? Need advice/feeling lost

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maddyjoann

maddyjoann

Member Since 2021
My boy Cooper was diagnosed end of June 2021, so it's only been about 4 months. He's still not regulated and is constantly in a very high range, and deals with pretty bad neuropathy in his hind legs. He currently sees 2 regular vets at the same facility, and one internal medicine specialist, who keeps in contact with his other vets before making any changes to his regimen. So 3 vets total are working with us on his care.

He's on 2.5u of Lantus right now, and we've been all kinds of up and down with his units since diagnosis. He's been on Lantus since diagnosis and always been using the SLGS approach. I wasn't using a spreadsheet then so I don't have that recorded, only current numbers. As far as we know, he does not have any kind of other conditions or internal problems that could be causing this rollercoaster of BG. He was treated with I-131 for hyperthyroidism just over a year ago. One vet keeps insisting an ultrasound/sonogram to see if there's something we've missed. I would love if someone could look at his chart here and give me insight/ideas?

We've tried B12 shots with the vet (weekly for 6 weeks and now once a month), but they keep saying there's not enough research on it and they're not confident it will work. I know it isn't the methyl B12 and that could make all the difference, but none of his vets know enough about it or say the research isn't substantial enough to go off of. He eats Friskies pate, but prefers dry food. He was eating Dr. Elsey's Clean Protein, but suddenly stopped and won't go back to it. My mom put down Hills GlucoSupport on a day he was low, and now he won't stop eating it. We know it is way too high in carbs and I am looking for another replacement.

He tolerated the Freestyle Libre for a while, but the last month has gotten worse. Today, he finally ripped it off himself after just under a week of having it on. Putting little shirts on him doesn't seem to work because he refuses to try to walk on his own while wearing one, and just flops over when we try to sit him up, like cats do. Home testing is hard because the lancing device with the Alpha Trak 2 is terrible and almost impossible to use, so we just have to prick him ourselves with the individual lancets. He has not tolerated home testing any more now than when we started and he gets very stressed/aggravated at test time. He's started wincing and meowing as we prick his ear.

His daily life is just eating, drinking a lot, and sleeping almost all day in the living room, under a bed, or in my brothers room. He struggles to walk with his neuropathy because our house is all wood/tile flooring and the main floor he stays on is quite big. This last week, his bathroom habits have changed to where he no longer covers things in the litter box, and today we found a small poop on his regular blanket. My mom has to do all of his stuff with me because I have a 9-5 job but she is able to be home most days to watch/take care of him, but this is why we have the Freestyle Libre for him at all. We just worry his quality of life isn't great and will decline, and we worry about how much we're putting him through to try to help him, yet he doesn't seem to be making great progress at all. I don't know how much more there is to do/try for him to just get him regulated, because I know we at least need to do that before trying to work on anything else.

I know this is a lot and I'm so sorry, I'm just feeling horribly overwhelmed and I don't know what else to do from here. I'm not even close to giving up on him, but I just worry about what I'm putting him through.
 
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Yes, at first treatment can be formidable.
Before 10/25 (first entry on your SS) what was dose?
I ask since the BGs on 2 units on 10/25 is very good. and would not warrant upping to present dose of 2 ½. One symptom of going beyond the opitman dose is theBG actually go up like you show but sometimes you can get lower BG like you showed on 11/05.

What dose Lantus was Cooper started on and what was highest dose reached? Was it decreased?
 
Can you add SLGS to your signature also

For the neuropathy
14.49 for 100 capsules , give 1 a day
https://www.vitacost.com/vitacost-vitamin-b-12-methylcobalamin-5000-mcg-100-capsules-6
Once you get him better regulated the Methyl B-12 will help
You can start it now
I saw a big improvement in about 2 months
Tyler is back to jumping on things and back to normal
A lot of vets have never heard of it, our cats have been on it for years
Just open up the capsule and sprinkle it on his wet food ,add some water also, it's tasteless

Previous threads
https://felinediabetes.com/FDMB/threads/numbers-difference-of-freestyle-libre.254171/


https://felinediabetes.com/FDMB/thr...-result-of-thyroid-issue.252905/#post-2853968
 
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maddyjoann said:
He eats Friskies pate, but prefers dry food. He was eating Dr. Elsey's Clean Protein, but suddenly stopped and won't go back to it. My mom put down Hills GlucoSupport on a day he was low, and now he won't stop eating it. We know it is way too high in carbs and I am looking for another replacement.
Click to expand...


Wysong Epigen 90 is the other low-carb dry food and

YoungAgain Zero Mature
 
Larry and Kitties said:
Yes, at first treatment can be formidable.
Before 10/25 (first entry on your SS) what was dose?
I ask since the BGs on 2 units on 10/25 is very good. and would not warrant upping to present dose of 2 ½. One symptom of going beyond the opitman dose is theBG actually go up like you show but sometimes you can get lower BG like you showed on 11/05.

What dose Lantus was Cooper started on and what was highest dose reached? Was it decreased?
Click to expand...
Yeah that's why I regret not having utilized the chart sooner. When he was very first diagnosed, he started at .5u. His highest was 5.5u before being brought back down. That was also all before bringing a specialist into the mix of his care. I was thinking the 2u was looking good, but he also had several says that would just read as HIGH allll day long, and that doesn't make sense to me. And I wouldn't be surprised if they tell us to come back down after the next glucose curve. They have us doing one every 2 weeks, and also wanted to schedule one at their facility, which I'm nervous about.
 
Diane Tyler's Mom said:
Can you add SLGS to your signature also

For the neuropathy
14.49 for 100 capsules , give 1 a day
https://www.vitacost.com/vitacost-vitamin-b-12-methylcobalamin-5000-mcg-100-capsules-6
Once you get him better regulated the Methyl B-12 will help
You can start it now
I saw a big improvement in about 2 months
Tyler is back to jumping on things and back to normal
A lot of vets have never heard of it, our cats have been on it for years
Just open up the capsule and sprinkle it on his wet food ,add some water also, it's tasteless

Previous threads
https://felinediabetes.com/FDMB/threads/numbers-difference-of-freestyle-libre.254171/


https://felinediabetes.com/FDMB/thr...-result-of-thyroid-issue.252905/#post-2853968
Click to expand...
Okay I added it.

I've seen these but I'm worried he would know something was added to his wet food and not eat it. It was a huge struggle anyway to switch him to wet food and he's soooo picky and peculiar. He's able to pick out old dry food and new and eat around what he doesn't like...so I'm worried.
 
maddyjoann said:
Okay I added it.

I've seen these but I'm worried he would know something was added to his wet food and not eat it. It was a huge struggle anyway to switch him to wet food and he's soooo picky and peculiar. He's able to pick out old dry food and new and eat around what he doesn't like...so I'm worried.
Click to expand...
They are smart aren't they, well you can still buy it and give it a try :cat:
 
Welcome to FDMB!

First, you can get a different lancing device. You don't have to use the one that came with the AlphaTrack. I'd suggest getting a back-up meter. Aside from the prohibitive cost of the strips for the AT meter, the other downside is that the only place you can get them is online. And, just like anyone would suspect, you'll be running low on strips just at the point that you need extra the most. Many people here use the Walmart Relion meter. If you get a back-up meter, it will come with a lancing device -- or you can likely order a different one online. Many people order supplies from ADW.

What gauge lancet are you using. If you've been successful at getting blood, it may be time to use a thinner gauge lancet (e.g., a 30 gauge). Also, are you giving Cooper a treat when you test?

Some of the high numbers are due to what we refer to as "bounces." When Cooper drops into lower numbers, his liver and pancreas go into panic mode. He's not used to spending time in those blue and green numbers. As a result, his liver and pancreas release a stored form of glucose along with counterregulatory hormones that cause blood glucose (BG) to spike upward. It can take roughly 3 days for a bounce to clear.

On average, how long have you been holding the dose?
 
Sienne and Gabby (GA) said:
Welcome to FDMB!

First, you can get a different lancing device. You don't have to use the one that came with the AlphaTrack. I'd suggest getting a back-up meter. Aside from the prohibitive cost of the strips for the AT meter, the other downside is that the only place you can get them is online. And, just like anyone would suspect, you'll be running low on strips just at the point that you need extra the most. Many people here use the Walmart Relion meter. If you get a back-up meter, it will come with a lancing device -- or you can likely order a different one online. Many people order supplies from ADW.

What gauge lancet are you using. If you've been successful at getting blood, it may be time to use a thinner gauge lancet (e.g., a 30 gauge). Also, are you giving Cooper a treat when you test?

Some of the high numbers are due to what we refer to as "bounces." When Cooper drops into lower numbers, his liver and pancreas go into panic mode. He's not used to spending time in those blue and green numbers. As a result, his liver and pancreas release a stored form of glucose along with counterregulatory hormones that cause blood glucose (BG) to spike upward. It can take roughly 3 days for a bounce to clear.

On average, how long have you been holding the dose?
Click to expand...
I've been looking into another lancing device because despite what my mom thinks, I think just using the lancet alone is harder. We use a .28 gauge and we can usually get blood pretty easily with it, but it also depends on the fear/apprehension on us to prick him.

I didn't know about the bounces so that is news to me. That's helpful to know. So based on what little I have on his chart and that in mind, do you think the 2 units was best for him?

Now, we hold a dose at LEAST 2 weeks. In the beginning, our first vet had been changing him every 3-5 days before I found out that was way too soon. I haven't been thrilled with this vet, which is why I brought in the specialist for extra eyes/care.
 
I did a search for you and this is what a member has said , plus Im have read other members have used this one also because it has a clear top

I have not used this one before so I cannot personally speak to how well it works, but it has a clear tip which may be more what you’re looking for

https://smile.amazon.com/dp/B07582777F/?tag=felinediabetesfdmb-20

If you ever want to try and find something about a certain topic go to the top where it says search and type something in such as lancing device and you will see a lot of posts you just have to look through them all , the word lancing device would show up in bold letters
Or anything else you might search for
 
maddyjoann said:
We've tried B12 shots with the vet (weekly for 6 weeks and now once a month), but they keep saying there's not enough research on it and they're not confident it will work. I know it isn't the methyl B12 and that could make all the difference, but none of his vets know enough about it or say the research isn't substantial enough to go off of.
Click to expand...
There are multiple forms of B-12. It sounds like the vet is using injectable cyanocobalamin B-12 (which is more geared for GI issues) rather than methylcobalamin (methyl B-12), which is what helps with neuropathy.

How is Cooper with taking pills? I used Zobaline, which is a brand of methyl-B12 for diabetic cats. It’s non-prescription and available online. The VitaCost option that Diane linked above is a cheaper version that many people use. Either would be worth a try. I understand about being finicky with food — if Cooper doesn’t tolerate things being put in his food and/or isn’t amenable to eating pills hidden in pill pockets, then you might need to shove the pills down his throat. I have do so that with most of my crew and a “pill popper” can make the process much easier.

I used carpet runners on my floors when Chip and later Tubby had mobility issues. They learned quite quickly that the runners gave them traction and used them as the path to the litter box, beds, and food. It might not have been pretty, but it was only temporary and helped relieve stress (on both our parts).
 
One of the issues with holding a dose when a kitty is in high numbers can promote glucose toxicity. This sounds a lot worse than it is. Basically, it means that a cat's body gets used to higher numbers and treats those numbers as the new "normal." It's why with the dosing methods we use here, doses are not held for more than a week if your kitty isn't in better numbers.

I suspect that Cooper needs more insulin. Even with dropping into the blue zone, he's still at the higher end of the range. This is the post on Lantus dosing methods. You may want to take a look so you have a feel for how we approach dosing.
 
Diane Tyler's Mom said:
I did a search for you and this is what a member has said , plus Im have read other members have used this one also because it has a clear top

I have not used this one before so I cannot personally speak to how well it works, but it has a clear tip which may be more what you’re looking for

https://smile.amazon.com/dp/B07582777F/?tag=felinediabetesfdmb-20

If you ever want to try and find something about a certain topic go to the top where it says search and type something in such as lancing device and you will see a lot of posts you just have to look through them all , the word lancing device would show up in bold letters
Or anything else you might search for
Click to expand...
You've been so helpful, thank you so much
 
JL and Chip said:
There are multiple forms of B-12. It sounds like the vet is using injectable cyanocobalamin B-12 (which is more geared for GI issues) rather than methylcobalamin (methyl B-12), which is what helps with neuropathy.

How is Cooper with taking pills? I used Zobaline, which is a brand of methyl-B12 for diabetic cats. It’s non-prescription and available online. The VitaCost option that Diane linked above is a cheaper version that many people use. Either would be worth a try. I understand about being finicky with food — if Cooper doesn’t tolerate things being put in his food and/or isn’t amenable to eating pills hidden in pill pockets, then you might need to shove the pills down his throat. I have do so that with most of my crew and a “pill popper” can make the process much easier.

I used carpet runners on my floors when Chip and later Tubby had mobility issues. They learned quite quickly that the runners gave them traction and used them as the path to the litter box, beds, and food. It might not have been pretty, but it was only temporary and helped relieve stress (on both our parts).
Click to expand...
He's terrible with getting meds/pills of any kind. We had to give him UTI medication with a syringe and he was able to spit it out at us more than once. Pill pockets don't work, so the only thing we haven't tried is breaking it apart over his food, but as I said, I'm worried he would notice and not eat it. I know it couldn't hurt to try it.

We have rugs down and we got little mats for his food and water areas so he can rest on them without slipping around. We carry him for bigger distances when we see him struggling.
 
Sienne and Gabby (GA) said:
One of the issues with holding a dose when a kitty is in high numbers can promote glucose toxicity. This sounds a lot worse than it is. Basically, it means that a cat's body gets used to higher numbers and treats those numbers as the new "normal." It's why with the dosing methods we use here, doses are not held for more than a week if your kitty isn't in better numbers.

I suspect that Cooper needs more insulin. Even with dropping into the blue zone, he's still at the higher end of the range. This is the post on Lantus dosing methods. You may want to take a look so you have a feel for how we approach dosing.
Click to expand...
I've tried to read this before and I was so confused, there's so much terminology that I don't understand. I'll have to try again.

I was told by several members of this board and the Facebook group before that Lantus is a depot insulin that shouldn't be changed too quickly so it has time to settle (or whatever you would say it's doing)??
 
Here’s a video that shows how much difference methyl-B12 supplementation can make. If you haven’t tried a pill popper to give pills, you might give it a try.

 
Maddy -

If the information in the sticky doesn't make sense, please let us know what's got you confused. We can help to translate!

Lantus (glargine) and Levemir are both depot types of insulin. Essentially what this means is that when you give an injection of Lantus, it forms microcrystals. These crystals are deposited in the fat cells and slowly dissolve. This is what gives Lantus it's long duration. Not all of the crystal dissolve over the course of a cycle which is why there is overlap between the cycles. It also means that if you change doses too quickly, the depot doesn't have a chance to catch up to the change and you end up with wonky numbers.

There is, however, a balancing act. You have to let the dose have enough time to allow the depot to stabilize after a change in dose. However, if you hold the dose for overly long, it may be harder to get the numbers to come down.
 
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