Semi newbie introduction

Fonzirelli

Fonzirelli

Member
Hi!
I’m a human medical provider. I’ve read things on the board from time to time Since Boots’ diagnosis in September, when she was in DKA. We didn’t know she was diabetic. She went into liver failure. My vet told me they couldn’t see me, so I had to get a new vet that day. That first week, three times they recommended euthanasia but I told him know that she was a fighter and only three years old. There were three weeks that I did almost everything for her, running a mini hospital from home. Eventually, we got an E tube placed, and my new vet didn’t want me checking blood sugars at home. I told her it was Very much within what I wanted to do after reading everything on these boards and other places including the animal hospital guidelines for diabetes. Liver disease has resolved. She’s on Prozinc now. I’ve been running her glucose Curves on weekends and have her up to 4.25 units twice a day now. I’ve been giving her injections in the scruff of her neck and only realize this morning that it would be better to give her them in other places. The vet wants me to feed her only one of the prescription diabetes foods but couldn’t tell me how many carbs are in each of them. I’ve done my research and, if the companies can be trusted, I have narrowed down what I’m willing to do with food as far as carb counts. I’ve been doing Dr. Elsies, mostly wet food, but I’m a little concerned about their under estimation of the amount of calories in their dry food. I still don’t have boots well regulated and that’s why I’m back on the board and researching. I have not been doing multiple tests during the day, and in many days I don’t even do one as she’s generally high and almost never within normal range. I’m looking into getting a freestyle libre to do more consistent glucose Curves. Last weekend, somehow I missed an entire day of giving her insulin and the next morning while she wasn’t extremely high, she did seem to feel unwell. I checked her urine -I do have urine dipsticks- And she had ketones and a uti in Addition to my stupid forgetting her insulin on Saturday. I label my syringes so I know if I forgotten one dose or another for the day. Usually I’m very consistent. She’s reyrned to normal after resuming prozinc and increased water.
I’m changing jobs and will have more opportunity to find a different vet.
she was 13 lbs in July, when my old vet said she was overweight but when I asked if Test for diabetes because she always was a heavy water drinker, the vet said no. When she was diagnosed with DKA in September, she had lost down to 7.9 pounds and looked ver skinny/ribs. I knew she was losing weight, but she was outside more, and very active, even brought in a rabbit two days before she was diagnosed with DKA. And the vet said she wasn’t worried about possible dm...
Since treatment, She’s regained her weight back to about normal - 10 lbs.

Does anyone have insight on Dr Elseys? I have a spreadsheet of their TNA.

She acts like she’s starving all the time. I’m giving 210-250 calories a day. Mostly wet, with some dr Elseys dry. I don’t want her to gain too much back.

She will eat cardboard and paper when it’s 2-4 hours to next meal time. I’ve checked her bg and it’s not low but she acts like she’s dying.

boots is bigger/ lanky. I worry about possible acromegaly.

I’ve had to separate feeding boots (sugar cat) and Lucy, a pretty small cat that is overweight at 7 lbs (incidentally old vet said she was fine, but body composition shows rolls). Lucy wants to graze. Boots scarfs now... didn’t use to. Boots will find a way to get whatever Lucy left in her bowl. I’m trying to work on Lucy losing a little weight. I’ve thought about timed feeders...

she’s started to play again, not as much as pre-Dx. We begin leash training as she’s not allowed out anymore.

I looked into the nearest Internal Medicine vet, they told me it would be about $500-1000 first visit.

im sure there’s more but that is what I can think of now.

I have a friend who is a vet across the country, that certainly made a difference for us but there’s been some things she isn’t fully aware of...
I hope I made the spreadsheet correctly. I put it values from my books. This will make it easier to keep up with.

Thank you all for proving your resources and knowledge thus far!
 
Oh, I did think of another issue. One or both have been urinating in hallway. I’ve done a lot of work to get three boxes going with good clumping litter that’s deep enough, try to remember emptying daily but honestly I forget, I know Boots urinates much more in volume and she’s on her third or fourth UTI so, until I get her regulated, I think it will continue to be an issue. im trialing multiple enzyme cleaners and carpet shampooed but if anyone has suggestions in that, I’ll take it.
 
Quick answer, since I just opened your SS. NO shot or perhaps a greatly reduced shot with that 79 at PMPS. If you haven't fed Boots already, stall and test again in 20 minutes. Please.

Boots earned herself a dose reduction with that low PMPS today, 1/13/21.

I bet you are exhausted after a full day of work Fawn.
Fawn Workman said:
I’ve done a lot of work to get three boxes going with good clumping litter that’s deep enough, try to remember emptying daily but honestly I forget,
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Three boxes sounds like a good number for 2 cats. Life does get busy and we have a lot of other responsibilities, from getting the laundry done, to getting meals for ourselves and our pets, to grocery shopping and work. One way to think about unscooped litter boxes, not scooped every day is to compare it to your own toilet. Would you want to use a toilet that hadn't been flushed for days? Think about trying to form a new habit, to scoop the litter boxes after you have used your own toilet.

In the meantime, keep up with the enzymatic cleaners.

Is one of the boxes in the hallway, where one or both of the cats are peeing? May not be an ideal location, but having one of the litter boxes there could help.
 
Hi! Thanks for the reply. I didn’t see it til later. I did check twice, and it was 80, then 79. I ensured she ate everything and then waited 30 minutes after finishing before giving her pm shot.
I did reduce the dose but not by enough apparently as I think she ‘bounced’.
 
Fawn Workman said:
Oh, I did think of another issue. One or both have been urinating in hallway. I’ve done a lot of work to get three boxes going with good clumping litter that’s deep enough, try to remember emptying daily but honestly I forget, I know Boots urinates much more in volume and she’s on her third or fourth UTI so, until I get her regulated, I think it will continue to be an issue. im trialing multiple enzyme cleaners and carpet shampooed but if anyone has suggestions in that, I’ll take it.
Click to expand...
My favorite pet cleaners are Anti Icky Poo Unscented and angry orange concentrate. Both I get on amazon
 
If 10 lbs is normal, about 200 calories is right.... But since she's diabetic and not regulated if go more with 250 calories. Wet food is best esp if she had issues with uti. The more liquid the better. Try putting extra water in the wet food. It will fill her up more and keep her hydrated. Split the meals up so she's not so hungry. I feed 4 times a day. Morning, noon, dinner and before bed. I have six cats and all of them graze whenever they want.... Just no food 2 hours prior to the preshot test so the number is not food influenced.
 
JanetNJ said:
If 10 lbs is normal, about 200 calories is right.... But since she's diabetic and not regulated if go more with 250 calories. Wet food is best esp if she had issues with uti. The more liquid the better. Try putting extra water in the wet food. It will fill her up more and keep her hydrated. Split the meals up so she's not so hungry. I feed 4 times a day.
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Thanks. I do aim between 200-300 between the 200-250 of wet food and a small ant of dry plus she goes after the civies leftovers. I’m going to start to try to feed times a day. We did yesterday, still not sure why that pmps was low. Then a bounce?? How long do ‘bounces’ last?
 
Fonzirelli said:
Thanks. I do aim between 200-300 between the 200-250 of wet food and a small ant of dry plus she goes after the civies leftovers. I’m going to start to try to feed times a day. We did yesterday, still not sure why that pmps was low. Then a bounce?? How long do ‘bounces’ last?
Click to expand...
A bounce is when they go low and then bounce to a number that's high because the body panics and is trying to protect itself from hypo.... Even if they were in perfectly safe numbers. So your cat went from 79 and then quickly back up to the 300's. Loos like a bounce to me. For some cats it lasts a cycle and for some cats 3 days.
 
Well crud. Tonight PMPS was lower than usual, not as bad as yesterday. Tonight, I did cut waaay back on her PZI to 1/2 unit. But +4 is 439. What do you make of this? Did she go hypo and bounce from the measly 1/2 unit, or did I not give her enough PZI?
 
Fonzirelli said:
Well crud. Tonight PMPS was lower than usual, not as bad as yesterday. Tonight, I did cut waaay back on her PZI to 1/2 unit. But +4 is 439. What do you make of this? Did she go hypo and bounce from the measly 1/2 unit, or did I not give her enough PZI?
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no I don't think she went low.... She didn't get a full shot and the last one wore off late.
Looks like she gets a long duration from the insulin and a late naidar which wore off at about 13-14 hours. I would cut the dose to 3.5 (you can always raise it if it's not enough) and so you will hopefully get two good shot numbers.... But also, next time you have a preshot under 200, stall for up to an hour without feeding and see if it is going up before skipping or doing a tiny dose. It may raise high enough to give the full shot. If after a few days 3.5 is to low go back to 3.75.
 
I’ve gone to 3.5 units this morning. I really want to get on a freestyle libre to figure out exactly what is going on.
she is enjoying staying in my room when I’m worried about her going low. I’m not sleeping well.... but She also provided a volunteer urine this morning :)

my real name is Fawn so my childhood nickname became fonzirelli . “Eh!”;)
 
Thanks for getting that SS up and filled in Fawn.

Still trying to find a dose that you can give to Boots both AM and PM.
The nadir will vary, and not always be at the same time.
Doses will change with time too.

Appetite can make a big difference in the BG numbers too. So if Boots isn't eating well one cycle, the BG numbers often trend lower. So that is another possibility for what happened. You have a note on the SS that Boots was not really hungry, but was chewing on boxes.
 
Yes, she had food in her bowl but sometimes will chew on paper for attention- whether that’s because she decided she was unhappy about food options or something else, hard to say. She has learned that I don’t like her chewing on paper/ boxes so she does it (especially first thing in the morning if she is let in my room)so I stop whatever I’m doing to pay attention to her. I have them watch “cat TV” YouTube channels to stimulate interest between 5-7 pm often because they both are persistent/ annoying for food to come out earlier than 7 pm, so this keeps them somewhat engaged. I’ve begun taking boots out on a leash again for additional stimulation.
 
522 this am. there’s a small possibility last nights shot poked through when she moved but not sure.
I’m just going to give her 3.5 units this morning.
 
Hi, just wanted to say that the Freestyle Libre has been great to see a ton of data and catch deep lows. They're pretty easy to put on after watching some Youtube videos. A good skin adhesive helps such as Skin Tac.
 
The Freestyle Libre has been on for two days (more traumatic for her than I expected....) and we have some info... not sure how good it is yet as only 2 days worth.
She has been pretty flat for the last 24 hours between 260 and 330.
yesterday, she ate grass on her walk as usual. She threw up on the rug, which is unusual.
Last night she refused her usual foods- Dr Elseys Duck and Tiki cat Tuna with crab surimi. Normally she doesn’t like most Fancy feast but she did eat the whole can of FF Tuna Feast flaked. She’s been high for days so I increased her PZI from 2 to 2.25 units


This morning She is still refusing tikis cat and dr Elseys.
I’ve been looking into homemade diets (more on that later) and decided to make scrambled eggs with no seasoning and light olive oil. She was given a tablespoon (maybe 1/2 an egg) of which she has eaten half.

she acts hungry and I think if I opened another can of FF tuna , she might eat it. (?aversion to usual food from vomit yesterday? )
 
Fonzirelli said:
The Freestyle Libre has been on for two days (more traumatic for her than I expected....) and we have some info... not sure how good it is yet as only 2 days worth.
She has been pretty flat for the last 24 hours between 260 and 330.
yesterday, she ate grass on her walk as usual. She threw up on the rug, which is unusual.
Last night she refused her usual foods- Dr Elseys Duck and Tiki cat Tuna with crab surimi. Normally she doesn’t like most Fancy feast but she did eat the whole can of FF Tuna Feast flaked. She’s been high for days so I increased her PZI from 2 to 2.25 units


This morning She is still refusing tikis cat and dr Elseys.
I’ve been looking into homemade diets (more on that later) and decided to make scrambled eggs with no seasoning and light olive oil. She was given a tablespoon (maybe 1/2 an egg) of which she has eaten half.

she acts hungry and I think if I opened another can of FF tuna , she might eat it. (?aversion to usual food from vomit yesterday? )
Click to expand...
So give her the ff. Cats love a food until you buy a case of it. Lol
 
Yep. I have given it. Scarfing it down now.
Cats are so weird.

I am considering homemade diets.

I want to get Boots under the best control I can (with magical wishes for Eventual OTJ if possible) while she has the libre in place. (I have 3 more, too).
I’ve been looking at some TR protocols, any idea which is best?
 
Fonzirelli said:
Yep. I have given it. Scarfing it down now.
Cats are so weird.

I am considering homemade diets.

I want to get Boots under the best control I can (with magical wishes for Eventual OTJ if possible) while she has the libre in place. (I have 3 more, too).
I’ve been looking at some TR protocols, any idea which is best?
Click to expand...
Now that she's not looking so bouncy I think it's time to try 2.25 again.
 
Was Boots fed that cooked chicken with the pre-mix added, somewhere before the +11?
Can't tell from the notes on your SS. You only state the clock time, not the + value time that we look for.
Would you please restate that 6 PM time in our + hour format. Also, please restate the 8:15 PM time in our + hour format. Thanks.

Fur shot? But that would not explain the higher +11.
Bouncing? A strong possibility, that Boots is going higher BG wise after she dropped to those low blues today.
 
I've updated the SS (what does that acronym stand for? I know its spreadsheet...)

At 6 pm ( approximately +9), i gave her about a tablespoon or smaller of cooked chicken breast (no premix) which she was really into. As far as I can tell, she didn't eat any additional tiki/ Dr e wet. No dry, no treats. At 8:15 pm (+11), i gave her about 60 gm, then another 30 (90 grams total) of ground cooked chicken mixed with Food Fur Life premix. her blood sugar seems to be skyrocketing, peak seemed to be at 8:40 pm (+ 25 minutes after PM shot and food) at 485. She is now trending dowwards at 9:30 pm (+75 minutes) at 438. No significantly abnormal behavior.

Since I don't always get to give meals/ shot at exactly 12 hour intervals every time, I don't always know where to put # on the SS. For instance, today I did breakfast at 9:15 am (quite late for us, usually it's at 7:30-8 am. ) so, it's really only +11 by the time I did the PM meal and shot at 8:15 pm. Does my confusion make sense?
 
I would upload a nice pic of her libreview, but it won't let me. she is trending downward still, my guess is she bounced even though not hypo (far from it). Looking back at 1/28 overnight into 1/29, it seems that she also bounced close to the next AMPS. (nadir was +9 )
 
Yes, SS is the shorthand abbreviation for spreadsheet that we use here. (SpreadSheet - S for Spread, S for Sheet)

Bounces happen even if a cat is not down in the hypoglycemic territory BG numbers.

I was trying to see if there was some sort of correlation between when you fed Boots, and when her BG levels started to increase.
We don't recommend that you feed much food after about the halfway mark in the insulin cycle. That is because the insulin is basically used up by then, and there isn't much or any insulin left to counteract the food intake.
 
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