01/15 Fortune IBD out of remission :( AMPS 371 +3 416 +5 396 +8 267 +10 286

Fortune is high today, after coming down a bit yesterday. I hope this is just a reaction to the increased dose, and he just needs to build a depot, since we are only 4 cycles into the new dose. The goods news is he is bleeding much more easily so we haven't needed to prick more than once (unless I jack up the meter ).

Tomorrow morning will be 6 cycles at the new dose. According to TR, we should be dosing up .25 after 6 cycles since his nadir is sometimes under 300. Is that right?

Additionally, can the nadir be at the end of a cycle? Fortune's lowest numbers seem to be right before his PMPS. Obviously we aren't capturing the entire night cycle, but I was under the impression that numbers drop in the middle and go up towards the end of the cycle.

A bit of good news too - Fortune's weight hasnt dropped since his visit on 12/26! Yay!

Hope you are having a great Friday!
@tiffmaxee
@Wendy&Neko

 

Some cats do a double dip and are lower right before insulin time. Others have a late nadir. I’m going to look at your ss. Be back.

 

This is only the 4th cycle at 1.75. The skipped shot starts the count all over again. I know it’s hard to see the high numbers but the depot needs to build.

 

Just wanted to comment - WELCOME! And yes, these are the early days...you're liable to see any kind of crazy numbers. Lantus takes time to start to influence those numbers - things will flatten out.

Since you're just starting and I see you have chosen to follow TR - you may want to be sure to get another test 2-3 hours after your last one - just so you can get some ideas of how Fortune likes to roll...he'll show you a pattern after a bit...and you'll be better able to predict when he's going to go one direction or another...a typical day will soon emerge - no guarantees that every day will be 'typical'...but at least you'll start to see patterns...

 

I know It's so hard. So 6 cycles is tomorrow morning, which would mean we can go up tomorrow night?

Thank you for the warm welcome!! I'm so so grateful for this group already, and it's been *only* one week!

Fortune has been on Lantus since July, and first came off in October, before we put him back on in December. It was all through urine dips and our vet's direction. in hindsight I cannot believe how completely BLIND we were. I have been trying not to regret, and just be positive and hopeful that we are here, now!

We have been trying to test at least 3 times during the day, and at +2 and/or +3 at night. Would you recommend a higher frequency?

 

Yes, you can go up tomorrow morning unless he surprises you tonight. If he’s reading this he might take the threat of an increase seriously.

 

hahaha I think he got the message, cuz he is down in the 200s again!

That would be tomorrow night though, for a full 6 cycles.

And we got the syringes that indicate .5 units today! We were eyeballing before

 

See what happens tonight and tomorrow morning then. You might need to hold the dose longer, 8-10. It’s up to him.

 

Good that you've gotten syringes with half unit marks, but they too aren't 100% reliable. If you have the opportunity, please get calipers - they've been a lifesaver for us! I use these:

https://www.harborfreight.com/6-in-...sae-and-metric-fractional-readings-63731.html

Inexpensive, and once you learn how to use them, you can measure the finest of doses pretty quickly and easily.

Perhaps if you study your SS, and see the gaps - where there were no tests - it's hard to tell what happens around that time of day...so perhaps one day get a test at a time when you've not gotten one before - just to see what's going on...or a few if the numbers are falling...it takes a little time, but soon you'll see a pattern develop about when the insulin is working at max, and when things start to slow down...it's helpful to kinda know when this is likely to occur...but as I said, it takes time and there are no guarantees that he's going to cooperate with the 'pattern' idea.

 

I feel so stupid.

I finally got Fortune's ultrasound report, and as the vet explained Wednesday, it shows that his disease (IBD) is out of remission. What caught me off guard was that it is moderate-severe and the ultrasound doctor indicated that something must have changed since showing remission in July (he thought we may not be giving the meds, we are).

Then it hit me, like a ton of bricks - we changed his FOOD! We went from a hypoallergenic novel protein food to Fancy Feast chicken and salmon. The vet suggested the change in July, right when we started the insulin (and urine dips) when he continued to have high blood glucose despite going off prednisolone. At the time, Fortune was having trouble eating yet devoured the Fancy Feast in the hospital - likely because his blood glucose was so high!

UGHHHHHH

So now we are going to feed him his old food while we wait for the low carb rabbit to arrive. I'm so upset. All of this feels preventable!

The vet was against switching to budesonide; he explained that he does not see the same results clinically, and feels confident we can manage the impact to BG because we are doing home testing.

I just hope and pray we can get his IBD back in remission, independent of all the drugs! I'm wondering too if he even HAS SCL (the pathology report was inconclusive).

Very overwhelmed, and so scared for Fortune.

We are discussing with our vet seeing an internist for additional input. He has been consulting directly with an oncologist and internist, but we would like to consult with someone. Now I'm just struggling with making the right choice for who!

@Wendy&Neko I know you (unfortunately) have a lot of experience with this, how did you find the right internist? I am planning on posting in the SCL forum too - just waiting on a copy of the lab work from Wednesday.

Oh that's great! Do you just clamp it to the syringe? I couldn't figure out from the site how it would work.

 

Here's a good link for info on how calipers work for us:

https://www.felinediabetes.com/FDMB/threads/dosing-with-calipers-updated-w-videos.79851/

Sounds like you have your plate full - sorry to hear about all of these challenges! You hang in there though...we're all here to support you

 

That is GREAT info, thank you! Wow! I am bookmarking it to watch later, but just a cursory glance I can tell it's much more accurate.

And I appreciate the support. It's so painful to think he has such a hard year and there was more I could do.

 

I'm so sorry you're going through this. You made the best decisions for Fortune based on information you were presented with from the vets, so try not to be too hard on yourself. You are doing a great job. FD on its own is not an easy thing to manage, and you're dealing with multiple health concerns.
I hope that switching back to the novel protein diet brings Fortune's IBD back into remission.

 

Thank you Trying to appreciate that at least now I’m working from a place of more knowledge (though still far from feeling knowledge). I appreciate your thoughtful words

 

Blind luck. There were two internists at the clinic, I got the junior one. I have no problem with that, he was more up on latest research on diabetes/acromegaly cause he was trained in Europe. He also consulted with the oncologist in the clinic (and cardiologist) as needed. More luck, the clinic is only 15 minutes away from me in good traffic.

Is Fortune showing any clinical signs? Vomiting, diarrhea or constipation? Inappetance? Chicken and fish, along with beef, are common allergens for cats. Specialty pet food stores should have low carb rabbit (or other novel protein) options in stock.

My girl often nadired towards the end of the cycle, it meant I had to get used to shooting lower. Cats that are breaking a bounce can also nadir later.

As for calipers, many people do fine without them. I found them more accurate, but no one here used them the first couple years I was here. Decide to use them or not at your own speed. You have a lot on your plate right now.

 

I hope the diet change reverses the IBD. It’s really good that that is probably the reason for him going out of remission.