1/6 Ozzy +11.5 287 PMPS 279 +2 261. +4 249

Yesterday's Antics

Pretty tired from last night but was able to get the ketone test and it was negative! Yay!

AMPS 333. Seems the PS number keeps going up. Not sure what is going on.

This is now cycle 6 of 1U. He had lower numbers on .75U but was still mostly all yellow.

What do you think we should do for next steps?

 

Giving you a bump up for some ideas

 

Thank you.

I will be able to monitor cycles starting tonight and for the next 5 cycles till I go back to work Monday.

TGIF!!

 

Most welcome! Might edit your thread title to add "dose help"
Yay for Friday!!
Surf safely Ozzy!

 

Sorry I missed your condo last night. We played 18 holes of golf yesterday and it's nice enough weather to walk so all that fresh air and I fell asleep on the couch!

I'm glad you figured out the lid/no lid thing for the box. Cats know what they like.

Don't worry that you will upset anyone here if you don't take our suggestions on food, feeders, LBs, ketone tests, etc. All of our cats are different in personalities and each of us knows what works for them and us. They are only suggestions but if they won't work, it's ok.

If you like feeding raw, and I am a huge advocate of it, you might want to try EZ Complete from FoodfurLife. It is a completely balanced supplement, and in fact has some wonderful things every cat should get like digestive enzymes and green lipped mussel, and none of the stuff they shouldn't have like gums. You just add the powder and water to meat you can buy ground at the grocery store. If your cats like chunks, you can just buy the meat and cut it in bite sized chunks and add the supplement and water.

I buy my meats ground, no bone, at Whole Foods and an exotic butcher for the venison and any other ground meat I can get that has no bones in it. The owners of the company have a lot of cats, each, and so they buy meats at the local supermarket and buy what's on sale. But I, personally, only eat pastured or grass fed, organic meats so that's what I feed our cats.

I make about a 1.5 lb batch of each food, put them in 1 oz portions in ice cube trays to freeze, and then take out the next day's portions the night before to thaw. Making the food takes me about 15 mins from when I get the bowls out u til I wash the last dish. My cats love it. You can also cook the meat and add the supplement. The website has a ton of directions on how to make the food raw or cooked and how to transition the cats. Interesting,y, I did try Rad Cat and my cats wouldn't touch it!

 

Marie....following Jo and Ozzy as we were both on vetsulin at same time. Am really interested in your info here about making your own kitty food. It's been a longing of my heart for some time so I am thrilled to read of your knowledge and experience in this area!!! This is exciting !!!

 

Sorry for typo..I typed Marje and spell check intervened

 

No worries...it happens a lot.

Let me know if you want more info but definitely check out their website. Wendy also knows a lot about feeding raw.

 

It looks to me like Ozzy is bouncing a bit. The approx. 100 point drop the evening of 1/4 may have caused his pancreas and liver to overreact. When that happens, a stored form of glucose along with counterregulatory hormones are released and it drives the numbers up. It's a normal reaction. The most annoying part of a bounce is that it can take some cats at least 3 days/6 cycles to clear the bounce. At this point, all you can do is be patient.

 

I am soooo excited...to be able to have you and Wendy's expertise in this is a gift

 

Remember that bounces can take six cycles to clear. That doesn't mean you have to hold the dose until it clears because he's still pretty high but you don't want to increase as he's clearing a bounce. That's not much fun.

So here's where it gets to be a tough decision for you. Under SLGS, you hold 1u for a week and do a curve. Under TR, you can increase the dose to 1.25u tonight as long as it does not look at PMPS that he's clearing a bounce. You can do TR until numbers start down more and then switch to SLGS if you wish. But this has to be your decision.

I know you might worry that he's overdosed but he isn't. There is no indication of that and cats don't get overdosed when you are slowly, systematically taking the dose up and testing.

 

Wow, I did not know this.

How can I tell at PMPS that he's clearing a bounce? His numbers will be yellow again?

I am not opposed to going to 1.25U tonight since I will be home with him for the next 5 cycles to be able to monitor. In fact, if I was going to do a dose increase, I'd rather start it tonight. Otherwise, I might not feel comfortable doing it during the week while I'm back at work and he'd might have to wait another week to go up.

 

This is funny because I initially thought when switching to Lantus, we'd do SLGS at first and then move to TR. But it seems like we might be doing the opposite. I just want to see him throw more blues regularly so I can stop worrying so much about the ketones. That is driving me (and Ozzy) mad!

 

Hubby got a +2 before he left the house = 265. So 68 point drop in 2 hours.

See on vestulin, that was like normal!! I understand it's not for Lantus though. Wonder what tonight will bring.

How about little Elmo and Beth! He is surprising us all, eh? So happy for both of them. I hope this NS thing keeps up and he gets his chance at remission. Paws and fingers crossed for them!!!

 

I started feeding raw after Neko got her diabetes diagnosis. For her, it was an almost immediate transition. The civie took a little longer. I started out doing premanufactured raw, cause there's a good one made locally (5 minutes away, I've gotten the plant tour, and knew people working there). They were also the only ones that gave me the As-Fed numbers to calculate carbs. Over time I added some home made, mostly because Neko needed lower phosphorus food for her CKD. It was really hard to find low carb/low phosphorus/low salt/unique protein food to satisfy both cat's dietary needs without going to raw/home made. I do about half home made/half premade now. We get some of the US manufactured raw products in Canada, but not all. I think Leslie @Gussie's mom has been doing raw even longer.

Good luck with the increase, when you do it.

 

Thanks Wendy.

I keep seeing everyone referring to their 'civie'. What is a 'civie'!!!

 

Civilian or non diabetic cats.

 

I think it stands for civilian like as in not part of an elite group but I could be WAY off.
I thought DH meant Domestic Husband for ythe longest time!

 

LOL
have you seen the LL slang dictionary?
http://www.felinediabetes.com/FDMB/threads/l-l-land-slang-dictionary.162551/#post-1744648

 

Don't feel bad, lots of us were sure GA stood for folks living in Georgia.. talk about faux paws
Yes, I've fed exclusively ( well except during this recent foray into pancreatitis for over 15 years now..I swear by it. There are lots of varieties now that didn't exist back then. Sure to be a fit for your cat somewhere in them! Just have to explore and not give up if he doesn't like one type! Some transition right away, Gussie did over about a week, week and a half when I got him. Some take longer. My GA siblings Buster and Jett were my first foray into raw. They took a bit of persuading, accomplished by hiding the raw in their wet and gradually increasing the raw and decreasing the canned until it was all raw. Each cat is different, or ECID as we say!
Feeding the raw you have control over the ingredients..I'm really glad it has become acceptable in the cat world as I can attest it is good for them!

 

ok, so what do you think we should do? Increase the dose, keep the dose, or reduce the dose? It seems he actually had lower numbers on the smaller dose. Even when I look back at when he was on lower doses of vestulin he had lower numbers.

Our vet actually said that if he has same numbers on lower doses and higher doses, it could mean he needs to be lowered.

What do you think?

Feeding now...then shot!

thanks!

 

got him at +11/5 =287
+12 PMPS = 279 so little bump down at the end of cycle.

 

It's actually pretty common to see a lower number at the end of a cycle like that.....we call it the lantus "double dip"

If you're going to be able to test for the next few days, I think I'd go ahead and take him up to 1.25

 

@Marje and Gracie @Kris & Teasel @Chris & China

Ladies, do you have any thoughts on my question above? Stalling to shoot... but will need to give one dose one way or another in next few minutes. Either decrease or increase? Thanks!!!

 

It's hard for me to say, Jo, and I'm not a Lantus pro. You don't have a lot of Lantus data yet but I see that most of the blues are at 0.75 u. My observation only. Not sure how that translates into a dose though. I understand the basics of the depot and that deposits/withdrawals to/from it can affect doses over a few cycles but don't know whether you should hold at 1 u or reduce back to 0.75 u.

 

I actually shot him with 1.25U. I got him on his hind and he did not like it and pulled away and cried. I tried to make sure the needle didn't come out and I didn't feel any wetness after so I feel like he got the full shot. Guess we will see in the next 2 hours if he starts coming down.

I am sure you ladies can relate to feeling like this is a big guessing game.

Kris, you are right- we don't have a lot of data and it seems he has gotten some type of blue number on almost every dose we have tried him on but he has never had any type of consistent blue cycle. He has rarely gone below 150 and the couple times he did, he was on a higher dose so I went with 1.25U for this cycle. This weekend is going to be fun. I am stocked up on post-pokey treats.

 

Thanks Chris, I went with your suggestion. I really appreciate you jumping on and offering advice. Thank you so much!!!

I'm so happy it's Friday!! Ozzy has his own bag of post-pokey treats, and now I am ready for my post-worky drinks!

 

Hang in there, Jo and Ozzy....blues are comin'

 

You,dear California girl, are a hoot ....like my neighbor says" if it's not fun, make it funny!"

 

I told Barbara & Uncle this yesterday and I think it applies here too

Don't fall in love with a dose....fall in love with the results

 

We HOPE so!!! We need to follow in Mr. Elmo's paw prints..

 

I like this...keeping us focused on the thing that is most important. Thank you!

 

Well I just had to increase China's dose after months of .5 and green

I want her to stay green....and if .5 don't do it, I don't have any problems going up, down or sideways in her dose

 

Love hearing veterans say stuff like this ...it really speaks volumes...ya do what ya gotta do ...I like that mindset !!!

 

PMPS = 279
+2 = 261

What the heck!? We increased his dose and I was at least expecting some sort of a meaningful drop based on his last doses. Grrrr....

Will be hoping for a better +4.

 

I have not. Thanks for sharing. We should add "sharking" to the dictionary. That's when your cat circles you in the kitchen starving for food! Hah!

 

Not sure, because I am new, but I don't think you necessarily see a better number right away (the first cycle) after the first increase
Hopefully someone else will come along along to either confirm this or correct me

 

I read somewhere...not sure where...that feeding raw ground food from the grocery store is not safe for your cats. Something to do with the fact that pet grade ground food is freezed immediately after grinding and tested for bacteria prior to being sold...and grocery store bought ground food is not immediately frozen so there could be a potential for harmful bacteria to grow. What are your thoughts on this?

 

That sounds nice and awesome!!!

Thanks for saying this. I just didn't want to put anyone off and after I read back some of my responses to people's suggestions, I realized I might have come off wrong. I don't want to offend anyone or put down anyone's suggestions. I really value the opinions and feedback from the people on this board. You all have helped me so tremendously and I can't even express my gratitude!!

 

Negative ketones yay!

 

Remember that you are dealing with a hormone, not a drug. You don't always see incremental improvements with increases in dose. Hang in there and good luck with the increase.

 

This could be some NDW (New Dose Wonkiness)

 

Thanks, Wendy - you are right. I do think I forgot about this. I am also post-vestulin which is an in-and-out insulin so getting used to the difference still I guess. I take thyroid replacement myself and it can take up to 6 WEEKS for a dose change to take effect, so I do get this. Thanks for reminding me hormone not drug.

I have said before I'm impatient...I'm learning. I swear... It's just hard. I have seen my kitty is high number for over a month and I just want to see some good progress in him. I want him to be safe, and happy, and healthy. I'm honestly having a bit of a hard time with this sometimes...

 

Yes it can be stressful because it is not a particularly linear problem or solution in a way and we have much worry about ketones (too high), hypo's (too low), lack of sleep, decision fatigue, maybe financial worries regarding supplies, missed work, change of social life etc. It can be a major adjustment.
All I can say is thankfully this place exists where we can empathize with others an be supported as well

 

I can totally relate to the despair on constantly seeing high numbers. Neko had two high dose conditions. I shredded several pairs of patience pants waiting for better numbers. Ozsy will get there.

 

I also have the unnerving worry about him having acromegaly. They said this at the vets, even put it on his paperwork even though we declined the blood test to confirm. But I still wonder in the back of my mind...

 

We don't even recommend testing for it until they're above 6 units or if they have definite symptoms

More reading for you!!

Acromegaly ....what we know

Acromegaly....the basics

 

I wanted to mention another option for measuring ketones, just in case you were interested. You can make a box just for testing for ketones by using non-absorbent materials, like aquarium gravel. I slipped a large box lid inside a garbage bag to make a temporary litter box. That's what we used when we took Punkin traveling. Then when the kitty pees in the box, you just tip it and the urine will all run to one side. Easy as anything to test that way. When you're not trying to test, leave that box in the garage or somewhere else out of the way.

Also, to second what Marje said about people giving suggestions and you taking/not taking them. We're brainstormers here, and what works for one cat might not work for another - either for the cat or the bean (human). No one is offended if you don't take a suggestion - we all get that.

I feel pretty competent about acromegaly, and there is nothing at all in Ozzy's spreadsheet that suggests that he might have acromegaly. Of course I could be wrong, but there are signs that suggest acro might be an issue and I don't see anything there to worry about. I'd take that one off of your worry-plate. You have enough other things to think about, lol!

 

Why would you think he might have acromegaly? Recent research does show one in four diabetic cats does have it. But like Julie said, I don't see anything that raises my acro radar at this point.

 

The acid in the cat's stomach is much stronger than human stomach acid and can kill most bacteria. I do take a precaution and freeze my meats for three days before making food. That will absolutely kill any toxoplasmosis. Did you know there have been more reported cases of salmonella in commercial dry cat food than in raw that people make?

I always order my meats early in the morning and Whole Foods is very careful with being sure their equipment is cleaned between grinding. However, as I said, the owners of the company said they just buy supermarket meats.

We have had other cats that had to go up to a little over 5u before they hit their fitting dose and then started a fast zoom down the dosing ladder. As hard as it is to see higher numbers (and I've been there), try and focus on how he feels and know that you are helping him because he is getting insulin.

 

Thank you Chris. I will read up!

 

Julie, thank you so much for your comments. I really appreciate you taking the time to reply.

I like the idea about the gravel LB for ketone testing, Thanks for proposing an idea that worked for you and Punkin.

I also really appreciate your comments (and Marje's) about the suggestions to others. I just don't want to be a naysayer or rebuke ideas from others, because sometimes folks will be less likely to offer help in the future if you don't agree with them or take their ideas into practice. I can see here now that folks on this board are really not like this. This is NOT true in real life. This is just proof that cat owners, like cats in general, are the better species!!!

 

Also, what signs would you see in the SS that might point to acro? So we can be on the lookout, if necessary, in the future?

 

Our vet said this when he was in the hospital. He had an U/S done and some other tests and they said they thought he might have it and recommended a blood test to confirm. We asked what the tx's were and they said chemo, radiation, and/or surgery and we said no way we are doing that to our cat so we didn't think it necessary at the time to do the blood test. We really felt that since our kitty was a bit of a fattie his whole life, that he probably developed DM due to his weight issues and diet (higher carb). We let them know that we'd like to test him out on insulin first and try to get him to loose a little weight and then we could maybe revisit the blood test for acro later on. Honestly, as we were driving home, Hubby and me decided we would not pursue such aggressive txs with our Ozzy if he did have acro because he is a very scaredy kitty in general and from a quality of life perspective, this would not make Ozzy happy at all.

When we checked out and took all Ozzy's tests and paperwork home with us, it said on his paperwork that he had/most likely had (sorry, I don't have his paperwork in front of me) acro. I actually questioned the vet tech on the way out...how could they know this and diagnose this as a disease process in Ozzy if we declined the blood test. Who gets to put this on some kitty's medical paperwork without confirming for sure!!??

 

Specifically - on 12/11 and 12/17, 1.25u got Ozzy into green numbers.
On 12/23, 1.0u got him into green again. - to me that is significant because it was a smaller dose that the times he got to green before this. While doses can and do go up and down, it is most typical for an acro cat's dose to go up.

The simple fact that he is on such a low dose is a huge factor in why I wouldn't worry about acro at this point. The hormones put out by the acro tumor create insulin resistance. That means that the insulin can't get the glucose into the cells, so the blood sugar is high (because the glucose is floating about in the bloodstream instead of getting into the cells) and it takes more and more insulin to move the blood sugar down.

Take a look at Punkin's spreadsheet in 2011, when we started here. You'll notice that it took 3u to get him to green, and after that he didn't see a green number until 2 months later when he was at 8u. That's the spreadsheet of a typical acro cat.

Having said that - I could be wrong. We know that there are some low-dose cats with acromegaly. But I would put the burden on your vet to justify why he is saying that Ozzy has acro, rather than on you to prove that he has it. At least for now, he doesn't have the size of dose to support that diagnosis.

Just saw your last post. I would ask what they are using as a basis to suggest that he has acro. The only diagnostic tool that I know of is either a picture of the pituitary gland or the blood test for IGF-1, which is only done at Michigan State University.

 

Thanks Julie. I'll pull out his paperwork when I get a chance and will share what they wrote.

 

Around only 35% of acrocats have clinical symptoms at diagnosis. What this means is that the majority of acros look exactly like other diabetic cats. I don't know how you can diagnose with an ultrasound. Only until many years into her acromegaly did Neko have larger organs, and then only mild growth in the heart and liver. And since she has Maine Coon in her, they are prone to larger hearts anyway. The cardio vet did not think it was significant.

If you didn't know, acromegaly is a benign tumor. It's the excess growth hormone put out by it that causes the diabetes and elevated IGF-1. The research study I mentioned above (Royal Veterinary College) did find low dose cats with acromegaly, but they've been very rare here.

As for treatments, they are radiation therapy (which both Neko and punkin had), surgery to remove the pituitary - I wouldn't do it in North America but they have had success in the UK, and there are some drug treatments. The drug treatments are new, not available when Neko was diagnosed, and the one with published research is very expensive. Jack (saltycat) is going to participate in a trial (with RVC) for a much cheaper drug solution.

But the above is probably too much unneccesary information for you now. Right now, Ozzy's SS just looks like many of those that are recently diagnosed and trying to work their way up to a good dose.

 

You know they make blood meters that test for Ketones right? I just received mine earlier this week. If you are interested they are here:

https://www.adwdiabetes.com//produc...eter-kit-10-ketone-50-glucose-strips_3401.htm

I haven't used mine yet, I bought it more as a precaution than worried about Gizmo having ketones.