1/1 Quintus +10.5=248 after NS, AMPS=173 +2=83 +3=53 green day, NS tonight

Discussion in 'Lantus (Glargine) / Levemir (Detemir)' started by Stephanie & Quintus, Jan 1, 2018.

  1. Stephanie & Quintus

    Stephanie & Quintus Well-Known Member

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    Dec 9, 2017
    condo: http://www.felinediabetes.com/FDMB/...oot-or-not-advice-welcome-for-tonight.188853/

    This morning, after skipping Quintus's shot last night, he's at 248 at +10.5 (using that notation for convenience's sake). I would like to note that over the night he turned his nose at his DM+NF mix (LC paste + HC/MC kibble -- where does HC start btw?) and mostly ate kibble.

    So anyway. He clearly needs some help.

    I am still low on strips. I can, however, monitor and break out the gravy and honey.

    My question is how much do I give him: 0.25 or a 0.1 sliver?

    Advice on the dose most welcome. We would of course like to stay away from the sharkz.

    ETA: given the kibble he's eaten in the last handful of hours I could very well this morning just feed him the DM (LC), not the mix. I don't know if it would be useful.
     
    Last edited: Jan 1, 2018
    Reason for edit: food precisions + corrected 11.5 => 10.5
  2. Chris & China

    Chris & China Well-Known Member

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    May 10, 2013
    I'd try the .25 and see how it goes.....if he still goes shark hunting, we can make a pretty good case for dropping lower.

    LC is below 10%
    MC is 11-16%
    HC is >16%

    I'm off for the night to cuddle with some nice warm kitties so I hope he minds his P's and Q's today and gives you some nice safe numbers!!

    You listening Quintus??? ;)
     
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  3. Stephanie & Quintus

    Stephanie & Quintus Well-Known Member

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    Dec 9, 2017
    I'm 99% certain 0.25 will bring us in shark territory, but will risk it.
    Will check my food DMA to figure out exactly what it is!
    Good night and good cuddles :)
     
  4. Stephanie & Quintus

    Stephanie & Quintus Well-Known Member

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    Dec 9, 2017
    Mistake, it's "+10.5" not 11.5. For realz: +22.5. Anyways. (correcting above)
     
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  5. Chris & China

    Chris & China Well-Known Member

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    DM is 6%

    NF is 27%
     
  6. Stephanie & Quintus

    Stephanie & Quintus Well-Known Member

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    Dec 9, 2017
    Yes for DM -- but the NF number (from Dr. Pierson's food charts) is for wet NF, and we're on the kibble. But I guess it would be HC anyway.

    So I have DM LC and NF HC. He just had his fill of HC :D
     
  7. Stephanie & Quintus

    Stephanie & Quintus Well-Known Member

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    I think I'm going to go for 0.1 -- not for the sake of going against Chris's suggestion, but because (reading her!) I think we'll get better numbers if I don't break out the honey and I think 0.1 gives us a much better chance for that than 0.25...
     
  8. Stephanie & Quintus

    Stephanie & Quintus Well-Known Member

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    Dec 9, 2017
    Oh, this is interesting (for the numbers, not buying into their quality evaluation, personally):

    NF kibble: 48.7% calories from carbs, 336 kcal/100g
    DM cans: 15.1% calories from carbs, 93 kcal/100g

    I ended up giving Quintus "0.1", a large drop and a half, as measured with the plunger flush with the first "0" line (just no daylight). Conforted in that option by the fact Quintus has come down to 173 over the last hour (from 248). I also cut the amount of NF in his mix by half given he's eaten enough during the night to keep his stool together.

    Fingers crossed and will keep you posted!
     
  9. Girlie's mom

    Girlie's mom Well-Known Member

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    Jul 3, 2017
    Stephanie, are you using the B/D 1/2 unit syringes? If so, you can use the insulin ruler that's referred to in the Management of Diabetic Cats (attached). Make sure you follow the directions and print it out as-is on A4 paper. I laminate mine to make it last longer. It makes giving uniform, tiny doses easier. Other people use calipers, but I've been using the insulin ruler for now. Others do as well.
     

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  10. Stephanie & Quintus

    Stephanie & Quintus Well-Known Member

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    So I am using them, and I did print out the ruler this morning, but the 0.1 "unit" is as big as a 0.5 on the syringe! I did print it at 100% though. Didn't take time to investigate more, I tested the "flush to the line" with water, and latched on to the "overall, consistency is more important than precise dose amount" guideline for the time being.

    I might be overoptimistic but I'm not sure it's going to be worth me getting calipers, given how fast this is going...

    (reminder: Quintus is a recent diabetic, two months approx, secondary to a bad pancreatitis which has been treated aggressively and which, given what I observe of his general state in combination with falling numbers, must be pretty nearly cured right now; I do know there is still depot in play, however)
     
  11. Stephanie & Quintus

    Stephanie & Quintus Well-Known Member

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    +3 is 83! w00t! :woot:
    :cat:
     
  12. Stephanie & Quintus

    Stephanie & Quintus Well-Known Member

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    Dec 9, 2017
    I am tired and making mistakes. That was +2.
    +3 is 53

    I'm almost a little concerned, thinking of those tumors that increase insulin production, on background that the ultrasound vet at one point thought his pancreatitis could be caused by a tumor. could the cancerous cells first inhibit the pancreas's activity by damaging it, and then migrate or spread in a way that multiplies beta cells? Probably looking too far and being my usual worried self.
     
  13. Stephanie & Quintus

    Stephanie & Quintus Well-Known Member

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    Dec 9, 2017
    Swimming with the sharks... testing in another 30 minutes, gave normal food but no honey/gravy as he has a little buffer and I would like to avoid sending him sky-high.
     
  14. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Well-Known Member

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    Dec 28, 2009
    Sorry to burst your bubble, but until Quintus' spreadsheet is all in normal BG range, he's not "cured." Further, cats go into remission -- they are not cured. They will remain diet controlled diabetics.

    To see what a spreadsheet for a cat that's nearing remission looks like, take a look at Chris' China's SS.
     
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  15. Stephanie & Quintus

    Stephanie & Quintus Well-Known Member

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    ETA after writing all this, and re-reading my post: I was using "cured" regarding his pancreatitis, anyway, not his diabetes.

    s/cured/in remission

    Though the choice of words seems a technicality, no? What is the difference between a cat whose pancreas was injured and "healed" back to working normally -- this is the word I see used here, regarding beta cells -- and a normally working pancreas, which might also be unwell, but is still working? Are we not using "remission" because as we are monitoring after being through FD, we will catch it when it next shows up, but what tells us this second bout is related to the first? Answering that: it is related if the root cause is the same, probably, and the underlying root cause has not been dealt with. So in Quintus's case, he has pancreatitis, "chronic" now given the absence of acute symptoms and the time it's been going on. But let's say he goes into remission. And three months later he has a pancreatitis flare-up that we aren't able to manage well, and we end up with FD again. Is he back on insulin because the FD has "come back", or is he back on insulin because pancreatitis can cause diabetes, and it's happened to him twice?

    Aside from that, do note the "nearly". I'm with you that it's too early to cry victory.

    I know we're not there yet, and it might be wishful thinking. But looking at his numbers back to at least the 28th, but even more so these last few days, all his "high" numbers have been following honey ingestion or rather rapid drops.

    The reason I want to stay away from too many lime greens and honey is that I want to see what happens if I'm not sending him down with insulin and then back up with sugar.
     
    Last edited: Jan 1, 2018
  16. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Well-Known Member

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    Dec 28, 2009
    Cured implies that if your cat ate your bowl of ice cream or needed a dental, numbers are likely to not go out of control. There are too many instances where caregivers became complacent, fed higher carb food or ignored their cat's dietary indiscretions and were back here with their kitty re-starting insulin. (If "cured," your cat's pancreas would be back to normal and exogenous insulin would not be necessary.) Likewise, infection or inflammation whereby cortisol is being released can put a cat back on insulin. Many FD cats who are in remission have impaired glucose tolerance hence the cat is diet controlled and not cured. See this article for more information.
     
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  17. Juliet

    Juliet Well-Known Member

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    Sep 8, 2017
    Where is the ruler? I only saw a tiny diagram of it.
     
  18. Stephanie & Quintus

    Stephanie & Quintus Well-Known Member

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    Dec 9, 2017
    Indeed, in those cases, completely agree. The underlying issue is still there but symptoms are "managed". Hence remission.
     
  19. MyTitan

    MyTitan Well-Known Member

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    Jul 20, 2017
    Quintus, stay away from the Sharks, they have nasty teeth!
     
  20. Stephanie & Quintus

    Stephanie & Quintus Well-Known Member

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  21. Stephanie & Quintus

    Stephanie & Quintus Well-Known Member

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    Been reading, found this that could be relevant to Quintus:

    "Type 3 diabetes is caused by an underlying condition such as pancreatitis or a hormonal disorder in the cat’s body. Total remission is possible in this case, provided that the underlying condition is properly treated."

    https://www.vetinfo.com/signs-of-cat-diabetes-remission.html
     
  22. Stephanie & Quintus

    Stephanie & Quintus Well-Known Member

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    Dec 9, 2017
    About an hour from now it will be exactly a year since I got the fateful phone call from the vet hospital where I had left Tounsi on the night of the 30th: his kidneys were failing and it was time to let him go. I did have time for the hour-long drive there so that he could die in my arms.

    I wanted to scatter his ashes in the garden today, but I completely forgot. I actually didn't think about this anniversary until now. Now I know why I didn't get anything done today and spent most of the day reading obsessively. It's dark outside now, raining and windy. Tomorrow will be a good day for his ashes too.

    I'm amazed that Quintus is still around. I really didn't think he would see 2018, when I lost Tounsi.

    He's had a green day. No honey for the first time in five days. Just a bit of gravy on his regular food when he swam with the sharks this morning.

    I'm declaring a NS tonight because I want to see how he does on his own. He was at 149 at +11, then he ate, and at 185 at +12.
    I'm still running out of strips and clearly not doing too well at saving them.
     
  23. Girlie's mom

    Girlie's mom Well-Known Member

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    Jul 3, 2017
    Hi Stephanie,

    You'll find that the lines on the syringe will rarely match the line on the insulin ruler. That's because the markings on the syringe (especially at lower doses) are usually way off. This is discussed in the Management of diabetic cats article. This really freaked me out initially as well, but then I was quite relieved knowing that Girlie was finally getting consistent doses as the doses on the syringes were clearly so off.

    I'd trust the ruler over the syringe any day!
     
  24. Girlie's mom

    Girlie's mom Well-Known Member

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    Jul 3, 2017
    Hi Juliet,

    Here's the link to the ruler: http://www.diabetes-katzen.net/insulinruler.pdf
    I've also uploaded it here so you can click on it to download it. Just make sure you print it out at 100% on A4 paper and don't resize it! You can only use it with BD U100 syringes: "For use with BD Becton Dickinson U100 insulin syringes with the BD Ultra-Fine™ Needle 0.3 ml 31Gx5/16" (8mm) with 1/2 u". The Management of Diabetic Cats article attached here also gives pics and info on using it.
     

    Attached Files:

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  25. Girlie's mom

    Girlie's mom Well-Known Member

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    I don't know about that - more experienced voices will have to chime in - but I'd put more faith in Tilly's remission info (written by a vet: Dr Rand of the Roomp and Rand on the Management of Diabetic Cats article I posted for you earlier).

    I'll be curious to see what more experienced people say, though.
     
  26. Girlie's mom

    Girlie's mom Well-Known Member

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    Stephanie, I am so, so sorry for your loss. I hope that you're able to spread Tounsi's ashes on a day that's right for you. That is so hard! I can't even imagine...

    On the other side, I am so, so glad to see how well Quintus is doing for you, and so quickly. Fingers crossed that 2018 is your and Quintus' year!
     
  27. Girlie's mom

    Girlie's mom Well-Known Member

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    Jul 3, 2017
    A drop: Maggie can verify this, but as I understand it, this is how you get a drop of insulin: depress the plunger and hold it tightly as you put the needle into the insulin bottle. Then let go of the plunger and remove the needle. What gets into the syringe that way is "a drop" of insulin. @Alicia & Maggie , is that how you do it?

    I thought it might be good to have that info up your sleeve, Stephanie, just in case you need it for a reduction down the track.
     
  28. Wendy&Neko

    Wendy&Neko Well-Known Member

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    Feb 28, 2012
    In the case of type 3 diabetics, the question is whether or how much the pancreas has been damaged. My Neko had two underlying conditions, acromegaly and insulin auto antibodies. These are under the hormonal disorder category. And sure, if hypophysectomy had been available in North America by trained experienced surgeons, or it had been available at the time at the Royal Veterinary College and I was made of money, I could have had her "properly treated". Instead, I went with what was available at the time, which did help, but not cure. And there was still be the question of whether being diabetic for as long as she had did damage to the pancreas. There are other conditions besides pancreatitis that also cause insulin resistance, such as hyperthyroidism, heart disease, kidney disease. Neko had the latter two, but she also showed signs of at least a partially working pancreas.

    Sorry about the tough anniversary. I know too well the memories that come at such a date. :bighug:
     
  29. Alicia & Maggie (GA)

    Alicia & Maggie (GA) Well-Known Member

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    Jun 17, 2017
    Yes, that's what I do. I also try to keep a little backward pressure on the plunger while withdrawing from the bottle so the insulin doesn't get sucked back into the bottle. At least that's the theory! I did do a test once to make sure I was getting something from this method, and sure enough, a small drop came out when the plunger was depressed.
     
  30. Stephanie & Quintus

    Stephanie & Quintus Well-Known Member

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    Dec 9, 2017
    Thanks everyone!

    Checked Q’s BG this morning (“+11”) and he has come down to 85 “on his own”. I think I’m going to continue to “see how he manages” while monitoring him. And I see he dug into his HC kibble again, which I’m going to remove this morning if he’s going NS again.
     
  31. Stacy & Asia

    Stacy & Asia Well-Known Member

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    Oct 2, 2017
    :woot: Way to go, Quintus! What a turnaround from “swimming in sugar” to “please make these lime greens stop”! Keep at it!
     
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  32. Girlie's mom

    Girlie's mom Well-Known Member

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    Go Quintus! :D
     
  33. Phoebes

    Phoebes Well-Known Member

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    Jan 16, 2017
    Yay what a good boy :D
     

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