Opinions?

Our boy seems to be improving quite a bit over the last week or so. His numbers have changed dramatically. I would just like to hear from you all on how you think things are going or if there's anything I should do differently based off his spreadsheet. I'm not sure if he is going to low to quickly? Or if what we are seeing is actually really good. I'm loving those green numbers but I must admit they are a bit scary too. Its currently almost 3am where we are and I am waiting to test him again to make sure his numbers start to rise before I can finally head to bed for the night. This whole process is very overwhelming and tiring. The doctors don't even begin to tell you what your in for when you get the diabetes diagnosis. They make it seem like its nothing when in reality it has taken over my life. As always, I appreciate all the feedback from everyone on here.

 

AMPS is 100. We are stalling 20 minutes and checking again.

 

I think he is doing really well (and you are, too ). He never went too low last night, but if it was too close for your comfort, and because he was too low for you to just give your 2u dose without having to do the stall and check this morning, you could drop to 1.8 now and see how that goes.

 

We stalled for 20 minutes and he went up to 128. We stalled another 20 minutes and he stayed at 128. I think we are going to give 1.4units.

 

1.4units for this mornings shot that is. @FurBabiesMama you mean giving 1.8units as his "normal" dose to see how he does with that amount now?

 

I'd definitely drop to 1.8 for the normal dose now. He was too low for you to give a shot this morning and you had to stall and wait...and he still didn't rise much. You want to be able to consistently give 2 shots without having to stall, so dropping the dose is a good plan.

 

Yes - what Rachel said!

 

Okay thanks guys! I'll give that a try starting tonight.

 

So with the delays today we didn't give Tootsie his insulin injection until right around 8am. We just checked him which it is 12:45pm here, so almost +5 and he was 55. He is eating right now so hopefully that will bring him up a bit.

 

He's trying to cut it pretty close... little daredevil . Based on previous numbers for day time, it looks like his nadir may fall around +6, so he may drop further over the next hour or so. Gentle carb steering should keep him from going too low.

He is responding so well to the insulin. I would have loved those numbers just a couple of months in. Depending on his PMPS, you may end up having to go a little lower than 1.8 as his new dose. I hope this trend continues for you.. wouldn't remission be great!

 

@FurBabiesMama I'm going to check him again at +6. That has typically been where he gets the lowest (except for last night when he dropped a little more at the +7) You have no idea how much a remission would mean to us. The stress from losing our dog and then this happening right afterwards has been so hard on me. It would also make our vacation in August one we could enjoy because right now that's adding even more stress on me, especially with his numbers right now lol.

 

Oh, I think I do. After a year of this, it has taken quite a toll... vacation? what is that?

 

Right? Honestly it wouldn't even be happening if we could get a refund, but its not refundable. Its our trip to Mexico for our 8 year anniversary and we booked it after we lost our dog and before Toot was diagnosed

 

Yes, as FurBabiesMama said, you may have to go lower for PMPS. It's hard to say for sure what to do ahead of time, but if you get a similar number as you did for AMPS, I wouldn't go any higher than 1.2 since 1.4 dropped you to 55 at +5. Maybe even 1...kitties tend to run lower at night.

 

62 at +6. We will have to see what he is at pmps and then decide on his dose from there Can you all explain to me a little better how remission works or when it happens? I've been reading about everything a lot but some things are a little hard to understand. I do know when/if it gets to that point he has to go 14 days without insulin to be considered in remission. But I guess what I'm wondering is at what point do you not give insulin?

Also another thing I've been wondering is how do you check his urine for the ketos? We haven't done this yet.

 

You can do it with sticks intended to be held in their urine stream, or you can do it with a ketone meter which is like a glucose meter (sometimes one device does both).

As far as 'how it works', while insulin is keeping them in safe, healthy numbers, it allows their pancreas to heal and the beta cells begin producing insulin. As a result, their numbers start getting lower, and they require less and less insulin until they require none at all. I have read that it is important to taper them off of the insulin gradually rather than to stop too soon, but I have also seen people dispute that.

I imagine that you will start to have to reduce your dose more and more because he will go lower and lower on less and less until you get to the point that his PS number is too low too shoot (which you will have a feel for due to having gone through the process and gathered data on his responses). Then, if the next PS number is also too low, you again do not shoot and so on and so on. As you said, after 14 days with no shots, it is considered remission. Then, you just do periodic checks to make sure he is staying in good numbers. (Unfortunately, remission can end, so you would want to catch it if that was happening.)

Maybe someone who has actually had the privilege of going through this will chime in with insights for you. Or you could snoop around in the OTJ forum.

 

Thanks! Maybe I'll make a post under that section just for some extra pointers. He was 73 at +8. He is seriously responding so well with the Prozinc. It makes me really happy. I feel like most people look down on Prozinc and they only want to use Lantus or Levemeir. I understand though that ECID.

 

You're exactly right. I might add that you want his numbers to stay under 120, with most numbers between 50-80 before you relax. When a cat is headed towards a quick remission like this, you'll likely go to micro-doses (0.25u, 0.1u, drop) and may need to stop giving shots even a little above those ideal numbers, but within a day or two, you should see the numbers settle into the greens. You'll also want to see that after eating, his numbers stay roughly the same or go down. A cat in remission won't have a food spike from low carb food.

You might find it helpful to pull up the spreadsheets of the cats in the OTJ forum and see how things went their last couple of weeks. It can get a little messy. On Sam's spreadsheet, there is a tab for Dx #1Prozinc that shows his remission. It went pretty quickly.

 

Okay so I just did his PMPS and his # is 88. Suggestions?

 

@Djamila @FurBabiesMama @Rachel

 

Wow. First though,, wasn't his morning shot an hour late? So, technically it is +11 and not shot time - correct??

 

Yes his morning shot was 8am today instead of 7am. But I was told he would be good to stay on schedule with his 7pm shot tonight. I am stalling right now but how do we get back to our normal times now?

 

ProZinc does allow you up to an hour of 'play' time, but I would split the difference and consider 7:30 the shot time tonight and back to 7 in the AM... BUT if he stays this low, I would not give a shot tonight.

 

This will give you a chance to see how he does this cycle with no insulin.... so excited for you... and jealous.

 

Okay. He was just 101 after the 20 minute stall.

 

I’d say still too low to shoot at this stage of the game.

 

I'm going to check one last time at 7:30pm to see what he's at and decide then. I feel like I want to give something because he is doing so well. But probably a smaller dose?

 

You could even push it to 8 ?? You gave 1.4 at 128 this morning, and he went to 55, and he goes lower at night than in the day. So, if you do decide give a dose tonight, please use caution.. it would need to be a greatly reduced dose, and you are going to want to be sure to check him (meaning possibly another night without much sleep).

 

I'd be very wary about giving anything if he doesn't rise more. You're stalling without food right?

 

Yes stalling without food. I just hate to stall much longer because we need to get back on our 7am/pm schedule.

 

Well what the heck. Now he just tested at 89 after the second stall.

 

Yeah.. umm.. just skip.

 

Lol I guess so. I'll still check him a couple times to see what he's at now through the night.

 

That's GREAT! I know it seems bad in a way because you're afraid to lose momentum, but it's really good. Try testing at +2 if you don't mind...I'd be interested to see if there's a food spike or not....that can indicate the pancreas are working if there isn't much of a spike.

 

@Rachel okay I will do that. I would test based off the time I fed him correct?

 

If it's two hours after he eats, the food impact would have cleared. So, I think she meant +2 from the shot time when you started stalling - maybe she will pop on to say for sure, but if she doesn't get a chance to, go with that.

 

But he didn't get the shot tonight? Unless you mean from the first time I took his preshot test?

 

Yes, from the time you were going to give the shot but started stalling instead. That would be like an hour or so after he finished eating then, correct?

 

We first tested him at about 6:50pm. Then 7:10pm. Then about 7:35pm. He ate about 7:40pm after the 3rd test and he had it all gone by 7:50pm. I just checked him at 8:50pm and he was 135.

 

Oops sorry! I'm not doing a good job of being clear today (I have days like this where I think everyone is already in my head I guess...). I was thinking 2 hours after you feed him. The reason for that is he usually gets a pretty good spike around +2 on your SS so I was wondering if the food spike would be there still or would be lower...usually around +2 the food spike hits its peak and starts to clear as FurBabiesMama points out, so if it wasn't that much higher than AMPS, it might show us that the pancreas were working.

 

Okay well I can check him again when it's at the 2 hour mark from when he ate. He was just 135 and that's 2 hours from his first preshot check. Another hour will be 2 hours from when he finished eating. That's where I would record the +2 on my spreadsheet right?

 

+2 on spreadsheet should be 2 hours after shot time or time you would have given it. Same time you got the 248 last night.

 

Okay well then that's the one I just did then and he was 135.

 

But I'll test him again in another hour and post the number here for @Rachel. That number will be 2 hours since he finished eating. But the 135 is 1 hour after he finished eating.

 

The next one will also be +3 for the spreadsheet, unless I have gotten confused. (You said it will be one hour from the test you just did.)

 

Yep I think we are just confusing each other hahaha. But yes it will be +3.

 

Sounds good! To clarify further (though I'm sure you don't need it...I now feel like I didn't explain myself well earlier though), 2 hours after he eats, the food spike should be clearing like FurBabiesMama said earlier. The reason I would be interested in that number is because with no insulin on board, I want to see if it's actually clearing on its own or if it keeps going. If it clears like it should after no insulin, that's a good sign!

 

Okay so he was 135 at +2 and 133 at +3.

 

I'm up feeding/testing Mia, so I checked in... I see he is up to 225. Bummer. Oh, well, more data for future decision making!

 

@FurBabiesMama yeah but that's okay. I still feel like we are definitely making progress. I'm wondering though if I should start him back at 2units tomorrow morning or try the 1.8units?

 

Hmmm, not sure on this one...On one hand, I would expect him to be pretty high by then, so if he is, you may want to do that. On the other hand, tonight could be considered like a 'fur shot', and you could continue with the plan to drop to 1.8 for the reasons discussed earlier. I think I would decide what to give in the AM based on AMPS result. And, I think that if it is under 250, I would go with the 1.8, but if it is over 250 (as I would expect it to be), I would probably go with 2u even though the drop to 1.8 is still probably going to be needed within the next shot or two.

I do not think there is a 'wrong' choice between 2 and 1.8, so do what seems best in the AM.

UPDATE: Unless he surprises us all and ends up actually low again in the AM in which case you know to adjust down as appropriate.

 

Awesome thank you @FurBabiesMama I think that sounds like a good plan. Afterall those 2units definitely got us some good action. Trial and error, trial and error! I appreciate you all always responding and helping out. I can't wait to be able to help some others out when they are in need. You have a good night

 

That +2 and +3 from last night looked pretty good. They were so close to each other it tells me there may have been a little pancreas action going on...which is great!

 

Tootsie ended up being 331 this morning after skipping his shot last night. His numbers have been pretty decent all day and his PMPS was 137. I decides to give 1.8units tonight. I guess I'll see how that goes and what it gives us for our morning pre shot number. Weekdays we wouldn't be able to stall more than once if it is low and I really want to avoid skipping shots as much as possible. So I'm thinking reduced doses if that ends up happening again?

 

1.4 took him to 55 from a 128 pre-shot yesterday, so hopefully that 1.8 on a 137 pre-shot will not send him too low. I guess you will just have a long night, if it does.

If you can only stall once in the mornings during the week, just make your call based on what you get. Based on how last night went, I would probably give a reduced dose should there be another low number like that. But, if no one will be around to monitor, I would make it VERY reduced to be safe.

 

@FurBabiesMama I did look at that number and dose but then I also looked at his pmps on the 6th which was 142 and we gave him 2units so I guess that's why I decided to go somewhere in the middle. I'll be keeping my eye on him and staying prepared just incase. Do you think if he were to get another low number like yesterdays preshot and after stalling the one time that .20units would be an appropriate reduced dose. I'm thinking just starting low to see how he does since we don't want to skip again.

 

If he is around 100 again (87, 101, etc) in the morning I would probably give .50... so, with your syringes I guess .40. With no one home to monitor, I would not do any more than that. And, if you are more comfortable with .20, that works, too.

@Rachel , @Djamila what do you think on this?

 

I agree. If he's that low in the morning, I wouldn't give any more than .40. If it was me, I might even go for the .20. Might be too little...but at least you'll know for next time and you won't worry all day.

 

Thank you guys! I guess we will decide on the spot in the morning or the next time we do see those numbers if we want to try .20 or .40. I will be around to monitor for his typical times where he usually falls (starting +5 +6 +7) I just say we can only stall once during the week because my husband takes the morning "shift" for his shot before work, I'm typically up late so I need those extra morning hours of sleep or I won't be able to function throughout the day haha.

 

I agree with FBM and Rachel - I would err on the side of caution right now. Tootsie is healing quickly so you don't want to over shoot at this point. If you need to give a mini dose or skip again, do it. Better safe than sorry. You can be more aggressive in the evenings and on weekends when you're home to make sure he stays safe.

 

Alright guys! We are dropping to low. He just tested 47 at +3. We are feeding him some higher carb wet food right now. I think I read we should only do about a tablespoon at a time so that he will continue to eat. How often do I need to keep checking him now? @FurBabiesMama @Rachel @Djamila

 

Yikes, pretty low for this early. Do you have syrup ready in case the food does not prove to be enough? I would test again no later than 30 mins from the last test.. maybe even 20. Then, assuming he has risen just a little, I would continue to test every 20 to 30 mins until the numbers are up and staying up...giving the food and/or syrup as needed.

 

Yes I have corn syrup. We just rub some on his gums correct? Can we continue to feed him small amounts of the high carb wet food as well?

 

Do the food then if the next test shows any additional drop, give a drop or two of the syrup. You can put it on the gums if he won't just eat it. I never had to do that. I put it on a little bite of food or even dry food kibbles, and Mia ate it.

 

49 after 30 minutes. Hes eating a little more food with some corn syrup mixed in now.

Can anyone help me figure out the carb % of the wet food I have on hand. It isn't listed on the food list.

I have Royal Canin Urinary SO in the 5.5oz cans
I have Royal Canin Urinary SO Morsels in gravy in the 3oz cans.
I have Hills Prescription Diet C/D Chicken 5.5oz
And Hills Prescription Diet C/D Ocean Fish 5.5oz

 

Royal Canin Urinary SO Morsels in gravy is in the database - it has 21% carbs
Looking for the others...

 

I see the SO pate, is that the other SO you have? It is 20% carbs.
Hill's C/D chicken and ocean fish are both 23%

You can use the link in my signature to get to the cat food database. It is easier than the list since you can filter.

 

@FurBabiesMama thank you! I appreciate it just so I know the % of these ones I have on hand. I can't believe ive missed that one on the database. I swear I've looked for them all.

 

If you can get/keep him over 50... just tread water... it is ideal as opposed to just dumping on the carbs to the point that he goes super high. But safety first, so do what you gotta do, sister!

 

Yes I believe its pate, it doesn't say it is and it doesn't have a flavor but it looks like pate. Anyways we are doing the morsels and gravy right now. He seems perfectly fine if that means anything. Loving that food and just purring away. Also just had a good potty break #1 and #2.

 

@FurBabiesMama I like that database you have listed. It looks different and has a lot more foods listed than the other ones I've seen.

 

We are at 65 now +5

 

I'm going to check again at +5.5 and if he has gone up again from the 65 then we should be in the clear correct? Also, I can give him his regular low carb food before bed still?

 

Sorry... I was getting a few minutes of sleep. He has gone up for each test you have taken, and I assume he has had food throughout, so that should continue to impact him for as much as a couple of hours, and if he has access to food throughout the rest of the night, he should be fine. Two nights ago, he continued to drop through +7.5, so if you happen to still be up or to wake up, another test about +7 would not hurt.. just to make sure he is still holding his own or rising.

 

That's okay @FurBabiesMama , I understand trying to get some sleep lol. I thought we were good once I tested him and got 70 and +5.5 but planned on checking him at +7. I dozed off but woke up just in time and he was back down to 56. He ate some more of his regular food and I'll stay awake to check him at +8 (3:00am) to make sure he is up and then I'd think I'll be out of the dropping zone and he should continue to slowly rise.

 

Wow an exciting night! Sorry I was fast asleep...I had this past week off, but I had to go back to work today and I'm up pretty early on workdays. So now we know for sure that 1.8 on a 137 was too much...that's good data! Looks like he surfed along in greens most of the night which means he might still be low this morning. I'd definitely stick with a low dose this morning like we talked about.

I see your husband takes the morning shift (love that!). Does he have your login here in case he ever needs anything so you can get some rest without him needing to wake you?

You did GREAT last night! I'm so glad FurBabiesMama was here for you. Hope you get some and rest today!

 

@Rachel he doesn't have my log in but I'm typically always awake anyways when he is doing everything in the morning. It's when he leaves that I finally get my few hours of uninterrupted sleep. It was definitely a long night. I know I said I wasn't going to skip again but with how last night went, and him still not rising much as of this morning, I decided to skip his dose so I could rest a little with no worry and he could have a small break. He was poked at so much and then having him get sick makes me feel bad. I can't believe I never realized when he was throwing up so often before that it could of been his hard food. My husband and I were just talking about how he hasn't thrown up in so long. Then last night when he went low I put 6 PIECES of his hard food on top of the wet to help raise his numbers, 6 PIECES, and he threw up tonight. That just can't be a coincidence.

Anyways, I do know now that regardless of what number I get tonight (unless its super low) I will be reducing him from 2units to 1.8units as his regular dose and see how he does with it. If for some reason he is still low tonight then I will do the extra reduced dose like I intended on doing this morning.

 

Wow, 76 this morning. Good job last night. Vomiting is a much less frequent occurrence around here since our food switch, too. It is sad that we start considering regular vomiting 'normal' then realize that the food we have been giving then is basically crap.

 

I couldn't believe it when he threw up and I pieced together what happened. Crazy. He is doing pretty good today so far since skipping his shot. We will see how this evening goes.

 

Will your next test be shot time?

 

@FurBabiesMama yes I planned on not doing anymore until pmps tonight, which for us is 6:45pm eastern time.

 

Okay. This is like a good book or tv show.. I can't wait to see what happens next.

 

@FurBabiesMama hahahaha! I'm going to guess he will be a little high since I skipped. But this will give me the chance to start him on his 1.8units and see how that goes. Unless he decides to really change things up on us lol.

 

@FurBabiesMama @Rachel @Djamila pmps is 142. This is after skipping this mornings shot also. So my plan of 1.8units is out. What do you guys think?

 

That is so awesome! I think maybe a very reduced dose. Maybe 1u at the most? Maybe even less. It will be another learning opportunity for sure.

 

@FurBabiesMama you think 1.2 would be to much?

 

I personally would not do that much.. I would not do more than 1u at the most.

 

I'm just thinking about last night and how much intervention you had to do to keep him safe, also the fact that his numbers did not rise like crazy with the missed shot.

 

Okay, I went with 1unit.

 

Sorry I was chasing my cat around to let him know I wasn't mad at him for having a hairball earlier! I'm sure you can all picture me lol...he probably thinks I'm nuts!

I agree that 1 unit was a good choice. He's gone low a few times now and often after they get low they have some insulin sensitivity. They just react more to the insulin for a bit than they normally would. 1 unit should hopefully keep him in good numbers...and I'm sure you'd like to get some sleep tonight!

 

@Rachel hahaha! I did go with the 1unit. I appreciate you 3 always responding. I have looked on the threads some and I don't know if there is anyone else you guys would recommend I could start tagging as well just in case. I know we all get busy so honestly the more help the better.

Now I'm wondering what you guys think I should do for his dosing once he gets back up to those 200s or even 300s (if he does that is). My plan was to reduce to 1.8units for awhile since we were at 2units and getting some low numbers. But we've been low so many times since I was going to make that change that our dosing has kind of been all over the place.

 

I have a feeling you may not see 200s/300s. Let's see how the 1u does.. that might be your 'regular' dose.

 

@FurBabiesMama that would be wonderful

 

At this point you really have to take it a cycle at a time. I agree that you may not see high numbers again, but even if you do, I'd stay with lower doses at this point unless those higher numbers stick around for a couple cycles.

 

Blahhh! 47 at +3

@FurBabiesMama @Rachel @Djamila

 

So, even 1 was too much.

 

Yep. So crazy how this all works. I've decided if he shows another low number tomorrow morning like he did this morning I am going to give probably .20u to see how he does with that. Then I guess I'll go from there.

 

@FurBabiesMama this is a little off topic but how could I get the food list like you have in my signature?

 

Well DANG! I mean good job Tootsie, but slow down!

Yes, I think it is time to drop down pretty far and work your way back up if needed. We're just guessing at the dose now and it's hard on you and Tootsie to keep going so low! I wouldn't give anything if he was as low as yesterday morning though. 76 is a number for a normal cat off insulin...it's just awfully low for any insulin that will just push him lower. And it only gives him a total of 30 points to drop ALL DAY before the take action number.

 

122 amps. I'm going with .20u.