03/25/12 Ella PMPS 479 (more questions:)

Hello Everyone,

Ella has been doing ok with her 3 units (not too low and not too high) so I've just continued on that for continuity.
I'm home today and testing so I can collect more data. I just did the +6 mark and was expecting a lower number but she had risen. Not sure why as she hasn't eaten anything since the AMPS but will continue to test throughout the day. I'm going to see if I can slowly get her interested in canned food. Any recommendations? I'm not doing any switch overs right now as I realize this will most likely bring her numbers down but I want to see if she can be tempeted by anything on her own accord. I feel like I need to be home when switching the food to monitor so may wait until the long weekend to do anything major.
I hope everyone is having a nice weekend

Tamara

Re: 03/24/12 Ella AMPS 273

Hi, Tamara & Ella!

just a tip here...it is a good idea to edit the subject line of your first post and add "Question" to it...
that way folks can drop by and give you input.

Don't be shy...call attn to your post!!

celi & binks

Re: 03/24/12 Ella AMPS 273

Many of the cats here eat Fancy Feast Classics. My vet once referred to FF as "kitty crack." Most cats do seem to like it.

I feed my cats Wellness. Initially, they wouldn't eat Wellness but were very happy with Fancy Feast. I had switched over and was feeding them a homemade raw diet. At one point, my shipment of the pre-mix was delayed and I tried Wellness again and they were happy with it. Its easier to feed them canned than for me to make the raw!

Merrick Before the Grain is a good brand as are some of other of the Merrick varieties. I'd take a look at Janet & Binky's list as well as this additional list and pick a few flavors to try. There is variation in price -- brands like Wellness and EVO are more expensive unless you are buying the large (12 oz?) cans. If you buy the big size, Wellness costs about the same per ounce as Fancy Feast.

Re: 03/24/12 Ella AMPS 273

Hey Tamara!

I heard TO was having a bit of a heat wave

We used to have to hold the plate up to Elie's chin height in order to get him to eat more of his plate. I never thought I'd have to beg my bigfuzz to eat more lol, we even spoon fed him for a while in order to get some food in him.

It would make sense to me that if his sugars are still high that he might feel a bit dizzy or "out of it". Food will help his body to heal and regulate, so it's still important. We also poured a little tuna juice on his food to entice him...he loves tuna!

Hope all is well with you guys! Great job on the testing! Keep it up!

Tanya

Re: 03/24/12 Ella AMPS 273

Tamara

I actually think her numbers are kind of high. However, I'm reticent to suggest you increase the dose because there are no night time tests. While I don't "think" she is going low at night, she very well could be and then bouncing back up by AMPS. We have seen cats go from 300 to 50 to 300 in one cycle and if the caregiver had not gotten the mid cycle test, we wouldn't have known. Is it possible to get a mid cycle test at night or at the very least a before bed test. Then we could perhaps suggest if this dose is ok or if it needs to be increased.

Thanks for letting us know you switched to the contour!

Re: 03/25/12 Ella AMPS 215 (see overnight data)

Thanks for the feedback regarding the food.
Miss Ella is a picky eater. Her kitty crack has only ever been dry food. I tried many times to tempt her with wet but she won't have it. She doesn't even accept yummy treats!!! What's wrong with her? :lol:
I took a +5.5 reading last night and she was 297. This morning her AMPS was 215. It's a bit lower than she's been but I gave her 3 u as I will be home today to monitor.

Happy Sunday!
Tamara

Re: 03/25/12 Ella AMPS 215 (see overnight data)

Should I have started a new 'condo?'

Re: 03/25/12 Ella AMPS 215 (see overnight data)

We open a new condo with every AMPS. The general "rule" is one condo, per cat, per day. This is also why we link the condos together -- you can then go back to find information easily if you need to.

Maybe one way to help transition Ella is to pulverize some of her kibble and sprinkle it on top of the canned food.

Re: 03/25/12 Ella AMPS 215 (see overnight data)

Hmmm never thought of that! That might be the ticket to get her to eat!

So I just took her +1 and she is at 183.

Do I link the condo's by copying and pasting the URL?

Thanks!

Re: 03/25/12 Ella AMPS 215 (see overnight data)

Another question: why does she look so hazed out at 183? That's not even considered normal range. She seems so much more comfortable when she's in the higher numbers.
She is just sitting in the corner and staring into space.

Re: 03/25/12 Ella AMPS 215 (see overnight data)

cats get used to whatever range they are in. it's common for people to report that when their cat has been used to 200-300's, they seem lethargic and wiped out at 100's. their bodies will adjust to the newer range. you want to keep in mind that her "natural" state is 50-100ish. if she's been in high numbers for a while, i'm sure it feels very odd to have it be different.

i imagine it might be like i feel without my morning caffeine. no-caffeine is the natural state, but it doesn't feel so great, that's for sure.

take a look at http://www.catinfo.org for suggestions on getting a dry addict to change to canned. you might take a look at Kitty's (world traveler's) post - Kitty was a dry food addict and he's starting an off-the-juice (off of insulin) countdown today. the food makes an enormous difference.

for today, i think since you've edited the subject line i wouldn't worry about starting a new condo. tomorrow start a new one, and the way you link them is to copy the url of the previous day's post and paste it right here. that'll provide an active link so if we need to look back to see what the recent advice/story was, we can go right to it. gets you better advice that way!

Re: 03/25/12 Ella AMPS 215 (new question)

So I just checked Ella at +7.5 and she was 508! I thought that was weird so I tested her again and she was at 472. I didn't give her a fur shot this morning so what gives?

Re: 03/25/12 Ella AMPS 215 (new question)

it's a bounce, tamara. it's not super-obvious to me what she's bouncing from, but it could be the 183 this morning. i think i'm going to guess that it is.

look at march 20 - she had a 185 in the morning and went straight up from there - you saw a 333 then a 398. she might have even kept going higher than night. no way to know.

ella's become used to those high 300's and when her liver senses a lower number, it lets loose with stored sugars and counterregulatory hormones, trying to save ella from a hypoglycemic episode. the liver doesn't know this isn't too low for her, it just knows she's lower than she's been.

as you get her into lower numbers, the liver will settle down and accept a new range as "normal." until then, the bouncing is part of it.

this is one reason that we are such fans of data - when you learn how lantus works in your cat, then the data spells out what to do next. if you'd stopped by the vet's today and gotten a 500+ out of context, the vet would've thought that the dose wasn't high enough and would've increased it. what we can see in context, is that this dose is getting her at least into the 100's.

often cats do get lower at night, so it's great you caught that mid-cycle number last night. you don't have to get up during the night to check, usually, just a before you go to bed check will tell a lot.

i asked mia/worldtraveler/kitty to talk with you about how she got Kitty off of the dry food. i suspect until you've had success with that, you're still going to see some crazy numbers. we see it a lot. don't be discouraged because ella's giving you trouble about it, something will hopefully *click* in one of the things you try and she'll decide it's pretty good! then you'll really see success with her blood sugar. :YMHUG:

Re: 03/25/12 Ella AMPS 215 (new question)

Thanks for responding to me Julie. I REALLY REALLY appreciate it!!!!!
Is there a high number that I should be worried about getting....like one that would say it's time to take her to the ER?
I just did a urine and she had neg ketones but doesn't that measure the urine from a few hours previously?

Would you recommend not feeding her the afternoon snack at 4:30 and making her wait until her PMPS meal so she doesn't spike even higher?

I'm such a newbie :mrgreen:

Re: 03/25/12 Ella AMPS 215 (new question)

ps. you gals and guys are the BEST!

Re: 03/25/12 Ella AMPS 215 (new question)

you know what, tamara? i've been at this for a year and i still learn new things all the time. it's amazingly complex for being so straightforward! ;-)

no, there's no high number that would send her to the ER - not an isolated high number at least. the danger is in sustained high numbers. that's why we look at the overall picture. that's also why we like to hear a WCR (whole cat report) in the morning that tells overall how ella is doing. their behavior tells a lot. we check the cat's 5 P's - is she purring, preening, playing, pooping & peeing? is she eating? those things are indicators of the bigger picture beyond the isolated numbers.

some cats graze throughout the day until +10 and do ok with that. i don't feed punkin after +3 unless he gets too low at his nadir, which is about +5.5. so he gets all of his food between the shot and +3.

always if they drop below 50 you feed. if not, it's ok to not feed them and see what it does.

what you're doing at this point in the game is learning about FD and learning how ella responds to carbs and insulin. i think it would be a good thing to know if that makes a difference in her BG.

it's good you're checking for ketones and checking urine is fine. it might be from a few hours ago, but that's ok.

are you adding water to her food, or is she drinking plenty? oh yeah, and one more "get her changed to canned food" tip - she might like Fortiflora. most cats love it - both of mine do. you can order it online or get it through a vet. i've never seen it in a pet store, although we only have 2 stores here. it's a powdered probiotic and you can sprinkle it on the canned food. it's worth trying. it's also good to have on hand to treat diarrhea.

just paying it forward - jill, sienne, libby, laurie & too many others to mention by name - they all helped me when i came on.

Re: 03/25/12 Ella AMPS 215 (new question)

PHEW!!!! Ok...my I can breathe a bit again.

I know Fortiflora well and have some. If I am successful with the wet will I need to bring her back to 1 unit and start all over again? My concern is that I am not home for testing during the day. I can't even do +1 testing in the morning. I feel like my circumstances may make it difficult to do the TR.

My vet said that she wanted to get her controlled on the dry first and then we could make the switch to wet but I'm not sure how we would do that in a safe manner. I didn't explore that topic with her further as this was before I joined this group so I didn't know much

Re: 03/25/12 Ella AMPS 215 (new question)

personally, i would make the shift to canned food gradually, over about 5 days. increasing the canned, decreasing the dry.

you could go either direction. either make the change cold turkey dry to canned, drop the insulin and work the dose up/down from there. or because you're already shooting, you could change the food gradually and be able to adjust the dose as you go.

i guess the question you need to answer is what your goal is. do you want to try for remission and having ella be diet-controlled only, or do you want to have a maintenance plan where she continues on insulin at a higher level of blood sugar.

that stats for newly diagnosed cats going off of insulin by using the TR protocol is pretty impressive - 84%. i suspect the remaining 16% are cats like mine, who have other reasons for becoming diabetic or other conditions.

not being able to test during the day wouldn't preclude you following the TR, but it would mean that you would absolutely want a timed feeder and get ella trained to eat from it. it would also mean that you've got to test some evenings. i shoot punkin at 7-7 and go to bed late usually, so i can get a +4.5 in every night before i go to bed at 11:30pm. you would also need to do what you're doing today - trying to catch the low point on the weekends. most people here work.

i think i'd like to get more input from others more experienced than me on how you make the change and adjust the dose when you are not able to get any mid-day tests during the week. others may be able to make suggestions on how to do it safely.

let me know before you make any sudden changes. at this point you can safely work on just getting her to like some canned food so that when you're ready, she's ready too.

Re: 03/25/12 Ella AMPS 215 (new question)

Julie's done a great job answering all of your questions. The one she missed was about linking the condos. You do, in fact, copy and paste the url from the previous day's condo. However, you need to click on the URL button above the text box and put the information in between the 2 sets of brackets: paste the info in here.

Re: 03/25/12 Ella AMPS 215 (new question)

Hi Tamara!
I just sent you a PM to give the background how the transition worked for Kitty.
In short summary - Kitty went to wet-food-only on March 8th, and I was giving him then 1.5u BID. In 3-4 days the dose dropped to 0.5-0.25u and from March 20th onwards, he has not needed any insulin any more. Okay, this may have happened faster than usually, and my travel plans screwed up the normal transition plans... the end result has been good so far.

I must admit it was a bit stressful to decide on the dosage when the wet food transition was on-going, but you will learn when not to shoot and when to shoot even when the BG is lower than you never had had before. My best support has been people here at FDMB

- Mia

Re: 03/25/12 Ella AMPS 215 (new question)

My non-diabetic cat was the hard one to transition to wet.
I tried sprinkling ground dry food on it, all kinds of things.
The one thing that finally worked was sprinkling freeze-dried chicken on top of the wet.
I did go from free feeding dry to only putting it out at certain times and leaving it out for only an hour too.
I always had some wet food out during the process. Eventually he started eating the wet and I stopped putting out the dry.

Thanks for the tips on feeding everyone. Will work at it over the next few days to see if I can entice her

Just did her PMPS and she was 479. Should I expect to see high numbers in the morning?
I also have a question about shooting. Does anyone ever experience their cat twinging their back during an injection? She doesn't make a peep but when I insert the needle near one particular area on her scruff her back will do a little twinge. I tent up the skin and don't think I'm inserting into muscle as I'm sure I'd hear about it
Also, does anyone's kitty have little hiccups after eating or drinking. This has just started since her diagnosis.

I'm the queen of questions tonight! Hopefully one day I'll be able to answer them

Thanks!

bounces can last up to about 3 days - so you could possibly see high numbers from this morning through wednesday morning. just depends on the cat. it could clear before then, could stay high. no way to know.

punkin doesn't twinge if we shoot nearer his left shoulder. if we shoot to the right of his spine, he always twinges. if where you're shooting bothers her, try a different spot.

now i don't know anything about the hiccups. if punkin's had them, i haven't been aware of it! :lol:

Hi Tamara,
You have gotten so many good tips on the food issue. One or more of them is sure to work for you.
With regard to the twitching, I agree with Julie: just try to avoid that spot. It may be near a nerve or an old injury.
Hiccups? Maybe try raising Ella's food bowl by putting it on a short box or board. I feed Rusty all of his meals in the trays of his 2-compartment auto feeder, using it like a tiny table. When I have to use it as an auto feeder, he feels right at home.

You're doing fine. Hang in there. Ella's numbers will come down when she gets settled in and switched to wet food.

Ella & Rusty (I have a special interest in how my "namesake" is doing! It is still weird to me to see my name with bg numbers after it! :lol: )

Ella is one of my favourite names

In regards to hiccups. I thnk they are more like body burps. It only happens after eating and drinking. She never had that beofre. Hmmmm....I'll ask my vet as well.