03/15 Raven AMPS 287; +3-272; +5-191; PMPS 211

This is my first post in the Lantus/Levemir/Biosimilars group. Apologies if this is too much context, I just want to be thorough. I recently took in a 6 year old foster cat -- Raven -- who was surrendered to the shelter due to the owner not being able to afford his food. He had no pre-existing diagnosis of diabetes, but was diagnosed a the shelter in late January/early February 2023 due to excessive thirst and urination with BG levels in the mid 500s.

He came into my care on Feb 8 (pulled from the kill list, since the shelter was unable to provide the appropriate care) and immediately started on low carb food and Lantus. I accidentally started him on 2us (after misreading the syringe lines), but lowered to 1u from there and then slowly increased to 2us in 0.25 increments. I've been using a hybrid protocol - started on SSGS but was encouraged to increase the pace giving my level of testing (when I'm not at work). However, on his 5th cycle of 2us yesterday, Raven's numbers dropped significantly and rapidly - to nadir of 71 and likely would have dropped lower if I hadn't interfered with high carb food (though I definitely overcompensated with too big a portion of high carb food - I panicked). So I was advised in the main forum to lower him back to 1.75 and monitor him for a few days.

He's been having a lot of on-and-off GI issues, and yesterday's episode coincided with persistent diarrhea, lowered appetite and potentially some vomit (not 100% clear if vomit or diarrhea). He's had a similar episode of repeated vomiting on March 3 and I took him to the vet. His blood panel and test for pancreatitis came back normal/negative. The vet also performed an xray due to concerns about Raven potentially ingesting a foreign object. But xray showed no evidence of foreign body. However it showed an enlarged colon, leading the vet to conclude that he had suffered from previous bouts of indigestion and a resulting megacolon. However, at this time no constipation has been detected. On the contrary, since he's been in my care he's had very frequent bowel movements (3-6 a day) which are usually formed but on the softer side and voluminous, even when he's not struggling with diarrhea or vomiting for indivdiual days at a time (as he did on March 3, March 5, March 14-15). I've been advised to try a novel protein diet and potentially get a ultrasound to see if IBD is the issue.

For context: I started Raven on an almost pure low carb wet food diet (Tiki Cat luau chicken = 0 carbs), with frequent meals ever 3-4 hours. The first few weeks he hoovered it up without issues, but recently he's gotten more picky -- leading me to try out FF pates (chicken, turkey, and beef) and Tiki and I and Love and You Salmon options (which I've been advised to eliminate since they may be causing issues). I'm also using Dr Elsey clean Protein Chicken dry food from time to time to supplement when he doesn't like to eat his wet food. In addition, I am giving treats after every BG reading (including FF Purely Natural Chicken Treats, Inaba Freeze dried chicken treats, and other low carb treats from time to time).

My hope is to increase the dose to 2 Us again next week, and hopefully to be able to get to more stable numbers in the 100s -- rather than jumping and dropping between 300s and below 100s). Below is my spreadsheet. Any advice is appreciated.

https://www.felinediabetes.com/FDMB...numbers-71-at-3-131-at-7.275283/#post-3055201

 

Welcome to the LBL forum

Good luck with the reduction and resolving his GI issues!

 

Thanks so much!

 

Yay you made it to end Lantus forum. Great post. You guys will do so well here!

 

Thank you!!! I was telling my foster colleagues yesterday, I feel like you've become Raven and my AA sponsor. Thanks for always being there for us!