New member - Headed for low numbers - 71 at +3 - 131 at +7 :)

[SophieFRA]

*** 03-15 7:17am - update, Raven is doing well this morning apart from continued GI distress. He seems to be in better spirits. He’s back at his regular preshot numbers range of 286. I the end the lowest he dropped was 71 and his numbers went up following high carb food. So in hindsight it was a pretty good streak. But I still reduced the dose by 0.25 this morning per Chris Ronkoski’s advice and will stick with this lower dose for a few days. I’ll be gone during the day Thursday/Friday and some of Saturday - so this approach seems safer. Also looking forward to getting some sleep tonight after a night of poor, interrupted sleep. Thank you so much for all the advice ***

Ravens numbers keep dropping -- at 71 at 3.5+ Just fed him high carb food****
Help! I think I just f***ed up. Raven’s preshot number was 145 on a human meter and I still gave his regular 2u shot of Lantus. I just remeasured after an hour and he’s at 157 - but I realize the Lantus has not kicked in yet. I just gave him some extra Dr Elsey which seemed to spike his numbers yesterday and will keep an eye on him. Should I give him something higher carb? He’s been on 2us for 4 consequutive doses (this being his 5th). So far his preshot values on this dose have been in the high 200s but this afternoon he’s been in the blues. This is by far the lowest preshot number he’s had. I don’t know what I was thinking…

#Admin

I just set up my account per advice on the Facebook group earlier. I haven't figured out how to add details to my profile yet. But wanted to quickly post. My foster cat Raven (6 years) was diagnosed with diabetes in mid-February and has been on Lantus since. I recently upped his dose to 2u (this pm shot was the 5th dose at this number). He was at 145 (an unusually low number for him - he's never been lower than high 200s at preshot). before his pm dose at 6:45pm EDT and I decided to shoot anyway (still new to this). Since he's beendropping. We're coming up to +4 and he's gone from 157 (+1), 173(+2) to 92 (+3) and 71 (+3:20). I just fed him a 3 oz can high carb wet food (16%) which he lapped up. I have syringes with maple syrup at the ready. 71 is the lowest number I have ever measured for him and I am getting really nervous. He just had a bout of diarrhea outside of the litter box (he's had GI issues -- but usually makes it to box) but seems fine otherwise. Will try to figure out how to upload his spreadheet here. @Margaret (and Pearl) has been advising me on Facebook.

 

[SophieFRA]

https://docs.google.com/spreadsheets/d/1pw2gozDXz_UhGSs897ptj3iAeUPqD-dGnxrcCwXgfWg/edit?usp=sharing

 

[SophieFRA]

20 minutes after high carb food he's back at 122.

 

[Chris & China (GA)]

Will try to figure out how to upload his spreadheet here.

If you click on your sign on name (top right of the page), there's a drop down menu. Choose "Signature" and a new box will pop up. In that box, we enter all the basic information so people don't have to ask the same questions over and over again. (you'll see an example under my comment). We usually ask for:

Your name/Cats name, age, sex, date of diagnosis, type of insulin, type of meter, type of food, any other health problems or meds?, Dosing method (TR or SLGS) and then at the end, put the link to your spreadsheet and then "Save".

These are the two dosing methods we use with Lantus. Tight Regulation and Start Low, Go Slow. The advice we give will somewhat depend on which dosing method you choose (and you're not "locked in"...if you start one and decide it's not for you, you can change).

You should probably go ahead and reduce the dose by 0.25 which would mean giving 1.75U tomorrow and you'd continue to give 1.75 for 7 days unless he dropped below 90 again. On the 7th day, you'd need to do a complete curve (testing every 2 hours from AMPS to PMPS) or every 3 hours for 18 hours. After seeing the results, we may suggest you increase the dose or hold it at the same level for awhile longer.

You do test enough to do Tight Regulation but until you decide if you want to be more aggressive, the advice I just gave you is for SLGS.

 

[Margaret and Pearl (GA)]

Glad you made it here @SophieFRA this is the best place to be for guidance, and I highly recommend posting here daily and getting dosing advice here on FDMB.

I’ll tag some dosing experts here so they can help get you settled in and welcome to FDMB! I highly recommend being here for dosing guidance. The FB group’s purpose is to drive traffic here to the FDMB where all the learning and magic happens! We keep trying to get everyone here, so very very glad you made it! The FDMB changed my life and my cats life. I learned so much!!

@Bandit's Mom @Diane Tyler's Mom @tiffmaxee

 

[SophieFRA]

Thank you so much for responding here too, Chris! Ok, I will reduce the dose for his am shot per your advice and will follow these guidelines. Still deciding on protocol. Had switched to tight from SSGS but may slow it down a bit. I just measured again close to +5 and he's now a 153 -- so high carb food is doing its magic...

 

[SophieFRA]

Glad you made it here @SophieFRA this is the best place to be for guidance, and I highly recommend posting here daily and getting dosing advice here on FDMB.

I’ll tag some dosing experts here so they can help get you settled in and welcome to FDMB! I highly recommend being here for dosing guidance. The FB group is meant to drive traffic here to the FDMB where all the learning and magic happens!

@Bandit's Mom @Diane Tyler's Mom @tiffmaxee

Thank you so much, Margaret. Will do. This is so helpful. Can't thank you and Chris enough for weighing in on Facebook. Looking forward to engaging and learning more here. Have a good night. Will get a few hours of sleep and set an alarm to retest. Hope I didn't keep you up (but really appreciate your willingness to give advice so late in the day!)

 

[Chris & China (GA)]

Good job on the Signature @SophieFRA!

I just measured again close to +5 and he's now a 153 -- so high carb food is doing its magic.

Next time, try just giving a teaspoon or two, not the whole can. We want to nudge them up or slow down how fast they're dropping without sending their BG to the moon, or "filling them up" when we might need them to eat later.

Generally, save the high carb for when he drops below 50. Try giving a teaspoon or two of his regular food to see if that's enough to slow him down from dropping too much. If the low carb food isn't enough, we can always go to something higher in carbs. It's all about learning how your cat responds to different levels of carbs.

What I'd do when China dropped below 50 was open a can of Fancy Feast Gravy Lovers (beef is 20% carb), put the lid back down on the can and then squeeze the gravy part into another bowl. (you get quite a bit of gravy out of 1 can!). Then you can give him a couple of teaspoons of just the gravy (which is where most of the carbs are anyway) and then test again in 20-30 minutes to see if he's starting to come up. By using just a little of the gravy, IF he does drop back down again, he'd still be hungry enough to eat more.

ETA: Another member that's good to tag if it's late at night and you need help is @Bron and Sheba (GA) She lives in Australia so our late nights are her early evening.

 

[Bandit's Mom]

Welcome to FDMB, @SophieFRA and Raven!

Now that you have your SS and Signature set up, you can start posting on the Lantus forum. There are a lot of experienced Lantus users who can help you.
Lantus / Levemir / Biosimilars

Considering how much you test, you could continue with TR. You need at least 4 tests a day - 2 preshots and 2 mid cycles - which you are getting. TR will enable you to keep him at a dose where he can see normal numbers for longer. Whichever dosing method you choose, please add that to your SS and Signature. Thanks.

 

[SophieFRA]

I just set up my account per advice on the Facebook group earlier. I haven't figured out how to add details to my profile yet. But wanted to quickly post. My foster cat Raven (6 years) was diagnosed with diabetes in mid-February and has been on Lantus since. I recently upped his dose to 2u (this pm shot was the 5th dose at this number). He was at 145 (an unusually low number for him - he's never been lower than high 200s at preshot). before his pm dose at 6:45pm EDT and I decided to shoot anyway (still new to this). Since he's beendropping. We're coming up to +4 and he's gone from 157 (+1), 173(+2) to 92 (+3) and 71 (+3:20). I just fed him a 3 oz can high carb wet food (16%) which he lapped up. I have syringes with maple syrup at the ready. 71 is the lowest number I have ever measured for him and I am getting really nervous. He just had a bout of diarrhea outside of the litter box (he's had GI issues -- but usually makes it to box) but seems fine otherwise. Will try to figure out how to upload his spreadheet here. @Margaret (and Pearl) has been advising me on Facebook.

131 at +7. Looking stable so far post high carb food. More diarrhea (in box) but got him to eat some FF with fortiflora and psyllium husk powder. earlier today he had such “nice” firm stool. Hopefully we’ll get back to some shape soon. Will recheck BG in a few hours.

 

[SophieFRA]

209 at +10. More diarrhea and some puke (I think - similar consistency and color as diarrhea but with a clear trail). Poor Raven is having a rough night…any thoughts on giving him some antidiarrhea drugs with his breakfast?
For reference he’s seen a vet about 10 days ago after puking through the night. Blood panel was normal (no pancreatitis either) and xray showed enlarged colon but no obstruction (likely prior occurrence of megacolon). Vet recommendec adding psyllium husk powder to food twice a day and fortiflora. I’ve been doing that but he’s been picky about his food and doesn’t always eat the mixture.

 

[Margaret and Pearl (GA)]

It is definitely good news he had a firm stool earlier yesterday. It is a good idea to track how often he gets a firm stool. May be that the psyllium husk is helping, but not enough (and sometimes too much of it also leads to diarrhea). How much of it is he getting?

I honestly would consider the ultrasound at this point. If all problems point to his gut (and at this point they do with no evidence of anything else on bloodwork) and the problems are not resolving, it is a good idea to get the full picture of what is going on in his gut. He is about the age IBD really starts showing up, and with the suspected diagnosis of megacolon in the mix, I would want an ultrasound.

 

[Diane Tyler's Mom GA]

. I just gave him some extra Dr Elsey which seemed to spike his numbers yesterday

Hi Sophie is the Dr Elsey's the dry food, if so you can only follow the SLGS Method
Can you please enter the number of units you gave this morning , and can you please add to your signature the food you are feeding such as lc(low carb)
or lc and dry
Thanks Sophie
I'm sorry Sophie but I'm not an expert when it comes to dosing

 

[SophieFRA]

It is definitely good news he had a firm stool earlier yesterday. It is a good idea to track how often he gets a firm stool. May be that the psyllium husk is helping, but not enough (and sometimes too much of it also leads to diarrhea). How much of it is he getting?

I honestly would consider the ultrasound at this point. If all problems point to his gut (and at this point they do with no evidence of anything else on bloodwork) and the problems are not resolving, it is a good idea to get the full picture of what is going on in his gut. He is about the age IBD really starts showing up, and with the suspected diagnosis of megacolon in the mix, I would want an ultrasound.

Thanks so much, @Margaret (and Pearl) . I'll bring this up to the foster org and will try to set up an ultrasound. He was "prescribed" 1/4 of a teaspoon of physillium in the morning and evening and fortiflora. I feed him much more often than that (every 3-4 hours -- so I don't mix it in all the time). He's unfortunately become a bit picky about his food and he only eats it sometimes - or a bit of it. So a lot of Psysillium does not make it into his system. If I see he doesn't eat it, I will try to sprinkle a bit throughout the day -- but it may actually deter him from eating it (even though it's a tiny amount and I mix it in with a bit of broth to ensure it's not dry dust).

I have been keeping track of his stools. They've been mostly formed (not superfirm but not diarrhea) between March 5 and March 13 (with 2 softer bowel movements) -- although very light beige -- likely due to his almost exclusive shredded chicken diet. Yesterday morning they were actually darker and harder than usual (like normal cat poo -- not consitpation -- but then it went downhill from there and since then it's been medium brown puddles inside and outside the box.) I assume the shift in color is due to me now feeding more darker pates vs the lighter shredded chicken earlier. He has been having 3-6 bowel movements a day often very voluminous - even when he is more "regular." A lot of wet food will do that I suppose. He's a fairly big boy and eats a lot if he isn't on hunger strike.

To @Diane Tyler's Mom's question on food. Yes, the Dr. Elsey is dry food (high protein chicken). I only feed it when he won't eat anything else or not enough of it. I started out feeding him Tiki Cat Chicken Luau (0 carbs) for every meal and he loved it and devoured it -- but since his GI episode on March 3 (after which I took him to the vet) he's been picky and I've been alternating FF pates (chicken, Turkey, beef), The Tiki Luau chicken, and I and Love and You Salmon (which is a food I feed my cats sometimes and seemed to be the only thing he wanted for a bit - other than the Dr Elsey High Protein Chicken dry food). This food has 1% carbs -- so it should be fine -- but of course Salmon could pose an issue. His original GI episode also came after he refused his Tiki Chicken and I gave him Tiki Salmon instead. But there have been other times when he seemed to handle salmon fine. I usually don't worry so much about him not eating his meals throughout the day -- though I try to stick with what his current preference is. But if he doesn't eat before his shot, I give him whatever he will eat -- including Dr. Elsey High Protein chicken dry food and Fancy Feast purely natural chicken treats.

 

[SophieFRA]

Hi Sophie is the Dr Elsey's the dry food, if so you can only follow the SLGS Method
Can you please enter the number of units you gave this morning , and can you please add to your signature the food you are feeding such as lc(low carb)
or lc and dry
Thanks Sophie
I'm sorry Sophie but I'm not an expert when it comes to dosing

It is -- I responded in more detail in my post below in response to Margaret. It's Dr Elsey clean protein chicken dry food. I believe it has between 4 and 6% carbs -- so very low for dry food and I just give him a little bit at a time. Sometimes it's the only thing he'll eat (especially if he's not feeling well). I didn't realize that this would not work with the TR. I don't think I have the option of dropping it fully since it's sometimes the only thing he will eat a sufficient amount of (especially right before a shot) if his stomach isn't feeling well.

 

[Margaret and Pearl (GA)]

@SophieFRA Thanks for the description of what is going on. Pancreatitis attack is always a concern with diabetics who suddenly start to have diarrhea and don't want to eat suddenly. Can't remember if they tested fpl when you got the most recent bloodwork? If so, what was the value on it?

I think the novel protein diet is going to be Raven's friend. I mean that it's definitely the top of the list in terms of next things to trial. Might take awhile to figure out which protein will work for him. If you want to go to Crunchies to find some different foods to try let me know, I can meet you there.

Jarrow S Boullardii + MOS is great for diarrhea caused by IBD. It works for sure. There is a stop diarrhea protocol for IBD felines using it. I can help you figure that out if you want. The ultrasound purpose is to confirm the IBD diagnosis, check on what is the state of megacolon (and it is for sure there), and see if there is anything else inflammatory or obstruction that could be causing Raven's issues.

I'm not sure of how good it is to poop 6 times a day. I suspect as you get the gut issues under control, that will level out to be fewer. But I would absolutely be tracking his hydration. Want to rub fingers along gums daily. Should be slick like an ice rink, not "tacky". Tacky indicates dehydration inside (no matter how much water he is drinking).

Also about the physllium - 1/4 tsp twice daily is a lot to start with. Could cause gut issues. The fact that he only gets a fraction of that may rule that out as a cause for the gut issues, but the idea is to work up to that amount over time little by little. You should notice some improvement in the stools, and as you keep working up little by little, if too much the stools will start to regress.

PS - make sure you create a new post in the Lantus forum for today and reply there. And you want to copy the URL for this post and put it in your new post. That's how we keep all your posts together over time.

Does this help Sophie?

 

[SophieFRA]

@SophieFRA Thanks for the description of what is going on. Pancreatitis attack is always a concern with diabetics who suddenly start to have diarrhea and don't want to eat suddenly. Can't remember if they tested fpl when you got the most recent bloodwork? If so, what was the value on it?

I think the novel protein diet is going to be Raven's friend. I mean that it's definitely the top of the list in terms of next things to trial. Might take awhile to figure out which protein will work for him. If you want to go to Crunchies to find some different foods to try let me know, I can meet you there.

Jarrow S Boullardii + MOS is great for diarrhea caused by IBD. It works for sure. There is a stop diarrhea protocol for IBD felines using it. I can help you figure that out if you want. The ultrasound purpose is to confirm the IBD diagnosis, check on what is the state of megacolon (and it is for sure there), and see if there is anything else inflammatory or obstruction that could be causing Raven's issues.

I'm not sure of how good it is to poop 6 times a day. I suspect as you get the gut issues under control, that will level out to be fewer. But I would absolutely be tracking his hydration. Want to rub fingers along gums daily. Should be slick like an ice rink, not "tacky". Tacky indicates dehydration inside (no matter how much water he is drinking).

Also about the physllium - 1/4 tsp twice daily is a lot to start with. Could cause gut issues. The fact that he only gets a fraction of that may rule that out as a cause for the gut issues, but the idea is to work up to that amount over time little by little. You should notice some improvement in the stools, and as you keep working up little by little, if too much the stools will start to regress.

PS - make sure you create a new post in the Lantus forum for today and reply there. And you want to copy the URL for this post and put it in your new post. That's how we keep all your posts together over time.

Does this help Sophie?

Thank you so much! I would love more info on the stop diarrhea protocol. I will go ahead and order the probiotic/prebiotic you mentioned. Is this it? https://www.amazon.com/Jarrow-Formulas-Sacharomyces-Boulardii-Intestinal/dp/B0013OVW0E? Ok will try to test hydration levels. And will create new post. Thanks so much for the guidance. I'd be happy to check out the store in Gambrills. Maybe this Sunday? If you're free would love to meet up but no pressure. I can also start by ordering some novel protein options. He didn't seem to be having trouble with the chicken -- well other than refusing to eat it sometimes after a while. But he did not have diarrhea when he was eating it initially. So I don't know if that's it. But always worth a try. Noted on fish being a bad option.

 

[Margaret and Pearl (GA)]

Yes @SophieFRA that’s the correct probiotic!

 

[Margaret and Pearl (GA)]

Good to know he can tolerate chicken. Maybe needs some variety. I know you have a lot of cats so no idea how possible it would be to make him some boiled chicken but that may also be an option for him. Can add cat nutrients to any meat you home cook.

Crunchies closed on Sundays.

 

[Diane Tyler's Mom GA]

It is -- I responded in more detail in my post below in response to Margaret. It's Dr Elsey clean protein chicken dry food. I believe it has between 4 and 6% carbs -- so very low for dry food and I just give him a little bit at a time. Sometimes it's the only thing he'll eat (especially if he's not feeling well). I didn't realize that this would not work with the TR. I don't think I have the option of dropping it fully since it's sometimes the only thing he will eat a sufficient amount of (especially right before a shot) if his stomach isn't feeling well.

Hi Sophie can you add SLGS to your signature and spreadsheet up top so members are aware of it
I hope you can get things sorted out with Raven
I love your pic of Raven , he sure is a cutie !
@SophieFRA