7/6 Ozzy PMPS 24.3 7 UNITS

Discussion in 'Prozinc / PZI' started by Andra&Ozzy, Jun 6, 2016.

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  1. Andra&Ozzy

    Andra&Ozzy Member

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    @Sue and Oliver (GA) @Rachel @Robin&BB @BJM @scoobydoox

    Switched to ProZinc today (8 am UK time), 3 1/2 units and doing a curve.

    Some quick info (this is also in my previous thread http://www.felinediabetes.com/FDMB/threads/switch-from-caninsulin-to-prozinc.159005/#post-1695009 and in the detail bit in my profile):

    He is still eating the Hills dry M/D and is still having a pancreatitis flare-up, plus he's on antibiotics for his upper respiratory infection. I understand the antibiotic itself raises the numbers? The latest antibiotic is Marbocyl. We tried Synulox but the infection came back, then another course of Betamox (?), and it didn't solve it. He has been on Marbocyl for the last 5 days and I am going back to the vet's today for more. Any advice on this would be much appreciated, too (e.g. ideas about a better antibiotic or ideas on what else to do to help him).

    **UPDATE**: Vet recommended holding off on more antibiotics for today and tomorrow, to see how he does.
     
    Last edited: Jun 6, 2016
  2. Rachel

    Rachel Well-Known Member

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    Morning Andra! Sorry none of us were around earlier. It's just now 5 AM my time.

    It looks like Ozzy had a nice number this morning for AMPS. Considering all the reds, that pink is good! I'm interested to see what kind of numbers you see today. I'll try to pop in and check on you occasionally, but I'm off to work in a bit, and I tend to have a hard time getting back on until I get home. Others will probably be around later.

    I don't have any advice on the antibiotic really. I don't know enough about the ones you mentioned.
     
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  3. Andra&Ozzy

    Andra&Ozzy Member

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    Thanks very much, Rachel! No problem, I am impressed you are on so early. :)

    Yes, it's not a bad starting number, given what we've been seeing lately. But then again, he didn't eat all that much overnight. He is due a Mirtazapine today and I'm worried that once I give it to him, he'll eat like a maniac and the numbers will go up too much. But I may have to give it to him later, if he keep grazing and not eating much.
     
  4. Rachel

    Rachel Well-Known Member

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    Haha, I'm the early bird around here! I head to work early in the morning, so I have to get up early to drink coffee. And when I say I have to...I mean it. Coffee gives me life. ;)

    Ah, okay that makes sense. Well, it might raise his numbers, but it is important that he eats. When do you give it?
     
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  5. Sharon14

    Sharon14 Well-Known Member

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    Morning Andra, looking forward to seeing how Ozzy does on ProZinc. I'm not familiar with those antibiotics either. Are they in pill or liquid form? Liquid sometimes has sugar in it, but pills should be fine. Have you tried Lysine for Ozzy's URI? Some say it can help.
     
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  6. Carol & Murphy

    Carol & Murphy Well-Known Member

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    Lysine helps for herpes related URIs Murphy gets frequent sinus infections from seasonal allergies and I have had the best luck treating those with doxycycline Fingers crossed for good numbers today
     
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  7. Andra&Ozzy

    Andra&Ozzy Member

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    I'm with you on the coffee front! I'm holding off on the Mirtazapine for now, he keeps going back to his bowl for the occasional graze, still.
     
  8. Andra&Ozzy

    Andra&Ozzy Member

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    Thanks, @Sharon14 and @Carol & Murphy ! The antibiotics are in injection form. All of the ones they've prescribed so far have been. He did well on an anti-inflammatory (in addition to the antibiotics, but the two times we tried, he got diarrhoea from it. I understand this is a common side effect for some cats.

    What is Lysine, @Carol & Murphy @Sharon14 ? How do you give it and how much? Glad it's helping Murphy, Carol! How were the allergies diagnosed, by the way?
     
  9. Andra&Ozzy

    Andra&Ozzy Member

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    Just checked his BG again right now for the +4 hrs curve. It's 19.5 from 20, two hour ago. He is coming down very slowly. The nadir is between +5 and +7 hours, right?
     
  10. Sharon14

    Sharon14 Well-Known Member

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    The Lysine -an amino acid- I use for one of my kitties is in a powder form. I mix 1/8 tsp in his wet food each AM. As Carol said it seems helpful for URI caused from the herpes virus. It also comes in a treat form, but I don't know if the treat has any sugar in it. Maybe ask your vet about it.
     
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  11. Bobbie And Bubba

    Bobbie And Bubba Well-Known Member

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    Good morning, yes the typical nadir for ProZinc is around +5 - +7 Good luck with your curve today
     
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  12. Andra&Ozzy

    Andra&Ozzy Member

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    Thank you!
     
  13. Andra&Ozzy

    Andra&Ozzy Member

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    Thanks, Sharon. I'll ask the vet when we talk today. I just read something online about studies saying that L-Lysine not only does not help, but is potentially harmful. I'll link here, for your info, but I didn't do a thorough search, nor can I see a link on that web page to the studies it's referring to. http://consciouscat.net/2016/01/11/...ptoms-of-feline-upper-respiratory-infections/
     
  14. Sharon14

    Sharon14 Well-Known Member

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    Thanks for the link! I read it. In the comments section some claim it has helped their cats. I guess it helps some. I haven't been giving it to my cat for long. Maybe I'll just give it when he starts a flare up and then only until he's better, and will do some more research.
     
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  15. Andra&Ozzy

    Andra&Ozzy Member

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    You're welcome, @Sharon14 , thanks for recommending it! I just spoke to the vet. He recommended holding off on starting anything else for now (even L-Lysine) and has also recommended we do not give him any more antibiotic for 48 hours (including today), to see how he does. Like you say, the Lysine probably helps some and others not. Might try him on it after these couple of days, if he still needs something.
     
    Last edited: Jun 6, 2016
  16. Andra&Ozzy

    Andra&Ozzy Member

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    Latest BG up already, to 21.8 at +7 hours. The lowest he got today, at the nadir, was 19.3, from 20.2 AMPS. this was on 3 1/2 units of Prozinc. Vet is suggesting giving him 5 units tonight. Thoughts?

    **EDIT** 18:00

    Just got a reading of 18.3, which is the lowest he has been today. Late nadir? This is the period in the day when he ate the least/ almost nothing.
     
    Last edited: Jun 6, 2016
  17. Sharon14

    Sharon14 Well-Known Member

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    Have you given the PM shot?
     
  18. Andra&Ozzy

    Andra&Ozzy Member

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    Is anyone around for some advice on dosage, please?
     
  19. Andra&Ozzy

    Andra&Ozzy Member

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    I am just about to do it. Glad you're here. :) 18.9. Vet said 5 units. Any advice? He didn't go lower than 18.2 today on 3 1/2 units, and that was with almost no eating. I have just given him a Mirtazapine, and he's eaten.
     
  20. Sharon14

    Sharon14 Well-Known Member

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    @Sue and Oliver (GA) , @Robin&BB , @Rachel
    It's usually not advised to jump in dose by that much. I don't know if your case is different though because of the high dose he's been on. Can you wait a few minutes to see if the others come on?
     
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  21. Robin&BB

    Robin&BB Well-Known Member

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    Are you checking for ketones, Andra???
     
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  22. Andra&Ozzy

    Andra&Ozzy Member

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    Sure! Yes, vet advised to jump to 5 because he didn't come lower than two points today (from 20 to 18). He has had 12 units of Caninsulin for the last few days/ couple of weeks and numbers weren't coming down lower than 14 (with two anomalies when he hadn't eaten).
     
  23. Andra&Ozzy

    Andra&Ozzy Member

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    No, he refuses to pee on that plastic litter. But I could try again tonight, maybe he'll go after all (I have everything I need). He just holds it in, won't pee if the plastic pellets are in.
     
  24. Andra&Ozzy

    Andra&Ozzy Member

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    Went for 5, as per vet's advice. I'll monitor him closely tonight.
     
  25. Sharon14

    Sharon14 Well-Known Member

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    Hope this dose brings him down for you.
     
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  26. Robin&BB

    Robin&BB Well-Known Member

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    Andra, I am very concerned about the dosing, because Ozzy has stayed in numbers that we call "high and flat" throughout this last cycle.

    I am uncertain of what to tell you to do about the dosing, but that said, it worries me that your vet wants so much of an increase in ProZinc dose because by raising the dose by too much, you could possibly "miss" the correct dose for your Ozzy. (Just read your post above as I was writing this, so am glad you'll be monitoring closely.)

    There are so many variables in play for Ozzy right now: the pancreatitis and other health issues, multiple medications, high-carb "prescription" diet, the fact that high-dose conditions have not yet been ruled out. (Have they? IAA, for example, is a very specific type of test that most vets are not even aware of. Ask @MrWorfMen's Mom , Linda, about this.)

    So in a nutshell: Ozzy's situation makes it a very "iffy" proposition for any of us to attempt giving you dosing advice at this point in time, because none of us are veterinarians here.

    In all honesty? If Ozzy were my own cat, I would be taking him to an additional vet for a second opinion and full "high-condition" workup, asap. :bighug::bighug::bighug:
     
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  27. Robin&BB

    Robin&BB Well-Known Member

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    @Elizabeth and Bertie - Is the type of ketone meter that tests for ketones via an ear poke available over there in the U.K.? (Over here in the U.S., I believe it's called "Precision Xtra")
     
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  28. Andra&Ozzy

    Andra&Ozzy Member

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    Is it this one?

    https://freestylediabetes.co.uk/our-products/freestyle-optium-neo

    I read about it yesterday after @scoobydoox told me about it. It seemed to me that all it does (from the description) is tell you to check for ketones once the BG number is 13 or higher. Did I miss something and it literally reads traces of ketones in the blood? If so, I'll order it tonight!
     
  29. Robin&BB

    Robin&BB Well-Known Member

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    This is the one I was talking about, available on Amazon in U.S.:

    http://www.amazon.com/Precision-Glu...qid=1465242826&sr=1-2&keywords=precision xtra

    And you have to order the ketone strips separately (they do NOT come with the meter kit):

    http://www.amazon.com/Precision-Xtr...-2&keywords=precision xtra ketone test strips

    So if the meter you're looking at only indicates you should "test for ketones" and doesn't read blood for ketone levels via special ketone strips, you don't want that one. (Maybe you can order this other one via Amazon U.S???)
     
  30. Andra&Ozzy

    Andra&Ozzy Member

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    Thank you very much @Robin&BB and @Sharon14 . I see what you mean... Yes, you're right about the variables. I think the logic of the vet is: get him down for now, so that we can avoid toxicity build-up and then maybe we lower the dose. I will be monitoring him tonight (and checking).

    I read about acromegaly and IAA last night, after @Robin&BB and @BJM mentioned it. told the vet today and he said he'd been meaning to talk to me about that, because he thinks Ozzy should be tested for these. so, i have an appointment tomorrow at 12:30 for this. they'll take blood and send it to the lab for both things. Hopefully, they're not in play. :( We also have an 'open' appointment with a specialist/internist that i need to book, as soon as the vet thinks it's ok to go. I think both my long-term vet and the new one want to wait a week or so before the internist appointment, to see what happens with the ProZinc dosage.
     
  31. Sharon14

    Sharon14 Well-Known Member

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    Hope I posted that right! If not, look on you tube for a video on using the neo to test for ketones
     
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  32. Andra&Ozzy

    Andra&Ozzy Member

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    Thank you, having a look right now. What's blood testing for ketones like, compared to testing the urine? Does it pick up the same kinds of elements, is it as precise, etc.? The vet tested two weeks ago for ketones (both blood and urine) and there were none. But he has been very high since. So, that was the first time I heard that ketones could be tested for in the blood, I don't know much about it...
     
  33. Robin&BB

    Robin&BB Well-Known Member

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    Oh, good! Looks like this one will do it!!!
     
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  34. Andra&Ozzy

    Andra&Ozzy Member

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    @Robin&BB , when you say this is what you call a 'high and flat curve', any indication of what this may mean? I know it's really hard to guess, and Ozzy is a very complicated case, but is it usually indicative of something specific?
     
  35. Robin&BB

    Robin&BB Well-Known Member

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    @Bobbie And Bubba - I know you have often had to test Bubba for ketones ... can you explain how it all works for Andra?
     
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  36. Elizabeth and Bertie

    Elizabeth and Bertie Well-Known Member

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    Hi Andra,
    This seems to get mainly good reviews on Amazon UK here:

    https://www.amazon.co.uk/FREESTYLE-...1465242984&sr=8-2&keywords=blood ketone meter

    My understanding is that it needs separate test strips for ketones and glucose. So, if you're planning on just using it as a ketone meter then you'd only need the ketone test strips....(at least I think that's the case (?!). See the info on the Amazon site, I found it a tad confusing....:confused:)

    Eliz
     
  37. Bobbie And Bubba

    Bobbie And Bubba Well-Known Member

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    Hey Andra ~ I use the Abbott Precision Xtra ketone meter. It was maybe around 30 dollars on Amazon. The strips are a bit pricey. The cheapest place I found them was from a Canadian Online Pharmacy for around $ 2.25 a strip. But for me, it was so worth it because I found trying to get a sample from the litter box impossible as I never knew when he was in the box and how long the urine had been there. Also, ketones show up immediately in the blood but it takes a while for it to show in the urine so you get important information faster with the blood sample.

    I would use the same blood sample that I was using to test the BG. I would have both of the meters ready to go and quickly get a sample on one strip then the other. If you need the Canadian Pharmacy information if you go with the Precision Xtra, let me know and I will get it for you.
     
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  38. DebG

    DebG Well-Known Member

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    Carol what are the symptoms for sinus infections? Fritz has been what looks like lip licking and his little nose is wet and has clear liquid, not all the time. I kinda thought it might be from asthma. The strange thing is about three weeks ago his asthma symptoms disappeared. I am happy but surprised.
     
  39. Robin&BB

    Robin&BB Well-Known Member

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    Here is a pretty detailed explanation of the various types of "rebound":
    http://www.diabeticcatcare.com/DCCCOK/Rebound.htm
    PLEASE NOTE: I am not a fan of Dr. Hodgkins' methods for treating FD (I consider some of the recommendations of this particular vet too extreme); however, the overview of rebound scenarios is actually pretty well written.
     
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  40. Rachel

    Rachel Well-Known Member

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    Andra, I think the high dose condition tests will help us. I just don't know how to advise for dosing. I wonder if we're dealing with high dosing conditions.
     
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  41. Andra&Ozzy

    Andra&Ozzy Member

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    May 18, 2016
    Yes, please! I'd love that link. I'll probably order this one from the US tonight (I'm in the UK- so, if they deliver). Like you, I have trouble doing urine testing for Oz, even though I've had the strips and the plastic litter for ages!

    Thanks for explaining how you do it and what it means, that makes a lot of sense. For the ketone/glucose tester from the US(the link above) I read that I actually does test for traces of ketones in the blood. For the Neo that's available in the UK, what I read on Amazon and their official site is that what it does is blink three times when your BG is 13 or higher. But maybe that was just for the glucose strips... Hmm... I'm confused. Couldn't find more info. It would help if I could order a UK one, as it would cost less and would be easier to reorder the strips, too.
     
  42. Andra&Ozzy

    Andra&Ozzy Member

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    Thanks, Rachel. I understand, it's tricky to advise in a complex situation... I'll be anxiously waiting for results.
     
  43. Andra&Ozzy

    Andra&Ozzy Member

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    Thank you! I'll get down to reading that.
     
  44. Andra&Ozzy

    Andra&Ozzy Member

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    Thanks, Eliz, that's what confuses me, too. The info I read last night explained that all it does is alert you when BG is 13 or higher. But now I'm wondering if what they mean is *with the glucose strips it also tells you that*. So it may be that the ketone strips do test specifically for that in the blood.
     
  45. Sharon14

    Sharon14 Well-Known Member

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    What I understood from the video, the Neo tests for both glucose and ketones, you
    use different strips.
     
  46. Bobbie And Bubba

    Bobbie And Bubba Well-Known Member

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    The Pharmacy is : Universal Drugstore Toll free Tel 1-866-456-2456 When using a human ketone meter, you do not need to be concerned with a reading under 2.4. When you get the meter and you are ready tag me and I will give you two links that were provided to me my one of the Moderators here about understanding the readings as compared to felines.

    I just saw Sharon's post above, the Precision does both too but the strips are so damn expensive so I use the Relion Prime for BG's and the Abbott Precision Xtra for ketones.
     
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  47. Robin&BB

    Robin&BB Well-Known Member

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    Andra, here's Q&A from Amazon users re: the Abbott brand meter you found on Amazon U.K:

      • Hi you would need to buy the Ketone strips as these do not come with the aparatus,
        By TUKSUMDUIN PHARMA 'UK' - (TUK… on 08 March 2016

      • The unit will process blood samples and provide reading for glucose and ketone levels. However you need the strips ( one type for glucose and another for ketone) to collect the blood and insert into the unit. I dont think this kit includes the strips. The stips are on line at a suprising range of … see more
        By Nick the digger on 11 March 2016

      • Freestyle Ketone strips. They are a different colour and when they are inserted your machine should come up with KET on the screen. I don't have to do this myself but all the instructions are on the information sheet supplied with the machine.
        By Amazon Customer on 11 March 2016

      • Optium Beta-Ketone test Strips are to test for blood ketone. Each pack contains 10 test strips , one calibrator and instructions for use, cheers Tuksumduin Pharma
        By TUKSUMDUIN PHARMA 'UK' - (TUK… on 09 March 2016
     
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  48. Andra&Ozzy

    Andra&Ozzy Member

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    Thank you very much, @Sharon14 and @Robin&BB , I think that clears up the confusion.

    @Bobbie And Bubba , I think I'll now order the UK one, but I'll definitely tag you when I get it, for those links, I have no idea yet how to use it, thank you very much for your help!
     
  49. Andra&Ozzy

    Andra&Ozzy Member

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    May 18, 2016
    Latest reading 24.8. he had food, and with gravy, so I think that's doing a lot of the work here...
     
  50. Bobbie And Bubba

    Bobbie And Bubba Well-Known Member

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    The gravy is High Carb and these numbers don't need High carb. Or maybe I am missing something?
     
  51. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Hi! I just had a quick peek at Ozzy's spreadsheet and am wondering how long the pancreatitis has been an issue. That info may be available elsewhere so forgive me if I am asking again about something you have already made folks aware of.

    With my Menace, she was pretty much flat all the time. Sometimes with a dose increase, I would see an initial minor drop in her numbers, get my hopes up and then the numbers would go right back to where they were. I think Wendy & Neko coined it as the "Dose going stale". Lower carb food vs. higher carb food made no difference whatsoever with Menace. Chronic pancreatitis was initially suggested to me as a possible cause but with no symptoms/flareups of pancreatitis ever apparent it seemed likely to me there was something else going on and that's when I pushed for high dose testing to be done.

    The test for the high dose condition IAA (Insulin Auto Antibodies) is called "Insulin Antibodies". It falls under Endocrinology, Pancreatic Function on the lab form. I'm sure the RVC would be able to direct you to where/how to get the test done in the UK if your vet is not familiar or co-operating. I would also get the IGF-1 (Insulin Like Growth Factor), done to see if perhaps you are dealing with acromegaly. IAA is somewhat rarer than acromegaly which is thought to occur in up to 25% of cats with diabetes. Some cats just need higher doses of insulin and certainly the pancreatitis and respiratory infection may be influencing that right now, but I noted Ozzy was on a high dose of Caninsulin before the ProZinc, so getting the high dose testing done may shed some light on why he needs more insulin than what is considered average. Just let me know if you have any other questions.
     
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  52. Andra&Ozzy

    Andra&Ozzy Member

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    May 18, 2016
    Yes, I bought some new wet foods earlier and in a bid to get him off the dry and lower his numbers I gave him this one, earlier. I then remembered that gravy raises numbers. I'm making mistakes, I'm that tired now... I haven't had an uninterrupted night since about a month and a half ago, when the pancreatitis started. I am going to stay up at least until 2 am, where the +6 is, to see where he's at.
     
  53. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Mogs isn't on the board often lately but she's in the UK and purchased a ketone testing monitor for her girl, Saoirse, earlier this year. She would be able to direct you. I'm going to tag her for you hoping she will see this.

    @ Critter Mom, can you provide some info about the ketone testing glucometer you purchased for Saoirse? Thanks!:)
     
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  54. Andra&Ozzy

    Andra&Ozzy Member

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    Thank you very much, that was really helpful. I'm getting the acromegaly and the IAA tests done tomorrow. Not sure how long it takes for results to come back. I asked my vet today after a couple of people suggested it on here last night, and he said that he'd been wanting to talk to me about that, too. So...we are testing for both tomorrow. How are they treated, do you know?

    No problem at all about asking for details! That's how you can help, I'm more than happy to repeat information, I know that the content in previous threads can be overwhelming, especially if one is trying to keep oneself alive in the process. :) The pancreatitis has been an issue for around 6-7 weeks now, at least diagnosed. He was never diagnosed with pancreatitis before, although he's been diabetic since 2010 and IBD for many more years than that (diagnosed around 2004, I think). He settled on the 8 units of Caninsulin for a long time- 6 years. At that point, and since he's become diabetic up until just recently, Caninsulin was the only animal use licensed insulin in the UK.

    How is Menace doing now? Was she diagnosed with IAA and/or acromegaly? Did you go to the RVC? That's where I've been referred to...
    How many units is Menace on now and what did she get up to?

    Was pancreatitis ever confirmed, did you figure out why the flat curve?
     
  55. Andra&Ozzy

    Andra&Ozzy Member

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    May 18, 2016
    This is really useful, @Sharon14 , thank you. I've now ordered the tester and strips. They came up to £70 (!!!).
     
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  56. Robin&BB

    Robin&BB Well-Known Member

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    (I like that you've ordered the ketone-testing meter, not what you had to pay for it with the ketone strips. Yikes!:eek:)
     
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  57. Bobbie And Bubba

    Bobbie And Bubba Well-Known Member

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    That's okay, I wanted to point it out or I would be remiss. You are doing great and I so understand those nninterrupted nights. We will help each other. ;):bighug:
     
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  58. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Glad to hear you are getting the testing done. It really does make us Beans feel so much better when we understand what's behind the frustration, causing us to feel we are somehow doing something wrong or not enough. Menace has IAA only and that explains her flat curves. Pancreatitis was never confirmed and has never been an issue since her diagnosis. Her acromegaly test came back negative. Acromegaly is however a pulsative condition so while the tests can come back negative, it's not 100% conclusive because the test may be done on a day when less of the growth factor is being produced. Acromegaly can be treated with radiation to the pituitary tumour that causes it but the treatment is very expensive. The alternative is to just try to keep ahead of the problem with high doses of insulin and deal with any other symptoms of the acromegaly as they occur.

    IAA tends to burn itself out usually after a year or so. With Menace, I got up to 16u of insulin BID and at just about the 1 year mark, I started seeing a few cycles with some movement in the right direction. I have gradually been reducing her dose in line with her test results and I just reduced her to 10.5u last night so we are still heading in the right direction! It can be a bit of a roller coaster ride while they start coming down but it's all worth the sleepless nights to see the progress and those of dealing with it have all learned to do BCS (BIG CHICKEN SHOTS) when the sleep deprivation starts to get the better of us while the numbers are dropping. I am finding Menace's drops happen in spurts so I get breaks and then back into the fray we go!

    Some cats with Acromegaly have needed as little as 4unit or as much as 100+ units of insulin twice daily and many folks dealing with the high dose conditions use regular insulin as well as one of the long acting insulins to keep their kitties in reasonable numbers. I was about to embark on that route myself when Menace's resistance started to break. Some of the more experienced folks with acromegaly and IAA cats have suggested that the ideal long acting insulins for these conditions are Lantus or Levemir because of their long action and predictability so if Ozzy's tests were to come back positive for one of these conditions that is something else you could consider. I'm in Canada so no RVC for me. I wish I'd had benefit of that expertise. Thankfully though, I have a wonderful vet who is super supportive and works with me, as well as the expertise of the folks here who have walked this path before me! They have been immensely helpful!!

    Here is a great thread (at least in my opinion:D) with a discussion about the different high dose conditions with several of the "experts" on this board. Hopefully Ozzy is just a high dose kitty with none of these high dose conditions but it helps to be informed so we can help our furry kids in the best way possible. :bighug:
     
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  59. Andra&Ozzy

    Andra&Ozzy Member

    Joined:
    May 18, 2016
    Thank you so much for this, it helps to learn as much as I can about this and to talk to people like you and the other wonderful people on this board, who've been so helpful. The anxiety and constant self-criticism with this stuff really does get to you, to the point where you make mistakes and destroy your health in the process. Thank you for linking to the thread, too, I'll have a read tomorrow. I'm so glad that Menace's numbers have started to come down. Were you/ are you testing for ketones? How did you keep that at bay for so long (the toxicity)?

    Ozzy's long-term vet thinks that Lantus or Levemir would be more risky for Ozzy, since the deposit will mean that if he drops, he'll stay there for longer. His BGs vary quite a bit, depending on how much he's eating, and, since I haven't yet been able to break his dry food addiction and that's high carb, a day of being home alone and sleeping and not eating might be dangerous (still amazes me that a diabetic food is high carb; how the pet food industry get away with that, I don't know).
    Regardless, I think that if any of these come back positive- I am so, so hoping they don't- we'll look at these alternatives.

    If needed, I will also be asking for help with these shorter-acting insulins.

    What is BID, by the way? I know there's a glossary, but I haven't been able to go through much of it yet, with everything else I've been reading about.

    Hugs!
     
  60. Andra&Ozzy

    Andra&Ozzy Member

    Joined:
    May 18, 2016
    Thank you! I know what you meant, and you're right, it needs pointing out. I have been kicking myself all evening for that mistake. Although, by the looks of the cycle so far, he wouldn't have come down much anyway. But it certainly didn't need raising. By the way, when you add a note on the S/S, how can you signal that one should scroll further for the note, from the numbers (left to right)? Or do people scroll anyway, as default?
     
  61. Bobbie And Bubba

    Bobbie And Bubba Well-Known Member

    Joined:
    Jun 15, 2015
    hmmmm, there is a way you can put in a comment that will show up as a little triangle in the upper right hand corner of the cell but, I am not sure if other can see it. Go to the upper right hand corner of your SS and click on Comment. There will be a drop down window to guide you and can add a comment and it will show up as a triangle in the upper right hand corner of the cell. I am really not sure if it is visible to others but try it and we can check it out.
     
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  62. Andra&Ozzy

    Andra&Ozzy Member

    Joined:
    May 18, 2016
    Thank you. I think I will attempt this tomorrow, my brain is fried. I have just taken his +6 hrs reading and it seems to be going up, not down. I know that the gravy will have played a part, but not even a dent in the numbers? What dose would you start on in the morning, given these numbers? I know that caution is advised, but at this point i am really worried about toxicity building up... :(
     
    Last edited: Jun 6, 2016
  63. Bobbie And Bubba

    Bobbie And Bubba Well-Known Member

    Joined:
    Jun 15, 2015
    I am going to let the more experienced peeps help you with the dosing. @Rachel and @Robin&BB are much more dose savvy than me.
     
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  64. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

    Joined:
    Feb 18, 2015
    Sorry about the "BID". My nursing days haven't quite totally left me even after all these year.:woot: It means twice daily.

    Menace has never been prone to ketones and I could never catch her in the litter box or she would just stop and leave. Also with 2 other four footers and with 6 litter boxes in the house, it's hard to keep track of who is going where & when. In the early days, I had the vet check periodically, but Menace, living up to her name, has recently decided that providing urine samples for ANYONE is beneath her dignity so I was contemplating a glucometer that measured ketones until her numbers started coming down. I suppose I am being a bit cavalier here but I am home all day and pretty much pick up on any sign that things are off, so I have procrastinated. Going forward, I would definitely go the glucometer route.

    I so understand the kibble issue. My Menace is a kibble addict of the worst kind. I have been trying to get this girl to eat wet food since I got her at 10 weeks old and all she does is try to bury it as if it were her own waste. She won't even eat her kibble if it is in the vicinity of wet food. Those mournful looks of disgust at her brother's food dishes say it all! The only soft thing to enter Menace's mouth has been a few bits off a peanut butter sandwich she decided to sample when Mom wasn't looking! What possessed her that day I have no idea! So I am feeding her kibble as low in carbs as I can get and that she will eat, but still less than optimal for a diabetic cat. She has to eat! Every day for more than 5 years, I offer her wet food and let her contemplate how hungry she is. Never does her hunger outdo her commitment to crunchy food. I have tried every trick in the book and more along with every variety of wet food I could find but to no avail. To my credit, I managed to transition my 17 year old cat to an all wet diet in the process and he won't even touch kibble now so I think I have just been outsmarted by an extremely willful feline named Menace. :rolleyes:

    Not being totally familiar with Ozzy's history, I can't argue with your vet's assumption about the long acting insulins but most of your experience has been with Caninsulin. The curve with Lantus or Levemir is much slower and smoother so from my novice viewpoint and what I see on Ozzy's spreadsheet now, I'm not sure how he/she came to that conclusion.
     
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  65. Rachel

    Rachel Well-Known Member

    Joined:
    Aug 25, 2013
    Andra, with all the factors that can be in play, it's hard to tell you for sure. I have suspicions about what is going on, but there are so many options...and I'm afraid I just don't know wha tto tell you on dose. When are you getting the high dose conditions checked?
     
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  66. Andra&Ozzy

    Andra&Ozzy Member

    Joined:
    May 18, 2016
    Hi Rachel. I know you can't know for sure, of course. What are you thinking, in terms of what may be going on, the high dose conditions? I'm asking because it might be a lead into investigating other possible causes.

    We went to the vet today and they took blood. They are sending it off to check for acromegaly and ketones. They took enough blood to check for insulin resistance too, but then the vet called and said that actually, there's nowhere in England that does this, they send it over to the US! And so...he wants to hold off on that for now, since he said the only identified high dose condition that would change treatment for us in the short term is the acromegaly. He said that there's nothing one actually does about insulin resistance (this is what I've read, as well) other than putting the dose up until it 'breaks' the resistance and things return to normal. Obviously, I'll be checking his BGs consistently, especially if everything else comes back negative, he ends up on a really high dose and that's the most likely explanation.

    In other news, as soon as I brought him back from the vet's, his eyes started producing yellowish stuff again and his breathing got a bit raspier. He's been off the antibiotics for the upper respiratory infection for two days now, and I was hoping it had gone away... :(
     
  67. Andra&Ozzy

    Andra&Ozzy Member

    Joined:
    May 18, 2016
    Your Menace sounds like such a character! Much like my Oz. He's very particular about a lot of things. Hasn't made caring for his IBD and diabetes any easier, but he's such a total sweetheart about all the poking, stinging, and the various other undignified things we've done to him, that I really can't complain! Besides, like your Menace, he's both very intelligent and wilful and quite the character, in many ways.

    I'm glad you can be home to care for her, that makes a lot of difference to the anxiety. That sounds like a really full house, and a happy one too, with all those little furry legs running around! :)

    What dry kibble did you end up feeding Menace after all? Does she even lick at any wet food? I am still ordering lots of things to try to get him onto a better diet (wet and the low carb dry that @Elizabeth and Bertie suggested). My next plan of attack is to order the EZ complete supplement and try and coax him into the homemade again. I think I have my work cut out!

    That's amazing about the 17- year old cat, by the way! Congratulations! It is so much to do with their characters (and other conditions, too).
     
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  68. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

    Joined:
    Feb 18, 2015
    Menace is indeed a character and lives up to her name quite frequently but that's just one of her many endearing qualities. She too is a real "pussycat" when it comes to testing and shots. Thankfully Menace has been very healthy except for the diabetes with IAA. She had a dental done in January and I thought it would be impossible to give her antibiotics by mouth, but she ended up being pretty good about it. I really think they know when we are trying to help them and as long as we have a "can do" attitude, they have confidence in us.

    As for kibble, right now I have Menace eating Nature Valley Instinct Ultimate Protein. Not sure if that is available in the UK or not. Sounds great but is about 15% carbs so still too high. Our selection of low carb kibble here in Canada is dismal. I used to feed her EVO but they left the Canadian market leaving me high and dry for anything under 10%. She will not even lick wet food. In fact she won't eat her kibble if it is near one of her brother's canned food meals. One day when her numbers were low, I tried to get her to take some gravy from some higher carb wet food. I had to try to get it in her mouth and let's just say, I got more on me than she got in her mouth! You would have thought I was trying to poison her!:rolleyes:

    If you can get TiKi cat food, they now have a kibble available called Born Carnivore which I am going to look into. It appears it will likely be about 15% carbs too but I haven't done the math yet. I tried home cooked, dehydrating, adding kibble to wet, etc. etc. but to no avail. My only regret now is that I wasn't more assertive about the wet diet when Menace was a kitten, but hindsight is 20/20 and there is no point crying over spilled milk.

    Interesting that they do the IGF-1 but not the IAA testing in the UK. The cost of those tests is very reasonable here but then the shipping gets added on, plus money exchange rates and the cost went up considerably so I can only imagine what the costs would be from the UK to the US. Your vet is correct in that all you can do with the IAA is keep dosing until the antibodies cry UNCLE so his decision was a reasonable one. I just hope he didn't get duped by some lab that doesn't know the test can be done locally. The lab my vet uses told her there was no IAA test. I insisted and provided the Univ. of Michigan test code # and then they were fine with sending it off. Such fun when you have to "manage" those who should be the experts for this stuff. :banghead:
     
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  69. Andra&Ozzy

    Andra&Ozzy Member

    Joined:
    May 18, 2016
    I think you're right about them knowing we are trying to help them. And they do trust us. It's such an honour, isn't it? This animal that could shred you lets you shove things in its mouth, poke its ear, its skin and occasionally its bum.

    Wow, Menace really hates wet! That's funny, that she won't go near her kibble if it's even in the vecinity of her brother's bowl. I also have regrets about letting him eat dry when he was diagnosed with IBD and the vet prescribed it (he was on wet prior to that, but in fairness, he'd stopped eating the meat, would only have the jelly). But, like you say, hindsight is 20/20. I will look into Tikicat. I doubt we have it here, in the UK. But I might find some place that imports it.

    That's interesting that the vet got duped... I wonder why. Surely, the lab has an interest in doing the tests and getting people's money? I'll double check. It's tricky though, raising the question, which is often heard as (and sometimes means) I don't trust your expertise and judgement. Even if we're right, as you were, it's tricky. How did the vet react to that? What does the code mean, by the way? I didn't even know testing places had a code!
     
  70. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

    Joined:
    Feb 18, 2015
    My vet is so cool and doesn't view herself as the consummate expert in everything as so many medical professionals unfortunately do. She admits her shortcomings and diabetes is not something vets treat on a daily basis. Most practises have very few diabetic patients. I think we have developed a relationship where she knows I will do anything for my kitties and I research until I'm ready to drop. She too is willing to research so we work as a team. The tests I wanted done were so unusual for the average practice that she never blinked an eye. I quite frankly think she is viewing our journey as a learning experience for her as she has never had a patient with IAA before.

    Labs often (if not always) have code numbers for the tests they do probably for billing purposes more than anything else. The Univ. of Michigan happens to have that information on their website so it was very easy for me to access it and straighten out the lab personnel who apparently had not run into anyone wanting the test done before either.

    I wouldn't shy away from asking again just to be sure. You are Ozzy's advocate and entitled to ask all the questions you want. It doesn't mean you are questioning your vet's expertise....it means you are making sure all the info you have is correct. Any vet/human doctor who takes offense to any questions, in my opinion, is too full of themselves to be worthy of my trust.
     
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  71. Andra&Ozzy

    Andra&Ozzy Member

    Joined:
    May 18, 2016
    Thank you, and sorry for the belated reply. I will try again on the antibody resistance test. There are a number of tests that vet practices do routinely send to the US, apparently, so this may just be one of them. We'll send it if we have to. Your vet sounds like they have the right attitude to this.
     
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