Peeka 9/9

[Peter (Boo) (Peeka GA)]

Good morning!

If I need to stop posting daily threads, then I will. Not a lot to report honestly, Peeka had another accident in our room yesterday which I was able to take care of before the wife got home, thankfully. Neuropathy doesn't look much better, but I almost feel like it's more manageable now, if that makes sense. Almost like it is still bad, but in a way that I feel like is an improvement from a week ago. I'm hopeful that we are getting closer on her dosage now with the food change. Today, she only had 3 little kibbles of her old food, and the rest was Dr. Elsey's. AMPS was in the mid 300's, and her +2 was 245, +3 was 217.

Someone can correct me if I'm wrong, but is changing things like diet and dosage more beneficial than just changing the dosage itself? Like let's say we kept her on her old food, but she was getting 3.25u of insulin and her readings were around the 150's. Or we change diet which in turn allows us to give her a lower dosage and the readings are still in the 150's, is that just a more efficient way to managing diabetes, or in the long run, is it better?

Like I said, not a lot happening in our house at the moment with Peeka. She's been walking around a little bit, not as much as I would like, and definitely not as graceful as I would hope for. I'm optimistic that we are getting closer on her dosage. I have seen some numbers below 200, They are just not consistent and typically come after lower than normal readings. Last night Peeka's initial +3 was 85, which scared me. She had 3 other readings which were around 230, and 1 more that was 180.

Anyways, I know that's a lot of words for nothing really being said lol. I hope everyone has a great day!

 

[jt and trouble (GA)]

This is the w

Or we change diet which in turn allows us to give her a lower dosage and the readings are still in the 150's, is that just a more efficient way to managing diabetes, or in the long run, is it better?

This is way it worked for us. Thats why you test before each shot.

 

[Peter (Boo) (Peeka GA)]

This is way it worked for us. Thats why you test before each shot.

Sounds good, I just was curious if it was better for the cats one way or the other.

 

[jt and trouble (GA)]

Sounds good, I just was curious if it was better for the cats one way or the other.

Well? There again ECID

 

[Critter Mom]

Neuropathy doesn't look much better, but I almost feel like it's more manageable now, if that makes sense. Almost like it is still bad, but in a way that I feel like is an improvement from a week ago.

Maybe make a weekly video of Peeka moving around? If you compare weekly changes it may help you to better determine her progress?

Someone can correct me if I'm wrong, but is changing things like diet and dosage more beneficial than just changing the dosage itself? Like let's say we kept her on her old food, but she was getting 3.25u of insulin and her readings were around the 150's. Or we change diet which in turn allows us to give her a lower dosage and the readings are still in the 150's, is that just a more efficient way to managing diabetes, or in the long run, is it better?

It is more beneficial to change to a lower carb diet because that opens the door to lowering the curve overall into much better numbers. The size of the insulin dose is affected by the overall carb load: cats who eat fewer carbs need less insulin.

For a cat on Vetsulin and with a high carb diet:

* the cat's BG baseline will be high.
* the cat will be in high numbers at the beginning of each cycle.
* because Vetsulin produces such big drops in BG levels there is only so far the overall curve can be lowered by increasing the dose until the nadir gets too low.
* the cat will return to high numbers for several hours in each cycle once the dose wears off.

See Saoirse's spreadsheet for 2014. In the early part of her treatment the vet we were registered with at the time insisted she eat Hill's w/d dry food which contains a completely INSANE level of carbs. She was on 3IU Caninsulin BID (aka Vetsulin).

Saoirse had a major Gi disturbance within 24 hours of starting the planned transition to low carb food and refused to eat any more of the high carb w/d. Not ideal. I wanted to reduce her insulin dose but the practice vet I sought advice from told me not to reduce. Like an eejit I followed his judgment instead of my own and Saoirse had her one and only symptomatic hypo that night (while she was still in the normal range - huge, steep drop).

Because of the less than desirable circumstances outlined above, if you look at the difference between Saoirse's BG levels before 13 July 2014 and afterwards you can see the massive, immediate iimprovement in her overall BG range that resulted from removal of the high carb food from her diet (and also why you need to reduce the dose when changing from a high carb load to a low one: Saoirse's insulin needs were also slashed).

We moved to our current veterinary practice shortly after Saoirse received her FD Dx, and our main vet asked an external feline diabetes specialist to review Saoirse's numbers while she was still on the w/d diet and 3IU BID of Caninsuiln. The FD specialist pronounced Saoirse a "true diabetic" with no hope of ever achieving remission. For the reasons outlined in the list above, had Saoirse stayed on the high carb diet, she'd probably have been right. Instead, following the switch to low carb, 4½ months after the FD specialist gave her prognosis - and 3 months after a switch to a longer-acting, gentler insulin - Saoirse proved her wrong. (((Saoirse)))

Back to Peeka and your questions. Yes, she may now need less insulin to stay in, say, the 150 range at nadir than she did when her food was high carb BUT that's not the end of the story. By greatly reducing the carbs in Peeka's diet you are also giving her a chance at achieving diabetic remission after a period of insulin treatment (no guarantees, but the high carb diet would preclude any chance at all - see what the FD specialist said about Saoirse above). Therefore, yes, it is much better to have reduced Peeka's dietary carbs, but it may take time for the benefits to materialise. Remember: marathon, not sprint.

The next stage will be to make a series of small incremental adjustments at regular intervals (usually 7 days, with a curve at the end of each week) until you get to the point where Peeka's nadir BG numbers are as low as they can be taken safely based on how Vetsulin works and as your circumstances will allow. As Peeka's regulation improves you should hopefully also see improvement in her clinical signs. As you accumulate more data you'll also be able to evaluate how effective this insulin is for her, notably what duration she typically gets and how high her BG levels rise when a dose wears off. If at that stage Peeka is spending too much time in higher numbers you might want to consider switching to a longer-acting insulin, although there is nothing preventing you from considering a switch earlier than that.


Mogs
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[Peter (Boo) (Peeka GA)]

Maybe make a weekly video of Peeka moving around? If you compare weekly changes it may help you to better determine her progress?

That may be the best option, every time I feel like we are making progress, I get home just to feel dejected again.

As Peeka's regulation improves you should hopefully also see improvement in her clinical signs.

I actually was looking into this earlier in the sticky for Vetsulin, her PMPS today was 306, hardly ideal, but still, lower than I’ve gotten before. If we can consistently get AMPS/PMPS below the 300 mark, is that how we go about maintaining her dosage or possibly decreasing it? And if we get those PS numbers at or below 300, is that a sort of turning point in seeing better visual results for Peeka regarding her neuropathy?

although there is nothing preventing you from considering a switch earlier than that

Our vet had mentioned having recently gotten Prozinc but we would essentially need to “start over” with dosage since we would need to see how her body would react. I know we have had success with Vetsulin with Boo, but would it be worth it to go ahead and make the switch for Peeka? And if we do decide to switch, would it be better to do it at a time where we can perform a curve, or have someone at home for extended periods of time?

Saoirse proved her wrong.

I’m very thankful to you and the Saoirse for learning all that you have and being able to impart this knowledge onto us, I truly have no idea where I would be without you all and I’m sorry to ask so many questions. I truly have learned so much in my less than a month here, and as I’ve said on others posts, I can’t wait to share our success stories with Boo and Peeka.

 

[Peter (Boo) (Peeka GA)]

Update: +3 Peeka was at a 191 and back in the blue!

 

[jt and trouble (GA)]

Dont worry about too many questions THATS what we are here for!
Peter you better get that straight. No question is too dumb even if it has been asked again and again. We will repeat until it sinks in. Its a HUGE learning curve remember? We've ALL walked in your shoes.

I LOVE the idea of the videos ! DO IT.

 

[Peter (Boo) (Peeka GA)]

I LOVE the idea of the videos ! DO IT.

The first few weeks are going to be very difficult to look back on if recent weeks are any indication. I do hope to start seeing progress though, especially if her numbers continue to lower.

 

[jt and trouble (GA)]

Dont think back think forward.