? Yemala 10/17 AMPS 428; +4 255; +5 235; +8 219; +10 311; PMPS 409; +2 358; +4 237; +6 168

Discussion in 'Lantus / Levemir / Biosimilars' started by Hroswitha, Oct 17, 2018.

  1. Hroswitha

    Hroswitha Well-Known Member

    Joined:
    Apr 11, 2011
    http://www.felinediabetes.com/FDMB/...402-6-367-pmps-402-4-407.204966/#post-2272330

    I didn't see the recommendation that we pick up some +2 and +10/11 numbers to more closely watch onset on Mala. I have, though, gotten a +4, and may be able to do later numbers as well.

    Some days, I will be able to get early cycle numbers, some days I cannot. We'll start working on it.

    I'm reading through the threads linked in on bouncing and control measures. I have some questions about feeding.

    Mala does not ever eat anything that isn't low carb. We have some high carb food used to feed outdoor kitties, and she has only eaten that in emergencies. While I wouldn't say we free feed her, she is a frequent grazer.

    At established meal times, Mala will be presented with food and will eat usually half of what she's given. She nibbles, walks away, thinks about it, then returns and nibbles more. She's typically done in about 10 minutes, and we put the remainder away to give her later. Around 2 hours after the meal, she'll begin to demand food again. We give her the dish she didn't finish, and she works on it some more.

    This little dance will begin around +4 in a cycle until we cut her off. The last 2-3 hours of a cycle, before the meal and insulin, are loud, demanding, and insistent hours for her. I won't feed her after mid-point in a cycle, so by meal time, she thinks herself starving.

    I've been wondering if her feeding cycle might affect her bounces, or if its incidental as she eats very low carb food.

    Currently, she eats one of three things - Nature's Recipe grain free chicken in broth, Weruva Chicken Frick-a-zee, or boiled chicken pieces. She will NOT eat anything in gravy, and we keep her from tasting the food in dishes for other cats - although we control what they eat as well and nothing goes above medium carb food.
     
    Last edited: Oct 17, 2018
  2. Sue and Luci

    Sue and Luci Well-Known Member

    Joined:
    Nov 3, 2017
    You might try feeding her small meals more often - sometimes that helps to minimize their blood sugar spikes/drops...if she's demanding food in 2 hours, she probably needs a little something to tide her over. Diabetic cats are hungry! That's the nature of the beast. Her BG's are all over the place - so give it a shot - nothing to lose to try giving her a small amount more frequently... hope this helps :)
     
  3. Hroswitha

    Hroswitha Well-Known Member

    Joined:
    Apr 11, 2011
    Mala typically eats mini meals at +4, +5, +6 through about +8. I have not been feeding her late cycle, though she would love it if I did.

    If I understand the threads, more frequent testing at onset is necessary so we can see where she goes and how quickly she drops. Today she began at 428 and, at +4, she's at 255. I'll try to get a +5 and +6 to see where she goes mid-cycle.

    Part of our current frustration is that Mala is resisting the ear sticks. If she's already agitated and demanding food, messing with her ears just annoys her. If it gets too hard, I've had to set down the testing equipment and soothe the cat, let her know she's loved. A minute or two of snuggles helps. Then, with luck, I can get a good stick and be done.

    Look for more numbers coming. I can get them today, but not later in the cycle as I'm at work.
     
  4. Sue and Luci

    Sue and Luci Well-Known Member

    Joined:
    Nov 3, 2017
    Luci resisted every ear poke initially...and I see you had a break for several months - she will get used to it. Especially if every poke is associated with a treat...Luci always gets food and/or treats with each and every poke. I keep wondering if she'll ever fill up...but so far..not happened yet...Do you see how often I poke her? A whole lot...and she eats every time...she too would love it if I'd feed her during that last two hours before PMPS - so I always try to get a test and some food at about 2.5 or 3 hours from the PM test - she's just climbing the walls if I skip that feeding - because she's so hungry by dinner time...that girl will eat us out of house and home if I let her... :)
     
  5. Hroswitha

    Hroswitha Well-Known Member

    Joined:
    Apr 11, 2011
    Mala achieved remission twice. Once in 2006 after a month on insulin, she was off to the falls. She stayed there until her vet prescribed a steroid medication for an ear infection, despite knowing she was in remission.

    In 2011, it took a month again to get her back on track.

    This time, it was the CKD prescription food that made her fall out of remission. Same vet prescribed it, which means I'm done with him. I'm interviewing a new vet tomorrow, hope to get a CDC panel to check for anemia, get a urinalysis, and get blood pressure checked as well. If she's amenable to working with me on potassium supplements and phosphate binders, I'll keep her.

    Mala just got a stick and a few pieces of boiled chicken, which she appreciated. After, she gets snuggles and pets, which she also appreciates.

    I will try to get a +6, then feed a mini-meal again. No one will be here who can test and feed from roughly +8 to her PMPS test. Husband bean works until 7 usually, but is trying to be home no later than 5:45 to test/feed/shoot. I have to be at work until 8 PM, so that won't help.

    We're working on it.
     
    Last edited: Oct 17, 2018
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  6. Sue and Luci

    Sue and Luci Well-Known Member

    Joined:
    Nov 3, 2017
    I think you're doing fine :) We are all doing the best we can do - under these trying circumstances - :)
     
  7. Hroswitha

    Hroswitha Well-Known Member

    Joined:
    Apr 11, 2011
    The vet in question who gave her steroids - I told him at the visit that she was diabetic. In fact, when I mentioned it to his vet tech, she insisted that we do a blood draw to test her bgs. I refused - we had been doing monthly checks and she's always high at the vet's. So he KNEW she was potentially diabetic.

    The meds he gave her didn't state outright that it was steroidal. I (stupidly) trusted him, and cleared up her infection, only to see the signs of high blood sugars.

    This same vet thinks that phosphate binders are premature despite the numbers, that I can't feed a high protein food to her even though she's in EARLY stage 2 CKD, etc. He won't listen. So I'm done.
     
  8. Sue and Luci

    Sue and Luci Well-Known Member

    Joined:
    Nov 3, 2017
    I agree wholeheartedly with your decision! It's just such a shame that vets won't admit when they're in over their heads :(

    My vet told me last November that if Luci were his cat, he'd put her down'....and that was advice I wasn't willing to take. So I'm done with him too. I understand completely! There are hopefully many other vets out there that will listen -but I've found it pays to take their advice with a grain of salt - initially - until you can do some research - or get some opinions from this experienced group - amazing that a bunch of laypeople such as this group have managed to save the lives of so many kitties :) I like their track record much better than the vets...
     
  9. Hroswitha

    Hroswitha Well-Known Member

    Joined:
    Apr 11, 2011
    On +8, she's down to 219. Interesting. Don't know what it means, but it's interesting.

    Feeding some fresh boiled chicken now.
     
  10. Wendy&Neko

    Wendy&Neko Senior Member Moderator

    Joined:
    Feb 28, 2012
    I think Mala needs more juice. An occasional dip into green isn't what we are looking for.
     
  11. Hroswitha

    Hroswitha Well-Known Member

    Joined:
    Apr 11, 2011
    Should we bump her into 1 u starting tomorrow?
     
  12. Hroswitha

    Hroswitha Well-Known Member

    Joined:
    Apr 11, 2011
    I am interviewing a new vet tomorrow. I'm trying not to overload her with papers, links, data, but I will take in a printed copy of Mala's spreadsheet and some info printed off the stickies on this site and the basic stuff from Tanya's CKD site. I'm looking for potassium supplements, phosphate binders, and support in continuing the Lantus for now.

    We will increase her dose to 1 u tomorrow and monitor as closely as schedules allow. No one will be at home with her from roughly 11 AM to 4:30, though Davey bean may show up between noon and two. He'll try to get some mid-cycle testing done.

    It's not perfect, but neither are we.
     
  13. Hroswitha

    Hroswitha Well-Known Member

    Joined:
    Apr 11, 2011
    Since her PMPS, Mala has dropped roughly 300 in her bgs.

    We're trying to test more, to get a better sense of how the insulin works in her body and how food affects her.

    A note on how we're feeding:

    Mala is presented with meals at 6 AM and 6 PM, then given a dose of insulin while she eats. She dives into the food and eats roughly half of what she's given.

    She will demand more food within an hour, and she'll nibble more of her breakfast at that point. She will get her dish again around +4 and +5, and when she's finished, she'll get small amounts of boiled chicken.

    Rinse and repeat for the PM cycle, if anyone is at home to look after her monstrous appetite.

    I've looked at the recommendations regarding using food to regulate BGs, but I don't know how what we're doing could be tailored to help her control those numbers. I need advice on this.

    None of her food is even medium carbs. Mala will not eat anything with gravy, and she detests Fancy Feast everything. We have to keep her off any food with a higher phos level, and she won't eat kibble at all.

    Anything that could help us would be appreciated.
     
  14. Wendy&Neko

    Wendy&Neko Senior Member Moderator

    Joined:
    Feb 28, 2012
    Good luck with the increase, and the potential new vet interview.

    Regarding food, I think you are mostly there now. However, there might be some fine tuning to try to prevent big drops, or at least slow them down. Large drops can also cause bounces. See how she dropped over 100 points from +2 to +4 tonight? For some cats, a drop over 50 points an hour will cause a bounce. ECID of course. If you could find when she's doing that big drop, maybe feed some LC 1/2 hour or so before hand, so she has fresh carbs on board when the insulin is really dropping her. It'll be an experiment. Maybe try moving that +4 feed to +3 and see if that helps level her out? Food experiments mean trying something for a week or so. You may not see results right away.
     
  15. Hroswitha

    Hroswitha Well-Known Member

    Joined:
    Apr 11, 2011
    We can start working on it. There are days when it will be more possible than others, but I'm willing to enlist the aid of husband and son beans to chip in.

    So we'll start recording when she eats and where her glucose is at that point. I worry about the massive drops she's doing and have wondered if we can tweak her feeding routine to level that out.

    Thanks for the input. I'll start to report in the posts on feeding schedules to help me keep track.
     
  16. Wendy&Neko

    Wendy&Neko Senior Member Moderator

    Joined:
    Feb 28, 2012
    Some people put a * in the SS cell where kitty gets fed. Gives you a visual that might help figure out patterns/effects.
     

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