10/10 ? Bootsie amps 296

I have been following the TR and increasing 0.5u every 3 days. I am feeling really discouraged as I see no change in her BG numbers. She is still ravenous and I am wondering how much I should be feeding her. If I calculate how many calories she should have per day, based on her weight it is a bit under 300 cals per day. But that does not seem to satisfy her appetite. If I feed her more is that bad? Or does it not matter because her body does not use the calories correctly. She is not over weight. She is on FF Classic Pate or Friskies Pate wet food.
And I still do not have her Acro or IAA results back. The labs were drawn on 9/30.

Feeling defeated. Jackie

 

I can understand how you feel when you see her numbers not budging despite the dose increases. She hasn't gotten to her good dose yet and you are increasing as fast as is safely possible.

Normally with yellow nadirs, we do not fastrack dosing, but considering that her yellows are pretty much close to 300, I will tag @Wendy&Neko to see if she will recommend increases by more than 0.5U at a time.

On the food front, are the meals spread out? That helps with the constant hunger pangs. But yes, uregulated diabetic cats cannot process their food and considering that she is not overweight, you can feed her more and see if that helps!

 

Hi Jackie,

Here is your last post for continuity (please cut and paste this into each of your new threads so that others can see what happened with your kitty previously): https://www.felinediabetes.com/FDMB/threads/10-8-somatasatin-for-acro-treatment.254009/#post-2863052

Cats who are hyperglycemic will be ravenously hungry. Feed Bootsie whatever she wants to eat. Once you have her BGs under some better control, she will naturally want to eat less. Cats with unregulated blood sugars are not turning what they eat into energy properly, so she will feel hungry. What you should be concerned about is if she stops eating and has really high numbers as that is a sign of DKA. Also make sure she has plenty of fresh water at her disposal, as the fluids help reduce the build up of ketones in her blood.

Hope you get some answers from her test soon.

 

I am doing the 0.5u increases because her nadir is never below 300 and I understood that increase was ok based on her numbers over 300.

 

Up to 5U, increases and decreases are in multiples of 0.25U. However, if nadirs are over, increases are in multiples of 0.5U
For doses between 5U and 10U, increases/decreases are in multiples of 0.5U and over 10U, increases/decreases are in multiples of 1U

 

This was the information I am following from this website - is this no longer correct?

Increasing the dose:

• Hold the dose for 3 - 5 days (6 - 10 consecutive cycles) if nadirs are less than 200 before increasing the dose by 0.25 unit.
  • if your cat is new to numbers under 200, it is recommended to hold the dose for at least 8-10 cycles before increasing.
  • when your cat starts to see nadirs under 100, hold the dose for at least 10 cycles before increasing.
• Increase by 0.25 unit after 3 days (6 consecutive cycles) if nadirs are greater than 200, but less than 300.
• Increase by 0.5 unit after 3 days (6 consecutive cycles) if nadirs are greater than 300.

https://www.felinediabetes.com/FDMB...-low-go-slow-slgs-tight-regulation-tr.210110/

 

What you posted above is correct.

 

Yes. It is correct. Is there something I said earlier that contradicts that?

The sticky does not mention the bit about dose increase/decrease being in higher multiples at higher doses.

 

That is what I was confused about. I was basing her increases on the BG levels not the dose being given. Thanks.

 

Jackie --

You're doing a great job! Not seeing the numbers budge is more than a little frustrating, through. Just keep doing what you're doing.

Hopefully, you will get the results soon. You may want to nudge your vet. We've had instances where MSU faxed the labs and the vet hadn't looked through the piles on his desk and thought to call about the results. Also, the lab at MSU only runs the tests once a week. Depending on when the sample got there, it may explain the delay.

 

Feed your cat based on what the scale tells you, and the total calories she's getting. Ask the vet what her ideal weight is, and feel more, less, or same based on what she weighs now. I found feeding raw food to be somehow more satisfying to Neko. It is more calorie dense. I also gave her 3-4 meals per cycle, the main one plus couple smaller ones spread out, but preferable all before nadir. Feeding after nadir can shorten duration as the insulin is waning at that point and carbs make it wear off even faster. I also found than when I was feeding her the later meals from an autofeeder, she started staring at it, instead of bugging me for food.

There is a condition called glucose toxicity, where there body gets used to higher numbers, and you have to go even higher in dose to get over it. Holding a dose overly long, or resetting the dose back can make this work. Unfortunately, insulin is a hormone, and it's not uncommon to not see much movement, until you get close to that better dose. Hang on, you are now on the right path.

The IGF-1 test is is an overnight test started only on Wednesdays, so blood received before then is held until then. Blood drawn 9/30 should have been tested on Oct 6th, results should be out now. Vet should have received them, so maybe you'll hear on Monday. Call if you don't.

 

Wendy - thanks - I will call the vet on Monday and see if they know anything. I usually feed her about 6:30 main portion then again about 8, 10, 12 and 2p. I try to give give her some nibbles of plain cooked chicken breast between 3-6P when I retest and give her another main meal. She then usually has another small meal about 7 and 10p and then nothing for the rest of the night unless she eats what we leave out. I do most of the BG’s during the day because I fall asleep about 10p. Am I feeling her too much - it is all LC wet food. And by raw food - do you make your own using Dr. Lisa’s recipe?

You mentioned glucose toxicity and setting the dose back - what does that mean? When I reached out for help that is what I was kind of doing was taking her dose back to 4 U because her numbers seemed better when she was on that dose but my vet had me increase her based on her high Fructosomine levels. I think it is all very confusing and I am a medical person!

Thanks

 

Hopefully it wasn't anyone here who suggested you to take her dose back. That seldom does anything but make it take longer to get to a good dose. Worst case, it can cause ketones to arise. By "setting back", I meant when you took the dose back down instead of up.

The nature of insulin resistance (of which there are different kinds in kitties) is that it's not uncommon to have a dose look good at one point, then start to look worse as the resistance increases. When it happened to Neko, I called it "the dose going stale". You sometimes feel like you are chasing good numbers. That's why we encourage following TR if you have a kitty in higher doses, and increasing as fast as safely possible, to keep on top of things.

When you have glucose toxicity (see the link for more details), their body gets used to higher numbers and you have to give more insulin to break through.

As for are you feeding her too much, weigh her regularly and see if her weight is going where you want it to. I started with premanufactured raw foodd. There are a couple really good local company with good ingredients. Later on, when Neko's phosphorus levels crept up, I moved to making some of her food with a premix. First TC Feline, then EZComplete. It's the lazy person's way of making raw food.