Re: 11/8 PMPS 252 +2 228

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Re: 11/8 Maverick AMPS 311.4

Morning guys! Another pink kitty this morning? Well, hopefully they all get together and start talking about coming down to the lower floors .. anyways, have a great day!
 
Re: 11/8 Maverick AMPS 311.4

Hi Karrie! this is your 11th cycle on that 1.0u right? Wondering if it's time for a little increase...are you talking to your vet about his dose?
Here in LL we watch for all 5 Ps each day...our kitties are a lot more than just their BGs numbers...
P=Purring
P=Pooping
P=Peeing
P=Preening
P=Playing
We talk about the Whole Cat and report on how many Ps we notice during the day.
So, how is Maverick doing lately? :razz:
 
Re: 11/8 Maverick AMPS 311.4

No not talking to my vet yet. I'll call today. I'll read the protocol right before calling.

He seems to be doing just fine. The only thing was talking his head off last night. Just lying there having a conversation with no one. We lost the hour of sleep we gained thats for sure. He seems to do this when his numbers are higher. In the three weeks before we started insulin he was yapping more too. But it was mainly begging for food (increased appetite due to diabetes).

Thanks for replying.
 
Re: 11/8 Maverick AMPS 311.4

I re-emailed the vets office our Cdn spreadsheet and left a voicemail to call me about dosing.

From the protocol I see that it would be a .25 unit increase. Wishing thats what she'll say.
 
Re: 11/8 Maverick AMPS 311.4 - comments?

I'd love any comments you guys have before I speak with his vet tomorrow about dosing.

We went to the specialty food store today and got two cans of each variety which I'll post later. I will be giving him one with a ZERO carb in it tonight along with pure bites chicken dust to tempt him. With his high numbers he is back to begging for food over night so wishing hunger alone will get him to eat a food he would not eat normally. I also have fortaflora now if I have to use it I will. I'll force myself to get up every three hours for a reading.

I really messed up with the vet the first time I reduced his dose on my own the very first day with advice from the group. I do want to be as prepared as possible. Edit - and she was very displeased. Just want some feedback on what you guys think about the numbers I've gotten so far. It seems his nadir on 1.0 units is before 6 hrs. Does this change when doses are increased? I suspect yes.
 
Re: 11/8 Maverick AMPS 311.4 - comments?

hi...the only comment i have is hoping for a very good conversation with the vet for you today. don't have enough experience to offer anything more than support and good thoughts, but of those...we are sending you many!

celi & binks
 
Re: 11/8 Maverick AMPS 311.4 - comments?

Hi Karrie, I agree that according to the protocol, Maverick should increase by 0.25u.

The timing of the nadir doesn't have anything to do with dosing. Some kitties have an early nadir, some have a late nadir, most are somewhere in the middle of the cycle. Every cat is different (ECID) and we encourage you to figure out where your cat's nadir usually is because it makes it easier to get nadir checks and assess when he might be heading low and need intervention. Nadirs can move though, they are not always exactly at the same time every cycle.

I would suggest that you also email the vet the link to the Queensland Protocol so that she can see what you are looking at when talking about the increase. Most/Many vets only dose in full units, or half units at best! She may suggest a full unit increase, but if you send her the protocol, she may be more inclined to agree on a small increase. It often is helpful if you can provide the info ahead of time so that she has time to review it before talking to you. This protocol was developed by vets! Vets are more inclined to be receptive to what other vets have developed than "something you found on an internet forum." KWIM?
 
Re: 11/8 Maverick AMPS 311.4 - comments?

I'm nervous about sending her the protocol. I don't know how she will respond. But I will try and address it with her - maybe sending her an email first. I communicate much better in writing than I do orally. People seem to take me the wrong way - especially vets ;)

What I would say is I've been reading a lot on this protocol and that it is getting a lot of good reviews about kitties going into remission, especially those diagnosed within six months. And that I have .3ml syringes with half dosing and can do a .25 unit to see how he does. That combined with the fact that I'll be getting him on a food that doesn't affect his blood glucose the way the grocery store brands are. Do you guys know if there is additional feedback anywhere on this protocol done by professionals? I haven't looked.

I think she doesn't want to get into managing a patient doing the tight regulation protocol. So initially I'd be confident with lower numbers until she gets more confident with my ability to test and manage him without being a high needs patient. I'm quite confident in my abilities to manage him at home. If I get a job outside of the home, a tight regulation protocol may not be an option. Them posts about lows seem quite scary. If I'm at home to manage him like I am now its a non issue.

I will try and get more info for the +4+5 parts of the cycle to see what his numbers do.

Thank you for your feedback.
 
Re: 11/8 Maverick AMPS 311.4 - comments?

Karrie- I very much doubt your vet is going to be supportive. She's worried about liability or something. However, to me, it seems more prudent and more cautious to raise the dose a little than by 1U (which is what most vets do). Also, the NORMAL range for blood sugars is 40-120. Most vets just want their patients to be under 300. Most do not advocate for the low carb diet OR hometesting. Unfortunately, it is quite rare that ppl treat their cats for diabetes (esp. cats who go DKA first) and I THINK vets don't want to stress out clients by discussing tight regulation. They don't have time to do phone consults with us every time there is a dose adjustment needed.

So... you're gonna need to decide how to handle your vet... I think in the Health forum there are some stickies like "convert-a-vet" and stuff. Take a look!!

I didn't share my spreadsheet link with my vet, and I LOVE him. I just printed it once in awhile and showed it to him. He said "good job" and showed it to all the vet techs b/c he thought it was so cool and we never ever talked about dosing. He did mention that PERHAPS I tested too much (snort).
 
Re: 11/8 Maverick AMPS 311.4 - comments?

First off, I don't think you messed up. I do think Maverick was started on too high of a dose. In retrospect, I suspect your vet realized this, too.

So here's what I would anticipate your vet saying -- raise the dose either by -.5u or by 1.0u. And you already know that we would say that you should follow the protocol and raise by 0.25u. Have you brought or sent a copy of the protocol to your vet? You might want to do so -- you can both be on the same page then (hopefully). I've attached a pdf file that's from a vet journal and has the protocol included. Hopefully, the reprint out of a journal your vet should be familiar with will help.
 

Attachments

Re: 11/8 Maverick AMPS 311.4 - comments?

Thanks guys. I was waiting for the right time to send the protocol to her but I think one week in to his lower dose and only seeing her twice ever - I think I'd lean towards it back firing. Just a gut feeling based on our last conversation. She has a diabetic kitty of her own. I think I would be able to build the trust both ways but it isn't there yet.

What about if she asks me to upgrade to 1.5 - if I ask her if it would be okay to start with a few cycles of 1.25 so I can keep a closer eye on how he does with the lower carb working in conjunction with the small increase in insulin. Or if she says to do the 1.5 not do that right away - wait a few cycles on 1.25 on my own?

Ugh.
 
Re: 11/8 Maverick AMPS 311.4 - comments?

Karrie...Maverick is YOUR cat, not your vet's cat. I know you don't want to alienate her but I'm guessing that most of us here don't consult our vets on how we are dosing our cats unless it is a vet that (a) knows/understands/supports the protocol (b) a vet like mine who is interested in learning or (c) a cat has really high (dangerous) numbers. My vet has access to our SS and we often discuss what I am doing with Gracie but she admits she cannot provide me with the kind of guidance this group can and she wants to learn. The "start low, go slow" process is very valuable; I'm not a dose expert but I do know if you go overboard with a dose, you potentially put your cat in danger. An increase of .25u may do more than you think it does. For example, I can tell a difference in Gracie's numbers when I change her dose by a DROP. I never would have believed it but I am seeing it happen. Again, ECID. I think it is absolutely great that you are monitoring and that you are trying very hard to educate your vet...that is most admirable. But in the end...Maverick is your cat and the vet works for you. I really wish you the best with this.
 
Re: 11/8 Maverick AMPS 311.4 - comments?

Reading your condo brings back memories.

I had found a vet (the 3rd one) who agreed to see us and respect the choices I made about the diet change for Luna.
My vet originally wanted us to start at 1.50 or so, but after the rollercoaster ride we had on Caninsulin, I was too chicken, and took the advice from LL at the time, to start at .75u. Luna did have to go up to 1u for a little while, and back down again, all the way down to a fat drop.

My vet saw my spreadsheet, saw numbers improving and yes - did tell me I test too much.
We had an agreement, as long as I kept her updated, she would support my choices.
At the end, she saved our file as an example for her other clients. :-D

So yes to working with your vet - it is hard, and intimidating, but as others have said, your cat is your cat. You are the client.
Keep them updated on kitty's progress. Show them the protocols, maybe direct them to Dr Lisa's Feline Nutrition website too.
 
Re: 11/8 Maverick AMPS 311.4 - comments?

I do think you may be able to manipulate the situation if she suggests an increase to 1.5u.

Let her know how spooked you were those first few days. You were really, really scared. You were so glad she suggested withholding insulin for a few days and really appreciated her suggesting that you start Maverick at a lower dose. Claim to not be confident yet and you're just getting the hang of things. And, with your schedule, not being able to be around 24/7, you're just scared. I'd even ask her will she be available after hours if something happens at that dose? What should you do? etc., etc., etc. You don't want to bother her. You don't want to be a pest. You know she has a busy practice.. Would she be OK with you're starting a little slower so you aren't so panicky?

I suspect if the vet feels that you are taking her needs into consideration, you'll be met with a whole lot less resistance. And if she says you can't measure 0.25u or she insists, ignore her. Like Marjorie said, Maverick is your cat.
 
Re: 11/8 Maverick AMPS 311.4, PMPS 252 (after no carb food)

You guys really are the best! I think of all the people doing this alone that haven't had an amazing forum to draw on for information and support. I will prepare in advance, I don't wing things well. I will have a plan for tomorrow. Thank you everyone who responded. It means a lot to me. I will post tomorrow on how it goes. I would like to keep her as a vet and learn to work with her. She handles Maverick like a pro, allows us to home test and recommended lantus right off the bat. She knows Maverick couldn't have been managed at her office. It will be a learning experience for me and training in assertiveness.

So Maverick has eaten about 2.5 oz of evo 95% chicken and turkey - with 0 carbs tonight. I put some purebites chicken in the magic bullet and it made a great dust. He licked it a couple times without the dust and then ate more with the chicken dust. Even eating this post 6+ his readings dropped to 14! That low carb food by presidents choice has to be misleading. I dont think they are accurate at all.

I will wake up every three hours to see what his readings are with the 0 carb food. I bought other foods ranging from 0 to 5% today also - a couple wellness varieties, almo nature (not a complete diet but to supplement), cowboy cookout. Just getting him to eat this food will be a challenge though. He just loves that purebites chicken though.

Hugs to all of you.
 
Re: 11/8 Maverick AMPS 311.4, PMPS 252 (after no carb food)

Hi Karrie
You have the big guns rooting for you here so I will just chime in agree with what has
been said.
Macerick is your kitty and you are the holding the syringe.
I went through 4 vets and not one of them supported anything I was doing with
regards to Max's dosing.
One vet told me I would never get him in remission.
Another vet told me to stop hometesting (okay they all did)
anothe vet told me to increase himfrom 5.5 to 6.5 at one shot
Max's last does was 6 before he came down the dosing ladder.

Max has been OTj since April, thanks to this board!

Yes its great to have vet support but in the end, he is your baby and we know you are
devoted to him.

BTW I am done with the world ss.
I am having someone test it out and then I will get it to you.
 
I would love that spreadsheet when you have it available. That was so cool of you to take it on and try and get one working again. I couldn't figure out how to get the formatting to work in google spreadsheet. It kept reverting to template formatting no matter what I did. Thank yoU!!!
 
klkelly said:
What about if she asks me to upgrade to 1.5 - if I ask her if it would be okay to start with a few cycles of 1.25 so I can keep a closer eye on how he does with the lower carb working in conjunction with the small increase in insulin.
Click to expand...
I think this is right on the money. Changing diet and dose at the same time can result in a big change all at once. Remember the motto, "start low, go slow."
 
I believe you can do this Karrie. I know it won't be easy for you, but look her in the eyes and speak from the heart. you've received great suggestions in here tonight. We're all in your corner and we'll be waiting to hear how it goes.

In the end, not only are you the one holding the syringe, you're the one holding the checkbook.

good luck tomorrow.
 
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