SIUJIM i am totally confused, pls HELP

[sun]

hi,

i am off for a while as siujim has been fluctuating a lot.
the vet suggested something 3 days a go:
feed (15-30mins) after the shot. as her +3 to +6 BG usually higher than the pre shot.
less meals, only 3 meals per day

siujim use do have 3 meals and 2 small ones, i think leaving no food for a diabetic cat at night time is not reasonable.
to play safe, i fed a bite of food before the shot, then fed after 20-25mins later.
and her BG goes up and she always asks for food. i guess after 7 months, she is NOT used to this kind of pattern.

here are the results:
15th july:
amps 239 (relatively good figure). pm pre shot urine 100-150mg (ok figure at pre shot).
at pm shot, THE FIRST TIME to feed after shot *but only 5 mins gap, just wanted to see how she reacted. perhaps it's only 5 mins gap, so it's more or less the same as before, so she was quite normal.

16th july:
amps (285) pmps (311)
meals at am --> 10mins later; pm--> 15mins later

17th july
meals at am -->20mins later; pm -->20min later
** (+3 and mid day lower than pre shot but the range is higher)
amps (365) +3 (347) +6 (256) +9 (282) pmps (351). pm +4 urine 50-100mg
leave less food at night time as suggested.

18th july (vomited in the morning)
meals at am -->20mins later; pm -->25min later
amps (316) pmps (333) +3 urine 150mg (no ketones)
leave less food at night time as suggested.

19th
meals at am 15mins later (she is super hungry)
amps (443) ** this is one of her history high...
=================================

she is on lantus for 7 months and since april, i hope to try a new one. but vets kept on not willing to do it...
she is on 4.5 unit with just 2.7kg.
and with BG still not regulated.

last month, when we first started supplements for her pancreatitis and she was better but just for 1-2 weeks. then later, fluctuate a lot.
pls note spreadsheet.

may i ask what is your opinion? change to another type? if yes, which type?

or what should i do further?
pls help, i am totally helpless.
my cat is trying alternatives lately (homeopathic remedies since last week) and still i hope to deal properly with the insulin treatment.

thxxx.
anson

 

[Ronnie & Luna]

siujim use do have 3 meals and 2 small ones, i think leaving no food for a diabetic cat at night time is not reasonable.
to play safe, i fed a bite of food before the shot, then fed after 20-25mins later.
and her BG goes up and she always asks for food. i guess after 7 months, she is NOT used to this kind of pattern.

Hi Anson

I'm hoping others can help out here.
Question, are you testing, feeding and then shooting? (test, feed, shoot, all within the first 15-20 min of shot time.)

You'll be home for a while, can you do some spot checks and post here for feedback? If you can ok?
Often times, it helps to hang out and keep us posted daily on your kitty.

As far as I know, unregulated kitties need to eat more.
I'm not too sure about with holding food over nite...it may help her to have food around +8 or +9...have you tried that?

 

[Libby and Lucy]

Thank you for starting to test more often, that makes it much easier to help you.

It looks to me like Siujim needs a higher dose of insulin. You have been on 4.5 units for quite a while, and nadirs are still in the 200's. I would increase the insulin dose to 5 units and keep testing as often as you can to see if that helps. Also, if you can get at least one test after each evening shot too, that really helps. Then you would know if the 443 this morning was the result of Siujim bouncing off of a lower number, or a result of a cycle that just kept going up all night.

About the food, it is my experience that smaller, frequent meals are better for diabetics (humans and cats). I agree with you that it does not make sense to withhold food from a diabetic at night. Many of our cats go lower at night than during the day, so it makes sense to have food available so they can feed themselves if they go too low.

 

[sun]

i have been doing this:
BG, then feed, then dhot.
but my vet says i should try feed after shot beause siujim +3 to +6 BG is higher than pre shot. and the vet thinks it's better to let the insulint ohave an effect that goes with the food.

yes, the mid day BG is lower than pre shot but in general the range is higher.
i did ask aboout fed abotu shoot in the forum here.
but not much response.

yes, i know diabetic cats need to eat. so instead of 3 meals suggested by the vet, i still give 4 meals (she used to have 3 meals + 2 mini meals).

this is why i was so frustrated because what the vet suggested is NOT a regular practice.
we can't strive our cats to keep the BG low... it only jumps it up...

and i regreted so much to do what she said...

siujim use do have 3 meals and 2 small ones, i think leaving no food for a diabetic cat at night time is not reasonable.
to play safe, i fed a bite of food before the shot, then fed after 20-25mins later.
and her BG goes up and she always asks for food. i guess after 7 months, she is NOT used to this kind of pattern.

Hi Anson

I'm hoping others can help out here.
Question, are you testing, feeding and then shooting? (test, feed, shoot, all within the first 15-20 min of shot time.)

You'll be home for a while, can you do some spot checks and post here for feedback? If you can ok?
Often times, it helps to hang out and keep us posted daily on your kitty.

As far as I know, unregulated kitties need to eat more.
I'm not too sure about with holding food over nite...it may help her to have food around +8 or +9...have you tried that?

 

[sun]

i also think of raising the dose.
vet doesn't suggest... so... the same old story... you know...

but then, do u think i should try another type of insulin? she has been on lantus for 7 months and besides the first month, she has never been regulated and riased from 1 unit to 4.5 unit..

thx.

Thank you for starting to test more often, that makes it much easier to help you.

It looks to me like Siujim needs a higher dose of insulin. You have been on 4.5 units for quite a while, and nadirs are still in the 200's. I would increase the insulin dose to 5 units and keep testing as often as you can to see if that helps. Also, if you can get at least one test after each evening shot too, that really helps. Then you would know if the 443 this morning was the result of Siujim bouncing off of a lower number, or a result of a cycle that just kept going up all night.

About the food, it is my experience that smaller, frequent meals are better for diabetics (humans and cats). I agree with you that it does not make sense to withhold food from a diabetic at night. Many of our cats go lower at night than during the day, so it makes sense to have food available so they can feed themselves if they go too low.

 

[Libby and Lucy]

Personally I wouldn't try another insulin, unless you want to try Levemir (but that has the same general kind of action as Lantus). I think you just need to use the Lantus more aggressively, then you will get better results.

Most cats don't see any response from Lantus until they get to the right dose. It's not like you're getting 300's on one dose, then 200's the next dose, then 100's the next dose. The numbers stay high until all of a sudden you get to a dose that is magic, and the numbers change suddenly. It looks like Siujim is not up to that dose yet. Some cats need small doses, some cats need larger doses, so the size of the dose doesn't matter, you just give her what she needs.

 

[sun]

yes, we can try.
she was normal for 2 weeks after the first 2-3 weeks of using insulin back in last dec/jan. however in mid jan, she had diarrhea, and ever since then, her BG keeps on going higher and higher with the raise of dose.

will try.
thx for your comments.
she is almost to her max dose though, as she only weights 2.8kg.

Personally I wouldn't try another insulin, unless you want to try Levemir (but that has the same general kind of action as Lantus). I think you just need to use the Lantus more aggressively, then you will get better results.

Most cats don't see any response from Lantus until they get to the right dose. It's not like you're getting 300's on one dose, then 200's the next dose, then 100's the next dose. The numbers stay high until all of a sudden you get to a dose that is magic, and the numbers change suddenly. It looks like Siujim is not up to that dose yet. Some cats need small doses, some cats need larger doses, so the size of the dose doesn't matter, you just give her what she needs.

 

[Janice & Johnny]

Hi Sun,

I'm pretty new here, but thought I would chime in with my experience.

I'm glad you have a very involved vet, but if you're comfortable, I would think about transferring some more trust to the people on this board and follow their advice. If you aren't comfortable doing so, that's okay. I know you are doing what you think is best for Siujim. From what I hear, diabetes is a less-than-one-day focus in vet school. For me, I'll say that I've felt so much more supported here than by my vet. They prescribed way too high of a dose and it was obvious by Johnny's numbers. Our vet didn't recommend home testing to us and I can't imagine where we'd be if I hadn't found this board. There is a lot of wisdom here and they've helped SO many cats/people, including us. It looks like Johnny will be off insulin soon.

I know the weight of pressure and stress you feel. Hugs to you. It's not easy and so stressful. I hope the best for you and Siujim.

Janice

 

[sun]

thx so very much.

i totally understand your words.
i will raise the dose for sure. i will TELL the vet that i will be doing so.
waiting for her reply.
i have changed to another. the previous one only work 2 days per week and off for a whole month in april which we suffered soooo very much.
other vet in the clinic simply not caring enough...

i even think of starting from 1.5 unit all over again and see which one is her optimal dose...
but my vet disagree.

will wait for her reply, then DO something.

thxxxx

Hi Sun,

I'm pretty new here, but thought I would chime in with my experience.

I'm glad you have a very involved vet, but if you're comfortable, I would think about transferring some more trust to the people on this board and follow their advice. If you aren't comfortable doing so, that's okay. I know you are doing what you think is best for Siujim. From what I hear, diabetes is a less-than-one-day focus in vet school. For me, I'll say that I've felt so much more supported here than by my vet. They prescribed way too high of a dose and it was obvious by Johnny's numbers. Our vet didn't recommend home testing to us and I can't imagine where we'd be if I hadn't found this board. There is a lot of wisdom here and they've helped SO many cats/people, including us. It looks like Johnny will be off insulin soon.

I know the weight of pressure and stress you feel. Hugs to you. It's not easy and so stressful. I hope the best for you and Siujim.

Janice

 

[Janice & Johnny]

Hi Sun,

I'm glad you agree that Siujim needs a higher dose. Her pancreas needs some healing time and an increase will give it rest. Going up in dose is not bad and it will help you find the dose she needs and step down from there, hopefully. Her body will be thankful and adjust and so on. But I think you need to put trust in one plan, though keeping others in the loop. You will feel better and she will too. Siujim is your kitty. Nobody loves and cares about her well-being more. Your vet is probably great, but for me, the everyday evaluation was too much to wait for feedback and go forward. Just me. But I think you are learning more and realizing that you can also be in control. You have the insulin. I'd love to see you feel more in control. You're doing great.

Janice

p.s. What does Siujim eat? Is she eating low carb and wet food? Hard food, even if it says low carb, is still higher carb. Sorry if I missed this info in an earlier thread. Siujim will benefit LOTS from a diet change (lower numbers) if you switch to low card wet food.

 

[Cyn and Cosmo]

Hello,
Maybe others who have posted in your condo before already know this... but how old is your insulin? When did you start using this vial?

I hope that it's not the same vial that you got from the vet 7 months ago.

You're in good hands here!! My vet was very impressed with how "we" handled dosing and checking my Cosmo's BGs when he was actively diabetic.

 

[sun]

i use a new insulin pen every month, to play safe.

thx

Hello,
Maybe others who have posted in your condo before already know this... but how old is your insulin? When did you start using this vial?

I hope that it's not the same vial that you got from the vet 7 months ago.

You're in good hands here!! My vet was very impressed with how "we" handled dosing and checking my Cosmo's BGs when he was actively diabetic.

 

[sun]

siujim eats shrimp + wellness core chicken (grain-free). very low carb diet.

i will feed her EVO venison soon (when the canned arrvied in US, we don't have it here in hong kong). and hope the novel protein helps her pancreastits.
i did try ziwipeak venison but there is green mussels. if i want her to quit seafood to avoid allergen, it is not a good choice. and also her carb % not as low as wellness grain free.

thx.

Hi Sun,

I'm glad you agree that Siujim needs a higher dose. Her pancreas needs some healing time and an increase will give it rest. Going up in dose is not bad and it will help you find the dose she needs and step down from there, hopefully. Her body will be thankful and adjust and so on. But I think you need to put trust in one plan, though keeping others in the loop. You will feel better and she will too. Siujim is your kitty. Nobody loves and cares about her well-being more. Your vet is probably great, but for me, the everyday evaluation was too much to wait for feedback and go forward. Just me. But I think you are learning more and realizing that you can also be in control. You have the insulin. I'd love to see you feel more in control. You're doing great.

Janice

p.s. What does Siujim eat? Is she eating low carb and wet food? Hard food, even if it says low carb, is still higher carb. Sorry if I missed this info in an earlier thread. Siujim will benefit LOTS from a diet change (lower numbers) if you switch to low card wet food.

 

[sun]

i have asked the vet for two days and she didn't reply.

so i just raise the dose myself. as long as i do home test, siujim is safe.
her pmps is 419 (quite high).

i know siujim not yet reach her max dose. may i ask, if she is 2.8kg, what is her max dose?

thx.
anson

Thank you for starting to test more often, that makes it much easier to help you.

It looks to me like Siujim needs a higher dose of insulin. You have been on 4.5 units for quite a while, and nadirs are still in the 200's. I would increase the insulin dose to 5 units and keep testing as often as you can to see if that helps. Also, if you can get at least one test after each evening shot too, that really helps. Then you would know if the 443 this morning was the result of Siujim bouncing off of a lower number, or a result of a cycle that just kept going up all night.

About the food, it is my experience that smaller, frequent meals are better for diabetics (humans and cats). I agree with you that it does not make sense to withhold food from a diabetic at night. Many of our cats go lower at night than during the day, so it makes sense to have food available so they can feed themselves if they go too low.

 

[Ann & Tess GA]

I don't think there is any set number for max dose/weight. Mainly I'm just bumping you post up. One thing to remember, after a dose increase the shed needs to fill again and you may see some increase in numbers for a few cycles, before they start to come down. Patience. :YMHUG: