Sam's First Year on Tresiba!

Discussion in 'Tresiba (degludec)' started by Sam & Esse, May 17, 2019.

  1. Sam & Esse

    Sam & Esse Member

    Oct 18, 2017
    Hello :bighug:

    I can hardly believe it's been a year since Sam started Tresiba! A year ago it seemed impossible that Sam would ever be regulated; now we're whispering behind our hands the magical "remission" word and keeping our fingers crossed. He still has a ways to go -- and he might not actually get there -- but he's currently at a .75u dose, and we never thought we'd get to this point. Yay!

    We switched away from the AT2 to a human meter a few months ago, although we have a vial of AT2 strips in reserve just in case. It's amazing to us how incredibly level Sam's BG#s are. I did set Sam's dose reduction number to below 60, since I have a deep suspicion that the Tresiba depot may very well be active for five, or even six days after a dose change. It's mostly a gut feeling, but it's keeping Sam safe :D

    Sam himself is doing good: very happy, very purr-y, and rolling in dust and debris every chance he gets! I've not yet been able to get a handle on his weight, however. He's getting between 211 and 247 calories a day, his latest weigh-in put him at 21.6 lbs, and I measured his sitting height from floor to the top of his shoulder at 15 inches and length from nose to base of tail at around 21 inches :confused: Maybe my math is all wrong, I just don't know... I'm going by the formula 13.5 times 15 (estimated perfect weight) plus 70 = 272.5 calories per day.

    I do, though, have an appointment with a new vet this upcoming Tuesday! Have my fingers crossed for this, as well lol! I'm hoping she can shed some light on this big big boy problem. Will also be discussing the rusting/graying issue with her. Right now I've figured he's getting roughly 43-45% of his calories from protein, but maybe he needs even a bit more. Otherwise Sammi is doing absolutely wonderful! I'll post lab results once I have them.

    Jill, I'm about at the point of trying to add raw in with Sam if he'll accept it. I was checking out the Food Fur Life website today :) Which reminded me that Sam's been on Tresiba for a year, and I should really let everyone know how he's been doing! But I like that the product can be added to cooked meat, since Sam loves himself some chicken (or salmon, or tuna, or tilapia... but I'm really trying to keep him to chicken).

    Since I can't get a current picture of Sam without him covered in what seems to be half the backyard, I'm putting up a picture of him as a kitten that I painted on a rock ;) Oh, I remember those day fondly!

    sammi kitten.jpg
  2. Jill & Alex (GA)

    Jill & Alex (GA) Senior Member Moderator

    Dec 28, 2009
    Just got back from vacation... what an FANTASTIC update!!!

    Preshot numbers look great! You know me, I like to see a few more mid-cycle spot checks just to make sure he doesn't drop too low, but the few mid-cycle spot checks look good so far! :p I know I sound like a broken record, but safety is always my biggest concern.
    Given the circumstances, setting the reduction number a bit higher helps. I'm glad you did that.

    That's an interesting observation about the depot. If I wanted to be sure the Lev depot didn't come into play with Alex, I waited for 5 cycles after a dose adjustment. It really helps us know what to do next when we can identify these responses in our cats.
    You know, I've always found that formula to be far too generous for Alex. I know others have found the same. It's probably an ECID thing... almost like with humans. You might want to gradually feed a little less until you see some weight loss.
    43 - 45% of his calories from protein isn't bad. I think it's Dr. Lisa who says at least 40%. I'm kind of curious about the rusting, too.

    The best part of your entire post: "Sammi is doing absolutely wonderful!" I love it! :D
    I'll tell ya, that Food Fur Life EZ Complete is freakin' awesome! I used to make 30 pounds at a time of my own raw and add all the supplements in Dr. Lisa's raw food recipe, but not any more. Food For Life is so darn quick and easy! Now I make small batches often. Besides my cats being fed well... I now have my freezer back! It's nice to see people food in it rather than being filled with cat food! LOL! I've never tried it with cooked meat, but I know others have served it with great success!

    Love seeing his picture... even if it's on a rock! :)

    Thanks for stopping by with an update! It's so good to hear from you and I love hearing how Sam is doing!
    Please stay in touch...
    Sam & Esse likes this.
  3. Sam & Esse

    Sam & Esse Member

    Oct 18, 2017
    Hi Jill!

    I hope you had a wonderful vacation!

    Sam went to see his new vet today :joyful: I think everything went good. Everyone in the office was very, uh, impressed with what a big boy Sam is. The doctor's recommendation was to actually increase Sam's daily calories; she suggested 295 kcal per day for an ideal 15# weight (looking at the notes she made right now). But I don't think I can bring myself to do that :facepalm: She did think upping Sam's protein a bit more might help with the rusting (barring anything popping up in the blood work). So I just ordered the sample of the EZ Complete. Sam does still get 12 grams a day of Dr. Elsey's dry as a treat; I'll see if I can talk him into believing the EZ Complete works even better as a treat. (The doctor didn't like seeing the dry on his feeding list, not at all :blackeye: But she was very nice about telling me to ditch his remaining spoonful.) If I can't wean Sam off his sinful spoonful, perhaps I'll see if he'll accept an ounce of raw in place of an ounce of his Friskie's. That should also tip the protein balance closer to 50%. I think. Haven't done the math yet.

    This makes good sense. I'll try subbing in a bit of raw first (or partially cooked), then try cutting back from there once (if) the change is accepted.

    It was interesting that the doctor mentioned several times that some cats are just big. I'm not sure if she was just doing her best to make me feel better about my lack of progress with Sam's weight, or if she was picking up on my worry that something metabolic is going on with the boy... Or if, with her knowledge, Sam is a big boy and not as badly overweight as I fear. :arghh: Very doubtful about that, though lol!

    I'll be posting Sam's labs to his SS once I get them in a few days :rolleyes: Hopefully everything's still good!

    And I had forgot to mention in my update a bit of information that might be important about Tresiba. Sam was on the last pen of his first 5-pack when his dose went up to 2.25u. That pack of pens had an expiration date of October 2019, so they should have still been fine. However, when I started the first pen of the new pack (expiration in 2020) I had to decrease Sam's dose back to 2u immediately. It could be coincidence, or it could be that the insulin in the older pen was losing efficacy before its expiration date. It's something to look for in the future, as the pens in this newer pack get older. It might also have some bearing that I lost power several times last summer, and although I kept his pens as cool as possible, the slightly warmer temps on a few days might have affected the insulin later on, shortening its shelf-life.

    :bighug: And here is a pic from today, of Sam in his beloved yard after rolling in the dirt to wipe off all the nasty vet cooties :p Some of his rusting and greying is visible here. ...And lots of dust.
    sammi after first visit dr sanders - small.jpg
    Sharon14 likes this.
  4. Sam & Esse

    Sam & Esse Member

    Oct 18, 2017
    Hello all! :bighug:

    Well, one of the vet tech's called me yesterday to tell me that Sam's labs look good, with the exception of high eosinophils. Suggestions were flea control medication, which I turned down because there's been zero signs of fleas, or fleabites (on any of the cats, or myself). A broad spectrum dewormer, which I'm considering, although there hasn't really been any indication of wormie-worms. A fecal exam, which so far Sam hasn't handed to me :p Maybe after the holiday weekend. She said it could be allergies, which would make sense since Sam's been having that problem with the rash/sores breaking out on his face and ears periodically -- but didn't offer any solution for that. Yet. Then near the end said that while the blood was at the lab that they could do a heartworm test, but that I had to let them know by the end of the day.

    There's no mosquitoes where I live; never seen one here in over 4 decades, certainly never been bitten by one, but I did a bit of quick research before calling back to decline the heartworm test. I figured since the tech didn't mention anything about basophils, I didn't need to worry about heartworm.

    Then I picked up the physical copy of his labs today... And I don't know if I made the wrong call for Sammi :( I've got all of the new labs entered in his SS, if anyone could take a look? @Marje and Gracie If you have the time to look, do you see anything concerning?

    I just can't help but be worried; his WBC differential doesn't seem quite right to me, but I am a worry-wart.
    There's also an ugly triglyceride number :facepalm: I have no idea where that came from. I'm... just going to ignore that one. Yep.
  5. Sharon14

    Sharon14 Well-Known Member

    Aug 16, 2015
    I hope all is well with Sam and his bloodwork.:bighug: He’s a beautiful cat!

    Oh and I want to know where one has to live to have no mosquitoes or fleas! I have mosquitoes, fleas, fire ants, horseflies, deer flies, gnats.....pretty much anything that sucks blood or Injects venom. :confused::arghh:
    Sam & Esse likes this.
  6. Marje and Gracie

    Marje and Gracie Well-Known Member

    May 30, 2010
    Here’s a quick assessment.
    Albumin: can be high from dehydration
    Triglycerides: can be high if he’s eaten recently. Usually an accurate triglyceride must follow at least a six hour fast.
    Monocytes: can be high due to stress from a vet trip and his are very mildly elevated.
    Lymphocytes: his are just barely low but definitely different than before. has he had any steroids recently?
    Eosinophils: so, yes, parasites but also allergies can raise this. Allergies to food or pollen, also asthma, etc can raise this. Other things as well such as IBD or mast cell tumors but it’s unlikely. A recent study (2018) done by the Winn Feline Foundation indicated the most common causes of increased eosinophils are (in this order): Internal or external parasites, feline allergic dermatitis, feline asthma, and eosinophilic gastrointestinal disease.

    My own cats have had elevated eosinophils and neither my vet nor I get too concerned about it because they are entirely indoor cats, we don’t have any fleas or mosquitos around here, and usually when we see it is in the springtime when there’s a bunch of stuff floating around and we have the windows and doors open.
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  7. Sam & Esse

    Sam & Esse Member

    Oct 18, 2017
    @Marje and Gracie Thank you so much! :bighug: This relieves much of my worry, and gives me a better idea of what to discuss with Sam's vet this next Tuesday. He does get supervised play outside, so I'll go ahead with the fecal test just in case, but he's in a middle of one of his bouts of getting little bumps/sores on his face, and the vet did write it down in her notes as allergic dermatitis. The only steroid he's ever gotten is in the topical Tresaderm; I last gave it to him at the end of February, then tossed the bottle because it was affecting his numbers more than I was comfortable with. I think I'll try my best to find out what he's allergic to, rule out intestinal parasites with the fecal exam, and then get a mini panel ran in... maybe six months?

    There is a note in the lab report that 'Albumin may be lower than reported due to a Hemolysis 2+, Lipemia 1+ but is still Abnormal.' But if it is a little lower, than it is probably about the same as his previous tests.

    Thank you again! Have a fantastic weekend and holiday!

    @Sharon14 :joyful: I hope so too; Marje explaining what the results might mean has me feeling much more positive now. :bighug: And one of Sam's nicknames is Mr. Handsome Pants lol! He's too funny, right after he gets brushed and he knows he's looking good ;) It's adorable, his catwalk strut.

    :eek: Yikes! I'm in the high desert, and I think there's just too little humidity for most of the year for the mosquitoes and fleas. Twelve or so years ago a neighbor did bring in poultry fleas, which were horrible. But after about a month and a half, they disappeared. The only critter I really worry about is rattlesnakes, but it's been years since I've seen one of those on the block, either. Well, and a tick still shows up occasionally. I'm not sure who drags them in; I always blame whichever neighbor has most recently gone camping :p
  8. Marje and Gracie

    Marje and Gracie Well-Known Member

    May 30, 2010
    You’re welcome!

    It’s not unusual for samples to be hemolyzed or have lipemia but it can affect some values. I wouldn’t worry about the albumin.

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