Previous post for continuity https://felinediabetes.com/FDMB/thr...6-1-313-2-305-3-325-7-hi.288194/#post-3165330 Looking for help and/or support after vet visit. I've yet to experience Luke being in the green for any length of time, I'm wondering what your thoughts are on the path forward. I am nervous that the vet will simply command me to drop the dose then I'm starting over again. This is what she said last time. Background: Luke has IBD, and as of the past few months a chronic eye issue which is being treated with eye steroids (which is driving his BG up slightly). In addition, he's been sometimes peeing outside of the litterbox (not often, maybe once every couple of months). I went to the vet today to see if she could run some tests on food intolerances as this worked well for him in the past with an old vet from my previous state. Unfortunately, instead of helping, I got a whole lot of lecturing. Apparently everything he's going through is likely "unregulated diabetes" and it's all because I'm not a good enough cat mom to take care of him properly. Her prognosis: reduce his insulin every time he has a number less than 100, and put him on a dry food only diet to control his IBD. Anything else I do will be wrong. I've tried reasoning with her, explaining what I've learned on the forums and I've read through all the posts on the myth of the somogyi effect. I guess at this point I'm wondering what exactly to do. It's been over a year since he's been diagnosed. His numbers are still wildly fluctuating, no matter if I use SLGS or TR. TL;DR: I just got done reading through other posts on this topic (including one on chronic low-level overdose) and see it's very controversial so I'm hoping someone can look at Luke's numbers and help me understand if there's a pattern I'm not seeing here. https://docs.google.com/spreadsheet...J6i1YwaWDO6BjMV84AlH2RnqXg/edit#gid=258379912
Starting over is the worse idea as you know. Luke needs more insulin rather than less. Any chance of finding another vet? What do you mean back to L on the ss? The two tests were so different at pmps before. How long between tests?
The words didn't get wrapped in the cell, what is says is: back to Libre (which had come off a few days earlier). Essentially from 4/29 to 5/4 I was using Freestyle Lite/Ear Pricks. When you say how long between tests, can you help me understand what that means? All of the data I gathered is in the sheet. The 64/PMPS on 5/4 was taken with a freestyle lite. I gave him some fancy feast with gravy and within an hour it came up to 157. I then gave him his shot.
Ok. I was referring to the pretexts you mentioned. You did not need hc at that point. Better to stall without food and retest in 30 minutes to see if the bg came up on its own as the food influenced the next test. I think you are seeing a bounce from the green now.
Ok, thanks. That makes sense. Not sure how to go about new vet again. This is my third one since he got diagnosed so it's really frustrating. Since he has other chronic conditions, I want someone nearby in case he has an emergency so I may need to figure out my game plan. The others I've tried around here were even more clueless, including the one who initially misdiagnosed him and led to him being in the hospital for 2 weeks with ketosis. I think what I'll do is stall giving her the numbers from the Libre. Her ask was to see all of his numbers and to do a curve in the office. I pushed back. For the future, if I didn't give him hc, and his BS remained low (say, 70-90), would I have given him a shot anyway and closely monitored throughout the night?
On 4/28, you reduced his dose even though he didn't go below 50 and your signature says you are following TR. With TR, you can shoot anything above 50, providing you can monitor. What time of day does he get the steroid drops? What type of eye condition is it? Just wondering if there is an alternative without steroids. What are you doing to control his IBD?
Ah, ok. I did drop too soon. I think I need to stop listening to my vet who legit warned me I was going to kill him last time if I shoot any number lower than 100. Sigh. The steroid drops are at 7am, 2pm and 8pm. They cannot find a root cause for the eye condition. It is some form of uveitis. We ran a bunch of tests and ruled out pathological diseases and other root causes, but they can't find anything. One eye changes color without the drops. It's normally blue but can change to brown/hazel and get cloudy. No ulcers in the eye, no cataracts and no glaucoma. Pressure is ok. I tried to take the dose down but it got worse and their concern is that if the eye gets worse, it can lead to pressure drop and blindness. I am taking him to an animal eye specialist for this. So I do trust them. For the IBD, I switched his diet to Primal Raw - turkey or venison, about 4 months ago and it got so much better (from Fancy Feast). But then about a month ago I went away for work for a week and it's been terrible since then. It had gotten bloody and so runny that I was worried for him, so took him into vet and they put him on a round of antibiotics and a stool firmer. That has helped. Now he is doing "ok" but it's still not great. Occasionally I give him Tiki Cat succulent chicken. Fancy Feast seems to be the worst right now. I tried to give him a can last week and he was in the litter box very shortly after and it wasn't pretty.
I have an IBD kitty too. Novel protein is good. Fish is a common allergy and a lot of FF has "meat by product" so who knows what meat. Along with a good protein, a probiotic (I like to give Visbiome) and something like psyllium husk fiber can help. The latter will help his stool. Inflammation can also raise BG. Can you tell me which antibiotic they gave? I was asking about the drops cause I was wondering if there was a pattern between them and higher numbers. Glad to hear you are going to an eye specialist vet.
They gave him metronidazole (100 mg/mL) and Propectalin for the stool. I will try psyllium husk, I have some. What is novel protein? And good to know about the probiotic. I wasn't giving him any for awhile but started with Fortiflora last week. Any specific things that can cause inflammation that I should be aware of? Because that's similar to what the eye doctor said. That it seems like there is a lot of inflammation in his body. This was before the IBD flare up. So now I'm wondering, is there any preventative for inflammation in cats?
I have a cat that likely has IBD too and she gets the same probiotic that Wendy uses. I’m giving it to my cat with skin allergies as well. They both are eating Prinal as well. I have read that some cats do not do well on it. Mocha was on Small Batch lamb which is a better food but her skin allergies started acting up. It might be environmental so I added Zyrtec and for now switched the protein. If she gets better I will likely go try Small Batch again. They supposedly make pork but I can’t get it where I live.
Novel protein is one they haven't had before, such as lamb, rabbit, pork, and goat. Neko even had wild boar, elk, bison, though she didn't have IBD. Metronidazole is not the greatest med and shouldn't be given except in certain situations. It can harm the gut biome. Fortiflora isn't a good probiotic. It's a single strain probiotic and better as a flavour enhancer.
You are all such a wealth of information. It's so hard to make heads or tails of what vets say these days. I know that in dogs, Fortiflora is not only not good, but actually considered harmful as it contains pre protein which is not good for dogs at all, so not surprising that the cat one is not good. I'll switch. He has had most of those proteins but I did have good experience with Rabbit in the past so can try that again as well as some of the others you mention. As for the meds, thanks for the info. It does have me concerned that so many vets I've tried don't seem to be as up to date with current protocols, thinking and the science/nutrition of foods. It's like, I have to use them for some things, but just can't rely that they won't be doing more harm than good at the end of the day. Take today even, the fact that she was pushing a DRY FOOD on my diabetic cat, because it is a single protein source, and insisted that there are no other safe foods for cats with IBD was making my blood boil. I could see it written all over her face and her body language that me pushing back that I will not feed my diabetic cat dry food and trying to educate her on the importance of low carbs was causing her to get very angry with me. She slammed the door as she left when I said I would not buy that food. So yeah maybe it's time for another vet.
