[UPDATE] Avery's comeback

[CheshireKitten]

Hey all,

Just wanted to follow up with my little buddy's story. I started at the Welcome page and made a post here.

He was diagnosed late Sept 2023 and started on ProZinc. We've met with a new vet that is more comfortable treating diabetes. She had some amazing advice and his levels speak for themselves.

We settled on 3 units of ProZinc as that was the amount we saw the best levels. Additionally, we finally made the hard switch to 100% wet food. We initially fed Fancy Feast Pate however some users pointed out that it may be high in phosphorous so he's on Weruva BFF.

Our vet recommended to feed only twice per day when we give him the shot; we were allowed to give snacks and settled on Vital Essential's freeze dried food since it appears to only have single ingredients. His levels slowly began to bounce before settling in the 'yellow' range. More recently, we began to see more and more blue and his pre-shot levels were looking great. Down significantly from the 500+ levels in the first month.

In the last two days we saw green (yay) however we've been very hesitant to give him the shot. This morning his AMPS was 89 and we decreased from 3u to 2u. I re-read the ProZinc info page on here and saw that >90 isn't recommended to shoot (I think). At +6 he was at 61 however my fiance was monitoring him all day and we have a hypo kit ready.

Now my dilemma, how do I navigate these levels? I want to see him stable, I'm not looking for immediate remission. The 3u was very helpful but it's perhaps too aggressive. I'm thinking keeping him at 2u and seeing how he does for the week. Likely will skip the shot if the PS is >90 going forward but I'm not sure.

I'm going to re-read the ProZinc help post but any suggestions are highly recommended. I also want to thank a lot of users here for being so welcoming and helpful. Shout out to Suzanne and Darcy as she was looking at the chart when I was away and asking for follow ups.

Go Mister Kittums, Go.

 

[Suzanne & Darcy]

Hi there. I’m happy to have this update on Avery. He is starting to have much better numbers. The switch to the LC wet food was definitely the way to go. Well done! While 61 is definitely a safe number and one that a lot of our members would love to see in their kitties, since you are following the SLGS method, you want to generally keep him between about 90 and 150. Later on, you may want to switch to the Modified ProZinc Method (MPM). Good job testing last night. When you got the 61, I hope you gave him a snack of some of his Weruva food. It looks like the 2 units when he was at an 89 preshot kept him safe, but next time you could try 1 unit and see how that goes and if it will keep him just a little higher but hopefully not allow his BG to go up too high. I’m afraid if you skip the shot entirely that his BG will really climb high over the night and into the next morning. Any time you get a lower end preshot like that, be prepared to get a few tests (perhaps a +2 and then a little later in the cycle.)

I am not sure why that 61 on his spreadsheet is color coded lime green because it’s not a lime number. Below 50 would be a lime number for a person using a human meter like your ReliOn. Did you start out with a pet meter perhaps?

 

[CheshireKitten]

Hi there. I’m happy to have this update on Avery. He is starting to have much better numbers. The switch to the LC wet food was definitely the way to go. Well done! While 61 is definitely a safe number and one that a lot of our members would love to see in their kitties, since you are following the SLGS method, you want to generally keep him between about 90 and 150. Later on, you may want to switch to the Modified ProZinc Method (MPM). Good job testing last night. When you got the 61, I hope you gave him a snack of some of his Weruva food. It looks like the 2 units when he was at an 89 preshot kept him safe, but next time you could try 1 unit and see how that goes and if it will keep him just a little higher but hopefully not allow his BG to go up too high. I’m afraid if you skip the shot entirely that his BG will really climb high over the night and into the next morning. Any time you get a lower end preshot like that, be prepared to get a few tests (perhaps a +2 and then a little later in the cycle.)

I am not sure why that 61 on his spreadsheet is color coded lime green because it’s not a lime number. Below 50 would be a lime number for a person using a human meter like your ReliOn. Did you start out with a pet meter perhaps?

Thank you Suzanne! I just want to say, I mentioned you to my fiance and she's very thankful for your help. Additionally, our hearts melted when we saw how you were writing notes for Darcy in your spreadsheet. You two must have had quite the bond<3.

I do recall having to adjust certain fields because the spreadsheet initially was for a pet meter and you're right, it shouldn't be dark green. Yes we gave him snacks when he hit 61 just to be on the safe side. We had actually panicked a bit on 11/05 and skipped the shot which caused a large bounce in the morning so now we know how to handle 'blue' readings. Luckily this morning he was in the 'yellow' AMPS (253) and his PMPS last night was 323 so I'm hoping he adjusts to these lower numbers. I definitely think skipping shots isn't necessary unless he's very very low. I'd prefer to give him a little something, I was just concerned that going from 3u to 2u or 1u would be too much of a jump.

Also, his infection has gone down significantly. We have an appointment for an extraction though as his canine is impacting in to his gum. He's gained weight, grooming, and fighting with his sister again

 

[Suzanne & Darcy]

Thanks for your kind words. It looks like today’s cycle has been a bit of a bounce.

Is his canine tooth being removed by a dental specialist? I’m just wondering because I have read that removal of canines can be more problematic than other teeth. I do have a cat who has FIV and one of his canine teeth has been poking down into his lower lip and had been making it bleed. We did some antibiotics and it helped him.

 

[CheshireKitten]

Thanks for your kind words. It looks like today’s cycle has been a bit of a bounce.

Is his canine tooth being removed by a dental specialist? I’m just wondering because I have read that removal of canines can be more problematic than other teeth. I do have a cat who has FIV and one of his canine teeth has been poking down into his lower lip and had been making it bleed. We did some antibiotics and it helped him.

Yeah his numbers can be a bit volatile. Not sure if it's due to giving 2u yesterday but we just did the PMPS and he tested at 133 and has gone from 5.5 lbs back in Sept to a little over 9 lbs now.

Truthfully, the dental work is still ambiguous and I'm not keen on a removal just yet. Muhc like your experience, his canine was impacting his gums causing bleeding and swelling. As it swelled, 50% of the tooth was engulfed in swollen gums. He got a shot of antibiotics at the vet and we've been cleaning his mouth 2x per day. Swelling has gone down, bleeding has stopped but the tip of his canine is still impacting a swollen lump from his gums. My vet does do dental work but I don't know if they're "specialists" per se. They haven't even mentioned x-rays which I find odd so I'd like a specific consult to determine if it's even necessary. They have taken some pictures of the tooth but that's about it. One things certain, at the moment the edge of all his gums are darkish pink and there's clear tartar build up. His gums also seem to be receding so I think there's clear signs of gingivitis. Thus far, the two vets we have visited haven't really wanted to address his teeth until the diabetes was under control. My plan is to keep the Dec 20th appointment but ask that they examine his teeth before extracting anything.

 

[Suzanne & Darcy]

I understand that a lot of vets say that same thing— to address the diabetes first before handling tooth problems. However, tooth problems can make the diabetes so much harder to control (causing insulin resistance like any infection or inflammation can.). A veterinary dental specialist is a vet who only does teeth and not ordinary veterinary stuff. So it’s something that you have to seek out and find. I see you live in NYC so it should not be a problem to find a veterinary dentist. What about the Animal Medical Center?

I definitely think it sounds like more investigation should be done before extracting teeth. I’m glad you are going to insist on that. X-rays would be a starting point (although that requires anesthesia so it’s usually done at the same time as a regular dental cleaning.).

 

[CheshireKitten]

I understand that a lot of vets say that same thing— to address the diabetes first before handling tooth problems. However, tooth problems can make the diabetes so much harder to control (causing insulin resistance like any infection or inflammation can.). A veterinary dental specialist is a vet who only does teeth and not ordinary veterinary stuff. So it’s something that you have to seek out and find. I see you live in NYC so it should not be a problem to find a veterinary dentist. What about the Animal Medical Center?

I definitely think it sounds like more investigation should be done before extracting teeth. I’m glad you are going to insist on that. X-rays would be a starting point (although that requires anesthesia so it’s usually done at the same time as a regular dental cleaning.).

I 100% agree and still believe that when his oral issues were at their worst, his BG levels were out of control. I just checked and there were only 3 non-species specific board certified dental specialists by me. I'll wait for the consult and see what their plan is before doing anything. If my current vet can't provide a reasonable treatment plan then I'll have to take a day and bring Avery to the city for one of the 3 specialists. One of them was at Animal Medical Center and one in Tribeca Vet Dentistry, which is a tad closer to me.

Also Avery's 3+ reading was high than his PMPS at the usual 3u. His PMPS was 133 and his 3+ was 183. This is the first time I've seen his BG higher than his PS levels. I'm usually pretty good administering the shot and always check to see if I got a fur shot. I'm gonna check again at +5.