09/29 Sibon PM +10 76 AMPS 110 +2 61

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Elinor & Sibon

Elinor & Sibon

Member Since 2017
Previous post: http://www.felinediabetes.com/FDMB/...-on-the-dosage-advice-in-this-website.184622/

Thank you everyone who replied to my last post. I called my vet this morning for advice if I should lower Sibon's dose from 1 unit to 0.5 unit (they don't like to hear about eyeballing 0.75) because his lowest numbers have me scared, and he vomits every time he goes below 70.
@Tricia Cinco(GA) & Harvey The vet was not pleased at all :facepalm: He said that a BG level anywhere below 100 is dangerous for a diabetic cat and could cause irreparable damage. He didn't want to lower his dose, but to stop injections completely, and to only give 1 unit if his BG anywhere above 200.
He said that minutes after I read @Girlie's mom 's reply where her vet didn't think 0.25u is a worth dose at all, so I wasn't too surprised.

I think I'm going to try 0.5u for a few days just for my peace of mind. Hopefully Sibon won't rise too much.
 
I would hold the 0.75 for six cycles. The green you saw today (09/28?, the date in your title says 09/18) is likely the hold over depot from the 1.0U. Do you give mid-cycle snacks? I haven't kept up with your condos so if this has already been address I apologize. The vomit may be stomach acid because his stomach is empty.

Any chance you can find a vet that specializes in cats and, more specifically, FD? Have you printed out the protocol and taken it to your vet to show him? Sadly, most vets are not familiar with FD, let alone regulation and remission possibilities.

Management of Diabetic Cats with Long-acting Insulin (protocol)
 
LizzieInTexas said:
I would hold the 0.75 for six cycles. The green you saw today (09/28?, the date in your title says 09/18) is likely the hold over depot from the 1.0U. Do you give mid-cycle snacks? I haven't kept up with your condos so if this has already been address I apologize. The vomit may be stomach acid because his stomach is empty.

Any chance you can find a vet that specializes in cats and, more specifically, FD? Have you printed out the protocol and taken it to your vet to show him? Sadly, most vets are not familiar with FD, let alone regulation and remission possibilities.

Management of Diabetic Cats with Long-acting Insulin (protocol)
Click to expand...

Thank you for the response. Doesn't the protocol you attached address dosage in the same manner as the website in my previous post, similar to what my vet advised? It calls for reduction of dosage if pre insulin BG is below 180 or if nadir is in the 60-70...

I don't give snacks at all, I suspect everything imported to Israel is junk. I leave out frozen Fancy Feast to thaw during the day before I leave for work and before I go to bed. If I test and see a low number, I would also add a little bit of Gravy Lovers in the bowl.
Since his numbers went down from 300s, I usually return home or wake up in the morning and there's still food left.
 
Elinor,

Check to see if freeze dried meat snacks are available in your country. There are a variety of them in pet stores here, and I actually purchase some on Amazon that are for human use. They are perfect for diabetics, as they have nothing but the meat in them, and most cats love them. I don't know what you have access to online, but you might do a search for freeze dried chicken.

Elinor & Sibon said:
He said that a BG level anywhere below 100 is dangerous for a diabetic cat and could cause irreparable damage.
Click to expand...
That is ridiculous. Has he ever tested a non-diabetic cat? Normal range is 50-80 on a human meter, or 68-100ish on a pet meter!!

Elinor & Sibon said:
He didn't want to lower his dose, but to stop injections completely, and to only give 1 unit if his BG anywhere above 200.
Click to expand...
That isn't going to work well with Lantus. Lantus needs consistency. Skipping shots will only result in wonky numbers.
 
Tricia Cinco(GA) & Harvey said:
Elinor,

Check to see if freeze dried meat snacks are available in your country. There are a variety of them in pet stores here, and I actually purchase some on Amazon that are for human use. They are perfect for diabetics, as they have nothing but the meat in them, and most cats love them. I don't know what you have access to online, but you might do a search for freeze dried chicken.

That is ridiculous. Has he ever tested a non-diabetic cat? Normal range is 50-80 on a human meter, or 68-100ish on a pet meter!!
Click to expand...

Hi Tricia, could you provide me with a link as an example for such a snack? Also, why give snacks at all?

The vet explained that the normal range is only normal in non diabetic cats, but it's not to be aimed for in diabetic cats. This is the second vet that's playing that note "If you're killing your cat I'm not on board". I think I'll just learn to nod and continue what I learned here, as some of the folks here recommended.
 
Elinor & Sibon said:
Thank you for the response. Doesn't the protocol you attached address dosage in the same manner as the website in my previous post, similar to what my vet advised? It calls for reduction of dosage if pre insulin BG is below 180 or if nadir is in the 60-70...
Click to expand...

Phase 4: Reducing the dose
When the cat regularly has its lowest BGs in the normal range of a healthy cat and stays under 100 mg/dl overall for at least one week, attempt to reduce the dose. Alternatively, if the nadir glucose concentration is 40 - <50 mg/dl at least three times on separate days, try lowering the dose. If the cat drops below 40 mg/dl once, reduce the dose immediately! The reduction is done very slowly in a step-by-step manner (0.25 or 0.5 IU increments). At each newly reduced dose, try to make sure the cat is still stable in the normal range before reducing the dose further.

If the cat will not stay in the normal range after a reduction, immediately increase the dose again to the last good dose. Sometimes, a cat can even manage to keep its BGs low for a day or two, but then the BGs begin to rise again because the beta-cells haven't recovered enough yet. Try to go from 0.25 IU to a drop before stopping the insulin completely. Reducing the dose too quickly generally does not work: most cats do not go into remission with fast reductions.
Click to expand...

The longer they spend in under the renal threshold (healing numbers) the better it is for kitty and the organs.

Someone will be along and be able to explain it better than I can ;)
 
Elinor & Sibon said:
Hi Tricia, could you provide me with a link as an example for such a snack?
Click to expand...
Sure. This is what I get for my kittens. They love it!! Here is one specifically for cats. Another that many here use is Pure Bites.
Elinor & Sibon said:
Also, why give snacks at all?
Click to expand...
Typically we give a treat after each test. Most cats are so enamored of their treat that they are happy to be tested.

Sometimes when we say "snacks" we actually mean giving a small amount of the cat's regular food. It is much easier on the pancreas if you feed several small meals, as opposed to one big one twice a day. Many here will give food at shot time, then a little more at +1 and +2 and +3, or +2 and +4. Most people that are gone all day use timed feeders for that.
Elinor & Sibon said:
I think I'll just learn to nod and continue what I learned here, as some of the folks here recommended.
Click to expand...
Welcome to the club!! Most of us here have remission as our goal. That is why we are striving for those "normal numbers". Some are content with regulation, so readings mainly in the 100s are fine for them. You have to do what you are comfortable with.

I had my cats treated for various things, along with FD, at the University of California at Davis Veterinary Medical Teaching Hospital, which is rated as the #1 in the US. A third year vet student there told me that they got exactly 5 hours of training on diabetes, and that covered both cats and dogs (which are very different in how they react to diabetes)! So it's not surprising that most vets are not that well-versed in diabetes beyond the basics. When you think about it, they have to know about a lot of different diseases and conditions in multiple species, so unless you are dealing with a specialist, you can't really expect them to know a lot about any one disease. We are not vets here, but many of us have been dealing with this for years and years, often with more than one cat. We base our guidance on the Roomp/Rand study - we're not just making it up as we go along. I also got the "anything under 100 is dangerous" reaction. They also told me I didn't need to test - just go by the cat's behavior. Well, both of my diabetic kitties hit the 20s at one time or another (US numbers), and they were not behaving any differently than they did at 100! Had I not been testing and intervened, I could have had a serious hypo event on my hands! I'm not saying don't listen to your vet, but I am trying to explain why they give you advice that conflicts with what you read here. Most vets are not accustomed to people that are willing to put in the time and effort to monitor their cat's BGs as we do.
 
Tricia Cinco(GA) & Harvey said:
Elinor, when he vomits, is it food or just clear liquid?
Click to expand...

5 days ago he vomited food at 04:00am (shots are at 07:00am/pm). 2 nights ago he vomited clear liquid at 02:00am.
It's always on the sofa, which is where he likes to sleep, and it's far from his food bowl.
10 days ago he vomited food as well but his numbers were still high then, if it's related.
 
Elinor & Sibon said:
5 days ago he vomited food at 04:00am (shots are at 07:00am/pm). 2 nights ago he vomited clear liquid at 02:00am.
It's always on the sofa, which is where he likes to sleep, and it's far from his food bowl.
10 days ago he vomited food as well but his numbers were still high then, if it's related.
Click to expand...

I was asking mainly because vomits of clear liquid usually indicate an acid issue, caused by an empty tummy. Pepcid is a good remedy for that. If he is vomiting food, a better option would be Cerenia and/or Ondansetron (Zofran). I have never heard of a cat vomiting when his numbers were low, unless they were VERY low and it was a hypo event. I'm trying to see what other issues could be causing the vomit that might correlate to being in low numbers.
 
Tricia Cinco(GA) & Harvey said:
I was asking mainly because vomits of clear liquid usually indicate an acid issue, caused by an empty tummy. Pepcid is a good remedy for that. If he is vomiting food, a better option would be Cerenia and/or Ondansetron (Zofran). I have never heard of a cat vomiting when his numbers were low, unless they were VERY low and it was a hypo event. I'm trying to see what other issues could be causing the vomit that might correlate to being in low numbers.
Click to expand...

My vet guessed that the vomit could be related to the high percentage of fat in Fancy Feast since he was diagnosed with a somewhat fatty liver along with his Diabetes diagnosis 2.5 months ago. She tried to suggest Hill's wet food but he wouldn't touch it so this was off the table. The only other type of wet food sold in Israel is Friskies and he had diarrhea when eating that.
 
Elinor & Sibon said:
My vet guessed that the vomit could be related to the high percentage of fat in Fancy Feast since he was diagnosed with a somewhat fatty liver along with his Diabetes diagnosis 2.5 months ago. She tried to suggest Hill's wet food but he wouldn't touch it so this was off the table. The only other type of wet food sold in Israel is Friskies and he had diarrhea when eating that.
Click to expand...
Gosh, you are between a rock and a hard place. I think we talked about doing homemade food and you said getting the supplement kit wasn't possible there - am I remembering correctly?
 
Tricia Cinco(GA) & Harvey said:
Gosh, you are between a rock and a hard place. I think we talked about doing homemade food and you said getting the supplement kit wasn't possible there - am I remembering correctly?
Click to expand...
I think you're confusing me with someone else, but I did discuss homemade food with the vet and she raised the concern that Sibon might not get all of his nutrients if this is not written by a nutritionist. We decided to put this on hold for the upcoming weeks.
What is the supplement kit?
 
Elinor & Sibon said:
I think you're confusing me with someone else, but I did discuss homemade food with the vet and she raised the concern that Sibon might not get all of his nutrients if this is not written by a nutritionist. We decided to put this on hold for the upcoming weeks.
What is the supplement kit?
Click to expand...
Oh, sorry. Maybe it was someone in Australia I discussed it with. :oops:

There are a few companies that make supplement packets that you add to meat to feed either cooked or raw. These contain things like taurine that are essential for cats. Some people get the individual ingredients themselves, but you have to know what to add and how much, so the kits make it easy. The one most people I talk to use is from Food Fur Life. I don't think they ship internationally, though. Dr. Lisa Pierson's site has a section on making food yourself, which you might find informative.
 
LizzieInTexas said:
They do!

http://www.foodfurlife.com/shipping-rates--policies.html

Elinor, I would send them an email to see if they can ship you. This might be a good option for you. I am tagging @Bobbie And Bubba I know that she is using it.

Another suggestion is the Aloe Vera juice for the stomach/constipation issues.
Click to expand...
If you can get George's Aloe Vera Juice shipped to you , that would a great addition to your regime. It was mecca for Bubba and his IBS and hairballs. If you can get FoodFurLife where you are , that would be great. If not go to Dr. Pierson's page and see what it is that you would need to supplement with for a raw diet or homemade. I use FoodFurLife but, I am in the states.
 
Elinor & Sibon said:
Thank you for the response. Doesn't the protocol you attached address dosage in the same manner as the website in my previous post, similar to what my vet advised? It calls for reduction of dosage if pre insulin BG is below 180 or if nadir is in the 60-70...

I don't give snacks at all, I suspect everything imported to Israel is junk. I leave out frozen Fancy Feast to thaw during the day before I leave for work and before I go to bed. If I test and see a low number, I would also add a little bit of Gravy Lovers in the bowl.
Since his numbers went down from 300s, I usually return home or wake up in the morning and there's still food left.
Click to expand...

Hi Elinor,

Really odd what your vets says re: under 100 is dangerous. My non-diabetic cat is always in dark green numbers when I test him, as was Girlie before she became a diabetic. And she's a much, much happier cat when she's in blue numbers and even dark greens. She's clearly not feeling well when she's in yellows and above.

With the Management of Diabetic cats: if you're using the TR protocol, you follow the phases outlined in Table 3, and if the SLGS, that would correspond to Table 2 in the paper. It's a lot to absorb, but I'd recommend reading it several times to get your head around the study and the management of it all. It's not the same as the info in the link you shared with us the other day.

I can only say that I've seen tremendous improvement in Girlie since I started following the TR protocol (and not listening to my vet... doing the wink and nod thing when she talks). It's like I have a different cat: she's put on weight; her coat is gorgeous again; she's happier and more energetic; she's the cat I used to have years ago, even at her advanced age of 18. I wouldn't do anything that would put her at risk, and I feel very safe managing her the way I am with the protocols here and the advice that all of these really experienced people have offered.

I do hope you can get the pukas issues under control! That sounds so uncomfortable for both of you...
 
Here is a post that has the link to what we are using and the benefits and cautions.

http://www.felinediabetes.com/FDMB/...-5-138-10-pmps-112-158-1.184260/#post-2046154

Gizmo loves FF Turkey and Giblets Classic - but it is too high in phosphorus for him (he has kidney disease and phos is bad for him). Most of the FF Classics are under 10% but be sure to check the list. I would suggest you try and keep a couple different flavors on hand as these kitties are known to turn up their noses at food for no apparent reason - food they have eaten for months even. :mad:

SEB (Slippery Elm Bark) or Marshmallow root (MMR) is good for the digestive system also. Gizmo gets a dose at AM and PM PS snacks. I don't want to overdose you with information. If you have an issue that comes up (like diarrhea) - when you make your daily condo (that is what we call the threads) put it in the subject line with a "?" and tag me or someone you know has given info previously and someone will chime in with help and info.

Here is the info on SEB (MMR is used in the same manner and preparation)
http://felinecrf.org/holistic_treatments.htm#slippery_elm_bark
 
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