8/13 Bob PMPS=147, +2=131

yesterday's condo

Good morning LL! I'm so sorry I haven't been around to visit very much lately. I'm being quite self-centered lately because I'm a big ball of stress and upset over Bob not feeling well. I really appreciate everyone visiting yesterday and wishing Bob well. He said "meow" (thanks!).

So, took Bob to the vet and saw one of the other doctors and had a lively discussion about the TR protocol. He listened and wasn't rude or un-interested but he did tell me about all the kitties who don't get their ears poked and who come in once a month to get checked and are doing fine. And he said their owners are not as stressed as I am (that part is probably true!). I told him I would email him some stuff on the protocol and he seemed interested. We'll see! I did say this protocol isn't for the faint of heart! It's only for someone willing to put in the time and energy (and loves their kitteh more than life itself!)

So, Bob's blood ketones were .4, which shows my Novamax meter is probably pretty accurate -yay! He got some fluids and I asked for a full blood panel including fructosamine (just for fun! why not??? I'm sure I can get my credit card up to $5000.00 if I try really hard). He did tell me his urine glucose was 500. Anyone know what that means? confused_cat My biggest concern is his weight - according to the vet's scale, he has lost almost a pound since 8/3. :shock: Not sure what to think about that - when I took him in on 8/3, I figured they would tell me he lost weight, because I could tell he was thinner from stopping the 20% carb dry food on 7/20, but when they weighed him, they said he gained .1. I wonder now if that was wrong. Also, the YA people tell me they will lose weight and eat way less. He's eating way less, but this food is 600 calories for 1 cup, and I'm almost positive he's eating 1/4-1/2 cup a day, which should start to decrease.

I also notice he's drinking more, is very tired and looks generally depressed. If I try to hold him, he immediately jumps down, which is not like him at all. He grunts and makes all kind of weird noises if I try to pick him up. What is going on???? I am so upset by all this. They do an exam and nothing in his abdomen seems to be bothering him. I'll have the blood test results in a couple of days. I can't stand seeing him like this.

I don't question that this protocol works, but I went to my doggie botique the other day and they have a diabetic cat who eats Pure Vita dry (30% carbs) is on 5 units of ProZinc and is the happiest cat I've ever seen! Bob had his moments of not feeling well before when he was on the dry food, but not like this. It makes me wonder if I should just put him back on his dry food he likes, give him as much insulin as he needs and if it ends up killing him at least he had quality over quantity. I just don't know what to do. Penelope and Hector seem to be doing good on the YA. So confused.

Sorry I babbled so much.

I hope all kittehs and beans are doing well today! Thoughts and prayers for all!

Re: 8/13 Bob AMPS=188, +1=269 Vet Visit Update

Urine glucose (according to Merck Veterinary Manual) means the blood glucose was > 240 mg/dL since the preceeding void. How long was he traveling to and at the vet? Vet stress may elevate the blood glucose from 100-190 mg/dL and persist for several hours.

Drinking more may be a function of the Young Again dry food.

He might be experiencing some diabetic neuropathy and that could make him uncomfortable. You might see if adding 3,000 mcg (3 mg) methly-B12 would help.

A weight change of .1 pounds could be poo (.1 * 32 oz = 3.2 oz).

Food changes may work best when done gradually, say 20-25% per day. If you changed all at once, he may not be eating enough due to GI upset. FortiFlora may help and many cats really, really like it (some do not). The not eating may result in fat breakdown, which may elevate ketone readings (ketones are a byproduct of fat breakdown).

He needs to eat, and if that means medium or high carb food, and adjusting the insulin upwards, then do so. It'll cost you more in insulin, and you'll still have your cat.

Re: 8/13 Bob AMPS=188, +1=269 Vet Visit Update

Hi guys .... I sure wish you weren't struggling with all of this like you are .. I can totally relate to stressing out over Bob and his health issues .. Knowing what I know from this board, I'd never be content to just take mocha into the vet once a month for an update on her numbers .. There were multiple times mocha was down low, in the 20's that we caught because we did home test and were able to feed her HC to get her back up .. would that have been that exact moment we had decided to take her to the vet for a check up? Unlikely, since it was always around 11 p.m. at night .. what would have happened to her had we not checked? One never knows for sure, but it makes me shudder to think of the worst case scenario ..

I know all of this can be hard and frustrating, and scary .. but all of that was worth it to me, for me to keep going with mocha pushing through all the hard days and getting her better .. And there were a lot of hard days, we were on the juice for two years before mocha went OTJ and she was never really regulated during those two years so we had lots of ups and lots of downs to deal with ..

You can do this for bob, just like anyone would do for a 2 legged child .. Just hang in there .. :YMHUG:

Re: 8/13 Bob AMPS=188, +1=269 Vet Visit Update

Hi BJM - actually, I thought I put this in my post, but I guess I dreamed it. He lost approx. 1 pound. He went from 14.9 to 13.8 in 10 days. But I have my doubts he actually weighed 14.9 10 days ago. I could tell at that point he had been losing some weight and he was 14.8 about 3 months ago.

Regarding the urine test of 500, I took my meter and got his BG right before they took him back to get blood and he was 207. The way that they test him is to spin the blood (don't remember what that's called) and they get the serum and put in on the urine dipstick. That's the way the internal medicine specialist told my vet to do it (easier than getting urine). That's where Dr. Lockhart told me his ketones were .4 and his urine glucose was 500. The specialist never mentioned any sort of urine result from that blood test. Well, now that I think about it, that's kind of weird. They did NOT get any urine from him - it was all blood.

He's pooping rather good with this new food. And the smell is getting better so he must not be eating as much as he was at first (which they say is normal).

How do I go about gett ing the B-12 and how do you admister it?

Re: 8/13 Bob AMPS=188, +1=269 Vet Visit Update

PeterDevonMocha said:

Hi guys .... I sure wish you weren't struggling with all of this like you are .. I can totally relate to stressing out over Bob and his health issues .. Knowing what I know from this board, I'd never be content to just take mocha into the vet once a month for an update on her numbers .. There were multiple times mocha was down low, in the 20's that we caught because we did home test and were able to feed her HC to get her back up .. would that have been that exact moment we had decided to take her to the vet for a check up? Unlikely, since it was always around 11 p.m. at night .. what would have happened to her had we not checked? One never knows for sure, but it makes me shudder to think of the worst case scenario ..

I know all of this can be hard and frustrating, and scary .. but all of that was worth it to me, for me to keep going with mocha pushing through all the hard days and getting her better .. And there were a lot of hard days, we were on the juice for two years before mocha went OTJ and she was never really regulated during those two years so we had lots of ups and lots of downs to deal with ..

You can do this for bob, just like anyone would do for a 2 legged child .. Just hang in there .. :YMHUG:

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Thanks for the encouragement! I'm just worried I'm missing something here. Sigh. I would always check Bob's blood no matter what, but if he doesn't start improving soon, I may just go back to his old food. He may not have been regulated, but he sure felt alot better! I'll give it a couple of weeks and see what happens.

Re: 8/13 Bob AMPS=188, +1=269 Vet Visit Update

Jasper's Story, which explains the background.

And specifically from that site sources such as Zobaline

Re: 8/13 Bob AMPS=188, +1=269 Vet Visit Update

I don't question that this protocol works, but I went to my doggie botique the other day and they have a diabetic cat who eats Pure Vita dry (30% carbs) is on 5 units of ProZinc and is the happiest cat I've ever seen!

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I suspect the reason he's on ten units a day, which is a pretty high dose of prozinc is because he's eating dry food that's 30% carbs. The problem with that "strategy" is "what happens if he decides not to eat, or barfs up his food"?
Now you have five units of insulin in his system, and no food to offset it. To me, that's sort of asking for a crash to happen. Especially if you aren't around to see it happen.

Re: 8/13 Bob AMPS=188, +1=269 Vet Visit Update

I know. I'm just upset because Bob's so sad and sick looking. So what am I looking for in his blood results? Liver values? Would that show that he's not eating enough? IF that's the case, what do I do?

Re: 8/13 Bob AMPS=188, +1=269 Vet Visit Update

Did they run a full blood panel? If so, get a copy of the results and post them here. I can't make much sense out of them, but there are many people here who can tell you what each number means.

The fact that he seems miserable makes me think there's something else off besides just his blood glucose. It may not have anything to do with what he's eating.

Re: 8/13 Bob AMPS=188, +1=269 Vet Visit Update

Carl & Bob said:

I don't question that this protocol works, but I went to my doggie botique the other day and they have a diabetic cat who eats Pure Vita dry (30% carbs) is on 5 units of ProZinc and is the happiest cat I've ever seen!

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I suspect the reason he's on ten units a day, which is a pretty high dose of prozinc is because he's eating dry food that's 30% carbs...

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I agree with Carl. If you take a look at Bob's SS, on 7/29, Bob started eating the YA (zero carb variety, correct?). On 7/28, you gave him 2.25 units in the morning and I note 1.25 units in the evening. I don't know why you decreased by a whole unit that evening, but I suspect it was due to the low, low numbers in his AM cycle. Nevertheless, Bob is only on 1.25 units as of this morning. I'd say the proof is in the pudding, if you look at his SS, overall, though I realize there was more going on; I haven't taken the time to read all your condos. He was receiving as high as 4.25 units on 7/21 and then started to try wet food on 7/20 and his numbers started to decrease along with units of insulin.

Re: 8/13 Bob AMPS=188, +1=269 Vet Visit Update

Carl & Bob said:

Did they run a full blood panel? If so, get a copy of the results and post them here. I can't make much sense out of them, but there are many people here who can tell you what each number means.....

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Once you get a copy of the results, you may want to add a page to Bob's SS (new tab) for labwork. And I would, if you don't have them already, ask for copies of his labs for the past few years (or ALL test for as long as you've owned him). When you get a chance, and have about 5 minutes, feel free to look at Gobbles labs on his SS. If you look at the bottom of his SS, click on the "Gobbles Labs" tab--you'll see detailed test names, ranges, and results. The high or low differences are in red or blue, respectively. The test dates are in reverse chronological order. It took a little time for me to complete it (labs go all the way back to 3/2009), but it really paints quite a picture. Also, I print this off when I take him to the vet (along with his SS).

Re: 8/13 Bob AMPS=188, +1=269 Vet Visit Update

(((((((Dara))))))) Yes, the ketones are probably a result of the rapid weight loss. You have to do what will make Bob feel the best, but as Carl said high carb food means more insulin and an off day on eating can cause big problems.

Cats need 20 to 30 calories a day per pound of body weight depending on activity. At 14 pounds that means that Bob needs 280 to 420 calorie a day to maintain body weight. 1/4 to 1/2 cup of 600 calorie food is only 150 to 300 calories. Bob really need to be eating an half cup of YA a day.

I have a tab for Tess's lab results too.
It is a lot of typing, but you can copy the column of test names from someone else's SS and paste it onto yours to make it easier.

Re: 8/13 Bob AMPS=188, +1=269 Vet Visit Update

Carl & Bob said:

Did they run a full blood panel? If so, get a copy of the results and post them here. I can't make much sense out of them, but there are many people here who can tell you what each number means.

The fact that he seems miserable makes me think there's something else off besides just his blood glucose. It may not have anything to do with what he's eating.

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Oh dear, hope that's not true!! He's acting alot like he did before he got diagnosed. that's why I took him in. Sleeping alot, etc. I did request a full blood panel and fructosemine and I will post results as soon as I get them.

Ann & Tess said:

(((((((Dara))))))) Yes, the ketones are probably a result of the rapid weight loss. You have to do what will make Bob feel the best, but as Carl said high carb food means more insulin and an off day on eating can cause big problems.

Cats need 20 to 30 calories a day per pound of body weight depending on activity. At 14 pounds that means that Bob needs 280 to 420 calorie a day to maintain body weight. 1/4 to 1/2 cup of 600 calorie food is only 150 to 300 calories. Bob really need to be eating an half cup of YA a day.

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Well, Bob is a slug and that is my fault because they are indoor and we don't do much around the house. The people at YA said they automatically won't eat much (afer a couple of months) because the food is so protein and nutrient dense. I hope that's true!

TheBowHuntress said:

I agree with Carl. If you take a look at Bob's SS, on 7/29, Bob started eating the YA (zero carb variety, correct?). On 7/28, you gave him 2.25 units in the morning and I note 1.25 units in the evening. I don't know why you decreased by a whole unit that evening, but I suspect it was due to the low, low numbers in his AM cycle. Nevertheless, Bob is only on 1.25 units as of this morning. I'd say the proof is in the pudding, if you look at his SS, overall, though I realize there was more going on; I haven't taken the time to read all your condos. He was receiving as high as 4.25 units on 7/21 and then started to try wet food on 7/20 and his numbers started to decrease along with units of insulin.

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That is true - I'm glad to see that he's not on as much insulin, but I wish he was just a little more stable and he wasn't going up and down so much. I usually can tell he doesn't feel well when that happens. However, this time he just seems extra crappy-feeling. And the weight loss is freakin' me out.

Re: 8/13 Bob AMPS=188, +1=269 Vet Visit Update

It doesn't have to be something drastic that is wrong, Dara. It can be something as simple as one or two of his values is "off" for whatever reason. His thyroid values might be a little high, which can cause weight loss, although it also usually causes an increased appetite. Or his potassium might be a bit lower than normal, which will cause muscle weakness and lethargy. That's why the labs will be helpful to see. My Bob had low potassium for a long time, and he was lethargic and his leg muscles were really weak for weeks. All it took was a slow increase using supplements to fix that for him. I have been very fortunate with him over his whole life, because he has rarely shown a lack of appetite. He's a "slug" too, which is why I sometimes call him "Blob". ;-)

Re: 8/13 Bob AMPS=188, +1=269 Vet Visit Update

Carl & Bob said:

It doesn't have to be something drastic that is wrong, Dara. It can be something as simple as one or two of his values is "off" for whatever reason. His thyroid values might be a little high, which can cause weight loss, although it also usually causes an increased appetite. Or his potassium might be a bit lower than normal, which will cause muscle weakness and lethargy. That's why the labs will be helpful to see. My Bob had low potassium for a long time, and he was lethargic and his leg muscles were really weak for weeks. All it took was a slow increase using supplements to fix that for him. I have been very fortunate with him over his whole life, because he has rarely shown a lack of appetite. He's a "slug" too, which is why I sometimes call him "Blob". ;-)

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Thanks so much Carl. I"m just really negative lately. I've had quite a few personal problems lately and so my cats were kind of my "refuge". Now with the stress of the diabetes and Bob not feeling well, I'm a train wreck. I just assume it's going to be something bad, but you are right. It could be something simple that needs treated. That's funny you call Bob Blob. I call my Bob - Bob, Bobby, Robert or Bobert. Haha. I need a life!!!

Re: 8/13 Bob AMPS=188, +1=269 Vet Visit Update

Dara sending hugs and prayers to you and Bob (scritches to Bob). I hope you get good test results back and Bob starts feeling better soon.

Re: 8/13 Bob AMPS=188, +1=269 Vet Visit Update

Sending tons of prayers for good test results and a happy appy for sweet little Bob. Sometimes, you just have to do what you have to do....quality is way more important than quantity. While eating certain things aren't ideal for FD, well, a cat's gotta eat. At least you home test, you know how to keep him safe, and you are able to adjust Bob's insulin needs accordingly. I know it's easier said than done, but take some time to just relax and enjoy Bob!

Re: 8/13 Bob PMPS=147, +2=141

Thanks Carla & Amy!! I

I think Bob is feeling better today. When I got home he wasn't so lethargic and looks a little better. I gave him a can of weruva chicken with extra water and he drank it all. I think he may have eaten some of the chicken too. I'm just going to start feeding him the canned food twice a day and leave the YA out. That way, I'll know he's eating something. Maybe he just wants variety. Although he was quite happy to eat his high carb kibble all by itself!

Bob had some pretty low numbers and I still shot his usual dose. Scawy! I'll see how he does through the night and post in the morning. I need to start thinking about what his dose will be while I'm gone, especially if I'm going to be feeding him the wet food too.

Thanks again everyone for all the support! I'm so glad I found you guys!

Yay Bob! Eat those fuds! :RAHCAT :RAHCAT

Those are some nice healing blues. Hope he surfs well for you!

By the way, although Dee is wonderful in every other way (now that I got her to stop scratching furniture :evil: ), her only fault is food pickiness. She won't eat Wellness Turkey (cause it's slimey) and she refuses any food that's too watery. :roll: It makes me want to smash her head in the bowl sometimes! :lol: Except that then I'd have to clean up the mess! ohmygod_smile

I miss dry food :?

Haha! Alexis - you are so funny. I know - the dry food days were so nice. Everything was so much easier, cleaner and cheaper!

I didn't see your condo today - what day are you on??

Well, I'm a bit worried. Bob just doesn't eat much these days. I'm worried he's on his way down. Yikes. I'm going to hope for the best!