Where to start? Maybe me asking for help?

Hi my fellow Lev using friends!

I guess it's been a while since i've been here as all of a sudden i was asked to log back on and was even asked to decipher a captcha - yikes! Where did my settings go and how do i find them again?

Ever since Molly's stay at Catspa, her numbers have been dropping thus her dose decreasing. There have been some different variables attributing... shot time and feeding times were systematically moved to 8 and 8 (8am and 8pm) for the staff at Catspa. I'm assuming she didn't eat as much there and that would attribute to her lower numbers (testing was not done at Catspa).

Once home, shot times continued(s) at 8 and 8 but feeding times changed (please stay with me here, i'm really trying to figure this all out). Here is her day:

6am - everyone is fed lc ff wet food
8am - Molly receives insulin (there is plenty of food left over from the 6am feeding)
5pm - everyone is fed lc ff wet food
8pm - Molly receives insulin (there is food left over from 5 pm feeding).
9pm - everyone splits one lc Friskies can

Now i know i shouldn't be feeding and then shooting 2 hours later but there is food left over and her numbers have never been better.

What is confusing me is that the longer we go (timewise), the lower her numbers are. Almost like her little (okay fat, she's way over weight!) body does better with more time in-between. Tonight for example - she was 165 at +9 and yet at +13 she was 58 (one hour late).

Is there any way she's struggling to keep up with the insulin? Sounds odd i know but again, it seems like the longer I wait between shots, the lower her number is. Is that possible?

Would you mind looking at her ss? I shot .5 on her bg of 58 tonight. That's one hour later than it should have been (she was 165 @ +9).

Thanks you guys, I really appreciate you all being here for me and the Moll-ster.

 

Hope all goes well with Molly Angels coming to keep an eye on things...Prayers and green healing light to help So wish I could help more Kath

 

Since it's summer and you're not working, I assume that 2 things have changed - her shot times are more regular than they seemed to be earlier this spring and that YOU have been giving ALL her shots, not interchanging with hubby.

Am I right? What do I win?

Those 2 things would be your answers. I hope it's that simple. I can't stay to post more explanation, but Lev is very particular about those 2 things - regular shot times and regular dose and I still believe that since 2 different people give shots that her dose was not consistent previously.

Hope that helps.

 

Good thing i love you enough to tell you that you're wrong on both counts (don't worry, you still win a prize :smile: It's the damn book 'Girl with the Dragon Tattoo' that everyone keep raving about, i'm an avid reader and it sucks! I'll send it to you.). Seriously everyone, go get 'My Name is Memory' - You will not be able to put it down!

W has been shooting in the mornings (he's been consistent with not only dose but also with timing) but her eve. shot has been kinda off as i am trying to learn to have a life and not be home at the exact time my fat girl needs a shot. That's the worst part, the part that makes me question everything...it's when i'm late that her numbers are lower (better). The longer i wait, the lower the number.

In general, I have learned that decreased time between shots is the same as or equals increased insulin (lower #'s).

Right now, Molly is doing better with increased amounts of time (more than +12) which in turn means less insulin. Boy this is making a lot of sense in my head, hope i communicated it effectively.

Off to test her before bed....

 

If you are waiting past +12 that is like a dose decrease, but if W shoots at the same time each morning (so he is "on time" and you are late) that cycle is like a dose increase. Are you shooting 11/13? Or 12/13/12/13 and getting later and later at EACH shot time? Sounds like it make be more like 11/13/11/13... right? If you are trying to stay with 8am/8pm.

She has been needing less insulin for a while now, not just since she was at Catspa. But maybe she did eat a little less there so her nadir was low, like 40 each cycle (perfectly safe) and her peak was not above 150-180. That was a week of that and it could have been enough to get her used to lower numbers AND for some beta cell healing to take place. I really think the healing takes place when the BG stays low and is mimicking non-diabetic numbers.

Right now, you have to go with the flow - Keep reducing each time she drops below 40-50 at nadir (you are testing for that, right?) and when you get to just barely any insulin (like .1u) set a do not shoot number and see if she can skip shots.

I hope you are getting spot checks tonight (or did, since it's already tomorrow). I would want to see how she handles insulin from the 58.

OK, I have to go to bed, I don't think that made any sense at all - sorry. I'll try again in the morning.

PS - maybe it's something in the air - Jeddie was 82 this morning! Is there a full moon coming on, maybe?

 

Thanks you guys! Of course Molly flew the other way today - all 300's. I'm sure she'll even out again. I'm convinced she just likes to keep me on my toes

Thanks again for your responses - i appreciate them.

 

Flying the other way - rebound, probably from shooting the .5 on the 58 even though it was an hour later. I think you have to be extra careful shooting on lower numbers here since she has been needing these dose reductions. Next time wait it out even longer if you can, without feeding (I know the Molly girl won't like that). Even just a half hour, see where she is at then. The fact that she was still at 58 an hour after shot time says a lot also since she was 165 just three hours earlier! I think you were expecting her to climb but she wasn't ready, so rebound city.

Why is she suddenly needing lower doses? I agree with Sheila that maybe her pancreas has had time to heal somewhat with her recent lower numbers being at the spa and eating less and all.

I hope it keeps up! Good for Molly!

ETA- I wonder, did she lose weight at the catspa? We have been saying for sometime that maybe the Molly girl's numbers may get better if she lost weight. Just a thought. This would of course help with her insulin resistance.

 

Ah, I see you started a new cart a few days ago. I wonder if it is a tad more potent that the old one? I always reduce the dose for a few cycles just in case.

I agree with Pamela that the higher numbers today are most likely rebound. And she probably will settle back down. Now the trick will be to catch her on the downward swing and maybe reduce the dose to a fat .5u. I'd say to try that as soon as she has a PS back in her normal range (low 100s).

 

Re: Where to start? "raiding the piggy bank"?

Hi everyone!

Remember my favorite analogy, the "ocean tanker"? You know, how you give a shot and deceptively, there is no change, and then you adjust the dose to invoke the numbers you think the cat "should" be showing and end up giving too much? Well, this is not that, but related.

I haven't been posting, but I've kind of kept up (Tom's beginning to pee more, and I'm worried, too). Anyway, to the point: I do think there is another set of misleading readings when the doseage is decreased too soon. -- The data suggests that many cats can detect the amount of insulin they are getting from the outside (reason for holding dose is to let the kitty can develop a baseline expectation, build the shed, etc.) and, once the cat's systems "perceive" that less is being injected, the cat is able, within limits of the recovering pancreas, to adjust its response and provide some low numbers -- for a while. But this is tantamount to the bean "raiding the piggy bank," and these low numbers are in fact misleading. Read Molly's spreadsheet with this in mind, and you might be surprised at the pattern.

I hope I won't get clobbered for saying this, but "someone has to," so .... a bg in the 100-130 range, after 300s or higher, is not, by itself ever a reason to reduce the dose. Nor is a reading in the 50s evidence that the reduction was the right thing. Quite the contrary, there is plenty of evidence that if you reduce the dose when you get lower readings after periods of 300s and 200s, you may be sabotaging success. Why? Exactly when the insulin is just beginning to work, allowing the cat to heal, you yank the carpet out, and ask the cat to steadily produce more on its own. In some cases it can. In many, it is not ready.

I am not a big fan or "rules,nothing but rules," but when I read, "I lowered the dose and the blood glucose went down!" I'm sorry, but I just want to tear my hair out. Well of course bg goes down if you have a cat that has, due to getting insulin, been able to reconstruct the pancreas at all. The cat is smart enough to detect that it is getting less insulin from us, and it makes up the shortfall. (Yes, there are exceptions, but they prove the rule in my opinion.) This is not to say "spontaneous remissions" can't happen, either, only that we can't count on such miracles. So often, if the dose is kept abruptly low, the hope and strategy are shattered within days or weeks, as the brave kitty's abilities are exhausted. (Lesson: A cat can lower its own bg in response to a lowered dose, the numbers are real, but therapeutically it is a fake. It is an inverted Somogyi effect -- and it can be prevented, as it is very harmful. It has not been adequately studied, but if you read the spreadsheets, you can see it over and over again. )

My three cents. =)

 

Very astute observation. Makes sense to me.

 

Interesting observation/theory, Ilkka. It is so hard to judge exactly how much support a sputtering pancreas needs and for how long.

And good to see you posting a bit, but sorry that Tom is seeming to be slipping. I am assuming you have checked the basics like teeth, UTI, etc.? How about hyperthyroid? Remember when Beau's thyroid issues were messing with his numbers? Or vice versa, maybe.

 

:::::I am not a big fan or "rules,nothing but rules," but when I read, "I lowered the dose and the blood glucose went down!" I'm sorry, but I just want to tear my hair out. Well of course bg goes down if you have a cat that has, due to getting insulin, been able to reconstruct the pancreas at all. The cat is smart enough to detect that it is getting less insulin from us, and it makes up the shortfall. (Yes, there are exceptions, but they prove the rule in my opinion.) This is not to say "spontaneous remissions" can't happen, either, only that we can't count on such miracles. So often, if the dose is kept abruptly low, the hope and strategy are shattered within days or weeks, as the brave kitty's abilities are exhausted. (Lesson: A cat can lower its own bg in response to a lowered dose, the numbers are real, but therapeutically it is a fake. It is an inverted Somogyi effect -- and it can be prevented, as it is very harmful. It has not been adequately studied, but if you read the spreadsheets, you can see it over and over again. )

I love reading comments like this because it pushes us to think and think and think. The people on this site achieve remission because they are like a dog with a bone. We are passionate types. I read this comment yesterday and decided to reply this morning. I asked for advice about decreases (plural) on the Lantus site. I dropped several doses in two weeks. I was very worried as it wasn't in the protocol. But fingers crossed it's working. I'm feeding my formally gutz cat very small meals of 80% no fat. I'm watching him carefully and he's riding with the decreases but I see no more decreases on the horizon. I think if there are to be exceptions to the rule the carer has to be vigilant, always around to feed and test and stingy with the meal servings.

 

I have the great fortune to "parent" a cat that doesn't follow the rules. Beau never follows the rules. I tried to force the protocol rules on him and he resisted. But I kept trying. I will always wonder how much sooner he would have gone into remission if I hadn't been trying so heard.

Yes, most of us our passionate, but I think "rules" are just a starting guideline. As owners we do have to think and think and think - and interpret, interpret, interpret. We all should be vigilant all the time anyway. We can't blindly follow rules and not watch for the results.

I do have to comment that I think it is a poor idea to use less food to balance blood sugar. Each cat needs a certain amount of calories (depending mostly on their weight) and insulin needs to be given to deal with that amount of food. Maybe you didn't mean to imply that food be withheld by saying be stingy with feedings. They need what they need. Although a lot of pet owners overfeed - until they end up with diabetics. Also, dietary fat isn't the issue (unless maybe you have a cat prone to pancreatitis). It's carbs that are the issue. Carbs are what cause increased blood sugar, increased insulin release (or exogenous needs) and storage of sugars as fat - not fat itself per say.

 

:::I do have to comment that I think it is a poor idea to use less food to balance blood sugar. Each cat needs a certain amount of calories (depending mostly on their weight) and insulin needs to be given to deal with that amount of food. Maybe you didn't mean to imply that food be withheld by saying be stingy with feedings. They need what they need.

ECID but I am now able to be "stingy" with the food because LB is allowing me to feed him less - he seems contented on less (small meals often). Even so he's gained weight since his last check up. :sad: Vet ok with it but I was perplexed. He's just over 20lbs (9.2 kilo's). He was 8.5kilos at dx in early June. He's got a huge frame - his ideal weight would be 19lbs.


:::: Also, dietary fat isn't the issue (unless maybe you have a cat prone to pancreatitis). It's carbs that are the issue. Carbs are what cause increased blood sugar, increased insulin release (or exogenous needs) and storage of sugars as fat - not fat itself per say.

I asked the vet this question because of LB's situation. LB appears to be allergic to beef. In OZ it's hard to get tinned food that doesn't have meat product in it. I buy him fresh, free range chicken breast and fresh fish from the market. He has one tin of FF (tuna or turkey) divided into two portions per day but he's still biting his fur off when he eats it. I changed to fresh beef, liver, kidney and kangaroo meat before he was diagnosed with diabetes. I suspected he had diabetes so googled what to do. His itching became a problem on the new diabetic diet. He was getting quite distressed with licking, biting and scratching. Whilst on these foods his numbers remained uneventful.

His pancreas is probably healing but he's a lot better since stopping red meat. The switch to fresh chicken breast and fish has seen us move down the insulin amount from 4.25 (12 August) to 1.00 (4th November). Coincidentally it is a low fat diet (coz I can't find him anything else he will eat/tolerate without meat listed in it). So he's low carbs and low fat. This is why I asked the vet - I know that it's carbs that are meant to be the problem. But I found it interesting how quickly LB's numbers have dropped since he's eating 80% fresh fish/chicken and how contented LB is on these foods - not always wailing for food the way he used to.

My Vet said it was an interesting question. He has never had a cat go in to remission from FD. He treated us with skepticism back in June - now he treats us with great respect and is willing to think about our observations and he even asked me to send him info on Metacam after I took it home (for LB's itching) and then emailed him that I wouldn't be using it after what I read on FDMB.

 

Is LB a Maine Coon cat? Just asking because of his size - and his photo. There seem to be a lot of MC cats here... Jeddie is part MC and Vicky's Gandalf is a MC. I wonder about the genetic predisposition to FD (if there is one)?

Have you read the information on raw food diets? It here: http://www.catinfo.org/?link=makingcatfood There is a ton of info there about how diets help/hurt feline health including the itchiness you describe.

I wonder if LB has a food sensitivity, or some sort of allergy. Does the FF have gravy? I'm not sure what "flavors" of FF you can get where you are, but the gravy ones have wheat gluten in them and many cats don't tolerate it well. I would think that low fat might cause dryness in the skin/fur and make the problem worse? Jeddie seems to be very sensitive to flea bites (I took them on vacation this summer and the place we stayed gave them fleas so we have been battling that since Aug).

I add water to my cats canned food to make sure they have enough moisture. You can also add salmon oil to his diet to help with dry skin.

There is someone on FDMB that has dealt with every possible health issue (I am pretty sure), so if you wanted help with the skin/itchiness issue I would suggest posting on the health forum and say where you are located and what food you have available to you. Someone is bound to have better suggestions than me since I haven't really dealt with it.

 

thanks for dietary advice/URL. I've started reading. I was really ready to address this issue. He was scratching up a storm tonight - I noticed his skin is quite flakey. Definitely needs fish oil added to his diet. Bought flax seed oil but he wouldn't eat it. GAve him Krill but it upset his tummy. But I am on to it now. He's quite low in energy - which is not such a bad thing as he crosses the road when he's feeling good. :twisted: Thanx again.