Discussion in 'Feline Health - (The Main Forum)' started by Adrienne & Molly, Apr 9, 2019.
Thread continued on from previous threads @Kris & Teasel @MrWorfMen's Mom
Found you and just posting to get notifications.
Liking that blue start tonight.
Still continue with the drop dose this morning?
Stay the course and give her the drop dose again. I know the pink is not what you wanted or even expected but if she is bouncing, you need to give her time to settle down.
The vet emailed me today. To see how Molly is after two months. Should I send him the spreadsheet?
He mentioned a fructosamine test?
You can share the spreadsheet with your vet. I take it he knows you are home testing.
As far as the fructosamine test is concerned, I don't personally think it's of much value when you are home testing everyday and can see what Molly has been doing day to day. The results can be skewed with a run of low or high BGs that are not necessarily indicative of what BG usually was during the period because it provides an average of another blood component (not glucose itself) over the past 2 to 3 week period. It's really up to you whether you do it or not. Molly is obviously relatively well regulated and I'm betting her Fructosamine test would come back saying she is in good control. Vets tend to rely on Fructosamine tests because most folks are not testing daily. Maybe the spreadsheet will satisfy him/her.
He hasn't emailed me back yet. I mentioned sending him the spreadsheet. I'm just worried he's going to see the pink BG and be concerned? I didn't think she needed to have the test done.
While the pinks are higher than wanted, Molly is not spending much time that high. Most of Molly's time appears to be in decent numbers as far as most vets are concerned. Your vet may be different but there are vets out there that don't aim for getting numbers much under 250 and some are even happy with 300. Kitties are far more tolerant of higher BG than humans so vets often don't aim for the lows or remission range numbers we aim for here. Of course some vets don't want people home testing either. It will be interesting to hear what he says.
Yeah Molly.....back in the blue! I'd check her around +3 and see what she has planned for today. I will be in and out today but will check on you and Molly a bit later between outings. If she drops to 60 or less (I don't think she will), give her a tsp or so of LC food and retest in 30 minutes to see if she has come up a bit or is surfing in the same range. No higher carb food is needed unless she drops to 50 or less.
Yes, I was happy to see the blue this morning . I’ll test her at +3
When should I test her again?
She's stayed pretty flat for +3 so I'd suggest getting a +6.
Molly’s being fussy with her food. Maybe I should’ve skipped the dose this morning?
Did she eat very little/less or is she refusing to eat?
Eating a little bit, but not all her food. She just looks at it
Ok so leave her a tsp or so of the higher carb SO mixed in with some FF to munch on while you are gone. I'm sure if she gets hungry she will eat. I would suggest checking on her at lunchtime today if you can. If not leave a bit xtra food out with a bit larger dollop of the SO mixed in.
She’s eating her FF now. Should I still give her the SO?
No! I only suggested the SO so that if she was only eating a little she'd get more carbs. Don't you just love it when they won't keep to a schedule!?!
I just wish she would stay in the blues. But it’s up then down. Then she gets fussy with her food. It’s like she’s testing me.
That's her job. She's a cat!
LOL gotta love them!
She’s 5.1 still give her a drop?
I say yes with the caveat that you must get a +3 and if she is down at that time, you might have to test again within an hour or a little later just to be sure she is safe. It's up to you what you can or are willing to do? I doubt this is going to be a problem but there is always the chance that she will need a little monitoring. You shot lower before but you tested again at +8. Keeping the momentum going is great but it has to be done with both you and Molly in mind.
Ok I’m going to give her the shot. But she’s still being fussy with eating. Is it because of the lower numbers?
Probably not as hungry when she is in lower range. Maybe she's just tired of what flavour you are offering? If she is eating but just not with her usual gusto, I think you are fine.
I switch it up every couple days. But she’s not eating her treats either. She’s eating but not very much
Appetite will go down with lower BG but if she is eating a seriously lower amount of food, then maybe there is something else brewing. How is she in the litter box.....no signs of straining to pee or frequent visits? When is the last time you had her teeth checked? That is often something that can put them out of sync.
Or it could be she is just being a cat and being fussy.
Have you ever checked her for ketones? You can get strips at the pharmacy to check but you have to get a urine sample. Some folks can just hold a designated ladle under kitty's butt but catching them in the litter box can be problematic. Others use plastic wrap crumbled up in the litter box to catch a drop or two to test. I doubt that's an issue but it never hurts to check when the appetite goes off in a diabetic cat.
I gave her turkey and she’s gobbling it up. So maybe she is tired of the beef and chicken
Just being a cat! Gotta love 'em!
2.9 @MrWorfMen's Mom
Fed her some FF and tested half hour later. Gave her some more FF gave her a tbs of the SO
Sorry Adrienne. I slept thru an alarm to check on you. Test her again please and post the reading here.
I fell asleep I checked on her around 2:30. She was good. Do I give her insulin this morning? Freaked me out to see her go that low.
What is her BG this morning?
Technically she earned a reduction to no insulin again with that drop below 90 last night however, she has been wobbling back and forth and you can swing a bit more toward a little more aggressive dosing and give her the drop this morning. She was quite safe last night but she hasn't jumped as high this AM either. It's up to you but I would give her the drop dose, leave a bit of SO in her food while you are out and check on her at lunchtime.
Just noticed I used the US 90 instead of 5mmol in post above. Sorry about that. Force of habit.
She’ll be ok with the drop dose this morning? I’ll leave a little SO out for her as mentioned.
She will be fine. Leaving a little of the higher carb food is just a little extra insurance she likely doesn't need.
I’m frustrated why such the high number. @MrWorfMen's Mom
Sorry, I never got an alert for your post!
Molly is bouncing from the lower greens last night. Nothing unusual so don't let it upset you. Molly has to get re-familiar with those lower numbers and is bound to bounce a little. This will pass. She will come back down again. She's never gone that low before so I was kind of surprised she wasn't higher this morning but sometimes it takes a few hours for the bounce to show.
That's what I figured, but I see other kitties going into remission so quickly. I guess Molly is going to be diabetic for life
We both know there are no guarantees of remission for any of us, however, you're just coming up on 4 months at the sugar dance which is still early in the game. It took me well over 3 yrs. which just goes to show you, nothing is impossible and the time on insulin isn't necessarily a picture into the future. Look at the progress you've made. Molly is only getting a teensy bit of insulin and doing well despite the bounces. NEVER give up hope! She has a good chance in my view.
I'm also worried taking her camping with us. For the Maylong weekend. What if she gets out etc.. I don't know what to do there. No one can come in to watch her and do I really trust them. If there was someone. Do I still give her insulin tonight?
I take it you haven't taken Molly camping before? I've never done that with my kitties but I know some folks here have taken their cat with them and they may be able to provide you with some tips/tricks. You could post a general question in Health with a title like "? re: taking kitty camping". The first thing I would do is get her a harness if she doesn't have one because that would be the safest way to be sure she doesn't get away on you. They can be masters at slipping out of collars. If Molly is not use to a harness, I'd start ASAP because sometimes at the beginning, our kitties act somewhat like those "fainting" goats that just suddenly fall over. It's quite comical but obviously you need to allow some time for her to become comfortable with the harness.
As for tonight and the insulin, let's see what your little girl's BG is at PMPS before making that decision.
No, she has never gone camping before. I don't know how she's going to react. But I will post the question on here.
I won't be home til 6:15pm ( my time). As soon as I'm home I'll be testing her.
You may have seen a number of cats go into remission but there have been several of them lately that IMHO appeared to be misdiagnosed by the vet based on one glucose test in the vet's office (probably excessive vet stress). There are others that get overdosed on insulin (again often thanks to vet stress) and for some reason, go into remission right after. In those cases I think the diagnosis may also be suspect. Then there are the cats that have been given steroids and once the steroids clear their system, they revert back to a non-insulin dependent state. And in some cases cats go into remission from a simple diet change to wet food. It's the luck of the draw to some extent and while we can help them to move toward the path to remission, we can't force it either. I've seen too many cats rushed into remission only to revert again because they didn't have a really strong remission. It's definitely harder when you are working during the day because you can't be as aggressive about dosing. That said, sometimes being aggressive with dosing doesn't work either. There is no perfect solution and we all have to be content with having a happy healthy kitty who is safe above all.
I just feel bad for her. She hasn't had it easy she came to our door as a kitten. Someone didn't want her anymore. We took her in fell in love with her instantly. She had urine crystals for a few months. Then she got asthma and now diabetes. But she still loves to play and cuddle with me every night. When I'm not around then its DH. Just would like to have her with steady numbers at least or go in remission. It's hard where I work every day but I'd rather her be safe with the dosage. Then me be here at work worrying. I've had sleepless nights worrying about her, but she's my fur baby.
I'm just jealous I guess where some people are lucky. To have their cat go into remission, or can be home with them everyday to monitor.
Lucky Molly finding the peeps who would take her in and love the daylights out of her! She may have started out on a hard path but she lucked out with "parents" who are obviously dedicated to her wellbeing. She certainly sounds like a very happy camper.
I get it Adrienne. Both Kris and I marvel about how you folks who are not home during the day manage. It's definitely a different situation when you can monitor as intensely as you want/need to. But life goes on and despite having the freedom to change my plans at will most of the time, there were times when I skipped shots, gave big chicken doses or did extended cycles to get back on schedule. The trick is to find that middle line where kitty is safe and healthy and their humans are not stressed to the max worrying about them. Any time you are not comfortable with a suggestion made by me or Kris, we are both OK with that. Molly needs you, so your wellbeing counts just as much as hers. Please always keep that in mind because it is not our intention to push you into doing anything you are not comfortable with. Molly is doing great but we want you doing great too.
No, Your're not pushing me at all. If it wasn't for you and Kris I would've been lost. Molly wouldn't be where she is at right now. Just days where I get frustrated like today. Little disappointing where I can't be home this year to see the family. But Molly needs me. It's a life changing experience that's for sure. I appreciate all the advice that you and Kris give me. DH is happy that I have you and Kris to help me, ( us).
Should I still give her a drop @MrWorfMen's Mom
Yes I would and again get the +3 test done. Looks like she is coming down a bit already.
I'm here catching up on your thread. I've been off the forum for several days because my sister, brother and I have been doing a lot of stuff for my 93 year old mom who still lives on her own. It was a lot for all of us to handle ...
Re camping with Molly: I have no experience but you might want to start training her on a good body harness/leash. https://www.amazon.ca/Harness-Adjustable-Harnesses-Reflective-Comfort/dp/B07P6KTYQK/ref=sr_1_5?keywords=cat harness and leash&qid=1555591294&s=gateway&sr=8-5
How about riding in the car? Is she OK with that? If you have the $$ one of these might be nice to have:
https://www.amazon.ca/Portable-Large-Tents-Enclosures-Outside/dp/B07G5BRGWT/ref=sr_1_1?keywords=foldable cat enclosure&qid=1555591123&s=gateway&sr=8-1
https://www.amazon.ca/ZuHucpts-Outdoor-Portable-Foldable-Enclosure/dp/B0791JMZ8N/ref=sr_1_4?keywords=foldable cat enclosure&qid=1555591123&s=gateway&sr=8-4
No worries I figured you were busy with family. I have a 97 year old grandmother. She still lives in her house, with my aunt.
I love the tent and the harness be perfect for Molly. I’ll buy it and get her use to it. I think she’ll really like the tent. No, she really dislikes going in the truck! Thank you for finding this for me .
My vet replied to my email about Molly’s spreadsheet. I’ll post see what you and Linda think!
it sounds like your diabetic is having a good clinical response and the blood values are often quite good in your spread sheet.
Fructosamine does give us clues about how well regulated the patient is without the stress of a blood glucose curve. A normal fructosamine value indicates that the previous couple of weeks have been good control of the diabetes. We often do this periodically for some of the stressed out cats instead of trying to curve in hospital.
If you are having good success with a curve at home this does still add a lot of information. I encourage you to still periodically do this as well. If Molly is doing well these could be stretched into 2 or even 4 week intevals.
Your vet sounds very pragmatic and reasonable, not insisting on anything but explaining their thought process. I like that.....your vet is a keeper.
It's really your call whether you do a fructosamine or a curve. You've heard my thoughts on the fructosamine and while a curve shows you what's happening on curve day, the results on a curve depend on whether it's done when Molly is having great numbers or bouncing. I still maintain the overall picture is far more telling. Molly is in a very good place BG wise and your vet has acknowledged that. The question is whether you want to push her a bit to see if she can get over that last hurdle.
I don’t know what to do about the fructosamine test. If she’s doing good why bother? He is a good vet. He has helped me a lot with Molly.
I do want to push her to get over the last hurdle. How do I do that? @MrWorfMen's Mom
I see Molly did another bounce but she's coming back down now. Straight flat yellow cycles often predict the bounce is going to break leading to a more active cycle (lower numbers) so while Molly is running a bit higher right now, it's still really helpful/important to get those mid cycle tests whenever you can and try to always get a before bed test (+2 is fine or +3 a bit better) and definitely when she may have been in yellows all day today. The more data you have the easier it is to figure out what she is up to and how to proceed especially when she keeps changing the steps to her dance.
As far as the fructosamine test is concerned, if the vet pushes for it, there's no harm doing it (except to your wallet). It's your decision but I wouldn't alienate a vet you like if he is pushes for it or insists.
I’ll do a +3 tonight. Will test her more during the day tomorrow. Was gone most of the day today. I’ll probably take her for the test. But she gets stressed going there. So not sure what to do.
I know that feeling. None of mine like the vet either and my extra sweet girl howls at the top of her lungs in the car....loud enough cars at stoplights look over to see what the noise is even with all my windows and sunroof closed.
Should I increase Molly’s dose tonight?
Are you home tomorrow? You could try 0.10 u again to nudge her down a bit.
Yes I’m home tomorrow. So start the .10 tomorrow morning?
You can start tonight or tomorrow provided her pre-shot BG is high enough. My preference was to do increases on a day cycle but if you don't mind getting up to test her tonight, you could start then. I'd get a +3 and maybe a +6 on the first cycle of the 0.10 dose.
I’ll start tomorrow morning.
I looked back on the spreadsheet. Just double checking on the dosage this morning. I can still give her .10?
I take it you have fed her this morning now. If so, then I think I'd drop back to the drop dose for today. The reason being that flat yellow cycle yesterday makes me wonder if she might possibly drop lower today and you won't be home to monitor more closely than one mid cycle at lunch. If you haven't fed Molly, stall (no food) and retest her to see if BG is rising on its own.
I gave her .10 and she has eaten. But I will be home at lunch to test.
Ok but make sure you leave her out a little extra food for her to eat should she need it between now and lunchtime.
Will she be ok?
I'm sure she will be Ok just leave the food out in case she needs it. You can add a tsp of the SO to her LC food if you are worried.
Next time she drops to blue at pre-shot after yellow the night before, use the stall to see if she is rising on her own. That makes it easier to make dosing decisions.
I tested her and she’s 7.9. She’s hungry so I fed her FF
Molly will be OK. It's stressful learning to make these "finer point" dosing decisions. Your spreadsheet data along with a few key guidelines (eg. watch for a possible drop after a run of flat yellow, etc.) are where to seek guidance if we don't happen to answer right away.
very stressful learning dosing decisions. I looked back at the spreadsheet. But never thought of the flat yellow. Still learning
2.8 @Kris & Teasel @MrWorfMen's Mom
Sorry Adrienne. I was out this afternoon. I assume you fed her and I see you retested her. Great job Adrienne. Now we know Molly does follow that pattern of going lower following a stint of pretty flat yellows. She isn't as fast at doing it as some (maybe most) but she does it. It will be interesting to see what he BG is at pre-shot tonight. She technically earned the reduction to a drop again today but let's see what she does tonight.
She sleeps til I get home for lunch. She finished the little bit of food. I left out for her and I tested her where she was at 2.8. I then gave her more FF. Waited for 20 min and retested and gave her more FF. I was going to give her SO food. But I don't want her getting to high BG. She was playing when I left so I'm hoping she'll be fine. I just don't understand every time I increase to .10 she does these. Decrease to a drop ans her numbers go up. I can't win!
Admittedly she is proving to be a bit of a tough nut to crack but you'll get there. Patience is key. She's wobbling and all you can do is follow her lead.
Will you be around 6ish my time. To see what her preshot is at?
5.8 @MrWorfMen's Mom @Kris & Teasel
I'm sorry I wasn't around last evening, Adrienne. You made a good choice in reducing to a drop. Linda is correct - all you can do is follow Molly's lead. I know that with Teasel the increase in dose will sometimes "shock" him into a bigger drop and then he gradually climbs a little higher. It's easier for me though - I can monitor after those drops. He can also run a little higher on a dose and then decide to drop lower after several days. Not saying Molly is like this but I know too well how unpredictable a kitty's responses can be. "Go with the flow" is an important thing to remember.
Sorry Adrienne I wasn't around last night either but you made the right decision dropping the dose back again. Molly is just taking a while to get used to those lower numbers and unfortunately there is no magic bullet. Some kitties are just bouncier than others so just take it day by day.
It’s ok ladies she’s high this morning. Do I give her.10 for dosage?
No. Give her the drop again. She is bouncing and it's not a good idea to give the larger dose when you know she is in a bounce because it could break and she could drop suddenly.
A drop for tonight?
You're getting the hang of this, Adrienne. Don't worry about the higher numbers. Try more tests on the weekend and maybe be a bit braver with dosing to see how she responds.
Thanks, I’m not sure really what I’m doing. I look at the spreadsheet but last time. I did that she dropped low. Because she was a flat yellow.
Should I increase her dosage again tomorrow? where I'll be home to monitor her?
I think it's best to play this reading by reading right now. We don't want Molly going too low and once again she is running in flat yellow which again could lead to lower readings. Let's see what her BG is tonight. I'll check in just before 6pm (9pm my time).
Ok sounds good!
It's a toss up tonight. If you give the drop dose, I think Molly will just surf along as she's been doing. If you give her the 0.10u dose, she may drop down and you may need to monitor her/steer her for a bit. It's your call.
Do the drop tonight and start the .10 tomorrow depending on her BG?
Sounds like a good plan!
I agree with Linda. You need to take it dose by dose for now. The weekend is the time to be a little braver.
Should I increase her dose this morning? @Kris & Teasel @MrWorfMen's Mom
Your spreadsheet shows a drop dose. Did you give it already? If not I'd try 0.10 u to see if she drops low like she did on 23 April when you gave that. If you're home to monitor it's worth a try.
I did the drop dose. Thought she might drop lower today? Test her at +2 or +3?
I gave Molly the drop today. I won’t be home this afternoon to monitor.
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