? Sprocket wacky bg's, some questions

[Darnell & Sprocket (GA)]

Hi there, posting here to hope get some different opinions.
Long story short....2.7 yr diabetic. 2xdka, 4xketones this year. 2x liver issues. Cystitis diagnosis in july. 30+days no flare up.
Has had so many meds this year. In july/august had sugar in some meds caused wacky bg. Had to start weird dosing due to going into 300s then under 100 as you will see on ss for past 3 months.
He got buprenex in august daily as it was helping to not have flare ups of the peeing constantly, some with blood with cystitis.
But buprenex was also raising his bg even though no sugar n no reason to with no consisitancy. His bg would rise from 50-100pts mostly but not all the time.
Now since he is doing better with that his buprenex is reducing more this week to none.
I have been giving a 3u dose when over 300 mostly to get him down. Then 2.87u for rest mostly. Sometimes he even went too low to give insulin so I had to feed n wait to give insulin. Just wacky bgs all over up n down with no predictability.

So this am was just over 300. Tried not to do 3u but he is still high. Tried to give 0 or 1 carb but he is sick of most of that food. Would rather starve than eat it. Wants 3 or 4 carb food instead. He seems to be somewhat sensitive to carbs as when i usually give 3 he will stay steady, under 2 carb will go down some and if 4 carb or more will go up on bg.
I have watched this happen for awhile so please dont tell me I am crazy.
Now he is wanting food from 3-5 carb mostly but hard to give that all the time as when I give higher insulin dose he goes under 100.
I was doing SLGS protocol. Not sure how to put him in 100s more while giving him food he likes as he is eating less as he is fussier.

Overall, I am baffled on how to regulate him more with all his issues & meds. I have a daily helper but she lost her diabetic not too long ago & its easier for me to talk one on one to a helper than to post n wait for answers. Sick of people arguing with me previously as his care is very stressful for me with my own medical conditions. So could use a 2nd helper with more experience to help sometimes without having to explain his long history all the time too.
Ok SS is updated and what are your tips or advice.
Thanks alot
Darnell n Sprocket

 

[Tricia Cinco(GA) & Harvey]

Hi Darnell.

Have you tried mixing some of the 0 or 1 carb stuff in with the stuff he likes, to lower the carb percentage? Start with just a little and gradually increase it as long as he tolerates it. Might work. Or no. He's a cat.

It looks to me like he's mostly hitting blues and then bouncing, but he's breaking the bounces fairly quickly. Keeps you on your toes, I'm sure.

 

[Sienne and Gabby (GA)]

I like Tricia's idea of mixing the food -- providing Sprocket cooperates. Have you tried mixing in a treat like freeze dried chicken or bonito flakes? I also agree that he's bouncing.

One additional consideration may be how long you're holding the doses. If you hold a dose that isn't bringing numbers into the range you want, your cat can develop glucose toxicity -- in other words, you cat treats the higher range numbers as the new "normal." It makes it harder to bring the numbers down. The other factor is that Lantus isn't particularly good at pulling high numbers down. When you give a "fat" dose because Sprocket has thrown you a higher than usual number, two things are happening. First, the one time shot disrupts the depot. Any time you change a dose, the depot has to readjust and it can take a few cycles for things to stabilize. The other factor is that you're trying to "shoot down" a pre-shot number. Lantus is too long acting to be good at this. Typically, a short acting insulin does a better job than a depot insulin. You're also basing the dose on the pre-shot number rather than the nadir.

Do you think the inflammation is under better control? It may be that the variability in numbers is due to the cystitis. Any inflammation or infection can mess with numbers. Some of this may be a waiting game until the cystitis clears.

One other thought... Are you feeding Sprocket distinct meals? If not, are you able to leave food out to see if he'll graze? Perhaps having food available will help to level out the numbers.

 

[Darnell & Sprocket (GA)]

Hi Darnell.

Have you tried mixing some of the 0 or 1 carb stuff in with the stuff he likes, to lower the carb percentage? Start with just a little and gradually increase it as long as he tolerates it. Might work. Or no. He's a cat.

It looks to me like he's mostly hitting blues and then bouncing, but he's breaking the bounces fairly quickly. Keeps you on your toes, I'm sure.

Not sure if that would work because the flavors are so different and his sense of smell seem to be so high since he became diabetic but i will try to mix a few flavors.
He is getting better at going in blues but he always ends up high after 4-5 doses of same amount. He is bouncing higher than he was before again.
Ya, he is all fussy cat alright...lol

 

[Darnell & Sprocket (GA)]

I like Tricia's idea of mixing the food -- providing Sprocket cooperates. Have you tried mixing in a treat like freeze dried chicken or bonito flakes? I also agree that he's bouncing.

One additional consideration may be how long you're holding the doses. If you hold a dose that isn't bringing numbers into the range you want, your cat can develop glucose toxicity -- in other words, you cat treats the higher range numbers as the new "normal." It makes it harder to bring the numbers down. The other factor is that Lantus isn't particularly good at pulling high numbers down. When you give a "fat" dose because Sprocket has thrown you a higher than usual number, two things are happening. First, the one time shot disrupts the depot. Any time you change a dose, the depot has to readjust and it can take a few cycles for things to stabilize. The other factor is that you're trying to "shoot down" a pre-shot number. Lantus is too long acting to be good at this. Typically, a short acting insulin does a better job than a depot insulin. You're also basing the dose on the pre-shot number rather than the nadir.

Do you think the inflammation is under better control? It may be that the variability in numbers is due to the cystitis. Any inflammation or infection can mess with numbers. Some of this may be a waiting game until the cystitis clears.

One other thought... Are you feeding Sprocket distinct meals? If not, are you able to leave food out to see if he'll graze? Perhaps having food available will help to level out the numbers.

Hi there, i do have bonita flakes and the freeze dried chicken flakes but he seems not to want them anymore.
Yes. After he was higher bgs in end of july n august he will bounce higher now which sucks again.

The reason I wasnt holding the dose was because the medicine was making him so unpredictable. He just keeps going into 300s but then he wasnt coming down unless I gave the 3u dose.
I get what your saying about the dose but I dont know how to fix it.

I do think his inflammation is more under control now. Its been 35 days since his last flare up and this week is his last week on buprenex but its a very low dose of 0.03ml 2xday.
His meds have messed with his numbers since he got them in july.
I feed Sprocket every 4 hours to try to keep him level. He usually eats 1.5oz- 2oz of food each meal but when he leaves leftover then I leave he food out except 2 hrs before amps/pmps.
You all taught me well months ago do I have tried all the advice I remember.

So now I am getting back to balancing him again and I hope he will stay healthy this time.
I just cant seem to keep him steady enough. He bounces too high and gets stuck there.
Not sure what next step is.

 

[Darnell & Sprocket (GA)]

Ok here is my problem. +3.9/144. He dropped 181 pts and if he doesnt eat now he will drop below 100. Tries 2 flavors with all sort of toppings. Eat some but i have to beg him.
I need someone to help me at night time. When needed.
Maybe the rules of no one on one help needs to be updated. Whats more important??? Rules or his life???

 

[Tricia Cinco(GA) & Harvey]

Maybe the rules of no one on one help needs to be updated.

We can help one-on-one. We just have to do it on the condo, not by PM. None of us are veterinary professionals, so we have to keep our guidance in the open where others can see and evaluate it. It's for your safety (and Sprocket's).

Eat some but i have to beg him.

Have you tried putting a little on your finger and seeing if he will lick it off? We've had members give whole meals that way before. Some people hold the dish so the kitty will eat (btw, just raising the dish off the floor a little can sometimes make a difference).

 

[Tricia Cinco(GA) & Harvey]

Darnell, please refresh my memory - are you giving any anti-nausea meds, like Cerenia or Ondansetron? An appetite stimulant like Cyproheptadine or Mirtazapine?

 

[Darnell & Sprocket (GA)]

He is off the cyproheptidine now because its possible it caused his cysistis because he was on it too long. I have ondansetron when needed.
He wont eat from my finger.
I need one person to follow him as I cant explain over n over. Plus this forum is so slow when it comes to freak out times.
I need the alerts the fb has to the person this forum doesnt do that.

 

[Tricia Cinco(GA) & Harvey]

I need the alerts the fb has to the person this forum doesnt do that.

Well, it does notify someone if there is a new post to a condo they are watching, but that person has to look at site to see that they have a notification.

If you are wanting advice on the FB page, you'll have to talk to the administrator of the page. The administrator makes the rules.

 

[Tricia Cinco(GA) & Harvey]

I have ondansetron when needed.

What do you mean, by "when needed"? It's possible the reason he won't eat is that he is feeling nauseated.

 

[Darnell & Sprocket (GA)]

Well, it does notify someone if there is a new post to a condo they are watching, but that person has to look at site to see that they have a notification.

If you are wanting advice on the FB page, you'll have to talk to the administrator of the page. The administrator makes the rules.

With fb messenger it notifies them on their cell phone that they have a message not only when they are on the site.
I need someone to follow him daily to see what I see. Its too much to explain.
Its 230am now. I tested at +7.6/92.
See he dropped more with a 5 carb of @2.5oz in belly.
Now I just had to give 8 carb friskies cause the flavor i have of 7 carb he wont eat now cause he ate that flavor a few hrs ago.
He ate @2.2oz w/o water of 8 carb. Then got 0.03ml of his buprenex.
This is what i have to do just so I can sleep at all.
I need someone to look at what i see daily cause I dont know what dose to give him to keep him in 100s more but not go above 300. What carbs do i feed to keep him there. It makes a difference.
My helper now helps but mostly in daytime plus her cat passed over a month ago now. He was predictable before but now she is even baffled cause he is so wacky now.
I give him the ondansetron when he acts like he is nauseous. I cant give it to him daily forever. I give the famotidine daily still and ursodiol.

 

[Darnell & Sprocket (GA)]

See. Alerts are not right away. It just now alerted me to your message over 2 .5 hrs ago.
This is why i need to use fb messenger. Its faster.

 

[Tricia Cinco(GA) & Harvey]

I can't solve the lag in notifications for you, Darnell. When I am watching a particular condo, I refresh the screen every few minutes to see if there has been another post. I don't wait for the notification to appear. Maybe doing that would help you?

Are you setting an alarm and getting up to test at +3 and +7? Is that why you always test at those times at night? It might be helpful to do +2, +4 and +6 once in awhile - in other words, change it up every now and them. Might give you a better picture of what's going on. I'm wondering if that +7.6 is his nadir, or if he is on his way up.

 

[Cherish Gallagher]

I don’t really think it’s right that you’re expecting someone to completely drop their life and follow your posts and be around to help you whenever you need it. You’re also not being very polite in the request either, especially when several people are trying to help you. I understand that it’s frustrating (for all of us) but what you are requesting is above and beyond what should be expected from sites like these.

 

[Gill & George]

See. Alerts are not right away. It just now alerted me to your message over 2 .5 hrs ago.
This is why i need to use fb messenger. Its faster.

Tricia is right, refreshing the screen will show the notifications up. I realised that one day in the beginning, when I was waiting for advice on how to proceed with BFG, his numbers were diving. I thought everyone had gone on a coffee break mid crisis.
When I refreshed the screen I realised that folk were waiting for me to respond and they were getting worried because they hadn't heard back

 

[Marje and Gracie]

I think the members here do a pretty good job of being responsive when numbers are low. It’s important to remember that we are all volunteers. People work, have families, have their own diabetic cats.

It’s just not possible to have one person dedicated to you and Sprocket unless you’d like to hire one of the people who do it for pay. There are those people in existence but not as part of this board. We volunteer our help because we love cats and we understand what it’s like to have a diabetic kitty.

I wish the best for you and Sprocket and you always have a “home” here for help.

 

[tiffmaxee]

I feel your frustration, understand you are frustrated and empathize, but I think you are expecting too much from a volunteer board. Many of us no longer even have sugar kitties but stay on to lend our expertise when we can because we want to pay it back and love cats.

If he’s not eating he’s more likely nauseous than tired of his food. I had to give one kitty daily ondansetron for the last year of her life. Max went months at a time getting it for chronic pancreatitis. When he got the right dose he didn’t need appetite stimulants. When it was his time, no medication helped his appetite. Your cat has to eat. If the food makes him feel sick he will likely develop food aversions. I would not hesitate to use nausea medication daily for any length if time. JMHO and experience FWIW.

 

[Darnell & Sprocket (GA)]

I can't solve the lag in notifications for you, Darnell. When I am watching a particular condo, I refresh the screen every few minutes to see if there has been another post. I don't wait for the notification to appear. Maybe doing that would help you?

Are you setting an alarm and getting up to test at +3 and +7? Is that why you always test at those times at night? It might be helpful to do +2, +4 and +6 once in awhile - in other words, change it up every now and them. Might give you a better picture of what's going on. I'm wondering if that +7.6 is his nadir, or if he is on his way up.

I set an alarm and test before every meal which is at those times as he has been so unpredictable I had to do that just to figure out which carb to feed him over past few months.
I am not great at computers thats why its hard for some people. Not everyone is young n up on computers. Many people dont even own them still. Many retired people are home & caring for special needs pets but cant do these fancy sites so lose out on all this help.
I am always asking my niece to help but try getting a 21yr old to come help.

 

[Darnell & Sprocket (GA)]

I don’t really think it’s right that you’re expecting someone to completely drop their life and follow your posts and be around to help you whenever you need it. You’re also not being very polite in the request either, especially when several people are trying to help you. I understand that it’s frustrating (for all of us) but what you are requesting is above and beyond what should be expected from sites like these.

I am not asking that. I am not being impolite but I have been on this board for months now and its difficult for people whom are not conputer savy. Plus I have had so many people arguing with me about how complex my cat is so I am hesitant to post because I have been treated badly in past.
I just post fast replies so Its just the answers and info so ita not rude just fast.

 

[Darnell & Sprocket (GA)]

Tricia is right, refreshing the screen will show the notifications up. I realised that one day in the beginning, when I was waiting for advice on how to proceed with BFG, his numbers were diving. I thought everyone had gone on a coffee break mid crisis.
When I refreshed the screen I realised that folk were waiting for me to respond and they were getting worried because they hadn't heard back

I usually do do that but I had gone to bed. When i woke to test n feed I noticed it had just sent the email notice 2.6 hrs after she sent it.

 

[Darnell & Sprocket (GA)]

I feel your frustration, understand you are frustrated and empathize, but I think you are expecting too much from a volunteer board. Many of us no longer even have sugar kitties but stay on to lend our expertise when we can because we want to pay it back and love cats.

If he’s not eating he’s more likely nauseous than tired of his food. I had to give one kitty daily ondansetron for the last year of her life. Max went months at a time getting it for chronic pancreatitis. When he got the right dose he didn’t need appetite stimulants. When it was his time, no medication helped his appetite. Your cat has to eat. If the food makes him feel sick he will likely develop food aversions. I would not hesitate to use nausea medication daily for any length if time. JMHO and experience FWIW.

All I am asking for is someone to look at his SS for 5 mins a day and 5-10 mins for chatting with me.
Many people are home also. I am home not by choice but it allows me help him. I just am not computer savy and cant do all this fancy stuff. If someone wants to post the info after then fine but I need experts to find when in crisis. I cant type this long stuff when freaking out.

He was on ondansetron about 6 months. His med list is long so vets r trying to reduce what is not needed. The cypro might have caused the cystitis.
He is still on famotidine daily.
I add ondansetron when he vomits or appears nauseous. I
Before I was told his appetite would reduce when he was feeling better when in 100s more.
Problem is he doesnt want food at worst times and is so picky.

 

[Noah & me (GA)]

Whats more important??? Rules or his life???

Hi Darnell & Sprocket and your Mom, I hope I can give you a little Sunday cheer up. I peeked at your profile and saw you were a nurse. To me two things are obvious; if you were a nurse you're not an idiot and you really love your cats. I've broken almost all the rules with Noah and his brother Nigel; free feeding, U100 syringes, the wrong food. No two cats are the same so sometimes the rules become general guidelines. I am in no way encouraging you to do something whacky but I understand your frustration. The most important thing of all is that you have to take care of yourself before you can take care of an animal. I also get very stressed and have medical issues coming out the wahzoo. Personally my big issue is I can't stand confrontation so I wrote someone I cared about out of my life. It probably saved mine. That's it, I need to step out of the way now so other people can help you with something out of my league. I hope your day gets better.
from Noah and Dickson

 

[Darnell & Sprocket (GA)]

Hi Darnell & Sprocket and your Mom, I hope I can give you a little Sunday cheer up. I peeked at your profile and saw you were a nurse. To me two things are obvious; if you were a nurse you're not an idiot and you really love your cats. I've broken almost all the rules with Noah and his brother Nigel; free feeding, U100 syringes, the wrong food. No two cats are the same so sometimes the rules become general guidelines. I am in no way encouraging you to do something whacky but I understand your frustration. The most important thing of all is that you have to take care of yourself before you can take care of an animal. I also get very stressed and have medical issues coming out the wahzoo. Personally my big issue is I can't stand confrontation so I wrote someone I cared about out of my life. It probably saved mine. That's it, I need to step out of the way now so other people can help you with something out of my league. I hope your day gets better.
from Noah and Dickson

Thanks for your kind words. I must correct you though. I am not a nurse even though I feel like one for all my kitties, past and present. And i am the kitty mom, my name is Darnell. Yes I am female. I know I have a name that is uncommon for females.
I am trying to care for myself too which is why I get frustrated with this board. I have a complex cat & I easily get stressed that I dont need which is why i cant believe no one wants to work with me a little. I open my personal info of my memory issues and on here it makes me feel like people dont believe me or just dont care about that. I cant post like this daily. Its too much stress especially since I am not computer savy with memory issues. I try to learn the feline diabetes info the best i can but some info I cant find. This website is complex and many younger people dont get how hard it is for people that dont know computers. I didnt have a computer or cell phone when I was in diapers like many young people today. I was adult when cells came out and computers were just getting started.
I just want help to help my diabetic cat so he can live as long as possible n be happy.

I guess I ask too much which is sad because I know people do it.

 

[Noah & me (GA)]

You're not alone Darnell but it's a big world and some people are out with their kids or have cats even sicker than yours and mine. The Board has almost nothing to do with your frustration, it's all volunteer run by a small group of people and we never see them ask for money. Remember you're asking a bunch of strangers who don't know you for help so if you sound angry to them they won't respond well. We're getting into something I'm not totally comfortable with so I'll keep this as short as I can. I'm not on Facebook or Twitter and as much as I dislike it things won't change but the people here show incredible kindness, patience and compassion. It may be the last place on Earth you'll find it so be patient. Soon enough the right person will connect with you and you'll get some answers.

 

[Sienne and Gabby (GA)]

Well, I'm not "young" -- I may be better at the computer than you but that's because I need to use it for work and frankly, I could retire any time I want. There is a huge amount to learn about feline diabetes. The best suggestion I can make is if you are having issues with memory, take notes. Create a set of guidelines for yourself so the information is written in a way that makes sense to you. Not everyone will agree with how you manage your cat's FD. If someone thinks you're endangering your cat, they'll tell you. Otherwise, you're the one holding the syringe and all we can do is present the information that we know. We may disagree with your interpretation of Sprocket's SS. The bottom line, though, is you're the one who has eyes on your cat.

You can add a document to your signature line that has the information you want people to know about Sprocket and you can refer people to that rather than repeating it. I have a Profile in my signature if you want to take a look at that. It doesn't need to be elaborate. You can cut-and-paste information you've already provided.

Just like you, everyone else here has competing demands. I was much more active, primarily on the Lantus/Lev board, when Gabby was alive. I still devote a fair amount of time to the Lantus/Lev board but other responsibilities have taken over the time that I devoted to managing Gabby's FD. We pay it forward in whatever way we can. As Marje pointed out, there are a few people who will provide personalized help for a fee. I can't say I've been overly impressed but that's my impression of the help they provide. As a rule, it is strongly frowned upon if members provide personalized assistance off of the forums. All advice/information is meant to be in the public domain. Moderators have warned members who violated that policy and if they continued to provide back channel advice were removed from the board. Keeping information in the public domain is meant to keep your cat safe.

 

[Noah & me (GA)]

@Darnell & Sprocket Hope you come back.