? Please advise - to shoot or not too shoot

Discussion in 'Feline Health - (The Main Forum)' started by Helena & Murinka, Sep 3, 2016.

  1. Alexi

    Alexi Member

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    Apr 10, 2016
    She is heading up, I think she will bounce by morning so don't give insulin in the morning and we'll see if we can get some people to put their heads together. You might want to leave a little food down overnight for her just in case.
     
  2. Helena & Murinka

    Helena & Murinka Member

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    Aug 23, 2016
    Okay, thank you very much for being with me. I will also try tofind a new vet, have already started a research among my friends.
    When I look at her SS, it doesn´t make any sense to me. I can´t understand how she could survive those 7 units she had for quite a long time when she has such a violent reaction to 0.5 unit?!

    Hope your humidity is better and you can get some sleep too. I will test her tomorrow (well today..) morning and +2 after meal? to see what´s hapening?

    Good night and enormously thank you.
     
  3. Alexi

    Alexi Member

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    One thing I'm wondering is if she is in a prolonged bounce and given time if her sugars will just go back to normal without insulin but it is difficult to tell exactly what is happening as you have never had any 'normal' in her spreadsheet. I think the priority is to keep her safe while you find a vet experienced in feline diabetes who can help you. You could request a fructosamine test which might give a better idea of what she has been averaging out at in the past couple of weeks.
     
  4. Helena & Murinka

    Helena & Murinka Member

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    Good morning, I just tested her and Murinka is 14.3. what should I do?
    I will try to find a vet but I also can´t have yet another night like last one. I can stay home officetoday and monitor her if it would be useful...
     
  5. Elizabeth and Bertie

    Elizabeth and Bertie Well-Known Member

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    Hi Helena, I was just thinking about you! :bighug:

    I'd suggest no insulin for the moment, just while we think this through... That insulin sensitivity is quite something....

    I was writing in your thread just now when I saw your new post. I'll just retrieve my other post. Be back soon....
     
    Last edited: Sep 6, 2016
  6. Alexi

    Alexi Member

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    After last night I would be wary of giving insulin, if you can monitor today without insulin that will be more data to help figure out what is going on.
     
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  7. Elizabeth and Bertie

    Elizabeth and Bertie Well-Known Member

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    Murinka certainly is sensitive to insulin!

    I also wonder if she's experiencing what often happens to my own cat...

    Bertie is insulin-dependent, but he has a pancreas that seems to work 'on and off'. What that means for him is that food may either raise his blood glucose or drop his blood glucose (because it can trigger his pancreas to work).

    For example...

    We may get a morning preshot reading of, say, 9.3. ...That is high enough for us to give a tiny amount of insulin. But he is also perfectly capable of dropping himself from that number if his pancreas starts to work... So, what I have to do is give him food, and then retest an hour or so later. If his blood glucose is rising I give insulin. But it may well be that his blood glucose has dropped on it's own. It may go down to 5 or 6, typically.

    Sometimes I get it wrong, I give insulin feeling fairly sure that his blood glucose will rise, but it drops instead :facepalm:... And that means that he has his own insulin in addition to what I've injected. And that can cause very steep blood glucose drops...

    It is unusual for a cat be like this long term like Bertie; but it is not at all uncommon for a cat who is trying to go into remission. We call it a 'sputtering pancreas' here!

    If you are home today I wonder if it's worth feeding small meals/snacks at intervals, and seeing if that stimulates Murinka's pancreas to work...?

    Eliz
     
    Last edited: Sep 6, 2016
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  8. Helena & Murinka

    Helena & Murinka Member

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    Eliz and Alexi, thank you!

    yes I stay home and can test her as needed.
    could be please give me "schedule" when to feed her and test her? so that is will hopefully say something ?
     
  9. Alexi

    Alexi Member

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    Apr 10, 2016
    Can you do a +1 and +2 to start with?
     
  10. Helena & Murinka

    Helena & Murinka Member

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    Aug 23, 2016
    yep :)
     
  11. Helena & Murinka

    Helena & Murinka Member

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    Dear @Alexi and @Elizabeth and Bertie[/USER] I am so happy!!! it looks like I found a vet that knows something about cat diabetes. Just spoke to her over the phone for almost 15 minutes and she actually listened! I described her in short what happenned (change of the diet, big doses, big drops ...) she was very pleased Im hometesting, I told her what happened last night after 0.5unit and she told me not to give her any caninsulin anymore. I have an appointment on Thursday PM, she will do her fructosamin test and ketones. From what I heard she really knew her stuff, she told me that lot of cats actually go to remission with appropriate food!!! it was almost in tears over the phone how much I couldn´t beleive my ears.

    I will test her today throughout the day so that we have some numbers and Im really looking forward to Thursday. I think we are now okay with Murinka, you can take a rest from us :)))) I will updated you on THursday how it went.

    THANK YOU thousand times! If you happen to be in Prague I would love to buy you at least a dinner!
     
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  12. Diana&Tom

    Diana&Tom Well-Known Member

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    That's brilliant news about your vet, Helena. It will make all the difference to how you feel about treating Murinka. And you already know that you are in excellent hands here with Eliz and Alexi.
    Celebrate!!

    Diana
     
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  13. Helena & Murinka

    Helena & Murinka Member

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    I will celebrate by sleeping, I am totally exhausted and I hope the new vet will really be THE one and I can't believe I was sticking with the old one for such looong time. I am happy we got rid off him. Thank you for your support, Diana,
     
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  14. Alexi

    Alexi Member

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    I am so happy for you. Having a good vet makes all the difference. You need a good rest now so you are all set for Thursday.
     
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  15. Helena & Murinka

    Helena & Murinka Member

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    thank you, I feel enormously relieved.

    Alexi, hopefully last think for today :) can you advise please on the best monitoring schedule for today and tomorrow? I must say that I don't actually know at what time she should be tested to do the curve.
     
  16. Alexi

    Alexi Member

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    Normally with insulin on board it is every 2 hours until the drop them hourly until it starts to rise again. With this you want to see the effect of food so maybe hourly until she starts to rise then every 2 hours. If she has a snack then maybe an hour after.
     
  17. Elizabeth and Bertie

    Elizabeth and Bertie Well-Known Member

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    Helena, it may be that Murinka turns out to be a 'micro dose' kitty for a while, and will need really small amounts of insulin (less than .5 of a unit).
    There are cats here who have needed absolutely tiny doses of insulin.
    Some of these can be measured by carefully looking at the syringe markings; but some other techniques have evolved here for measuring miniscule doses. Here's a link to one of Manxcat's posts where she describes one such technique; and the post that immediately follows it describes 'drop dosing'....

    Device to Administer Doses Smaller Than .5 Units?

    Eliz
     
    Last edited: Sep 6, 2016
  18. Elizabeth and Bertie

    Elizabeth and Bertie Well-Known Member

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    Here, using U100 syringes with half-unit markings, are some other examples of small doses:
    .
    Pictorial guide using a U-100 syringe marked with half units:

    [​IMG][​IMG]
    [​IMG][​IMG]
     
  19. Elizabeth and Bertie

    Elizabeth and Bertie Well-Known Member

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    Don't know how I missed this post earlier... :oops:

    Wonderful news about the new vet!
    :D

    Ooops, I posted info above about micro-dosing but had missed that your vet said to hold off on insulin....
    Sorry, Helena. I obviously haven't had enough coffee today.... (Doh!) :facepalm:

    Eliz
     
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  20. Helena & Murinka

    Helena & Murinka Member

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    Eliz, thank you! I continue to test her today to see what numbers she will give me when off on insulin. I feel relieved this new vet sounded very intelligently and respectfully, we'll see, fingers and paws crossed !
     
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  21. Elizabeth and Bertie

    Elizabeth and Bertie Well-Known Member

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  22. Alexi

    Alexi Member

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    Lovely blue! :):):)
     
  23. Helena & Murinka

    Helena & Murinka Member

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    @Alexi @Elizabeth and Bertie

    YEAH!! Could you beleive it?
    Yesterday in yellow numbers and today morning 6.6 and no insulin for 36 hours. I couldn´t believe my eyes.

    Sending huge hugs!
     
  24. Kris & Teasel

    Kris & Teasel Well-Known Member

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    This is wonderful, Helena!!
     
  25. Critter Mom

    Critter Mom Well-Known Member

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    I'm really sorry to hear how shabbily your previous vet behaved towards you, Helena, but based on the crazy early doses and treatment advice s/he gave you I think the old vet did you one enormous favour by withdrawing from the case.

    If you start getting blues and greens with the diet change it is possible that Teasel Murinka may go into remission just on the change to low carb, wet food.

    I've treated my cat with both Caninsulin and Lantus. Like Murinka, when Saoirse's diet was changed her numbers improved hugely and astonishingly quickly. Also like Murinka she would get potentially dangerous BG drops on only a tiny amount of Caninsulin after the diet change. However Saoirse didn't quite get into remission with just the diet change. Rather than mucking around with a harsh insulin like Caninsulin I managed to get our vet to prescribe Lantus (insulin glargine) for Saoirse. Its action is typically gentler and less likely to produce huge drops on small doses so I was able to continue her insulin therapy safely and not long after she went into remission. If Murinka's data should show that she needs to be on insulin a bit longer, I suggest you discuss the possibility of switching to Lantus for a while so that you can continue treatment with greater safety and increase the chance of a strong remission.

    Great job handling the BG roller coaster ride, BTW! Wishing you a much better time of it with your new vet (who sounds infinitely better than the last one!). :)

    :bighug:


    Mogs
    .

    EDITED TO INCLUDE CORRECT KITTY'S NAME.
     
    Last edited: Sep 7, 2016
  26. Kris & Teasel

    Kris & Teasel Well-Known Member

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    I think you mean, Murinka, Helena's cat. :)
     
  27. Critter Mom

    Critter Mom Well-Known Member

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    I certainly do, Kris! :oops: Thanks for catching my howling faux pas; I'll go back and edit my previous post. :)


    Mogs
    .
     
  28. Helena & Murinka

    Helena & Murinka Member

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    Thank you all!

    I will update you after tomorrow visit at the new vet.

    Thinking back over all the years I tried to stick with the old vet and remembering all he said and done over these years I just can´t beleive I didn´t leave him ages ago. He´s such an arrogant guy .. I should stop thinking about how terrible he was because it´s over now, but still it´s been such a terrible moment that I can´t still believe he said what he said....
     
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  29. Critter Mom

    Critter Mom Well-Known Member

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    He's not unique, sadly. Many, many of us have had problems with vets who prioritise their own egos/insecurities over the wellbeing of their patients (sometimes with fatal results). We all want to believe vets and doctors have all the knowledge and experience necessary to help their patients. A lot of the time they do but so many of them fail when, instead of acknowledging that their knowledge is less than complete, they opt for protecting their image instead of better educating themselves. I don't think they realise just how many of their clients would prefer that to the ex cathedra approach to treatment.


    Mogs
    .
     
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  30. Elizabeth and Bertie

    Elizabeth and Bertie Well-Known Member

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    I had to Google "ex cathedra"....
    I've learned a new expression today! :smuggrin:
    .
     
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  31. Diana&Tom

    Diana&Tom Well-Known Member

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    Me too - never heard of it! Useful to know!
     
  32. Critter Mom

    Critter Mom Well-Known Member

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    @Elizabeth and Bertie, @Diana&Tom -

    Although few and far between, there are some plusses to being a (lapsed) cradle Catholic. ;)

    As you've seen from your web searches it refers to papal infallibility. According to what I was taught, historically a pronouncement could only be considered infallible provided the pontiff was physically seated upon the papal throne (cathedra) when issuing it.


    Mogs
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    Last edited: Sep 7, 2016
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  33. Diana&Tom

    Diana&Tom Well-Known Member

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    :)
     
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  34. Helena & Murinka

    Helena & Murinka Member

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    Can you believe that Murinka has got another 6.6 before evening meal ? Im really curious to see what her tomorrow fructosamine test will be...

    Do you think this development is possible? yesterday in yellow numbers and today morning and evening in blue? without insuline?
     
  35. Critter Mom

    Critter Mom Well-Known Member

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    I was hoping for this result for Murinka! :) It looks like her lower carb diet is helping. :)


    Mogs
    .
     
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  36. Alexi

    Alexi Member

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    Apr 10, 2016
    Yes, very possible she is going into remission, 6.6 is within normal range for the cat, so if you can get a +1 and +2 this evening we can see what she does in response to food, but she needs to stay on lower carb for life as she will still be diabetic even if she doesn't need any more insulin.

    ETA: can I just say a big WELCOME BACK to Mogs who helped me when I was just starting out.
     
  37. Elizabeth and Bertie

    Elizabeth and Bertie Well-Known Member

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    It's absolutely possible, Helena. Murinka's pancreas is getting stronger. :)
    .
    [​IMG]
     
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  38. Diana&Tom

    Diana&Tom Well-Known Member

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    Yes! It just goes to show what correct, species-appropriate diet can do with or without insulin.
    Well done Helena!
     
  39. Helena & Murinka

    Helena & Murinka Member

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    @Alexi @Elizabeth and Bertie @Diana&Tom @Critter Mom
    Thank you ladies!!!!!
    I have to complete my provision in low carb food - still a bit testing what she likes.
    I spent loads of time with my Iphone and the Low carb calculator reading the etiquettes and calculate, standing in the store for loooong minutes and checking the food one by one, shopping staff started looking weird at me :)
    I am cautious of being too optimistic but it definitively looks positively
     
  40. Diana&Tom

    Diana&Tom Well-Known Member

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    It does look positive, Helena. Just bear in mind that Murinka will need to stay on a low-carb diet to minimise her chances of going high again, as Alexi said.
    Oh and also remember that the fructo test gives an average of a kitty's BGs over two or three weeks, so the result may be higher than you expect given recent numbers. If you show your new vet your spreadsheet she will take this into account when you discuss the way forward.
     
  41. Elizabeth and Bertie

    Elizabeth and Bertie Well-Known Member

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    Yes, indeed... ...Actually, I wonder what use a fructosamine test would be at this point, given how much the situation has changed for the better...
    I see there's a very nice 5.7 this evening..... :cool:
    .
     
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  42. Critter Mom

    Critter Mom Well-Known Member

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    5.7!!! Go Murinka!!!! :D

    Did you feed Murinka just after the PMPS test, Helena?


    Mogs
    .
     
  43. Helena & Murinka

    Helena & Murinka Member

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    Yes I did, I correted it in the SS now.
    Just tested her now and she's again 5.7, Im sooo impatient to hear what the new vet will tell.
     
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  44. Critter Mom

    Critter Mom Well-Known Member

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    Murinka's doing great, Helena! :cool: Can you get tests at +2 and +3 after her meal this morning to see how her pancreas is responding after eating?


    Mogs
    .
     
  45. Helena & Murinka

    Helena & Murinka Member

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    Unfortunatelly Im not able to test her during the day today - I am in the office, heading home now to get her to the new vet.
     
  46. Critter Mom

    Critter Mom Well-Known Member

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    No worries, Helena. Fingers and paws crossed for a very successful consult with your bright and shiny new vet! :)


    Mogs
    .
     
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  47. Helena & Murinka

    Helena & Murinka Member

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    Dear @Alexi, @Elizabeth and Bertie, @Diana&Tom and @Critter Mom,

    I just got back from the new vet and I really found the ONE! She spent with me and Murinka 1,5 hour! I love her. shee was excellent, explaining everything - she was aware of the low-carb diet, of other insulin (the old vet was telling me, that it's not possible to use human insulin for cats...) - btw she knew my old vet from school ...

    To make the story short - besides all the talking and thorough Murinka's examination, she did the fructosamine test and she was at 287 which she said in norm. She also checked my glucometre to see how accurate it is and we discovered it measures cca 2 units less than the actual BG is - it means that Murinka numbers as stated in the SS aren't completely accurate and shows a lower BG, so her low numbers bellow 3 were actually numbers below 5 ...

    She told me that I sorted out the situation at Murinka's best - no insulin and change of the diet!!!! She proposed me the M/D veterinary diet canned and dry (that is supposed to be low-carb) but we agreed that I can stick with what she eats now since it seems to be working. She will make her also some urine test to check for some kind of bacteria (I didn't really understand that part, but it sounded reasonably). In 1 month she will make another blood check ...

    So no insulin, just low carb diet, fructosamine control in 1 month. Once she'll be okay, the vet will take of her stomatitis.

    I can't express how much Im grateful to all of you, you gave me advice, support and courage and without you and FDMB Murinka would have been treated wrongly maybe with fatal consequences.

    THANK YOU!

    All my very best from Prague
    Helena & Murinka & Bila (Murinka´s sister)
    IMG_0570.JPG
     
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  48. Diana&Tom

    Diana&Tom Well-Known Member

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    That is FABULOUS news, Helena! Thrilled to hear the new vet "gets it" and that you can have complete confidence now in how Murinka will be treated.
    Wishing you all the best (and of course do carry on posting here and/or Facebook to give us updates or ask further questions.
    Yay!

    Diana
     
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  49. Alexi

    Alexi Member

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    That is an excellent report. This vet is definitely one to keep! Please do keep us updated with Murinka's progress, she looks so happy in the photo!
     
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  50. Elizabeth and Bertie

    Elizabeth and Bertie Well-Known Member

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    Helena, I am SO pleased that the vet visit went so well! That's a fantastic outcome! :bighug::bighug::bighug:

    The way that vets measure blood glucose means that their numbers are often higher than we'd see on a 'human' glucose meter. But both are usually 'correct', in the same way that 'centigrade' and 'Fahrenheit' are both correct; they're different ways of measuring the same thing.
    Most of us here use human meters, so we tend to 'think' in human meter numbers. But the numbers you're getting are still very good indeed. And, hopefully they should improve as time goes on too.... :)

    (Edited to correct misinformation!) We'd consider the Hills foods to be too high in carbs. The only prescription food that is low carb is the Purina DM (the original canned version), but many cats seem to get bored with it over time. And, to be honest, many of the ordinary low carb foods that we can buy elsewhere are of better quality... ;)

    You've done a brilliant job with Murinka, Helena! And the photo is just gorgeous..... :joyful:

    Eliz
     
    Last edited: Sep 9, 2016
    Reason for edit: Correcting food info: Had muddled up my MD's with my DM's, ha-ha!
  51. katiesmom

    katiesmom Member

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    I have been following your story, Helena, and I am so happy for you both. I was terribly upset with your original vet, and like someone else said, he did you a favor by "firing" you.
    Murinka is absolutely BEAUTIFUL! I am sure Bila is too, I just cant see her face:)
     
  52. Critter Mom

    Critter Mom Well-Known Member

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    It ain't. ;)

    Great report, Helena, and your kitties are bee-yoo-tee-ful! Lovely photo. :)


    Mogs
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  53. Kris & Teasel

    Kris & Teasel Well-Known Member

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    I'm so happy for you and Murinka, Helena. How far you've come in such a short time! And Murinka and Bila are obviously very happy kitties. :)
     
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  54. Elizabeth and Bertie

    Elizabeth and Bertie Well-Known Member

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    Quite right, Mogs! :facepalm:
    Thanks for that.
    I'd confused 'MD' with 'DM' in my earlier post, and have now corrected it.
    (I've forgotten how to 'strike through' text, so have rewritten the info)...
    .
     
  55. Helena & Murinka

    Helena & Murinka Member

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    Thank you all! For all your beautiful and warm words I’m so moved to receive so much support and sympathy! Thank you.

    Yes, I’m grateful he fired us and he did me also a favour by his stubbornness because it made me go and look up for information elsewhere - here. I don´t want to think what would have happened if I didn´t find you!

    I know that Murinka might end up one day on insulin, but I’m perfectly okay with it.. The great think that I have now a vet that follows the same goal :)

    I feel so relieved, for the first time since she was diagnosed, a month ago. I can finally start thinking about other things than Murinka´s diabetes :)

    I wish you and your kittes all my very best, I´ll keep you updated.
     
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  56. Elizabeth and Bertie

    Elizabeth and Bertie Well-Known Member

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    [​IMG]
     
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