Beginner, need advice for dosing tomorrow morning

Discussion in 'Prozinc / PZI' started by Anita and Stewie, Jun 18, 2017.

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  1. Anita and Stewie

    Anita and Stewie Member

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    Hi there, First of all, I'm new with this, and I've been reading like crazy, but I already goofed today with Stewie's shot and it makes me sad that I still don't have the knowledge I need...there is so much to learn! Stewie was diagnosed June 2nd, and his SS has the vet's readings first, sorry I copied and pasted from the USA sheet over to the World (I'm in Ottawa, Canada, EST) and the green colour came along when I pasted.
    But I started his BG curve myself today, and I didn't know about the readings with the AlphaTRAK which I use, so I learned from someone on the forum, too late, that I should not have given him his morning dose as his reading was too low at 5.9. He went down to 3.0 as the lowest this afternoon, which I didn't know was bad (I thought 2.8 or lower was too low) but by luck I fed him small amounts of food a couple of times and he didn't go hypo. His reading went up to 7.5 by 7 pm.

    I want to know about tomorrow morning, as I read this on one of the stickies for this group: NOTE: Because pet-specific meters (such as the AlphaTrak2) often read higher than human meters, you may want to adjust the NO-SHOOT number to 225 mg/dL {12.5 mmol/L} or even 250 mg/dL {14 mmol/L} This gives you an added margin of safety when using an AlphaTrak2 or other pet-specific meter.

    Does this mean that tomorrow morning, if his BG reading is 14 or lower, that I should not dose him? when do I know to give half a dose, or just one dose a day?
    As an added note: as soon as I found out he had diabetes on June 2nd, I switched to a low carb canned/wet food. He used to eat dry and wet. Thanks so much!
     
  2. Yong & Maury GA

    Yong & Maury GA Well-Known Member

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    Glad you were testing to catch that 3.0, Anita :bighug:. Diet changes to all wet can have a big impact on numbers. If he's under 12.5 mmol/L in the morning and you won't be home to monitor, I would probably skip the insulin again. I think you skipped tonight's because the 7.5 is in +1 of PM cycle :). Keep in mind some cats show no signs of hypo until it gets really bad but I am glad to hear he didn't have a serious event. Well done with feeding small amounts too. Usually, when they hit the "take action" number (AT2 is 68) you feed tiny amounts, retest in 20 minutes. If number is the same or drops, feed tiny bit again, retest in 20 minutes. When you get above like 5.5, hold off on food, retest in 20 -30 minutes. The goal is to get 3 rising number tests without giving any food and then you can test in an hour, then a couple hours. Hope that makes sense :cat:

    If he is like 12.6 - 14 and you will be home to monitor him and get mid cycle tests, you could try a 0.25U dose. You can also post his number, I think @Rachel checks in around 07:00am EST when she gets off work (I think :smuggrin:) to ask for help too.
     
    Last edited: Jun 18, 2017
  3. Djamila

    Djamila Well-Known Member

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    Nice work! You have a signature, a spreadsheet, you're home testing, and you're on good food. You're doing great, and it looks like Stewie is too!

    So it looks like you did not give a shot tonight. Is that correct? If so, can you put "NS" in the box for the PM dose? You can actually shoot below 14 as long as you can monitor (get mid-cycle tests like you did today).

    If you aren't going to be home though, then yes, skip if the number is below 14. You don't have enough data yet to be sure what will happen, so that's why we say to skip the shot in the early days.

    If you are going to be home, it looks like you need to reduce the dose anyway. Based on your pre-shot this morning, and the lower numbers today, it looks like 1.0u is too much. So whatever you get in the morning that's higher than 14, I would recommend reducing to 0.5u until you get a bit more data.
     
  4. Kris & Teasel

    Kris & Teasel Well-Known Member

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    That can be a good starting point in the early days. I believe I said 11 (200) earlier and that could be your guide if you ask for advice here first.

    Please post here for advice. Someone will see it and help you. I'm usually on by 8 AM to check the forums.

    First, you need to get more data. We can coach you through this data-gathering process and give dosing advice. Somewhere along the line you'll have enough data and confidence to decide doses for yourself. As for once a day - that isn't recommended because cats metabolize insulin very quickly. They need a dose every 12 hours.

    This is excellent! The fact that you did it right away helps a lot.
     
  5. Kris & Teasel

    Kris & Teasel Well-Known Member

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  6. Yong & Maury GA

    Yong & Maury GA Well-Known Member

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    Oops. I hadn't gotten to Main yet. I always make a point to check Prozinc first :smuggrin:
     
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  7. Rachel

    Rachel Well-Known Member

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    I am here! I'm usually around a little after 5AM Central Time on weekdays. I wish I was getting off work, Yong...nope, I just go to work really early. :coffee:
     
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  8. Anita and Stewie

    Anita and Stewie Member

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    Hi there, thank you everyone, I am home to monitor him today. I work from home often, and I am very lucky for that.
    His reading just now, no food, was 4.9 I'm surprised, I thought it would be up. I am thinking no shot, but see what happens after food? I will wait to see what advice you have, but he's very hungry. I think he should eat? Thanks!! I updated his SS with today's reading.
     
  9. Anita and Stewie

    Anita and Stewie Member

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    Hi Rachel, I just took his AMPS at 4.9. I'm glad you're around, sorry you aren't getting off work!
     
    Last edited: Jun 19, 2017
  10. Rachel

    Rachel Well-Known Member

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    Go ahead and feed him, Anita! I'll put more info in another post, but feed him and definitely no shot!
     
  11. Anita and Stewie

    Anita and Stewie Member

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    Ok, thanks so much! He is happy to eat, he was quite vocal about me hurrying up!! :)
     
  12. Rachel

    Rachel Well-Known Member

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    Okay, wanted to let you know you could feed so he didn't give you that betrayed look they all have when they're hungry. :smuggrin:

    Generally, if you get a number that's too low to shoot, we do what's called stalling. Basically that means we wait for 15-20 minutes WITHOUT FOOD, and retest. Sometimes that is enough to get them up to above 200 so they can eat and get their shot. We try to avoid skipping shots since it can mean they'll be high for the next shot. HOWEVER, since you're using an AT (which means that 88 is basically a normal number for non-diabetics) and what with yesterday's numbers, stalling isn't even something I'd worry about. It's just too unlikely he'll come up since he's at a completely normal number. Most people who stall do so because they're closer to a shootable number and want to see if they can get the kitty there.

    It is surprising that the number is so low! Since you're home to monitor, could you grab a test sometime mid-cycle today? I know it sounds a bit crazy, but it'd be interesting to see what his BG does with no insulin onboard. :)
     
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  13. Anita and Stewie

    Anita and Stewie Member

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    Thanks, I know, I am surprised! He had a small feeding last night, maybe around 10 pm? Is that a no-no? He loves food and it keeps him from waking me up at ungodly hours, but I can stop at his dinner which is around 7 pm and leave him without until the next morning. I'll just have to deal with gentle and then more persistent paw pats on my eyes and grumbles in the night.

    What does 'mid-cycle' mean....does it mean before I feed him again? I normally feed him 7 am breakfast, 11 am small amount, 3 pm small amount, 7 pm dinner, 10 pm small amount...that has usually been our routine as he pesters me relentlessly while I'm working (home office). But I can change this if I should. He is on a diet too, as he is a bit heavy, but not obese. I am trying to keep his amounts conservative.
     
  14. Rachel

    Rachel Well-Known Member

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    That routine should be fine! We generally say no food 2 hours before the preshot to avoid it being food influenced, but that's it. Other than that, we all feed different times...whatever works for you and Stewie is fine!

    For mid cycle, try to get a test between +5 (5 hours after you feed this morning) and +7 (7 hours after you feed this morning). That's called nadir (the middle point of the cycle, usually the lowest point. The nadir will vary based on the cat, but it's usually between 5 and 7 hours after the shot, or for you today, after you feed him this morning). Don't worry about it being food influenced. The only ones we want to avoid the food influence on are the before shot numbers.
     
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  15. Anita and Stewie

    Anita and Stewie Member

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    Ok, thanks Rachel. so the test at 12 and then 2 pm. I will also send info to my vet as she knows I'm doing his BG curve at home, but to be honest, I trust everyone here more for their advice/knowledge.
     
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  16. Yong & Maury GA

    Yong & Maury GA Well-Known Member

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    Looking very nice Anita :). Curious to see how he does with a 2nd skipped shot :woot:
     
  17. Anita and Stewie

    Anita and Stewie Member

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    Thanks Yong, me too! I ordered Zobaline today, thanks for that info as well. His back legs aren't great, but he's not walking completely on his hocks.
     
  18. Djamila

    Djamila Well-Known Member

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    Wow! What a great number this morning! Now that he's on low carb foods, his weight will likely go down slowly. It's carbs that make them hold weight.
     
  19. Kris & Teasel

    Kris & Teasel Well-Known Member

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    This is an excellent BG number! No shot for sure this AM. I agree with the advice to check him mid cycle for information's sake.

    A switch to low carb wet food only fed in reasonable amounts will get him slimmer and trimmer. Teasel's brother (non diabetic) was a little "fluffy" a year ago at his last checkup. I switched him to Teasel's low carb wet food and over the year he's lost a kilogram.

    There's really no reason why you can't give him his late evening snack if he's happier with that. If you don't want to overfeed just divide his proper daily allotment into several meals including that evening meal.
     
  20. Anita and Stewie

    Anita and Stewie Member

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    Reading just now at noon was 4.8! That's good, right? He didn't eat anything between his morning breakfast and now. I just fed him after the reading.

    Thanks Kris & Teasel, I'm glad he can have smaller amounts in more feedings, as it seems to make him happy. :)
     
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  21. Djamila

    Djamila Well-Known Member

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    Yes, that's a great number! Wow! Way to go, Stewie!!!
     
  22. Anita and Stewie

    Anita and Stewie Member

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    Excellent, yayayaya! :joyful:
     
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  23. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Fan-flippin'-tastic!!! :D:D:D
     
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  24. Yong & Maury GA

    Yong & Maury GA Well-Known Member

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    Way to go, Stewie! :D
     
  25. Rachel

    Rachel Well-Known Member

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    Awesome!!!!
     
  26. Anita and Stewie

    Anita and Stewie Member

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    Stewie's reading at 4 pm today, 5.9. Starting to creep up. Is it still a good reading though?
     
  27. Rachel

    Rachel Well-Known Member

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    With NS last night and this morning that's an excellent number! It's still in normal range.
     
  28. Anita and Stewie

    Anita and Stewie Member

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    Wonderful! I'm looking for info on how a curve should look.
     
  29. Kris & Teasel

    Kris & Teasel Well-Known Member

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    ProZinc should give a "smile-shaped" curve where the AM and PM pre shot BGs are at the ends and the nadir is at the lowest point. Ideally the curve is shallow. You might see numbers like 10 or 11 at AM/PM PS and 5 or 6 at nadir (measured with the AlphaTrak meter).
     
  30. Anita and Stewie

    Anita and Stewie Member

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    Ah, ok! So he is kind of the opposite? Lower at AM PS, then higher in midcycle? What does a BG curve for a healthy non diabetic cat look like? I'm still reading all of YourDiabeticCat.com, but no curves there.
     
  31. Djamila

    Djamila Well-Known Member

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    A non-diabetic cat will be pretty flat. Maybe a little higher right after eating, a little lower if they're hungry, but really not a whole lot of variation. They usually range between 50-80, but up to 120 is normal. (Sorry, I'm not sure on metric numbers?)
     
  32. Kris & Teasel

    Kris & Teasel Well-Known Member

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    A non diabetic cat wouldn't have a curve per se but a series of small fluctuations through the day depending on whether they'd just eaten, undergone extra physical activity, etc. It's an infinitely responsive physiologic system. Giving insulin to a diabetic cat only roughly approximates what the body of a non diabetic cat does on its own. It's the action of the insulin we shoot into them that creates the BG curve we talk about.
     
    Last edited: Jun 19, 2017
  33. Djamila

    Djamila Well-Known Member

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    Kris explained that much better than I did! Thank you, Kris!
     
  34. Anita and Stewie

    Anita and Stewie Member

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    I see, thank you, this is all so important to know and I keep reading more every day. For metric, I read to divide by 18.
    I'll do another BG test of Stewie tonight. And, of course continue tomorrow as per the 3 days. My vet will be interested for sure, to see these readings.
     
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  35. Yong & Maury GA

    Yong & Maury GA Well-Known Member

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    Normal range on human meter is 50 - 120 (2.8 - 6.6mmol/L)
    On AlphaTrak 2 normal range is 68 - 150 (3.8 - 8.3mmol/L)
    For Djamila's reference too :p
     
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  36. Anita and Stewie

    Anita and Stewie Member

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    Stewie's reading tonight at 10 pm was 5.7. I know that it's too early to get out the party favors, but I'm smiling a lot more than I have been since June 2nd. :D
     
  37. Kris & Teasel

    Kris & Teasel Well-Known Member

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    This is wonderful! I'll say nothing more so I don't jinx it. :smuggrin:
     
  38. Anita and Stewie

    Anita and Stewie Member

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    :bighug::bighug::bighug:
     
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  39. Yong & Maury GA

    Yong & Maury GA Well-Known Member

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    :cool::cool::cool: (anti-jinxing!)
     
  40. eknodt

    eknodt New Member

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    Hi Anita,

    I am new here too, your numbers look amazing. Just want to say hi.

    eva & cookie
     
  41. Rachel

    Rachel Well-Known Member

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    Woohoo! (That was in a whisper so it won't jinx anything).
     
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  42. Rachel

    Rachel Well-Known Member

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    Also, how's Stewie looking this morning?
     
  43. Anita and Stewie

    Anita and Stewie Member

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    Awww, you're all so sweet and supportive! His reading just now was 6.4. Still good, but it has slowly been creeping up? Maybe that's normal with no insulin and it will stay anywhere from 4 to 8? Fingers crossed. One nice thing, his yukky dandruff is almost gone, and he's lost a little weight. His fur is shinier and silkier. He always has had nice fur, but it's much nicer and losing the dandruff is great. Look out, he's going to be the George Clooney of cats! haha! PS I hit a spot in his ear this morning that made him bleed more than usual, awww, I hate this part. I am too gentle at first and nothing happens, and then I might be a bit too hard, and this time, oops, quite a bit of blood. It's hard to get the hang of it. Luckily he forgives me quickly.
     
  44. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Just keep testing to see where his BG settles. You probably hit the tiny vein slightly in from the edge of his ear and that can cause a lot of bleeding. It's harder to see where to poke in black cats. Good boy for being so forgiving. :)
     
  45. Anita and Stewie

    Anita and Stewie Member

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    His reading at 2:30 was 6.0 :)
    Yeah, he's awesome, very chill and smart, but also strong willed and he sometimes bullies my civvie Sammy.
    I have a lot of "Stewie" stories. He's a character. <3
     
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  46. Anita and Stewie

    Anita and Stewie Member

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    Hi Eva & Cookie! I'm so glad to have found this group! Hello and welcome too! I'm excited about the numbers for Stewie, being that he was only diagnosed June 2nd. I think the change of diet from dry/wet to just wet has been the key. Good luck with Cookie!!
     
  47. Rachel

    Rachel Well-Known Member

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    Very nice!!! You're gonna have to share some of those Stewie stories with us!
     
  48. Anita and Stewie

    Anita and Stewie Member

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    Stewie's morning reading, 5.8!! I didn't do one last night, so I only had the two readings from yesterday. I think I'll only do two today.

    I would love to share! I'll post a couple of videos first to show his lovely playfulness.
    This is him playing fetch. Someone must have taught him before I had him. I adopted him from the local shelter at 6 years old.
     
  49. Beenie (GA)

    Beenie (GA) Well-Known Member

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    Hi Anita!

    Aww Stewie is too cute!!:cat: He clearly knows how to have fun.
     
  50. Kris & Teasel

    Kris & Teasel Well-Known Member

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    He's so cute! Lucky boy too to be adopted into a good home. :) Great number this morning. No shot needed.
     
  51. Djamila

    Djamila Well-Known Member

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    What a fun video!!! And I love his "ball." We have a few of those around here as well!
     
  52. Yong & Maury GA

    Yong & Maury GA Well-Known Member

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    So cute! Maury used to play fetch with his mouse toy but wouldn't go that far and always had to bring it back to me on the bed :smuggrin:
     
  53. Anita and Stewie

    Anita and Stewie Member

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    I sent Stewie's BG curve to my vet and she just called me. So, he is officially in remission!! I'm so excited!!! :joyful::joyful:
     
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  54. Anita and Stewie

    Anita and Stewie Member

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    Thanks everyone for watching and your lovely comments about Stewball. :kiss::p
     
  55. Yong & Maury GA

    Yong & Maury GA Well-Known Member

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    Not trying to stomp on your good news but we like to see kitties with NS for 14 days just to be sure ;). Regardless, I think Stewie is headed that way :joyful:. Don't get rid of your testing supplies though! You'll still want to do spot checks to make sure he stays in remission and can catch it should his BG start to rise again. Hopefully, you will enjoy a nice long remission :bighug:

    Don't disappear on us yet :smuggrin:
     
  56. Kris & Teasel

    Kris & Teasel Well-Known Member

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    That's just wonderful! Keep up the low carb wet food and stay on top of dental, bladder, etc. issues. You don't want to have any of those tip him back onto the juice. :smuggrin::smuggrin:
     
  57. Anita and Stewie

    Anita and Stewie Member

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    Thanks Yong and Kris & Teasel, I am not going anywhere! I was wondering how long with NS it should be. I am planning to spot test him, how often do you think is good? I'll never feed dry to my cats again and I'm telling everyone I know to switch to low carb wet or raw, although some people think raw isn't good. What do you guys think of raw? I've never tried my cats on it.
     
  58. Kris & Teasel

    Kris & Teasel Well-Known Member

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    I have no experience with raw food. Many here swear by it. You could post on the main forum for info.

    Re testing: maybe AM and PM for several days? There's a protocol of sorts for tracking kitties going into remission. That's where the 14 day timeline Yong mentioned comes from. It's to ensure their BG really is staying in remission numbers. It also gives you data on where your kitty likes to "hang out" BG-wise. Some run higher/lower than others.
     
  59. Yong & Maury GA

    Yong & Maury GA Well-Known Member

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    Phew! I was just thinking, Anita is going to hate me for that post :oops:.

    I was trying to find OTJ info but from one's I've read about (other kitties), 14 days you still do AMPS and PMPS, maybe 1 mid cycle (one day do day, another do evening mid)
    Week 3 - 4: Test a couple days out of the week.
    Month 2: Test once every couple weeks.
    Month 3: Test once a month
    Month 6+: Some will only test once a month every couple months

    If it ever happens for Maury, I probably won't go past Month 2 testing routine and just test him once a week for life :smuggrin:

    Forgot my thoughts about raw!
    I'd be open to try homemade when I had a steady job/income and a bigger kitchen :). The more I'm learning about canned foods, the more I want to make my own for my baby :cat:
     
  60. Yong & Maury GA

    Yong & Maury GA Well-Known Member

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  61. Rachel

    Rachel Well-Known Member

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    I have no experience with raw either but I hope to one day try it!

    As for remission, yay!!!!!! I would definitely still test AM/PM for a few days and then you can move to testing less often. :)
     
  62. Djamila

    Djamila Well-Known Member

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    I feed store bought raw, and even leave it out for several hours with no problem. My civvie pretty much only eats raw. Sam eats about 3/4 canned, 1/4 raw, but he will only eat raw rabbit which is expensive, so I don't mind that he eats less of it! ;)

    I like feeding raw because it's easier: no scooping out cans, rinsing, and recycling. It's just a bag in the freezer with a bunch of chunks in it. Plus, it doesn't stink like canned food does. You still have to be careful though because as more brands of raw food hit the market, not all of them are low-carb, and it can be hard to get straight information about the content. Especially be careful if you try the freeze-dried raw that you have to rehydrate. A few of those are worse than kibble as far as carbs.

    As for the testing, yes, keep up on it! Sam went into remission after three weeks the first time. He was OTJ for over a year, and then he fell out of remission very very quickly. I was testing about every 2-3 weeks during the in-between time. One test he was fine...then two weeks later he was in the 300's. You want to catch it as quickly as possible if they fall out of remission and get them back on insulin asap.

    It's so exciting to see him get back into healthy natural numbers so quickly!!!
     
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  63. Anita and Stewie

    Anita and Stewie Member

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    Thanks Djamila, I didn't see until now that you had posted! I might try raw then, and maybe stop the Primal freeze dried. I am now suspicious of it.
    Wow, why would a cat go back to being diabetic once in remission? I thought that with a better diet, low in carbs, it might stay away? I'm sorry to hear that Sam had to go back on insulin!
     
  64. Djamila

    Djamila Well-Known Member

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    There are a variety of reasons cats go out of remission. Any type of infection can send them back into FD (dental, UTI, etc.), medication (especially steroids), and poor food choices are the leading causes. In Sam's case, I was feeding him Stella and Chewy's Freeze Dried Raw Salmon and Chicken. I thought it was okay because it was "raw", but it turned out to be over 20% carbs. :banghead: Definitely learned my lesson about believing marketing material instead of doing my own research! Lots of kitties come back because of unknown infections like a bad tooth or gum disease, but sometimes there is just no apparent reason for it. Kind of like in humans, the older we get, the more likely we are to have Type II Diabetes. It's just one way our biology breaks down with age. Same with kitties. That's why food, monitoring, and good vet care are so important though - to give the kitty the best possible chance of staying as a diet controlled diabetic.
     
  65. Anita and Stewie

    Anita and Stewie Member

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    Thanks Djamila, that's good to know. Awww, I feel so bad for cats getting sick. I'm sorry you didn't know about Stella and Chewy's. I think that company had a couple of recalls too. It's so much to take in, lots to learn. I want to find a better food than what I'm feeding now too. I will keep monitoring him and trying to find lower carb food. I'm amazed at the change in Stewie. He has no dandruff, his coat is so shiny, he has more energy, has lost some weight, isn't always bugging me for food, it's so lovely to see. I am sad that he mustn't have been feeling well for quite a while. Poor boy. I hope Sam goes back into remission. :bighug:
     
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  66. Djamila

    Djamila Well-Known Member

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    I think we all feel like that as we see our cats heal. That realization that they weren't feeling good for awhile before they were diagnosed. Cats are masters of disguise though and hide their illnesses so darn well! It's great to hear that Stewie is feeling so much better! I hope Sam goes into remission too, but at this point he's been well regulated and is healthy and super active and doing so well, that he'll be okay either way. I try to keep reminding myself of that when I start to feel impatient. ;):p:D
     
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  67. Rachel

    Rachel Well-Known Member

    Joined:
    Aug 25, 2013
    Generally speaking, the changes in our cats are over time too...so when they suddenly start feeling better, we notice! It's not that odd really that we don't notice until the diagnosis when you think about it...I remember one member once saying that she discovered her cat was diabetic only because she'd been out of the country for some time and when she returned, the changes in her cat were noticeable to HER because she hadn't seen him in some time. The changes were too gradual for her family to notice, but it was obvious to her because she'd last seen him in perfect health.
     
  68. Anita and Stewie

    Anita and Stewie Member

    Joined:
    Jun 2, 2017
    Oh, that makes sense then. It's a gradual change, when they start to get sick, and we don't notice. I thought it was aging, that he was slowing down. I thought his dandruff was just that he had 'dry skin'. No vet that I know has mentioned the possibility of a connection between dandruff and diabetes. But I should have thought Stewie's drinking and peeing a lot were signs. I just thought he was like that. Silly me. My civvie Sammy drank a lot too. I think it's due to the dry food they were getting. They got wet food too, morning and evening, but the dry was the issue of course. Upon hearing about Stewie's remission, my friend's cat sitter wrote this to her, "I have a book written by a vet who used to be employed by the pet food industry, and she is adamant that all of the major common cat illnesses, which include diabetes, are caused by feeding dry food."
     
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