9/18 Squeaky AMPS 342, +8 205 PMPS 486 yikes .....and celebrating good poop!

https://felinediabetes.com/FDMB/threads/9-17-squeaky-amps-371-7-249-pmps-208.235467/

Squeaky has been feeling and doing better the last two days. The 462 early this morning, was not long after he ate.

I note that we had a 208 recently and understand if we get below 200 I need to stall/token dose/or skip shot.

I can never thank you all enough for being here and coaching me through this play by play. This is the most support I have ever gotten for anything in my life and I am so grateful! Couldn't be doing this without you, I would have had a nervous breakdown by now. The level of detail is SO GREAT. Thank you.

 

The 200 number for stalling/token dose etc is only till you collect enough data on how your kitty behaves on insulin. The idea is to be able to eventually shoot any number above 90 with SLGS and any number above 50 with TR.

But till then, if you encounter a lower than usual pre-shot number, you stall, don't feed and post here for help

 

I am liking those behaviour changes you are noting!!! Will be interesting to see if he comes down for his AMPS number.

 

Okay today he is in and out of the closet looking kinda punk.

The vet wants to increase his insulin dose to 1.5. ????????????

Also for the mid-cycle BG, if I give him a snack right before, it'll affect the numbers, right? Is there anything I should be looking for or doing for the mid-cycle BG? ????????? Thanks!!!

 

Okay his BG was 462 last night; I had just given him something to eat immediately prior to the test.

His BG was 205 right now, he didn't have anything to eat probably most of the afternoon.

How can we know anything? ????? Other than, he ate and his BG went up? Am I supposed to fast him also for the mid-cycle tests???? ??? Otherwise it seems like apples and oranges.......

Thanks

 

We know he ate at +9 and then it went down again for AMPS. So something is working insulin/pancreas. And we know even with insulin/little food, he dropped to a low yellow (squinting that would be a high blue).

I wouldn't go up to 1.5u..too big of a jump. Have you decided on TR or SLGS? Your answer will direct what advice will come for a dose change.

That is ok, we are still working out all his issues. Has he pooped yet today? Is he drinking and peeing ok? Does he seem nauseated at all? Have you given an appy stim lately?

 

They have a "like" button, it should be "love." Thank you for being there.

Okay, I was thinking about his issues too. He hasn't pooped for three days, and he was similarly sluggish before the last poop on Tuesday. Actually there were too poops, not too far apart, and it was a sizeable poop. They were soft-solid, not much liquid (tiny bit).

So I'm guessing that he's getting ready to poop, and it's uncomfortable, painful, or just sapping his energy.

I'm not really seeing signs of nausea and he just drank nicely a little while ago. A good drink but not one of those crazy looks-like-he's-drinking-the-whole-bowl kind of drinks.

He's not eating a lot at a time, he's been in the closet and he purrs and has eaten when I've gone in. He's pretty droopy this evening. We did go out side to sit on the grass, but didn't move around very much (inside the playpen). Then I decided, human digestive peristaltis is stimulated by movement, so when I brought him inside I carried him upstairs (so he would have to move a bit, to go downstairs). He was happy about being upstairs and when I jumped on my minitramp, he came and danced with me a little bit! That has been one of his tricks, to dance with me.

You know when the vet tech told me Dr. Angie said raise him to 1.5, I balked, saying "That flies in the face of what the board is telling me," and then, "Well I guess I have to decide between the two sets of advice, I'm the one ultimately responsible because I'm the one here." Hmmm, I could tell that my statements didn't go over well, although they are so impressed with the help I'm receiving from all of you. Sigh, vet relationships are challenging.

Okay so I didn't understand the entirety of your message. "We know he ate at +9 and then it went down again for AMPS. So something is working insulin/pancreas. And we know even with insulin/little food, he dropped to a low yellow (squinting that would be a high blue)." Well wouldn't it go down just because he had the insulin and his stomach was empty before the AMPS? What does "squinting that" mean?

Fasting means not eating 2 hours before BG test. Sometimes he eats at the 2 hour mark. He has small portions throughout the day, not just two big meals.

Thanks a bunch. I'm so grateful that I'm not doing this alone.

 

Oh about TR or SLGS. I'm not sure I understand them well enough. Yes I have tried to read the descriptions. I don't understand everything and it's hard info for me to absorb like that. I would love to have a phone conversation about this, or a brief summary of the pros and cons of each. Thanks.

 

YAY! HIS POOP WAS SOLID AND IT WAS IN THE BOX!!!!! Time to Celebrate!!!!! I think the last good poop we've had like this was July 9!!!!!

 

Woohoo, do the happy dance! Hopefully he'll feel better now. Constipation can also raise the numbers a bit.

As for the dose, you are the one holding the syringe. You are there with Squeaky and have to deal with whatever happens. We will support whatever you choose to do, but we'll also have opinions about the vet's suggestions.

Don't worry about whatever you are feeding him influencing his blood sugar numbers before his mid cycle tests.

TR vs SLGS cliff notes:
- TR increases every 6 to 10 cycles, depending on the values of nadirs you are seeing. SLGS, you wait a week before increases. And whether you increase also depends on the nadirs.
- TR reduces the dose if you see an under 50 on a human meter (for newly diagnosed cats like Squeaky) or if you get a week in solid green. SLGS reduces if you see an under 90.
- TR is a bit more aggressive a method, so you need to get at least 4 tests per day, 2 per cycle, the preshot and one other. SLGS requires preshots and weekly curves + spots checks.
- TR requires all low carb wet food or raw be fed. SLGS allows dry for kibble heads who just won't convert, or if you have special medical conditions requiring higher carb food.

 

Thanks Wendy!

Okay which of the two methods tortures the cat LESS? That might be the deciding factor.

Also which of the two methods, controls the diabetes more? That might be the deciding factor.

 

Egads. So why did it jump up to 486? He pooped, then he played. But he was unhappy about BG test..... as usual....

 

Yayyyy for Poop!!!!

 

One theory is you'll see some action tonight. This is the sixth cycle after the green, which could mean he'll break the bounce tonight. Some cats go high before they come down.

Some people on SLGS test less. With a cat seeing lower numbers as you would in TR, you do have to be more vigilant and test more to make sure they don't go into dangerous numbers. The flip side is that the more time spent in green numbers, the more pancreatic beta cells can heal, with increased chances of regulation and possibly remission. For my cat, I found that I needed her nadirs to be in the 70's or better for her to be regulated. Nadirs above that meant more bouncing and higher numbers above renal threshold. I picked TR because my girl started out in horrible high numbers and I didn't have the patience to wait a week to increase. Plus the odds of remission are better. Not impossible with SLGS though. An some people just don't have a lifestyle that suits TR. Which dosing method really has to be up to you.

 

Thanks Wendy.

"Some action" means.... lower numbers?

Okay so do I have this right. TR means testing 4 times a day and adjusting the dose more frequently (as often as every 3 days) to match more subtle changes, better chance at remission. SLGS means testing 2 times a day and once a week testing every 2 hours, but fewer changes in dosing, just once a week.

Diet is not a problem, we always eat homemade raw or cooked food. I've been offering both and letting him choose what he wants.

Is there a file to read explaining bounces, please?

Thank you soooooo much.

 

How important is it to get the mid-cycle reading at +6?

 

About appy stims, is there one that you think is better than another? Or just mirtazapine? Vet is willing to order it, says it will take a week to get here.

 

I think the IBD/pancreatitis is doing very well right now! Love the poop! Only people here would understand! Happy Dance in this corner. Happy Scritches for you Squeaky!

I like cyproheptadine myself. It affects their personality less in my experience. That said, you may want to try it and see what works best with Squeaky since you have already tried mirtazapine.

 

Thank you, I only tried mirtazapine once. His appetite was fine after that, but I'm not sure it was the mirtazapine. Are there others?

 

Yes, cyproheptadine is an appy stim.