04/04 Shmee AMPS 311

[Amanda & Shmee]

Previous condo: http://www.felinediabetes.com/FDMB/threads/04-03-shmee-amps-273.193581/#post-2163715

Good morning everyone,
Unfortunately Shmee was high last night and this morning . As a newbie, I feel like Feline Diabetes is like some sort of sick joke. We do what we are supposed to (or at least I am trying to the best of my ability?) and when I think the numbers should be going down they just shoot back up. It's so frustrating! I could tell he didn't feel that great this morning, I feel so bad for him. I have a vet visit today to check his liver levels, they were very high originally and he has been on Denamarin (or at least for the most part... sometimes she spits out half a pill .... Anyway hopefully his liver levels have fallen. I also have a feeling the vet is going to want to increase his dose even more, but she knows I am following TR so hopefully she won't give me too much trouble.

Question: You all think I should continue with TR and be patient right, even though I am still seeing 300's? I have a feeling this is going to be my vets reasoning as to why I should stop TR and be more aggressive. Is the numbers still being high around +11 and PS time normal?

Thank you!

 

[Tracey&Jones (GA)]

There is a saying around here. FD is a marathon and not a race. It takes patience. Some kitties with food changes or a dental go racing down the dose chart and in remission quickly. Some take a very long time. Then others...well they are just extra sweet on a permanent basis!

Shmee's body needs to get used to these lower numbers. His body thinks the high numbers are normal and needs time to re-adjust. I see some great improvement in numbers overall. I also see some reactive bounces in there. That first green seems to have scared his liver and it likes to bump out glucose as soon as it perceives a low. Eventually, he will stop bouncing as much (fingers crossed) and overall the numbers will lower.

Keep hanging in there.

And it isn't odd for them to feel a little rough when bouncing...you don't feel good either when your sugar is all over the map. Keep giving him loves and scritches.

Good luck at the vet today, hope the news is good.

 

[Stacy & Asia]

You and seeing good smatterings of blue and your preshots are slowly transitioning from pink to yellow. This is good stuff, trends are changing for the better. It’s not always easy to see it in your own SS. But yes, just hang in there, it’s working. You can look at Asia’s SS and check out all the other SSs you have time for, scroll back to when they first started insulin and you will see Shmee is making pretty good progress.

Once you hit that magical breakthrough dose, it all starts to come together. Waiting it out until it happens is really, really hard, but worth the reward. Shmee looks to be very close to a good dose.

Good luck at the vet today.

 

[Amanda & Shmee]

Thank you @Stacy & Asia and @Tracey&Jones I appreciate it.

+1 240 - made sure he ate more of his LC food that was out and gave a snack, per the condo yesterday to try and slow his drop a little.

And actually @Tracey&Jones you mentioned dental - on my first visit to the new vet she did find gingivitis and said he might need teeth removed. But they have been focusing on the diabetes. I will ask what they recommend doing that at the vet visit today. I assume she will want to wait until he is better regulated. Any advice on when I should do dental work?

 

[Tracey&Jones (GA)]

When he is regulated a bit more might be a good time to get him in and get it done. If teeth have to be removed I am assuming there is lesions of some sort which can be very painful and maybe have an infection that could start. Which for FD kitties will drive up those numbers - which makes it a catch 22 scenario - need to get the numbers down to get dental but dental needs to be done to get numbers down. Ask @Sean & Rufus about his story on this one. I would ask your vet what she needs to see at a minimum to do the dental - also if the liver issues are a concern.

 

[Shawna & Davidson (GA)]

HI........

Welcome and YES - Get the dental done ASAP..........look at my 2018 SS for Davidson, he's been in remission for 4 yrs and I tested every month and on Jan 19th he was 72, then March 6 was 231. Strange, he's been in the green for 4 yrs and never had any issues at the recent Vets visit last Nov...........so I did lots of testing and same high BG levels meant he was coming out of remission and something was wrong. A trip to the Vet showed gingivitis and he has some infections around his teeth - HENCE higher levels and out of remission. I scheduled surgery immediately as the SOONER we can nip the diabetes in the butt the better chances of attaining remission. Davidson had 4 teeth removed and there was 3 big infections which were not visible, nor did his breath smell. Luckily I was still testing or I'd never catch it.

You can still regulate Shmee while he recoups from surgery, just understand his numbers will be higher due to stress of surgery, ab's and pain meds..........so Shmee will mope around and not feel that great but you need to get him on the insulin and get him working it asap. I weened Davidson off pain meds the first day - if he could eat crunchy no carb chicken cookies with 4 teeth pulled, he wasn't in pain. The ab's need to be completed to work and that gave him a bit of liquipoo (diarrhea) so I gave him some probiotics at the same time...........

Keep patient, trust me - I'm edgy with Davidson as well after 4 yrs of not worrying about anything, now back to testing a zillion times a day to make sure I catch his lows as I want to get him back into remission and it does take time and a lot of patience............not up to us, it's ECID and they have a mind of their own.

 

[Wendy&Neko]

Question: You all think I should continue with TR and be patient right, even though I am still seeing 300's? I have a feeling this is going to be my vets reasoning as to why I should stop TR and be more aggressive. Is the numbers still being high around +11 and PS time normal?

Yes, stick with TR. You will get there. I do see improvements in the SS. Look at that nice string of yellow preshots. Everything is starting to come down a little. Bouncing is very normal (and frustrating). So is getting higher numbers at the end of the cycle when the insulin is wearing off. He will get better duration and number flatten more as his insulin dose gets closer to a breakthrough dose. Are you feeding anything after nadir? Feeding carbs late in the cycle can also put the brakes on the insulin action.

Do get the vet to check the teeth again. Neko had her first dental (by her regular vet) when she was still visiting the red floor regularly. Some vets don't like to do a dental until kitty is more regulated, but they can't get regulated until the dental. For an extreme case, take a look at Sandy's post and 2 year tribute to Black Kitty today. Is there a dental specialist in your area? They are more used to dealing with older animals and animals with secondary conditions. Plus they typically monitor more during the anesthesia. Maybe your vet can give you a referral to a dental specialist if they won't do the dental.

 

[Amanda & Shmee]

Thank you all for the advice, I appreciate it.

HI........

Welcome and YES - Get the dental done ASAP..........look at my 2018 SS for Davidson, he's been in remission for 4 yrs and I tested every month and on Jan 19th he was 72, then March 6 was 231. Strange, he's been in the green for 4 yrs and never had any issues at the recent Vets visit last Nov...........so I did lots of testing and same high BG levels meant he was coming out of remission and something was wrong. A trip to the Vet showed gingivitis and he has some infections around his teeth - HENCE higher levels and out of remission. I scheduled surgery immediately as the SOONER we can nip the diabetes in the butt the better chances of attaining remission. Davidson had 4 teeth removed and there was 3 big infections which were not visible, nor did his breath smell. Luckily I was still testing or I'd never catch it.

You can still regulate Shmee while he recoups from surgery, just understand his numbers will be higher due to stress of surgery, ab's and pain meds..........so Shmee will mope around and not feel that great but you need to get him on the insulin and get him working it asap. I weened Davidson off pain meds the first day - if he could eat crunchy no carb chicken cookies with 4 teeth pulled, he wasn't in pain. The ab's need to be completed to work and that gave him a bit of liquipoo (diarrhea) so I gave him some probiotics at the same time...........

Keep patient, trust me - I'm edgy with Davidson as well after 4 yrs of not worrying about anything, now back to testing a zillion times a day to make sure I catch his lows as I want to get him back into remission and it does take time and a lot of patience............not up to us, it's ECID and they have a mind of their own.

Wow! I see he started to not see pinks after the dental procedure, even before you started the insulin. Now I am nervous that once he does the dental work he might be on too much insulin.... I wonder what his dose should be after the procedures since he is already up to 3.5 starting tomorrow. But I can do a new post once that time comes and hopefully we can figure that out. Thank you for giving me your story.

Are you feeding anything after nadir? Feeding carbs late in the cycle can also put the brakes on the insulin action.

Do get the vet to check the teeth again. Neko had her first dental (by her regular vet) when she was still visiting the red floor regularly. Some vets don't like to do a dental until kitty is more regulated, but they can't get regulated until the dental. For an extreme case, take a look at Sandy's post and 2 year tribute to Black Kitty today. Is there a dental specialist in your area? They are more used to dealing with older animals and animals with secondary conditions. Plus they typically monitor more during the anesthesia. Maybe your vet can give you a referral to a dental specialist if they won't do the dental.

I will definitely be asking my vet about this. And you mean if they get a nadir at +6 you don't feed them all the way until the PMPS? He eats pretty much all day (AMPS @9am, more at +3 (12pm) if needed, more at +6 (3pm) if needed). His nadirs aren't very consistent, they are usually from +6 to +8. Since he is on the Denamarin and needs an empty stomach for it I take away his food by 5:30 (+8.5), and he gets his pill at 7:30, and then eats at 9 after the PMPS. Would you take away his food earlier? I thought you were supposed to feed them when they were hungry because their bodies are starving? I feel like he would be incredibly hungry and I always seems like him not being able to eat those last few hours before PMPS shoots his numbers up, but maybe hid numbers go up toward PMPS because that's just how it goes?

 

[Wendy&Neko]

If he's a grazer, it's OK to leave food out, but in the beginning we suggest you pick it up for the couple of hours before preshot so that number isn't food influenced. You can also feed zero or very low carb food later in the cycle. Some people bake or boil chicken breasts and give a piece of that as a snack.

 

[Shawna & Davidson (GA)]

Also keep in mind if you get the dental done,need to fast 12 hrs before so you will need to make some adjustments on the feeding and shooting.....or perhaps miss the morning dose since there will be no food at all. Check with others once you speak to the vet.

 

[Amanda & Shmee]

If he's a grazer, it's OK to leave food out, but in the beginning we suggest you pick it up for the couple of hours before preshot so that number isn't food influenced. You can also feed zero or very low carb food later in the cycle. Some people bake or boil chicken breasts and give a piece of that as a snack.

Makes sense I will keep that in mind. And I have baked chicken for him as snacks but he wasn't all that interested.. but I have gotten suggestions that say to poach/boil the chicken instead, so I think I will try this and use it as his "before PM shot snack".

Also keep in mind if you get the dental done, need to fast 12 hrs before so you will need to make some adjustments on the feeding and shooting.....or perhaps miss the morning dose since there will be no food at all. Check with others once you speak to the vet.

Ok Shawna thank you, I actually just got done at looking through Black Kitty's SS like Wendy suggested, and I noticed she had fasted. I will definitely be following up with that the vet says. It makes me so mad that I have had him since he was a kitten, and the vets never once looked in his mouth until my latest vet. Ughhh! Can't look back now though...

I appreciate all of your advice.

 

[Shawna & Davidson (GA)]

Ok Shawna thank you, I actually just got done at looking through Black Kitty's SS like Wendy suggested, and I noticed she had fasted. I will definitely be following up with that the vet says. It makes me so mad that I have had him since he was a kitten, and the vets never once looked in his mouth until my latest vet. Ughhh! Can't look back now though...

I appreciate all of your advice.

I’ve had Davidson (and Harley) 16 yrs, and they were at the vet last Nov....all I was told was teeth could use some cleaning soon....never told me what cold happen, etc. And then a few months later Davidson has infections,teeth extracted,etc......at the time vet said I could wait, maybe in hindsight I should have done dental but really nobody knows how anything will react - cars, dogs, humans.......we’re all machines and wish we had the crystal ball.

Just do what you can.....as we all try to do.