Newbie and my vet has written me off, please look at my SS

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Catannc

Catannc

Active Member
Hello,

So my vet put my cat on hills W/d dry, we were having no response in any meaningful way to insulin, so I said "screw it" and switched her to the Pierson diet on my own over the weekend and monitored her insulin myself. She has improved greatly, but when I called monday to let the vet know she was not happy. Apparently cats will get sick on a low carb diet (kidney disease), she wants her back on hills but will concede to wet m/d, and I can't keep switching her insulin because she will go hypo. She told me on this new food and with the insulin changes that my guess on dosage was as good as hers. And yes, I'm switching vets. But it will likely be next week before I can get in, so I'm looking for input on her insulin. I had been trying to keep her above 100 per my vet worrying she would crash if she was allowed to drop too far too fast, which means i had to lower her insulin and offer some additional food at times, this is noted in the SS. I am no longer trying to doing this, it caused her to go above 400 again.

She is 8.5 years old, 9 lbs on a very small frame. On a half unit of Prozinc, if I don't give her additional food, her fasting values seem to drop 30 points from feeding to feeding so she is still coming down. On the other hand, her numbers on the 25th when she was on one unit in hindsight look pretty good-but I freaked out. Best to leave her on the half unit to settle in?

https://docs.google.com/spreadsheet/pub ... utput=html
 
Re: Newbie and my vet has written me off, please look at my

I cannot pull your spreadsheet up at work, but read this thread concerning the impacts on dry food regarding blood glucose levels.

viewtopic.php?f=24&t=64352


Now, to some additional thoughts-- You do NOT need to feed MD , my vet tried that on me also. I had the dry and the wet MD--it wasn't an option for me, because Kitty, my cat, turned her nose up to it! And, NO, feeding wet low carb foods does not cause Kidney disease!

You have the right attitude..."screw it!"... find you a NEW vet!

I am curious about your spreadsheet, so I am going to hijack another computer at work without firewalls and see what it is showing!
 
Re: Newbie and my vet has written me off, please look at my

just in case something went wrong with the first link:

https://docs.google.com/spreadsheet/pub ... utput=html

I think i answered my own question about dosing with her 4 hr test today, she needs to be held and allowed to come down on her own for now.

OH! Also, any idea why the same dose of insulin with the same volume of food does not seem to bring her down anywhere near as much in the evening? Didn't know if this was a common thing?
 
Re: Newbie and my vet has written me off, please look at my

The link is fine I am sure--it is the computer firewalls at work! I am heading to another computer now....

Some others will be along for advice also!

I forgot to say, "Welcome"

Kim
 
Re: Newbie and my vet has written me off, please look at my

Hi! (What's your name?)

I replied on your thread in Health. Welcome to PZI. As I mentioned, not as many people here mid day, but I see Kim (kse) is around.

Your +4 number is lovely. Usually they are lowest between 5-7 hours after the shot, so we shall see. If she would go down to the 40s -50s, you might want to intervene with some food, but she has had a nice drop so far.

It's an Every Cat is Different Thing (ECID) which unfortunately, applies to lots of things. We have cats that are lower at night, and that are higher at night. Sometimes it is food. If they eat more during the lower cycle, then you can feed during the other cycle to see if that changes things. If they eat less during the lower cycle, vice versa. If they excercise more/less during the lower cycle, that might influence the numbers. Getting numbers at each cycle and then looking at the food/excercise coorelation, sometimes you can figure it out.

The other ECID that applies is the food. Some cats show an immediate lowering of bg levels when you switch from dry. Some cats drop slowly over weeks. That can influence the cycles too.
 
Re: Newbie and my vet has written me off, please look at my

Catannc said:
On a half unit of Prozinc, if I don't give her additional food, her fasting values seem to drop 30 points from feeding to feeding so she is still coming down.
Click to expand...

My Grayson went from free-feeding Kitt-N-Kaboodle to canned food 2x/day at shot time. This CLEARLY was not enough. I've had to pull his head out of the dog food bowl, the cabinet w/ dry food - that used to be in a box - 3/4 of which was missing, from eating anything any other cat had spit up, and most recently a bag of egg noodles from the cupboard. He now gets a can of Fancy Feast Classics - either chicken or turkey - w/ his shots, AND at least half a can halfway through each cycle. Even with all of this, he's still got a skinny little butt at the ~14# he carries on his large cat frame. A far cry from the 21.6 he was 6 months ago, but better than the 12.2 in January. Some people actually just do a tablespoon of food at various times... I expect this helps them to transition from free-feeding to mealtimes.
 
Re: Newbie and my vet has written me off, please look at my

Oh so sorry, I'm Cathy.

The funny thing is her food is measured, she eats exactly the same, and while i guess she sleeps more during the night she's not exactly "active" during the day. Her neuropathy is making her slower, her idea of exertion is laying down and attacking a string. We're hoping as her legs improve she will return to her normal self, but she is happy to be feeling better already. Thanks guys,

Cathy
 
Re: Newbie and my vet has written me off, please look at my

Here's my take!

The best comments on your spreadsheet were on 2/24--Fed up with the wait and see approach...l am going to do it myself....!

It does appear she has a quick onset and nadir (lowest point of the cycle)- it actually looks like her nadir is happening around +4. I can understand why your vet said to "feed the drop" so it doesn't happen to sharply and quickly. I don't think it is a bad idea to offer a little food at +2 or +3 to slow your drop, you can offer that and see what it does to the numbers and you can adjust your insulin accordingly.

I actually think the spreadsheet does not look bad, after you gave up the MD dry and starting making diet changes-- 2/25. I would stick with the .5 and let her settle into the dose a little before changing it. And, if I did increase, I would not go to 1 unit. Think of the increase in percentages--a 1 unit dose would be a 100% increase--that is a lot on any dose. Go slow if you decided to increase-- .6 then .75 ect... It takes some time to get the kitties to adjust to the insulin and settle down. I think your evening cycles are staying higher, due to the lower numbers you are seeing during the day. A lot of times if a kitty has been in high numbers, their bodies begin to think that the high numbers are "normal"- and when they see lower numbers--like the 100s, their livers react and dump sugar and hormones to offset the drop. It takes a few hours or cycles for the sugar etc to clear the cats body. So, it is not uncommon to see higher flatter cycles after a cycle of good numbers.

I would continue to shoot the .5 and keep your spreadsheet update. There will be others that can offer a lot of help with dosing.

You can attach your spreadsheet to your signature in the control panel- then it will always be available for everyone to view and offer suggestions at all times. If you have problems attaching it, we have a resident expert, Sue. I am sure she will be glad to help you!

I hope this makes some sense and helps. You are doing great!
 
Re: Newbie and my vet has written me off, please look at my

Hi Cathy :-D

You can put your spreadsheet in your signature so that it comes up every time you post. Great if you want an answer fast. Go to User Control Panel, Edit Signature, and paste that long url in. Then Submit.
 
Re: Newbie and my vet has written me off, please look at my

She has been doing great on the transition, but then again this cat will eat anything! She gets about 1/3 c raw diet at every shot, it takes her about 20 minutes to finish cause she's a nibbler, and she really doesn't seem to mind not free feeding. Granted, about 2 hours before dinner she starts hanging out in the kitchen, but she isn't screaming nonstop for food like she used to or trying to steal my dinner. Now she is only mildly interested if I'm in the fridge, so I'm not really worried about her. What I like about the Pierson diet is the ability to adjust the fat content to deal with weight loss, so if she gets too thin I can take care of that. Again, i stress she is very petite and 9 pounds. Her name is Kitten, because that's what she looked like until she ballooned up! From nose to butt she might be 14 inches, her head is about the size of a tennis ball.

Cathy
 
Re: Newbie and my vet has written me off, please look at my

One more thing and I promise I will go away! Are you giving anything for the Neuropathy? If not, check into Methyl B-12. It is great and works wonders-- it must be Methyl B12--not just B12.

My Kitty is also small---9.5 pounds!
 
Re: Newbie and my vet has written me off, please look at my

Kim,

No I am not, I asked my vet about the methylcobala-whozit, and she said never heard of it, don't try it, it might affect her liver as it processes many vitamins. So I was afraid to try.

Also, how to give extreme fractional doses? When the vet put me on .5 I asked "how?" as I have U-40's marked at 1 unit increments. I asked about getting u-100's and she didn't seem to think that was a good idea.

Cathy
 
Re: Newbie and my vet has written me off, please look at my

I said I was leaving...but.... I read your post in Health. We are neighbors! I am in NC--not so far from you. You have a great contact in Barbara. She is in your area and will be great at providing you information and vet referrals. I really am leaving now!

Get the Methyl B12-- it is Great! Many here use it.
 
Re: Newbie and my vet has written me off, please look at my

I use U40s and eyeball doses---BUT, my cat is a guzzler and point anythings don't matter! But, many here use the U100s-- BUT, you MUST use the conversion chart. Ask someone to post the conversion chart for you.
 
Re: Newbie and my vet has written me off, please look at my

Hi Cathy and welcome!

I have to agree w/ Kim on the numbers. They don't look too bad at this point. Keep in mind, Kitten's condition didn't happen overnight, and you may do everything in your power to try to get her regulated, but it will likewise take time. You're doing good - and moving in the right direction. Good luck w/ the search for a new vet. There are a few other recent posts with suggestions to ask potential vets via phone before you go meet them (so as not to waste your time w/ someone with no experience or lack of willingness to work WITH you). Check Nudderbaby's recent posts for one. Perhaps someone else will come along and provide some links.

In the meantime, here are some of the questions from my memory:

How many diabetic cats are you currently treating? (and/or have you treated)
What kind of food do you recommend for them?
What insulin do you typically use?
What is your typical starting dose?
How is the insulin level adjusted?
Do you support home testing?
Do you offer consultations with your clients to keep up w/ what they are doing regularly?

Likewise, if you post where you are located (ie: 1/2 hr from Philly) there may be others in your area that can recommend helpful vets. You may even want to do this in the Feline Health section of the board index on a new post, and title it "Looking for Vet in Philadelphia vicinity", etc.

Hope this helps!
Lu-Ann
 
Re: Newbie and my vet has written me off, please look at my

Catannc said:
She has been doing great on the transition, but then again this cat will eat anything! She gets about 1/3 c raw diet at every shot, it takes her about 20 minutes to finish cause she's a nibbler, and she really doesn't seem to mind not free feeding. Granted, about 2 hours before dinner she starts hanging out in the kitchen, but she isn't screaming nonstop for food like she used to or trying to steal my dinner. Now she is only mildly interested if I'm in the fridge, so I'm not really worried about her. What I like about the Pierson diet is the ability to adjust the fat content to deal with weight loss, so if she gets too thin I can take care of that. Again, i stress she is very petite and 9 pounds. Her name is Kitten, because that's what she looked like until she ballooned up! From nose to butt she might be 14 inches, her head is about the size of a tennis ball.

Cathy
Click to expand...

hi Cathy,
I may not know about the insulin you are using, but I recognize a lousy vet, so I am very glad that you were wise and tried a better diet, realized that it was helping your Kitten, and stood your ground. WELL DONE!

If you stop and think about it, do you really need your vet for diabetes related things other than getting your rx for the insulin? Nope. You get your insulin and you home test, and you feed a good healthy low carb wet diet. You are able to to handle dosing decisions yourself, record Kitten's BG numbers, and with your own eyes, see a healthier Kitten.

If you should find she is eating more, that's OK. Many cats, until they are regulated, seem to eat more but when you get to her 'good' dose, she'll level off to a good appetite.
I would suggest you free feed because cats are very good at self regulating. Say her numbers go a bit low when you are not around, she will naturally search out some food to eat and it will bring up her numbers.
One thing that is tried is to lift up all food for the 2hrs prior to shot times, if possible, so that food can clear her system and the number you get at ps time will not be food influenced.

Sure we need vets for some things. We can't do dentals or Xrays or ultrasounds, or draw blood to have tests done. We can't draw out urine to have tested, and we can't set broken bones.
You want a vet who is good at such things, who can be a decent diagnostician if possible, but for diabetes, it's pretty much something that you can handle on your own.

There are many people here who can help you along the way, and they will be the first ones to say, SEE A VET if it's out of scope of home care.

Your vet wrote you off? I don't think you lost out at all; you gained.
Best of luck on the new vet.... take a list of questions to ask to see how the vet feels about points important to you like diabetic diet and home testing.
 
Re: Newbie and my vet has written me off, please look at my

Yes, it's VERY hard to eyeball 1/2 doses on the U40 needles I had. I use the U100s from Walmart w/ the 1/2 unit increments, and have successfully given doses as low as .2 and .4 units. It's even easier for the larger doses! i've attached a PDF w/ the Conversion chart - as Kim said, CONVERSION IS A MUST!!! Print this out and hang it on the fridge or keep w/ your needles.




Each half unit line on this U100 needle = .2 units of U40 insulin.
 

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Re: Newbie and my vet has written me off, please look at my

Kim,

You were right on about her nadir, just tested her 5 hour and she is 114. At least I am now free to go about my day! Unfortunately my work schedule won't allow me to be home tomorrow at this time, which makes me a little nervous, so "feeding the drop" won't be possible. I guess I may slightly undershoot the .5 if her starting value is lower tomorrow than today, I'm just hoping she kinda settles in and becomes predictable because I hate leaving her and worrying.

Cathy
 
Re: Newbie and my vet has written me off, please look at my

Catannc said:
Kim,

You were right on about her nadir, just tested her 5 hour and she is 114. At least I am now free to go about my day! Unfortunately my work schedule won't allow me to be home tomorrow at this time, which makes me a little nervous, so "feeding the drop" won't be possible. I guess I may slightly undershoot the .5 if her starting value is lower tomorrow than today, I'm just hoping she kinda settles in and becomes predictable because I hate leaving her and worrying.

Cathy
Click to expand...

many people are unable to be home during the daytime cycles when working, and dosing is usually based on data gathered... it's tough to say now what you will do in the morning; you just have to wait and see what the boss says... in case you don't know who that is, it's your cat .. always.
She will let you know when you get her ps number, but what you can do if you like is to test her at +11 in the morn and see where her numbers are heading. it's reassuring to see the ps number higher than the +11.

if you have any doubts in the morn, just post and someone should be able to talk it over with you.
 
Re: Newbie and my vet has written me off, please look at my

Welcome Cathy!

Looks like you two are in excellent hands so I just wanted to say hi!

Heather
 
Re: Newbie and my vet has written me off, please look at my

I'm not sure how raw would work, but lots of us leave food out. I freeze Fancy Feast in silicone cupcake pans, plop out the food when frozen and refreeze in plastic sacks so I have a whole supply of food pucks. I also have an automatic feeder so I can set it to go off whenever it's time for him to eat. Some have Freezer packs to keep the food cold.
 
Re: Newbie and my vet has written me off, please look at my

Hey Cathy,

I'm the one who lives in Hampton. I was using a vet in Hampton (16 yrs) but switched to Dr T. I hate tackling the HRBT but my other vet was about to kill Thumper. I'm curious who you were/are using? I had looked around for another vet but until I got the recommendation from Carolyn for Dr. T I hadn't found anyone else. You will get some great advice from everyone here. Thumper was on Pro Zinc but we switched to Lantus to see if I could get Thumper to stop bouncing so much.

Oh, just make sure you keep your SS updated cause Sue will get upset if you don't! :lol: Just kidding, we love Sue, in fact her nickname is Saint Sue!
 
Re: Newbie and my vet has written me off, please look at my

Sue and Oliver (GA) said:
I'm not sure how raw would work, but lots of us leave food out. I freeze Fancy Feast in silicone cupcake pans, plop out the food when frozen and refreeze in plastic sacks so I have a whole supply of food pucks. I also have an automatic feeder so I can set it to go off whenever it's time for him to eat. Some have Freezer packs to keep the food cold.
Click to expand...

lots of people just use ice cube trays! Easy peasy to make up a batch and then do as Sue suggested, put frozen portions into the sections of an autofeeder. You can leave the first meal unfrozen, and the others will thaw by the time they are offered to be eaten in the feeder.

Here's a feeder that many people are using, and it sure puts your mind at ease that you don't have to worry about his going hungry when you are away.
Petsafe 5-meal Auto Feeder
 
Re: Newbie and my vet has written me off, please look at my

I'm not sure how free-feeding would work with her, she kinda has my view on food, "if it's there, I'll eat it." Previously it had seemed that the second any room opened up in her belly, she'd refill it. Maybe because of her super high blood sugar, maybe because she just loves eating. The other problem I have is my 15.5 year old Maine Coon, he is an old man and set in his ways. He already doesn't like being closed off to eat his separate meals, he's been Kitten's "daddy" ever since I brought her home and becomes inconsolable if he can't get to her, so I can't separate them during the day.

On a separate funny note, I just bought Kitten a small covered litter box so I could better monitor her output, too small for my 17lb monster to fit in. She loves it, uses it almost exclusively, except when something really stinky is about to happen. She leaves those "presents" in the other cats box. So he must not appreciate that too much, because I just saw him try to get into her box-which he couldn't turn around in once he got his body through the door. So he gets out and goes in hind feet first. She perked up when she heard noise in the area of her box, he finished and at least went back in the normal way to cover it, she realizes what is happening and flew at him! It's the little things in life.

Cathy
 
Re: Newbie and my vet has written me off, please look at my

Barbara,

Was your vet out towards Tabb? Probably just alot of bad vets when it comes to diabetes. Actually I'm headed to Hampton right now, have a property out there I'm fixing up and need to get some work in, as Ms. Kitten has set me back a couple weeks. HRBT is horrible, but luckily I don't work tues/wed so I can make a midday appt and miss most of the traffic. Be nice if there was something closer, but at least I have the 24hr emergency in yorktown only 5 minutes away.

Cathy
 
Re: Newbie and my vet has written me off, please look at my

If you put the feeder in a spot that is awkward for the big guy to reach, then Kitten's food is all hers. I did that for mine when working. I put the feeder in a spot where the open section could not be reached by a bigger cat. So that settles and eliminates the need to separate the cats!

Now, it sounds like the feeder will be perfect for Kitten because you can spread out her food and she would be able to gobble it all down at one time! Just divide her total amount of food into 5 portions and then put one in each section. You are going to have more level numbers when the feeding is spread out through the day. Even human diabetics have more frequent eatings, just smaller amounts.

As for the litter boxes, it's sounding like little Kitten is one very smart kitty! Why would she want to stink up HER litter box, when she can just use the other one LOL. She's a smart one!
 
Re: Newbie and my vet has written me off, please look at my

So if I did the feeder, wouldn't I need to feed the entire normal meal regularly and then just leave a snack for about 2 hours in? Because she drops her entire 260 points in the first 4 hours?
 
Re: Newbie and my vet has written me off, please look at my

That would work. Be aware too that sometimes the nadir is early in new kitties on PZI and gradually gets later. One of the many complications of this sugar dance.
 
Re: Newbie and my vet has written me off, please look at my

How much ounces do you feed her at the main meal?
A whole can of food?
What is your normal feeding routine and can you say how many ounces you feed each time?
It will help to know what you are doing now that can be adjusted to help with that big drop in 4 hours.
 
Re: Newbie and my vet has written me off, please look at my

Catannc said:
Barbara,

Was your vet out towards Tabb? Probably just alot of bad vets when it comes to diabetes. Actually I'm headed to Hampton right now, have a property out there I'm fixing up and need to get some work in, as Ms. Kitten has set me back a couple weeks. HRBT is horrible, but luckily I don't work tues/wed so I can make a midday appt and miss most of the traffic. Be nice if there was something closer, but at least I have the 24hr emergency in yorktown only 5 minutes away.

Cathy
Click to expand...

The one I was using is in Hampton. I don't have any confidence in the 24 hr emergency on J Clyde anymore either. Thumper spent the night there a few months ago, I believe it was due to a mistake my old vet made. They gave me 2 different DX but ended up saying the real problem was her diabetes wasn't controlled. :roll: I already knew her diabetes wasn't controlled. When I first took her in they told me she was DKA. They treated her & when the ketones went away they said she wasn't DKA after all. It was almost as if I was talking to two different vets. Anyway another good thing about Bay Beach is they are open 24 hrs, they turn into an emergency vet at 5:00. You can make an appointment up until 7:00 though. I like it cause if she ever gets sick she gets to stay right there where all her records are & her regular vet is there to check up on her during the day. Dr. T is only there limited hours though. They will give you her schedule but I think she doesn't get there until 2:00 on Tues & she might be off on Wed.

Gosh, I still haven't read your entire thread so I don't know what your exact questions were. The bottom line is since you already have the Pro Zinc you don't need your vet for diabetes. You can get all the help you need here. You don't need to take your cat back for curves, you can do that yourself. You do need to establish a relationship with a vet though cause sooner or later you will probably need something.

Barbara
 
Re: Newbie and my vet has written me off, please look at my

Gayle,

She is on the Pierson semi-raw diet. Can't tell you in ounces, but she eats 1/3 c 2 times a day and it takes her awhile to finish it, bout 20 minutes. I don't think I could get much more in her if I tried. Should i try less insulin? BTW, as expected she has dropped about 30 point pre-meal (333) from this morning, and we're getting ready for dinner. If this trend continues she will be about 303 in the am, so anyone on here have a recommendation about tonight/tomorrow?

Cathy
 
Re: Newbie and my vet has written me off, please look at my

Catannc said:
Gayle,

She is on the Pierson semi-raw diet. Can't tell you in ounces, but she eats 1/3 c 2 times a day and it takes her awhile to finish it, bout 20 minutes. I don't think I could get much more in her if I tried. Should i try less insulin? BTW, as expected she has dropped about 30 point pre-meal (333) from this morning, and we're getting ready for dinner. If this trend continues she will be about 303 in the am, so anyone on here have a recommendation about tonight/tomorrow?

Cathy
Click to expand...

Cathy,
Do you just leave the 1/3cup out for her until it's gone? Or do you pick up the plate after a certain length of time. How long is quite awhile?
You don't have to be feeding MORE food, just more frequently.
If you are around, maybe you could feed her 1tbsp each hour for the first 4 hours to slow her dropping numbers; some people find that feeding mini meals in the early hours of the cycles, they eliminate any steep drops.

Two meals a day is not the best way for a diabetic as you want to have the meals more frequent as it helps to level out the numbers.

I can't say anything on dosing as I am not familiar with the insulin you are giving.
 
Re: Newbie and my vet has written me off, please look at my

Cathy,

First want to say welcome. I have a Maine Coon also and he is 17.5lbs now. He was 23lbs at one time before FD. Can't believe i've been in this dance for 5mths now so still pretty new. My cat, copper, also has the neuopathy really bad. He is on the Zobaline pills 5xday. You can get it from lifelink.com. They are made for the FD cat and do not contain any sugar or additives. A lot of people use them on the board. Still haven't seen a ton of improvement yet in his neuro, but i haven't been able to get my cat regulated yet. Once they get regulated then they will slowly start getting better. But they have to get regulated first. Dr. Lisa Pierson says it takes months after you get regulated before you see some signs of improvement. This is the hardest thing for me to see in my cat. He walks on his hocks and it looks painful. I hate seeing him like that, but he doesn't really seem to be bothered too much by it all. He still gets up and down stairs, slowly and goes outside.

Hang in there, it will get a little easier. You did the right thing in finding another vet. It took 3 try's before i found one that even knew what he was talking about on FD.

As for the diet, you have an excellent one Dr. Pierson's diet. We are on a raw diet too (half raw and half FF). I've noticed my cat's BG has raised up a bit with adding the raw diet. But ECID. He loves it though and it's the best thing for him to get his muscle's back. He has lost so much since being DX.

Good luck in getting regulated.

lori and Copper
 
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