Sam's Fourth Month on Tresiba

Discussion in 'Tresiba (degludec)' started by Sam & Esse, Sep 17, 2018.

  1. Sam & Esse

    Sam & Esse Member

    Oct 18, 2017

    September 13th marked Sam's fourth month on Tresiba, or as I'm celebrating it -- his 1/3rd of a year Tresiba anniversary! He's doing incredibly well; he's alert, actively hunting when outside, his fur is soft and shiny, and his fluffy belly practically begs for raspberries. In fact, I'm actually having a bit of a problem keeping him from putting on more weight. I try cutting back on his portions, but when he looks at me and tells me that he's honestly hungry, well... I haven't the heart to deny him.

    I thought today would be an interesting day to post his progress, as it highlights one of the difficulties of using Tresiba. Sam's AMPS was 66 on the AlphaTrak, technically a 'take action' number. So I fed him breakfast as usual, then shot his regular 2u dose. Which would mostly be unthinkable on any other insulin. ECID, but for Sam Tresiba's onset is so late, and so gradual, that my only fear was that he might dip down slightly lower from the persisting duration of last night's shot -- which breakfast usually corrects. Another thing to note is today is a good representation of what I consider a 'Tresiba bounce'. There's a small bounce in progress, but the insulin is putting the breaks on it -- hard. A normal day for Sam will usually see a BG variance of between 2 to 20 points. On a bounce day that variance might be as much as 50-60 points, but that's still considerably better than the luck we'd had from other insulins. And he should still be within normal BG ranges for the AlphaTrak by PMPS. I don't think I could ask for anything more from an insulin.

    That being said, I do not know how many people (if any) would be comfortable shooting that low, or if they even should. Perhaps I shouldn't be, although I feel I have a good grasp of Tresiba's action as it pertains to Sam. I'm looking forward to Sammi's Tresiba half-year anniversary, true anniversary, and many, many years to come.

    I've added some supplements to Sam's diet; SEB to help with loose stools and D-mannose as a bit of a preventative measure since Sam's diabetic, a boy kitty, and was fixed when he was young. When I was a child, a close friend of the family that was a veterinarian at UCLA told us that male cats shouldn't be fixed until they'd 'fully developed' for health reasons. It didn't make sense then, since everyone else said to neuter boy cats early before they got into the habit of spraying. Now that I'm ever-so-much older and ever-so-slightly wiser, I understand that poor boy kitties are more prone to urinary obstructions, and that any extra bit of, erm, 'size' is of benefit. Hopefully a wet diet and the D-mannose will keep Sam 'flowing' smoothly all his days.

    @LuvinThisPig had talked about green lipped mussel powder from Super Snouts. Sam's always had shaky front legs and the belief that he had old man bones, so I figured I'd give it a try with him and my civvie girls that I'd inherited from my grandmother. Oh my goodness! what a noticeable improvement! For the first time in years, Sam jumped to the top of the fence in a bid to prowl about the neighborhood. He's jumping into the high planters under the front windows going after lizards. He's up in the cat stands. He's froggy, and proud, and now under probation since he knows he's not supposed to leave the yard. Spice girl -- who truly has old woman bones -- is also showing more movement than she has since I got her, playing and running up and down the hall, and Jazzabelle, who'd slowed down after I131 treatment, is once again showing signs of being rough and tumble. I'm so happy for them all!

    @Cheryl and Yoda Cheryl, I hope you and Yoda are doing well. I find it very interesting that your ATs actually register that much lower than lab values. Mine kinda meander to either side of them, but still close. I wonder if the difference could possibly be due to humidity, or some other climate related factor? Humidity here tends to run for months in the single digits.

    Here's Sammi from this morning. The first is him waiting patiently for a lizard to appear (it didn't), and the second is of him sunning his fine belly. Which I then walked over and raspberried. ...I really need to stop giving in to his hungry looks; that is some belly... Sam in sun small.jpg Sam sunny belly small.jpg
  2. Jill & Alex (GA)

    Jill & Alex (GA) Senior Member Moderator

    Dec 28, 2009
    Thank you for posting a progress report. It sure is good to hear how well he's doing!
    Ha! I know that look and so do many others! Some caregivers have found leaving the house is a good way to keep from giving in. I found using a digital baby scale to weigh Alex on a weekly basis really helped to maintain my focus. :)
    I found this comment interesting because I found the same using Levemir and I've known others who also have had to shoot very low. I suppose it's one of those ECID things we're always talking about or perhaps simply a combo of being carb sensitive and the cat's response to a long-acting insulin which has a late onset. "Knowing thy cat" becomes of vital importance before/when deviating from the norm.
    This appears to be what caregivers using other insulins see when the dose becomes optimal or close to it... the long flat curves the long acting insulins are known for. It makes me think there's probably an insulin out there for every cat... it's just a matter of finding the right fit for that cat.

    Love the pictures! I'm so happy for you and Sam... happy you tried Tresiba. The progress you've made with Tresiba is amazing!

    Thanks again for the update... keep them coming!
    Sam & Esse and Yong like this.
  3. Sam & Esse

    Sam & Esse Member

    Oct 18, 2017
    Hi Jill! I'm very sorry it's taken me so long to write!

    I bought a scale, but it's not big enough for Sam :confused: So I've been weighing him on my 'iffy' human scale and subtracting my weight from it. :facepalm: So far, no luck on getting his weight down. I'm weighing Sam, I'm weighing his food, and making him slowly trot down the driveway several times each day... (Sam tells me they're death marathons and that I should have a mouse waiting for him at the end to make all that effort worthwhile.) I'm just not sure what to try next. Maybe I just need to put in earplugs lol!

    Since Sam's bloodwork almost a year ago, he's had a problem with a rash/sores in the space between his eyes and ears, and going up along the edge of his ears. I'm fairly sure it's caused by a virus he picked up from the hood the vet tech used -- not that I can get the clinic to admit to anything :mad: I was given Tresaderm to treat the outbreaks... and this last bout, Sam lost his beautiful regulation. So I've been working on getting his BG#s back within range. It's proving harder this time, but there's slow improvement. It's almost time to have his bloodwork done again, but I really need to find a different vet for him. Hopefully one that doesn't spend ten minutes of the appointment chewing me out over Sam's weight. :arghh: I know I have a big boy, I don't need a vet shaming me over it.

    I still love Tresiba. However... I don't know if it's a side-effect of Tresiba, or a quirk of Sam's genetics, or something else entirely, but...
    Sam's going grey o_O In some spots he's almost white. His entire chest, under his front legs, to his belly -- light grey. Along both shoulders. The long hair on his back legs. Grey. It's adorable, but so, so odd! And his ruff below his head is fading to red/orange, as is some of the hair along his flanks. It's like my black cat up and decided he'd much rather be a very dark calico. Or maybe a tortie; although the patches are a bit too large for that. I'm baffled. I'll need to get a good picture of him in the sun to show off his 'new' winter coat.

    I hope the other Tresiba cats are doing well :bighug:
  4. Jill & Alex (GA)

    Jill & Alex (GA) Senior Member Moderator

    Dec 28, 2009
    You might have to! I wasn't kidding when I mentioned some caregivers have found it necessary to leave the house rather than give in to feeding more food. :D
    Has Tresaderm helped? If not you might want to try Halo Cloud Nine Healing Herbal Salve for Dogs and Cats. I've used this on pets for years. A big plus is it doesn't raise BG numbers and it's safe if kitty ingests it while grooming. I've yet to find anything minor that it hasn't cleared up.
    Ugh. It's always harder to bring BG numbers back down. Any chance of getting any mid-cycle spot checks to find out how low the increased doses are taking him? I vaguely remember there is some difficulty with mid-cycle testing, but just thought I'd ask.
    Ack! No, you need a vet who will be your partner!
    Hmm... I have heard of cats getting grey as they age (especially black cats) much like humans, but Sam's not that old. Odd, but then some humans turn grey prematurely... maybe it can be the same with cats. There is a skin condition that supposedly can affect the fur color called vitiligo, but it's extremely rare. I'd be surprised if it's that, but talk to your vet.
    I think that's known as "rusting". It's another subject worth bringing up with your vet. Copied straight from Google: 'Nutrition plays a role in cat colors. A diet deficient in the amino acid tyrosine can cause black cats' hair color to change from black to reddish. Tyrosine is needed to make melanin, the dark pigment in cat fur, and if a cat doesn't get enough tyrosine in his diet, his ebony fur may fade.' I've only heard of it. I don't have any first-hand experience with it.

    Thank you for stopping by. It's good to hear from you as well as hear about Sam's progress!
  5. Sam & Esse

    Sam & Esse Member

    Oct 18, 2017
    Hi Jill :bighug:

    I've started just going outside, and dragging Sam with me to explore the yard. Now to figure out a way to stop myself from sleep feeding him :banghead: Sam knows I'm a zombie at night, and the little sneak's been taking advantage of it.

    The Tresaderm does help, but Sam's becoming increasingly intolerant of the steroid in it. I'll order the Cloud Nine! At this point, anything would be better than the Tresaderm for his next outbreak. It works, but it raises Sam's BG uncontrollably.

    :blackeye: I've been trying for weeks to get in a midday test, but kept forgetting. Luckily I read your post right at +6, so I grabbed up Sam and got a test in. I'll do my best to get a few more in during the next week. Maybe more sticky notes around the house will help.

    I did try to research various reasons why a cat's fur might change color. The "rusting" sounds exactly like what's going on with the red/orange change, but Sam gets plenty of protein :nailbiting: I'll be getting a senior panel done during his next appointment (I've been working on a letter to send to a new possible vet; well, old/new considering she's the one that snipped Sam when he was a kitten -- at a different clinic). I'll need to see if there's a specific test that can check for tyrosine levels.

    Thank you so much for writing, and the advice! It's all greatly appreciated!
  6. Jill & Alex (GA)

    Jill & Alex (GA) Senior Member Moderator

    Dec 28, 2009
    Whatever works! Random spot checks will let you know if whatever dose you're giving is safe.
    For years I had been so preoccupied with finding low carb and later, foods low in phosphorus, that I really didn't pay much attention to the percentage of protein in commercially prepared foods. Quite a few of them, including some I was feeding, contained a lot less protein than I thought. I ended up supplementing canned food with raw just to increase the amount of protein they were getting. The premix 'Food Fur Life' made it easy to add protein to make a balanced meal to add to the rotation. I have no idea the amount of protein in the foods you're feeding, but it might be something worth checking.

    This article discusses the role of nutrition: Why Is My Black Cat Turning Brown?
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