Please help get Finster back on track

Discussion in 'Prozinc / PZI' started by Finster, Aug 12, 2022.

  1. Finster

    Finster Member

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    Finster, 15 years of age, was diagnosed about six weeks ago.
    Six months prior to diagnosis he was on Prednisilone 5 mg twice daily. He has seasonal allergies and asthma. His appetite increased the longer he was on the prednisolone. June I took him to vet and blood work showed diabetes.
    Vet sent us home with Prozinc script 1 unit twice daily and script for low glucose wet food also instructed to ween off prednisolone. Took us a few weeks to figure out the food and ween from Pred. He is now on an inhaler of Adivar. Went back to vet at 8 day mark for BG curve and it was higher-500's. Vet increased insulin to 2 units twice daily. In the mean time I found fancy feast chicken and tuna that he will eat and got him off the prednisolone. The first time I gave 2 units he freaked out. Tried to hide, unsteady on his feet, tail twitching, just very upset. I stepped down to 1.5 units and it was better but still not himself. I've been back at 1 unit for weeks now BUT two days ago I stepped down to .5. His next PS was at 149 and that seemed high so I went back to 1 unit. Then last night he wouldn't eat and I gave the 1 unit anyway. In the night he threw up a huge fur ball which explains why he didn't want to eat last night. This morning his BG was 120 too low to give shot. I've been taking it all day and it's gone even lower EVEN after eating most of his 3 oz can of fancy feast. What Should I do? Skip tonights shot as well? Only give half?
    Thanks for any guidance. I really appreciate any and all help.
    Lisa
     
  2. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    Hi there! What is he currently eating? Diabetic cats need to be on a low carb diet. Is he only eating the Fancy Feast now? Is it the Low Carb pates? The prescription foods are all too high in carbs for a diabetic cat.
     
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  3. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    My reaction to reading his spreadsheet is to reduce insulin to .5 units for now - but it’s important to know what kind of food he is eating. Switching to a low carb diet can lower blood glucose- so if you are in the process of switching then you need to be extra careful. His numbers are low already, especially considering that you are using an Alpha Trak meter. I am very happy to see that you have been tracking this with more frequent testing. Well done!
     
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  4. Finster

    Finster Member

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    Thanks so much for the quick replies! He eats Fancy Feast Chicken and Tuna-full stop-nothing else for about two weeks. Just checked BG and its 126. That's 11 hours post shot with about 3 oz of Fancy Feast chicken and tuna so far for the day. Is that high enough to give .5 Units for PM shot? Thanks again!
     
  5. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    Do you know the carbs in the FF CHICKEN AND tuna (sorry phone doing caps)?
     
  6. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    And just to make sure, you do know about the no food for two hours prior to the preshot test rule — so that the preshot test is accurate and not in any way influenced by food?
     
  7. Finster

    Finster Member

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    The website lists "Dry matter carbs" as 1.9%
     
  8. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    There’s a big difference in carbs between the chunky, pate, grilled, etc.
     
  9. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    Can you tell me the exact name on the label. I will look it up. I just pulled up the food chart.
     
  10. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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  11. Finster

    Finster Member

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    "Can you tell me the exact name on the label. I will look it up. I just pulled up the food chart."
    The Label reads
    FANCY FEAST CHICKEN & TUNA FEAST-FLAKED
     
  12. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    You shot .5 the other night when his preshot BG was 131. His next morning BG was 150. He seemed to stay in blue numbers.
     
  13. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    Thank you. That is helpful.
     
  14. Finster

    Finster Member

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  15. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    I see the FF flaked chicken and tuna feast is 5% carbs. That will be good
     
  16. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    That’s what I needed to be sure of - the food and carbs. Please forgive me, but it’s very important to the interpretation of the BG numbers.
     
  17. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    He looks like he’s been doing a whole lot better since you switched to the low carb food. As he has a similar BG to a few nights ago when you gave .5 units, it looks like it would be safe. You could even try giving just .25 units- although we don’t know his actual preshot number yet. Hopefully you can find a dose where he will be able to have it consistently so we can see where he goes on a given dose. If he drops below 68 on the Alpha Trak meter, you would reduce his dose.
     
  18. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    And I don’t know if you saw my post above about no food for two hours before preshot BG test. That’s very important.
     
  19. Finster

    Finster Member

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    Thank you! I picked up his food at 5:30 pm so I'll take BG at 7:30 and give .5 if BG is in the blue?
     
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  20. Finster

    Finster Member

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    Hi! yep eastern time. Just checked BG 122. I'm not sure if I should give 1 or .5 units
     
  21. Finster

    Finster Member

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    I've been told that 80-120 is the normal range. If he's in normal range won't he dip too low after insulin?
     
  22. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    You can skip and gather data to see if he goes above normal range if you feel comfortable with that. Just do get some tests in tonight though.
     
  23. Finster

    Finster Member

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    I gave .5. What low am I looking for tonight? I have kit with Karl syrup and instructions, if needed.
    Also, I'm worried about am shot. :( diabetes is so confusing. Thanks for taking the time to help us.
     
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  24. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    If your shot time was 7:30 eastern? Have you gotten a +2 yet?
     
  25. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    Okay. I am signing off for the night. I checked your spreadsheet and I don’t see any tests yet- so I am assuming all is well. See you tomorrow.
     
  26. Finster

    Finster Member

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    He ate again at 10 pm and slept with us all night. I didn't check BG. His ears are a mess. I was putting neosporin pain relief on each time I pricked his ear and turns out he's allergic. All the fur fell off and he's got scaly patches :(
    0600 BG was 145. I gave 1 unit at 0715. His appetite has decreased for some reason during past week. He has lost about 1/2lbs. He also seems nauseous. licking his lips a lot. He did throw up huge fur ball yesterday morning but still not very interested in food today. Maybe I should I look for new food? Or change dose to .5 for a few days and see how he does? Or put dose to 1 unit and leave it for a few days?
     
  27. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    I know that a lot of people put plain coconut oil on their ears if they seem irritated. I have used extra virgin olive oil before. These won't hurt them if they lick them off after cleaning ears with their paws. It's no longer recommended to put neosporin on cats ... I'd have to find the article on that. I'm so sorry about poor baby's ears! Such a beautiful cat! The fur will come back though -- one of my cats (a white one) had skin cancer on both of his ears and had surgery to trim it all off this past December. His ears are all furry again.
     
  28. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    I would not have shot one unit this morning at all. Not so much because of the preshot number -- what I am considering here is that yesterday in the a.m. cycle, you skipped the shot and look at the blue and green numbers that you got -- and the Alpha Trak meters already read a little higher than the human meters that most of us use here (and those numbers are the ones used in the dosing methods used here.) You did shoot the recommended .5 unit last night, but then we have no tests to see what happened on that reduced amount. I am not criticizing this, but it gives us absolutely no data to go on. I'm just concerned for Finster's safety. His numbers aren't very high anyway and he may not even need insulin at all. What was his Fructosamine blood level when he was diagnosed at the vet?
     
  29. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    Also, it is very important when giving insulin that your cat eat first. The food will help stabilize their BG. It's fine if they eat a small meal at pre-shot time and have small meals throughout the day as well -- just no food for two hours before the preshot test. A lot of vets give the bad advice to only feed twice a day. This is not good for diabetic cats on insulin.
     
  30. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    I'm wondering what is causing his nausea. Sniffing and walking away from food, licking lips, only licking a little of the top and walking away, tooth grinding also... these are some of the signs of nausea. You said he was licking his lips a lot. Do you have any idea what could be causing this nausea? Do you have a copy of the lab work that was done in June? Do you know what his BUN and Creatinine were at that time? Anything out of range?

    Please do get some BG tests in today. I'm concerned about that 1 unit dose taking him too low.
     
  31. Finster

    Finster Member

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    Hi Suzanne and Darcy, thanks thanks thanks so much for following us through this. Should I give him some high protein treat? I have some freeze dried chicken breast treats. He didn't eat much this morning but the 149 BG concerned me. I'm so worried I'm going to kill my sweet boy :( The vets office is using a one size fits all approach and I don't like it but not sure how to adjust plan. should I do curve today? his ears have some bruising along with dry scaly patches, but if I need to do it I will. I'm not sure what the fructosamine was but I will find out. Also, the fact that he's been off the pred and on a strict diet for weeks now should be accounted for. Thanks again!
     
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  32. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    Looking at his numbers, I'm not sure that he even needs any insulin at all -- or perhaps just a small dose. Look how well he did yesterday when you skipped. Definitely he's way lower now he's off the pred and on a low carb diet. He's doing great in that way. I'm concerned about the nausea though. Some cats will feel odd when their numbers are lower and they definitely can eat less because they don't feel as hungry -- but his seems like more than that.
     
  33. Finster

    Finster Member

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    He was the most like his old self yesterday! We kept thinking that. I'm trying to figure out how to attach his june results. I'll look around the forum for instructions and post in two minutes.
     
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  34. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    If he will eat the freeze dried chicken treats that's fine, but I doubt if it will be enough. My cats love those chicken treats crumbled up on the top of their food. Do you have any Forti Flora on hand. Most cats love the smell and taste of that and it's good for getting them to eat if you sprinkle it on their food. Also, some cats love a sprinkle of parmesan cheese on their food. Baby food is always good -- baby foods that are pure meat with no onions or garlic (like the Gerber or Beech Nut meat baby foods). Some cats love these. Ham is a favorite.
     
  35. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    You can take a photo of it and drag and drop it in. The upload link does not work.
     
  36. Finster

    Finster Member

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    Total Protein 7.5 5.2 - 8.8 g/dL
    Albumin 3.6 2.5 - 3.9 g/dL
    Globulin 3.9 2.3 - 5.3 g/dL
    A/G Ratio 0.9 0.35 - 1.5
    ALT (SGPT) 45 10 - 100 IU/L
    Alk Phosphatase 48 6 - 102 IU/L
    Urea Nitrogen 24 14 - 36 mg/dL
    Creatinine 1.4 0.6 - 2.4 mg/dL
    BUN/Creatinine Ratio 17 4 - 33
    Glucose 579 64 - 170 mg/dL
    The glucose concentration in this cat is >170 mg/dl. A fructosamine
    level may be helpful in differentiating stress hyperglycemia from
    early or sub-clinical diabetes mellitus. If you would like to add on
    this test please call Customer Service. Please use test code 500016
    for this additional testing.
    Potassium 4.4 3.4 - 5.6 mEq/L
     
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  37. Finster

    Finster Member

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    [​IMG] Hopefully this works. page 2/2
     
  38. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    Kidneys look okay. That's a relief. Do you have any anti-nausea medication to give him (like Cerenia or Ondansetron). Probably not, I would imagine.

    I would get a +2 at 9:15 and see where he is at that point.
     
  39. Finster

    Finster Member

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    page 2:2.png
     
  40. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    You know, his labs look really good (except the glucose.) I'm uncomfortable that they didn't diagnose him with a Fructosamine test (as it recommends on the labs sheet as a matter of fact.) However, it's likely that, at that time, it was high because of the Pred anyway. Some of those labs are because of the steroid. Low lymphocytes would be caused by the Prednisolone. The absolute neutrophils are okay (which is what you really need to look at and not the percentage number.) So I don't think any infection was present.
     
  41. Finster

    Finster Member

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    He did eat the freeze dried chicken and some more of the fancy feast :) Next week I can get a mobile vet to come do a fructosamine test.
    I'm going to do the BG right now and will post shortly.
     
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  42. Finster

    Finster Member

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    BG 76. That seems low for only +2.
     
  43. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    It is low for +2. And that's on an Alpha Trak. I'm very concerned. Do you have any higher carb food that you can give to him? Anything like Fancy Feast Gravy Lovers? Fancy Feast Grilled foods are medium carb foods.
     
  44. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    You may be in for a long day of testing. That one unit was too much insulin, I fear. Please keep checking him so we can avoid a hypo. If all you have to feed is low carb food, then you can put a little drop of Karo syrup on there. I don't want to wait until he drops further.
     
  45. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    Please stay with me to let me know what is happening and what his BG is
     
  46. Finster

    Finster Member

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    I have some science diet wet food but it's like 24% carbs. It's what he was on before diagnosis. How much of that do you think I should feed?
     
  47. Finster

    Finster Member

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    I fed him two tablespoons of science diet chicken and rice melody. He ate it all!
     
  48. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    A teaspoon is fine. Then retest BG in about 20 or 30 minutes
     
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  49. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    Okay. That’s fine. We just don’t want him to get full because you may need to give him lots of little snacks through the day to keep his BG up. So we usually just give small spoonsful.
     
  50. Finster

    Finster Member

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    okay. 15 minutes I'll test and post....hopefully he will eat something later. He loves that science diet.
     
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  51. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    It should be+3 now if you shot at 7:15
     
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  52. Finster

    Finster Member

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    BG 88....thank goodness it's headed back up. Hopefully not too much?
     
  53. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    Okay. It’s come up a little bit but not a lot. That’s the food. Please retest in another 30 minutes to make sure it’s not going down again. It’s still very early in the cycle and the insulin will be very active.
     
    Last edited: Aug 13, 2022
  54. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    Please also make notes in your spreadsheet about the food that you fed (you can just put 24% carb if you want to) and at what hour the food was given at what BG. You can put this in the remarks cell or in the actual cell where it was fed - but then you have to manually color code the cell and I am not sure if you know how to do that.
     
  55. Finster

    Finster Member

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    I will test in 30 minutes. If it's headed down should I give tsp science diet or something else? I have a can of fancy feast white meat chicken florentine with garden greens in a delicate sauce- the chart says 15 carbs on that one.
     
  56. Finster

    Finster Member

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    I added to remarks and coded it the light green used for BG at the time of food. Hope that's correct.
     
  57. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    Let’s see what the number is.
     
  58. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    It looks fine except that you fed the food at about +2
     
  59. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    I assume you are testing in 5 minutes for a +4?
     
  60. Finster

    Finster Member

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    My wifi keeps dropping...I have to wait a couple minutes for it to reconnect. 11:05 BG 97. I hope it'snot going to get too high.
     
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  61. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    Okay just test in one hour for a plus 5. Don’t worry about it going too high. He doesn’t seem prone to high numbers lately. If you give a teaspoon of low carb Fancy Feast flaked food that would be good right now.
     
  62. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    I will check back with you at 12:15
     
  63. Finster

    Finster Member

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    11:30 I fed tsp of chicken and tuna flaked low carb BUT had to sprinkle tiny amounts crushed freeze dried chicken breast-he ate it all :)
    12:15 BG 103
     
  64. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    Excellent number and not going up too fast. So glad about the food with the magic chicken dust. Like I said, my cats like it too.
     
  65. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    You can give more of the teaspoons of LC whenever you want to- up until-+10 and then no food. Could you test again at +7 (2:15).
     
  66. Finster

    Finster Member

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    I never thought to crush it. It makes all the difference! Thank you!!
     
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  67. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    Small low carb snacks like that can actually help them surf in good numbers like greens and blues.
     
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  68. Diane Tyler's Mom

    Diane Tyler's Mom Well-Known Member

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    When you get a chance it would be helpful to set up your signature
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    Take a look at mine
     
  69. Finster

    Finster Member

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    Hi, I've update the signature block. Please let me know if it doesn't display properly.
     
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  70. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    Did you get a +7?
     
  71. Finster

    Finster Member

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    I did...BG 93.
    I've been trying to get him to eat some more fancy feast with chicken. he ate maybe 1/2 tsp. He's licking his lips again. I also took him outside. He likes to walk around in the yard and I think it may help with the glucose.
     
  72. Finster

    Finster Member

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    He really doesn't like being in the 90's :(
     
  73. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    Okay, you’re doing well.
     
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  74. Finster

    Finster Member

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    Here are so labs from back in December.
     

    Attached Files:

    Last edited: Sep 2, 2022
  75. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    It’s not uncommon for cats who are used to being in high numbers not to feel well in the low numbers. Their bodies are not used to it. Some will even hide or get lethargic. It’s like me when you take my caffeine away. Poor boy.
     
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  76. Finster

    Finster Member

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  77. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    All those labs look good for a cat of his age. The low lymphocytes are caused by the steroid of course. What I don’t understand is that you said he was diagnosed in December, but is BG was only 141.
     
  78. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    Test at +9?
     
  79. Finster

    Finster Member

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    He was diagnosed June 27. The labs I sent a couple hours ago are from December. Just for comparison with the labs I sent from June visit. Sorry for the confusion
     
  80. Finster

    Finster Member

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    BG 123. He looks good too :)
     
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  81. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    I am really pleased with this.
     
  82. Finster

    Finster Member

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    7:10 pm BG 113. I'm going to give him dinner but 113 is the lowest i've seen evening pre shot.
     
  83. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    Can you monitor tonight for a while?
     
  84. Finster

    Finster Member

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    I can...what's the protocol?
     
  85. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    Did you shoot yet?
     
  86. Finster

    Finster Member

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    no shot...too worried about the low number.
     
  87. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    Okay. Try to get a few tests before you go to bed so you can see where he goes with no shot.
     
  88. Finster

    Finster Member

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    8:15 BG 142
    I don't know how to add this on spreadsheet.
     
  89. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    Put it in the +1 cell and be sure to put “ns” or “no shot” in the units cell for this evening.
     
  90. Finster

    Finster Member

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    Thank you and I added to spreadsheet. Also BG 9:15 144
     
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  91. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    Good job. So we can see that he was on his way up at preshot time. But for now, he is still pretty stable in the 140s. Interesting.
     
    Last edited: Aug 13, 2022
  92. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    Okay. I got it now. I was driving in a car most of the afternoon and my daughter was reading it to me. I thought she said “in December when he was diagnosed.” Then I told her what to type for me. :)
     
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  93. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

    Joined:
    Jun 4, 2020
    When was the steroid started? Do you recall what month/ year? A BG of only 141 at the vet would not really be cause for concern as any cat might have that due to stress of being at the vet. Some of my non-diabetic cats have gone higher.
     
  94. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

    Joined:
    Jun 4, 2020
    I hope I am not inundating you, but at this point you probably don’t need to pay for the fructosamine test. It will give a number that is an average of blood glucose over about the last two weeks or so. Now that you are testing, you can figure this out for yourself- you will have a good idea anyway. My meter even has a function where it will tell me a 7, 14, and I think even a 30 day average of my BG readings.
     
  95. Finster

    Finster Member

    Joined:
    Jul 11, 2022
    10:15 BG unchanged-144
     
  96. Finster

    Finster Member

    Joined:
    Jul 11, 2022
    He has been on and off prednisolone for many years. This particular round was started back in December. By June, date of diabetes diagnosis, he had been on 5 mg twice daily for five months. Also during those five months he ate everything he could get ahold of-people food included.
     
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  97. Finster

    Finster Member

    Joined:
    Jul 11, 2022
    Looking back at my text I see where I posted that he was diagnosed in december...So sorry for the confusion. He saw vet in december for allergies/asthma. They did blood work which came back fine and put him on prednisolone. By June he was ravenous and drinking water like crazy. I took him in and that's when the labs showed diabetes. June 27 diagnosed with diabetes and started on insulin.
     
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  98. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

    Joined:
    Jun 4, 2020
    Isn’t that amazing!
     
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  99. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

    Joined:
    Jun 4, 2020
    That’s quite a high dose of pred (I mean twice a day). Steroids do increase thirst and hunger, but it does look like it sent him into diabetes. He doesn’t seem to need much insulin at this point. Maybe we can find a dose that will just give him the support he needs while (hopefully) his pancreas heals.
     
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  100. Finster

    Finster Member

    Joined:
    Jul 11, 2022
    BG at 0630 142. His appetite is much improved. He ate 1/2 low carb FF this morning :)
    Not sure If I should give .5 insulin? Also I'm down to five test strips. Shipment is coming tomorrow.
     
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