? New member: dosing advice, bounces, flat curves... we need help

That is yesterday:
3rd 20g (4%) 4th 20g (8,6%) - 5th 15g (8,6%)
This is tonight:
3rd *she has played hard after I checked her BG at 368, so I tested again after 30 mins 298: so I gave her 20 g (9,4%) to slow down the BG's drop - 4 th+0,5 15g (7,2%)

I'm trying... and I note to keep the experience
 
This is typical for some cats. Every cat is different. It can take quite a while for their bodies to adjust to this hormone again (the insulin is a hormone). Some cats have been diabetic for a long time before it’s discovered. You are doing really well. I am sorry it’s not easy and absolutely exhausting.
 
I think you should not worry too much. At least she has stayed in very safe numbers. Maybe she needs the higher carbs at +3 even though she was still in pink (last night). I would anticipate her dropping between +3 and +4. Sometimes she may not if she’s having a high cycle (like she did today in the morning cycle) but it doesn’t matter. - feeding the 8% will not hurt her because it’s still low carb.
 
Ok, thank you for all your advices

I am sorry, I'm not usually so..( I can't find a word: crying, boring, heavy, fearful) really: I' m sorry and thank you for your help
 
Tonight I think will be a stuck-yellow cycle... I don't think it depends on food... Suzanne, yesterday I have asked your opinion about reducing the dose, now I' here to ask you the opposite: do you think should we increase the dose or hold it? Today Nala has drunk more water than usual with the same values, I feel her a little bit depressed, perhaps she is more starving too. Thank you very much.
 
I have another doubt, between 31 January and 16 February Nala has had 1,75 and 2,00 u.i. (sorry, I don't know if I'm understandable), I want to say: we have used the same dose some weeks ago, and I decide to reduce it. In past (recent past) that dose worked better, is it possible Nala's diabete is getting worst, or can it happen? Nala had the last addominal eco on 7 February, should I be worry about her reaction at the same dose and check her in clinic again? Thank you, I'm really in difficulties... perhaps I should try to look for another Vet, I'm lost.
 
You can increase the dose if you would like. I think you have held the dose long enough for us to know if it will be safe to increase to 2.25 units. She has come down a little tonight into yellow. Still, we have room for her to come down into lower numbers so I believe she will be safe.
 
CHIARA said:
I have another doubt, between 31 January and 16 February Nala has had 1,75 and 2,00 u.i. (sorry, I don't know if I'm understandable), I want to say: we have used the same dose some weeks ago, and I decide to reduce it. In past (recent past) that dose worked better, is it possible Nala's diabete is getting worst, or can it happen? Nala had the last addominal eco on 7 February, should I be worry about her reaction at the same dose and check her in clinic again? Thank you, I'm really in difficulties... perhaps I should try to look for another Vet, I'm lost.
Click to expand...
I doubt that you need another ultrasound. It hasn’t even been one month since her last one. It’s not unusual for a cat’s dose to change over time. Sometimes it feels like you are chasing after a good dose. I see it all the time where people are questioning their dose because they feel like their cat was doing better before on a lower dose. I don’t know if that is making sense.
 
Thank you, it is clear.
I had cats and dogs with any sort of ills, but diabete is "difficult", unpredictable.. strange. Thank you a lot with all my heart. Tomorrow I'm going to work from home, so it is a good day for an increasement. I can't thank you enough.
 
Keep going. She will break out of these high numbers soon.

Is she eating and drinking all right? Activity level normal? Ketones looked okay at .5.
 
Hi Suzanne, let's keep our fingers crossed :)
She lost 0,1 kg ( i think 0,2 pounds) and she is starving... so I decide to feed her a little more (40g more in a day). She drinks a little more after main meals. I tested her urine too for chetones (i do it when she let me do it) and no chetones in urine. Today i saw her happy, despite high BG... Let's hope! Thank you a lot
 
I tried to use a medium carb, in 2nd hour BG was 361, in 3rd 263 (-98 points), checked after 15 minutes without food BG was 229 (-34 points in 15 minutes)... I decided to give her 10 g medium carb (12,4%)... if you tink it can damage her, please tell me. I know BG is "safe", perhaps I'm a little bit obsessed to slow her drop...I don't know, it is stronger than me. Thank you very much
 
Hi Suzanne, I'm thinking about another increasment, but I'm not sure. I think keeping the dose another day could be useful to avoid (it's a big word, perhaps better to say "try to limit") drops, but on the other hand following the method I think I should increase, because of her nadirs (unless she is still in a bounce/stuck after the green numbers five cycles ago). Therefore a lot of doubts, can I ask you what do you think about? Thank you a lot and have a nice day.
 
Hello Chiara! I think you should hold the dose at least one more day to see how it goes. She had green nadirs on March 7 and I am happy to see some blue today (so not bouncing during the morning cycle.)

Let’s see how she does for another day and then decide what to do after that. Would that be all right?
 
Hi Suzanne. I would like to give you updates about Nala and ask you an advice/opinion. In the last 3 days I' ve noticed Nala had loose, yellowish and smelly stools (once a day, I mean she has no repeated episodes of diarrhea. She is fine, eats, drinks, plays and I think her BG is better than last days). The same thing happened some weeks ago too: I started feeding her with low fat food (even low carb obviously) and it seemed to be solved (until 3 days ago). Now I'm worried about her pancreas or liver, I don't know, I think pancreas, surely I'm worried, I'm giving her probiotics. I've found another Vet (diabetologist) and I'm going to take Nala thursday morning at 11.00 a.m. I shoot Nala at 7.00, the clinic told me to shoot her half dose and not feed her. So I decided not to increase the dose until thursday. Really I'm very worried about shooting half dose without feeding her, can I ask you what do you think about? Thank you very much.
 
Why should you not feed her? Unless they plan to do an ultrasound, abdominal x-rays or surgery (obviously not) why can she not have a little food? That’s not good for a diabetic cat.
 
She is having better numbers too! I am very happy to see it!

I suppose they think that shooting half a dose will cover her not eating, but we have no guarantee of that. She could still drop low. And the appointment is at 11 a.m. so how many hours will she have to be without food — a long time I think.
 
Eh... I think they want to be free to make eventually an rx, or perhaps blood-tests... Clinic always say without eating from 6/8 hours. Last time (in another clinic) I took appointment at 3.00 pm so I fed her at 7.00 am... Don't know what to do... I spoke today and asked, I waited for the doctor's opinion and it was. It is the first time there.
 
Suzanne & Darcy said:
She is having better numbers too! I am very happy to see it!

I suppose they think that shooting half a dose will cover her not eating, but we have no guarantee of that. She could still drop low. And the appointment is at 11 a.m. so how many hours will she have to be without food — a long time I think.
Click to expand...
Mmm.. I know, really I don't know, surely, without food with half dose, I'm going to check her any half hour
 
I would feed her a little food with her insulin at least. Maybe just a teaspoonful. I would just not mention it.

Do they want you to bring a stool sample with you? They should test for giardia. It could be something going on with her liver or gallbladder, but it doesn’t necessarily mean it’s something really bad (hopefully something easy to correct.)
 
Suzanne & Darcy said:
I would feed her a little food with her insulin at least. Maybe just a teaspoonful. I would just not mention it.

Do they want you to bring a stool sample with you? They should test for giardia. It could be something going on with her liver or gallbladder, but it doesn’t necessarily mean it’s something really bad (hopefully something easy to correct.)
Click to expand...
Do you mean with the half dose? Yes I was thinking the same.. I think a little bit food can influence (perhaps) only BG. But if she drops I will feed her, in past she dropped even with 1,25 u.i... I was thinking to give her 1 u.i.... and I'm not happy to do, if no-feeding her won't be necessary.
They don't ask me a stool sample, but I could take it. I don't think it could be Giardia. Giardia gave a different smell... I had a lot of experience with it with dogs and cats, but Nala had Giardia when she arrived (I was a volounteer, she came from road) and I could be wrong. I'm going to take the sample, thank you. Let's hope, better giardia than something worse.

I had a cat with intestinal malabsorption problem, at the end it was a lymphoma. It seem to me any kind of malabsorption by smell and colour.. but I'm tired and confused, perhaps I' m too much pessimistic.
 
CHIARA said:
Do you mean with the half dose? Yes I was thinking the same.. I think a little bit food can influence (perhaps) only BG. But if she drops I will feed her, in past she dropped even with 1,25 u.i... I was thinking to give her 1 u.i.... and I'm not happy to do, if no-feeding her won't be necessary.
They don't ask me a stool sample, but I could take it. I don't think it could be Giardia. Giardia gave a different smell... I had a lot of experience with it with dogs and cats, but Nala had Giardia when she arrived (I was a volounteer, she came from road) and I could be wrong. I'm going to take the sample, thank you. Let's hope, better giardia than something worse.

I had a cat with intestinal malabsorption problem, at the end it was a lymphoma. It seem to me any kind of malabsorption by smell and colour.. but I'm tired and confused, perhaps I' m too much pessimistic.
Click to expand...
I understand! I get like that too, when I have been battling for the health of my cats. But didn’t you say before that she had an ultrasound at diagnosis and they checked everything? It wasn’t very long ago.

I have occasionally had some strange things come back from the laboratory for my cat’s stool. The strangest one yet was clostridium perfringens alpha toxin. Indoor only cat for years. Who knows where this stuff comes from? But it caused severe diarrhea. Anyway, I only say that to recommend that they send out a sample for testing to a laboratory and don’t simply rely on their own microscopic analysis. I pray Nala will be well soon.
 
Suzanne & Darcy said:
I have never heard of a Diabetologist vet. I wonder what the vet’s credentials (degree/training) is?
Click to expand...

Forgive me, I've been hasty, it doesn't exist.

She is specialized in small animal internal medicine, had a master of Canine and Feline Endocrinology and in an initiative of a group of veterinarians created to support the management of diabetes. I used an improper term to say that she is an expert on diabetes (should be, I hope she is, surely she is.. but better say should be), forgive me. The last 4 vets were unable to give me any advice since Nala did not have ordinary glycemic curves.
 
Suzanne & Darcy said:
I understand! I get like that too, when I have been battling for the health of my cats. But didn’t you say before that she had an ultrasound at diagnosis and they checked everything? It wasn’t very long ago.

I have occasionally had some strange things come back from the laboratory for my cat’s stool. The strangest one yet was clostridium perfringens alpha toxin. Indoor only cat for years. Who knows where this stuff comes from? But it caused severe diarrhea. Anyway, I only say that to recommend that they send out a sample for testing to a laboratory and don’t simply rely on their own microscopic analysis. I pray Nala will be well soon.
Click to expand...

Yes she had 2 ultrasound (the last at 7 February).
The diagnostic conclusions of the first (05 December) were: "Diffuse liver disease of likely metabolic/lipidic nature, mild distension of the extrahepatic bile ducts. Mild diffuse pancreatopathy of likely nonspecific reactive nature."
The diagnostic conclusions of the second (7 February) were:
"Diffuse liver disease of likely metabolic nature (diabetes in history) The findings on the pancreas are compatible in the first hypothesis with previous inflammation, absence of signs of current inflammation."

I can't understand myself either, maybe I've had too many losses in the last few years and I'm too used to bad news, I don't know.

You are absolutely right. Then for what it costs, I will take a stool-sample and I will recommend complete analysis.
Nala is fine anyway, as long as she eats willingly, plays and purrs while I scratch her belly I know I should feel calm, maybe it really is a problem with some food, or a small problem anyway. Let's hope for the best.
So on Thursday I will inject her 1.00 i.u. with a teaspoon of food. Thanks again I can never thank you enough
 
You must log in or register to reply here.
Back
Top