Week of 1/23/17: cliff notes

amps=441
5.25

Will be increasing tonight. Hope everyone has a great week!

 

Here's hoping that increase helps!

 

Hi Michele,

Cliff might well be stuck in high numbers in which case the steady increases should get you somewhere eventually. Another thing to consider is whether he might be a kitty with a high dose condition like acromegaly or IAA (insulin autoantibodies). There are tests for these things and his FD is still treatable but he'll need significantly higher doses than an average FD kitty. I'm not mentioning this to worry you, only to give you something to consider. You could post on the main health forum to ask about this.

 

I hope I didn't upset you by mentioning high dose conditions, Michele. I have no idea whether it applies to Cliff, just putting it out there.

 

It's definitely worth checking out. There are some links in the high dose forum I believe and you could just see if any of those apply to Cliff.

 

How are you doing, Michele?

 

Oh my! I've been on the board but never got notifications abt my thread and I missed these messages. I don't usually "check" on my own thread when commenting each day.

I've been busy at work. This week and next week are busy times since I work at a university and spring classes start soon. I appreciate the info abt IAA. I probably won't have time to research that until the weekend. Was planning to check in with the vet soon too, abt higher doses and what that means for Cliff.

He seems really good though (despite high #s). Pretty active, happy, hanging out. Eating good. Litter box good. Been doing blood ketones test and got a urine one. All good. Just keeping on right now, bc that's all I can do with work being busy. And Cliff being Cliffy.

 

A quick Sunday pm checkin-

Full disclosure, it's been hard keeping up with everything the past couple weeks. Work is its busiest right now, and we are short staffed. I have my own health issues, which have not been great. On top of that, I've been feeling a bit anxious/depressed. I'm sure my worries about Cliff (& work) are contributing to that, so I'm trying to relax and take care of myself. Cliff still gets lots of attn from me and the Hubs, he is still our #1 focus, trying to get him well, or #s lower, at least. I'm just not posting as much when there's nothing to report (#s still high.) but I try to look at this forum at least, once a day.

The plan is to keep increasing (we gave 6units tonight) and monitoring. Ketones are good, he gets almost daily ketone blood checks and the urine test when we can. He seems fine behaviorally and physically. Work is gonna be busy this week, but after this week, I plan to check in with the vet with an update (it's been abt a month since we touched base) and to discuss next steps. I haven't done a curve in a while, but there's been nothing to curve. I might switch up his food on the weekend (go back to what he was eating in December.)

Hope everyone is doing well! I can't believe it's almost February. We're coming up on 3months since Cliff's diagnosis, so I have to keep reminding myself of that. It's still early days.

 

He is certainly unique, and difficult. He just isn't coming down at all, regardless of dose. Have you looked at the symptoms of high dose conditions? We start looking at those once they get above 5 units. Although the forum is not active and some of the links don't work, there is some info here:

http://www.felinediabetes.com/FDMB/...-other-high-dose-conditions-what-we-know.375/

I think I might consider a different insulin. If he turns out to need high doses, Levemir is the favored one as it is said to sting less at higher doses. @Sharon14 can you chime in?

I can't remember. What does he eat?

 

Figuring out food was tricky for the first two months because both cats couldn't agree to eat the same thing. Right before Christmas they were on nature's variety-beef/chicken/duck. However, when cliff's appetite dropped right after Christmas, i tried friskies classics out of desperation. They both love it and tolerate it well. I've been feeding 3-4 varieties that were listed under 10% on Dr Lisa 's food chart. I even contacted friskies to ask them to verfiy carb counts. However, he's been high all the past month while on the friskies so i want to test going back to NV (but also worry abt switching them off a food they both like.)

This can be so stressful sometimes!

 

My suggestion for you is to take a night for yourself and the hubs. Go out to dinner or to see friends...I think you need a little break to help break the stress...it's what I have to do sometimes.

 

My cat will spike 100 or more points when I feed Friskies, so it's good that you want to switch. You may want to consider Fancy Feast or Sheba pates, they are low carb and a good bit cheaper than NV, and most cats love them.
As far as high dose conditions, Colin was only tested for acro, and though he showed no outward signs, he was definitely positive. The switch to Levemir was made and we got up to 17u BID. We are now on 7uBID, so it appears he may have had IAA as well, so if you choose to have Cliff tested, I recommend you test for both conditions. If you'd like I can tag Wendy who is the resident high dose guru from the Lantus and Levemir forum. She can give you lots more info than I can.

 

FF gave stella (civvie) runny poops..never tried sheba pates. It wasn't on my vet's short list (which I've compared to the longer list here.)

I won't have much time to research anything this week, but if anyone wants to chime in-i will definitely read/take a look when i can! Thx.

 

Thanks, All! I read a few of the links. As I said, I don't really have time for the vet this week, or money for more tests right now (still paying off last month's tests) and I just got a new bottle of ProZinc, so I want to keep going with Prozinc for at least this bottle.

Definitely willing to try switching foods, either back to NV or try Sheba pates. I wish I kept a list here of what we tried that didn't work, but short list of foods that didn't work: DM (wouldn't eat), ProPlan (stopped eating), FF (upset tummy for civvie), Wellness (Cliff was picky, Stella threw up some flavors), wild calling (picky, stopped eating.) we tried at least 7 OTC from a list my vet gave us, and I bought tons of different brands from petco. I have a tablet full of notes.

Anyways, I didn't see Sheba in any LC lists. Anyone got flavor reco's? Cliff needs GF too.

I'm also thinking of switching the relion prime meter to save money. Keeping AT for curves.

Ok, done for tonight.

 

So maybe you try some different foods, keep going with the Prozinc for now. If, as you near the end of this bottle, we're still not breaking through, start looking into Lantus/Levemir and getting tested for high dose conditions. I'm not sure about the Sheba food...but you might post on Health and ask for some food/flavor recs.

 

From the info I received from Sheba, the pates are all about 2.7 carbs
Any food change you do should be done slowly.

 

Thanks for the reminder about going slow. I'm thinking of introducing a new food at lunch or dinner only for the next few days.

 

Cliff's #s a little lower today... Pinks vs reds. I gave them the nature's variety for lunch. I think I will continue to replace lunch with NV, and maybe work some Sheba in soon. Bought that tonight. Husband is on board with food switch and meter switch. Just gotta make my way to Walmart to pick up relion meter and strips.

 

Pink is better than red for sure.

 

Pinks all day yesterday, with the exception of one 400. But that came at pm +3 and I believe I stressed him out bc I dropped the meter. Skittish Cliff went into hiding under couch and was hissing and everything.

However, he came out on his own within 5min and I tested. Just think he would've been a all pinks if it wasn't for that!

Pulled 6.25 for Dave to give later at pm shot. I feel like we might be moving towards a breakthrough. I am willing to keep at this through the weekend. They got their first Sheba pate last night and loved it. Just gotta watch boxes now.

Happy February and happy Wednesday!!

 

Hurray for pink!!! I sure hope you're cracking his code finally.

 

Busy week, and then I got hit by the flu! Made it through the whole week of work, got home and was immediately down for the count. Just starting to feel better. Made and ate some soup.

Cliff had a low (for him) amps=282
He then had a high today at +10 =519

Been working in the Sheba and natures variety while weening them off friskies. (Just a test, friskies was popular, but Cliff's #s were high/stuck.)

That's it for an update.

 

Nice yellow! And three cheers for soup when you're sick ...

 

Thanks! Soup was yummy-carrot ginger shiitake. I used an immersion blender for the first time. Very exciting. And now I have leftovers in the fridge and freezer.
I miss you guys though, and hope to be back online more soon!

 

OMG your soup sounds delish! I make a very simple but wonderful butternut squash soup that I smooth out with my immersion blender after it's cooked.

 

Woot! Woot! Look at those yellows !!

 

Yay! I'm happy but confused. He's been in yellow for amps past two days, but then he goes up? I'm going to test him around +10 today.

I understand the higher # at +3 because of food, but I was looking for more of a curve throughout. Oh well, I'm happy his #s are trending down... He actually played with a toy this am after I got that yellow. He was crying (or more meeping, as I call it, for attn) and woke us up, so I tested. I had a talk with him and explained this is how the insulin is supposed to work! So if he's feeling funny, not to worry, he's supposed to feel better!

 

Amps=281
+3=371
+6=381

 

Beautiful amps but definitely bouncing. Hang in there and feel better!

 

Sometimes Cliff cries/meeps to get our attn in the am, right before shot time. Today, it was +11 so I tested and was gonna shoot but he was 248.

I'm a little confused by the lower #s pre-shot in the AM lately, when he doesn't seem to be getting in to the 200s at all during the rest of the 12-HR cycle. Waiting until +12 to test again. Gonna keep at 6.5u today...

 

Amps=260
Ate good, gave 6.5u
Will check at +4 and should be home for lunch at +7.5

 

+2 415

 

Kind of looks like the insulin lasts a long time at night. That does happen, though I don't have any good reason for it. Some kitties have lower or longer cycles at day or nighttime and Cliff seems to be one lately.

 

I like those yellows that are starting to creep in - good sign.

 

It's odd, but I'll take the yellows. The only thing that's been different that I can think of is that my Husband has taken over the PM shot. Perhaps he's shooting him in a different location? He mentioned having his own technique that works for him.

 

Maybe doublecheck. Could you be pulling up different amounts? A different shot spot can make a difference in some cats too.

 

Since I'm not really seeing a "curve" in the middle of the day, should I keep bumping up the units? He's due for a bump tomorrow to 6.75. At this point, do I keep doing 0.25

So, I actually pull the syringe for Dave to shoot when I'm home during lunch. So, I know he's getting the right amount. I roll the bottle before pulling and Dave rolls the syringe before shooting. But that is a good thing to check!

Since I'm not really seeing a "curve" in the middle of the day, should I keep bumping up the units? He's due for a bump tomorrow to 6.75. At this point, do I keep doing 0.25 increases? Anyone who wants to chime in!

 

Yes, bump up to 6.75 u. If they'be been high a long time their response to insulin is blunted so you might not see a typical curve until he's in lower numbers and more sensitive.

 

Thank you for the reply! It makes me feel better to have the feedback.

 

Any time, Michele!

 

He woke me up at +9, & my personal rule is-if he wakes me up, I test.
+9=241

I keep telling him, "this is what the insulin is supposed to do! And these #s in the 200s may feel funny (after months being high), but you are supposed to feel better in lower #s, don't fight it!"

 

+11=207

He seems really mad at me that I won't feed/shoot him! He is such an old man/grumpy kitty sometimes. Keep telling him--200's are good! I'll check again in an hour.

 

+12 was 241
So I stalled for 20min and got 275 for amps

Both ate well, 6.75u (increase over yesterday)

Will get a test before I go out the door +3, and again around lunch +7.

 

Keep us posted! Those yellows are awfully nice.

 

+2.5 is 412

 

Food spike and/or bounce. Hurray for those yellows! You might be punching through that glass floor finally!

 

oh my goodness, I hope we are breaking through to some yellows and blues! that would make our whole house happy.

I really, truly believe (and I've almost been nervous to type this up) that Cliff fights the insulin because he doesn't know how to be happy. He's always been our skittish cat that doesn't sleep on furniture, or the comfortable cat beds. We always find him laying on the hard floor, or with his head leaning on on box. I just want him to know that the insulin is suppose to make him feel better, and feeling better is good! I keep telling him this lately, for about the past week. So, I think I'm going to focus on sending this positive message to him about what the insulin is for, and what it is meant to do, and that it's OK to feel good/be happy!

 

I totally get what you mean, Michele. It's his way of being in the world. I've known people like this and they've made life much harder than needed for themselves - and it's hard enough as is!

 

Yep my Elektra does that sometimes. She's so skittish (and I mean like...we can't touch her skittish) and she makes life so hard! I often want to point out to her that she can be comfortable and sit with us and be happy.

 

Pm was nothing to write abt-reds/pinks.

Amps=307
Ate good, 6.75 u

 

Running away from those yellows - they feel like the abyss to him right now. Keep at it and don't stay at 6.75 u too long.

 

Hi Kris, I've been staying at each increase for 6x--would you recommend moving up sooner than that?

He was really cuddle-y last night, came and hung out with us. Climbed the stairs several times, and was jumping up on a spot that he likes to sit. All good things that he seems to do when he's feeling better. I've been testing ketones too (blood) but not posting about that. He's stayed low 0.1 was his last reading. I've been adding water to all his food for the past month.

 

Pmps=335
6.75u
+3.74 =441