Sam's First Year on Tresiba!

[Sam & Esse]

Hello


I can hardly believe it's been a year since Sam started Tresiba! A year ago it seemed impossible that Sam would ever be regulated; now we're whispering behind our hands the magical "remission" word and keeping our fingers crossed. He still has a ways to go -- and he might not actually get there -- but he's currently at a .75u dose, and we never thought we'd get to this point. Yay!


We switched away from the AT2 to a human meter a few months ago, although we have a vial of AT2 strips in reserve just in case. It's amazing to us how incredibly level Sam's BG#s are. I did set Sam's dose reduction number to below 60, since I have a deep suspicion that the Tresiba depot may very well be active for five, or even six days after a dose change. It's mostly a gut feeling, but it's keeping Sam safe


Sam himself is doing good: very happy, very purr-y, and rolling in dust and debris every chance he gets! I've not yet been able to get a handle on his weight, however. He's getting between 211 and 247 calories a day, his latest weigh-in put him at 21.6 lbs, and I measured his sitting height from floor to the top of his shoulder at 15 inches and length from nose to base of tail at around 21 inches Maybe my math is all wrong, I just don't know... I'm going by the formula 13.5 times 15 (estimated perfect weight) plus 70 = 272.5 calories per day.


I do, though, have an appointment with a new vet this upcoming Tuesday! Have my fingers crossed for this, as well lol! I'm hoping she can shed some light on this big big boy problem. Will also be discussing the rusting/graying issue with her. Right now I've figured he's getting roughly 43-45% of his calories from protein, but maybe he needs even a bit more. Otherwise Sammi is doing absolutely wonderful! I'll post lab results once I have them.


Jill, I'm about at the point of trying to add raw in with Sam if he'll accept it. I was checking out the Food Fur Life website today Which reminded me that Sam's been on Tresiba for a year, and I should really let everyone know how he's been doing! But I like that the product can be added to cooked meat, since Sam loves himself some chicken (or salmon, or tuna, or tilapia... but I'm really trying to keep him to chicken).


Since I can't get a current picture of Sam without him covered in what seems to be half the backyard, I'm putting up a picture of him as a kitten that I painted on a rock Oh, I remember those day fondly!

 

[Jill & Alex (GA)]

Just got back from vacation... what an FANTASTIC update!!!

Preshot numbers look great! You know me, I like to see a few more mid-cycle spot checks just to make sure he doesn't drop too low, but the few mid-cycle spot checks look good so far! I know I sound like a broken record, but safety is always my biggest concern.

I did set Sam's dose reduction number to below 60, since I have a deep suspicion that the Tresiba depot may very well be active for five, or even six days after a dose change. It's mostly a gut feeling, but it's keeping Sam safe

Given the circumstances, setting the reduction number a bit higher helps. I'm glad you did that.

That's an interesting observation about the depot. If I wanted to be sure the Lev depot didn't come into play with Alex, I waited for 5 cycles after a dose adjustment. It really helps us know what to do next when we can identify these responses in our cats.

Sam himself is doing good: very happy, very purr-y, and rolling in dust and debris every chance he gets! I've not yet been able to get a handle on his weight, however. He's getting between 211 and 247 calories a day, his latest weigh-in put him at 21.6 lbs, and I measured his sitting height from floor to the top of his shoulder at 15 inches and length from nose to base of tail at around 21 inches Maybe my math is all wrong, I just don't know... I'm going by the formula 13.5 times 15 (estimated perfect weight) plus 70 = 272.5 calories per day.

You know, I've always found that formula to be far too generous for Alex. I know others have found the same. It's probably an ECID thing... almost like with humans. You might want to gradually feed a little less until you see some weight loss.

I do, though, have an appointment with a new vet this upcoming Tuesday! Have my fingers crossed for this, as well lol! I'm hoping she can shed some light on this big big boy problem. Will also be discussing the rusting/graying issue with her. Right now I've figured he's getting roughly 43-45% of his calories from protein, but maybe he needs even a bit more. Otherwise Sammi is doing absolutely wonderful! I'll post lab results once I have them.

43 - 45% of his calories from protein isn't bad. I think it's Dr. Lisa who says at least 40%. I'm kind of curious about the rusting, too.

The best part of your entire post: "Sammi is doing absolutely wonderful!" I love it!

Jill, I'm about at the point of trying to add raw in with Sam if he'll accept it. I was checking out the Food Fur Life website today Which reminded me that Sam's been on Tresiba for a year, and I should really let everyone know how he's been doing! But I like that the product can be added to cooked meat, since Sam loves himself some chicken (or salmon, or tuna, or tilapia... but I'm really trying to keep him to chicken).

I'll tell ya, that Food Fur Life EZ Complete is freakin' awesome! I used to make 30 pounds at a time of my own raw and add all the supplements in Dr. Lisa's raw food recipe, but not any more. Food For Life is so darn quick and easy! Now I make small batches often. Besides my cats being fed well... I now have my freezer back! It's nice to see people food in it rather than being filled with cat food! LOL! I've never tried it with cooked meat, but I know others have served it with great success!

Love seeing his picture... even if it's on a rock!

Thanks for stopping by with an update! It's so good to hear from you and I love hearing how Sam is doing!
Please stay in touch...

 

[Sam & Esse]

Hi Jill!

I hope you had a wonderful vacation!

Sam went to see his new vet today I think everything went good. Everyone in the office was very, uh, impressed with what a big boy Sam is. The doctor's recommendation was to actually increase Sam's daily calories; she suggested 295 kcal per day for an ideal 15# weight (looking at the notes she made right now). But I don't think I can bring myself to do that She did think upping Sam's protein a bit more might help with the rusting (barring anything popping up in the blood work). So I just ordered the sample of the EZ Complete. Sam does still get 12 grams a day of Dr. Elsey's dry as a treat; I'll see if I can talk him into believing the EZ Complete works even better as a treat. (The doctor didn't like seeing the dry on his feeding list, not at all But she was very nice about telling me to ditch his remaining spoonful.) If I can't wean Sam off his sinful spoonful, perhaps I'll see if he'll accept an ounce of raw in place of an ounce of his Friskie's. That should also tip the protein balance closer to 50%. I think. Haven't done the math yet.

You know, I've always found that formula to be far too generous for Alex. I know others have found the same. It's probably an ECID thing... almost like with humans. You might want to gradually feed a little less until you see some weight loss.

This makes good sense. I'll try subbing in a bit of raw first (or partially cooked), then try cutting back from there once (if) the change is accepted.

It was interesting that the doctor mentioned several times that some cats are just big. I'm not sure if she was just doing her best to make me feel better about my lack of progress with Sam's weight, or if she was picking up on my worry that something metabolic is going on with the boy... Or if, with her knowledge, Sam is a big boy and not as badly overweight as I fear. Very doubtful about that, though lol!

I'll be posting Sam's labs to his SS once I get them in a few days Hopefully everything's still good!

And I had forgot to mention in my update a bit of information that might be important about Tresiba. Sam was on the last pen of his first 5-pack when his dose went up to 2.25u. That pack of pens had an expiration date of October 2019, so they should have still been fine. However, when I started the first pen of the new pack (expiration in 2020) I had to decrease Sam's dose back to 2u immediately. It could be coincidence, or it could be that the insulin in the older pen was losing efficacy before its expiration date. It's something to look for in the future, as the pens in this newer pack get older. It might also have some bearing that I lost power several times last summer, and although I kept his pens as cool as possible, the slightly warmer temps on a few days might have affected the insulin later on, shortening its shelf-life.

And here is a pic from today, of Sam in his beloved yard after rolling in the dirt to wipe off all the nasty vet cooties Some of his rusting and greying is visible here. ...And lots of dust.

 

[Sam & Esse]

Hello all!

Well, one of the vet tech's called me yesterday to tell me that Sam's labs look good, with the exception of high eosinophils. Suggestions were flea control medication, which I turned down because there's been zero signs of fleas, or fleabites (on any of the cats, or myself). A broad spectrum dewormer, which I'm considering, although there hasn't really been any indication of wormie-worms. A fecal exam, which so far Sam hasn't handed to me Maybe after the holiday weekend. She said it could be allergies, which would make sense since Sam's been having that problem with the rash/sores breaking out on his face and ears periodically -- but didn't offer any solution for that. Yet. Then near the end said that while the blood was at the lab that they could do a heartworm test, but that I had to let them know by the end of the day.

There's no mosquitoes where I live; never seen one here in over 4 decades, certainly never been bitten by one, but I did a bit of quick research before calling back to decline the heartworm test. I figured since the tech didn't mention anything about basophils, I didn't need to worry about heartworm.

Then I picked up the physical copy of his labs today... And I don't know if I made the wrong call for Sammi I've got all of the new labs entered in his SS, if anyone could take a look? @Marje and Gracie If you have the time to look, do you see anything concerning?

I just can't help but be worried; his WBC differential doesn't seem quite right to me, but I am a worry-wart.
There's also an ugly triglyceride number I have no idea where that came from. I'm... just going to ignore that one. Yep.

 

[Sharon14]

I hope all is well with Sam and his bloodwork. He’s a beautiful cat!

Oh and I want to know where one has to live to have no mosquitoes or fleas! I have mosquitoes, fleas, fire ants, horseflies, deer flies, gnats.....pretty much anything that sucks blood or Injects venom.

 

[Marje and Gracie]

Here’s a quick assessment.
Albumin: can be high from dehydration
Triglycerides: can be high if he’s eaten recently. Usually an accurate triglyceride must follow at least a six hour fast.
Monocytes: can be high due to stress from a vet trip and his are very mildly elevated.
Lymphocytes: his are just barely low but definitely different than before. has he had any steroids recently?
Eosinophils: so, yes, parasites but also allergies can raise this. Allergies to food or pollen, also asthma, etc can raise this. Other things as well such as IBD or mast cell tumors but it’s unlikely. A recent study (2018) done by the Winn Feline Foundation indicated the most common causes of increased eosinophils are (in this order): Internal or external parasites, feline allergic dermatitis, feline asthma, and eosinophilic gastrointestinal disease.

My own cats have had elevated eosinophils and neither my vet nor I get too concerned about it because they are entirely indoor cats, we don’t have any fleas or mosquitos around here, and usually when we see it is in the springtime when there’s a bunch of stuff floating around and we have the windows and doors open.

 

[Sam & Esse]

@Marje and Gracie Thank you so much! This relieves much of my worry, and gives me a better idea of what to discuss with Sam's vet this next Tuesday. He does get supervised play outside, so I'll go ahead with the fecal test just in case, but he's in a middle of one of his bouts of getting little bumps/sores on his face, and the vet did write it down in her notes as allergic dermatitis. The only steroid he's ever gotten is in the topical Tresaderm; I last gave it to him at the end of February, then tossed the bottle because it was affecting his numbers more than I was comfortable with. I think I'll try my best to find out what he's allergic to, rule out intestinal parasites with the fecal exam, and then get a mini panel ran in... maybe six months?

There is a note in the lab report that 'Albumin may be lower than reported due to a Hemolysis 2+, Lipemia 1+ but is still Abnormal.' But if it is a little lower, than it is probably about the same as his previous tests.

Thank you again! Have a fantastic weekend and holiday!

@Sharon14 I hope so too; Marje explaining what the results might mean has me feeling much more positive now. And one of Sam's nicknames is Mr. Handsome Pants lol! He's too funny, right after he gets brushed and he knows he's looking good It's adorable, his catwalk strut.

Oh and I want to know where one has to live to have no mosquitoes or fleas! I have mosquitoes, fleas, fire ants, horseflies, deer flies, gnats.....pretty much anything that sucks blood or Injects venom.

Yikes! I'm in the high desert, and I think there's just too little humidity for most of the year for the mosquitoes and fleas. Twelve or so years ago a neighbor did bring in poultry fleas, which were horrible. But after about a month and a half, they disappeared. The only critter I really worry about is rattlesnakes, but it's been years since I've seen one of those on the block, either. Well, and a tick still shows up occasionally. I'm not sure who drags them in; I always blame whichever neighbor has most recently gone camping

 

[Marje and Gracie]

There is a note in the lab report that 'Albumin may be lower than reported due to a Hemolysis 2+, Lipemia 1+ but is still Abnormal.' But if it is a little lower, than it is probably about the same as his previous tests.

You’re welcome!

It’s not unusual for samples to be hemolyzed or have lipemia but it can affect some values. I wouldn’t worry about the albumin.

 

[Sam & Esse]

I found an interesting article recently. Although I don't agree with their conclusion that Toujeo would be better for cats than Tresiba. Toujeo's duration was about 16 hours compared to Tresiba's 11... But that means Tresiba can be dosed twice a day for full 24 hour coverage, but Toujeo would likely only be given once a day for safety, and there'd be an 8 hour window of decreasing to almost no coverage

https://ce.vetmed.ucdavis.edu/sites...pdfs/NotesGilor--WhatsNewInCanieAndFeline.pdf

The Exenatide Extended-Release in cats section was worth a second reading. While for now it doesn't look like a feasible treatment for diabetic cats, I'm really interested in how it might possibly extend remission in diabetic cats. Then again, it might prove to be too much for a newly healed pancreas to handle. There are so many different things that have to be considered when treating feline diabetes -- it really is a monstrous, multi-faceted illness.

 

[Sam & Esse]

Since I've still been puttering around the internet looking to see if there's been any new research/studies/trials with Tresiba and extra-sweet kitties...
https://www.stlouisvma.org/wp-content/uploads/GSLVMA-11.2018-Diabetes-Willis-Mahn.pdf

A rather interesting power point presentation that took place at the end of last year. Wish I could have heard the full presentation I'd really like to know how, if Toujeo does eventually get prescribed to a diabetic cat (unlike the poor "purpose-bred non-diabetic cats" used in the study -- and that phrase actually brought me to tears) how an owner is supposed to measure out a dose of a u300 insulin. The presentation does go on about the supposed benefits of the pen needles over syringes, but as Sam just earned another decrease to .5u... pen needles just aren't the way to go when treating feline diabetes. I wish the researchers pushing this trend would take a step back and view the bigger picture. There's a page devoted to hammering in the fact that 60% of 1u doses by syringe are inaccurate -- but no mention made of how inaccurate that dose would be using a pen needle that's either improperly primed, or pulled too soon, or just didn't enter correctly. Let's see figures and research on that!

Somogyi effect is now termed Insulin-induced hyperglycemia. And I think this also includes what the FDMB has known for well over a decade (or is it closer to two now?): Too much insulin can look like too little.

Then, the part of the presentation that was a bit scary: 75% of hypoglycemic events are unrecognized, and that most events are associated with no clinical signs -- but may still lead to neuroglycopenia. I'll need to study up on that, but gosh, it doesn't sound good. I've read a few times over the past year on the board that if there's no signs of hypo, then it's just a low bg event. There's a need to monitor, and to steer, but it's not an emergency. Now I'm wondering if we need to worry a bit more about dips below the take-action threshold -- or if this is another case of the researchers making assumptions without the full facts or real-life experiences to back up the statement.

Hmm. Me, I'm going to be celebrating Sam's dose decrease, and keeping my fingers crossed that it holds! Go Sammi!
...and, we might have managed to get a half a pound off of my dusty sack of Sammi potatoes That's a good start!

 

[Tracey&Jones (GA)]

Sam looks like my Libby. Her mane has gone brown as well and she now has 1 white whisker.

 

[Sam & Esse]

Libby is beautiful! I hope we're able to figure out a cause behind our color-changing black kitties I've upped Sam's protein, but it'll be months at the soonest before I can tell if it's helping. Sam's new vet has no idea why so much white/grey was appearing, though.

 

[Jill & Alex (GA)]

I'm glad Marje was able to look at Sam's labs and put your mind at ease!

I found an interesting article recently. Although I don't agree with their conclusion that Toujeo would be better for cats than Tresiba. Toujeo's duration was about 16 hours compared to Tresiba's 11... But that means Tresiba can be dosed twice a day for full 24 hour coverage, but Toujeo would likely only be given once a day for safety, and there'd be an 8 hour window of decreasing to almost no coverage

https://ce.vetmed.ucdavis.edu/sites...pdfs/NotesGilor--WhatsNewInCanieAndFeline.pdf

I also found this article interesting. All along I've been seeing similarities between what you've been finding with Tresiba and Levemir. It was good to hear the observation justified.

I hope to see someone try Toujeo one of these days. I am very curious to see what kind of duration it offers our diabetic cats.

A rather interesting power point presentation that took place at the end of last year. Wish I could have heard the full presentation I'd really like to know how, if Toujeo does eventually get prescribed to a diabetic cat (unlike the poor "purpose-bred non-diabetic cats" used in the study -- and that phrase actually brought me to tears) how an owner is supposed to measure out a dose of a u300 insulin.

My current understanding of Toujeo:
Toujeo (U300 glargine) is supposed to last up to 40 hours in humans.

• Study results are showing positive outcomes with U300 performing the same in controlling blood glucose as insulin glargine but with less hypoglycemia during the day and night.
• U300 is based on the glargine molecule but requires a smaller volume of SQ injection
• U300 demonstrates a flatter and longer PK/PD profile than that of insulin glargine
• contrary to popular belief, U300 Toujeo and U100 Lantus doses are converted 1unit : 1unit (https://www.toujeopro.com/toujeo-insulin-dosing-and-titration-calculator)

That sheds a new light on measuring from what we originally thought/assumed.

It *sounds like* Toujeo is more concentrated (requiring less volume than Lantus) and the 'higher concentration' is what makes it last longer. Of course, I can't verify since I've yet to see it in use with diabetic cats.

The presentation does go on about the supposed benefits of the pen needles over syringes, but as Sam just earned another decrease to .5u... pen needles just aren't the way to go when treating feline diabetes. I wish the researchers pushing this trend would take a step back and view the bigger picture. There's a page devoted to hammering in the fact that 60% of 1u doses by syringe are inaccurate -- but no mention made of how inaccurate that dose would be using a pen needle that's either improperly primed, or pulled too soon, or just didn't enter correctly.

Using pen needles is known to be more accurate when drawing up to 5 units. However, as mentioned, not being able to make dose adjustments in increments of 0.25u is a problem when dosing our kitties. While I agree it's certainly possible/probable that up to 60% of 1u doses by syringe are inaccurate, you make good points wondering how accurate the dose would be using a pen needle that's either improperly primed, or pulled too soon, or just didn't enter correctly. Heck, we've even found measurable discrepancies in syringes themselves!

Somogyi effect is now termed Insulin-induced hyperglycemia. And I think this also includes what the FDMB has known for well over a decade (or is it closer to two now?): Too much insulin can look like too little.

Ha! Interesting.

Then, the part of the presentation that was a bit scary: 75% of hypoglycemic events are unrecognized, and that most events are associated with no clinical signs -- but may still lead to neuroglycopenia. I'll need to study up on that, but gosh, it doesn't sound good. I've read a few times over the past year on the board that if there's no signs of hypo, then it's just a low bg event. There's a need to monitor, and to steer, but it's not an emergency. Now I'm wondering if we need to worry a bit more about dips below the take-action threshold -- or if this is another case of the researchers making assumptions without the full facts or real-life experiences to back up the statement.

Hypo unawareness has also been a concern of mine from the very beginning of this journey with Alex. However, when processing the above, I think it's very important to take into account all protocols/methods geared to regulating our diabetic cats were written for use with meters calibrated for humans. That creates a bit of a cushion since human meters yield results lower than pet-specific meters. This can be especially important for those attempting to tightly regulate their cat's blood sugar.

Cushion aside, it drives me crazy and I get upset when I see caregivers take a nonchalant approach when kitties are running in the 20s and 30s because the cat 'isn't showing any symptoms of a hypo'. As far as I'm concerned, when kitty is running that low it's time to get those numbers up and get them up NOW. Things can go south in an instant and neurological damage can be done before it's ever seen.


Sam is looking great... BG numbers and down a half pound! How's his ear healing?
I'm curious to see if upping the amount of protein in his diet takes care of the 'rusting'. When I was reading up on solutions to the rusting I came across info saying the white/grey is part of the aging process.

 

[Sam & Esse]

Hi Jill

My current understanding of Toujeo:
Toujeo (U300 glargine) is supposed to last up to 40 hours in humans.

• Study results are showing positive outcomes with U300 performing the same in controlling blood glucose as insulin glargine but with less hypoglycemia during the day and night.
• U300 is based on the glargine molecule but requires a smaller volume of SQ injection
• U300 demonstrates a flatter and longer PK/PD profile than that of insulin glargine
• contrary to popular belief, U300 Toujeo and U100 Lantus doses are converted 1unit : 1unit (https://www.toujeopro.com/toujeo-insulin-dosing-and-titration-calculator)

That sheds a new light on measuring from what we originally thought/assumed.

It *sounds like* Toujeo is more concentrated (requiring less volume than Lantus) and the 'higher concentration' is what makes it last longer. Of course, I can't verify since I've yet to see it in use with diabetic cats.

I'd be very interested if anyone decides to try Toujeo in treating their diabetic cat. Measuring dose is the biggest hurdle I see. The smaller Toujeo pen is 1.5ml, and holds 450 units. So a unit of Toujeo is only a third of the size of a unit of Lantus. I liked the comparison drop sizes on the Toujeo site A person would either have to be skilled with using digital calipers, or would need to use the pen needles and deal as best they can with changing doses a full unit at a time. I actually gave this quite a bit of thought. An insulin that minimizes hypoglycemia, and that has an extended duration, might (and I say this guardedly) be more forgiving of full unit adjustments.

A very large positive that Toujeo has over Tresiba is that insulin glargine is already known to be safe and effective in felines. A bit odd, though, that it usually takes a higher dose of Toujeo to achieve the same (relative) level of control as Lantus. Then I began wondering if larger doses of Toujeo sting less than the same dose of Lantus, since there would be a smaller volume of insulin. I might go check out some of the human diabetic boards to see if this is mentioned anywhere

Hypo unawareness has also been a concern of mine from the very beginning of this journey with Alex. However, when processing the above, I think it's very important to take into account all protocols/methods geared to regulating our diabetic cats were written for use with meters calibrated for humans. That creates a bit of a cushion since human meters yield results lower than pet-specific meters. This can be especially important for those attempting to tightly regulate their cat's blood sugar.

Cushion aside, it drives me crazy and I get upset when I see caregivers take a nonchalant approach when kitties are running in the 20s and 30s because the cat 'isn't showing any symptoms of a hypo'. As far as I'm concerned, when kitty is running that low it's time to get those numbers up and get them up NOW. Things can go south in an instant and neurological damage can be done before it's ever seen.

I keep Sam's SS visible so people that are interested can see how he's doing on Tresiba, but I'm always worried that someone new (or newer) to FD will look at it and think that the minimum that I'm testing Sam is actually okay when it's not. I'm trying the best I can, but anyone that can test more, should. I've considered putting a warning on Sam's SS that only testing preshots isn't safe or acceptable if it can at all be helped... Good idea?

I do wish vets weren't pushing the AT2 so hard. Over the past year I've noticed an increase in people posting because they're a little bit worried about their cats BG#, but it takes several posts (or several hours later) for someone to realize that it's an AT2 being used, and those "okay, not too low" numbers are actually an emergency. I'm so glad my new vet is fine with human meters. I told her I still have the AT2 and an unopened vial of strips in case of emergencies, and she said there was no need, she understood the different ranges because when she was treating her diabetic cat, a human home meter was all she had

Sam is looking great... BG numbers and down a half pound! How's his ear healing?
I'm curious to see if upping the amount of protein in his diet takes care of the 'rusting'. When I was reading up on solutions to the rusting I came across info saying the white/grey is part of the aging process.

Thank you for asking! His left ear (and now his right) is taking a bit longer to heal than I'd like. I tried getting the Halo Cloud Nine salve, but Amazon and Chewy are both out of it, and my computer security isn't liking the company's website. When I try to go, it automatically closes the page saying it's detecting potentially harmful script. I'm blaming the recent changes Chrome made For now I'm still using Neosporin and trying to keep Sam's ears clean, but he's not helping with his constant rolling in dust and debris. At least they seemed a little less sore this morning.

In regards to his rusting, I figure I'll be patient and see if the higher protein has helped when he grows in his winter coat in November. Although I'm starting to feel like Sam's made the decision that he wants to be a ginger instead of a black cat lol!

 

[Jill & Alex (GA)]

I'd be very interested if anyone decides to try Toujeo in treating their diabetic cat. Measuring dose is the biggest hurdle I see. The smaller Toujeo pen is 1.5ml, and holds 450 units. So a unit of Toujeo is only a third of the size of a unit of Lantus. I liked the comparison drop sizes on the Toujeo site A person would either have to be skilled with using digital calipers, or would need to use the pen needles and deal as best they can with changing doses a full unit at a time. I actually gave this quite a bit of thought. An insulin that minimizes hypoglycemia, and that has an extended duration, might (and I say this guardedly) be more forgiving of full unit adjustments.

OR... one could try diluting Toujeo for ease in measuring.

From the Insulin Care & Syringe Info: Proper Handling, Drawing, Fine Dosing sticky in the Lantus, Basaglar, & Levemir ISG:

The manufacturers do not recommend diluting Lantus and Levemir. However, some human diabetics and caregivers of diabetic cats have diluted Lantus or Levemir without any apparent problems. See the section "Administration of small doses of glargine and detemir: dilution and insulin dosing pens" in the attached file, "Management of Diabetic Cats with Long-acting Insulin": management of diabetic cats.pdf

Personally, I wouldn't want to have to dilute the insulin prior to every shot, but it sounds like you'd almost have to. I think back to those early mornings when I was half asleep and feeling rather cross-eyed at that while I was attempting to draw a dose!

A very large positive that Toujeo has over Tresiba is that insulin glargine is already known to be safe and effective in felines. A bit odd, though, that it usually takes a higher dose of Toujeo to achieve the same (relative) level of control as Lantus. Then I began wondering if larger doses of Toujeo sting less than the same dose of Lantus, since there would be a smaller volume of insulin. I might go check out some of the human diabetic boards to see if this is mentioned anywhere

I wondered about the possible "sting" factor myself.

I'm trying the best I can, but anyone that can test more, should. I've considered putting a warning on Sam's SS that only testing preshots isn't safe or acceptable if it can at all be helped... Good idea?

I hadn't given it much thought, but good idea! At the very least it'll make some stop and think.

I do wish vets weren't pushing the AT2 so hard.

You and me both!

Everyone is so wrapped up in buying the best meter for 'accuracy'. They haven't yet reached the point where they realize 'accuracy' is not important... and they certainly don't believe you when you tell them... especially when their vet is also telling them otherwise.

I tried getting the Halo Cloud Nine salve, but Amazon and Chewy are both out of it, and my computer security isn't liking the company's website.

I recently found out Halo has discontinued making the salve. I'm really disappointed because I loved that stuff! A few members have been able to find a container or two left in stock at random places, but it's truly hit or miss. I hope his ears heal quickly!

 

[Sam & Esse]

Hi Jill!

OR... one could try diluting Toujeo for ease in measuring.

Thank you for linking that info! I read over it several times over a period of about a week. I completely agree with you; I wouldn't want to be trying to measure out a proper syringe full before every shot. If they could recommend mixing in the vial, that would be easier, but in the syringe? It would mean drawing out at least an exact amount of ...saline?... after pulling up your insulin, then shaking the syringe to make sure they mixed, then releasing the excess to the correct line... All the while hoping your math was right And my math is seldom right. Especially not before the sun's up lol!

I hadn't given it much thought, but good idea! At the very least it'll make some stop and think.

I added the warning to Sam's SS. It looks good And is, thankfully, the only pink showing this year

After much debate, I got Sam his vaccines on June 26th. Big mistake. The spike in his numbers was horrifying, and there was much praying going on that the deregulation was temporary. He still has a lump the size and shape of my thumb on his left hind leg which has me worried. I'm fairly certain that leg is the one that got the rabies; the vets around here really don't want to write exemptions, but I can't justify putting Sam through this again. If Sam's SS doesn't convince the vet to write him an exemption 3 years from now, I'll just keep paying Sam's license without providing proof of vaccination -- and keep that lock on my gate secure so animal control can't come knocking at my door. Hopefully it won't come to that

Thankfully Sam's BG#s came down. As did his dose. And down went his dose again. And now... I'm not sure if he's ready for an OTJ trial, but I don't think my hands are capable of doing a 'needle juice' shot. We've now skipped two shots, and it'll be really interesting to see what this evening's PMBG (or PMPS) will bring. And since I don't really know how long a Tresiba depot may last, I'm not sure if an OTJ trial for Sam should last for 14 days, or maybe a touch longer.

What has really surprised me is that these low numbers have appeared around the 4th of July -- and it's been sounding like an absolute war zone here. The bombardment started Wednesday night, and it hasn't let up yet Add the two earthquakes and the aftershocks, and every critter in this house has been stressed I'll need to find a way to post the video of the earthquake; the indoor cam was centered on Sam, and the poor boy just looks so confused about it... Until I do that, here's Sammi laying outside this morning, wondering why it's already so hot

 

[Jill & Alex (GA)]

After much debate, I got Sam his vaccines on June 26th. Big mistake. The spike in his numbers was horrifying, and there was much praying going on that the deregulation was temporary. He still has a lump the size and shape of my thumb on his left hind leg which has me worried. I'm fairly certain that leg is the one that got the rabies; the vets around here really don't want to write exemptions, but I can't justify putting Sam through this again. If Sam's SS doesn't convince the vet to write him an exemption 3 years from now, I'll just keep paying Sam's license without providing proof of vaccination -- and keep that lock on my gate secure so animal control can't come knocking at my door. Hopefully it won't come to that

Vaccines! That's a tough subject for me whether the cat has diabetes or not. I think vaccines are also an issue for my vet, but I've never pushed the subject with him. It's something we no longer talk about.

They do require rabies vaccinations where I live, but they don't check/enforce the law. After a lot of research, soul-searching, and having titers done, I've opted not to inoculate knowing a titer does not satisfy the legal requirements nor does it negate the risks involved. It's very much a personal decision and my decision is not for everyone.

Keep an eye on that lump.

And now... I'm not sure if he's ready for an OTJ trial, but I don't think my hands are capable of doing a 'needle juice' shot. We've now skipped two shots, and it'll be really interesting to see what this evening's PMBG (or PMPS) will bring. And since I don't really know how long a Tresiba depot may last, I'm not sure if an OTJ trial for Sam should last for 14 days, or maybe a touch longer.

How exciting!!! The best advice I could possibly give you is to play it by ear. There's nothing magical about 14 days. See how things go. You might find it helpful to get a spot check in here and there to make sure his numbers are staying down. He may or may not need a little more support... even an occasional tiny dose. If he does, give it to him and go on from there. If he doesn't, all the better!

What has really surprised me is that these low numbers have appeared around the 4th of July -- and it's been sounding like an absolute war zone here. The bombardment started Wednesday night, and it hasn't let up yet Add the two earthquakes and the aftershocks, and every critter in this house has been stressed I'll need to find a way to post the video of the earthquake; the indoor cam was centered on Sam, and the poor boy just looks so confused about it... Until I do that, here's Sammi laying outside this morning, wondering why it's already so hot

Interesting on the timing. Although, some cats do react to stress with a drop in BG numbers. My mentor here on the FDMB had a diabetic kitty whose numbers would drop during a vet visit. Pam's Stasha would drop into the 20s at the vet's office when on insulin! ECID is no joke!

Sorry you had to deal with the earthquake and it's aftershocks. I have family out there and they're still a little nervous about all that's been going on. I sure hope the worst is over.

Sammi's looking so good!
Wishing you the best of luck whether his OTJ trial has started or not!

 

[Sam & Esse]

Hi Jill!

Vaccines! That's a tough subject for me whether the cat has diabetes or not. I think vaccines are also an issue for my vet, but I've never pushed the subject with him. It's something we no longer talk about.

They do require rabies vaccinations where I live, but they don't check/enforce the law. After a lot of research, soul-searching, and having titers done, I've opted not to inoculate knowing a titer does not satisfy the legal requirements nor does it negate the risks involved. It's very much a personal decision and my decision is not for everyone.

Keep an eye on that lump.

I'm keeping close track of the lump. I'm going to give it one more week, then call the vet about it. A lump that size just isn't right; it can't be. Last year I skipped all of Sam's shots because his health was too poor. This year, going into the new vet's office, there were signs everywhere that if your cat came in without current rabies, it wasn't leaving without the vaccine. Luckily the doctor agreed with me to see what Sam's blood work showed before making a decision. Of course, when the blood work came back, she felt there was no reason to delay Sam's shots any further. I could have skipped the other boosters, but Sam loves going outside and rolling around in the dirt and the feral population here has increased drastically this last year. (The feral colonies seem to have population booms every few years, actually. The people supporting the colonies, though, absolutely refuse to TNR. I keep printing out the paperwork and taking it to them; maybe one of these times they'll realize what a blessing TNR actually is.)

If Sam was indoor only, or if he didn't do his best to carry half a cubic yard of the yard on himself each time he goes out to play... It was a hard decision, and I have regrets -- but with as sickly as the ferals are looking, I think I would've ended up with regrets either way.

How exciting!!! The best advice I could possibly give you is to play it by ear. There's nothing magical about 14 days. See how things go. You might find it helpful to get a spot check in here and there to make sure his numbers are staying down. He may or may not need a little more support... even an occasional tiny dose. If he does, give it to him and go on from there. If he doesn't, all the better!

Sounds like good advice to me! I'm cheering Sam on! I've pulled up the OTJ trial guidelines to read again (and again), and it turns out that my mind had shifted the ranges a bit since the first time I'd read them. I had the understanding of 'Mostly under 100, with only a few readings in the 100-120 range' when what I actually want to see is 'Most readings in the range of a non-diabetic cat, 50-80, with an occasional higher reading'. That alone could be the difference between a strong or weak remission. I don't mind restarting insulin if Sam starts running in the 90s up... I'd just need to do some tests with the syringes and water to see how big of a droplet I'd need to release from a .1 dose to approximate needle juice.

Interesting on the timing. Although, some cats do react to stress with a drop in BG numbers. My mentor here on the FDMB had a diabetic kitty whose numbers would drop during a vet visit. Pam's Stasha would drop into the 20s at the vet's office when on insulin! ECID is no joke!

Oh my! As far as I know, vet stress has always raised Sam, but I can imagine that different types of stress can have different effects. It must be terrifying, to have your cat come in so low at the vet, and know that your cat will raise and be fine once you get it home -- but the vet wants to keep the cat and put it on a glucose drip.

Sorry you had to deal with the earthquake and it's aftershocks. I have family out there and they're still a little nervous about all that's been going on. I sure hope the worst is over.

I hope your family is okay! I haven't put anything back up on the walls yet -- or put the car into the garage. All of Cal Tech's probabilities are for a week... so I'm going to give it a week

Thank you so much for writing! It's a little lonely in the Tresiba ISG I really appreciate you keeping an eye on me and Sammi

 

[Jill & Alex (GA)]

I'm keeping close track of the lump. I'm going to give it one more week, then call the vet about it. A lump that size just isn't right; it can't be.

And it may be nothing at all, but it's good to have it checked out.

... but Sam loves going outside and rolling around in the dirt and the feral population here has increased drastically this last year.

Yep, that definitely makes a difference. Mine are indoor cats only by choice. We have too many different species of predators around here for going out to be safe. My feelings wouldn't be the same if they were able to be outside.

(The feral colonies seem to have population booms every few years, actually. The people supporting the colonies, though, absolutely refuse to TNR. I keep printing out the paperwork and taking it to them; maybe one of these times they'll realize what a blessing TNR actually is.)

That's weird! I don't understand their thinking.

Sounds like good advice to me! I'm cheering Sam on!

As am I!!!!

I've pulled up the OTJ trial guidelines to read again (and again), and it turns out that my mind had shifted the ranges a bit since the first time I'd read them. I had the understanding of 'Mostly under 100, with only a few readings in the 100-120 range' when what I actually want to see is 'Most readings in the range of a non-diabetic cat, 50-80, with an occasional higher reading'. That alone could be the difference between a strong or weak remission.

Yes! There's a big difference and I'm glad you noticed. Many members don't.

I don't mind restarting insulin if Sam starts running in the 90s up... I'd just need to do some tests with the syringes and water to see how big of a droplet I'd need to release from a .1 dose to approximate needle juice.

I've found that's the best attitude to have when dealing with feline diabetes. Don't get me wrong... having a cat go OTJ is absolutely wonderful and a huge bonus no matter how long it takes, but once we get past all the excitement and hoopla... having a cat who feels good, is healthy, and living the best and longest life possible because his blood sugar is controlled... well, isn't that the ultimate goal?

Micro dosing can be challenging. I did a lot of micro-dosing (mostly in the way of dose adjustments) with Alex... so much so that my vet and I spent more than one occasion laughing hysterically about it. What one calls the dose is not important. What's important is relatively simple. All one has to do is attempt to replicate the same dose over and over again. That said, all we can do is try our best. Given the variability with food and insulin absorption* on any given day that are beyond our control... I realized accuracy and exactness were not as important as we seem to think. This removed so much stress and allowed me to become relaxed about eye-balling minute dose adjustments. This is when it all came together for us.

Oh my! As far as I know, vet stress has always raised Sam, but I can imagine that different types of stress can have different effects. It must be terrifying, to have your cat come in so low at the vet, and know that your cat will raise and be fine once you get it home -- but the vet wants to keep the cat and put it on a glucose drip.

Luckily, Pam and her vet had developed a good working relationship. He understood what was happening.

I hope your family is okay! I haven't put anything back up on the walls yet -- or put the car into the garage. All of Cal Tech's probabilities are for a week... so I'm going to give it a week

I've been loosely following Dutchsinse on Youtube. Some think he's a quack, but he has quite the track record in predicting areas where earthquakes are likely to strike in the near future. His methods are intriguing. He also thinks the area will be in the clear (for now) if nothing happens through the 11th. I hope so for all your sakes!

Thank you so much for writing! It's a little lonely in the Tresiba ISG I really appreciate you keeping an eye on me and Sammi

You're welcome!
I know it's not the same as writing, but people do seem to be interested based on the number of views your threads have received. Sometimes people are shy or don't know what to say. If anyone is following, please take a minute to say hello and cheer Sammi on!

Thinking out loud... I'm really surprised more haven't tried Tresiba yet.



ETA:
* insulin absorption: studies have shown in humans that there can be up to a 50% variance in insulin absorption from cycle to cycle.

 

[Chubba (GA)]

Go, Sam, go! You’ve got this! So exciting!

 

[Bellasmom]

Beautiful cat

 

[Tracey&Jones (GA)]

Wow...that is amazing! You got this Sam!

 

[Julie and Honey]

Great news! Had never heard of this insulin until Jill mentioned it. Good to have options for our furry children.

Out of curiosity googled the fur color change and there can be several reasons, but one is protein level, so you may be on to something there...

Good you know his labs are in good shape and don’t have to worry about some of the other reasons for fur color change.
https://www.vetknowhow.co.uk/blog/why-is-my-black-cat-turning-reddy-brown


Or maybe he is just rolling in some red clay dust

 

[Bobbie And Bubba]

Wonderful news! We will have our fingers and paws crossed for you and Sam!

 

[Sam & Esse]

Hi Jill!

I've found that's the best attitude to have when dealing with feline diabetes. Don't get me wrong... having a cat go OTJ is absolutely wonderful and a huge bonus no matter how long it takes, but once we get past all the excitement and hoopla... having a cat who feels good, is healthy, and living the best and longest life possible because his blood sugar is controlled... well, isn't that the ultimate goal?

Absolutely! And it's not like there's any kind of deadline for Sam to meet I admit I feel a little sad for cats with humans that greet the diabetes diagnosis with, "Well, we're going on vacation in three months so this needs to be taken care of by then." Yikes! Me, I tell Sam, 'You keep doing you, bobo.' And... I'm still pretending to give Sam his shot twice a day. The first skipped shot, he sat in his 'pokey-pokey' chair pouting, letting me know loudly I forgot part of our routine.

* insulin absorption: studies have shown in humans that there can be up to a variance of 50% in insulin absorption from cycle to cycle.

That makes an incredible amount of sense, and certainly helps to explain some fluctuations. I use the Carepoint veterinary syringes -- and there's a lot of variation on the placement of their marks. I've gotten fairly good at consistent doses, but the .1 dose was at the limit of my ability to see, even with my lighted magnifiers. Maybe later today I'll practice getting a consistent drop out of the .1 dose, so I'm prepared if Sam needs a little support

I've been loosely following Dutchsinse on Youtube. Some think he's a quack, but he has quite the track record in predicting areas where earthquakes are likely to strike in the near future. His methods are intriguing. He also thinks the area will be in the clear (for now) if nothing happens through the 11th. I hope so for all your sakes!

I'll need to go look! Thank you for linking; I like learning about any and all types of earthquake prediction.

Thinking out loud... I'm really surprised more haven't tried Tresiba yet.

Honestly, it's surprised me as well. I tried Tresiba because Sam was declining on Lev, and switching to Lantus wouldn't work if Sam's reaction to Prozinc was any indication. Maybe it's just a case that more experienced users already have their cats well regulated on the Ls, and for less experienced users, switching to Tresiba might be too daunting. Unless someone follows one of the dosing guidelines from the LB&L ISG, there's no one to offer dosing advice specifically for Tresiba. That's... a really large deterrent.

 

[Sam & Esse]

Go, Sam, go! You’ve got this! So exciting!

It is exciting! Thank you I honestly never really expected Sam to get to this point, but I luv my lug no matter what

Beautiful cat

Thank you! When he's feeling especially pleased with himself, we call him Mr Handsome Pants

Wow...that is amazing! You got this Sam!

Hello! Thank you from me and Sam!

Great news! Had never heard of this insulin until Jill mentioned it. Good to have options for our furry children.

Out of curiosity googled the fur color change and there can be several reasons, but one is protein level, so you may be on to something there...

Good you know his labs are in good shape and don’t have to worry about some of the other reasons for fur color change.
https://www.vetknowhow.co.uk/blog/why-is-my-black-cat-turning-reddy-brown


Or maybe he is just rolling in some red clay dust

It is good to have options; the more weapons in our arsenal against feline diabetes, the better! And I hope Sam's journey provides hope to others that might be having trouble regulating their kitties and are running out of options.
I'd like to believe he's in to red clay, but all the dirt here is... kind of golden once it dries. Except for when he rolled in the dust left over from me putting down Rainbow Pink landscaping rock. --Then, he was pink on top of his red lol!

Wonderful news! We will have our fingers and paws crossed for you and Sam!

Thank you! I'm so happy for Sam, and even if it turns out that his OTJ trial is completely successful, we never thought he'd be doing so well as he is. It's been a true blessing.


Thank you everybody for writing and liking. I had no idea so many people were keeping track of Sam's journey. Thank you all so much!

 

[MrWorfMen's Mom]

Another member of your fan club here to cheer you and Sam on! This is so exciting!

Go Sam!

 

[Olive & Paula]

This is exciting. And Sammie is gorgeous rust, dirt and all.

I have a full jar of Halo if you want it (for shipping cost) Olive had reaction to it. Just PM me.

 

[JeffJ]

You have done a stellar job of regulating and taking care of your sweet kitteh Sam. I really like the pics too. Who cares if he is a bit overweight, I think he looks gorgeous.

Fingers crossed for the potential OTJ. That is so very exciting.

 

[Red & Rover (GA)]

Your thread is a fascinating read. I learned an incredible amount. Your dedication is amazing. Thank you.

Sammie is incredibly gorgeous. He's big, not fat.

I had a long-haired tuxie decades ago that went brown in his middle age but only noticeable in the sun. The vets at the only clinic in town at the time told me that it was a combination of sun and saliva. (They were not great vets and didn't care much.) He was with us for 18 years and not sick a day in his life until a very quick end (vet shrug: 'probably liver'), with the exception of dental treatments due to the occasional tooth left in the occasional dog who thought it was greater than.

I hope the OTJ trial is a success. And do keep posting. The information and research will help many kitties to come.

 

[nslade001]

Just saying hi
Sam's looking great with love, Nikki

 

[Sam & Esse]

I cannot express how much it has meant today, everyone coming by to wish Sam well! I've teared up several times this afternoon -- and Sam's been giving the funniest looks over my blubbering. FDMB truly is one of the greatest groups of people in the world. Thank you all so very, very much.

Drat, I'm crying again.

Another member of your fan club here to cheer you and Sam on! This is so exciting!

Oh, I love the graphic! Thank you! I haven't let my hopes get too high yet... but it really is exciting!

This is exciting. And Sammie is gorgeous rust, dirt and all.

I have a full jar of Halo if you want it (for shipping cost) Olive had reaction to it. Just PM me.

Thank you And Sam agrees that he is gorgeous I can tell him the fridge seems to be running a tad warm, and he'll tell me what does it matter, he's gorgeous lol! And thank you for the offer of the Halo! You and Olive's Dad have been in my prayers. If you don't mind, I'll PM you in a few weeks, when things are hopefully much less hectic for you all

You have done a stellar job of regulating and taking care of your sweet kitteh Sam. I really like the pics too. Who cares if he is a bit overweight, I think he looks gorgeous.

Fingers crossed for the potential OTJ. That is so very exciting.

Thank you! That you think I've done well -- it means so much coming from you, because I've seen all the love and dedication you gave to your sweet Leo. I hope you don't mind that you, Theresa and Little Dude have also been in my prayers this past week. Leo touched the hearts of so many people, and although I never posted, through your posts and pictures I am grateful I got to know him. Thank you for letting us share in his life, and now share in your grief

Your thread is a fascinating read. I learned an incredible amount. Your dedication is amazing. Thank you.

Sammie is incredibly gorgeous. He's big, not fat.

I had a long-haired tuxie decades ago that went brown in his middle age but only noticeable in the sun. The vets at the only clinic in town at the time told me that it was a combination of sun and saliva. (They were not great vets and didn't care much.) He was with us for 18 years and not sick a day in his life until a very quick end (vet shrug: 'probably liver'), with the exception of dental treatments due to the occasional tooth left in the occasional dog who thought it was greater than.

I hope the OTJ trial is a success. And do keep posting. The information and research will help many kitties to come.

I'm glad my thread has provided some information about Tresiba I do feel bad that I couldn't follow one of the dosing protocols, as that would have given even better information, but a little knowledge is better than none.
And thank you for saying Sam's just big I had an (ex) vet be not so complimentary, but his new vet also thinks Sam is mostly just -- big

It's really interesting, that it seems like the rusting of black on cats is maybe more widespread than reading on the internet led me to believe. It would be nice if there were better, more definitive answers about it.

Just saying hi
Sam's looking great with love, Nikki

Hi Nikki! Thank you for looking in!

 

[JeffJ]

 

[Red & Rover (GA)]

I do feel bad that I couldn't follow one of the dosing protocols, as that would have given even better information, but a little knowledge is better than none.

Innovation, with research and knowledge behind it one day leads to its own protocol – this we have seen many times in this forum. You are an innovator.

 

[Olive & Paula]

PM anytime your ready.

 

[MrWorfMen's Mom]

Great start to Day 4.

 

[Sam & Esse]

Innovation, with research and knowledge behind it one day leads to its own protocol – this we have seen many times in this forum. You are an innovator.

Thank you! Although for the longest time, it felt like the balance was tipped more towards desperation than innovation in trying to get Sam feeling better. I do hope future Tresiba users are able to build on the observations I was able to make with Sam.

Great start to Day 4.

Yay! Thank you I think Sam would get a kick chasing after toys if they looked and moved like these adorable cheerleaders

Sam seems to be settling deeply into the 70s. I'm hoping he stays in this range, and doesn't keep slowly creeping up. I have a feeling that today may have been the last of the Tresiba depot. I need to try to get a mid-cycle reading from him tomorrow like Jill suggested, or perhaps a reading 3 hours after his breakfast to see how much his BG might be fluctuating, and/or how much his pancreas is working. I'm -- cautiously hopeful It's a bit unreal, that my boyo that I was so grateful just to have regulated might be going into remission. Not quite ready to pinch myself, yet

 

[Sam & Esse]

Good morning!

I'm not really happy with Sam's morning number of 98 I'll be doing my best to get a late morning reading to see if it's come down. It was a hard night with the boy, that started with him deciding to take over my spot in bed -- and slapping at me when I tried to scoot-scoot him over Sure, he was purring the entire time, but my boyo has the paw-size of a bobcat. Or it seems that way to me, when he's got the claws spread wide for swatting. Sam was vocal and restless the entire night; basically, he threw a 7-hour long temper tantrum, complete with tearing at the carpeting, body-slamming the closed hallway door, and jumping up to head-butt me a little harder than was needed A play session would quiet him down for a bit, then he would start back up with the caterwauling. In the SS notes yesterday I remarked that Sam seemed off somehow... Last night really drove that home.

This morning Sam's happy, ravenous, and is hunting with the laser focus of a cat that wants to tear something apart I'm putting on shoes, because he's eyeing my toes a little too intently lol!

 

[Jill & Alex (GA)]

I tried Tresiba because Sam was declining on Lev, and switching to Lantus wouldn't work if Sam's reaction to Prozinc was any indication. Maybe it's just a case that more experienced users already have their cats well regulated on the Ls, and for less experienced users, switching to Tresiba might be too daunting. Unless someone follows one of the dosing guidelines from the LB&L ISG, there's no one to offer dosing advice specifically for Tresiba. That's... a really large deterrent.

I often forget how members now arrive here with a set of directions on how to use the insulin they're giving their cats listed at the top of every forum.

There were NO stickies in the ISGs when I joined the FDMB. All we had was those who were experienced with other insulins encouraging us to move ahead slowly and cautiously. There were two dosing methods available at the time. However, Dr. Jacquie Rand's/Dr. Rhett Marshall's TR Protocol was deemed far too risky for use on the FDMB and the German TR Protocol wasn't talked about much. I didn't know too much about the German method until I contacted Kirsten Roomp... shortly before Alex went OTJ.

I'm not really happy with Sam's morning number of 98

Not bad, but i understand. Don't let it ruin your day! One day at a time...

It was a hard night with the boy, that started with him deciding to take over my spot in bed -- and slapping at me when I tried to scoot-scoot him over Sure, he was purring the entire time, but my boyo has the paw-size of a bobcat. Or it seems that way to me, when he's got the claws spread wide for swatting. Sam was vocal and restless the entire night; basically, he threw a 7-hour long temper tantrum, complete with tearing at the carpeting, body-slamming the closed hallway door, and jumping up to head-butt me a little harder than was needed A play session would quiet him down for a bit, then he would start back up with the caterwauling.

Wow, I wonder what was up with him!

This morning Sam's happy, ravenous, and is hunting with the laser focus of a cat that wants to tear something apart I'm putting on shoes, because he's eyeing my toes a little too intently lol!

Hope all goes well. Have a good day!

 

[Sam & Esse]

Hi Jill

I often forget how members now arrive here with a set of directions on how to use the insulin they're giving their cats listed at the top of every forum.

There were NO stickies in the ISGs when I joined the FDMB. All we had was those who were experienced with other insulins encouraging us to move ahead slowly and cautiously. There were two dosing methods available at the time. However, Dr. Jacquie Rand's/Dr. Rhett Marshall's TR Protocol was deemed far too risky for use on the FDMB and the German TR Protocol wasn't talked about much. I didn't know too much about the German method until I contacted Kirsten Roomp... shortly before Alex went OTJ.

It must have been harrowing, ten and twenty years ago, to have your cat diagnosed with FD -- and after frantic searching to find the haven of FDMB. I want to imagine a Wild West type atmosphere, with a 'shoot from the hip' mentality, but I know that instead there must have been a slow, methodical approach to developing directions. Trial, and error, and always always careful monitoring.

Now, there is a wealth of knowledge in the stickies... and too many vets berating diabetic cat caregivers for listening to Dr Google and crazy cat people

When Sam was diagnosed, I immediately went searching for information. From the Feline Diabetes website I came here... and read every sticky in the Prozinc forum. Then I read every post in the Prozinc forum going back about a year and a half. Then I went to the main forum and devoured the stickies there, and while I slowly worked my way back through about a year of posts, I alternately read the stickies in the other ISG forums. (I do admit, the daily posting in L&L was daunting at first, but the stickies, and the index of links are invaluable.) I still try to reread at least one sticky/info link every few days, because my mind has a very bad habit of wanting to shift information into something it thinks is proper. I suppose the situation is along the lines of 'Witnesses make the worst witnesses.'

We owe the early trailblazers both at the FDMB and elsewhere a huge debt of gratitude

Wow, I wonder what was up with him!

Me, too Taking a lot of java to keep going today. Sam, though? He's zonked out under the air, belly up and paws up in the air. He's got no worries today lol!

Not bad, but i understand. Don't let it ruin your day! One day at a time...

Yes. Sam decided he wanted a second breakfast, so the pancreas-check test got pushed back to +4. And it was wonderful to verify that, yes, his pancreas is working, even if Sam himself is zonked and zombified in the presence of AC. So happy to see that 61 --I'm not sure if +4 is the proper way to phrase it, since he's not getting insulin, but I'm kinda stuck in a 12-hour cycle mode. A few days ago, when my Aunt asked when I'd be by, I told her by +7. What's worse, I guess I've been using this way of telling time long enough that she didn't need to ask me to explain myself!

Hope all goes well. Have a good day!

Thank you! I hope your day is as lovely as mine will be hot So, a very lovely day!

 

[MrWorfMen's Mom]

Happy Day 5!


Sounds like Sam was trying to party last night! LOL!

 

[Sam & Esse]

Sounds like Sam was trying to party last night! LOL!

Lol! At least last night was a little quieter; Sam waited until 4 am before going on his bender this morning. Well, I suppose this shows how good and spunky he's feeling!

 

[Camille and Cyclone]

Looks like a celebration may be in your future. Sending a pm!

 

[Jill & Alex (GA)]

It must have been harrowing, ten and twenty years ago, to have your cat diagnosed with FD -- and after frantic searching to find the haven of FDMB. I want to imagine a Wild West type atmosphere, with a 'shoot from the hip' mentality, but I know that instead there must have been a slow, methodical approach to developing directions. Trial, and error, and always always careful monitoring.

The latter describes the atmosphere purrfectly! It was pretty much the same when Levemir came into the picture.

Yes. Sam decided he wanted a second breakfast, so the pancreas-check test got pushed back to +4. And it was wonderful to verify that, yes, his pancreas is working, even if Sam himself is zonked and zombified in the presence of AC. So happy to see that 61 --I'm not sure if +4 is the proper way to phrase it, since he's not getting insulin, but I'm kinda stuck in a 12-hour cycle mode. A few days ago, when my Aunt asked when I'd be by, I told her by +7. What's worse, I guess I've been using this way of telling time long enough that she at you +7 didn't need to ask me to explain myself!

Wonderful news! He's right back on track.

I have to laugh at your +7 comment! There was a time when those kind of comments were the norm in our family. Even our older grandchildren spoke to us in +hours!

Lol! At least last night was a little quieter; Sam waited until 4 am before going on his bender this morning. Well, I suppose this shows how good and spunky he's feeling!

Awww, that made me smile. Hearing about any of our diabetic kitties feeling good and feeling spunky is heart warming to my very core!


Keep on keepin 'on! Sammi's looking good!
Goooooooooooooooooooooooooooo Sam!!!

 

[Sam & Esse]

Looks like a celebration may be in your future. Sending a pm!

Thank you! I hope I didn't go too overboard.

Wonderful news! He's right back on track.

I have to laugh at your +7 comment! There was a time when those kind of comments were the norm in our family. Even our older grandchildren spoke to us in +hours!

It's an excellent way of keeping track of time. I think... it also really represents how our days and nights revolve around our kitties. And by breaking the days down to one cycle at a time, it makes things seem much more manageable. At least to me.

Keep on keepin 'on! Sammi's looking good!
Goooooooooooooooooooooooooooo Sam!!!

Sam's still insisting he needs his 'mojo' shot. I forgot last evening, and he yowled from his pokey-pokey chair until I wised up. I'm using a feeding syringe to pretend -- and Sam's amazed that I've gotten so good that he's not able to feel a thing

 

[MrWorfMen's Mom]

Whoo Hoo! HAPPY DAY 6 !!!
Here are some kitties to party with Sam when he's feeling frisky!

 

[Amanda and a Loudogg]

Hiya Esse! Sam is looking absolutely FANTASTIC!!! Happy Day 6!!!! I just read through this thread and I absolutely LOVE the amount of research and information you provide! You're a gal who takes after my own heart. I'll keep checking in and sending good pancreas vines for Sam!

 

[Sam & Esse]

Here are some kitties to party with Sam when he's feeling frisky!

Oh, I love love love! that graphic! Kitty struts have to be one of the most adorable sights in the world. Thank you!

Hiya Esse! Sam is looking absolutely FANTASTIC!!! Happy Day 6!!!! I just read through this thread and I absolutely LOVE the amount of research and information you provide! You're a gal who takes after my own heart. I'll keep checking in and sending good pancreas vines for Sam!

Hi Amanda! Thank you for looking in! I'm sure Sam appreciates the cheering on, too His response is happier snores during nap time

The tiniest bit higher this morning at 82, but I figured if I had tested him a few more times, one of the tests would've come in at 79 or below... I'll try to get in a midday test today to make sure he's backed down like he should.

Something I've been curious about lately is the long-ago days when lente and ultralente were used to treat FD. The few bits I've been able to find describe them being excellent for sugar kitties -- then they were discontinued in favor of NPH and the newly released Lantus (for use in humans; as far as I can tell no consideration was given to the cats using them). Does anyone around at the time remember if Lantus -- when it began being used for cats -- worked better, the same, or worse for our sugar kitties? It had to have been a huge shake-up, regardless. The historian in me is just really, really curious Any existing threads from that time?

 

[Sam & Esse]

Hello

Sam's still doing good. Even better, he slept more these last two nights. I like sleep, he likes sleep; sleep is good lol! There's been a steep spike in his appetite that I can't account for, though. His weigh in is supposed to be this morning -- I'm waiting for him to finish with the 'important business' before I bring out the scale

The bad lump from his rabies shot has gone down, although it's not completely gone yet. I'll keep checking it several times a day. I keep a sheet of paper where I squiggle a blob on how the shape and size feels to me so I don't have to second guess my memory.

I hope everyone has a great week!

 

[MrWorfMen's Mom]

HAPPY DAY

!!! Go Sam!

So glad to hear he's quieted down at night and letting you get some sleep. Hope the lump keeps improving!