Food struggles, hospitalization, and insulin

Discussion in 'Feline Health - (Welcome & Main Forum)' started by JennC & Diago, Feb 21, 2018.

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  1. Kris & Teasel

    Kris & Teasel Well-Known Member

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    No, I think that's too low to give Novolin. It starts acting quickly and fairly strongly. I suggest you get some tests through today to see how he does with no insulin on board. This boy is on a mission ... I'll say no more! ;)

    How is his appetite and is he feeling well otherwise?
     
  2. JennC & Diago

    JennC & Diago Member

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    I'm not going to give him the insulin, we're past his normal dosing window and based on yesterday when I gave the 0.5 it lowered it by 100 points. Do you think I should check his BG before his normal pm dose
     
  3. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Yes, I'd get a couple of tests. These would be good info on how he does for himself without insulin - maybe a +4 and a +8?
     
    Last edited: Feb 25, 2018
  4. JennC & Diago

    JennC & Diago Member

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    Ok, that sounds good! Hopefully they are just as good :)
     
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  5. JennC & Diago

    JennC & Diago Member

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    BG at +4 is 106!! WHOO HOO!!
     
  6. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Fantastic!!! You must be SO happy! :D:D:D:D
     
  7. JennC & Diago

    JennC & Diago Member

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    I am so excited and happy for him. I can tell he is feeling tons better!
     
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  8. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Such good news! :)
     
  9. JennC & Diago

    JennC & Diago Member

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    144 at +8.5! Kris, do you think he might be a food controlled diabetic with these numbers or too early yet to tell?
     
  10. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Looking really good but I think it might be a bit early. Let's see what his PMPS is tonight and, if no shot tonight, what his AMPS is tomorrow.

    If it comes to giving a little insulin support a while longer you have these options:
    • a "skinny" 0.5 u - draw up to 0..5 u and let out a drop
    • 0.25 u
    • 0.1 u - draw up insulin to about 0.25 u and let it out until the plunger *just* touches the bottom of the zero line
    • a "drop" - push plunger into syringe firmly, insert into vial keeping pressure on the plunger, release pressure while needle is in the insulin, withdraw then when needle is in the cat put firm pressure on the plunger before and while taking it out of him.
    Vets would think this is nuts but we know it works. ;)
     
  11. JennC & Diago

    JennC & Diago Member

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    What glucose number or range of numbers do you recommend with your doses above? I remember the vet saying if the number is under 200 not to dose but would love your thoughts.
     
  12. Kris & Teasel

    Kris & Teasel Well-Known Member

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    It's hard to say. It can depend on how flat he stays at a dose - ie., flatter = ability to give a larger micro dose. You'd also want to be home to monitor. Like a lot of this FD stuff, it's trial and error.

    If it was my kitty I'd be tempted to try 0.25 u if BG is above 150 tomorrow AM. Do I know with certainty that this will work? No, I don't but based on his responses at 0.5 u and the fact that he coasted nicely but above dark green today it's worth the calculated experimental "risk". I'd be prepared to monitor frequently and give carbs if he decides to dive.

    If giving 0.25 u at a PS of 150 drops him too low I'd try 0.1 u at a PS of 150 next time. If that works out, I'd try 0.1 u at a slightly lower PS and so on. Lots of little back and forth adjustments between dose size and PS number. The end result you're after is a teeny tiny dose that keeps him running in very low blues or high dark greens but favouring the dark greens. Eventually, if you're lucky, an experiment where you stop insulin results in him maintaining these dark greens on his own.

    So much of this is guesswork. o_O
     
    Last edited: Feb 25, 2018
  13. JennC & Diago

    JennC & Diago Member

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    Yeah, this is one of the hard parts. I won't be home tomorrow during the day. If he was yours would you give the 0.25 tonight since he's over 150 and then check at +2? I won't be able to check past that I'm afraid.
     
  14. Kris & Teasel

    Kris & Teasel Well-Known Member

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    If he was mine I'd only experiment with shooting on a lower PS (for the first time) if I can definitely monitor up to at least +6. To be safe you can skip tonight and see where he is tomorrow AM. If he's above 200 (yellows) tomorrow AM give 0.5 u again. If below 200 you might have to skip again if you can't be there.
     
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  15. JennC & Diago

    JennC & Diago Member

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    You're a life saver, thanks!!
     
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  16. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Should have added: get a urine ketone test in daily if you can when skipping insulin. Safety precaution. :)
     
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  17. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Will check in soon to see AMPS.
     
  18. JennC & Diago

    JennC & Diago Member

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    126 this morning!! WHOO HOO. I'm loving these numbers based on where he started in early February. :)
     
  19. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Excellent! No shot this AM because you won’t be there to test.
     
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  20. JennC & Diago

    JennC & Diago Member

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    Sounds good, and I'm sure he'll appreciate one less poke. :)
     
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  21. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Two things:
    1. you missed putting "NS" for last night on your SS
    2. time to start a new thread because this one is long.
    I'm bossy, aren't I !? ;)
     
    Last edited: Feb 26, 2018
  22. JennC & Diago

    JennC & Diago Member

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    LOL not bossy at all! Thank you for catching that, I've updated. I just talked to my vet about his progress and he asked how much fiber was in Fancy Feast, do you by chance know? If not, no worries. After this question, I'll start a new thread. :)
     
  23. Kris & Teasel

    Kris & Teasel Well-Known Member

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    My guess is little to no fibre because it's a low carb wet food so protein, fat, low amount of carbs and moisture would be the main ingredients. Why does your vet want to know fiber content? Old school thinking was the high fiber kibble was best for diabetics because it slowed carb absorption or something along those lines (lower glycemic index I think). Newer thinking is low carb wet food.

    What does your vet think about the drop in BG numbers and you dropping the dose?
     
  24. JennC & Diago

    JennC & Diago Member

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    He didn't say why, but he's gonna call me back later so we can look at the ss together. I'll definitely ask but if I had to guess it's the old school way of thinking.
     
  25. Kris & Teasel

    Kris & Teasel Well-Known Member

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    It would be great if your vet works collaboratively with you and trusts that you can handle the FD treatment yourself. Some vets with egos that are a bit bigger than they should be are a little harder to deal with when they see an owner doing things without vet's guidance. I hope yours is the first type. I'm very lucky to have one who's like that.
     
  26. JennC & Diago

    JennC & Diago Member

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    We talked further. I told him I'd prefer to not dose if his BG levels are in the low 100's, he agreed. I said that I think if he's over 200, I should give 0.5 and if he's over 300 give 1u. He agreed. He did say that I can't keep this up forever and 99% of his clients don't track their animals this way. He also said there is NO way I will be able to regulate on Fancy Feast and he needs to be on a prescription diabetic food to be regulated which I found interesting given the success we've had so far. Not saying it will always be this good, but I have to admit, we have a good start. I told him I plan to check twice a day for the next two weeks and then do another BG curve in there somewhere and he was like well keep me updated. :) BG tonight at PMPS was 148, NS.
     
  27. Kris & Teasel

    Kris & Teasel Well-Known Member

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    This is the part where, if you're in the office with the vet, you just smile and nod politely. ;)
     
  28. JennC & Diago

    JennC & Diago Member

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    Lol, love it!
     
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  29. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Look at that wonderful green after no insulin for several cycles! So happy you’re seeing such great numbers! :D
     
  30. JennC & Diago

    JennC & Diago Member

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    Me too!! I wasn't sure what number I would receive this morning, he was a little grumpy today Lol!
     
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  31. Kris & Teasel

    Kris & Teasel Well-Known Member

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    :):cool::D:smuggrin::woot:!!!! Look at that 78 that he did all by himself! Sure looks like his pancreas is working. If so, he's a diet-controlled diabetic and needs to stay on a strictly low carb diet.
     
  32. JennC & Diago

    JennC & Diago Member

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    I know, I was so excited to see that 78!!! He's doing so good. I know I've said it before in this thread but you Kris have been a lifesaver literally for Diago and I. :bighug::cat:

    Couple of follow up questions:
    • Do you think I should continue testing twice daily for two weeks or do you think one week is sufficient?
    • Also, is fancy feast ok to stay on long term as long as he continues to eat it?
    • Once we stop testing daily, how frequently should I test just to make sure his pancreas is still working as expected?
     
  33. Kris & Teasel

    Kris & Teasel Well-Known Member

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    I'm so glad to have been able to help and what a success! :D

    I think different people do different things. If it was my kitty, I'd do twice daily for a week and then decide if I feel the need to do twice daily for another week or drop to once daily for that week.

    Yes, it's absolutely fine to feed long term because it's nutritionally complete. Just make sure it's the low carb versions.

    Again, I think it varies with the owner. I'd do a once a week test for quite a while then maybe drop to every 2 weeks. If anything arises that could threaten his BG status - eg. any sort of infection, dental issues, high carb contraband, etc. - you should increase the testing to see if he's holding in good numbers. If he starts to slip you'll catch it and might be able to turn it around faster. If luck is on your side this remission will stick. Kitties do come out of remission, though, sometimes after a few weeks or months or even several years. Don't think about that right now though. Happy thoughts only! :)
     
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  34. Dyana

    Dyana Well-Known Member

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    Beautiful numbers today! Congratulations are in order :D!
    I would test twice a day for about 2 weeks, to see how it goes. And then test at least once a day for another two weeks, and then maybe every other day as long as he is seeming normal. Eventually, you can go to testing about once a week, but that is about a month or so off. If he ever seems "off" or doesn't eat or is lethargic or throwing up, I would test immediately, and several times that day, and for a couple days to make sure he is still in remission. Also, keep ketone test strips handy. They last for 6 months? after opening the bottle. I would test for ketones if he ever seems off, as well. Best Of Luck to you and Diago. Remember, he is still diabetic, just in remission, so will still need low carb food only.
     
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  35. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Thanks for your input, Dyana. :)
     
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  36. JennC & Diago

    JennC & Diago Member

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    Ok, that sounds good. I'll be sure to do it twice daily for another week, see his progress and go from there to either continue twice daily or once.
    Perfect! He's really liking the FF classics. And so are my other two kitties. :p
    This made me laugh!
    Let's hope it sticks but if not, you and Dyana have provided some much knowledge I'll know what to do.
     
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  37. JennC & Diago

    JennC & Diago Member

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    Is remission only considered if they are a diet controlled diabetic? Thank you again for following along with our progress and recommendations. I've been so happy with his numbers over the last 3 days. :D
     
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  38. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Yes, remission means a diet controlled diabetic. The kitty is forever a diabetic but the pancreas has healed enough to supply enough insulin unless forced to deal with too high a carb load or some other health issue raises BG.
     
  39. JennC & Diago

    JennC & Diago Member

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    Ah, gotcha. I didn't realize that.
     
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