Peeka 8/27

Hey everyone,

Sort of a down day today, Peekas neuropathy was more evident today. She is still able to jump up on certain things, like the ottoman in the living room, or making her way on to the kitchen table via a chair. She has started laying down in the hallway and meowing for one us to pick her up and take her to the food bowl. Not sure if she is being a prima-donna, or if she doesn’t want to make the walk down the hall and make the jump onto the chair and her table. With that said, she will have walked a little bit to make it to the hallway, so that could be the case.

She also peed in our room today, no clothes around, just on the carpet. Tried telling my wife that is more or less somewhat normal with diabetic cats. Just feels disheartening since she was making good progress earlier in the week and we seem to be taking a step back. Not sure if anyone else has experienced some progress only for there to be some setbacks. I posted in the Vetsulin forum regarding a possible increase in dosage, haven’t heard anything back yet. Her spreadsheet is up to date with every test we’ve been able to do so far.

Thanks, I hope everyone is having a wonderful week!

 

Hi Peter, sorry you did not get a response on the Vetsulin forum. It's a little quiet over there, only a few of us check it very often. Posting here will get more eyes on your questions.

I'll comment on your dosing question from the Vetsulin forum; I do not have experience with neuropathy so can't comment.
Your question was wondering if it was time to up the dose from 3u.

I see you have posted several times, so I probably don't have the time to go back and read through ALL the threads, so I'll just ask - it looks like you were started on 2u. What made you increase to 3u? Was it your vet, personal decision, or did someone here on the forum recommend it?

Peeka does not have much information on his spreadsheet to work with. With Vetsulin, it is usually most effective in the first 1-5 hours, and then starts to trend up again. Not all cats, but most.
Are you not testing every pre-shot? If not, I would recommend putting "no test" in the pre-shot cells so people know you did not check. Are you struggling with getting tests in right now?

I literally can't offer increasing advice right now; there simply isn't enough data to make that judgment. We would need EVERY pre-shot test (especially on Vetsulin, for safety) and ideally at least 2 each cycle (day and night). You'll have to think of it right now as standing in a dark room and shooting at a target. Because the room is dark, you don't know where you're aiming or if you're hitting anything at all. And now you're inviting us to come into the dark room and tell you how to adjust your aim. We have no way of helping you in the dark. D: Help us help you by turning on the lights and getting those tests in!

Has anyone told you to switch to a low-carb, wet food? Royal Canin dry is high-carb and actually increasing Peeka's need for insulin. Switching from dry can drop the BG 100 points, and decrease the need for insulin! Anything under 10% is good; Fancy Feast Classics and Friskies Pate are favorites, but there's many options found here. When switching you need to be carefully monitoring, and switching over the course of several days, so you can note the BG drop and adjust the dose accordingly.

As a general guide for you, it would be beneficial if you could get tests done on alternate days. For example, Day 1 you test at +1, +3, and +5, and on Day 2 you test at +2, +4, and +6. That way we are filling in the gaps on Peeka's spreadsheet. Any drop under 90 earns a 0.25 unit reduction.

 

Excellent analogy, Elizabeth!

 

Hi Peter, neuropathy is nerve damage due to persistent high blood glucose levels. But the good news is that it can very often heal completely.
Giving supplements of a form of B12 called methylcobalamin can help speed up the healing process considerably in some kitties, although some with not see significant improvement until their blood glucose is also in a better range.
In the US many folks use a cat-specific brand called 'Zobaline', but other brands may be fine as long as they don't contain additives or sweeteners that are not good for kitties. The typical dose is 3mg methylcobalamin. The Zobaline brand also contains 200mcg of folic acid; and if you want to use another brand and mimic the Zobaline formula then you can just give that in addition to the 3mg of methylcobalamin.

B12 is usually considered a 'safe' vitamin because it's water soluble and any excess is normally excreted in the urine. (But in cats with loss of kidney function it may be necessary to give a reduced dose.)

There could be quite a few reasons for this...
Cats in high blood glucose levels usually pee a lot, and sometimes they just don't make it to the litter tray.
Neuropathy can affect the bladder as well as the legs, and cats can be less aware that they need to pee. (My first diabetic had bad neuropathy at diagnosis. He used to sleep on my pillow, and I sometimes woke up to find my hair soaked in cat's pee, with him still fast asleep on the pillow by my head...)
Diabetic kitties are more prone to urinary tract infections (UTIs), and this can cause inappropriate peeing.
Cats who may have experienced discomfort during using the litter tray may seek out soft surfaces to pee on.

I agree with Elizabeth's suggestion above about your trying to get more test data. It 'may be' that your kitty needs more insulin, but it is impossible to know for sure without seeing a bit more of the picture...

If it is the case that the insulin dose is not enough then there are a couple of options available to you. One would be to increase the insulin dose, the other would be to lower the carb content of the diet (which can have a similar effect to increasing the insulin dose.) But it is important to only do one of these things at a time, and while you are able to monitor the blood glucose to see the effect of the dose increase or the diet change.
'If' you could get your kitty onto a lower carb diet that could make managing the diabetes easier and more effective. (As an example of what can happen, my current diabetic came here in Feb of last year on a dry presciption diet and 4 units Vetsulin/Caninsulin. Switching her to a low carb wet diet immediately reduced her insulin requirement by half, to 2 units. Her insulin requirements continued to drop and she's now in remission.)

Oh gosh, yes! I'm guessing that many of us, or even most of us, have experienced exactly that. ...Diabetes can be a very frustrating condition to deal with at times. And that is why we sometimes refer to dealing with diabetes as a 'sugar dance'; the steps we make aren't always forwards in the same direction, the dance may take us sideways, or even backwards sometimes...

Eliz

 

Absolutely! Only this week in fact. We were getting on famously with our new food and with managing our dosing then Kyra stopped eating. The tears were streaming on Wednesday and you should see the breakout of my face from all the stress!! This really is a one step at a time kind of deal and remembering all the positives that you have witnessed so far.

Keep up the testing attempts. It really is the best thing for Peeka and for you, as you'll be able to get so much more knowledge from all of the amazing people on this forum.

Sending positive vibes your way!

 

Morning all!

For members playing catch-up with Peter, Peeka and Boo, here's a brief summary:

* Peter and Mrs. Peter both have very busy schedules so testing needs to be fitted around this. So does any future diet change.

* Peeka was recently diagnosed with FD. Peter is treating her with Vetsulin plus B12 for neuropathy. Peeka's neuropathy is improving.
* Boo, Peeka's brother, is also a diabetic. Peter has been treating Boo with Vetsulin for some time. Boo's also getting B12 now.
* Both cats are eating Royal Canin Hypoglycaemic dry food. Peter hopes to transition both cats to a lower carb diet when schedule permits.
* Boo is stable and has been doing particularly well of late. Peter is keen to keep him this way, so he is understandably wary of changes.
* Peter has started home testing Peeka. Historically, Boo has not been home tested, but Peter hopes to also start testing him (again, as schedule permits).

I've previously provided Peter with an outline of how to transition food safely in this post.


Mogs
.

 

Thanks for the history, Mogs.

Peter said Peeka's neuropathy was more evident today, which is a shame since the kitty is already on methylcobalamin... ....I wonder if postassium deficiency could also be an issue...?

Mogs, what are your thoughts on any dose change for Peeka..?

 

They are my thoughts, Eliz, and they are going to remain my thoughts.


Mogs
.

 

I will say that Peeka's response to Vetsulin is very typical. She may be a fast metaboliser (see the one PM+6 test result available). I will say that a safely managed diet change with appropriate dose adjustments made in tandem with the food transition is what I think would likely help things the most - but there are two cats on insulin to consider in this picture, for one of whom there is as yet no data at all, and Peter is working with an intermediate-acting insulin and all the safety considerations that entails.

Lots of moving parts. Lots of complexity. I would be happy to suggest that Peter run a full curve for Peeka and contact his vets to discuss the curve and the rest of Peeka's test results.


Mogs
.

 

Hi Peter, you ask if anyone else has gone through the up and down back n forth... That would be my Trouble. BTW if Trouble had close the the numbers Peeka does? I would have been thrilled.

Troubles turning point was the day I removed his dry food. Since his numbers were in the 4-500's consistently I just removed the dry. Finally his numbers came down to where they COULD be managed. It wasnt long after that he was OTJ completely. Poor kitteth was THAT carb sensitive. I STRONGLY RECOMMEND AGAINST the removal of dry the way I did. (we were VERY lucky it worked out the way it did) Point is Troubles journey was more of a roller coaster ride. UP for a day, level for a day, lower for a day... rinse repeat... To say I was frustrated was an understatement.
The people here helped me keep my sanity with good solid advice that eventually WORKED.
It will work for Peeka too.

 

There was actually some miscommunication in my first post regarding Peekas initial dosage. When we first started noticing the symptoms we took her to the vet and we started off 1u 2x/day, this was around the end of June. In August, when she kept urinating and living by the water bowl, we took her back where the vet recommended 2u 2x/day. Then on the 18th, two days after an emergency visit to the vet where her nueropathy was at its worst, her BG levels were high enough that the vet recommended 3u 2x/day. It was around this time that I discovered this forum and the wealth of knowledge you all have here. Since then, I have been testing her numbers as frequently as our schedule allows, the most difficult time to test both AMPS and any test afterwards.

We have been advised that this would help tremendously, our only issue is that back to school is her busiest time of year, and I'm working a 2nd job on the weekends. She is also 5 months pregnant and I would rather not put any extra stress on her plate regarding this since Peeka can be slightly erratic at times. That said, she has done very well with her shots, especially when she sees her Purebites are within reach!

 

I sincerely appreciate your post and your advice. I am 100% on board with making changes, and have left nothing off the table, as I noted above though, we are not home enough to monitor Peeka's BG levels for testing and ensuring her safety at this current point. I had mentioned in a previous post feeling overwhelmed by all the information, and I feel at this point I've got a slightly better handle on things right now, I would just prefer to take it one step at a time right now, especially since my wife and I are as busy as we are. I am still working on trying to get more data for her spreadsheet, and hopefully filling in on the weekends will help some, and with my current schedule for the upcoming week, there may be time to get some tests in on Monday & Friday.

I do believe we have seen improvements with Peeka, she can walk certain distances now, she still does need to take rests and what not, and she still has a bad gait, but our Day 0 if you will, was the day we took her to the emergency vet and were told she may never get better. As I have since learned on here, that is not necessarily the case. I just get discouraged when we are making these adjustments and she is not on a straight trajectory to getting better. That is my own personality flaw though, not a discredit to anything anyone here has told me lol.

She has also been taking methly b12 from Vitacost, as recommended on here. One thing that may be playing a factor in that is that her food is shared with her brother, who also has diabetes and has been on a nice recovery with his own neuropathy. So she may not be getting the full effects of that, it has only been a week since we started her on that.

 

I do hope Kyra is able to turn her appetite around. I COMPLETELY understand about the stress going on with all this. I'd be lying if I said I haven't shed a few (many) tears during this whole ordeal. I've told my wife I've never experienced anxiety like this before, it hurts seeing something you love not at their 100% best.

 

There is a full curve on the docket for Labor Day. I know it isn't today, or soon for that matter, but I'm committed to testing that day and getting a better look at the numbers for everyone here, as well as sharing with the vet.

Her neuropathy isn't getting MUCH worse, just noticeable, which I may be blowing way out of proportion. This morning she managed to make her way from the living room to the hallway near her food bowl in one go and she looked more like Sunday and Monday when she was looking her best. It is well within the realm of possibility I am blowing it out of proportion and it is just the normal ups and downs of diabetes with cats. It wouldn't be the first or the last time I have overreacted to something.

 

Great stuff, Peter. I take it you'll be stocking up on the Purebites!

I think perhaps as we become better observers of our little ones and we start noticing the improvements we become all excited and then get greedy for more. And we want them YESTERDAY!!!

Did I ever mention I do a very nice line in Patience Pants?





Mogs
.

 

I think Purebites will definitely be on our autoship from now on. Both cats love them!

I'm hoping this is just part of the process and as we can get her dosage sorted out, she will continue to get better. 1 step back, 2 forward, etc. I just get caught in the moment and get sad that there's no magic cure I can do right now to make it better.

Those pants are INCREDIBLE!

 

They're on a 3-for-2 special offer this month. Cash or card, sir?




Mogs
.

 

If only ...

(((Peter)))

You'll all get there.


Mogs
.

 

As a fellow anxious person who shed many many tears in the beginning (let's be honest, it's overwhelming!), I did find solace when I started testing. That is, I was too scared to even try to test the first two months. It was just too much to ask of myself at first. Testing put me in control, and made me feel less in the dark. You're already testing obviously, but you may feel more assured when you begin testing regularly. That's what happened with me anyway!

I think, what with so many factors going on right now (your schedule, the dry food, etc) I would hold off increases until you can get the testing in. Many people with 12 hr shifts at work end up getting test data in at night (I guess it's not actually good for us to wake up every 2-3 hours every night, but eh I got used to it when I needed to do it lol), or doing the curves during the weekend when they're home. You know your schedule better than anyone and what you are capable of.