Food struggles, hospitalization, and insulin

Discussion in 'Feline Health - (The Main Forum)' started by JennC, Feb 21, 2018.

  1. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    No, I think that's too low to give Novolin. It starts acting quickly and fairly strongly. I suggest you get some tests through today to see how he does with no insulin on board. This boy is on a mission ... I'll say no more! ;)

    How is his appetite and is he feeling well otherwise?
     
  2. JennC

    JennC Member

    Joined:
    Feb 16, 2018
    I'm not going to give him the insulin, we're past his normal dosing window and based on yesterday when I gave the 0.5 it lowered it by 100 points. Do you think I should check his BG before his normal pm dose
     
  3. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    Yes, I'd get a couple of tests. These would be good info on how he does for himself without insulin - maybe a +4 and a +8?
     
    Last edited: Feb 25, 2018
  4. JennC

    JennC Member

    Joined:
    Feb 16, 2018
    Ok, that sounds good! Hopefully they are just as good :)
     
    Kris & Teasel likes this.
  5. JennC

    JennC Member

    Joined:
    Feb 16, 2018
    BG at +4 is 106!! WHOO HOO!!
     
  6. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    Fantastic!!! You must be SO happy! :D:D:D:D
     
  7. JennC

    JennC Member

    Joined:
    Feb 16, 2018
    I am so excited and happy for him. I can tell he is feeling tons better!
     
    Kris & Teasel likes this.
  8. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    Such good news! :)
     
  9. JennC

    JennC Member

    Joined:
    Feb 16, 2018
    144 at +8.5! Kris, do you think he might be a food controlled diabetic with these numbers or too early yet to tell?
     
  10. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    Looking really good but I think it might be a bit early. Let's see what his PMPS is tonight and, if no shot tonight, what his AMPS is tomorrow.

    If it comes to giving a little insulin support a while longer you have these options:
    • a "skinny" 0.5 u - draw up to 0..5 u and let out a drop
    • 0.25 u
    • 0.1 u - draw up insulin to about 0.25 u and let it out until the plunger *just* touches the bottom of the zero line
    • a "drop" - push plunger into syringe firmly, insert into vial keeping pressure on the plunger, release pressure while needle is in the insulin, withdraw then when needle is in the cat put firm pressure on the plunger before and while taking it out of him.
    Vets would think this is nuts but we know it works. ;)
     
  11. JennC

    JennC Member

    Joined:
    Feb 16, 2018
    What glucose number or range of numbers do you recommend with your doses above? I remember the vet saying if the number is under 200 not to dose but would love your thoughts.
     
  12. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    It's hard to say. It can depend on how flat he stays at a dose - ie., flatter = ability to give a larger micro dose. You'd also want to be home to monitor. Like a lot of this FD stuff, it's trial and error.

    If it was my kitty I'd be tempted to try 0.25 u if BG is above 150 tomorrow AM. Do I know with certainty that this will work? No, I don't but based on his responses at 0.5 u and the fact that he coasted nicely but above dark green today it's worth the calculated experimental "risk". I'd be prepared to monitor frequently and give carbs if he decides to dive.

    If giving 0.25 u at a PS of 150 drops him too low I'd try 0.1 u at a PS of 150 next time. If that works out, I'd try 0.1 u at a slightly lower PS and so on. Lots of little back and forth adjustments between dose size and PS number. The end result you're after is a teeny tiny dose that keeps him running in very low blues or high dark greens but favouring the dark greens. Eventually, if you're lucky, an experiment where you stop insulin results in him maintaining these dark greens on his own.

    So much of this is guesswork. o_O
     
    Last edited: Feb 25, 2018
  13. JennC

    JennC Member

    Joined:
    Feb 16, 2018
    Yeah, this is one of the hard parts. I won't be home tomorrow during the day. If he was yours would you give the 0.25 tonight since he's over 150 and then check at +2? I won't be able to check past that I'm afraid.
     
  14. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    If he was mine I'd only experiment with shooting on a lower PS (for the first time) if I can definitely monitor up to at least +6. To be safe you can skip tonight and see where he is tomorrow AM. If he's above 200 (yellows) tomorrow AM give 0.5 u again. If below 200 you might have to skip again if you can't be there.
     
    JennC likes this.
  15. JennC

    JennC Member

    Joined:
    Feb 16, 2018
    You're a life saver, thanks!!
     
    Kris & Teasel likes this.
  16. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    Should have added: get a urine ketone test in daily if you can when skipping insulin. Safety precaution. :)
     
    JennC likes this.
  17. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    Will check in soon to see AMPS.
     
  18. JennC

    JennC Member

    Joined:
    Feb 16, 2018
    126 this morning!! WHOO HOO. I'm loving these numbers based on where he started in early February. :)
     
  19. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    Excellent! No shot this AM because you won’t be there to test.
     
    JennC likes this.
  20. JennC

    JennC Member

    Joined:
    Feb 16, 2018
    Sounds good, and I'm sure he'll appreciate one less poke. :)
     
    Kris & Teasel likes this.
  21. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    Two things:
    1. you missed putting "NS" for last night on your SS
    2. time to start a new thread because this one is long.
    I'm bossy, aren't I !? ;)
     
    Last edited: Feb 26, 2018
  22. JennC

    JennC Member

    Joined:
    Feb 16, 2018
    LOL not bossy at all! Thank you for catching that, I've updated. I just talked to my vet about his progress and he asked how much fiber was in Fancy Feast, do you by chance know? If not, no worries. After this question, I'll start a new thread. :)
     
  23. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    My guess is little to no fibre because it's a low carb wet food so protein, fat, low amount of carbs and moisture would be the main ingredients. Why does your vet want to know fiber content? Old school thinking was the high fiber kibble was best for diabetics because it slowed carb absorption or something along those lines (lower glycemic index I think). Newer thinking is low carb wet food.

    What does your vet think about the drop in BG numbers and you dropping the dose?
     
  24. JennC

    JennC Member

    Joined:
    Feb 16, 2018
    He didn't say why, but he's gonna call me back later so we can look at the ss together. I'll definitely ask but if I had to guess it's the old school way of thinking.
     
  25. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    It would be great if your vet works collaboratively with you and trusts that you can handle the FD treatment yourself. Some vets with egos that are a bit bigger than they should be are a little harder to deal with when they see an owner doing things without vet's guidance. I hope yours is the first type. I'm very lucky to have one who's like that.
     
  26. JennC

    JennC Member

    Joined:
    Feb 16, 2018
    We talked further. I told him I'd prefer to not dose if his BG levels are in the low 100's, he agreed. I said that I think if he's over 200, I should give 0.5 and if he's over 300 give 1u. He agreed. He did say that I can't keep this up forever and 99% of his clients don't track their animals this way. He also said there is NO way I will be able to regulate on Fancy Feast and he needs to be on a prescription diabetic food to be regulated which I found interesting given the success we've had so far. Not saying it will always be this good, but I have to admit, we have a good start. I told him I plan to check twice a day for the next two weeks and then do another BG curve in there somewhere and he was like well keep me updated. :) BG tonight at PMPS was 148, NS.
     
  27. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    This is the part where, if you're in the office with the vet, you just smile and nod politely. ;)
     
  28. JennC

    JennC Member

    Joined:
    Feb 16, 2018
    Lol, love it!
     
    Kris & Teasel likes this.
  29. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    Look at that wonderful green after no insulin for several cycles! So happy you’re seeing such great numbers! :D
     
  30. JennC

    JennC Member

    Joined:
    Feb 16, 2018
    Me too!! I wasn't sure what number I would receive this morning, he was a little grumpy today Lol!
     
    Kris & Teasel likes this.
  31. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    :):cool::D:smuggrin::woot:!!!! Look at that 78 that he did all by himself! Sure looks like his pancreas is working. If so, he's a diet-controlled diabetic and needs to stay on a strictly low carb diet.
     
  32. JennC

    JennC Member

    Joined:
    Feb 16, 2018
    I know, I was so excited to see that 78!!! He's doing so good. I know I've said it before in this thread but you Kris have been a lifesaver literally for Diago and I. :bighug::cat:

    Couple of follow up questions:
    • Do you think I should continue testing twice daily for two weeks or do you think one week is sufficient?
    • Also, is fancy feast ok to stay on long term as long as he continues to eat it?
    • Once we stop testing daily, how frequently should I test just to make sure his pancreas is still working as expected?
     
  33. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    I'm so glad to have been able to help and what a success! :D

    I think different people do different things. If it was my kitty, I'd do twice daily for a week and then decide if I feel the need to do twice daily for another week or drop to once daily for that week.

    Yes, it's absolutely fine to feed long term because it's nutritionally complete. Just make sure it's the low carb versions.

    Again, I think it varies with the owner. I'd do a once a week test for quite a while then maybe drop to every 2 weeks. If anything arises that could threaten his BG status - eg. any sort of infection, dental issues, high carb contraband, etc. - you should increase the testing to see if he's holding in good numbers. If he starts to slip you'll catch it and might be able to turn it around faster. If luck is on your side this remission will stick. Kitties do come out of remission, though, sometimes after a few weeks or months or even several years. Don't think about that right now though. Happy thoughts only! :)
     
    Dyana likes this.
  34. Dyana

    Dyana Well-Known Member

    Joined:
    Dec 28, 2009
    Beautiful numbers today! Congratulations are in order :D!
    I would test twice a day for about 2 weeks, to see how it goes. And then test at least once a day for another two weeks, and then maybe every other day as long as he is seeming normal. Eventually, you can go to testing about once a week, but that is about a month or so off. If he ever seems "off" or doesn't eat or is lethargic or throwing up, I would test immediately, and several times that day, and for a couple days to make sure he is still in remission. Also, keep ketone test strips handy. They last for 6 months? after opening the bottle. I would test for ketones if he ever seems off, as well. Best Of Luck to you and Diago. Remember, he is still diabetic, just in remission, so will still need low carb food only.
     
    Kris & Teasel likes this.
  35. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    Thanks for your input, Dyana. :)
     
    Dyana likes this.
  36. JennC

    JennC Member

    Joined:
    Feb 16, 2018
    Ok, that sounds good. I'll be sure to do it twice daily for another week, see his progress and go from there to either continue twice daily or once.
    Perfect! He's really liking the FF classics. And so are my other two kitties. :p
    This made me laugh!
    Let's hope it sticks but if not, you and Dyana have provided some much knowledge I'll know what to do.
     
    Kris & Teasel likes this.
  37. JennC

    JennC Member

    Joined:
    Feb 16, 2018
    Is remission only considered if they are a diet controlled diabetic? Thank you again for following along with our progress and recommendations. I've been so happy with his numbers over the last 3 days. :D
     
    Dyana likes this.
  38. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    Yes, remission means a diet controlled diabetic. The kitty is forever a diabetic but the pancreas has healed enough to supply enough insulin unless forced to deal with too high a carb load or some other health issue raises BG.
     
  39. JennC

    JennC Member

    Joined:
    Feb 16, 2018
    Ah, gotcha. I didn't realize that.
     
    Kris & Teasel likes this.

Share This Page