http://www.felinediabetes.com/FDMB/threads/dosing-advice-for-nigel-asap.210161/page-2#post-2329612 No insulin for 5 cycles.
Super. Glad you didn’t shoot. BTW, if you don’t shoot, you need to show it in your subject line as either AMBG or PMBG depending on whether it’s the a.m. cycle or the p.m. cycle. AMPS and PMPS indicates you shot Thank you and have a great day.
Still looking good. You know the drill. Also out of curiosity, can you upload a shot of the graph from the FL for last night when you can spare a minute? It fills in the pic of what happened through the cycle even if we aren't trusting those numbers right now.
Good morning, Grant Now that shot is skipped, you can also remove the ? from the title. When you grab his next tests, you can add that to subject line as well. Doing the titles like that allows for members that are skimming to see at a glance what's going on. Nigel is obviously not currently needing insulin, but you still need to be monitoring in case he does need it again. The fact that his numbers had increased so much with that tsp of karo a few days ago indicates that he is prediabetic if nothing else. His pancreas has some damaged cells, but not beyond repair. He will need to stay on low carb wet food. How is Nigel feeling? How are *you* doing?
I went back to bed this morning which was nice! Nigel has been good—I think the wet food is giving him a nicer coat and making him shed less. He’s been as sweet and playful as ever. Thanks again for walking me through all of this. BTW, yesterday I went out on a group bike ride and we came upon a dog way out in the countryside who appeared to have been separated from his owners for days. We gave him some of our food and water and he went from being terrified of us to being our best friends. A couple trucks passed by and we asked if they would take him into town to the pound. The first said he didn’t have time and the second said he didn’t want the dog in the cab and we didn’t trust that he wouldn’t jump out of the back, so two of us broke off of the group to go into town with the dog. It felt like the timing to be presented with an opportunity to help someone else with their pet was a little uncanny and it felt good to help another stranger that I will never meet, and I guess it relieved me of the little bit of guilt from accepting help from all of you on here. Thanks again!
There's no need to feel any guilt, we are all here because at some point someone helped us and now we pay it forward. Glad you boy is doing so well
You definitely don't need to feel guilty! Paying it forward is great though. It helps someone, and feels great yourself. I'm glad you were able to help out One of the first changes I had noticed with Rhubarb was her coat. She was no longer greasy and stopped getting mats. Her sugars were still high at that time, but with the weight she lost, she *could* groom. Cats feel so much better being able to groom. The change to the wet food did help her coat on its own too.
How nice of you to take time out of your day to help the poor dog! I just hope he wasn't one of those that for whatever reason is just dumped in the country to fend for themselves. In any event you got him to a safe place where he will be cared for and can be reunited with his family or find a new furrever loving home. Don't ever feel guilty asking for help here. This community is loaded with folks like yourself who love and respect the furry four footers who share our lives and we all support one another! You are part of that community now. You're stuck with us! HAHAHAHA! As for Nigel, so glad to hear he is feeling well and looking good! His graph is looking AWESOME! Look at those numbers now.....what a change and all for the better! Your vet is going to be flabbergasted I'm sure and hopefully learns something from all this especially about not making hasty diagnoses.
Reminds me of a hike DH and I did in the mountains. We were able to help someone, and it was a little amusing in a way. We had started off on our own, and there was an obvious path to the one side. When we got to the end of it, we felt it was out of our abilities, and so turned back to go a different route. It was then that we met a man with his dog. Great dane or something like that. We told him that there was a route that would be easier on his dog, and so he followed. We ended up visiting, and effectively ended up becoming a hiking party. When we reached the summit we all took a break. When it was time to head back, the dog wouldn't get up. The guy said to just go on, his dog only needed to rest a bit. Rule #1 in the mountains- nobody gets left behind. So we stayed despite his insistence. He did nothing wrong- his dog had been to every summit with him in the past. This time, it turned out that his dog had cut 2 paws on a sharp bit of rock. Long story short, the only way to get his dog off the mountain was to clear a soft path for him. Dh would scout ahead to route find, and I would clear away twigs for softer footing. When there was no decent ground, the guy would carry his dog. So dh took his pack, and wore 2 packs. It took a very long time to get off that mountain, but there was no way we were leaving them behind. It was kinda comical making a trail for a dog, and carrying 150+lbs of dog, but he had to get down. At the bottom, I found some lidocaine and disinfectant wipes in our car's first aide kit and gave them to the guy. He was so incredibly thankful, and it made our day to help. He felt bad for taking up our time. He wanted to pay us, and we said no, just pay it forward. He msgd on fb later on saying thanks again, and shared how he paid it forward. Helping out doesn't have to be so grand as this. It can be something as simple as a word of encouragement. I didn't share this story to hear "good for you". Just to share an example of paying it forward.
Yeah, he doesn’t seem to have lost any weight so far. Have any of you had any luck walking your cat outside? I’m thinking of getting him a harness and giving it a try. Or any other ideas for how to get him to exercise more? He likes to play fetch with hair ties that I shoot across the room, but he gets bored more quickly with any sort of games as he gets older.
Likewise. The point is that there is reward in helping others, even if there were no money or recognition or even acknowledgment from the other. I think that one of the positives and the negatives of interacting with people over the Internet is that it can expose the better and worse of people’s individual natures, or who they have become by virtue of nurture. Some people dehumize others through the web and don’t treat them with the same dignity that they would face to face, since there is nobody holding them accountable. Others have the character to hold themselves accountable and be decent regardless of punishment or praise.
It’s gong to be interesting sharing all of this with the vet. It seems like there is so much information, that it’s going to be a challenge to make it all concise enough for a quick read. If any of you have a sense of how I can summarize it, I’m all ears (well, eyes). Also, do I need to start a fresh thread for every AM/PMPS test, assuming that things stay the same?
I think if you are willing to spend the time, you can get them to walk but I think it's much harder to do with a mature cat. In my experience it's not like walking a dog. Cats very much do things on their time....not yours. I met a woman living on a houseboat who walked her cat daily. He'd strut along the dock just like a little puppy and seemed to love it. When I asked her about how she had trained him she said she had started when he was a kitten. I've had mixed results. I couldn't get one of mine to even stand up once I wrestled him into a harness. My extra sweet girl will walk on a harness (I started early with her) but she drags me all over the place and has never stopped trying to remove the harness every so often so she can go explore at will. I would never take her out on the street for fear she might one day be successful in her attempts to pull a Houdini. I may try one of those jacket type harnesses and see if that works a little better. Good Luck!
Also, regarding the haste of the diagnosis: if Nigel seems to still have been pre-diabetic, would the fructosamine test have let on that insulin wasn’t necessary?
I LOVE that you took the time to help an animal in need! I would have done the same thing. You may have saved that dog's life.
The fructosamine shows the average over a time period, so it would really depend what his numbers were like. It also wouldn't show how high the numbers got, which I think is how prediabetes works- sugars jump higher and take longer to come down. Here, the test costs $250 cdn. Your vet may have been trying to save you some money, and also initiated insulin to hopefully nip it on the bud quickly.
@majandra yes, that was the explanation that she gave. She said that it’s extra money and that they usually feel pretty confident diagnosing on a normal blood and urine test if other symptoms are present. So it sounds like there isn’t a clear and easy answer.
If you do a "show and tell" the vet should be able to follow what has transpired. Take the SS and pictures of the graphs with you to show her the timelines corresponding to the dose reductions/skips. The FL graph shows a "normal range" (Green strip) that is for humans so make sure she doesn't misinterpret that. Normal on a human meter for a cat is 50 to 120. I looks like the FL is reading closer to the Prime now in lower range. The SS will show the BG pattern, insulin given as well as readings taken. Goal is to have numbers mostly in dark green but some low blue (120 or less) are still normal. The SS is quite visually telling as is the FL graph which serves to confirm that the BG has dropped considerably with the withdrawal of exogenous insulin and BG through the last 12 hour cycle is far flatter and within normal range. IMHO, you are well armed with evidence that your suspicions were bang on! It's really up to you how you want to proceed but given the history, I would suggest continuing to monitor and post (yes a new thread each day) at least until the FL monitor fails or stops working. It looks like Nigel is not diabetic now but the history suggests he is at risk of becoming insulin dependent if a temporary diet change sent his BG high enough to elicit a diagnosis of diabetes. Ongoing periodic BG testing at home would be prudent. I agree the fructosamine may or may not have provided a more definitive or accurate diagnosis. If BG was elevated due to the diet change for half the period covered by the fructosamine test, the result could still have been elevated. The question is whether that elevation would have suggested full blown diabetes or borderline.
I don’t think that I’ll be needing to see the vet in person unless I’m not able to get the FL sensor of myself, so I’ll need to send her an email with all of this info. Anyway, I think I’ll be able to figure out what to include, but I guess the interesting part will be in telling her that I’ve come to my own conclusions, along with the help of this forum, rather than waiting for her dosage advice based on the numbers from the FL, as originally planned.
If you need help constructing the email, we are only a holler away. Given what we know now, I shudder to think what could have happened had the vet blindly used the readings off the FL to give dose advice. With numbers being as high as they were initially, she might have suggested an increased dose which could have had catastrophic consequences.
I’ve been out and about, but he seems ok. Been lounging and hasn’t eaten a lot but just put him in front of his food and he went to town. Could the fact that he doesn’t really eat as much when I’m not around (always been that way) be a contributing factor?
Beautiful greens! I don't see why it would, as long as he is still eating in total what he should in a day.
