It's been awhile, but could use some advice for Oscar

Hey everyone! Sorry I haven't been around in a little while, I promise I always check in now and again to see how things are going. Recently went back to school and things are pretty busy around here, so please don't judge my spreadsheet! I have a couple months worth of updating that I need to get to, but I have all the numbers to plug in.

So the reason for this post, Oscars been weird lately. We scheduled a check up for him next week but I could use some advice. Basically Oscar post DKA was great, we were able to get him pretty well regulated (never over 300, nadir's around 100-120) and his dose pretty much staggered around 4-4.25u (Prozinc). Occasionally dropping to 4 when he dropped below 90 or raising when he didn't drop below 150. But things were steady.

Until about 2-3 weeks ago. We had a two day long period where his Dr. Elsey's couldn't be delivered for some reason after expecting it, and there were no low carb options in stores so for those two days he had to go back on Crave dry food (about 20g carbs). At least I think that's when it started. Roughly a couple days later it seemed like he just wasn't dropping. And over that period we brought him slowly but steadily up to 5u with no lasting change, and he's still too high. I can sometimes get a random blue out of him, but his preshots are hanging out in the high 300's to low 400's and sometimes it seems like the insulin barely brings him down.
For instance, tonight Oscars cycle went like this:

AM Preshot: 348
+5.5: 161
PM Preshot: 431
+6: 382

As an aside, vet suggested to give him an additional 1u after his evening +6 when he barely dropped (thought was maybe he got a fur shot, but I don't think so). I don't normally do this, but I've done it before with little to no result in the past so I agreed, and will be keeping an eye on him tonight. This was normally done post DKA to keep his numbers down which made sense then, but I'm thinking now it won't hurt as much to leave him in high number for a couple hours, so as not to have the possibility of interfering with his next cycle. Thoughts?

His diet and routine have not changed and I can't understand what's going on. Clear of ketones, but with his history I get paranoid of high numbers quickly (even though he actually didn't have high numbers for his first).

His three P's are all coming back. Polyphagia has been back for about a week and Polydypsia/Polyuria seem to be creeping up.

I'm going to update the spreadsheet, but it's going to take some time. I'm not really trying to ask for any dosing advice anyways- I think I have that down pretty good. Just trying to get an idea on what might be causing this sudden change after he was doing so well. What should I ask from the vet?

 

Start with the last two weeks of spreadsheet data - that's what's really relevant in terms of helping you with dosing. Is his diet back to his usual 100% now?

I wouldn't add more Prozinc to the picture part way through the cycle. Better to find a dose that's getting him better numbers overall.

 

Yeah I'm regretting that now. I'm not so much worried about him going hypo as I am having it affect his next cycle. I felt like it was a good idea when we were still in the DKA grey area but seems more harmful than helpful at this point (dosing in the middle of a cycle).

Good call on doing most recent two weeks first- going to change my original game plan and start working backwards.

Diet is back to normal. We let him free feed after the DKA on his dry food since he was doing well and he had a pretty regular routine on when he would eat so we didn't need to regulate it so much. But now that he's becoming ravenous again, I think we're going to need to switch back to timed feeds.

 

He won't eat any wet at all?

 

No. He can have pate with water, and he just drinks the water (while his sister's eat), but anything more than that and he becomes sick. He has IBD/lymphoma and wet food (any kind, tried em all) is a problem.

 

Chloe -

Have you tried ZiwiPeak air dried food? It's more like a jerky treat in appearance and texture. It's low carb and it's available in novel proteins so it should be OK for an IBD kitty. I'd also recommend making sure that Oscar has plenty of water available if you're using dry food. Water is very important for kidney health especially with a diabetic kitty since FD is hard on the kidneys. Dry food has virtually no water content so getting water or some form of liquid into Oscar is crucial.

 

Its the food. Its ALWAYS the food. I often wonder why they didnt call it Foodabetes. (tongue in cheek)

That said, I commiserate about the wet food. Trouble was a kitty crack addict too.

GOOD LUCK sending best wishes
j