Tilly 6 cycles Revisited ??

Status
Not open for further replies.
Marci and Buddy

Marci and Buddy

Member Since 2009
so now that i have understood Tilly 's reccomm. of .25 u adjustments to be wrong for Buddy(way too much),
i am questioning if it really is best to wait 6 cycles to adjust dose. My poor boy is on cycle 2 and drinking/peeing like crazy, :sad:
tempted to go back to last dose of 1.25 tonight.....I'm thking since ECID maybe i have to adjust Tilly to Buddy in this way -.
thoughts on waiting for 6 or going for change early,please?
 
Marci, I think the consensus was back in your November 29 thread was to reduce back to the last good dose which was .05 or even .75. Vicky thought .05 so you would have room to increase. It just seems like you need to confirm that he isn't rebounding since his numbers sure do look like it on this higher dose.

I know that is hard to do. We hate seeing them in those higher numbers and feel like we just aren't giving them enough when we try these smaller doses.

It is just that he was doing so well back on those doses. I still wonder what happened? Cats insulin needs do change, I am aware of that, but ever since you increased his dose it looks like his numbers got worse.

Again, it is up to you of course, and since you are home during the day you can try increasing like you want but of course be diligent for those lows.

See what others say. Like I said in that thread I am usually all for increasing in steps to bring down high numbers, but it really does look like he is rebounding here.

Is there a health issue that we aren't aware of maybe?

Here is Vicky's post from that thread:

"by Vicky & Gandalf » Wed Dec 01, 2010 2:31 pm
Hi Marci and welcome back.

Taking in to account the entire chart, it seems very possible that Buddy is a diabetic cat who is flirting or has flirted with remission. The indicators to me are those 30s. A cat who is eating well on their dose rarely gets in to the 30s. 60s even 50s yes, 30s are a red flag for dose decrease as long as the cat's appetite is strong.

So now you must wonder what decrease you should make. I suggest going back to his last best dose - which was .5U. That may seem like a big drop, but if it doesn't pan out, you have room to work back up.

Also, .25U increases when dose is 1U or less are too large. Think in percentages - .1U is 10% of 1U, while .25U is 25% of 1U, so an increase of .25U from 1U to 1.25U is a 25% increase. Ideally Lev regulates best when increases are no more than 12-15% of present dose. A bit contrary to Tilly protocol recommendation, but I see better regulation when I increase by .1U or even .05U than by .25U at one time. I also feel it is why so many cats experience what Buddy is - constant fluctuations of BGs within 1 cycle, especially at the lower doses.

Another key with Lev is give it time - you will see responses to dose changes that will make you think rebound, that will make you think it's not enough insulin, that will make you crazy!! So that's why it's best to decide on a change, give the dose 5 days. As long as the cat is otherwise healthy - good eating habits, no infections, the 5 Ps - you should not run the risk of ketones or other problems. Curve after 5 days and see what the +7 to +10 BGs are. A good dose should produce steady numbers, not necessarily low/double digit numbers either. BGs steady in the 100s are better than BGs ranging from 30 to 300/400.

Hope that helps. I've been offline for a week now and just now back on the boards, but will try to keep in touch here."
 
I am inclined to take the recommended 6 cycles as a minimum - unless the cat is prone to ketones or drops to sub 40 numbers.

Are there possible other reasons for him drinking a lot - such as dry air? I have not noticed a response that fast to higher numbers, but remember they could be from rebound as well as not enough insulin. If he was having a tendency to "push back" against a slightly too high dose, his body will still push even though the dose is less - for at least a few cycles - and that would keep him higher.

I would want to see some spot checks today and tonight to see what is really going on BG-wise. He could still come down to decent numbers today.

PS - I think Pamela meant to type .5u (half) not .05u.
 
need help with tonight's shot

No other health issues going on, other than his arthritis ,
(nine yrs ago he fell out the window six stories and broke 3 legs -pushed right thru the screen chasing a bird ) I give him adequan IM, and he's fine, thanks to this site.
also ,i give him fortaflora at each meal, but i understand that doesn't effect the bg, right?.
So what do i shoot tonight? continue with the new dose for 6 cylces, or drop to .50??
advise, pleeease.
 
Marci,

I am not super great at dose advice since my PK is so cuckcoo about insulin at all, but just a quick study of recent numbers/dose shows me the basic rule that the more insulin Buddy gets, the higher his numbers are...the less insulin he gets, the lower his numbers are.

Remebering the immediate BG's are not neccessarily a direct result of last dose, but probably a dose or two before (shed theory) and plainly seeing rebound 400 following the super low greens he had to be fed out of, I would consider the lower dose, though it seems counter intuitive.

As to wether you choose the step down for less shock value or just go for the gusto and slam the lower dose on him is entirely up to you and your gut feeling.

What do you think feels more right to you?
 
I guess i feel more comfortable going down slowly, but that wd. mean more bg #'s bouncing around to the dose adjustments, right?
thinking i'm going to live dangerously and go for the .75 tonight....see what happens.does that sound ok? just want to be sure i am understanding the suggestions correctly-thanks.
 
no matter what you pick, there will inevitably be more bouncing around as the body adjusts to the different dose...it's just part of getting a kitty regulated and we do our best to soften the bounces with food, love and comfy blankies.

Whatever dose you pick for tonight, please consider keeping it the same for a MINIMUM of 6 cycles....as Sheila mentioned, I too see that suggestion as a minimum and prefer to hold a dose for PK at least 12 cycles.

Of course, if you see extreme highs continuously through cycle or get a low that is too low even once, you'll want to change the dose before the settle time, but on average I think 4 or 5 days (8-10 cycles) to hold a dose is not unheard of.

Hang in there! You are doing a great job learning and asking for suggestions and we all know you are doing your very best for your sugarsnack!

(((hugs)))
 
Re: need help with tonight's shot

Marci and Buddy said:
No other health issues going on, other than his arthritis ,
(nine yrs ago he fell out the window six stories and broke 3 legs -pushed right thru the screen chasing a bird ) I give him adequan IM, and he's fine, thanks to this site.
also ,i give him fortaflora at each meal, but i understand that doesn't effect the bg, right?.
So what do i shoot tonight? continue with the new dose for 6 cylces, or drop to .50??
advise, pleeease.
Click to expand...

Awww, poor baby. That must have been horrible for you and for him. :(

I wonder about the Adequan. Vicky also uses this for Gandalf and I remember looking it up before, but didn't see this....

http://www.treshanley.com/cic/arthritis.html

"PLEASE NOTE for DIABETIC DOGS NEVER give supplements containing GLUCOSAMINE as this nutrient must be avoided by diabetics because Glucosamine blocks the formation of insulin. Also DO NOT feed your a diabetic pet any pet foods containing GLUCOSAMINE. Many 'Senior Foods' have this added now to help aging pets with arthritis and joint mobility. It is a good thing for arthritic and older dogs but NOT if they are diabetic! In March 2001 issue of PREVENTION Magazine tells more of the dangers for diabetics and this supplement both in HUMANS AND ALL ANIMALS. It is shown taking Glucosamine if you are Diabetic can trigger INSULIN RESISTANCE. This means that the body stops recognizing insulin and, as a result sugar in the blood can build up to a dangerous level. Adequan (below) may or may not contain Glucosamine so discuss this with your vet. Many vets are currently unaware of the dangers of Glucosamine for Diabetics as this finding is recent. Another online article on this is found here at Nutrition Science News."

According to this article it does contain glucosamine:

http://www.vin.com/VINDBPub/SearchPB/Pr ... R00190.htm

"Chondroprotective Drugs
Adequan® is polysulfated glycosaminoglycan (PSGAG), made from an extract of cow lung and trachea that is then sulfated. The result is a large, charged molecule composed of galactosamine, glucosamine, and hexuronic acid......"

Could this be the cause of his insulin resistance/hyperglycemia? When did he start on this medication? Maybe I am way off base here since I have no personal knowledge of treating an arthritic animal - Vicky and others do however. I know lots do use it on this board so again, I could be way wrong here. Wondering what others think? And I don't know what you would do anyway, you have to treat the arthritis but possibly he does need more insulin? (I am sorry - not trying to complicate things here). :( Maybe we should see how the lower dose does first??

Why do you use the Flortiflora? I just use it occasionally as an appetite stimulant sprinkled lightly on Tigger's food.
 
WOW-this is interesting! He started on adequan jan'10----VICKY, and others on it---what do you think about this???
Fortiflora is sprinkled on every meal b/c he loves it, not as interested in meals otherwise.
 
also, this article recognizes glucos. as an obstacle in dogs with diabetes, could it possibly be different in cats? Or,perhaps it is the exact explanation as to why Buddy is so difficult to regulate past 6 months.
 
I think Vicky is working late tonight (pre-holiday hours), but she might be able to shed some light on it.

I think trying the .75u is fine for now. He did have good numbers on it before. You have to restart your settle timer.
 
Adequan

Pamela, your net searching skills never cease to amaze me.

I'm a bit leery of the first link because the info about glucosamine states source back to 2001. If it was known back then, why did the info get lost in the interim because FDMB is on the forefront of FD care and it should be known in our circle that glucosamine affects insulin usage.

Can you search on the old board and see if there's any reference to this?

I told my vet when we first started Adequan at the beginning of 2009 that I thought it affected his BG. She inquired and came back with no known incidents of that. I believe I saw increases immediately afterwards for perhaps the next 2 cycles, but it's very hard to tell because Gandalf is not well controlled, however I felt it happened enough times after the once a month shot to bring it up with my vet, so I don't think I imagined it.

He was getting it in the muscle then. Since we started acupuncture later that year the acu vet gives it to him in acu points. I no longer notice a BG anomaly when it's given.

Another fact to note is that it's now accepted practice to give it sub-Q, like insulin. I had that confirmed by my vet.

After the holidays I'll have to look in to this further. I still find it hard to believe that glucosamine has that much affect on diabetics and we don't know about it here. Or I have not seen it written about at least, but obviously I'm not keeping up as well lately.
 
well at the very least i will now go from giving him adequan EOW to 1x a month, and subQ ,not IM, which has always been difficult for me anyway...wonder why IM was reccommened im in the first place if subq is ok?
 
Hi Marci,
I just wanted to chime in about the Adequan/glucosamine and insulin resistance. I had heard this before, but I don't think it has been definately proven. Here's a link on Wiki, page down to the part on Glucose metabolism: http://en.wikipedia.org/wiki/Glucosamine

My Blackie has had arthritis for many years. He was on Cosequin for several years and I swtiched to Dasuquin over a year ago. He also gets monthly subq injections of Adequan and daily doses of Gabapentin. I have never seen any reaction of his glucose to the Adequan. I put a note in my spreadsheet when I give the shot and you can see that it never changed his cycles.

If Buddy is in pain and has trouble walking I would suggest you talk to your vet about Gabapentin. It is an anti-seizure drug used for chronic pain. It has been a wonder drug for Blackie. Within a couple days of starting it he was jumping on chairs again and walking much better. There are several kitties on FDMB on it now (including some civies) and I think it really helps most of them. The only side effect is sleepiness if the dose is too large.

I hope this helps.
 
I've been giving adaquan IM not SubQ [to a civie]. I think it is supposed to be IM not SubQ. You can get your vet to give you an IM lesson. It is a little more difficult. I have been using the same insulin syringes to give the IM injections :smile: :smile: - hope I've been doing it right. It's difficult on kitties that have reduced mussel mass - that have wasted. I've hit the a source of blood in that back leg a couple times now - so do pull back on the plunger to test before you shoot it all.

BTW Adaquan is available at Costco now - or at least the ones doing pet meds. I hope they expand this to all stores soon.
 
Gator & H (GA) said:
I've been giving adaquan IM not SubQ [to a civie]. I think it is supposed to be IM not SubQ. You can get your vet to give you an IM lesson. It is a little more difficult. I have been using the same insulin syringes to give the IM injections though :smile: :smile: - hope I've been doing it right. It's difficult on kitties that have reduced mussel mass - that have wasted. I've hit the a source of blood in that back leg a couple times not - so do pull back on the syringe to test before you shoot it all.

BTW Adaquan is available at Costco now - or at least the ones doing pet meds. I hope they expand this too all stores soon.
Click to expand...

I also was adamant about Adequan being IM, but others on the board said it had been approved for sub-Q use (found to be just as effective as IM administration). I confirmed that with my vet, so you might want to check with yours. I don't know who changed the standard, if it was the FDA because I don't think it is yet to be FDA approved for use in cats, so you might want to check on that too. Suggested use may also depend on what university/teaching vet hospital the vet works through/contacts. My vet seems to depend on her University of Missouri and IL vet school contacts a lot.
 
Vicky & Gandalf said:
I also was adamant about Adequan being IM, but others on the board said it had been approved for sub-Q use (found to be just as effective as IM administration). I confirmed that with my vet, so you might want to check with yours. I don't know who changed the standard, if it was the FDA because I don't think it is yet to be FDA approved for use in cats, so you might want to check on that too. Suggested use may also depend on what university/teaching vet hospital the vet works through/contacts. My vet seems to depend on her University of Missouri and IL vet school contacts a lot.
Click to expand...
Thanks for the 411 - very helpful. :smile: I'll make sure to question.
 
I think the point is that one should check with their vet and ask them if they are aware of any new guidelines for injection of Adaquan. Or at least that is what I intend to do. It sounds like IM injections are still likely just fine too. So if you can get the lesson from your vet then you have that option too. One can use the same syringes needles assuming your cat gets less than .3ml or so of Adaquan. Technically I think it's good technique to use a syringe only to to like 3/4 of it's total volume but that never stopped me from using them to their full. Or you can go to wal mart and get 1/2cc diabetic syringes with the smallest needle [they also sell in packs of 10]. The nice thing about diabetic syringes is that a) they generally have very small needles and b) they generally do not waste as much medicine at the tip and c) they are cheap. You just have to do the conversion from units to ml which for U100 syringes is very easy: each 10 units is .1ml.
 
Status
Not open for further replies.
Back
Top