MPM - Steady Progress

Rewster's Mom (Renee)

Rewster's Mom (Renee)

Member Since 2024
Previous thread: https://www.felinediabetes.com/FDMB/threads/starting-mpm-today-new-thread.287111/

So far so good with Rewster. We recently upped her dose back to .75S units to get her back on track after a very stressful two weeks. Dog houseguests + sprained arthritic hips + diarrhea from eating sticks (PICA) threw her off track, but she seems to be stabilizing again.

We noticed that Proviable for cats may correlate with higher BG? Rewster took this probiotic most of her life because she is prone to diarrhea since kitten-hood. She had stopped Proviable in late May/June of this year because I just didn't think she needed it. When she had a bout of upset stomach the first week of August from panic chomping on sticks, I gave it to her again and it seemed to make her numbers higher (8/5-8/9) and/or contribute to loss of duration. Cosequin seems to be helping her range of motion, but she is still very hesitant to be squirrelly.

Trying to get more mid-cycle testing as much a possible to stay informed about dose adjustment.
 
I don’t really see a big difference in her numbers when she was taking Cosequin. But I do see a lot of lovely blue and green numbers.

My cat with arthritis moves so much easier and seems so much happier and more comfortable with the Adequan injections we give her. Adequan has been around a long time and is safe (I don’t trust Solensia at this point). We first had to inject her twice a week for four weeks, then once a week for 4 weeks and now only once a month. They are intramuscular injections though so quite different than giving insulin.
 
Suzanne & Darcy said:
I don’t really see a big difference in her numbers when she was taking Cosequin. But I do see a lot of lovely blue and green numbers.

My cat with arthritis moves so much easier and seems so much happier and more comfortable with the Adequan injections we give her. Adequan has been around a long time and is safe (I don’t trust Solensia at this point). We first had to inject her twice a week for four weeks, then once a week for 4 weeks and now only once a month. They are intramuscular injections though so quite different than giving insulin.
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Adequan sounds like a better option for us too because she loathes going to the vet, so the fact we can do it at home is much preferred.
We have an appointment on 9/29 scheduled, so I will inquire then.
Thank you as always!
 
Hi Suzanne! She’s doing really well! Her arthritis seems to be doing a bit better and we plan on speaking with the vet about the Adequan at her next appointment. Thank you so much for checking in on her!
 
That’s great to hear! She seems to be doing well on the current dose. It looks like you haven’t been able to get any mid-cycle tests recently.
 
Hi Suzanne, yes we’ve had a crazy month and didnt get to mid cycle test as much as we would have liked. Good news is things seem to be settling down so we should be able to resume regular mid cycle testing.
 
Hi @Suzanne & Darcy! Wanted to update you on how things are going.

Diabetes seems to be tightly regulated. The vet wants me to switch her to .5 units once a day, but I can't see the logic in that with her numbers at this point. Her kidney indicators in her bloodwork are on the rise. I updated her labs tab in her sheet to show you September's bloodwork. We're going to take her to the vet again in December for a 3 month follow up with additional bloodwork to compare how it escalates.

Question--Rewster previously was prescribed Royal Canin Veterinary Diet Adult Renal Support Early Consult Loaf in Sauce, and ate that as her main diet for 2022-2023. We switched her food to BFF Pate when she got diagnosed with diabetes because we wanted a lower carb, lower phosphorus option that was diabetes friendly. I know the main way of managing kidney disease is through diet and then fluids as the stages progress. What are your thoughts on if I should switch her back to the ROYAL CANIN, or something similar? I also bought phosphate binder for her food to see if that helps as well.
 
Hey Renee. I saw your post on the Tanya CKD support group site. I don’t think her phosphorus is high enough to warrant a binder. I would try her on the Weruva Phos Focused WX foods perhaps? Royal Canin Aging 12+ is low in phosphorus, but also somewhat low in calories. I use it as a supplementary food because cats seem to love the taste. Her kidney values are creeping up a little, it’s true. If anything, I would add a scoop of Epakitin to her food once a day and then see how she’s doing in December when you take her back. Her phosphorus isn’t high enough to start aluminum hydroxide powder.
 
Also, I forgot to say. I’ve not been feeling well this past week/weekend so I am sorry I haven’t been around as much and didn’t see your post here.
 
Suzanne & Darcy said:
Also, I forgot to say. I’ve not been feeling well this past week/weekend so I am sorry I haven’t been around as much and didn’t see your post here.
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Hi Suzanne! No worries at all...I totally understand! I hope you have been feeling better.

I'm definitely going to try out the foods you mentioned. Thank you!

We'll probably take her in again for another blood/urinalysis panel before December to ask for subQ fluids, running a spec fPL, and a UPC test for proteinuria. The vet tried to run a fructosamine test with her 9/27 labs, but he said the lab had an error and the result couldn't be processed, so he told me he owes me a fructosamine test anyway.

I've been whisking a Pro Plan hydra care pouch into her meals and she has been not loving it, but still eating it, and it is definitely making her urinate more so I'm hoping that is evidence its hydrating her a bit. She is so dramatic about drinking any liquids so her dehydration is on my mind. She has also been taking the Azodyl capsules with no problems or fights which I'm so grateful for.
 
That was so kind of you to check in. I am doing well and I hope you are as well! I can see Rewster is doing great. That makes me so happy to see so much green on .25 units. I don’t see any mid cycle tests. Can you ever manage to get a +4 or a +6? On a weekend could you run a curve (or a mini curve) so we could see what her actual nadirs are?
 
Rewster's Mom (Renee) said:
Hi @Suzanne & Darcy ! Yes everything is okay. Thank you for checking!! I just transferred from our notebook to the spreadsheet.

we’re going to do some mid cycle testing tomorrow.
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Hi @Suzanne & Darcy. After getting in a few rounds of mid cycle testing we decided to go back to .5 units for now. We're also going to be more diligent not letting her snack after her nadir. Hope you're doing well!!
 
Rewster's Mom (Renee) said:
Hi @Suzanne & Darcy. After getting in a few rounds of mid cycle testing we decided to go back to .5 units for now. We're also going to be more diligent not letting her snack after her nadir. Hope you're doing well!!
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Hi @Suzanne & Darcy! Wanted to update you.

We've had a bit of a dose increase recently to try to get back to steady pre-shot greens. Not sure what is causing the uptick, since we had whittled our way down to .25 units, but we're back up to .75 units at the moment. Ran a little curve today to check in on her nadir.

It seems like when I take food away at around her nadir, the begging makes her BG jump even more than light snacking does. Could that be true?

I've noticed she also almost always eats her PM meal totally, but her AM meal she leaves like 1/3 of. She is really food insecure and rations when we're not home, and panics when I take it away.
 
Rewster's Mom (Renee) said:
It seems like when I take food away at around her nadir, the begging makes her BG jump even more than light snacking does. Could that be true?
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Well if you keep the food very low carb, just let her eat a little longer- even though I normally don’t recommend feeding after nadir. If it’s LC and she’s just grazing, we can try letting her do it a little longer (the grazing, that is.). Then trCk her numbers to see if ot makes a difference (test your theory). Why do you think the poor baby is food insecure? You mentioned it before, but do you know why?
 
Now, looking at her SS, I am very pleased with your management of her dose. You are doing a great job. What beautiful greens! I am sorry you had to go up in dose. It’s always a disappointment, but it’s true (as lame as it sounds) that cats’ insulin needs can change over time (up and down). As long as we do not see a trend upward that doesn’t respond to increases - or nothing really dramatic - I am not worried about their being a veterinary/health issue.
 
We've been sticking with the BFF chicken and the hydra care packets--which I'm still trialing to determine if they're having a tangible effect on her BG. She is certainly almost always hungry, and she eats heartily when me or my partner are near her.

I wonder if her food insecurity comes from before I adopted her in 2013. I believe she had to maybe eat from garbage and eventually asked humans for help. The vet that I adopted her from told me that she walked up to someone in a wooded area essentially asking for affection, and that she wasn't really domesticated before then (she was less than a year old).

She has always had a strong affinity for things like jarred pasta sauce, chickpeas, and really most canned foods. This has led me to wonder if her food insecurity stems from only having access to old, canned food when she was very young. She had a severe, severe case of worms when I first adopted her (threw up large piles of writhing worms), which also made me wonder how long she had suffered with feeling not satiated. Since then, she seems to have associated people with feeling better, and she is extremely affectionate and flexible. I was nervous when Rewst and I started this beamies journey, and now we are both so communicative and in-sync about it I don't even think about it as an extra thing we do.

Earlier in 2024 we had bobbed from .75 units to .25 units and eventually back to .5 units, where we saw a lot of gains. I'm wondering if that may be a sweet spot over time, and taking her down to .25units maybe wasn't the correct choice before. We shall see!

I'm a little trepidatious knowing that she has this fledgling kidney disease going on, and her long term dental history has been very, very poor. She's had maybe 10-13 teeth removed in total before getting diagnosed with diabetes. Our last visit in September of 2024 the vet had noted she had a lower tooth that really could benefit from being removed, but I was worried about fasting her leading up to anesthesia and ultimately postponed it. I'm now going to monitor the trends in her BG to see if that could be negatively impacting her diabetes progress and re-evaluate.

Thank you as always for checking on us and hearing me out! I know it is a lot to read and I appreciate it so much. How have you been?!
 
I’m so glad you have her. Poor girl struggled alone and hungry. That actually explains a lot.

I would be more worried about the anesthesia and her kidneys. If you can avoid it, I would. I would try pulsed doses of antibiotics (Antirobe) if the tooth situation gets really bad — although she still has Creatinine within normal limits. Nevertheless, unless it’s absolutely necessary, I would avoid it.
 
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Suzanne & Darcy said:
I’m so glad you have her. Poor girl struggled alone and hungry. That actually explains a lot.

I would be more worried about the anesthesia and her kidneys. If you can avoid it, I would. I would try pulsed doses of antibiotics (Antirobe) if the tooth situation gets really bad — although she still has Creatinine within normal limits. Nevertheless, unless it’s absolutely necessary, I would avoid it.
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I will monitor it and thank you for the antibiotics suggestion. I will definitely pursue that if it worsens!
 
Rewster's Mom (Renee) said:
I will monitor it and thank you for the antibiotics suggestion. I will definitely pursue that if it worsens!
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Quick question, in your experience does Porus One possibly impede the efficacy of insulin? I’ve noticed her trending upward at pre-shots and wondering if it’s causative.

Going to stop all supplements and stick with 3oz food and insulin to see if her pre-shots recede. If not I’m thinking this change might warrant a vet visit and labs.
 
If her preshots are getting higher, it’s very subtle. What about the hydracare? Could that be it? I can’t find any evidence/sources saying Porus One raises BG. Since it’s basically charcoal, I would doubt it. If you stop the supplements and get bloodwork done, you won’t know if they are lowering her BUN. We can adjust her insulin if needed.
 
I know from her last ultrasound at least one of her kidneys is small and has stones. Also her creatinine jumped from her prior bloodwork to the Sept 2024 bloodwork, which I know could mean she just was particularly dehydrated. She was 113 this AM which made me relieved. I hadn’t seen a number in the 130s for a while and got spooked.
 
The increased creatinine could be from her gaining weight between those two sets of labs? Gaining muscle mass from the time she was diagnosed to the later bloodwork? Is that a possibility? Has she lost weight when she became diabetic? BUN fluctuates and also can be high due to dehydration. I hope anyway!
 
Suzanne & Darcy said:
The increased creatinine could be from her gaining weight between those two sets of labs? Gaining muscle mass from the time she was diagnosed to the later bloodwork? Is that a possibility? Has she lost weight when she became diabetic? BUN fluctuates and also can be high due to dehydration. I hope anyway!
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She definitely gained weight between those labs..about a half pound. She lost weight pretty quickly in the last three months of 2023 and that is part of the reason I took her to the vet in January 2024, when she got diagnosed.

PMPS tonight was 134.
 
I doubt if she will have any bounce. She doesn’t look bouncy at all from her spreadsheet data (mostly in the evenings.). If she were truly bouncing, we would see sustained higher numbers.

She should be safe today with the .5 and you won’t have to worry all day long! A +10 would be great!

Remind me, what kind of food do you leave out for her while you are at work?
 
Suzanne & Darcy said:
I doubt if she will have any bounce. She doesn’t look bouncy at all from her spreadsheet data (mostly in the evenings.). If she were truly bouncing, we would see sustained higher numbers.

She should be safe today with the .5 and you won’t have to worry all day long! A +10 would be great!

Remind me, what kind of food do you leave out for her while you are at work?
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It’s the BFF play chicken checkmate. Today I also whisked in a pro plan Hydra care packet.
 
107 @ PMPS :)
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Rewster's Mom (Renee) said:
Yes this AM too! Seems like the lower dose might be better. :)
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Hi Suzanne. Updating you.

I think Rewster ate a foreign object and it may be lodged in her throat. At emergency vet now. Gagging when she tries to eat. Doesn’t seem nauseous—seems like it’s gag reflex. I can’t see if anything is in her throat. My regular vet couldn’t either and referred me here. Started at 11:30am est today.

Tested her BG and it was 76 at +6

I’ll keep you posted as I learn new information
 
They told me that she has slight esophagus and stomach irritation that could be because of eating something, but not definitively so. They’re still waiting on ultrasound results, but briefed me after getting X-ray results. It does not seem like there is something in her throat.

They are giving her anti nausea medication and an esophagus coating medication and sending her home
If it persists and does not subside or resolve she will be brought back to be hospitalized. But her bloodwork does not show anything I didn’t already know. The xray showed her kidney is shrunken but I knew that.
They also said she could have these symptoms from mild pancreatitis
 
This is what the invoice reads:


Stat CBC/Chemistry IN HOUSE

Alfaxan 10mg/ml per ML

Butorphanol Injectable 10mg/ml (per ml)

Sucralfate 1gm Tablet

Cerenia Tabs BP 16mg Per TABLET

Emergency Consultation

Ultrasound Abdomen

Radiograph w/ Consult-3V Abdominal

Radiology Stat Fee ANTECH

Medical Waste Fee-Out Patient

Cerenia Injectable per ml

Fluid Therapy - SQ

Pantoprazole 4mg/ml Injectable per ML
 
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