18 Oct | Girlie | AMPS 590; PMPS 178; +2=158; +3=106; +5=97

Condo: http://www.felinediabetes.com/FDMB/...high-black-dose-question.185517/#post-2059887

Still solid black despite dose increase last night and new cartridge of insulin yesterday morning; also using new (and tested) vial of test strips. Some poo overnight.

Missed her AM wee, but will try to get another ketone test today; yesterday's was negative

Last night:
PMPS 632 +2= 608 +4= 500 +9 = 596 +11 = 590

Does anyone use a blood ketone monitor? That would be easier than catching a wee, I think!

 

Thanks to @Beenie , @Alicia & Maggie , @Mandy & Rex , @LizzieInTexas and @Toebeans for your support (and the cute pic, Mandy and Rex!). I'm doing a virtual "like" of your posts so that I don't bump yesterday's post up and cause confusion with today's.

 

Girlie, it's time for you to come back down!! We miss you near the water.

 

@Sienne and Gabby (GA) : I just transferred your post here so it would be in today's post and I wouldn't have two posts running concurrently and confuse everybody.

Yes, you're right: end of August when she also had Zydax but wasn't constipated - does that rule out the constipation factor? Also, with that insulin cartridge, I did everything that you could do wrong when drawing insulin; not sure whether that was a factor for the high run of blacks there, but started and new insulin cartridge and increased the dose, and she came down.

The only things that happened after 10/10 were:

• 6 Oct: started using insulin ruler to measure dose on 1/2 unit BD 0.3 syringes: clear from that that just eyeballing the dose based on syringe lines resulted in very different doses per syringe compared to insulin ruler
• Vet checkup 10 Oct: blood and urine draw and Zydax injection; her last blood draw on 21 Aug didn't change her numbers at all: stayed in blues
• Constipation: Microlax enema at home (easy and no adverse reaction after - just lots of poo w/no straining or pukas)
• BCS reduction to 0.1 on pm of 10/10 and AM of 11 Oct (panicked at being away all day after the 83 on 10/10 and signs from her that she wanted to dive down); she was already at 504 on 10/10 for her PMPS, though. Previously, she came down pretty quickly after a BCS and even a NS. Could the depot have drained from just those two reductions?
  
• Test results: only big thing was the increase in creatinine to 290 (was 190 end of July). Will do another check on this next month. Haven't entered all results in Lab section of SS yet; will do soon.

Zydax: Started in 2013 for arthritis; originally got 1x shot/week for four weeks; last year switched to 1x/month to see if that would maintain her better. @Bron and Sheba used Cartrophen (as did Wendy and Neko, I think?), which is also Pentosan (like Zydax), but they had no adverse BG reactions. I can try Zydax again next month to see the reaction, or I can ask the vet about trying Cartrophen instead? In Australia, there are meds that you can get in the US that we can't here, and vice versa. Meloxicam is another example: I believe we use a different concentration here specifically for cats and that's why we don't have the black box warning that you get in the US. However, I stopped the Meloxicam a while ago due to her kidney issues.

Flixotide: I've been using this all along, so I don't know whether this can figure in?

If it's the stage of the moon, or that she wants a set of pearls to go with her new black dress, Girlie is going to get a stern talking to!

 

AMPS 583
+2= 526

At least she's headed in the right direction...

 

Hope you start to see some movement soon.



Good luck with the litter box lurk.

 

I'm ordering George's Aloe Vera Juice now! I increased her Miralax a bit to see if that helps re: poo. These high numbers don't help there, though...sigh...

Very hard to type right now as she's got her head on my left arm and on my lap at computer. Love it, though! I'll have to put her cat bed back up on the puter as in her pic so she can be near me, but I can type!

It's a gorgeous day: not sure why she's not in her usual place on the verandah. She doesn't seem to be feeling terrific, though; can't blame her with these numbers.

 

Fingers crossed she doesn't get backed up again.

Hope it's not to hot for you, were expecting our first autumn rain here, we need it desperately. Spent the day making sure drains weren't blocked by debris so we don't get any flooding, with the way the weather has been, it wouldn't surprise me if it stayed dry

 

I love rain! The weather here has been hot, then cool: confused. We've had a really dry winter; no rain for months, which is not good. I lived in Berlin for years ('90 - '94) but, very unfortunately, never made it to Spain. I hope I can get there the next time I go to Europe.

 

What's going on, Girlie? I hope she gets sorted.

Please don't take this as anything more than an observation (because I'm new to this and have no experience and barely know what I'm doing), but the last time she was in the sea of black, the 1 unit dose seemed to right the ship. Maybe that will be the magic number again for awhile and your next dose increase will do the trick?

As far as stalking her litter box goes, I've seen somewhere far down one of my many google feline diabetes rabbit holes, little square papers that have the same reaction as ketostix, but instead you sprinkle them atop the litter (so you don't have to catch them midstream). I would think you still have to know when they go so you can read the results in the appropriate time window. Perhaps that's something to look in to? I can try to find it again if you would like.

 

Avoid our summer especially if you want to visit the south, sight seeing in 40deg heat is no fun. Spring and autumn are great though I prefer spring as usually everything is a lot greener, and the countryside is full of wildflowers and swallows.

If you find yourself in our neck of the woods, we can have a fdmb meet up

 

With Lantus it may take another couple cycles to see what the .75u dose will really do for Girlie. Looks like you some momentum in the right direction at least.


The colour today is yellow - we will even take a yellow today!

 

+2 = 526
+4= 324

There she goes! 200 point drop in two hours.

 

Movement downward!

YAY!

 

Thatta Girlie!

 

268 @+5 (a further drop of 56 points in an hour), so that's a 257 point drop in three hours.

She's not unduly hungry or looking for food, but I'm keeping a close eye on her.

 

Girlie, you're dropping a lot today like I am. Wheeeeeee!!!
-Felix

 

209 @ +6: another 59 point drop in an hour

Going to try to stall her some more

 

I'll be curious to see where she is at her PMPS: it may be a long night...

 

So nice to see her out of the blacks

 

Must be the day for drops ... Gizmo dropped 148 points in 3 hours this morning and 109 points in 2 hours this pm. Though I must say, Girlie's drops have his beat! Glad she came down some for you.

 

Yikes! Gizmo! Still, it's great to see blue numbers for him again.

Girlie historically takes deep dives, but it's now +6, so I don't want her to keep sliding down too far, too quickly, and then bounce again. Next test in 9 minutes, so we'll see if she's decided to try to level out a bit or just drop at a more reasonable level...

 

Fingers crossed!

 

166 @ +7 Yikes!!!

 

Even though this is only a 49 point drop, I'm not sure whether it's safe for me to leave her for a few hours right now. Any thoughts?

 

Her nadirs are usually around the +6 or +7 mark so you're probably safe, but the higher dose is setting in and it's a new vial. These 2 variables are hard to say where Girlie is going on this cycle.

 

Give her some low carb food and leave some in the dish to encourage the surf and to help stop the drop. She may bounce big tonight.

 

Thanks, I'll do that, and only stay at work for as short a time as possible. Is there a PMPS number that should make me hesitate to give another 0.75 Units? She could well decide that the 0.75 is more than she bargained for, even with all those endless days of high black numbers.

 

Wow, Girlie is sure taking you on a ride today/tonight! Surf safely sweetie!

 

Post closer to shot time and see where she is.

Get a test before you go out the door to see if you need to give a higher carb food or not.

 

And there's still the possibility that the old vial loss it's potency, keep a close eye if you stick with 0.75

 

Will do; thank you so much!

 

149 @+8: going down.

 

AMPS: 583 +2= 526
+4=424
+5= 268 1 tsp MC 13
+6=209 1 tsp HC 22
+8=149 1 tsp HC 22
+10=167 left 2 tsps HC 22
+11= 162

She dropped a LOT today, even though I tried to stall her dive with HC food from +6 on so I could run in to work quickly. I'm happy to see so many colours, but it's a bit disconcerting in one day!

I'm a bit anxious about the 0.75 at PM (cycle 3) as she's gone down all day despite the HC food. I have lots of strips and supplies and can monitor all night, but I've just got this feeling that she might continue to dive down as she hasn't risen at all today on her own since she started her dive at +4.

I'm just wondering whether it'll be safe for me to shoot 0.75 with a day like this and still coming down at +11. Any thoughts?

 

Oh Girlie, time to get off the slide!

 

I would shoot 0.75 units. 0.5 wasn't doing much for her. Not sure why you gave her HC late in the cycle. She is still in plenty safe numbers.

 

Thanks, Wendy. I left some HC at +8 because I had to leave, and the MC and HC I gave her earlier had no affect: she just continued going determinedly down. I'll give her the 0.75 and monitor closely.

Should I try to stall with low MC (12) if she continues to dive, do you think, or just see how low she goes?

 

I was looking back at her SS: her biggest dive, I think, was from AMPS 545 to 76 at +4, and on 27 July she went from AMPS 470 to 65 @+7, despite attempts to stall with food.

Tonight will be interesting! I've got my PJs ready for the party.

 

PMPS 178: Gave 0.75 insulin
+1= 196
+2= 158

So far so good!

 

My Gizmo is the same way. He will creep up and I just keep increasing until he decides "ok, I get it" and tumbles down. I have to go up to get him back down to good numbers (just went up 1/8th dose this morning). Usually it is due to pancreatitis but I think this last time was all related to the food.

Hope Girlie just slides down to safe and surfs for you.

 

I'm glad I gave her the .075 as Wendy suggested: the blue numbers so far are good, and she's stopped the headlong dive to the bottom of the ocean (so far!). Pancreatitis must be so tough to deal with: I really feel for you there. I assume you're sorted out your food issues? Have you found something that will work well for Gizmo?

 

Might have spoken too soon there:
+2 = 158;
+3= 106 (52 point drop).

Problem is, she's just not very hungry tonight; she ate a lot during the day and isn't keen on eating much now at all. I don't want to have a situation later when she's dropping and she doesn't feel like eating. What do you do when that happens? Or maybe Gizmo is a good eater.

Hmmm...what should I do? Wait til +4 and see where she is or try to get her to eat some more now, either LC or MC? I am way too tired to be able to make this decision!

During the day today, MC and HC had no effect on her: she just kept going down, down, down - even with HC 22 food.

 

Try just s little MC gravy. See if you can get her to surf. Gravy hopefully won't fill her up.

 

I was trying a certain food one.last.time. I think it makes his tummy upset. It is only 4% carb but it causes his numbers to rise (well, I thought it did, now I know for sure). I hadnt given it in over a month so it was a good test. It will go into the pile to go to the shelter. I am using Weruva Fowl Ball and various Soulistic foods. It is very difficult with both FD and Pancreatitis AND ckd (must be low phosphorus). Fowl Ball isn't very high in calories or I would just feed it but so far so good with the mixture I create.

 

I just tried some gravy, and she liked that. For some reason, it's really hard to separate the food from the gravy! I think we have less gravy here in Oz - Bron mentioned that. Is there a secret to just getting the gravy out? I've tried everything I could think of...

 

Can you get this?

http://www.weruva.com/catsitk-chick-magnet.php

 

Another trick if you are using canned (fancy feast?) is to use the lid to squeeze the gravy out. Remove lid and then put it back on the can and squeeze the gavy out into another container them use a spoon to portion it.

 

Mine like Cats in the Kitchen as well, and although the phosphorous is at a good level, the protein is too high. Girlie's phosphate levels are good, still, although her creatinine is up. It's tough to find the right balance! Be glad you're in the US: you have more varieties to choose from, at least. Choices are pretty limited here in Oz.

 

Superb idea!

I can get the pouches here; I didn't even think of them, of course, because they are higher carb. The store closest to me is out of stock, but I'll look around while I wait for the next test coming up. It'll be easy to just get the gravy out of the CIK food, for sure!

Thanks, Christie!

Oops: the only store that has them is out of stock. When they're back in, I'll definitely stock up, though.

 

?? For what?

The Chick Magnet has great gravy and it is easy to get it out. Just tear off a small corner and squeeze it out. The meat will stay in the pouch.

Another trick I use is MC/HC gravy gets a special bowl. It is a small metal bowl and I make a big deal with the clink of the spoon in it and "talk" it up to him and act like it is s big deal. Now all I have to do is clink the spoon on the metal bowl and he is there waiting for his "treat" even if he isn't hungry.

 

I order mine by the box from Chewy. Ask the store to order it for you. I keep the gravy in the fridge for 3-4 days.

 

Well look at Girlie! The poop + an increase = movement! Sometimes when Bubba was dropping fast I would just give Bubba a tsp or so of LC with every test to see if I could get him to surf. If he wanted to continue to drop quickly, I would then bring out the MC or HC. I agree with Wendy that when it's late in the cycle and the numbers are still nice and safe to just give LC to keep to drops minimal so you don't have a big carb spike along with a possible bounce.

 

Like @LizzieInTexas I wonder what you mean by the protein is too high???

If it's CKD that you are concerned about, current thinking is that its the quality of the protein that's important.
It used to be thought that a low protein diet was better for the kidneys, but it's the quality of the protein source that's important.

Nice numbers, hope she's got her surfboard out.

 

Re: the protein: I wondered about that, too. She has mentioned that before, and when I do a urinalysis, she's interested in the protein (usually "trace" in her tests). It has something to do with the vet's view of CKD. She said that if Girlie wasn't diabetic, that she'd recommend a CDK, low protein diet (ca 3%, I think?). From what I've read, the specific CKD food out there (Hills, etc.) aren't really good for CKD cats. Interestingly, Girlie's lab results show that her phosphate is fine; her protein is fine; but her urea (BUN) is high (20 mmol/L) and creatinine is high (290; was 190 in July). SDMA is 17 (mildly high). And her cholesterol is high (8.4). I don't know where this puts her on the CKD spectrum, though; I'll have to research that. Just by the by, her lab results are in her SS now.

As I don't feed a raw diet, I wonder how I would know whether the protein source in the canned foods is good enough? Would that depend on the brand?

She's doing okay now re: surfing: 97 @ +5. She hasn't eaten anything since +3:30: she's just not hungry tonight, probably because she ate a lot more than usual today.

 

AVJ is on the way, Bobbie - should be here next week. I can't wait! Both my cats are going to get it, and from what I've read about what else it's good for, I'm going to try it myself.

She's not hungry, so I think I'll just see how she goes with the drop @ +5 to 97 (green! yay!) as the night goes on. I don't want to give her too much food in case she decides to do a dive. I'm not used to night drops, and don't have as much data on that as she tends to drop more during the day - or at least, that's what I've noticed....

How will I know, I wonder, when it's okay for me to go to sleep? Her lowest number during the day today was at +8 (149), which is unusual for her: usually I see her lowest numbers from +2 to +4/5. I think I mentioned above that the last food she ate was HC gravy at PM+3.

I'm so tired I can't think straight; been up since 3:00 am this morning. What do you think? I just can't think right now! Maybe I'll just wait and see where she is at +6 without food and then make a decision? If she's still going down then, I assume I should still keep checking?

 

Wonderful! Such great gravy tips! Thank you so much...

 

George has early ckd stage 2.
The food I have researched for him is high in protein and has P below 1%, most of the food I feed is made in Germany, and is made with human grade protein some of it organic. I doubt whether they are available in Aus.
But Here's four of the varieties I feed.
http://www.granatapet.de/Katze/Nassfutter-Katze/Lachs-Pute-in-natuerlichem-Gelee-html/# (sorry no english language option with this site, but maybe you'll manage since you lived in berlin)
https://www.feringa-katzenfutter.de/en/
https://www.terrafaelis.co.uk/
https://thrivepetfoods.com/cats/wet-food

Not all of the varieties from these manufacturers are low in Phosphorus, so I pick and chose.
Ideally a homemade/raw food diet would probably be better but I'm not in a position at the moment to be able to do that, so I've tried to pick the best I can.
Have you come across http://catinfo.org/ search for CKD and read the section on what Dr Lisa thinks of Renal Diets....

Here's an extract from that section
Renal’ diets restrict protein to the point that many cats – those that are not consuming enough of the diet to provide their daily protein calorie needs – will catabolize (use for fuel) their own muscle mass which results in muscle wasting and weight loss.

This internal breakdown of the cat’s own muscle mass will cause an increase in creatinine (and BUN) which needs to be cleared by the kidneys. The rise in creatinine and BUN, and muscle wasting, can lead to an often-erroneous conclusion that the patient’s CKD is worsening.

But please read the link to where this is taken from so that you don't take it out of context.
Reading around the subject of protein in cats diets, it seems that elderly cats don't absorb protein as well as younger cats, and consequently suffer loss of muscle mass, so if anything are older feline friends need more good protein than a younger cat.

 

Fantastic info: thank you so, so much for that! I've read the catinfo site several times, but it's a lot of info to absorb.

I'll check out those different foods; the German won't be a problem (I say confidently after being away since 1994!, so we'll see)

I can get ZiwiPeak; just looking at the first food link reminds me of that, but the protein is much higher in that (32 - 36), and the phosphate is higher as well. I'll do more thorough research tomorrow; thank you again!

I can't do raw right now, either, but maybe in future.

I've been wondering about Taurine; do you add that to George's diet?

 

+6 = 121

 

No I don't.....
Should I be??

 

I had meant the HC at +10. I can understand HC at +8 if you have to leave. Nice cycle tonight - glad she ditched the basic black.

 

So lovely to see all those blues yesterday!!

 

She had a really nice run in blues last night and look! ...... she is already clearing the bounce at +4.

As she starts getting used to being in numbers under 200, she could start to flatten out some. The more data you get on her during that time, she will start to revel a pattern for you to be able to gauge how she could react at a certain point in a cycle. I am hopeful that that time is right around the corner for her.