11/26 Webster PMPS=379

Happy post xmas. I hope everyone is recovering from the holidays. I'm still cleaning up the house from our xmas party and getting things back in order.

Ever since I upped his dose, Webster has been almost completely out of the reds and spending quite a bit of time in the yellows, blues, and even greens! His ketones are down and he's looking good.

Last night he dipped down to 49 but I boosted him back up quickly with a couple tbs of 20%. Since this is so close to 50 and meter variance is involved, I really don't want to return his dose back down 1/4 unit as ketones are still a threat and he seems to be doing quite well with the 1.5u.

After being in lower than average numbers I have noticed a change in his appetite. He's not insanely hungry all day. I've noticed that he's been more of a slow grazer, returning to his bowl every few minutes to eat a little more instead of inhaling all food at once. A couple time I had to open the feeder lid to allow him to go back and eat unfinished portions from earlier in the day. While its taking him longer to finish, the good news is that hes finishing all of his food and he still seems to have a good appetite.

I've also noticed that he's getting quite hungry around +2 to +4. This is also the time when his BG's have been falling fast lately. In response, I cut out his +3 meal and shifted more food to his +1 meal.

As of tonight, his food schedule is PMPS=1oz, +1=2oz, +2=1oz.

While on the topic of food, With his recent change in appetite, I've been considering a couple different options.

#1 Return to free feeding. Since he's not immediately inhaling every bit of food that I put in front of him anymore, maybe he can self regulate and eat when his Bg is dropping. It's very obvious when his sugar is dropping. If no food is in his bowl he starts jumping up on counter tops and scavenging everywhere for food. Perhaps I can just put out his meal and let him eat when he feels the drop.

#2 Put out all of his food at once (1/2 in morning, 1/2 in evening) and weigh his food every 1/2 hour. I would document the amount ate and at what times. From here, I can take this information, match it up with his bg readings, and try to determine exactly where he starts to drop. I would use this information to adjust his rations.

Your thoughts?

 

Hi Mike,

Merry post-Christmas to you, too. I've been following your journey with Webster and just wanted to commend you on what a wonderful job you're doing.

I'll leave the guidance to the more experienced members, but I'll share my observations. I, too, have noticed Kay's ravenous behavior during/around her nadir. She is a free-fed grazer and usually takes 3-4 hours to finish 1.4oz of food. She eats anywhere from 3/4-1 can a day (she's a tiny cat at only 6lbs). I tried scheduling her meals for a week, but found the effort unnecessary because she is so good about eating when her BG gets low. I now feed her 1.4oz 4x a day @amps +4 and @pmps +4. Leftovers, if any, are taken away at +8 or +9 and added to the next meal. I'm now thinking about feeding her just x2 a day @amps and @pmps. A lot of this is trial and error and we won't really know until we try. Best wishes.

 

Deer Webster,
Do you think we're cavin' to do these blews?
Sinserly,
Mikey

 

Hi Mike! Here is your last post from 12/24: http://felinediabetes.com/FDMB/threads/12-24-webster-amps-443-2-516-6-372.130320/#post-1340495

Was the 0.4 ketones on the blood ketone meter? If so, I believe that's negative, right?

What was the reasoning for waiting on the dental for Webster? Was that just in order to get an appointment?

Great news on his appetite! I think what you're doing is working and if you want to tinker with what you're doing, go ahead, just take notes (which you are already great at doing!) so you can reflect back on what seems to help and what might not be helping. In general, I think you want some food spread out over the first few hours in each cycle, although if he will graze some cats do fine with free-feeding throughout the cycle. Just depends on the cat.

I think this dose is looking great for him, too. Did you mean for those pm cycle tests tonight (the 114 and 142) to be colored green?

 

Nice to see such a good Webster report.

 

Hi there

Looks like Webster has been working this dose - and yes he is indeed losing the red and black. And best of all the ketones are at bay!

The extra insulin has facilitated transport of energy (from food he has consumed) into his cells.
Being that 2.4-2.5 on the blood ketone meter is about when trace ketones appear in the urine, Webster now has 8 negative days under his belt!

Time to find out if his teeth and gums may be the source of a BG raising infection .
As soon as your budget will allow, make an appointment for a dental. If your vet has dentistry experience and you are comfortable with him/her start there. After a good look inside Websters mouth and at the xrays, the vet will determine if a referral to a specialist is best.
With BK, he had a lump on his neck removed for biopsy (it was negative) and while he was under, the vet had a good look inside his mouth. She saw the remains of a broken tooth and easily removed it. She also saw his teeth and gums needed the attention of a specialist - they were way beyond what she was comfortable handling.

Regarding the feeding, ECID. My goal was establishing a schedule that was effective and uncomplicated and that I could be consistent with indefinitely. Once established, it was no longer a variable ( and the fewer variables I had to deal with the better ).
I still use the 5 compartment programmable timed feeder and the same schedule.

BTW, are you using Ketostix to test his urine for ketones using the identifying color key below?


If you feel like you are uncertain if the reading is negative or trace, try reading the result in a different light. There should be no doubt - It should be clearly negative or trace.
BKs litter box is in the bathroom and sometimes I had difficulty reading the result. When I ran into the kitchen and stood by by the window, the natural light made it easy to read.

 

Nice to meet you Mel and thanks for following along.

It looks like Kay was diagnosed around the same time as Webster and it also looks like shes been making some progress here lately. Congrats!

Now that Webster doesn't immediately inhale everything that I put in front of him, I've been considering just 2 feeding per day but will start by reducing to 3 and then perhaps 2 or 1 depending on how he does. If he ends up eating it all too fast, having a meal reserved for him sometime between +4 and +7 sounds like a great idea. Thanks for suggesting.

 

Nice blues there Mikey! Let's keep it rolling!

 

Hi Julie. I somehow missed Websters previous day. Thanks for posting this.

I believe that 0.6 and below might be negative but that seems to be for humans from what I have read. Either way, 0.4 will work for me and it sure does make me feel much better!

As for the dental, after heeding the advice of Sandy, I decided that it might be a good idea to wait until Webster is in the clear with his ketones. I'm thinking that time is almost here and will have to figure out which animal clinic that I should go with. The two options that I'm considering now are my regular vet, who has all of the equipment and may or may not be able to do it in the next couple weeks or the local university who has a new patient wait until at least Feb but should have more experienced vets and from what I'm hearing will work for less. I'm going to start looking into this early next week.

Webster has always been a grazer prior to diabetes. I only recently started rationing out his food because the diabetes and high numbers would cause him to eat non-stop. Now that his number are down, he doesn't eat everything in one sitting.

It looks like my wife fixed the colors last night. She was up late keeping eye on him. Her being a night owl, she has agreed to stay up with him as long as I take care of him in the morning. So far, it's working out well.

 

Thank you Tiff. I'm so glad to see that Webster seems to be making progress with his new dose.

 

Hi Sandy. Thanks for stopping by.

My wife and I were theorizing about how the extra insulin was allowing his body to process and use the sugars which prevents him form feeling hungry constantly. Thanks for explaining as this confirms what we were thinking. I feel like we are finally beginning to get an understanding of how this disease works.

The dental appointment is next on my list. I really want to give it a few more days to ensure that this dose sticks and we don't have to back down, putting him back into the ketone danger zone.

As for the vet for his cleaning, I'm most likely going to start with my vet and go from there.

Concerning the ketostix, (I'm using the Relion brand) I'll try a different light and see if this makes a difference. Right now its showing tan but It still seems to contain a hint of pink. I'll see what it looks like under the sunlight.

Thanks for suggesting.

Finally, I'm going to experiment with his food over the next week or so to try to figure out what works now that he's not eating everything in sight immediately.

 

When I used the ketostix on J.D., the test pad would become a little darker beige (once it was wet), but was definitely still beige when I held it next to the Trace on the picture. Have you tried testing yourself to compare?

I'm glad he's eating well, and I wish you luck in your feeding experiments.

Did you sign up on the waiting list for the dental at the college, just in case?

 

I just tested the stix on myself and they are coming back completely tan. Will try to test him here shortly (if I can catch him) and look at stix under the same natural light to compare.

As for the college, I'm probably going to go with my vet for the dental. He has all of the equipment and I really don't want to bypass him and ask for a referral before giving him a shot. I have no real reason not to allow him to preform the dental so it seems logical.

It would however be nice to have the university do it because there is of course going to be more knowledge there and it will be less expensive from what I understand. I'm still torn and have not completely decided which direction to turn from here.