12/10 - Toulouse - 374 PMPS

Toulouse’s Mom

Toulouse’s Mom

Member
Hello! We have been working on getting our boy regulated with so much kind help from this group.

As of today, we have been doing 4 consecutive days of .5 units twice a day. It looks like now we have been stuck in the high 300s (Libre 2) for over a day and a half which has me a little concerned as it feels like the .5 units isn't giving him what he needs.

Toulouse seems to be okay for the most part but is acting just a little off. Nothing super concerning he just can't seem to get comfortable and is constantly screaming for food. He is still eating his wet food when given it AM/PM and a few snack during the day.

Could any one share any advice on increasing the doses starting this evening or should we consider continuing with .5 units to be consistent for longer?

Thanks so much for your help!
 
Link to previous post:
https://www.felinediabetes.com/FDMB/threads/hi-toulouse-amps.296382/

Could you remind me why you are feeding RC Glycobalance? Will he not eat regular low carb canned food? Cutting out the carbs could make a big difference to his numbers as well as his insulin requirements.

The higher numbers you are seeing could be from the skipped shot and the depot rebuilding. With SLGS you hold a dose 7 days which you have (with the skips). I'm going to tag @Wendy&Neko who stops by around now to check if you can increase to 0.75U from tomorrow.
 
I am concerned about the trace of ketones in the urine today and the fact he is seeming a little off today. Would you say he was lethargic?
I’m glad he is eating well. Continue to make sure he eats plenty.
I think an increase in dose to 0.75 units is needed with those ketones in the urine and him feeling a bit unwell. I see @Bandit's Mom has tagged @Wendy&Neko. Let’s see what she thinks.
When is the next dose due?
 
I see a 1.0 shot tonight on the spreadsheet? Followed by him hitting a 78. That is too low when feeding higher carb food. 1.0 units is too much. You probably could try 0.75 unit given the trace ketones.

What day did you drop the m/d food? Please mark it on the spreadsheet in the Remarks section. Events, such as food changes can impact blood sugars and it's good to see those events indicated.

After our discussion in your last post, did you increase the amount of food/calories he is getting?
 
Wendy&Neko said:
I see a 1.0 shot tonight on the spreadsheet? Followed by him hitting a 78. That is too low when feeding higher carb food. 1.0 units is too much. You probably could try 0.75 unit given the trace ketones.
Click to expand...

We discussed with our vet last night prior to administering the insulin and they agreed that with him acting a little off and sitting super high that we might need to up his dosing a bit. I really did not like seeing him drop to 78 and sat up with him from 12 AM - 4:30 AM making sure he got a little sugar in him and didn't crash further. We waited about 1 hour more than the 12 hour mark to give him his insulin this morning and ended up giving him .5 when his glucose was at 323. He is now is still reading hi +6 hours post shot (at the time of this post).

Wendy&Neko said:
What day did you drop the m/d food? Please mark it on the spreadsheet in the Remarks section. Events, such as food changes can impact blood sugars and it's good to see those events indicated.
Click to expand...

We pretty much dropped the m/d as meals right at diagnosis. He only got maybe 4-5 pieces of dry food every few days if he was screaming for food. Now we just use wet food for his snacks since we've increasing his calories little by little.

Wendy&Neko said:
After our discussion in your last post, did you increase the amount of food/calories he is getting?
Click to expand...

Yes! We are feeding him 1.25-1.5 can in the morning probably .25 can twice as a snack mid day (.5 total) and 1.25-1.5 can at night. So probably averaging a little more than 3 cans a day (170 cals) i could probably give him a larger portion for mid day snacks if we felt like he needed more calories. I've just been slowly working that up because sometimes he gets fed up with 1 can around supper time if he has too many snacks.

Thank you so much for your continued support! We really are doing our best over here to learn and get this right :cat:
 
Last edited:
Bandit's Mom said:
Link to previous post:
https://www.felinediabetes.com/FDMB/threads/hi-toulouse-amps.296382/

Could you remind me why you are feeding RC Glycobalance? Will he not eat regular low carb canned food? Cutting out the carbs could make a big difference to his numbers as well as his insulin requirements.
Click to expand...

We are still feeding Glycobalance as I was worried to switch to completely no carb while we are still figuring out dosing since there isn't really anything consistent in our dosing equation at the moment I figured I should at least keep the food as such. Maybe I need to reassess this!

Bandit's Mom said:
The higher numbers you are seeing could be from the skipped shot and the depot rebuilding. With SLGS you hold a dose 7 days which you have (with the skips). I'm going to tag @Wendy&Neko who stops by around now to check if you can increase to 0.75U from tomorrow.
Click to expand...

Does this mean I might've messed up the rebuilding from the skipped shots? I wanted so badly to stay consistent for 7 days, but I was nervous with how hi he was sitting for a 2 days plus acting a bit off.

(When I say off, it isn't lethargic per-say, but he is just kind of not his full self. Not as playful and just kind of stares at us. I have seen him lethargic before but this feels a little different?)

Many many thanks for your advice!
 
Toulouse’s Mom said:
We waited about 1 hour more than the 12 hour mark to give him his insulin this morning and ended up giving him .5 when his glucose was at 323. He is now is still reading hi +6 hours post shot (at the time of this post).
Click to expand...
He is bouncing from the green BGs last night because he is no longer used to being in normal numbers. Many newly diagnosed diabetic cats bounce.
Explanation on bouncing:
  • Bouncing - Bouncing is simply a natural reaction to what the cat's system perceives as a BG value that is "too low". "Too low" is relative. If a cat is used to BGs in the 200's, 300's, or higher for a long time, then even a BG that drops to 150 can trigger a "bounce". Bouncing can also be triggered if the blood glucose drops too low and/or too fast.The pancreas, then the liver, release glucogon, glycogen and counter-regulatory hormones. The end result is a dumping of "sugar" into the bloodstream to save the cat from going hypoglycemic from a perceived low. The action is often referred to as "liver panic" or "panicky liver". *Usually*, a bounce will clear kitty's system within 3 days (6 cycles).
 
Bron and Sheba (GA) said:
He is bouncing from the green BGs last night because he is no longer used to being in normal numbers. Many newly diagnosed diabetic cats bounce.
Explanation on bouncing:
  • Bouncing - Bouncing is simply a natural reaction to what the cat's system perceives as a BG value that is "too low". "Too low" is relative. If a cat is used to BGs in the 200's, 300's, or higher for a long time, then even a BG that drops to 150 can trigger a "bounce". Bouncing can also be triggered if the blood glucose drops too low and/or too fast.The pancreas, then the liver, release glucogon, glycogen and counter-regulatory hormones. The end result is a dumping of "sugar" into the bloodstream to save the cat from going hypoglycemic from a perceived low. The action is often referred to as "liver panic" or "panicky liver". *Usually*, a bounce will clear kitty's system within 3 days (6 cycles).
Click to expand...

Thank you :) Gosh I just can't seem to get this right, it is so frustrating and my poor buddy can't be having fun either. How does one bounce back from a bounce?
 
Toulouse’s Mom said:
Thank you :) Gosh I just can't seem to get this right, it is so frustrating and my poor buddy can't be having fun either. How does one bounce back from a bounce?
Click to expand...
Don’t be hard on yourself. It is a really big learning curve in the beginning. And we all started where you are now.
In regards to a bounce…You just have to wait it out. It might last 1 cycle or it might last 6 cycles. Don’t be tempted to increase the dose when you see the high BGs during a bounce.
As Wendy suggested in post 5, you might like to try 0.75 dose which is half way between the 0.5 mark and the 1 unit mark.
 
Toulouse’s Mom said:
We are still feeding Glycobalance as I was worried to switch to completely no carb while we are still figuring out dosing since there isn't really anything consistent in our dosing equation at the moment I figured I should at least keep the food as such. Maybe I need to reassess this!
Click to expand...
Like with human diabetes, diet is a critical component in the treatment of feline diabetes. Feeding carbs and then giving insulin is like trying to put out a fire, while adding fuel to it! :-)
Rather than increase the dose, you want to gradually phase out the Glycobalance and switch her her entirely to a low carb canned diet. Regulating a newly diagnosed cat can take a few months (although some get regulated pretty quickly) and it can involve going up and down the dosing ladder depending on its numbers.
 
170 calories is too little for a 16 lb cat - which is what he is telling you too. A rough approximation from the formula on catinfo.org can be to use the formula there:
Required calories per day = [13.6 X optimal lean body weight in pounds] + 70
Click to expand...
. I don't know how 16 lbs compares to what his optimal lean body weight is, but assuming it's what he should be, that would be 287 calories per day. Even if he should lose a couple lbs and be 14 lbs, that would work out to 260 calories. The formula is just an approximation to start. There are lot of variables such as age, activity level and metabolism of the cat. Weighing weekly and seeing where the weight is going compared to where you want it to be is the best way to tell if he's getting the right amount of food. Any weight loss needs to be gradual.

You don't need to feed a zero carb diet. Many cats do well with a little bit of carbs. A lot of people here feed foods in the 3-5% range.
 
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