Question: 06/17 Bodie PMPS 646 +3 576 +6 570 AMPS 320

sadye claxton

Member Since 2020
Bodie has hit some serious highs over the past two weeks, but then come down. But in the last 4 days he's been super high. Vet said "increase to two units", so we did for a shot BUT I'm now refreshed on the SLGS method and am committed to get more readings to try and figure this dosing out. I was hesitant to not increase every time he got higher, but I'm reading "stick to a dose for 7 days no matter how high he gets". SO
1-any suggestions on what dose to stick with for the next 7 days?
2- do you think infection/illness could be an issue? He's acting fine. But he's prone to chronic ear infections. We medicated 4 weeks ago with ear meds that you put in his ears and don't clean for 3 weeks. I've been cleaning them. She also gave me an oral anti-fungal ( I can get the name) but after reading about kidney clearance issues and adverse effects on kidneys I'm hesitant to give them because he's also CKD and SUPER sensitive to meds. He can only tolerate about 15 mg of gabapentin without becoming comatose...when he was put under for his dental we almost lost him. Since he's not shaking his head or scratching I don't think this is the issue. But he's always got black wax in his ears.
-he did have "bubble gut" this am. Could hear his belly ( it happens sometimes ) and he isn't interested in food....pancreatitis? I gave him a Cerenia which helped and he ate. He's acting fine.

I am feeding him at 8 am with insulin, letting him eat what he wants off that bowl through the morning...usually gets another snack around 3pm, I pull uneaten food by 6:00. Then he gets 8pm food with insulin and then I put another snack down around 10pm for him to eat off during the night. This has been fine with his sugars overall, but wondering if I need to adjust this too..?

Suggestions on a dose to pick for next 7 days? And thoughts on illness I need to explore?
JUST DID A +5 amps it was 341
 
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Hi. I can't advise on dosing but wanted to say that you have on your spreadsheet that you are following TR not SLGS. If you are following SLGS please change your spreadsheet so folks can know what protocol you are using. Looks like the last three days you have been giving different doses. You are not supposed to do that but I'll try to get you some good help. @tiffmaxee or @JaxBenji
 
Summer is right that you are changing doses way too often now but before were holding the dose too long. Which method are you going to follow so we can make a plan going forward?
 
My apologies about the method..yes SLGS. I understand we've been doing the dosing wrong. Just so you know...we have been going by our vet's orders. I would never just adjust dosing myself without consulting with her. The dosing you see on our spreadsheet are all what she ordered us to do. That said, I obviously value this forum and everyone offering me their expertise and experience. SO we're going to veer off the vet's advise for now as it's obvious she's not really well studied on all of this. She's great but I'm looking for another in our area to consult with who has more experience with feline diabetes. It's quite the challenge though to find any vet without a 3 week wait righ tnow. THANK YOU ALL FOR YOUR TIME!!!
 
When Max diagnosed and I first joined, I was shocked that folks were giving me dosing advice. Fortunately my vet was versed in FD, but had never used a human meter. He wasn’t around when I needed help so I soon was following the guidance here. My vet was fine with that and told me I handled FD better than any client he ever had. He showed my spreadsheet to his third year vet students when they spent time at his office.

Lantus likes consistency. It’s dosed based upon how low it takes your cat and not the Amps/Pmps. You want the low points to be in the 10’s if possible or at least under renal threshold. That varies from cat to cat and is when sugar is in the urine. So you need some tests between +4-7 which I see you are now starting to do. Good job. I would continue that way and stick with 1.75 for 7 days unless he drops under 90 which would earn a reduction to 1.75. You started to see nadirs under 300 but then reduced which as not helping him. Keep asking questions and reread the SLGS directions. I would print them out as well as how to handle low numbers and what to do if you get a lower than usual preshot. You would stall, not feed, and retest in 2-30 minutes btw. Also pi’s for dosing advice when it happens.

Does this help? Keep asking questions. :bighug:There’s a lot to learn. We are here to help.
 
Hi Sadye,

Ruby has seen 5 different veterinarians in the last 9 months because of her various complications, and none of them have been as good with managing her diabetes as the accumulated knowledge of the members here on the FDMB. She came close to remission because of all of the guidance I've received here but sadly remission is probably not in the cards for her anymore because of the steroids she needs to be on. The moderators and senior members here have helped me and thousands of other caregivers get control of their cat's diabetes and hundreds who have achieved remission. One of Ruby's vets basically said keep doing what you're doing and I make all of her decisions with regards to the diabetes management the help of the kind people here.

Regarding health concerns, I have seen some kitties have higher numbers because of ear infections which make them difficult to regulate. Those black numbers could also make him not want to eat, as well as pancreatitis. Do you have Ketodiastix to check his pee for ketones?
 
Sadye, I hope that is your first name, you are in the right place on this site. Sometimes, vets do not really understand what is required to help a cat with diabetes. If you will post, everyday on this site, and provide all your testing information on the spreadsheet the folks on this site will be an enormous help in getting Bodie's glucose down. You are doing a good job of testing right now by getting those preshot test and at least one or two more during the am and pm cycle but you need to stick to a certain dose (1.75 units) for at least 7 days. If you switch to TR you can increase sooner and I would recommend that due to his high blood glucose. Bodie needs some help right now to get those numbers down. Will you stay with this group and let us help you?
 
I was looking at the Fancy Feast Shrimp and Fish Flakes and could not find them on the food chart. Do you happen to know how many carbs are in the can? Do you think Bodie might be interested in the Fancy Feast Classic Pates? They are pretty low carb and unless he has a pre existing kidney problem they would be good for a low carb food. What do you think? Do you want to try a can or two?
 
I'm not sure what general consensus is, but I've found more success with an Internal Medicine specialist to advise on diabetes.

I didn't even know that was a thing (never occurred to me) until Minnie's second hospital stay when an IM vet was looking after her and our primary vet said she would defer to the IM on diabetes (Minnie is a 'challenging case'). I wasn't happy with progress so got a recommendation from our primary vet, and scheduled in with a different IM. It was a 2 month wait but I got on a wait list and ended up only waiting a month. I think they are usually associated with animal hospitals, not a regular vet practice. Just something to consider!
 
I am so excited to read all the above comments this evening. I cannot thank you all enough for your help! You're truly Godsends!!!
 
When Max diagnosed and I first joined, I was shocked that folks were giving me dosing advice. Fortunately my vet was versed in FD, but had never used a human meter. He wasn’t around when I needed help so I soon was following the guidance here. My vet was fine with that and told me I handled FD better than any client he ever had. He showed my spreadsheet to his third year vet students when they spent time at his office.

Lantus likes consistency. It’s dosed based upon how low it takes your cat and not the Amps/Pmps. You want the low points to be in the 10’s if possible or at least under renal threshold. That varies from cat to cat and is when sugar is in the urine. So you need some tests between +4-7 which I see you are now starting to do. Good job. I would continue that way and stick with 1.75 for 7 days unless he drops under 90 which would earn a reduction to 1.75. You started to see nadirs under 300 but then reduced which as not helping him. Keep asking questions and reread the SLGS directions. I would print them out as well as how to handle low numbers and what to do if you get a lower than usual preshot. You would stall, not feed, and retest in 2-30 minutes btw. Also pi’s for dosing advice when it happens.

Does this help? Keep asking questions. :bighug:There’s a lot to learn. We are here to help.
YES! Helps a ton! We are getting on the 1.75 for 7 days now! To clarify...for the instructions that "if you get a lower than usual preshot... stall, not feed and retest", how far back to I pay attention to the pre-shot to gauge "lower than normal?" For instance, 10 days ago he was starting around 233 at times. IF he was that low in the next 7 days, does it still constitute a 1.75 dose? THANK YOU
 
I'm not sure what general consensus is, but I've found more success with an Internal Medicine specialist to advise on diabetes.

I didn't even know that was a thing (never occurred to me) until Minnie's second hospital stay when an IM vet was looking after her and our primary vet said she would defer to the IM on diabetes (Minnie is a 'challenging case'). I wasn't happy with progress so got a recommendation from our primary vet, and scheduled in with a different IM. It was a 2 month wait but I got on a wait list and ended up only waiting a month. I think they are usually associated with animal hospitals, not a regular vet practice. Just something to consider!
thank you for these thoughts!!
 
I was looking at the Fancy Feast Shrimp and Fish Flakes and could not find them on the food chart. Do you happen to know how many carbs are in the can? Do you think Bodie might be interested in the Fancy Feast Classic Pates? They are pretty low carb and unless he has a pre existing kidney problem they would be good for a low carb food. What do you think? Do you want to try a can or two?
he LOVES those fancy feast flavors...but when he was eating those he was having diarrhea at least 6 times a day, every day that wasn't controlled with metronidazole. Poor guy has been diagnosed with IBS and CKD as well..she's also mentioned pancreatitis. So for now he gets boiled chicken mixed with the Purina Dietetic Management Pate' and he's been normal with his stools without meds. I did get the EZComplete and add a little every now and then because the research on that seemed amazing for diabetic and CKD patients, but he's not always into it
 
Sadye, I hope that is your first name, you are in the right place on this site. Sometimes, vets do not really understand what is required to help a cat with diabetes. If you will post, everyday on this site, and provide all your testing information on the spreadsheet the folks on this site will be an enormous help in getting Bodie's glucose down. You are doing a good job of testing right now by getting those preshot test and at least one or two more during the am and pm cycle but you need to stick to a certain dose (1.75 units) for at least 7 days. If you switch to TR you can increase sooner and I would recommend that due to his high blood glucose. Bodie needs some help right now to get those numbers down. Will you stay with this group and let us help you?
Of course I'm going to stick with this group! I am SO thankful for all of you! I'll be keeping up the spreadsheet and posting questions. As of right now I'm familiar with the SLGS and committed to the 1.75 units for 7 days while we check. But I'll read up on TR ASAP too thank you
 
Hi Sadye,

Ruby has seen 5 different veterinarians in the last 9 months because of her various complications, and none of them have been as good with managing her diabetes as the accumulated knowledge of the members here on the FDMB. She came close to remission because of all of the guidance I've received here but sadly remission is probably not in the cards for her anymore because of the steroids she needs to be on. The moderators and senior members here have helped me and thousands of other caregivers get control of their cat's diabetes and hundreds who have achieved remission. One of Ruby's vets basically said keep doing what you're doing and I make all of her decisions with regards to the diabetes management the help of the kind people here.

Regarding health concerns, I have seen some kitties have higher numbers because of ear infections which make them difficult to regulate. Those black numbers could also make him not want to eat, as well as pancreatitis. Do you have Ketodiastix to check his pee for ketones?
I"m sorry to hear about Ruby! I am so thankful for this group. I do not have Ketodiastix but it's on my list to get tomorrow thank you
 
You might want to defer from the Fancy Feast Classic Pate if Brodie has CKD. Might not be a good idea to feed the Fancy Feast. I understand it is high in phosphorous which your boy does not need. So glad to hear you will be following this site. Truly, these folks are the best and I would trust them before I would trust my vet. Good luck, girl. We will all be looking to help and guide you. By the way, there are a lot of folks on this site that have kitties with CKD and they will be more than happy to help guide you. Good night.
 
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