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Bron and Sheba (GA)

Bron and Sheba (GA)

Member Since 2015
My name is Bron and Sheba is my kitty. I have posted in the Introduction and Main Health Forums during the last couple of weeks.
Sheba is a 12 year old Australian Spotted Mist. She was first diagnosed in 2011 and after 3 months went OTJ until November 2013, when she fell out of remission following a bout of chronic diarrhoea and a week or two of dry low allergy food. She started on Lantus 1 unit. She changed to Levemir in Sept 2014. I have been unable to get her regulated. Pain from her arthritis definitely affects her BSLs. That is being addressed at the moment and she is not only more comfortable and moving a lot more, her BSLs are improving. She bounces from fast drops in blood sugar and I have been trying to slow the drops with food. Wendy and Neko and BJM have been giving me suggestions in the main forum which are helping.
Sheba frequently has high AMPS. I really want to get her regulated and ultimately OTJ if possible. I know it is harder the second time. Any help or suggestions would be very welcome. I have recorded Jan 2015 to now in the SS with the exception of a couple of weeks mid Jan as they were more of the same.
These are the last two days
5 March AMPS. 25.2. 6.25 u levemir
+3. 20.9
+6. 15.5
+8.5. 12.1
+10. 12.8
PMPS 11.0. 6.25 u levemir
+2. 17.6
+4. 13.7
+7. 10.3

6 March. AMPS. 13.8. 6.25 u levemir
+3. 19.8
+5. 12.2
+9. 7.0
PMPS. 15.1. 6.25 u levemir
+ 3. 13.1
+4. 7.9 Med carb 1 teas to slow drop
+4.5. 6.3. Med carb. 1 teas to slow drop
+5. 5.9
+6. 3.5 Med carb 1 teas to slow drop
+7. 5.4
+9. 7.8
This was a strong cycle and she would have dropped below 2.8 (50) if I had not controlled the drop
7 March. AMPS. 21.1. 6.25 u levemir

These are the best BSLs for a while.
Thanks, Bron
 
Hi Bron! Welcome to Lantus/Lev Land! I'm sorry Sheba is back out of remission, but hopefully you can get her feeling better and into better blood sugar control now.

Yesterday was a pretty good day for her - looks like this dose is doing very well!

Did BJM and Wendy talk to you about the two options you have for dosing? Here's a little blurb some of us wrote that hopefully helps lay it out for you so you can decide. We ask people to choose what they want to start with so that you're given appropriate advice. Some of it doesn't apply to you since this isn't your first time, but i'll give it to you to look at anyway. When you've decided, would you put either "SLGS" or "TRP" in your signature block so we know how to help you.

Keep posting and we'll do our best to help you help Sheba!

Welcome to Lantus and Lev land – the best place you probably never wanted to be! If you are like most of us, if this is your first few weeks of trying to wrap your head around the fact that your kitty has diabetes, you’ve no doubt been terrified, in tears, in a state of shock, and completely overwhelmed. Don’t worry. It gets easier. It really does.

None of us here are veterinary professionals but many of us have been working with our cat’s diabetes for a long time. Even those of us who have been here for a short time are here to help. This is a wonderfully supportive community.

There are a few first steps. We firmly believe that home testing is the best way to keep your cat safe. We keep a record of our cat’s blood glucose (BG) data on a spreadsheet (SS) which you can create using these instructions: http://www.felinediabetes.com/FDMB/...te-a-ss-and-link-it-in-your-signature.130337/. If you’ve not mastered home testing, we’re happy to offer suggestions or you may want to spend some time on the Health board mastering the basics of testing, low carb diet, and getting your SS set up. We’re happy to help you with those things, but you should be aware that this is a busy board and if there’s an emergency, everyone’s attention goes to helping the caregiver and his/her kitty.

Once you’ve got a handle on the basics, you will have the option of following the Tight Regulation Protocol or the Start Low Go Slow (SLGS) method for managing your cat’s diabetes. You don’t have to stick with whichever approach you initially choose but it is helpful to give your choice a chance so you can evaluate the results fairly.

The Tight Regulation protocol was developed based upon the premise that a cat's pancreas may be able to heal and return to producing insulin if the cat's BG is kept in a normal range (i.e., 50-120}. Caregivers following this protocol adjust insulin doses following the protocol guidelines to aim for that range. Basic information on the TR is here: http://www.felinediabetes.com/FDMB/threads/lantus-levemir-tight-regulation-protocol.1581/. The advantage of this approach is that it is based on research published in a leading veterinary journal and has an admirable track record of getting cats who are within the first year since diagnosis into remission.

The Start Low Go Slow (SLGS) approach has caregivers start with an initial dose based upon the BG at diagnosis and whether kitty has been transitioned to a wet low carb diet, hold that dose for a week or two while testing for ketones regularly, being consistent with food and testing before shooting every 12 hours. Once a week a curve is done (test every 2 hours for one cycle) to check for the lowest point. the low number in that curve determines any dose change for the following week. This approach was the original method used in the FDMB prior to the TR protocol. It is an alternate approach if TR is not the right fit for you or your kitty. Basic information on the SLGS approach is here: http://www.felinediabetes.com/FDMB/threads/lantus-levemir-start-low-go-slow-method-slgs.129446/.

Both approaches require that you test at pre-shot times and do your best to test at least once each 12-hour cycle. Lantus and Lev dosing is based on the lowest number in the cycle (i.e., the nadir) so getting at least one spot check is important to guide your dosing decisions.

If you are switching to lantus or levemir from any other insulin, please post for suggestions on the starting dose before you change insulins. You should also get your vet’s recommendation.

Amy&Trixie, Dyana&(GA)J.D., Julie&(GA) Punkin, Marje&Gracie, Sandy&Black Kitty, Sienne&Gabby, Wendy&Neko​
 
Hi Julie and Punkin (GA),

Thank you for the welcome and the information on the 2 protocols.

Yes, Sheba has had a couple of days with good BSLs. She looks like she might be bouncing today after last nights lower numbers. I tried to slow the drop as she is usually OK with the low numbers now; it is the speed of the drop which seems to be causing the trouble.
I am sure all the experienced eyes on the forum will see things I can't see. I am out of ideas of how to help her.

I would like to follow the TRP please, as I have basically been doing that up until now (probably not as strictly or as well as you do here). I am home most days and can test anytime, although I am gone over the nadir period for up to 2 hours, three days a week, picking up grandchildren from school. It concerns me when I have to leave Sheba with a dropping number, as up until now she has not been a gentle dropper. When she decides to drop she dives! I know I could always give her some high carb if necessary. If I had to I could probably take her with me, except in the summer (now) it is too hot to leave her in the car and I am gone for at least 30 mins once I get to the school, park and walk to the school.
Apart from that I am generally around. I take my hat off to all of you who work and have a diabetic kitty. I am sure my concerns are trivial compared to how you all have to juggle it every day!!

My one worry with the TRP is having to let the BSL drop to 40 to gain a reduction ( if I should ever be so lucky to get one). It scares me letting it drop that far. I am fine to 3 but once it goes lower I am very uncomfortable -more so at night.
 
Opps! Sorry I pressed the wrong button and posted before I was finished.
Thanks for your support and guidance. It means a lot to me. I am fresh out of ideas as to how to help Sheba and was starting to feel really down about it all.
Bron
 
You can tweak your dose adjustment criteria to levels which are more comfortable for you as you gain experience with your diabetic cat. The TR protocol can be nerve wracking when you try to control very tightly.
 
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I think it helps to understand that a non diabetic cat might have blood sugar in the 30's. The TRP calls for you to intervene with carbs if a newly diagnosed cat goes under 50, or a cat that's been diabetic more than one year goes under 40. As long as you are monitoring, you'll be able to intervene and bring his blood sugar up. You can always intervene at 50 instead if you want.

There are a couple of posts that I'll get for you that have good advice on feeding to reduce bouncing. I have to swipe the computer to get it for you....later tonight.
 
Hi Bron - good to "see" you over here.

There are a couple of other ways you can earn reductions on TRP with a longer term diabetic. You can also do 3 times under 50 or a week in all normal numbers. And as BJM suggested, you can try reducing at numbers you feel more comfortable with, but the proviso is that you may need to take the dose back up if the reduction doesn't hold. Over time, a number of us have tweaked things to what works for our kitties. With Neko, if she's seeing lots of green and goes below 50, I'll often shave the dose (.125U reduction).

Until Sheba gets used to spending more time in green, she'll bounce more, and those higher numbers mean steeper drops. Which can in turn lead to bounces. What is Sheba's regular low carb food? Do you know what the carb % is?

Julie's going to look up some posts for you, but in the mean time, we've put together a post that is an index to a lot of useful topics. You may with to bookmark this one called "Where Can I Find". There's at least one post on feeding the curve in there.
 
Thank you Julie and Punkin(GA) and Wendy and Neko for the under 50 information. I am sorry I am such a scaredy cat when it comes to letting Sheba go very low. I am better during the day but it seems to happen more at night when things seem so much worse. Rhrett Marshell told me I had to be brave (that was to shoot under 10) so I guess I will have to toughen up:nailbiting:. I know Sheba's natural numbers are in the 30s as I have seen them there when she was OTJ!

Sheba normally eats homemade chicken and kangaroo so no carbs really although I do add a quarter can of 4 % weruva per meal just to cover any supplements I might have missed. If I need higher carb I use another Weruva which is 16 % and I keep a 22 % can of FF in the cupboard in case needed.

Thank you for the information on feeding the bounce. I haven't read it yet, but will as soon as my visitors (who are expected any minute) leave. I fell asleep this afternoon after the pajama party with Sheba last night and have just woken up! You are really kind to go to all this trouble
Bron:)
 
Hey Bron!!!

Glad to see you and Sheba here and I hope your DH is much better.

Great cycle last night for Sheba. Looks like she likes this dose. We often find that kitties coming back from OTJ exceed the dose they were on the last time they went into remission. We might find that you need to add some carbs to stop the diving or at least feed them at specific times to help.
 
Hi Bron good to see you over here where you will get the best advice for levimer kitties. Thanks again for your food post on health. I have been out this afternoon to collect weruva, wellness, holistic and a couple of the advance products from pet barn. Your post couldn't have been better timed for me as Vyktor has had some digestive issues and gone off all his regular foods. Fingers crossed Vyktor takes to some of these new ones and that Sheba goes into remission again :) you certainly seem to be willing to put in the effort :):):)
 
Hi Marje,
It is great to be here and thank you for all you did getting me this far with all your work on my troublesome SS!!
DH is improving each day thanks. It is good to have him home. Hope your Mom continues to stay well also.

I am learning a lot already. There are so many knowledgeable people here. I have just read a post from the above link 'Where can I Find' about Jetta and bouncing and diving. Sounds just like Sheba and so many great questions were asked by Jetta' s owner. So much fantastic information just in one post!

Yes, on advice, I am now giving some extra carbs if Sheba drops fast to try and control the drop. She tends to do this about +3 or +4 if she is going to have an active cycle. I think it is helping. She has had a bounce today after her lower numbers last night - or I assume it is a bounce??
She has very few carbs in her current diet as I home prepare her food (raw kangaroo meat, cooked chicken, raw chicken liver and heart and cooked egg whites and small amounts cooked egg yoke). The only carbs are a small teaspoon cooked pumpkin twice a day and a quarter can Weruva 4% mixed in with the chicken twice a day (half can per day) .

I must comment on how great I thought Mike was with Gracie while you were away. Staying up at night with her and managing the cycle - Wow!
Thanks for your support. Bron
 
Hi Vyktors Mum,
Am glad you found all those brands at Petbarn. They have quite a good range of cat canned food there, don't they. I hope Vyktor likes some of them. It is always a worry when they won't eat.
If Vyktor is having digestive issues, have you ever thought or tried home cooking his food? Sheba used to have chronic diarrhoea which turned out to be from the M/D -probably the grains in it. I swapped her to Fancy Feast for a while and she was OK but then I found she had a few renal issues and the FF was too high in phosphorus so I changed her to home prepared and she has been much better on that. I get the meat from WW in the human section. I don't use the raw pet food. I hated the idea of using kangaroo meat - I could never eat it myself - but she has to eat meat so I chose that as it is very high in omega threes and B vitamins and is free range.
Let's hope we both have success with Vyktor and Sheba.:cat:
Thanks for your support.
Bron
 
Thanks Bron,

I have thought of it BUT I am vegan and I have had companion chickens in the past and currently have a rabbit. Dealing with the cans is about as much as I can manage :confused: he actually has the opposite problem anyway, not really constipation because it doesn't come out hard but he has developed problems getting it out. Vyktor has been in remission for three years thanks to all the wonderful people here. Recently he went through some serious dental issues without falling off the wagon so I'm hoping he's one of the few that never relapses. Currently I am dealing with my mums cat - Purrdy - he looked like he would be an easy fix but he is turning out to be quite the problem child as far as remission hopes are concerned - probably karma for me being such a problem child!

Serryn
 
Hi Serryn,
I can understand you being unable to deal with meat if you are vegan. Good on you for managing the canned food.
Have you tried cooked pumpkin for Vyktors bowels? It is good for both constipation and diarrhoea or softening the stool. I buy the Queensland Blue pumpkins and boil or steam until tender, drain well, then mash and freeze into small lots and get out as needed. I use it as roughage everyday, about a small teaspoon twice a day. Start with a small bit and increase as tolerated.
That is great Vyktor has been in remission for 3 years. Sheba was for over two years and when she got the diarrhoea and we had tried everything to stop it, the vet said to try dry low allergy for a week. I think that is what might have tipped her back out of remission. I never thought for a moment, at the time, I would have so much trouble getting her back again. She was so easy the first time. :(
Good luck with Purrdy.
Bron
 
Unfortunately second time around can be a lot harder. Luckily Vyktor wasn't a dry food cat anyway (issues with struvites when he was young saw us ditch the dry food)), but he was on those rotten FF canned cereals. We have just started pumpkin in the last week or two, also coconut oil which he loves and will eat straight from the spoon and I am seeing better poop. Notably he gets it all out in one try instead of doing it in increments. We started on 1/4 tsp of pumpkin twice daily but since he just had another three days between poops I have just increased.

Much as it can be more difficult second time around I have seen it happen a lot here so you are in the right place to give Sheba her best chance :)
 
Angela & Blackie & 3 Others said:
Welcome to Lantus Land! You've definitely come to the right place for knowledge, advice, support, and everything else in between! :D
Click to expand...
Thank you Angela and Blackie.
Yes I am learning fast what an amazing place this is.
And congratulations to you on achieving remission. I am so happy for you. It is a wonderful achievement and I am sure richly deserved. :cat::cat::cat:
Bron
 
Good luck with the increased pumpkin Serryn and the coconut oil should help as well.
Yes I live in hope that one day Sheba will go back into remission. It seems a distant dream at the moment. Right now I would be happy with regulation.:)
Bron
 
Hi Bron,

I'm sorry for not getting back to you sooner - i ended up out of town. In any case, Wendy (an angel) gave you the post "Where Can I Find?" with lots of other posts on it - you found one of the posts I was thinking of. The other one is also in the bottom section, called "Feeding the Curve, Tashie." One thing we've seen sometimes is that some cats on basically a no carb diet or minimal carbs can improve the bouncing if the carbs are increased.

It's one of those trial and error things - and I don't know how you change up the carbs when you're making the food yourself.
 
By the way, now that you're over 6u in dose, you probably want to do at least 0.5u increases. If you think in terms of percentages, a 0.25u increase on a 1.0u dose is an increase of 25%. On a 6u dose, that's only an increase of 4% - so you're essentially fattening the dose rather than giving a significant increase.

Also, at 6u we often bring up the issue of what might be causing a need for a high dose. I don't know if you're interested in testing or not, but acromegaly is the most common cause of a cat needing a high dose and it is apparently quite common. It might explain her going off of insulin in the past. IAA (insulin auto-antibodies) is another cause of a cat needing a higher dose. The least common that we see is Cushing's. There are more information on all of those in the "Where CAn I Find ?" post under the "New to the Group?" sticky. Slide down to the bottom and there are many single-topic posts that include information on insulin resistance.

If you want help figuring out how to proceed, just holler. Several of us (me included) have/had high dose cats and can of course, give you a hand.
 
Whoops - i just saw you had a post yesterday that i'd missed when i replied to this post. Also that you'd discussed the dose increases - if a smaller dose increase works for Sheba, then go with it. I totally understand the value of getting the dose onto the line, too!

So just file this away for future info when you do dose increases as something you can consider.
 
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