8/18 Callie PMPS 253 , 277 +2, 228 +4

Thanks for checking in on us, Summer :) I would say that we are very loosely guided by the TR timing in that we (along with our vet) want to be aggressive in treating Callie and we are able to test enough to have the data to do everything possible to keep Callie safe. We can't actually/officially follow the TR protocol at this time because Callie still eats a small amount of Young Again dry food.

A handful of cycles ago, Bhooma suggested talking to our vet about an increase and we agreed that it was time and were about to do that when Callie went into the greens (as I understand it, many cats respond that way to the "threat" of an increase lol)... and she has been bouncing up and down since. If Callie doesn't come back down in the next few cycles, we'll revisit the increase. (Callie - are you listening??!) At the moment, I'm thinking 10 cycles since the last green so a few cycles from now but I will seek guidance from Bhooma/others here who have been helping us and our vet before doing anything.

I see that you increased Susie by a little bit this am. I hope she has a good day today! :bighug:
 
278 +2 Callie's really liking this mid to high 200 range these days... will get +4 just in case.
 
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Actually considering the 8 cycles since the last green i would already search for some guidance regarding increasing :)

I agree that you test enough for TR and i definitely recommend starting to follow it as soon as possible :) When is the planned transition to all wet?
 
Good morning Jessica :) just wanted to stop by and see how you and Callie are doing. Is she liking the canned food? Dolly was a dry food junkie but never on board with Young Again except for their treats. I did give her Dr Elsey’s for awhile when she followed SLGS. I transitioned her to all wet food when I started putting FortiFlora on top of her food.

Hope you and Callie have the very best day. Hope her numbers start coming down with the “increase threat “ :p Surf safely Callie :bighug::bighug:
 
Marina & Chico said:
Actually considering the 8 cycles since the last green i would already search for some guidance regarding increasing :)

I agree that you test enough for TR and i definitely recommend starting to follow it as soon as possible :) When is the planned transition to all wet?
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Thanks, Marina. No specific timeline. Unfortunately, we have other challenges with Callie we are trying to balance, primarily her severe allergies (likely some food and others) and related conditions and her general tendency toward wet food "boredom." So it is a work in progress at the moment... (Don't want to bore you with too many details but if you are interested, I went into a bunch more detail the other day here: https://felinediabetes.com/FDMB/threads/8-15-callie-pmps-320-280-2-292-4.251433/ )

Just so I am sure I understand what you wrote about an increase: are you thinking that it could be time to increase Callie's dose even now (before the 10 cycles since green) or did you just want to make sure that we get input now so we are ready to increase in case she remains the same over the next couple of cycles? It definitely looks like she is going to remain the same for this one :(

Thanks again for looking in on us :)
 
Our Dolly Girl said:
Good morning Jessica :) just wanted to stop by and see how you and Callie are doing. Is she liking the canned food? Dolly was a dry food junkie but never on board with Young Again except for their treats. I did give her Dr Elsey’s for awhile when she followed SLGS. I transitioned her to all wet food when I started putting FortiFlora on top of her food.

Hope you and Callie have the very best day. Hope her numbers start coming down with the “increase threat “ :p Surf safely Callie :bighug::bighug:
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Hi Adrienne, thanks for stopping by :) ! Callie likes wet food "ok" but is always much more interested in dry. She actually LOVES Young Again but we usually limit her to only 10-15 kernels as a treat during/after her insulin shots. (She is not at all happy about those limits as you can imagine!) Despite the increase threat, it seems like Callie has another yellow day planned for today... and so we wait.

It is great that you were able to transition Dolly to all wet food. It looks like she had a nice start this am. Hope you and Dolly have a wonderful rest of day :bighug:
 
I had forgotten if kitty was eating any dry they couldn't do the TR. I'm still a work in progress on this site but you seem to have learned a lot in your short time here. I'll be following her progress.
 
Summer and Susie said:
I had forgotten if kitty was eating any dry they couldn't do the TR. I'm still a work in progress on this site but you seem to have learned a lot in your short time here. I'll be following her progress.
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Summer, that's really nice of you to say but I am honestly always feeling like I have soooo much to learn. Even though we've been at this for a few weeks already, it can still be quite overwhelming at times, especially with Callie having other health issues along with diabetes. But everyone here has been so generous with their knowledge, experience, time and patience, all of which have helped me (and Callie) tremendously. :)

I so appreciate you checking in on Callie and following our progress. We have been keeping an eye on Susie's progress also, especially since you mentioned a bit ago that you understood my frustration with all of our bouncing. I've been so happy to see that Susie has been doing well, which is really a tribute to how much you know about all of this and how very dedicated you are to her. :bighug:
 
Jessica A said:
Summer, that's really nice of you to say but I am honestly always feeling like I have soooo much to learn. Even though we've been at this for a few weeks already, it can still be quite overwhelming at times, especially with Callie having other health issues along with diabetes. But everyone here has been so generous with their knowledge, experience, time and patience, all of which have helped me (and Callie) tremendously. :)

I so appreciate you checking in on Callie and following our progress. We have been keeping an eye on Susie's progress also, especially since you mentioned a bit ago that you understood my frustration with all of our bouncing. I've been so happy to see that Susie has been doing well, which is really a tribute to how much you know about all of this and how very dedicated you are to her. :bighug:
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Thank you, Jessica. Every day is a new learning experience for me and I don't always have the patience I need. You are a great example for me that when I am trying to help others I need to consider their kitties other medical issues. If you need advice on the eosinophilic granuloma I know that Elise, @tiffmaxee, has had a cat with it too.
 
Jessica A said:
Thanks, Marina. No specific timeline. Unfortunately, we have other challenges with Callie we are trying to balance, primarily her severe allergies (likely some food and others) and related conditions and her general tendency toward wet food "boredom." So it is a work in progress at the moment... (Don't want to bore you with too many details but if you are interested, I went into a bunch more detail the other day here: https://felinediabetes.com/FDMB/threads/8-15-callie-pmps-320-280-2-292-4.251433/ )

Just so I am sure I understand what you wrote about an increase: are you thinking that it could be time to increase Callie's dose even now (before the 10 cycles since green) or did you just want to make sure that we get input now so we are ready to increase in case she remains the same over the next couple of cycles? It definitely looks like she is going to remain the same for this one :(

Thanks again for looking in on us :)
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I didn’t know about the dry food, so i guess you are following SLGS, therefore i guess it is correct to wait the 10 cycles :)

good luck and i hope you find your way to excluding the dry food to switch to TR and go fo increases sooner :bighug::bighug:
 
Marina & Chico said:
I didn’t know about the dry food, so i guess you are following SLGS, therefore i guess it is correct to wait the 10 cycles :)

good luck and i hope you find your way to excluding the dry food to switch to TR and go fo increases sooner :bighug::bighug:
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Thank you! Technically, we aren't really following either protocol and in terms of dose changes, I would ideally like to be more aggressive than SLGS allows.

I guess my question is whether, if we were following TR (I know we can't be), would it be suggested/ appropriate to increase at this point or wait after the 10 cycles to see if this bounce clears?

This is what I was looking at that made me think we should wait the 10: (From TR protocol)
  • 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.
Although Callie had some nadirs under 100 earlier on, it wasn't clear if we were just getting inaccurate low numbers from the Freestyle Libre. On 8/10/21 and 8/12/21 we got nadirs under 100 using a manual BG monitor. In fact, on 8/12/21, we got as low as 56. So I was counting 10 cycles after that.

But I am not sure if I am making correct assumptions so I would love for the experts here to weigh in with your thoughts/ recs. Again, I do know that we are not technically doing TR because of the dry food but when I spoke to our vet she agreed that if we could test enough at home, we could be "aggressive" in treating/ dosing. I just don't want to be so aggressive that I end up hurting rather than helping...

Thanks in advance for any guidance/ thoughts on this.
 
I cannot say that i read that somewhere, but from my understanding the reason to not allow TR when dry food is being served is because TR pushes the BG overall much lower. Now imagine that u start seeing nadirs in the 50s and then decide to exclude dry food, considering that dry food can inflate BG the risk of a hypo is too high. There are cats that require much less insulin after ditching dry food, we don’t know how Callie would react after excluding dry but nobody would like to see you try excluding it, when she is nadiring in the 50s.
 
tiffmaxee said:
Is there absolutely no way to get rid of the YA? Can’t you give more freeze dried treats to replace YA?
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I would feel a lot better about trying to get rid of it if I had something to replace it with that she loves the same. I just don't have that at the moment -- Callie likes the freeze-dried food fine but really just to help her be interested enough to eat her wet food when she is bored of that. She is quickly becoming bored of all of the freeze-dried we have as well. (I literally bought our local specialty pet food place out of everything rabbit and lamb to try.) The only thing that will make her come running is YA.

I know I am probably being an overly sensitive worrywart mom but I feel like we are "torturing" Callie literally all day long these days -- "puffing" her twice a day (I increased to two puffs twice a day since her recent asthma attack), pilling her twice a day (we used to use the allergy pill pockets but she didn't react well to them and I know they are not low carb anyway...), giving her insulin shots twice a day, taking her BG every few hours, removing her food when we never did that before....so cutting out the only food she really loves seems like it is too much right now.

We should have the 5 strands results back soon and hopefully those will open up a whole new world of freeze-dried treat options as well as help us help Callie with her terrible itching. I'm also going to increase her Zyrtec dose. We're pretty desperate at this point - the itching, scratching and biting at her fur has only gotten progressively worse again over the last few weeks since we stopped feeding her the (high carb) prescription hydrolyzed protein food she had been eating. I really hope she doesn't get rodent ulcers again since the only thing that helped those were steroid shots.
 
Marina & Chico said:
I cannot say that i read that somewhere, but from my understanding the reason to not allow TR when dry food is being served is because TR pushes the BG overall much lower. Now imagine that u start seeing nadirs in the 50s and then decide to exclude dry food, considering that dry food can inflate BG the risk of a hypo is too high. There are cats that require much less insulin after ditching dry food, we don’t know how Callie would react after excluding dry but nobody would like to see you try excluding it, when she is nadiring in the 50s.
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I guess now I am really confused because that's what I thought Elise was asking about just above -- us stopping the dry food. Sorry, I am sure I'm missing something here. It hasn't been a great day for Callie and my brain is pretty scrambled...
 
Jessica A said:
I would feel a lot better about trying to get rid of it if I had something to replace it with that she loves the same. I just don't have that at the moment -- Callie likes the freeze-dried food fine but really just to help her be interested enough to eat her wet food when she is bored of that. She is quickly becoming bored of all of the freeze-dried we have as well. (I literally bought our local specialty pet food place out of everything rabbit and lamb to try.) The only thing that will make her come running is YA.
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George didn’t like freeze dried treats either - and I tried ALL of the flavors! I use tiki cat ahi tuna as his “treats” now…just a tiny bit and keep the rest of the can in the refrigerator with a lid after I open it. It was a life saver for us when it came to testing - absolutely nothing was working until we switched to that.
 
You are correct. I was asking about the dry. You are right. The reason being that you could switch to TR. I see why that’s not wise right now. So stick with SLGS. Marina explained why as long as the dry is being fed it’s not safe to do TR. Some do Custom dosing once they have lots of experience and know their cat’s response to food and insulin. We can’t really give dosing advice that deviates from the methods but you and your vet can work together. We can still help in other ways, feeding the curve for example.
 
Hshray said:
George didn’t like freeze dried treats either - and I tried ALL of the flavors! I use tiki cat ahi tuna as his “treats” now…just a tiny bit and keep the rest of the can in the refrigerator with a lid after I open it. It was a life saver for us when it came to testing - absolutely nothing was working until we switched to that.
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Thanks for the suggestion. Probably out because of her allergies but will keep in mind. Glad you found something that works for you!
 
Jessica A said:
I guess my question is whether, if we were following TR (I know we can't be), would it be suggested/ appropriate to increase at this point or wait after the 10 cycles to see if this bounce clears?
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To clarify this for any lurkers, with TR, you hold the dose 10 cycles from the first cycle in which you saw green.

In Callie's case, I don't know whether I'd consider the green she saw on the Libre since they were most likely wonky. But she did see green with a human meter on 8/12.


Jessica A said:
+2 277. We'll get a +4 before bed but I am guessing it will be more of the same.
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Hopefully she reads your mind and responds to the threat of a dose increase.

Btw, in your SS, the pink(?) strips denoting the meter change - could you change the text to not repeat? Just say changed from X meter to Y and center it. My eyes just crossed trying to read what was there! LOL.
 
Bandit's Mom said:
Hopefully she reads your mind and responds to the threat of a dose increase.

Btw, in your SS, the pink(?) strips denoting the meter change - could you change the text to not repeat? Just say changed from X meter to Y and center it. My eyes just crossed trying to read what was there! LOL.
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LOL it was a little busy, made that change. Yes, hopefully she reads my mind and starts to come down. Thank you :)
 
Jessica A said:
I guess now I am really confused because that's what I thought Elise was asking about just above -- us stopping the dry food. Sorry, I am sure I'm missing something here. It hasn't been a great day for Callie and my brain is pretty scrambled...
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Hope Elise’s clarification from after this made it a bit clearer. We were both talking about dry food and not being advisable using TR protocol when it is still being given.

Regarding food, it does seem like you already did a lot of trial and error with Callie, just in case its not something you tried yet did you consider raw single protein foods? Up until now it seems that what works best for Chico is turkey thighs including bone, liver and the rest of the components per Dr. Lisa’s recipe. We tried recipes with Felini complete (which is the equivalent of the EZ complete) and it didn’t do the trick (Chico really wants me to grind those bones :D). The point is to try to exclude as many allergens as possible from the commercial brands and just focus at one protein at a time, then switch to other single protein sources when the first doesn’t work. I won’t lie, its a looot of work (it takes 2-3 hours every 2 weeks) but it is worth it when you start seeing results.

the most important Jessica is not to lose motivation, FD is a marathon not sprint, it takes time to get them regulated, Callie just needs more juice and a bit more time :bighug::bighug:
 
Marina & Chico said:
Hope Elise’s clarification from after this made it a bit clearer. We were both talking about dry food and not being advisable using TR protocol when it is still being given.

Regarding food, it does seem like you already did a lot of trial and error with Callie, just in case its not something you tried yet did you consider raw single protein foods? Up until now it seems that what works best for Chico is turkey thighs including bone, liver and the rest of the components per Dr. Lisa’s recipe. We tried recipes with Felini complete (which is the equivalent of the EZ complete) and it didn’t do the trick (Chico really wants me to grind those bones :D). The point is to try to exclude as many allergens as possible from the commercial brands and just focus at one protein at a time, then switch to other single protein sources when the first doesn’t work. I won’t lie, its a looot of work (it takes 2-3 hours every 2 weeks) but it is worth it when you start seeing results.

the most important Jessica is not to lose motivation, FD is a marathon not sprint, it takes time to get them regulated, Callie just needs more juice and a bit more time :bighug::bighug:
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Elise's clarification did make it clearer for me, thanks Marina. And thanks also for the recommendation of raw single protein. I am not sure whether that would work with rabbit (also not 100% sure I could stomach it if it did) and the vet wanted us to stay away from chicken and turkey completely at this point but I will look into doing it with other novel proteins once we get the sensitivity test results back.

I have to keep reminding myself that it is still early in our journey with FD. It is just really hard when Callie doesn't seem to be getting much better BG#s, but ironically, the changes we've made to help with diabetes management (to her food, for example) are making her other health issues worse... Anyway, thanks for the pep talk. :bighug: We are going up to 2.25 this am so helpfully that will help a little.
 
Jessica A said:
Elise's clarification did make it clearer for me, thanks Marina. And thanks also for the recommendation of raw single protein. I am not sure whether that would work with rabbit (also not 100% sure I could stomach it if it did) and the vet wanted us to stay away from chicken and turkey completely at this point but I will look into doing it with other novel proteins once we get the sensitivity test results back.
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That is great that you did a sensitivity test, that should make your life much easier. We tried chicken, turkey, duck, rabbit and pork, for now turkey works best, duck was the worst (even though he likes it best :D). Rabbit can be prepared the same way, its a matter of proportion of meat/bone/liver no other secrets there :) I have to add that we are very lucky that Chico eats well (huge antijix) and loves raw meat compared to kibble but a lot of people manage to get their kibble addicted kitties interested in raw as well (with more or less effort).

Here is an article that has a section for feeding raw to allergic cats, i thought it might be useful.

Jessica A said:
I have to keep reminding myself that it is still early in our journey with FD. Anyway, thanks for the pep talk. :bighug: We are going up to 2.25 this am so helpfully that will help a little.
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It is very early :) better not to make any deadlines because it can last 4 weeks (as i have seen recently few cases), it can take 7 months (like it did for us) but it can take a couple of years as well. It's very individual and the less expectations you have the easier the process will go :)
 
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