LB update..

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Anyname

Anyname

Member Since 2010
LB is now on 8.5/ 2 daily. He started to show lower numbers about a week ago. After bounces he showed more very encouraging numbers - like they were settling in. The diet of raw diced skinless chicken breast/no fat with a sprinkling of Royal Canin GI was hitting the target @ 8.5 units. I decided to keep working at it and ordered 10 ground rabbits to arrive this wednesday gone. Just when I was getting some great numbers along came Mr Rabbit and messed everything up - too coincidental to blame it on a bounce IMO! Me thinks Mr. Rabbit is a problem food for LB. Thinking back his numbers have gone up since rabbit came on the scene. He's not itchy when he eats it but he gets constipated if I only give him rabbit. I flush some water thru it and try to pick out some of the bone.

So with a freezer bursting with plastic bags of ground rabbit, I'm thinking one bag a day is plenty to keep his calcium ok and to avoid constipation. I'm going to make most meals as stated above.

I would really like to get the SS working for me to use coz I'm testing but have no sense of the over-all progress. (old one and new one won't let me write in it) I am following the posts of others who have similar problems and following the advice they get. LB's numbers seem related to diet primarily - he's lethagic but apart from this morning he's not drinking much at all. A week of smaller meals consisting of diced skinless, fatless chicken pieces with a teaspoon of royal canin GI dry on top put him into good numbers. Since the rabbit he's messed up again. Back up to 260 this morning after 106 @ naidar a few days ago (pre rabbit). I'm going away this week and the house sitter won't be testing - I'm ok with that as I think the cattery is too stressful and I'm really lucky to have a friend willing to stay here and look after our boy. I've had him read as low as 34 without a sign of weirdness - he's not been under a 100 for a very long time. Even in the cattery they won't watch him that closely.

One thing, my vet emailed to me to say that with Lantus its ok to give 1 unit per kilogram of weight. He's 9 kilograms. He went on to say that when he's needing 2 units per kilogram they start seriously consider other problems. This is the guy that worked with Qld protocol group - the guy who helped get Max of Max & Amy OTJ recently.

I have one more syringe of the six week course of B12 to give him. He seems to drop his numbers for 24 hrs after the shot. Anyone got any insight into why that would be? I am not sure why he was given the course.

thanks for reading,
marilyn
 
hi marilyn!

i wonder if you posted in the tech forum if someone could help you get a spreadsheet up and working. it is so helpful to see BG laid out in a chart.

i posted punkin's story about his treatment for acromegaly in the acro/iaa/cushings forum http://www.felinediabetes.com/FDMB/viewtopic.php?f=12&t=52744. about 3/4 way down the page there are 3 links to pdfs that the vet student who worked with punkin prepared for a presentation to the Colorado State Univ Vet School. i'd encourage you to look at least at the first one - there is a slide in there about at what point dose they consider insulin resistance. i know it's near impossible for you to get the blood tests done, but even without the tests for iaa/acro you can follow the treatment. it's basically increasing the dose enough to keep their blood glucose in non-organ damaging numbers. for a cat that's typically considered as less than 225-250ish, but it may be an "every cat is different" thing.

regarding the dose - everything i've read says that dose is based upon lean body weight - so even a chunky cat wouldn't just get a bigger dose. is your vet talking about per dose (ie, twice a day) or per day?

if you would like advice on the constipation, you could edit your first post's subject line and ask for thoughts on it. a lot of people deal with it and would likely be able to offer some ideas.
 
Marilyn --

Feeding only raw food with no supplements is not a nutritionally complete diet. Cats need certain supplements (e.g., taurine) to maintain their health. Please see Dr. Lisa's site on feline nutrition if you are going to feed raw. She has a recipe for what to add to the raw meat. Not adding the supplements will cause all sorts of medical problems for LB. (Think in terms of humans developing scurvy if we don't get enough vitamin C or anemia if we don't get enough iron.) The supplements should be available at a health food store or on-line. Alternatively, there are pre-mixes that you can add to raw food to make the meals nutritionally complete.

I have not heard anything about a cat getting 1.0u per kg of body weight. We generally start thinking about the possibility of high dose (i.e., acromegaly or insulin autoantibodies) when a cat is getting over 6.0u of insulin. The tests for these conditions are run at Michigan State University here in the U.S. I'd encourage you to call the Centre for Companion Health at University of Queensland to find out if they do the tests or if they know where you can get the tests done. There is information on high dose conditions in this forum.
 
Sorry to hear about the food issues. Have you read Dr Lisa Pierson's page on making raw food, just the meat and bones is not enough. You need to add supplements as well. she also discusses the , constipation problem from too much bone.

Have you tried making your own SS on Google Docs? It's more work than using the template, but not that hard. I'm not sure how to create the second sheet that converts World values to US values, but just getting a sheet up should help you. I'd start off w/ a new blank SS in Google Docs, select all the cells and set the conditional formatting (Format menu> Conditional formatting…..) You will need to set the text color and background color for each BG range. Then Remove the formatting from the dat, dosage and notes columns. Set a different color background for the dose columns.

Remove the formatting from the top 2 rows. Type in the column headings and set color. And you should be set. Well maybe a few more tweeks. :roll: :lol: I'm still adjusting things on mine.
 
Hi, Marilyn!

so good to see a LB condo!!!

I have nothing of value to add except that we think about you and your handsome devil so very often!

big sloppy kisses from Binks to LB.

celi & the Binkster

funny-pictures-cat-wants-to-cook-rabbit.jpg
 
Julie, I read quite a few posts of yours at the time of your visit to the vet hospital when Punkin was being operated on. Your posts were excellent and addictive. I will take a look a the things you suggest I read. Basically he's doing ok except he is on a high dose of Lantus. I've tried different vials to see if there was something wrong with the vial I was using.

celi, I've read but a small number of your posts in support of people who post - I love the way you send good thoughts to everyone. Thank you for stopping by.

DIET.

I have read Lisa's pages many times. It looked confusing at first but I suspect I know it off by heart now. The closest I came to making it was a couple weeks ago. HE wouldn't touch it - very depressing. We made a batch of minced free range chicken, a few chicken livers. A rabbit, ground by an ancient hand grinder and egg yoke raw and cooked egg white. It's still in the freezer. I tried to cook it when he wouldn't eat it fresh. I mixed it with some RC GI dry. I let him get hungry. It's still in the freezer. The episode lead the next day to his first low number since I returned from the UK in mid Sept. Eat far less get low number!

My personal belief is that LB eats TOO much food. He seems to want to eat every few hours. He eats at 7am, then a top up at 10am, then 2pm then 7pm then 10pm and a meal left out thru the nite. He eats about equivelent to 4 tins of 185grams FF a day.

I've tried to giving him fish oil and evening primrose oil. Anything with oil causes the 'unwell' phase. After the rabbit of the last few days he's back to eating grass.

Royal Canin GI is sprinkled on the chicken for every meal - a level teaspoon x 6 small meals a day, is providing the additional nutrition. (or not?) Rabbit is high in taurine and calcium. I think he needs a drop of omega 3 every day but at this point I'm not giving it to him.

I use duphalac for constipation. Highly recommended by vet and very safe for kitties.

This is the email I got from vet.

Hi Marilyn

The simple answer to this is, he isn’t getting enough insulin.
Keep increasing until you do see values that don’t worry you 6-12.
This is still < 1 unit/kilogram. When he gets above 2.0-2.5 units per kilogram, then we really start to worry.

Thanks for the update

Regards
Richard @ the cat clinic

SS is a work in progress. He's being tested and has been regularly tested for 18 months now. I'm doing up to five tests a days but today I've only done 2 tests. 280 this morning and 158 @ 4pm.

Sienne I'll talk to vet about the possiblities - need to give him the 6 week course of vit B12 and then we go back to see him.

thanks guys,
marilyn
 
Marilyn --

It's not just taurine that's necessary for a cat's diet. If you look at the ingredients in some of the better cat foods, it will give you an idea of what is added to provide a nutritionally complete meal. While protein is essential, a cat in the wild is a predator. The cat may eat a mouse, but the mouse has eaten other food and those element that are necessary for the cat's survival are in the mouse's digestive system and the cat gets nutrition that way. The more you feed just raw meat, the greater the risk to LB's overall health. I would discuss what you're feeding with your vet. Simply stating you're feeding a raw diet implies that you are feeding a nutritionally complete diet and that's not what you're doing.

Again, check Dr. Lisa's site. In the section on obesity, she provides a formula for calculating calories per day. Once you know how many calories per day for maintaining a good weight for LB you need, divide that amount of food up into portions and feed that amount at the times you noted over the course of the day.
 
This is the slide in the powerpoint i was referring to:

Uncontrolled Feline Diabetes (Insulin Resistance)
most cats controlled with less than 1.0U/kg intermediate or long acting insulin per dose
Insulin Resistance - greater than 1.5U/kg per dose to control blood glucose levels under 300mg/dl
Or failure to get blood glucose levels below 300mg/dl.
Typical dose of Glargine is usually 1.0U per dose.
Click to expand...

punkin weighs 6.3kg (13.8lbs) and was getting a dose of 15.5u lantus twice a day at the point we were at Colorado State University in September. punkin eats 3+ cans of fancy feast/day plus another 1/2 cup of plain chicken and he has lost a little bit of weight on that amount.

the next slide in the powerpoint says this in giant letters:

Punkin was on 1.3units/kg per dose!
Click to expand...

the vet tech updates it later by saying that punkin was on a dose of 2.5u/kg.

there's nothing "wrong" with LB having a high dose need. But what would be helpful is to know if it's because he's insulin resistant or because he has acro. The tactics overlap but are somewhat different. insulin resistance will eventually resolve. acro will not improve without treatment, although the tumor can increase/decrease its output.

does LB have any of the signs of acro? it doesn't mean he doesn't have it if not, but most do have signs. Big feet, big tongue, constipated from having an enlarged colon, a forehead that is pushed foreward (more vertical than slanted), a potbelly, a sound when they breathe called "stridor" which is from excessive tissue in the airways rattling . . . i know he's got the constipation problem. what about the other signs, does he have any of those. non-stop hunger is another sign. the acro tumor is causing them to continue to grow and like a teenage boy, they are a bottomless pit of hunger.

Sandy is the expert on insulin resistance and tactics to tackle it.

From the next slide in the powerpoint - does LB have any of these issues, or had any of them ruled out?

Disorders that interfere with insulin action:
Severe Obesity
Chronic pancreatitis
Renal insufficiency
Hyperthyroidism
Oral infections
Acromegaly
Hyperadrenocorticism
Click to expand...

i would agree with your vet - i don't think there's anything wrong with giving more insulin. you do want to make sure none of these other conditions is causing the underlying problem of him not responding to the insulin.

also, most people give all the food in the first few hours after the shot. that means that the insulin is at its most potent when the carbs are in the cat's system. you could try giving all of his food in the first 4ish hours after the shot and see if it improves his numbers.
 
Anyname said:
celi, I've read but a small number of your posts in support of people who post - I love the way you send good thoughts to everyone. Thank you for stopping by.
Click to expand...

binks and I are just friendly goofballs... :-D
but we've been following LB's story...
and sending most positive thoughts for a good outcome.

celi
 
270 AMPS, 240 @ +7 I guess I have to be looking for something else going on. Will make appointment to see vet tomorrow. I'll read up all the things you've passed on Julie and discuss supplements/dental/etc with vet. Studying this posts recommendations and making notes to raise these issues with vet. I'm sure he'll be thrilled at another mention of FDMB. :?
 
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