5/15 Lucky AMPS 420 PMPS 385

Hi, I'm fairly new to this forum, hope I'm doing this correctly, LMK if I'm not please. Lucky's my stray kitty, I've had him for about 6 years. I think he's around 10 to 12 years old. Weighs about 14.5 pounds. Diagnosed in Feb 2016, on Lantus, currently 3.5 units. Can't seem to get him regulated. Runs high consistently. I'm tieing myself in knots trying to figure this out. Any advice and help is greatly appreciated. Thanks!

 

Is Lucky on 100% low carb wet food now? I'm asking because DM dry is too high carb for a diabetic.

Take a read of the Sticky Notes at the top of the forum. There is lots to learn, but feel free to ask questions. We love to help here. In particular, take a look at the Tight Regulation Protocol or the Start Low Go Slow Method. People here choose one or the other to use to decide on dosing. If Lucky is eating any dry food, then it's SLGS that must be used. You'll note that we only make changes by .25U, unless kitty is seeing only high numbers.

Good job getting your spreadsheet up and doing the testing. Your primary vet is wrong about testing - it's what keeps our kitties safe and tells us what dose we should be using. Try to get a test before every preshot at least, so you know it's safe to give insulin. Night time tests are also important because many kitties go lower then.

Any other medical issues with Lucky? Has the vet checked to see if he needs a dental. That's a common reason people find it hard to get regulated. But sometimes cats also just need more insulin than others.

 

Hi Cindy. Welcome to Lantus & Levemir Land, the nicest place you never wanted to be.

You're doing great so far. I'm sorry your vet told you not to test. He/she could not be more wrong. Testing is how you keep Lucky safe. How does Lucky react to testing? If you are having trouble getting him used to it, let us know what the issues are. We may have suggestions that will help. Unfortunately, most vets know very little about Feline Diabetes. They get about 5 hours of study on diabetes in Vet School, and that covers BOTH dogs and cats (and dogs react very differently to diabetes). Also, many vets don't have much experience with it because a lot of people are not willing to commit to the time and expense that is involved in treating FD. The people you will find here are not vets, but we have a LOT of experience with FD. Some of us have/had more than one diabetic kitty.

When I came here in 2011, I knew nothing about FD. My vet told me to give Cinco x units and bring him back in a week for a curve. She kept increasing the dose, and his number kept going up. He got DKA and almost died. She told me to euthanize him more than once. A friend told me about this site and gave me her testing supplies. I soon learned we had started Cinco on too much insulin. I adjusted the dose, started testing, changed his food from the prescription stuff the vet sold me to Fancy Feast, and within a few weeks Cinco was feeling much better and his numbers were coming down. In three months he was Off the Juice - in remission! The vet was amazed. He later lost remission due to a virus he contracted, but we managed his FD with help from the people here for the next 4 years, until cancer took him from us last month. Meanwhile, another of my cats became diabetic due to the steroids he takes for his lymphoma. He's very well regulated, because I ignore what the vets say and follow the TR protocol.

That was the Readers' Digest Condensed version of our story, but I tell you this because I want you to know it's possible. We've all been where you are. We were all confused, overwhelmed, scared and frustrated. Hang in there, read the stickies at the top of the page and ask lots and lots of questions. You've come to the right place to get help for Lucky. You can do this!

 

Hi, Thanks for responding.....Lucky is on Classic Fancy Feast Pates, a variety. No dry at all. Luckys numbers are in the RED zone the last few testings, altho he is eating more. This morning was 442. I think he may be drinking a bit more too. Vet wants me to go to 4 units. I feel like I'm tieing myself in knots here, as I don't know what to do. Could he be bouncing? Should I lower or increase. Vet doesn't know much about FD. Thanks!

 

PS~~ He has no other health issues that I'm aware of, Blood work was always good except for the BG and a slight elevation in the BUN. and no he has not had a dental check up.

 

Hi Thanks for responding, Lucky does well with testing, I'm sure he hates it, but he doesn't try to get away, as I test him right before he eats, so he knows whats coming. I test , feed, at 900 am .... shoot, at 930 am. Hope this is ok. I have no clue if he is getting too much or not enough. Vet wants me to increase to 4 units, if you notice his spread sheet he was on 4 a few weeks ago but acted lethargic, so I backed it down, now numbers are climbing, altho he has been eating a little bit more. He was only eating two times a day with 2 snacks in between, but I thought this couldn't be good, so I increased his food as he ravenous. I swearhed eat two full cans if I allowed it. anyway, this am amps was 442. ugh. I feel nauseous. Thanks for your input!!!

 

When cats have uncontrolled diabetes, they are essentially starving. Being ravenous is a sign of numbers that are too high. We usually recommend several meals a day, in the early half of the cycle. It's easier on the pancreas.

One thing I forgot to ask is, are you testing for ketones at all? When kitties have sustained high numbers, that becomes a risk, although there are other risk factors that usually contribute, and it doesn't look like Lucky has those.

Since you say Lucky doesn't mind being tested, would you be able to get a few more tests in during the cycle? I'm wondering if there are any lower numbers hiding in those time ranges with no tests. An occasional +2 or +3 would be helpful, to see if we can figure out when his dose onsets. Not all kitties nadir at +6 (in fact, most don't), so switching up the mid cycle test could be helpful, too - get a +5 one cycle, a +7 the next, etc. Think of the spreadsheet as a jigsaw puzzle. with just a the edges and a few middle pieces filled in, it's hard to see what the picture is, but the more pieces you add, the clearer it becomes.

I've asked a few veterans to look at your SS and see if they have some feedback for you. I know it's frustrating and discouraging, but hang in there. Lucky didn't become diabetic overnight, and he won't get better overnight, either. BUT we can help you get him started in the right direction!

 

Hi again, I do not understand, in the early half of the cycle..sorry. How long is a cycle, what is the cycle? from shot to shot or 24 hours? I apologize if I missed this somewhere, I did read all the info, but there's so much its overwhelming, and there were times I had to step away.
No I am not testing for ketones. Have seen 2 vets, no one ever mentioned that to me. I had his urine tested twice, both times glucose was over 1000. I think I have this on his ss. you say several meals a day, is there a chart advising how much he should eat for his weight? I wonder if I'm feeding enough or too much...seems as those he was holding steady, altho high, until I increased.
Now I'm going to ask this, since food intake has increased slightly, and numbers have increased, is this leaning toward not enough insulin, instead of too much? Next, the FF I had added was a few of the seafood varieties from the DRs list here on the FDMB. Low carb, but higher in phosphorus, cod sole shrimp, and whitefish and tuna, wonder if I should eliminate those and stick with the variety pack of the chicken, beef and turkey. Is this a factor I'm wondering?
sorry I feel like I'm rambling again, I did this a few weeks ago, I panic and make myself sick over this. I can tell when he's not feeling well, as we all know how our furkids react to things. Today hes not interested in a thing. (except food) He ate at 1:30, I will try to get a test after 330 today. Thanks so much.

 

Hi, Cindy and welcome. Most of us have our war stories about how we got here and how overwhelmed and scared we were. You're in good company!

I noticed from the notes on your SS that your vet was consulting with OSU. Are you in Ohio or more specifically the Columbus area? If so, I have a great vet who is knowledgeable about feline diabetes, supports home testing, and supports caregivers taking an active role in managing their cat's diabetes. (She also makes house calls!!)

Can you give us some sense of what your schedule is like? Do you work outside of the house or are you around during the day to grab a few more tests? My hunch is that you're testing based on the assumption that Lucky's nadir is at +6. While that may be the case, not all cats have their nadirs where they're "supposed" to. (My kitty's nadir was at +3 or +4, except for those times when it wasn't.) These darn cats just refuse to follow the rule book!

What Lucky's SS looks like to me is that doses have been held for too long. I don't know if you've had a chance to read the sticks on the Tight Regulation Protocol and the Start Low Go Slow approach. These are the two methods we use for dose adjustments. The longest a dose is generally held is a week. If a dose that isn't bringing your kitty into a more desirable BG range is maintained, you can risk glucose toxicity developing. The term is scary but all it means is that your cat's system treats the higher range of numbers as the new "normal." This makes it more challenging to get the numbers to come down. It may be reasonable to increase Lucky's dose to 4.0u.

A cycle is a 12-hour period -- the period from shot to shot. Thus, there is an AM and a PM cycle.

The amount of food a cat needs, just like for a human is a bit of trial and error. Lisa Pierson, DVM uses this formula on her website on feline nutrition to approximate the number of calories a cat needs daily:

Required calories per day = [13.6 X optimal lean body weight in pounds] + 70​

Does your vet think Lucky's weight is at a good place? When you referred to a food list, ("DRs list here on FDMB") what were you referring to? Was it the food chart from Dr. Lisa's site?

Many of us feed our cats several small meals prior to nadir. This allows the pancreas to work a little less hard. If it works for your schedule, it's something to consider.

I would also suggest trying to get a curve. It's important to have a solid handle on when Lantus onset and nadir fall and how much duration you're getting. A curve involves testing every 2 hours or a mini-curve is testing every 3 hours. This information along with getting at the minimum a test before bed every night will give you a better snapshot of what's going on with Lucky's numbers.

Please keep those questions coming!!

 

Sienne, her profile says she's in Pennsylvania, but not what part.

 

I'm south of Pittsburgh, several hours away from Columbus. I work from home, I can get some tests, I do have to leave for extended periods occasionally. I'm supposed to leave May 22 for 3 weeks, and now wondering what in the world I'm going to do....I was so hoping he would be regulated by then. I don't know about taking him with me, its a 9 -10 hour trip by car. Not sure how well that would go over.
The doses were all prescribed by the vet, I didn't question anything in the beginning until I started to do research. Then I found the FDMB and realized how misinformed I'd been.
Yes the info I read about the food was Dr Piersons site. Under FF pate, but then I was also thinking....(oh Gosh my brain is fried),,,if I added lower carb food, even lower than the beef, turkey, etc and he's going higher, am I overdosing him with the lantus? As in the beginning if you notice on his spread sheet his very first trip back to the vet he was 300, Id love to see a 300 now. he was at 2 units then, she increased that day an entire unit, saying 300 was still too high, but what if it wasn't? what if he was even lower then 300 and just Vet stressed? she should've never jumped from 2 units to 3 units?
do you see why I'm going crazy here???
On one of the last phone calls the vet said we may have to start over. is this an option? Just go back to 2 unist and see what happens?
I did a curve a few weeks ago april 23 or I tried,,,, I did every two hours for 6 hours, and all numbers were in the 300 to 400 range. I think I posted a 911 post here on the regular forum. its still should be fairly high up as I'm still commenting on that thread. entitled "scared to death" as I was...

as for his weight, he was 15 pounds, had lost a half pound, so hes around 14.5 now. He's fat, he was not an active cat, as I said he was a stray. when he showed up on my doorstep he had been declawed on all four paws. Thank Goodness a coyote or dog didn't get a hold of him. He had several more surgeries to fix the awful declaw job to try and repair some of the damage, so he limps around a good bit. This is why my heart breaks for him, and thus his name. I thought he was pretty lucky to land here with me
I will get a BG soon and post to his ss then I need to head out for a few hours, but I will check back tonight. Thanks again for your kindness and understanding.

 

PS I almost feel as tho I'm slowly killing him, by misinformation and I really don't know what to do to help him, I limit food as this is what I was told to do, probably not the right thing, then I increase food, and his numbers are not good, and he looks so pitiful the last two days.

 

{{{Cindy}}}

You are not killing him. You have done the best possible thing for him by coming here and asking for help. It is overwhelming, for sure, but just try to absorb a little bit at a time, and it will start to make sense.

Cinco was also a stray that someone had abandoned. He had excellent inside manners and was neutered, so I know at some point he lived in someone's house. He was in bad shape when we took him in. I didn't think we could save him, but we did. You can help Lucky, too. Unfortunately, it does take a little time to figure out the right combination of food, insulin, etc., but it will happen.

As for your trip, that's a tough one. A lot of people here take their sugar cats with them when they travel. If he's never done a lengthy car trip before, it would definitely be a challenge. Others (like me) find a petsitter that can give insulin and test while they're gone, either at your home or theirs (or a facility). Some people just never go anywhere! What are you options? Do you know of someone that can give him his insulin every twelve hours, feed properly, and test him at least four times a day? Does your vet to boarding? Maybe there is someone else on the board (any of them) that lives in Pittsburgh and can recommend a sitter or vet. You can do a post on the main board, asking for recommendations.

Regarding the food, I'd go with Sienne's suggestions. She's a veteran here and knows what she's talking about. She's one of the people that helped saved Cinco when I first joined.

 

Cindy, breathe and know that YOU are the most important part of the equation when it comes to helping Lucky feel better. He chose your doorstep because he "knew" you were the right person to help him. You've already done so many things well and although it's a steep uphill climb at first, taking care of Lucky will most certainly get easier. You need time to read, absorb information and then put what you've learned into practice. When we were first starting out a year ago we were so worried and scared. Our sweet kitty was miserable and we weren't sure that anything we were doing was actually helping him. These are for you Hug your sweet Lucky and enjoy his furry company. We hope you will keep asking questions so we can help you help Lucky.

 

Hello again, I am exhausted, today was so emotional for me. I just get into panic mode when he has these high numbers. Sorry if I seem a bit nuts here.I can have my husband give Lucky his insulin, as for testing, I doubt he would be able to test him several times a day, I was away for a week and he didn't test him once, so not sure about that. Thanks again for all the kind words. I think I'm supposed to edit Luckys numbers on my thread. not exactly sure how to do that, will play around here and see if I can figure it out. Have a good night!!

 

Hi there Jan, I am burned out for tonight, no questions come to mind. I'm sure I'll have a new batch tomorrow tho. LOL I am scared, and tired. This has been ongoing since Feb, I really am not sure how much longer I can do this, I also care for me 95 year old mom with dementia, and today was simply one miserable day. Its after midnight and I still wanted to do some reading, but not sure if I can. Eyes not cooperating! Thanks for your kind words, this board is keeping me sane!!!

 

Hi Cindy,
and welcome to LL, we have all felt overwhelmed at the beginning and racked with guilt for one reason or another, don't beat yourself up, you are doing the best you can and you will get a handle on FD for sure, just take it one step at a time. You have a lot on your plate dealing with an FD kitty and a elderly parent with dementia,

I see you took Lucky up to 3.75u, for now if you hold that dose, unless he drops we can see where it is taking him. As others have commented, getting some tests in midcycle (by midcycle we mean anything from +1 to +11) we will begin to get a better picture of what the insulin is doing for him and what you need to do with the dose, FWIW, looking at the ss it looks as though he needs more insulin, and I would have taken him up to 3.75 based on the tests you were getting.
Paws crossed Lucky starts to see some better numbers soon

 

There's actually a contingent of Lantus/Lev users in the Pittsburgh area. They actually have a yearly reunion in Pittsburgh. I posted a note on the Lantus Land Facebook page asking them to stop by with suggestions regarding resources for when you're traveling if you opt to not bring Lucky with you.

Starting over is an option. It's not always the best option, though. If you didn't by pass what could have been a good dose for Lucky, you will lose considerable time getting him back to the current dose. It may be that systematically increasing the dose will finally break through this wall.

One thought is for you to read through the sticky notes on the Tight Regulation Protocol and Start Low Go Slow and decide on which approach to dosing will work best for you.

 

Good morning! Thanks, I found some of the Pittsburgh users the other night, as another newbie posted they were from the "burg" area. No responses yet. I'm sure someone will respond in time. Yes I will refresh the sticky information. I will try this 3.75 a few days and see what happens, his amps was better this morning. You folks here are simply wonderful and I appreciate all the info. Have a good day and I will try to get some more numbers.

 

are those all the numbers you have on your ss? if so, could be going lower when insulin at its best and now bouncing. why will hubby not test?
where exactly are you located. we can network with others to see if sitter available

 

Hi,
The ss goes from Feb, when diagnosed, where there were only a few tests, to current, where there are many numbers the passed few weeks. Vet told me not to test, so in the beginning there isn't much. just scroll to current day. Thank you!
Hubbys just nervous. I need to work on him.

 

Cindy, I'm just wanting to lend you a little support tonight. Taking care of your mom, being the only one taking care of Lucky Boy . . . all of that is a lot.

The way I got my husband to help is that at first I just had him sit by me and help hold punkin still. Eventually I got him to try testing, then shooting. If you've been doing it for a couple of months, you know that it gets easier and easier. Hopefully he'll step up and give you a hand.

Thanks for getting the extra tests in - whenever things are confusing, usually more tests will help make the way obvious. At least one test in between shots in both cycles will really be helpful for the next little while.

When you post tomorrow, go ahead and open a new thread. It's one of the things we do in this group to keep things manageable.

 

HI, My husband has given him his shots, he just hates poking his ear as it obviously hurts lucky, he flinches, and now runs when he sees me getting things ready. I copied this link to todays new thread. LMK if I did t his correctly/ Thanks, Nervous again this am, Luckys not doing well.