? 8/14 Simon AMPS 346, +5 68, +7 88, PMPS 88

Yesterday

Good morning! Confused and frustrated by Simon's readings over the past 12 hours. Why is his BG going UP like this? Maybe he won't go into remission right away. So frustrated. Im thinking about staying at 0.5 this am though, just to try and stabilize his numbers? Thoughts?

 

Please don’t be upset. He’s reacting to the skipped shot. The depot needs to fill again. You get a pokie break. I’d get a +3. Let’s see if he comes down.

 

Thanks for being here @tiffmaxee ! Do you agree with 0.5 for this morning?

 

Absolutely I agree!

 

Okay good!

 

Hi Kyle! It's very early in the game for you guys...try to take a deep breath...you're going to see a whole lotta ups and downs.

So the other thing I notice looking at your SS, is that dose is different too often. And then there's a skip...I know you were on the forum and there was some discussion - so at that point unless you're looking at a low BG level that you're uncomfortable with, please try to maintain the same dose consistently - of course you don't want to shoot a number that's too low - please stall at that time and post - ask for help.

I presume there are previous conversations that indicate a .5 is a better early dose for Simon - so for now, please try to stick with that dose. Lantus is a depot drug - a hormone actually - and by being consistent you'll get better numbers. Also please try to get another test at night if at all possible.

Hang on for the ride...let's get Simon back into those lovely greens

 

Thank you @Sue and Luci ! I think we were operating under an assumption that Simon might just slide quickly into remission since his diabetes was steroid induced and he is no longer taking steroids. Oh well. I guess we aren’t getting a free pass out of here after all Hoping we can get some better numbers in the days ahead. Thanks for your help!

 

Kyle - I have a strong hunch that Tina's diabetes was also steroid induced. That's part of why I feel I was able to get her into remission, but it took about 5 months of insulin. And that was after 5 months of needing insulin and not getting it.
I learned to always, always request blood work - was told over the phone her bloodwork was fine five months before diagnosis, then I later learned her BG was almost 600 back then; vet chalked it up to stress and didn't mention it. Sorry, OT. Later apologized - he thought her arthritis was crippling her when it was worsening neuropathy. She's pretty great now.

Love to Simon!

 

Kyle, if this was answered I just don’t remember. How long was Simon on prednisolone?

 

Actually there were several reasons why I thought it wise to skip that shot. The first one was the difficulty drawing blood to test. It was already after 8:30 and I was concerned you would possibly need to be up all night and I couldn’t stay with you past +3. Another factor was how new Simon was to to Lantus and lack of data to know how he would respond. Possible quick remission was not the reason to skip quite yet. My vet made that mistake early on with Max when his nadir was 60 and I wasn’t home testing yet. He though he was in remission and stopped insulin for three weeks. Max wasn’t. That’s when I came back and started testing myself.

 

Yes, I can second the vote on that. Although Luci's dx was not steroid induced, I've seen a number of cats come here to the forum...and unfortunately it can take months to yes, years to get them back to the normal place.

I'm still mystified as to why vets want to give steroids when they must (I hope) understand the risk is to put a cat into diabetes by basically destroying the normal functions of their pancreas'...what the heck are they thinking' ??

Once again, I have to fall back to one thing I've learned from this forum - over and over and over again - vets have fallen short of their education on Feline Diabetes...sad but true. They just do not have enough knowledge to be able to make the best decisions for the poor kitties... where is the shaking head icon???

 

The problem is steroids work for lots of things. I had a cat that vets couldn’t figure what was wrong. She was on pred on and off for feline acne and then the mystery illness. She are well but was losing weight until the night before I lost her. She had lung cancer that was then throughout her body. Three vets couldn’t figure it out. That’s why with each illness my cats get I learn more about feline health. I’ve had an education in lymphoma, CKD, pancreatitis, CHF, diabetes, and currently allergies.

 

Did you try to get another test?

 

I was working on it, but he reached his limit. I don't know why last night and this morning went so easily and now its back to square one! Im going to give him an hour to recover and then try again.

Simon was on prednisolone for about 4 months. It definitely saved his life after a bad flare when the ER vet told me to put him down. However, my new vet never once suggested adjusting the dose or taking him off of it. It was my suggestion to try a taper. Unfortunately that led to another flare and a trip to the ER and that's when we discovered his diabetes. It has been a roller coaster! Of course we have had to learn all of this stuff the hard way!

 

I hope the internist puts him in budesonide and gets rid of the nausea making one or puts him on pulsed. Do they suspect small cell or IBD?

Good thing he didn’t start low. Not cooperating with tests means we need to be cautious with dosing. That will improve.

 

I really feel like my inability to reliably test him is a major factor in managing this disease right now.

I think budesonide could work very well for him, although it can also contribute to diabetes I guess in some cases. He was doing really well on prednisolone and weighed 14lbs! Happy, eating, and playful. Now he just seems tired, nauseous, and uncomfortable a lot of the time, plus annoyed with me!

My vet said she would treat small cell and IBD in the same way so there was no need to get a definitive diagnosis. Obviously he is not a good candidate for a biopsy, but I have asked about ultrasounds but she felt that was unnecessary. I am hoping the internist can give me better advice about how far we need to go with the diagnosis. If we could manage him w/ budesonide alone, and get him eating again so I could really dial down his diet, that would be ideal. Oh and get this diabetes into remission!

 

I also think that Simon's nausea has also been a factor as managing him with food could be difficult when he won't eat. Maybe I should shift his pm dose to an earlier time so that I can do a few pm post tests without having to set alarms or ask someone else to stay up late with me?

 

Yes this is such good advice. So sorry that we have to learn some of this the hard way!! So glad to hear that she is doing well!

 

Oh my @tiffmaxee I am so sorry you and your cats have been through so much! I guess every cat develops some issues at some point, but you have really been through a lot.

 

You must be reading my mind. I was just going to ask you if there was any reason you shoot at 8:30. If it fits your schedule then great. If not I’d consider shooting earlier. More people are around to help if needed earlier. I found it was easier to make plans shooting earlier.

 

The good news is only one passed young. Max was 19.

 

Oh sweet Max! I honestly cried when I looked at your spreadsheet for him. It was just obvious what great care you took of him.

 

Seriously? Now his BG is 68 ? This is unbelievable!

 

No surprise. When did he last eat?

 

Really? This seems like a big drop to me from amps. He has been sort of nibbling throughout the day. I did try 8 mg of Cerenia and I think he is less nauseous, but he hasn't had a full meal yet. Should I try to give hime something extra yummy? Is it time for Gravy Lover's?

 

Not time for gravy. You could give some lc or mc, whichever he will eat.

 

He didn’t jump from 346 to 68 in an hour. It took ( hours to get there. A test at +2-3 will let you know if he’s going to have an active cycle. I bet he was in 200’s by then.

 

Yes, of course. Just amazed at how dynamic this whole thing can be! He won't eat. I will test again at +7 and see where he is at. Sorry if I am being as jumpy as his BG right now!

 

Poor boy. This is very stressful. Max ate most of the time so I learned how to manage him with food. When he had a pancreatitis bout I could get him to eat with ondansetron (zofran) and once in awhile an appetite stimulant. But with Simon nauseous so much it’s tough.

 

Hi
My Rico also had steroid induce diabetes from pred- he was 19 (if memory is working) and although it cleared up his IBD I now had another diabetic! But because I knew all the signs I caught it very quickly and started insulin that night We also switched to budesonide.
For us I knew his pancreas worked so I was extremely cautious with dosing and trusted my gut-
I (again this is just what I did) did not shoot under 200-
At his age I was not looking for him to be in the 80s or 90s I just wanted him to feel good and get the IBD under control and it is true that the budesonide can raise the numbers and it did for him but I was fine with that and he felt good. I started shaving the budesonide 1mg to about .75 - this lowered his bg and it worked for the IBD.

For the record I use the alpha track meter.

Rico was not diabetic for very long he went into remission in about a month and I would spot test if I was suspicious.

It was mentioned in your thread about supporting the pancreas and that was pretty much my mind set and it worked out quickly for us. I did give him zofran 2-4mg....cerenia 8 mg..and cipro the appetite stimulant ...I combined them all into 1 gel cap and he got 2x a day, more if needed ( cerenia 1x a day and often injectable given only after fluids in the fluid bubble so it wouldn't burn and kept it in fridge) Rico was about 11 pounds.

You have great people watching over you so take a deep breath -- I also used (and use on Dre) a terumo needle and barely graze the ear for blood.

Sadly my Rico passed at 21 about 8 months ago....we miss him terribly.

 

Okay I got Simon to eat a bit, and we are at 88 for +7! Feeling better

 

Thank you so much for sharing your experience @@jayla-n-Drevon! Were you able to control Rico's IBD using budenoside alone? I am so inspired by your story! Ive had a number of vets sort of write Simon off since he is 18, you know acting like it isn't worth treating him at his age? The fact that your Rico lived to be 21 gives me a lot of hope. I am so so sorry for your loss- it is never easy

 

Some vets treat senior cats like doctors write off seniors. You just haven’t found the right one. About where in California do you live?
Simon’s numbers are good today. You don’t need to feed him any more.

 

We live about 2 hrs north of Lake Tahoe- both Chico, CA and Reno, NV are within 2 hrs driving distance for us. The internist I found is in Chico, as well as my current vet at Chico Cat Hospital. I could get to Davis where there is a very good veterinary school in about 3.5 hrs- but this would be a 7 hr drive round trip and potentially too stressful for Simon. Even driving to Chico is a lot for him, which is why I try to get as much done locally (labs, etc.) as I can. I know there are good vets in the bay area, but this is not really feasible for me.

 

Hi,
Yes may vets do just write them off I was lucky that I found good clinic that got the hint I knew enough to hold them accountable. I really believe just like people when they are ill need a advocate for them. Before the steroids we tried the "poo pills" it is experimental but it uses the poop of healthy cats in a gel cap to help cats with IBD and other conditions rebuild good flora in the gut which he did but at his age it was not as effective especially during a flare up.
The budesonide did control his IBD which was amazing ! it is also tasteless (I tasted it) and can be mixed with just a teaspoon of baby food or the churro treats that have baby food texture. It mixes easily if pilling is hard or if you have to go away and have a sitter.

I was very supported by @tiffmaxee and don't know how I would have done without her.... Rico also got other things for arthritis etc... (adequan and such)

 

Yes @tiffmaxee has been helping me through every single dose so far! I am hoping we can give budesonide a try at some point soon. Thank you for sharing your insights!

 

Speaking of which, will you be around this evening @tiffmaxee ? I am nervous about tonights dose, and will need your advice as usual

 

I’ll be here at 8:30.

 

Thank you so much! I don't want to send him into a roller coaster again, but if his numbers are low I am going to be hesitant to shoot

 

Elise asked me to look in too. My girl had either IBD or small cell, though the IM vet was leaning to small cell lymphoma. She had plenty of ultrasounds, but could not have a biopsy or endoscopy (needed for proper diagnosis) due to her heart. She went on budesonide - again cause her heart couldn't do prednisolone - and it really helped. Ultrasounds showed it reduced bowel wall inflammation by 35%. It also did not impact her blood sugars. She was reasonably well regulated at the time, so I could tell the impacts of meds. Neko also went on chlorambucil (Leukeran). She started with the every other day dosing, and it did horrible things for her appetite. I did manage to convince my IM vet so switch her to the every other week protocol, and it gave us over a week of happy appy in between chlorambucil doses. I found she needed both Cerenia and onsdansetron at the same time though.

Deciding on a Lantus dosing method is really important. It has to suit your lifestyle not ours. Today, he might have eared a dose reduction, might not have - depending on which dosing method you are following. Simon is seeing some nice numbers - healing greens.

 

Thank you @Wendy&Neko! We will look forward to your insights and advice! I would do anything for Simon, so if I have to stay up all night for him I will. I am still learning to get BG readings, and it his hard sometimes, but I will do whatever it takes to keep him safe and healthy. So glad to hear Budenoside helped your sweet girl!

 

Hi. Do you have a PMPS?

 

Struggling but finally got it at 88!

 

So Wendy raised a good point. We haven’t decided which method you want to follow or did we discuss that? I’ve been on so many condos I can’t remember. With SLGS you reduce under 90. With TR it’s under 50.

 

Oh poor you! I know you have been helping so many people. My dosing method so far has been to ask you what to do. Except for day 2 when I went ahead and shot @96 and triggered a huge bounce. I am very uncomfortable shooting anything with him at 88 and not eating honestly. I know my last NS triggered a roller coaster, but he has been at 88 for 5 hours, so how much will he come up from here? Maybe I could stomach a 0.1, although even that makes me super nervous.

 

I think his pancreas is kicking into gear. I’m supposed to tell you to shoot but given his poor appetite and being hard to get results I’m thinking skipping is fine. This also gives you the option to change his shot time to any time you want. Is this the most convenient for you?

 

If following SLGS, you don't shoot under 90. All you can do is stall a bit and see if he comes up to a shootable number. If he goes down, or you have to stall too long, you skip.

 

Wendy he’s worried because he’s not eating. I meant reduction number.

 

I want to do what is best for Simon, not what is convenient for me. Since I am struggling with testing, don't feel able to handle a hypo situation in the middle of the night tonight by myself, and he is not eating, I think that skipping is probably more prudent.

 

I am female btw

 

Oops. I’m sorry. Don’t know why I thought otherwise. Guess your name.

 

Yes of course, you wouldn't be the first!

 

I can see if Bron will be around to help. She’s in Australia.

 

Well we can’t see or hear each other I. My defense. Lol.

 

I thought my emoticons would give me away?

 

Maybe if I get up early and change his shot time to ~6 am I can avoid depleting the depot too much by skipping tonights shot?

 

I’ve been too absorbed in numbers and such I missed that. So are you going to shoot? I will tag Bron if you want to. You can see f he’s come up. I made a mistake. I said no shot but it’s reduction numbers I was quoting.
That will help a bit. There will be more people staying with you if you shoot then. I did 6:00 because it gave me afternoons free and I could shoot and go out to dinner back when we could do things like that before Covid. If I wanted to catch a movie and he needed a test I’d stop home in between. Shooting at 8;30 would have kept me up all night.

 

I’m putting the iPad away for tonight and going to watch some tv. If you decide to shoot tag Bron and Sheba for help. Good night.

 

Good night @tiffmaxee ! Thanks for all of your help today!