Sam's new plan

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KristenP&Sam

KristenP&Sam

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So, Sam is home from the vet's and rather full of himself at the moment. He had a constant low of 60-70 for several readings today, which the vet thinks I would have had too if not for the free feeding. Here's what's going to happen:

I'm going to stick to a feeding schedule (8:30 am and pm) for at least 30 days (her set time, not mine) to help get him regulated. My other cats are going to hate this, but if I have to feed them in another room, I will. Tonight, I'm going to check Sam's bg before bed. If it's over 300, I'm going to shoot 1 unit, if it's under, no insulin. Then recheck bg in the morning around 8:30 am (before his 9am shot) and call her with the reading. She'll make a determination as to what dosage for that shot. They want me to only check his bg's for amps, nadir and pmps. She firmly believes she can get him regulated in 30 days and into remission in a few months, if it's going to happen at all. We're sticking with the Prozinc for now too.

She brought up Somogyi's almost right away and says she doesn't think that's what's happening, although it's always a possibility. She also has no problem with me switching to the U100 syringes if need be.

I'm going to give this new course of action a chance and see what happens. As for now, I have to give Sam his sub-q's and finish my work for the day. Will be back later to nose around. If the rest of the cats haven't gnawed me to death from lack of food. ;o)
 
Sounds like what she has planned for you is a little "sliding scale" dosing... which is just fine. Do continue to test those ketones - especially periods during/following a dose decrease. Do make sure he's got food out [especially at night]!

I'm basically fine with what she said except the difference between 1u and 2u is quite large [and 2u IMHO is maybe a little too much insulin right now even at a PS of 500]. So in this sort of situation I might have wanted to take a little more nuanced approach. But it sounds like she is totally on board with you and is willing to help you even on a supper immediate basis. So sounds good and will hopefully keep you out of too much trouble. Your vet needs to be very commended for being willing to stand behind you like that.

Interesting that she does not feel rebound is happening but is basically advising a dose decrease [if anything]. hehe I remain skeptical of rebound too.
 
I'm happy. Sam's not, as he and the other cats are now circling me like vultures, crying like they're near death with starvation. (I need an eye rolling smilie.) Did I mention I'm supposed to call her every morning with Sam's amps?
 
You are one incredibly fortunate mama bean! I wish my vet was 1/100th as supportive as yours!! Good luck with the new plan. Charlie would eat ME if I only fed him twice a day!!
 
Jack has tried to cut me off at the ankles twice already, once launching a mid-air attack that, if he weighed anything, might have actually taken me down. This is going to be an exciting process... lol
 
Just tested Sam's bg at 9pm after eating at 8:30pm - 116 I'll retest before I go to bed (the way I was supposed to but forgot out of habit). Hopefully it stays low.
 
If 9pm doesn't mean much to you, you might want to get watch. ;o)

Sam's SS is updated. Just gave him his AM shot, however, I don't think I got it all in because there was some wetness on his fur that was definitely insulin. Vet says just to check his +6 bg and we'll go from there. Since he doesn't have any food out today, I'm not super worried about it. (I might just check his bg at +2 anyway to make myself feel better.)
 
I think what Gator meant was that being in a different time zone your 9pm is different than his 9pm.

That is why we post bg #'s with +'s, injection time is AMPS, that starts the cycle clock, +1 is 1 hour after injection, +4 is 4 hours after injection. That way someone in a different time zone knows exactly where that bg you post was in your 12 hour cycle.

It's interesting that your vet is insisting on twice a day feeding vs free feeding. I've been looking at a new clinic here and have been asking questions about their FD protocol and that is something they insist on too, twice a day feedings, no more free feeding. So that's the second time I've heard that in the last few weeks. The theory is that you already have a compromised P so why stress it every few hours by letting them eat, if they eat only twice a day their P can rest for a longer period of time.

Gator, as our resident nutritionist, what do you think of that.
 
I don't know about that theory. Doesn't mean it doesn't have credibility.

All I know is free feeding worked for us. And much like testing before every shot is is hard to imagine not always having food available for a cat to eat [and try to self correct] if they get into trouble [when their BGs go to low]. But the is just my opinion, I'm sure there are many here that do do timed feeding here for different effects. But the probably test more than just the PS and nadir and have specific goals they are trying to achieve with that timed feeding [and I'm unsure of their timed feeding plan].

I'm sorry I mis-read the feeding schedule thing before. :oops: I thought she said to continue free feeding. I'm sorry. Yea I kind of disagree with that especially in light of what actually happened at the vet where they had to feed her.

Also although this is about normal cats, Small Animal Clinical Nutrition 4th ed [the old ed.] says that normal cats should eat 10-20 small meals thought the day and night. You cat is a DM cat so [and has other issues]

Here the link to the partial chapters of SACN 5th ed:
http://www.markmorrisinstitute.org/inde ... &Itemid=82
I'm not really feeling up to combing through there to find an appropriate quote currently. But the cat chapters [or the partial ones that are available] are good background info.

None of the vets I've visited with have suggested I change the free feeding thing I was doing, in fact quite the opposite.

So your vet must have a good reason for it - no need in speculating. You should ask her exactly why she says to do that. It's her responsibility to make you comfortable. :smile:

The one exception to free feeding is for "hoover" kitties - those that will eat too much. In those cases I usually recommend timed feeders with the most slots to try to most closely approximate free feeding.
 
The vet's reasoning is that she wants to get Sam regulated and doesn't feel the free feeding will make that happen in a timely manner. After a month, if he's regulated, we can loosen up a bit, but until then, this is how she wants to go. I know it might be contrary to what a lot of other people have been doing, but I'm willing to give it a shot. Sam had NO pm shot last night and this mornings AMPS was still the lowest it's been in five days. When I do his +6, I'll be able to see just how well this is working. Also, the vet feels like the free feeding is what's causing his big spikes at the +10 point - not rebounding. If he still spikes at that time, then we'll know differently. This way we can make a more conclusion judgment.
 
KristenP&Sam said:
The vet's reasoning is that she wants to get Sam regulated and doesn't feel the free feeding will make that happen in a timely manner... Also, the vet feels like the free feeding is what's causing his big spikes at the +10 point - not rebounding. If he still spikes at that time, then we'll know differently. This way we can make a more conclusion judgment.
Click to expand...

So the reasoning was that the food was causing the spikes. OK I don't think low carb food would do that but I'm open to experiments. I've said it here before, we don't care HOW you get it done in here, just that you get it done. In other words, I think here in PZI we are really open to all tactics. I'd call this a fairly well controlled experiment so in theory I'm behind it.

This not shooting insulin seems to be from something else [I won't breath the word yet] until we have more data.
 
gosh, this theory is so confusing for me and tom. he always goes down with lots of small meals and if i dare let him go 10 or more hours without a meal he spikes to kingdom come. is this a case of ECID. i want to do what's best for tom.
btw, if anyone wants to see how sexy tom is he is currently being viewed over in community.
 
What food are you feeding? [this is the part where I go verify that they are low carb] Also some cats are very carb sensitive and find better luck with foods that are very low carb than just low carb.
 
Sam's food since he's been home has been mostly liver (beef or chicken, raw or flash-boiled), organic chicken breasts and thighs, chopped and served with the water they're poached in, and some small quantities of FF, Friskies or 9-Lives varieties from Binky's list. He really prefers the chicken though, so he usually goes to that first.
 
OK liver is very high in vitamin A. You have to be very careful how much you give. Too mcuh can be toxic.

Also you should not feed any unbalanced food as more than 10% of their diet. So 90%+ of what you feed should be a balanced food.


As for the "balanced" foods you are feeding, try to find the lowest carb ones you cat that Sam likes. Have you tried Wellness Turkey or Chicken? I think they are like 4% as % cal which is pretty low and are pretty good P content wise [relatively to other canned foods].
 
He doesn't eat that much of the liver, it's mostly the chicken he wants. I wouldn't be giving either to him, but the vet at the hospital suggested it until Sam gained some of his lost weight back.
 
I disagree whole heartily with that advice. Kcal is Kcal it all has to do with how many they consume as to the weight they gain or not. Not whether it's cooked chicken or canned chicken.

If you wanted your cat to gain weight then free feeding would be best so they could consume more Kcal [calories].

There's lots of good reading here about nutrition:
http://maxshouse.com
http://maxshouse.com/Tuna_and_Cats_Nutr ... _Facts.htm

Cooked foods lack the taurine that raw foods do [which is important to cats]. That's just to start with.
 
While I agree that free feeding would be the best way to put weight on him, I've already agreed to abide by the scheduled feeding. I also ordered a sample of the Alnutrin supplement, so once that gets here I'll try it out and see if they like it. If so, I'm going to start making food for them.

And I think the vet suggested the chicken because Sam wasn't eating as much as he needed to in the beginning. I could probably cut it out now, but I hate to waste what I've already prepared.
 
umm did anyone see what i wrote about tom's experience with not eatting for 12 hours about 5 posts up? is it irrelevant?
 
I don't think irrelevant. It sounds like Sam is on an experiment and we'll just have to see how it goes. It would be interesting to see if Sam spikes at +10 under the new plan [or exactly what happens] but Kristen is only supposed to test at PS and nadir :sad: .

If this experiment works then I think it will be valuable perhaps to more than just Sam.
 
Lori, I did see that post. I can tell you that yesterday when Sam spent the day at the vet's and they did the scheduled feedings, he was in the 60-70 bg range for about 3 hours.

Ultimately, this is an experiment. I'm about to test Sam's +6, so that will be interesting. Will update his SS asap.
 
Okay, Sam's +6 is 263, which seems high, but I know he didn't get his full dose of insulin in his AM shot because his fur was a little wet. I don't think I missed the shot entirely, because I've done that before and this wasn't that much liquid. Anyway, I'll probably do a +10 just to see where he is in addition to the PMPS.
 
I like the idea about this experiment, at least we'll know which one hold true. I also think that Lori should be in on this experiment too, if both Sam & Tom have the same results or ECID, we might find out that different approaches have different results. Either way it will be great information.

Besides Sam is staying on this feeding schedule while Lori can change to free feeding after the experiment.
 
Hi, lori is basically doing free feeding now. the last 4 days or so. a 3am meal. :YMSIGH: followed by food given every 2 hours or so. will post results when have a good amount of info to piece together.
 
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