? 7/22, Sprocket, ? @dosing with UTI, giving more carb

Ok he has been doing well till now.
Last week had a death so I was unable to be home as much to test so i gave some higher carbs (higher for him but under 10% as he is a little sensitive to carbs even though most of u dont believe me)to keep him from dropping when i couldnt monitor.
Then after he was dropping some and being finiky with eating so I ended up giving some 3-5 or 7 carbs when I wasnt normally cause he wouldnt eat anything else.
Problem with this is vet said he is dropping sugar in his urine and this bacterial UTI is probably from the more carb I fed.
So he now has orbax antibiotic. She said it may make him insulin resistant so he will go lower.
I am worried about doing his usual 2.75u dose as he is unpredictable right now with eating. In late june, I already tried 2.5 dose and 2.68 dose & it was not enough. So we went back to 2.75u & feed more than 4 carb when he is lower or drops fast.

So if the higher carb is causing UTI then i cant feed the lower bg so now what do I do?
He is at 12oz per day of food, 6 meals in 24 hrs. Every 4 hrs.

When he ate less his bg would drop.
So do i do less food and lower the dose to 2.5?
Or what?
And tonight after vet I gave a fat 2u dose cause today he already had 2.5oz less of food and he wont eat anymore right now. He is so uncomfy. I was worried he would drop hard n fast as less food, sick, & his bg lower(161) at pmps.
Advice please.
Thanks. I think I posted all info.

 

Higher, but still low carb food is not likely causing the UTI. It could be sugar in the urine because he is spending so much time above renal threshold, causing sugar to spill into the urine.

Insulin resistant does not mean lower numbers, but rather higher. Infection can cause insulin resistance. Treating the infection, if the antibiotic works, can break insulin resistance and cause numbers to go down a bit. If he has had an infection, that may have impacted his appetite. I hope he will eat better now.

 

Ok so going forward, how should i feed him & what dose so this doesnt happen again?
Doesnt the higher carb cause the more sugar in urine? It is giving more sugar right?

 

As long as you are feeding low carb, I wouldn't worry about it. The sugar from feeding true high carb also only lasts a couple of hours in the system. I wouldn't change what you are feeding. Instead, focus on getting a dose that gets him into better numbers overall. Since you are following SLGS, you want a dose that gets nadirs between 90 and 150.

 

Thats my problem. I havent fed over a 9 carb all week and last.
No dose is getting him into 90-150 on regular basis.
2.5oz with 12oz food daily didnt work. Nor did 2.68 dose.
2.75u gets him there sometimes but he drops like a thud & i feed carbs to keep him from dropping too low.
So not sure what to do now?

 

Follow the guidelines in SLGS. A cat's dose requirements change over time. You need to evaluate the dose each week and change it if it's not getting you the numbers you want,

 

Idk what to change to. The doses are not working.
Thats why i am here but since end of may barely anyone will answer me at all.

 

The only way to get the sugar to stop showing up in the urine is to get the numbers down below renal threshold....that means increasing the dose when necessary and letting him drop into those numbers instead of feeding to try to stop them

You could be feeding food that's 100% carbs.....it would just require more insulin to counter-act the carbs......the reason we want them on low carb is there's that much less to "fight" against

Think of diabetes like it's a bonfire....if you squirt a little gasoline on (feed low carb food), it's still easy enough to put the fire out....but if you dump lots of gas on it (feeding a high carb food), you'd need a lot more water to put it out.....and it's possible it would still burn out of control.

All food is converted to sugar (glucose)...protein, fats, carbs...everything....the body needs glucose to live. Insulin is what allows the glucose to get into the cells to nourish them. In a normal body, the pancreas produces enough insulin to cover it no matter what you eat, but in diabetics, there's either not enough insulin being produced, or the body isn't using it efficiently so we have to give extra.

If you're not giving enough insulin to get the numbers down, the excess glucose "spills over" in the urine.....and sugary urine is a perfect medium for bacteria so you end up with a urinary tract infection.

 

Ok so lately, (weeks) he is getting fussy with lower (under 4%) carb food. He barely touches the fancy feast now. What if I gave some zero carb dry to try to give less carb?

 

The actual carb percentage for YA is around 4-5%....there's no such thing as truly zero carb dry no matter what the salesmen try to tell you

And as long as it's below 10%, it really doesn't matter that much.....each can of cat food is going to vary a little from the last can....so even if the chart says "This food is X %", the actual percentage could be several points different

We have tried to explain this to you several times.....that the carb percentage isn't an exact number....a really carb sensitive cat might have trouble with a 9% compared to a 2%, but they are rare

If you're shooting for feeding something 0-5%, one can might be 1%, the other might be 4%, even if it's the same food...it's not that exact

 

I get that but I have tried different doses and different foods. I dont know what else to try.

 

Patience and trust

We can only tell you what's worked in the thousands of cats that have come through here, but you have to do the real work and just trust that what we tell you is true and be patient while you work on it

We have told you that he needs to get down below renal threshold to stop the sugar from spilling over in his urine and reduce the workload on his kidneys, but every time he drops more than you're comfortable with, you prop him up with a higher carb food

Unless he drops below 50, there's no need to feed a higher carb food (and yes, I know he's on SLGS)....the "reduction point" (90) and the "time to act" point (50 on a human meter) are different.

Relax....feed him whatever he'll eat in the 2-5% range and stop obsessing over the exact number...and let him get into lower numbers before you intervene.

I totally understand this is something that scares you and you're uncomfortable with, but it's the truth. We can't make you do it.....in the end, he's your cat and you make the decisions.

We can only try to lead....we can't make anybody follow

 

I have been trying to let him go lower but I cant be home 24/7. If I cant monitor what am I supposed to do? I barely leave the house now. I only leave for doctor appts, some shopping, and emergencies. I had 2 deaths this past week. One was my boyfriends father so I had no choice but to feed some carb to keep him higher to stay safe while not home.
I dont understand how to monitor him to stay safe while he drops & still sleep, & leave the house when I need to. No one has really answered those questions for me. I need a plan for him so i can stay sane. I cant just wing it when I dont know how to handle it completely.
I had a 2nd helper until she went perfection on me & flipped out yelling at me. No one is perfect including a diabetic cat whom has been unregulated for 2 years.
I am trying me best. When i post here now barely anyone answers so unless someone wants to actually answer my questions as to how to do lower numbers then how can i trust on everyones word when my questions are still unanswered. I am doing my best as i basically have lost alot of my life to take care of him.
So not sure what else you want from me.

 

Tell me if I am wrong. Sprocket woke with a very high AMPS on Friday. 297 ...wow. At 1 pm he was in 120 so you only gave 5 carb 2 ounces. Then he went back to being unregulated in 200's on low carb 4 and under until 6 am Saturday when he started showing evidence of being sick. So she feels the 2 ounces of 5 carb causes this ? I feel unregulated diabetes with that high 297 he was dumping sugar rather than 2 ounces of 5 carb. Giving YA is not an option for your cat. I know in the past with a few kibble he goes high. I agree he has to be regulated.

 

I would tag or PM people who you trust. I'm not on the board every day but I do try to see who has a question. If you PM some of the more experienced members, we'll check your condo and reply.

the thing that strikes me is how long Sprocket has been at the 2.75 dose. I'm skimming back on your SS and it looks like Sprocket has been at this dose since 6/30. If you're not getting numbers into normal range, you need to stick with the protocol you're using and increase the dose by 0.25u. Unless you are very close to or in normal range, fattening the dose is likely not helping much.

The reason you need to make more frequent dose adjustments is that if the dose isn't bringing numbers where you want them, you risk Sprocket's developing glucose toxicity. (This sounds a lot worse than it is.) What this means is that you cat's body starts treating these higher than desired BG levels as the "new normal." It can take some work to get your kitty's numbers to be where you want them. What I usually suggest is that you stick closely to whichever dosing strategy your using. You'll need to evaluate the dose every 3 days if you use TR and every week with SLGS.

If you pick up Ketodiastix, you can test to see if there's sugar in Sprocket's urine. This will at least let you know where you stand on this issue. I also responded to you on FB. It didn't sound like the vet ran a C & S to determine if Sprocket is on the best antibiotic for his UTI.

Wendy also underscored that insulin resistance doesn't cause a cat's numbers to drop. I suspect what your vet meant is that the UTI has artificially raised Sprocket's numbers -- any inflammation or infection will do this. Once the antibiotic kicks in, numbers may drop.

 

Thanks.
The 2.75u dose he also had in may/june for almost a month too. He would earn reductions but when I tried the lower doses he would not get into 100s much at all. Thats why I went back to 2.75u. Since I was not trying to earn any more reductions I would give him a higher carb when he went to drop below 100.
Thats what I thought I was to do since he wasnt going to reduce his dose.
Now that I am trying to get him in 100s more I dont understand the complete process of how to do that especially if you cant be home to monitor at times?
I dont see any instructions on how to get the nitty gritty of nearing the regulation time. Obviously i am not doing it right.

 

Hello Darnell,

I know you only allow the highly skilled opinions in your condos but because you commented that no one replies as often as you‘d like I thought I‘d try my chances. I don’t mean to be invasive at all…

I think the greater challenge no one accentuate before is for you to face your fear of possible Hypo if you increase the dose. And increase you must. Make no mistake, I don’t minimize it, it is the greatest fear a human being can experience – an inner enemy, the strongest one. This fear is so natural and also so common, it was experienced by EVERYONE on this board, that I hope you will believe me when I say “I know exactly how you feel”, because I do. But I believe you have to increase now and keep doing so per SLGL as prescribed. Not what you want to hear, I know. Sorry.

And yet, it is exactly what you have to overcome, that fear. There is no way around it. There is only the way thru.

I think if you carefully plan facing those horrendous drops you (and I, and many others here) encountered you can overcome that fear once and for all for the future and to achieve better regulation for Sprocket whilst regaining/maintaining your social life.

You have to deal with “drops” and do not sink his progress to lower numbers – whether blue or green- by food. Sorry, dear, that’s how it looks to me now; you were drawining it with too much food...

I really think you need to make a plan ahead to go thru his “dropping like a thud” antics with the help of the Board. Once you dealt with it, and I know you will be very successful, you’ll make your own schedule. I do not see other way to deal with evil but to confront it heads on. I did .And I am glad I did.

See the SS. I shoot my first Green on Apr 7th, and should I’ve known any better I’d wear a diaper that day. It was scary. But it was healing for Ducia. And that is all that matters at the end.

I wasn’t ever alone – not for a moment. The LL was there for me. Neither will you should you decide to go on. I announced beforehand that I would need help. And I was helped; I wasn’t alone for a single test I took and was guided as to when/ what to feed or test by the hour. You see, bodies are not machinery; you cannot have a “plan” once and forever; bodies’ change. Today plan might be ok for today, but it’d be wrong in a week, or next Wednesday.

The next day brought my first below 50 numbers and I wasn’t alone again – I was coached thru the entire cycle. Several days later 4/11 Ducia gave me another below 50 which I started to handle on my own as per instructions earlier that week – and it was successful… I’ve being handling low numbers on my own ever since. The liberation I experienced by getting rid of my fears is the pure bliss. Please believe me when I say that if I can do it – so can you. You already are better skilled than me – you can pill, you can syringe feed, you understand med terminology better, etc. You’ll do great.

I do understand so much your concerns about being out of the life – that’s exactly how it feels for me. But by keeping Sprocket in what you perceive as being “safe” numbers is actually contradictory to your goals – there more you keep him in yellows the more damage you do to him/his body, the more expensive vet’s tests you ‘d encourage, the more medical intervention he’d need, the lesser time you have for yourself bc he is unregulated.

With hugs and deeply felt sympathy, how about the following:

1. Make up your mind as to try the very low numbers out by handling them differently than before;

2. You figure out when he clears a bounce. Prepare for the cycle of lows (luckily). Let the people you trust to know that you’ll possible need their help;

3. You find a friend who owns fast PC or a laptop and is willing to lend it to you for a few days so you can stay in immediate FAST contact with your helpers online(I understand your current IT equipment isn’t fast enough, just like mine);

4. You make plans for several days ahead so you do not have to leave the house for groceries, cat food, lancets, cigarettes, and such, and you are able to focus on how to handle the greens in a sort of "work shop" sense;

5. Once Sprocket has low pre-shot/ at least clears the bounce you contact your trusted LL people asking for hourly support and proceed with giving his reg dose. You do not give him food by ounces; you’ll do it by teaspoons or Tbs, if really needed. You’ll wait until he reaches BG 59, let’s say, and then intervene with higher carbs foods. Nor earlier, but do test frequently.;

6. You try trusting this Board in their instructions.

7. Repeat as often as necessary. Until it is your routine. And will be sooner than you think.

I promise once you’ve done it once or twice you are free to plan on your own. You’ll beat any Lime Green comes your way by not sending him to Yellow but by keeping him SAFELY in greens. You won’t have to keep him in Yellows to feel safe to sleep or to go out.You and him, both, deserve it.

And they don’t lower/drop 24/7 as you had posted. It is down to nadir and then back up, mostly. No need to sacrifice the entire day/night. There is room for YOU, too.

You can always throw your experience out. No obligations here. But I sincerely believe in this way, by facing Greens and your fear of them, you’ll give Sprocket better chances. And to yourself, too. Give it a try. Then you’ll decide. You are in charge, remember? It all be only as YOU wish.

With kindest regards ever,

Tanya and Ducia

 

Very good and very wise advice, Tanya.

 

I worked full time throughout Gabby's FD history. I was lucky in the regard that she had an early nadir so I was able to test before I left for work and leave out HC if it looked like it was needed.

If you are trying to prevent reductions and get Sprocket used to lower numbers, then hold what seems to be a dose that may drop numbers but use food to keep the numbers in a safe but still as close to normal as possible range. Ultimately, Sprocket may throw you a low number and you need to reduce. The idea is to keep your cat in normal numbers for as long as possible so there's an adjustment to being in normal numbers.

Where do you think Sprocket's nadir falls?

 

Seriously???!!! This is what I have been doing for months!!!! Why is no one hearing me???
I only fed higher carb this week or 2 because my boyfriends father died!!! Amd i wasnt home when i needed to be to monitor or even feed.
He was earning reductions on this dose many times but I didnt take it.
Idk what else to do!!!

 

You are stressed with all going on in your life.... It's hard to think clearly when you are this stressed....

It's OK to feed foods higher carb but under 10. You seem to be obsessing about the foods carb count. Put the chart away. ANY ff classic is ok. You don't have to be home all day every day to test. People have obligations and jobs.

If you want faster results then switch from the slow go protocol and try the tight regulation protocol.
I think your vet had you overly focused on the food. Giving your cat a can of 6 or 7 percent carbs is not going to CAUSE a UTI. He got it because diabetic cats are just more prone to then. **** happens. He's on antibiotics so you have to just wait for them to work. Fact is he may get another one in the future. I have a non diabetic cat who had had about 5 of them. Some cats are just prone to it.

What is concerning me is on the fb boards he seems to be having trouble passing the urine. If there's a blockage it may need to be flushed out. I would call the vet and let him know what's happening with that.

 

This may be the issue. If Sprocket is getting too much insulin, I realize it sounds ridiculous but too much insulin can look like too little insulin. As tough as Gabby was to regulate, I always took the dose reduction. It may help to keep in mind that the dose that works this week, may not work next week. Insulin needs change sometimes for logical reasons and sometimes for reasons we can't figure out. It can be exceeding frustrated even for very experienced caregivers.

To be honest, it's hard for me to get a good feel for Sprocket's SS if I'm at home on my laptop. I can only view about 2 - 3 lines given the size of your cells. I have a better view when I'm at work and I'm not always able to log in during the day. I'm not sure you've been doing what I noted as a strategy. If you have, you also need to maximize the amount of insulin you're giving. It looked to me like you were holding the dose longer than you may have needed to.