboard doors if he isn't getting what he wants, will turn the light on and off (touch controlled so he unses his nose) to get us out of bed. And, do NOT pet the belly when the tail is twitching! He will turn from a sweet boy to nothing but teeth and claws in a second. He is my brat cat.
Click to expand...

Awww, have to love those brat cats. :) My Tigger can be like that sometimes. Have you tested him for hyperthyroid? Is he older than Missy?

Maresydotes said:
Pamela, thanks for the thought on asking for samples. Think I will. That is why I stopped the raw experiment. It was kind of expensive to watch them bat them around and then throw out the bag. (couldn't find anybody who wanted the raw) But, if I can get samples, I am willing to try it again.
Click to expand...

Yes, do look into it. Especially with all the antibiotics she has been on. It will do her gut good. :)
 
Pamela,
No problem in you mentioning the ketones and DiaGel. It is always good to have a fresh viewpoint. Sometime you get so involved you can't see the forest for the trees.
Long story on the DiaGel. When Missy went back on insulin, the vet gave her Clavamox in case there was an infection (even tho her blood work and urinalysis did not show anything) I was watching her stools, because I know that ab's can cause diarrhea. She had diarrhea, alright. I have to say I don't know if she had it before the Clavamox or not....I wasn't looking for it then. I did all the usual things.....FortiFlora, yoghurt, other probiotics, kitty antidiarrheals and DiaGel. She had diarrhea for a long spell. That is why we checked for parasites and looked for evidence of IBD. She eventually got back to normal stools after a course of metoclopramide.
I also had an idea that her dragonfly eating may have had something to do with the diarrhea and going back on insulin, since the timing was coincidental. I researched that until I found dragonflies can be a vector for Potomac Horse Fever. That is why we did the tick panel and found the Lyme disease exposure. (she was negative for PHF)
So the diarrhea caused me to use the DiaGel. I guess, since she had exposure to Lyme, there could have been a bacterial infection going on at that time.
I quit using the SS at that time, because I was trying Hodgkins Protocol and that group uses a different format. I just never sat down to figure out how to add those numbers to this SS. (not the most computer savvy)
Haven't tested Phoenix for hyperthyroid. He and Miss are litter mates, so same age and both have a tendency to being heavy. His coat is really nice, too. I just think he is a healthy boy who likes to pick on his sis and doesn't deal with frustration well. Part of it is jealousy over the attention Missy gets, although I try to give them both equal amounts of
attention. The FDC she gets during test time is the biggest thing....I am not so sure he cares about the attention so much as the goodies. I have to give him some too. He knows the microwave (for warming her rice sock) and will come running from the back yard when he hears it go off. :lol: Here is a video of him coming for his 'treaties'.

http://www.youtube.com/watch?v=qcS30RPB ... ata_player

I appreciate you looking at Missy's SS in so much detail. As I said, sometimes a fresh set of eyes will see something we have missed. Thanks.
She is doing pretty well on the 5.75 units. 222 @AMPS. I can live with that number. She definitely seems less bouncy on Lev. And I read it is the insulin that humans gain the least weight on, so maybe we can take some off of her.
 
Maresydotes said:
Pamela,
No problem in you mentioning the ketones and DiaGel. It is always good to have a fresh viewpoint. Sometime you get so involved you can't see the forest for the trees.
Long story on the DiaGel. When Missy went back on insulin, the vet gave her Clavamox in case there was an infection (even tho her blood work and urinalysis did not show anything) I was watching her stools, because I know that ab's can cause diarrhea. She had diarrhea, alright. I have to say I don't know if she had it before the Clavamox or not....I wasn't looking for it then. I did all the usual things.....FortiFlora, yoghurt, other probiotics, kitty antidiarrheals and DiaGel. She had diarrhea for a long spell. That is why we checked for parasites and looked for evidence of IBD. She eventually got back to normal stools after a course of metoclopramide.
I also had an idea that her dragonfly eating may have had something to do with the diarrhea and going back on insulin, since the timing was coincidental. I researched that until I found dragonflies can be a vector for Potomac Horse Fever. That is why we did the tick panel and found the Lyme disease exposure. (she was negative for PHF)
So the diarrhea caused me to use the DiaGel. I guess, since she had exposure to Lyme, there could have been a bacterial infection going on at that time.
Click to expand...

Sounds like you did everything you knew to do at the time. Not trying to criticize at all. Thank you for explaining all that. I love that you researched and looked into everything. :)

Maresydotes said:
I quit using the SS at that time, because I was trying Hodgkins Protocol and that group uses a different format. I just never sat down to figure out how to add those numbers to this SS. (not the most computer savvy)
Click to expand...

Understand - followed Dr. Hodgkin's myself years ago. :) Yes, as far as putting your numbers out there in a SS, the format with the Hodgkin's protocol was much simpler. You added it into your message/post update, but not as in a spreadsheet. Back then we didn't do as much hand-holding either, because it was not as necessary. These longer-acting insulins are a little more of a challenge and the guidelines here are so helpful in that regard (especially in the beginning).

Maresydotes said:
Haven't tested Phoenix for hyperthyroid. He and Miss are litter mates, so same age and both have a tendency to being heavy. His coat is really nice, too. I just think he is a healthy boy who likes to pick on his sis and doesn't deal with frustration well. Part of it is jealousy over the attention Missy gets, although I try to give them both equal amounts of
attention.

The FDC she gets during test time is the biggest thing (I am sorry, what is FDC? Sorry!) ....I am not so sure he cares about the attention so much as the goodies. I have to give him some too. He knows the microwave (for warming her rice sock) and will come running from the back yard when he hears it go off. :lol: Here is a video of him coming for his 'treaties'.

http://www.youtube.com/watch?v=qcS30RPB ... ata_player
Click to expand...

Ack, I tried to open the video. I would have loved to have seen it. I think you need to put the URL signs on each side. Here is a post on Tech that explains it better than I can:

http://www.felinediabetes.com/FDMB/viewtopic.php?f=6&t=39108

This new board.....I am not that computer savvy either. Sigh. But it is not that hard. I would really love to see the video. :)

Maresydotes said:
I appreciate you looking at Missy's SS in so much detail. As I said, sometimes a fresh set of eyes will see something we have missed. Thanks.
She is doing pretty well on the 5.75 units. 222 @AMPS. I can live with that number. She definitely seems less bouncy on Lev. And I read it is the insulin that humans gain the least weight on, so maybe we can take some off of her.
Click to expand...

I will probably harp on you about the raw. Sorry, can't help it! I think it is the 'cure' for a lot of things healthwise with our kitties, IBD the one major one. Of course, getting them off dry food is the first step, then canned, then raw......:)
 
Pamela,
Sorry I have not been back. I was having computer issues. Groan. I couldn't get online. I will see if I can get the video to work for you.....it really is cute. (not that I am biased :-D )



http://www.youtube.com/watch?v=qcS30RPBFw0&feature=youtube_gdata_player


I have another one of him on bupe for pain, when he had an abscess last November. It is also funny. He couldn't stop purring. Ignore my baby talking him (they get goofier the more you do that.....Missy is camera shy, I get very few of her)

http://www.youtube.com/watch?v=sZc7db2-V7g&feature=youtube_gdata_player

Gosh....I have to get off here. NOW my cable tv is messed up, trying to get it back up before DH gets home from work. I want to pull my hair out! I love technology and hate it.

I wanted to ask if anyone thinks I should bump up Missy's dose, now that I have her SS up to date. I am a little disappointed in the numbers she is seeing right now.


Thanks a lot and I hope you are able to see the videos.
 
Both of those videos worked, but the "stoned" one would only play when I double clicked on it to open it full screen - and then it was sideways (vertical).

It's so funny how that sound of food banging in a container gets them every time. I had to use that trick on Leanne when she was 5 months old and got outside at the house in MI, surrounded by woods, at dusk. She wasn't even that familiar with the sound, but I did eventually lure her to me with it. Whew! She didn't come running like Phoenix did though.

You can probably raise Missy's dose again to 6u. She seems to respond to the increase pretty quickly and then back slides in another day or so.
 
Thanks, Sheila.
I thought the same thing.....first a response then backsliding. It seems like almost anything I try with her works that way, not just the insulin.
Oh and Phoenix doesn't always come running....only when he's hungry.
Glad they opened up......
 
Loved the videos! Sounds like her motor got stuck on MAX.

For dosing- you keep bumping it up in .25 increments- there came a time when I started increasing by units rather than half units. I know Missy isn't acro or IAA, but with all the information you have, except for some blues- she is bouncy alright, maybe increasing by half units would be okay.

Now I increase by 3u at a time does have a "YIKES! Here goes and you better go lower this time!" feel to it.

Dang those dragonflies!
 
Wow! Increasing by 3 units :shock: That makes .25 sound puny. I used to increase by .5 but when she was going down in dose, she seemed to want to do it in .25 degrees. She makes me dance to her tune, that is for sure. I will be taking her in to see if she cleared the Lyme or needs more ab's. I love her but she is definitely a unique girl.
 
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