11 Aug | Girlie | AMPS 709; +2=724; +4=713 Sigh...

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Girlie's mom

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Condo: http://www.felinediabetes.com/FDMB/...2-545-4-470-colitis-gone.182011/#post-2017691

Well, it looks like 9 August's "colitis" (or whatever it was) episode is having repercussions, as Girlie's back in black again. Would one day of being unwell that way be enough to send her back to black? (I've told Girlie to stop channeling Amy Winehouse...)

I've put her on predictably low carb foods (Fancy Feast pate's that are under 5%) as I know her tummy won't object and I know these are very low carb. I'm assuming that when she's bouncing like this that there's no point in trying to see whether it's a reaction to these low, low carb foods or whether I should even try a higher carb food (though under 10%)?

I'm thinking of the interesting post I read from @manxcat419 re: Carb sensitivity - thoughts:
"It is possible to get an idea of a cat's actual carb sensitivity level. But that can't be done by trying to pin down an exact carb % in food and whether or not it changed the numbers by a tiny amount in a day. Not unless you're going to analyze every single can of food you open before you feed it. A more accurate way to tell whether or not a cat is overly sensitive to carbs is to see what their reaction is to being given a food that we know is high in carbs...a situation that arises for all of us sooner or later when kitty drops a little too low. If you are able to get those numbers back up safely and effectively every time with very few carbs, or even by giving a regular low carb food, then kitty is likely more carb sensitive. If you find you are having to give large amounts of high carb food, or even high carb food + simple sugars every single time, then kitty is actually not all that carb sensitive at all."

And this one: Low carb vs lower carb

@Wendy&Neko also mentioned something about Girlie on 4 Aug re: LC not seeming to do the trick with slowing her drop: "Cats are different in how carb sensitive they are. For some cats, regular LC will slow the drop. Others need a higher (may 8-9%) LC, others need MC or HC. You need to experiment to see what works for Girlie. Regular LC is not doing the job. And slowing the drop is an excellent idea. Fast drops often cause worse bounces than going low."

Any thoughts?

Good news: still no ketones :)
 
I'm sorry Girlie's not feeling great. When Maverick was first Dx, I tried to get a better understanding of diabetes in general, and you raise some interesting questions. Not knowing anything about diabetes in people, nor diabetes in cats, I guess I wonder if things like glycemic index affect them in a similar way? Sorry, just some general thoughts, I wish I knew more, maybe not much help I guess to analyze and troubleshoot what's happening with Girlie, but I sure hope you can get her back down to more comfortable levels soon.
 
I'm sorry Girlie's not feeling great. When Maverick was first Dx, I tried to get a better understanding of diabetes in general, and you raise some interesting questions. Not knowing anything about diabetes in people, nor diabetes in cats, I guess I wonder if things like glycemic index affect them in a similar way? Sorry, just some general thoughts, I wish I knew more, maybe not much help I guess to analyze and troubleshoot what's happening with Girlie, but I sure hope you can get her back down to more comfortable levels soon.
Hi Christie,
Thanks so much for replying. She's better today after the episode two days ago, thank goodness! I guess what I really need is a week or so of no dramas with her where she's not bouncing so I can see how things affect her. It's just been a bit of a roller coaster ride since the beginning. But I guess all of our kitties are like that, eh?

I hope she gets out of the black soon, too. I'm happy that there have never been ketones in her urine, but if she keeps visiting the dark side, that day might come, unfortunately... I'm keeping positive, though! :)
 
Hi Christie,
Thanks so much for replying. She's better today after the episode two days ago, thank goodness! I guess what I really need is a week or so of no dramas with her where she's not bouncing so I can see how things affect her. It's just been a bit of a roller coaster ride since the beginning. But I guess all of our kitties are like that, eh?

I hope she gets out of the black soon, too. I'm happy that there have never been ketones in her urine, but if she keeps visiting the dark side, that day might come, unfortunately... I'm keeping positive, though! :)

I've checked in on your posts a few times because Mav's hit a lot of PS blacks too, especially in the a.m., and is quite good at bouncing! No ketones for Girlie is wonderful, and your spreadsheet has some good results, if I knew more I might understand some pattern hidden there! I hope the weekend is drama-free for you both, you need a break from the roller coaster :bighug::bighug:
 
I've checked in on your posts a few times because Mav's hit a lot of PS blacks too, especially in the a.m., and is quite good at bouncing! No ketones for Girlie is wonderful, and your spreadsheet has some good results, if I knew more I might understand some pattern hidden there! I hope the weekend is drama-free for you both, you need a break from the roller coaster :bighug::bighug:
Hugs back to you! :bighug: I see you've just joined and that you're using the AlphaTrak as well. I was SO SCARED when I started doing BG tests, until I realised that Girlie just slept through them and didn't even notice. The only thing she seems to really mind if she's awake and I test her is that I'm playing with her ears. I think she's wondering why I feel compelled to play with her ears every two hours... They do get a wee bit sore (especially with the number of tests I do), so I make sure to put a tiny dab of Neosporin pain-relieving ointment on them after I do a test; that seems to help a bit.

How are you coping with everything? I'd be happy if I had Maverick's chart: at least I'd see some consistency. Girlie is just too multi-coloured at times... I found this whole thing terrifying initially. How are you coping?
 
Lol, the first blood tests were...interesting. Mav has black ear tips. I have learned SO much...1) put my glasses on to see blood drop on black fur, no need to poke again 2) place lancet against ear, not 3 inches away (scared to hurt him, but likely wasn't poking anything at all at that distance :confused:) . Girlie sleeping through is a bonus for you I think! They do probably wonder why all of a sudden their ears are so interesting! It's the same with tenting the skin, I'll just randomly pull his fur up, just so he gets used to it. I'll keep the neosporin pain-relieving ointment in mind, for sure!

It was terrifying at first, mostly because I didn't know anything. I'm a big need-to-know what I'm facing, so I can face it head on, so I read as much as I could. Honestly, it's strange, when you get more familiar with things, it gets better. And I did things in bite sized pieces. Read up on food, carbs, dry vs. Wet, etc. Then tackled insulin, dosing, how to, etc. Then tackled testing. There's still more to understand but I feel a lot better than I did a week ago!

I just do one day at a time, and hope that tomorrow is better than today :D, that's what we do when we love them, just get them hopefully to a better place than they were yesterday. And when I need to think and process, I take my dog for a walk, it works wonders.

I wish I understood the reason for the multi-colors you have with Girlie. Does your vet have any thoughts on what's going on?
 
Wow. I just looked at your SS for 15 minutes.
It looks like after the last two blues she bounced for 7 cycles. Started clearing it in the 7th then hit blue again in the 8th. If this is a real pattern you might see the bounce break in the pm cycle tonight. Then maybe another blue in the AM cycle on 8/12.
I wondered if you tried steering her drops and tried to let the nadir be around 50%?
To go from 600-700 to <200 is a big drop. Ecid of course but when Chuck drops a large amount he will bounce every time.
I wonder if you could keep her nadir to around 50% if that would calm the bounce then maybe her next preshot wouldn't be so high? And the next after that...
It's hard to predict. I swear, Chuck had to get use to being in better numbers. He was red and black a lot before switching to Lantus. Even on lantus he would bounce from blues and bounce even harder from greens. It seems like once he got use to being closer to normal numbers he stopped bouncing so hard.
I hope Girlie starts to come down out of those blacks and stays out!
 
Girlie definitely likes to visit all the floors.....
Rainbow_Slide_emoticon_by_HeadyMcDodd.gif



What are you giving for her arthritis? Pain can really affect those numbers...
If you aren't using Adequan, you might want to start.
 
Girlie definitely likes to visit all the floors.....
Rainbow_Slide_emoticon_by_HeadyMcDodd.gif



What are you giving for her arthritis? Pain can really affect those numbers...
If you aren't using Adequan, you might want to start.
Today is starting out even more interesting: http://www.felinediabetes.com/FDMB/threads/12-aug-girlie-amps-556-2-236-here-we-go.182114/

I was giving her Meloxicam, but I haven't given her that since her visit to the vet emergency room on 9 August. I'm also a little concerned because the vet thinks she's in the process of developing CKD. She's been on Meloxicam for years now. We used to get Zydax injections 1/month (initially started on 1x/week for a month every quarter but changed that to 1x/month as her arthritis got worse. We then did acupuncture, but shortly after that she was diagnosed for diabetes, and we had to put that on hold.

The vet said to pass on the Zydax, continue with the Meloxicam, and go for the acupuncture again. I'm not sure about the Meloxicam: what do you think? She is a bit stiffer after these few days off Meloxicam, although she went for several weeks without it after her initial diagnosis with diabetes.

It looks like we can't get Adequan here in Australia.
 
@Bron and Sheba is in Aussieland.
I think she had something that was the equivalent.... tagging her so she can give input.


Meloxicam or Metacam, has a black box warning on it from the FDA against use on cats. It's very hard on kitties kidneys because it is a non steroidal anti-inflammatory drugs (NSAIDs) which are known to contribute to renal failure in cats.

Vyktors Mum
Joined:
Nov 15, 2011
Meloxicam is one of metacams names. It is very very nasty stuff and has a black box warning for use in cats in the US HOWEVER it seems that we might get a lower dose product in Australia that doesn't have as much potential for damage. I also gather it's also not as bad given orally as it is by injection. @@Bron and Sheba knows about that one.
 
@Bron and Sheba is in Aussieland.
I think she had something that was the equivalent.... tagging her so she can give input.


Meloxicam or Metacam, has a black box warning on it from the FDA against use on cats. It's very hard on kitties kidneys because it is a non steroidal anti-inflammatory drugs (NSAIDs) which are known to contribute to renal failure in cats.
I've been reading that, but it's used here in Oz without any black box warnings. Still, I'm getting a bit anxious about it given that Girlie might be heading to CKD at some point (if she's not well on the way there already at her grand age). I'd rather go the acupuncture route if I could.
I've started a new post today: should I put our conversation in there, do you think? http://www.felinediabetes.com/FDMB/threads/12-aug-girlie-amps-556-2-236-2-50-122-here-we-go.182114/

I really appreciate your feedback re: arthritis stuff - very helpful.

And @Bron and Sheba is one of my favourite people in the world! She's helped hold my hand through some scary moments here in Oz...
 
Lol, the first blood tests were...interesting. Mav has black ear tips. I have learned SO much...1) put my glasses on to see blood drop on black fur, no need to poke again 2) place lancet against ear, not 3 inches away (scared to hurt him, but likely wasn't poking anything at all at that distance :confused:) . Girlie sleeping through is a bonus for you I think! They do probably wonder why all of a sudden their ears are so interesting! It's the same with tenting the skin, I'll just randomly pull his fur up, just so he gets used to it. I'll keep the neosporin pain-relieving ointment in mind, for sure!

It was terrifying at first, mostly because I didn't know anything. I'm a big need-to-know what I'm facing, so I can face it head on, so I read as much as I could. Honestly, it's strange, when you get more familiar with things, it gets better. And I did things in bite sized pieces. Read up on food, carbs, dry vs. Wet, etc. Then tackled insulin, dosing, how to, etc. Then tackled testing. There's still more to understand but I feel a lot better than I did a week ago!

I just do one day at a time, and hope that tomorrow is better than today :D, that's what we do when we love them, just get them hopefully to a better place than they were yesterday. And when I need to think and process, I take my dog for a walk, it works wonders.

I wish I understood the reason for the multi-colors you have with Girlie. Does your vet have any thoughts on what's going on?
I'm with you there! I still use the AlphaTrak lancet thingy: I've tried doing it manually twice so far and found it only works if she's asleep so I can get over my fears... I put a big light on and target her head so I can make sure I don't miss a blood drop and do an unnecessary second prick. Girlie's ears are a dark grey, but her veins are really prominent (not that I aim for them as that apparently hurts a wee bit), so I can see where to aim for.

I also like to really understand things; it seems like all I do is read, read, read, read, and read again....there's SO much to learn.

Girlie's multi-coloured spreadsheet have to do with a variety of factors, I think. She was quite ill at the beginning as she had to have an enema under anesthesia and then got pneumonia, so she was in hospital for several days and looked really, really ill. Then she had a hypo incident and ended up in hospital again for ca. a week where they used a different insulin (Caninsulin) and ActRapid to try to get her high numbers down. I think that that probably messed with her body. I became a real scaredy cat about giving insulin when she was in the blues and so skipped shots or gave less insulin than I should have on occasion. I'm braver now because @Bron and Sheba walked me through a night where she was dropping too quickly and how to give glucose syrup and test and just feel confident again. So now I'm confident that I can get her numbers up in a hurry if I need to, so hypos aren't so terrifying for me anymore. Then I dropped her insulin down to 0.25 as I had to be out and about for three days and wanted to make sure she was safe. Then (9 August) she had an incidence of colitis/too much water from being so high + Miralax and Cisapride that led to us going to the emergency room again as she was straining/vomiting and wouldn't eat and that led to the latest high numbers that put her in the black again.

She's a really bouncy cat right now who does really quick, deep dives, so she requires a lot of monitoring so I can try to head that off by feeding her either LC or MC or - if needed - HC food. On several occasions she's done a 300+ point dive within two hours which means feed and monitor closely for us.

I think one of the biggest things I've learned since she was diagnosed and since getting help here is a) try to be as consistent as possible with the insulin dose and b) test frequently and c) based on the tests and the patterns you see over several days, learn what works for your cat (e.g. does LC food bring them up or do you need to use MC or HC food or glucose syrup or honey?). Also, I've learned to record EVERYTHING on the SS so I can see what might have influenced a particular day (cycle), especially the food. Patterns are key, and I can't see what influences them without knowing everything that has gone into - and come out of :-) - her.

I think Girlie might be a little more hard work than the typical diabetic cat, but that's okay: she's my beloved 18 year old girl and I'll do whatever it takes. And - oddly enough - aside from the days when her numbers are really high and she doesn't feel so well, she's looking better, moving better, and seems happier since she's been getting insulin. Odd, but true!

Good luck with your kitty; it sounds like you're doing really, really well. :-)
 
Wow. I just looked at your SS for 15 minutes.
It looks like after the last two blues she bounced for 7 cycles. Started clearing it in the 7th then hit blue again in the 8th. If this is a real pattern you might see the bounce break in the pm cycle tonight. Then maybe another blue in the AM cycle on 8/12.
I wondered if you tried steering her drops and tried to let the nadir be around 50%?
To go from 600-700 to <200 is a big drop. Ecid of course but when Chuck drops a large amount he will bounce every time.
I wonder if you could keep her nadir to around 50% if that would calm the bounce then maybe her next preshot wouldn't be so high? And the next after that...
It's hard to predict. I swear, Chuck had to get use to being in better numbers. He was red and black a lot before switching to Lantus. Even on lantus he would bounce from blues and bounce even harder from greens. It seems like once he got use to being closer to normal numbers he stopped bouncing so hard.
I hope Girlie starts to come down out of those blacks and stays out!
Apologies for not replying earlier! I was about to, but then we had some dramas and had to go to the emergency vet on 9 August (after the lovely blue and yellow day we had on 8 August, as you predicted...).

And now she's back in black again...sigh.

I don't understand what you mean by "steering her drops and (trying) to let the nadir be around 50%". Do you mean giving her food to try to keep the nadir around 50% of the AMPS or PMPS? She just seems to dive quick and early, and that's making life pretty challenging, even with giving her MC food to try to stop that dive. She's even dropped from black (545 AMPS) to green (76 @+4) on 4 August. Oh I sometimes so wish she wouldn't keep me on my toes like this...my toes are getting tired right now... :-)
 
Apologies for not replying earlier! I was about to, but then we had some dramas and had to go to the emergency vet on 9 August (after the lovely blue and yellow day we had on 8 August, as you predicted...).

And now she's back in black again...sigh.

I don't understand what you mean by "steering her drops and (trying) to let the nadir be around 50%". Do you mean giving her food to try to keep the nadir around 50% of the AMPS or PMPS? She just seems to dive quick and early, and that's making life pretty challenging, even with giving her MC food to try to stop that dive. She's even dropped from black (545 AMPS) to green (76 @+4) on 4 August. Oh I sometimes so wish she wouldn't keep me on my toes like this...my toes are getting tired right now... :)
It's ok. Sorry you had drama and all that.
The steering is just what you said... Giving her food to try to stop the dives. She's a tough case. I'm surprised at the very dramatic reaction she has with lantus. My boy's SS looked similar on ProZinc in the beginning but not always black.
She's lucky to have you. Hopefully she'll give you and your toes some rest!
 
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