? 1/28 PMPS 100, +1 88, +1.75 68, +2.25 58, +3 64, +4 79, +5 84 Dosing Guidance for Tomorrow AM

Mellow Yellow


Ahh....we are stuck in yellow! This is so frustrating!!! We just want to come and play in the water and go surfing again!!

Do we need to wait this out? Is he stalling out?

 

Yep, I think it's time for some patience pants! Maybe this is still feeling the effects of that big drop the other day??? One of the pros might have some other interpretations, but that's all I can see in the spreadsheet.

When do you get the results of the bloodwork, next week sometime? If there's some pancreatitis in the mix, that can also boost numbers until the associated discomfort is addressed, but of course we don't know yet if that's even an issue. How is he otherwise?

 

We are supposed to get a call from the vet today with the test results (and I will go down and pick up a hard copy). I will post results on my SS.

He seems to be doing really well. Both kitties have always been lazy cats and sleep a lot, but I think that's pretty normal. When he's up, he's loving and cuddly and tries to pounce on Fig at least 2xs a day. Has a great appy.

I am happy to report that today is second day straight with no liquid vomit in am (though I have been getting up earlier last 2 days as I'm trying to get back an hour on schedule for work and maybe he's not caught up to my new rising time yet), and 6 days without any vomiting up of food.

 

BTW... Forgot to say...

HAPPY CATURDAY!!

 

@Nan & Amber What do you feed your kitty? I was just looking at your SS and it is envious! How did you know your kitty had pancreatitis? What were Amber's symptoms that tipped you off?

 

Yeah, despite the high level of stress I was feeling the whole time we ended up with a pretty smooth FD ride to the current remission state (knock on wood). She eats Fancy Feast pates (she will only eat the Tender Beef Feast) are the main food, and then for some texture contrasts and snacking I leave some bowls of Young Again kibble and Stella+Chewy's freeze-dried raw (un-rehydrated) that she nibbles on sometimes.

Amber has always been one of those cats that often vomited clear liquid in the early am (sound familiar?), then one day she vomited several times over the course of a couple hours and I took her in to the vet, got the test done, and bingo. Other signs during that period and later flares: extremely pungent LB deposits, and some pain along her right flank (if I tried to inject insulin there she'd jump as soon as I went in to pinch the skin and I'd have to move to another location).

 

Yikes.... we are also dealing with super stinky poo right now.

@Nan & Amber How did you treat it, how long did it take for her to recover? Has the vomiting/stinky poo situation resolved? I am kind of afraid we are going to be told Ozzy has it, too.

 

We haven't had a flare in a long time, I think in part because (this is speculation) now that she is OTJ and in normal BG numbers all the time her pancreas is under less stress. It is a chronic condition, though, so I am always on the lookout.

Care is supportive-- sub-Q fluids and pain meds are the first line of attack to try to address the discomfort, plus anti-nausea for the vomiting and to make sure she kept eating (some cats also need appetite stimulants and other meds). She improved pretty quickly from each flare, the vomiting was a one-day affair that first time and most other things went back to her baseline in a couple weeks at most. The thing that took longest to resolve, sadly, was the sensitivity on one side, in fact she never really let me give her a shot there again. I always tell myself that that was probably just habit-- it hurt once when she got a shot there so even if it wasn't still sensitive she didn't want me to do it again. She doesn't sit in "meatloaf" position, which is the usual sign of pain in a cat.

There are lots of causes of super stinky poo (unfortunately!), so let's just assume for now that Ozzy's digestive system is still working out what to do with his current food options. See what the vet has to say.

 

DANG!!! Just as I was typing in my food and vomit tracker for Ozzy, 'no vomiting of any kind today" into yesterday's comments section and feeling so happy that he seems to be turning the corner on this....I hear him vomiting in the back bedroom. . This was not clear liquid- it was a full food vomit. And food he has been eating daily for awhile now. I can't help but feel defeated with this poopy/pukey problem and it's ruining my house. This just makes me more nervous to receive news from the vet today. The only thing I haven't tried yet that has been recommended is the SEB. Not because I have not wanted to, but I'm a bit of a stranger to health food stores (we just believe in getting our nutrition from healthy foods and a multivitamin) so I honestly don't know where to go to get it and just haven't had a chance to do some research on it. I will definitely try it though.

When Ozzy threw up this time, I noticed a small bone in his vomit. Sorry TMI. There are some bones in his vitals chicken giblets treats so I'm sure that's where it came from. We don't normally feed the cats bones so wondering if that could have caused him to toss it up???

Of course, moments after he was done, he decided he was hungry again and went back to his bowl to clean up what was left.

 

Well, that's kind of a good sign, isn't it? I mean, the vomiting is terrible (for Ozzy, for you, and for your carpets!), but at least he isn't feeling terrible.

Kind of disturbing that there was a bone in it, though-- not sure I'd keep feeding those treats, I'd be worried about choking or obstructions.

 

Ozzy, bean-scaring might be fun but it's not very nice! Time to get off the trampoline and onto your surfboard.

This might be a bounce from a low 1/26 nadir if he kept going down after the 87 at +4. I hope yesterday's flat yellow means that he's going to come down today.

 

I was thinking the same thing...not sure how low he went but he bounced up by PMPS.

 

It looks to me like he's trying to clear a bounce today. Also...remember you skinnied his dose a few cycles ago and so he had to also deal with that in addition to the bounce. It probably didn't have a huge effect...just one skinnied shot...but it might have delayed the bounce clearing just a tad.

 

Threw up again after this snack too. Now he's back in the kitchen AGAIN. Nope, not getting anymore food for a few hours.

 

From when? 1/26? AM or PM Cycle??

 

....Ozzy and Elmo are having exit problems today... Elmo needs it exit the other end

 

Ozzy is back in blue! +6 =165.

He repaid me the favor of not giving him more food after he vomited twice earlier by throwing up some liquid on my carpet and hard wood. He had been laying in the kitchen and trying to tell me he was hungry, but I was afraid to feed him after the last 2 episodes and he was inbetween feeding times. I just gave him about a tablespoon more of food. Let's see if he keeps it down.

 

Just got a call back from the doctor with Ozzy's blood results. The only thing pending is his Free T4. Once in, I will go down and pick up the paper copies.

Here is what the vet had to say (forgive me if I am spelling names of medical tests wrong as I don't have the paperwork in front of me):

• BG at time of test was 308. He was 236 immediately before and 241 immediately after at home on relion human meter.
• Amylase was mildly decreased. This is a test for the pancreas. She said with pancreatitis the test would come back high. The lower number doesn't indicate any type of pathology and she is not concerned.
• SpecfPL Pancreas test came back normal
• Liver enzymes normal. These were elevated on his last tests when in DKA.
• Kidney values normal.
• SDMA (test for early kidney disease) normal.
• WBC/RBC normal.
• Platelets value is lower but there is mild clumping under microscope so she is not concerned/normal.
• Eosinophils mildly increased. This was also high on Ozzy's 12/5 labs. I am wondering if the number has gone down. She said this is usually from parasites. She said she didn't notice any fleas on Ozzy but we just treated both cats with flea meds on 1/8. Since our cats are indoors only we don't always give flea treatment monthly (will start from now on) but they do occasionally get fleas. She asked us to send in a stool sample for examination. Will be fun trying to figure out what poo belongs to which cat. We will figure it out.
• Ozzy's urine sample was dilute and he had glucose in his urine (2+). No ketones. She said that cats with diabetes will always have sugar in their urine unless they are in remission. He had trace amounts of blood in his urine but could be from collecting the sample (what? how do they do that?) and she was not concerned. He had no bacteria or crystals in his urine.
• His thyroid levels were normal. The only test pending is his Free T4 and she expects that to be normal too.

Overall the vet said everything looks good. He does not have pancreatitis, kidney disease, or heart disease and we just need to focus on treating his DM. Also will test him for parasites and treat accordingly. She felt his vomiting/loose stools is probably from diet changes and to try to stick with one food for awhile. If he continues to vomit, she said we might want to bring him back in for a repeat ultra sound. She also calculated that he should be consuming 300 k/cal per day. I need to figure out how much that is based on the cans we are feeding him.

Any thoughts on the above??? Especially related to the amylase and eosinophils feedback? I will post the actual lab reports when I pick them up. Probably later today or tomorrow. Want to take the stool sample in at same time so I only have to make one trip.

 

Given what the vet said, I think I am really going to try out the SEB. Looking online now and reviewing @Marje and Gracie 's feedback on what kind to buy and how to administer. Hope this helps.

 

Lots of thoughts on the above. My civie had higher eosinophils, which vet #1 was not worried about. Since Theo came from a shelter, she said that often shelter cats are exposed to lots of things and even if it's been a while, they could still test positive for them years later. Different story with vet #2. I took him to the new vet when he started regular puking. We ended up with an ultrasound and a diagnosis of IBD. And he had stinky poo too. I do agree with your vet that sticking with one food for a while ( at least two weeks ) to see if he is OK with it is a good idea.

Not true - I was very proud of the fact that Neko seldom had glucose in her urine the last few years. It meant I was keeping her blood sugar below renal threshold, which was my goal. It makes some vets nervous if the urine has no glucose in it, but most vets are happier with upper blues as the nadir.

Good news on the kidney and liver values. i used to get the vet to email me the b/w results, so I didn't have to go there, and I found it easier to enter them into the spreadsheet labs tab that way.

 

I had a feeling someone was going to comment on this and disagree. I don't know what Ozzy's renal threshold value is and he has had some nice blues and greens for awhile now, but he's been bouncing a little the last few days and hanging out in the yellows. Wonder what his result would have been if he had this test performed on 1/15 or at a time when he had been surfing.

 

I asked if they could email me my results like my last vet did, but they seem technically challenged or something. Let me ask again.

 

Nope, their system is not hooked up to the internet (even in 2017) for them to be able to email me the results. But they can fax them. Um...who uses a fax anymore.

See, we left some modern conveniences behind when we left the big expensive vet hospital (VCA). At least this vet prescribes lantus. So I'll pick my battles. It's a short drive away.

 

yeah for Ozzy ... glad reports were good ..... I am learning so much just by following you and Ozzy

 

Could the increased Eosinophils be caused by IBD? And the IBD be caused by the recent diet changes? I don't even know what to feed my cat anymore...

 

@Beth 73 Beth, I am reading more about raw diets and know you are looking to switch. Please note that you will probably want to stray away from raw diets with bones since these tend to cause constipation and you are already struggling with that. Rad Cat Raw is a high quality commercial raw food that has great results and reviews. Maybe you might want to purchase a tub and see if Elmo will take to it. You will most likely need to wean him into it. This is the raw food we use and both kitties love it. It does not contain bones. Jut and FYI..

 

This is Maru, the famous YouTube kitty in Japan. I love him!

 

I had no idea. I just thought it was a funny gif of a fat cat trying to get into such a small box.

I just watched one of Maru's videos on YouTube and it cracked me up. He is absolutely adorable!!!

 

Maru is a riot! Good for what ails you when the wheels are falling off the FD cart ...

 

+8 = 131. I tested a little later than I normally do because I had a feeling he was going to keep going down later this cycle. Wouldn't be surprised if he pulls a blue preshot. He is lower this cycle at +8 than his normal nadir (when ever that is...it's always something different with this cat!). Glad to see him back in blues so I won't complain.

 

Thanks Jo . Not sure Elmo would go for raw but glad for your experience with Rad Cat Raw that I can ask u about it if I go that route. Going to switch all 3 of them cos tired of the canned food chase. It just isn't working with my guys. Also interested in EZ Complete Marje has mentioned as Gracie did not go for raw . How once again awesome is it to have ALL this info, ALL this experience ALL in one place. I will never cease to be amazed and appreciative. Hugs to all your guys and of course to you

 

Amen, Kris....laughter is good medicine to the bones

 

Where do you guys buy SEB certified organic? I called every health food store around me and no one carries it!

 

i just found this one on amazon. Will this do?? Was really hoping to get it today.

 

Here's a page on IBD, that describes Eosinphilic IBD and food allergies. One thing I've learned about IBD and food allergies, is that you need to make changes slowly. It makes feline diabetes look like a fast dance. I have found with a couple of proteins, that if I withhold them for a while, like 3-6 months, then I can reintroduce them again. Which I am so grateful for, cause for a while all the civie could eat was the expensive novel proteins (rabbit, venison, buffalo, duck). Now he's OK with chicken, turkey and beef again. Whew!

Have you tried Whole Foods for the SEB? You only need a little bit. Unless you plan on using it yourself, that one on Amazon will last you practically forever. I got a 3.6 oz container last year and still have lots left.

 

There isnt a Whole foods near me unfortunately.

I ended up ordering this SEB from Amazon. Should be here tomorrow before 9pm:

https://www.amazon.com/gp/product/B0170MXI7C/ref=oh_aui_detailpage_o00_s00?ie=UTF8&psc=1

 

I just read that article on IBD earlier today and tagged it on my ss under helpful info. Had lots of good info. Thank you.

 

I've been watching the progress of your beautiful Ozzy and I'm so glad his results were good. Had to comment because I can so relate to not really knowing when my cat's nadir is. Hoping for some good numbers for Ozzy tonight!

 

Thank you so much! That means a lot to me. Hope all is well with you and your kitty. Thank you for commenting on my condo.

 

Guys, literally no one sells SEB around here! Not even the asian herbal store in cerritos! WTH!!?? I live is southern California- the capital of the health food and vitamin supplement craze! This is ridiculous! Gonna have to order from amazon (my most reliable trusted retailer for everything) and poor Ozzy is going to have to wait longer for some tum tum relief!

 

Guys...these baby food containers are literally the answer to my prayers to freeze non-pate style kitty food in the freezer for the later cycle in my auto feeder.

https://www.amazon.com/gp/product/B01CD0GR38/ref=oh_aui_detailpage_o00_s00?ie=UTF8&th=1

These just came in the mail today and I'm very happy with them. I like that the material is bendable so it seems like the food will pop out easy once frozen. I already filled one up and stored in the freezer for later.

 

Girlfriend, I already have an Amazon obsession problem and u pointing this stuff out does not help my propensity to shop in my pjs at all .....

 

Hahah. I know what you mean @Beth 73 Amazon is very addicting. Like really addicting. And everything I can't find anywhere else is sold on Amazon. I literally almost never go to the stores anymore. I even get my groceries delivered by vons. Online shopping/delivery is a lifesaver for people like me who are busy and don't have time to shop a lot or want to stand in long ole lines.

 

Oh I so hear you !! My UPS guy, Andy, is like family !!! He teases me and says " see ya tomorrow Beth "... girls at post office tease when I haven't received a package. For me , living in a small town 45 minutes away from large shopping areas, Amazon is a life saver and has spoiled me for ever

 

PMPS = 100. See...there's the be careful what you wish for PS. His PS is at 11 hours 35 mins from his last shot. We need to work him backwards another 30 minutes by Tuesday morning so have been doing it slowly.

We will be watching and monitoring him tonight. I was expecting a lower PS number tonight because he hase been coming down all day.

I noticed on one of the last cycles when he went down all day and had a lower pre-shot number that he was hungrier during the day. It was like his body knew he was headed for lower numbers even if they weren't yet showing up on the monitor. I'm kind of feeling he will be earning that missed reduction on the 1/28 PM cycle tonight or tomorrow. We will see.

 

1/26 p.m. Most likely.

Sorry to say your vet is a bit behind the times. Before there was a test for pancreatitis, some vets thought the amylase was an indicator of pancreatitis in cats. It's not. Dogs, yes, but in cats, it's really of no signicance. Occasionally, it "might" be a bit elevated in cats with chronic kidney disease. Also, if the sample was hemolyzed, the amylase might be affected. I wouldn't worry about it.

Eosinophils can be elevated in cats with IBD, fleas, parasites, or even just any kind of allergy. You are looking for trends so it would be good to see if it is up or down from the last elevated test.

How can his thyroid be normal if the fT4 isn't back yet?

It's curious his urine specific gravity indicates dilute urine. Is he drinking a lot of water??? Often FD cats have higher USG unless they are drinking a ton of water or also have concurrent thyroid or kidney disease or are getting fluids.

It would be good to always get a hard copy of his labs and enter them on his lab tab. I've seen vets say a value was normal and it wasn't...especially when it comes to kidney related numbers.

 

@Marje and Gracie
Being a person who suffers from thyroid disease myself, I can say that a lot of Drs assume the thyroid is normal if the T4 comes back normal. Now we know that it is the free T3 and free T4 that actually indicates how well the thyroid hormone actually gets into the cells. So we will just wait for the free T4 to come back and I am hopeful it is normal. Hypothyroidism is rare in cats I hear. He doesn't seem to exhibit any hyperthyroid symptoms...in fact, he was a fattie for a long time.

I really don't notice him drinking a lot of water anymore. Ozzy and Figgie both used to love to drink from the faucet in the bathroom. Before Ozzy's DM Dx he was drinking a lot from his water bowl, too. We have been really watering down his food lately because he has had higher BG levels and are scared of him developing ketones again. A lot of folks here said to add water to his food. Should we not be doing that??? The vet said dilute urine is common in cats with DM...guess she means from drinking a lot of water, but I just mentioned that we have not seen that going on as of late. His test results show he does not have kidney disease.

I will definitely be bringing home a copy of the labs and posting them here for you to look at. I was asked to get a fresh stool sample (to check for parasites) so will have to wait till tomorrow (he hasn't gone yet today after the vet called/office closed). Hoping for success tomorrow. If not, I will definitely go pick up his labs (was also waiting for the free T4 to come in).

 

PMPS = 100
+1 = 88

He has been climbing down all day.

Should we give him more food now at +1 (he normally gets more at +2) to steer him up? If so what? LC or MC? How much?

On 1/23 he started with PMPS of 98 (2 points lower, but we shot him early tonight as we are trying to get back on schedule) and he dropped to 47 at +2.

Thanks!

 

Question: If you steer a BG drop with food and are able to avoid having numbers dip down too low, are you able to prevent a bounce?

I'd hate to see him bounce after tonight's cycle after just taking a couple cycles to clear the last bounce.

 

Teehee how much can change in a day. I would give a tsp or two of LC now since it's very early in the cycle to be dropping.

ETA I have also had urine negative for glucose on two different diabetic kitties at the vet. He was really worried the first time but we both had a laugh when I pointed out that this was what you hoped for with TR!

Answer to your question above is - maybe ECID

 

No chit! Ok, will do.

 

Thanks! Good to know.

 

ok, just gave him about 1/2 Tbls of LC. Will test him again when? +2?

I'm really not wanting to break out the honey or kibble again tonight. But we will do what we have to do... I think my cat hates me.

 

Just checked the carbs on what I fed him just now and at his PMPS dinner an hour ago- 2 carbs. Next snack will prob be MC. He was vomiting a lot earlier today (won't be giving him that same food - 3 full food vomits and 1 liquid) so a little worried about what is about to transpire over next few hours.

 

PMPS = 100
+1 = 88 (1/2 tbls LC 2%)
+1.75 = 68 (1/2 tbls HC 20 % FF)

He's already dropped another 20 points in less than an hour (32 points down in less than 2 hours) and he's not yet at +2. Just gave him about 1/2 tbls of FF gravy lovers and squeezed out extra gravy. Hoping to stall up his drop here. Going to be a long night...

I'm not sure HC was correct at this point, but he's super early on in the cycle to be dropping low so I want to try to steer him up. Hope this was the right choice. Trying to avoid Hubby from grabbing the kibble. He was a little rogue with the food last time. This cat is only on .5U of insulin!

@Wendy&Neko Any thoughts on the steering this early in the cycle??

 

PMPS = 100
+1 = 88 (1/2 tbls 2%)
+1.75 = 68 (1/2 tbls HC 20 % FF)
+2.25 = 58 (small amount of HC FF 20% with gravy)

He's had 2 small snacks since his +1 and he's still dropping. Just gave him another small amount of HC food with gravy. Will test again in 30 mins. It's still really early in the cycle. I am reducing his dose to .25U tomorrow AM. He skipped his last reduction because he earned 4 reductions in 7 days.

 

Any advice on food steering this early in the cycle??? We have been HC'ing him last hour and he keeps dropping.

Maybe no one is on the board right now that can answer? Or maybe there are more important kitty emergencies other than Ozzy's weekly dramatic lows. This is unfortunately not our first rodeo with this with Ozzy. Worst case scenario is we overcarb him I guess.

 

This is a bounce breaking cycle, so he's got downward momentum. As you've noticed. Slowing him down this early in the cycle is fine.

 

Thanks Wendy for your reply. So we should keep on with the HC? When should we switch to MC/LC?

 

Let's see what the next test says.

 

If he's still going down, I would do high carb. If he's flattened out or up, you can go to low carb.

 

ok, sounds good. Thank you.

Next test is in 15 mins.

 

PMPS = 100
+1 = 88 (1/2 tbls 2%)
+1.75 = 68 (1/2 tbls HC 20 % FF)
+2.25 = 58 (small amount of HC FF 20% with gravy)
+3 =64

He is having his normal LC snack now. Will test again in an hour.

 

PMPS = 100
+1 = 88 (1/2 tbls 2%)
+1.75 = 68 (1/2 tbls HC 20 % FF)
+2.25 = 58 (small amount of HC FF 20% with gravy)
+3 =64
+4=79
+5 84 (LC, regular snack time)

I feel Ozzy would have definitely gone below 50 tonight if we had not done early monitoring and steering with food early in the cycle. I really hope he does not bounce by the AM. I am thinking of giving him the reduction he earned on the pm cycle of 1/23 down to .25U tomorrow am. Any objections?

 

This is the one that I use. I buy it at a store in Whittier, but you can order online directly from the company. Starwest Botanicals Organic Slippery Elm Bark Powder

 

Nice #s, Ozzy!!

 

Thank you!

 

That flat curve was mama bean induced. Lol! I'm sure he'll pay me back with a big fat bounce.

 

"Herbie's Naturals" in Whittier.

 

@Taffysmama Looks like Taffy is on his way back to the greens too!

 

We'll see. Seems his poopy probs and possibly the lactulose are messing with his numbers, but I have got to get him pooping better. He ate well today, though.

 

I didn't see him go below 50. Usually we wait until they go under 50 before reducing and don't go by what might have happened. Of course you can reduce if you want. Just be prepared that if he does't hold the reduction, you may have to go back up.

 

What about the reduction that he earned and we skipped?

 

Do you mean the one the night of the 23rd that was probably due to the .75u depot? We don't usually take back to back reductions.

As I said you can try this as a reduction if you want. He may hold it.

 

Hi Jo.

He might bounce, or he might not (way to commit, huh? ). It was a beautiful cycle. Nice job steering him without overdoing the carbs. You are learning, grasshopper!

You haven't mentioned any more vomit, so can I assume he's kept his food down this evening (anti-jinx)? I hope you don't need to give him any more gravy, as that can sometimes cause tummy upset.

 

yes, he has kept things down so far so good tonight. Snuggling in his window bed under a blankie looking all super cute. We gave him some more food at +5 (regularly timed snack) and decided to give Ozzy a break (he has been sleepy last couple hours and didn't want to keep waking him up to poke him).

 

Nice surfin', Ozzy Dude!

 

Yep, he bounced. Guess you can't trick the body - it knows it's crashing down and the steer up was artificial.

 

Thanks for your comments Wendy. We held the dose at .5U. You guys have never been wrong with Ozzy so far so I trust the guidance received here. He started his 14th cycle this morning on .5U.

 

@Beth 73 Beth- check out the purrfect little meat pops these containers make! And they hold their shape when defrosted too. so cute! perfect answer for freezing non pate style food and they pop out of the container super easy!

 

Joanna !!!!!! Now I have to have some !!!!! You are an Amazon Enabler

 

And your photo is a must see. Been taking food to sweet neighbor/friend of 35 years. Out of the blue , she had a stroke on thursday. She thought she had indigestion. Has caused me to call to memory the stroke acronym FAST(Face,Arm,Speech, Time) ..by the grace of God she is doing well and a full recovery is expected.

 

Oh Beth- I am so sorry to hear about your sweet neighbor/friend. That is so scary. It is so wonderful of you to be able to look out for her and after her. you are a great friend. Hope she starts feeling better very soon.