2/5 AMPS HI,+4/406,+8/412,PMPS HI

2/4 Condo

Morning all.

This is getting old. :sad: I'm frustrated. Tired of getting 'greeted' by the meter. :sad:

So far, no matter the dose, same result. BG level will drop for 1 or 2 cycles, then right back up. :sad: He has spent much too much time being 'HI' and it really worries me.

This morning, he must be feeling bad, he's being 'rude' and 'snippy' to the other cats and was combative with me for his test. :sad:

UP - DOWN - HOLD :?: :?:

Now what?

Please offer suggestions.

Hope all your kitties are healthy and happy.

Re: 2/5 AMPS HI - Frustrated!

Hang in there hon, I'm going to see if I can round up a couple more seasoned eyes to bounce a couple ideas off of....I think I know what is going on with him but I want to go reread some stuff and get a couple folks that have had some problematic kitties look at his spreadsheet. The ones I'm calling in helped me greatly when Musette was frustrating the heck out of me.

((((((hugs))))))

Mel, Maxwell, Autumn & The Fur Gang

Re: 2/5 AMPS HI - Frustrated!

Thanks Mel, I appreciate any suggestions/insight you or anyone else have to offer.

I spend a lot of time looking at other threads and other cats SS and I have seen very few kitties running as high, as often, as Lucian. :shock:

I don't know if dropping him to .5 and starting that uphill climb might be a good idea or just increasing. He's already been at 1.0, same issues.

Yeah, I'm sure there have been fur shots and a missed dose, but dammm. From what I've seen, I've managed to be AS consistant, if not more so, than many. Why he wants to hang out on that black floor, is beyond me! :-x

After 3+ weeks, he's managed 1 green and 4 blues, in all his testing. :sad: I'm positive that him staying so high, repeatedly, is doing damage.

I can't take him to the vet, to see if there are other issues, i.e. infection, uti, etc - no $$$ and, of course, I'm sure she will throw a fit when she finds out I have not been following her prescribed dosage. It would be different if I can show her progress on what I have been doing, but I have none to show. :sad:

Crying at 8AM is not how I like to start my day. :cry:

Re: 2/5 AMPS HI - Frustrated!

Okay found what I was looking for....here read this http://petdiabetes.wikia.com/wiki/Somogyi_rebound

but this is the part that has been nagging at me....

"The blood sugar readings may go from a lowish number very suddenly to a high number, with a 'checkmark' shaped curve (see graph below). If overdose goes on for a few days, you may see few or no low readings, and just lots of very high and unpredictable readings that don't seem to correlate with feeding. Once in a while, a very low reading or even a symptomatic hypo may ensue. "

Which is what for all the world he looks like he is doing to me. He gives us a good drop and then bounces right back up to those high numbers and hangs there. I would really love to know what his original dx number was. That would tells us if he is higher now on insulin than he was before he started.

I've seen it handled both ways...one by reducing until they finally stop bouncing around and just go high and flat but not sky high or by constantly raising the dose until their bodies finally can't override the rebound and they drop suddenly. Honestly hon, this isn't something that I have had to deal with, with any of mine so now calling in the reinforcements.

Mel, Maxwell, Autumn & The Fur Gang

Re: 2/5 AMPS HI - Frustrated!

Good morning Debbie and extra extra sweet Lucian. I'm no HELP but I will share a cup of and a BIG HUG. I KNOW your frustration, I'm SO tired of seeing PMPS's mostly in 300's and some in 400's. I've raised dose, lowered dose, cussed, threw my meter (THAT didn't help...)... Most of the time I swear KT is a big ball - spends more time bouncing than in low numbers. We've been working on this for over 1 1/2 years, I'll never be an expert 'cos I can't even get MY cat under 'control'. THEN comes a few days ago - didn't change anything, still same cuss words, same food, same vial of insulin, same needles, same cat...suddenly he's running blues and BIG TIME greens for longer and longer on doses that he's refused before! His bounces are clearing faster too. Suddenly Mr. Liver must be getting used to those numbers - 'bout time, he's REALLY REALLY slow to learn. Maybe it just takes patience - which I don't have a lot of very often...

BIG HUG! And another one just 'cos we need them!

Re: 2/5 AMPS HI - Frustrated!

Thank you Mel! :YMHUG: :YMHUG:

I don't know what his BG was when he was DX'd, but they started him on 1U, then 2 days later went to 2U, then 2 days later, when I was going to pick him up, they wanted to keep him 2 more days and upped him to 3U because they couldn't get him off 700. So he was increased from 1, to 2, to 3 in 6 days. :shock: I picked him up with a prescribed dose of 3U BID, brought him home, researched, changed him to all LC canned food and dropped him to 1U BID and the rest is on the SS. Looking back, I feel I should have dropped him to .5, but didn't know then what I've learned since. I'm still considering bringing him down to .5, maybe he is still on too high a dose? God knows, his #'s can't be any worse on .5 than they are now! :-x

Thank you Lyresa, I appreciate the hugs!

Re: 2/5 AMPS HI - Frustrated!

I wish I knew what to tell you, I keep going back and looking at his spreadsheet and wondering what I'm missing. I'm just as frustrated as you are, I hate seeing those high numbers especially after losing one to DKA...but that is what else is puzzling is that he isn't throwing ketones and is starting to act more like his old self...that would say he is feeling better, but those high numbers are puzzling. Musette would hit a high number and she would give me at least a trace on the ketones...but then there is Autumn that can survive almost a year in the 500s and never go DKA...Some days I really hate the ECID...couldn't they just agree on to do something alike :roll:

Mel, Maxwell, Autumn & The Fur Gang

Re: 2/5 AMPS HI - Frustrated!

I know, me too. No matter how long I look at his SS, nothing changes, nothing jumps out at me, except a bunch of black blocks! :-x

I've got so much on my plate right now, I can't even think straight. :cry: That's why I am so grateful for the insight and the 'hand holding' that I've received here. I would, most certainly, be pulling my hair out without it!

I have until this evening to decide what to do, up, down or hold........I feel like I'm damned if I do and damned if I don't. I have never been so uncertain about anything in my life! Normally, decision making is not difficult for me, this is a whole new story here! I just don't know! :?

Re: 2/5 AMPS HI,+4/406 - Frustrated!

:YMSIGH:

Re: 2/5 AMPS HI,+4/406,+8/412

...headed back up.....probably got below 400, but I'm sure it wasn't by much.

I was expecting that.

Trying the unorthodox, dropping him to .5..can't get any worse and his readings are leaning toward too high a dose, so we'll see what happens over the next couple days.

Couldn't bring up the site for over an hour, nice to see it's back up.

fingers, toes,paws and tails all crossed that this works. If not then we just reverse directions and keep going up until we force the numbers down.

Mel, Maxwell, Autumn & The Fur Gang

nckitties3 said:

I was expecting that.

Trying the unorthodox, dropping him to .5..can't get any worse and his readings are leaning toward too high a dose, so we'll see what happens over the next couple days.

Couldn't bring up the site for over an hour, nice to see it's back up.

Click to expand...

UGH, please tell me you are testing for ketones often.... the drop to the .5u dose - not a move I would have chosen, but now you can see that .75u not enough and maybe 1.75u possibly too much...

FWIW, I do not believe that Somogyi exists, and nobody has been able to show me an example of it.
I don't see it on Lantus, but maybe others can say more.

OK look at the ss, go back to the point where you had better numbers....
The blues on 2/2-103, 1/28-134, and the 1/25-98 make me wonder if you can try food manipulation.
That starting dose of 3u is way too high; that's for sure.
That 1.75u is maybe a little too high, and that .75u is too low.

I don't know what the others may suggest, but it's said to go back to the dose that seemed best before your change.....

On 1/18, your comment is first shot with syringe; what were you using before?
On 1/19, you mention maybe a fur shot.

I think I'd try food manipulation, and give the 1.5u dose a try. After 7 cycles, 1 fur shot in there, you got some decent numbers by 1/22, but then something happened.... not sure what but it could well have been a bounce, so I don't think I would have increased. The next few days got you that real low 98 and that was followed by a definite bounce.... I think I would have dropped back to just 1.5u or even 1.25u, just to get the extreme numbers to settle.

Some cats fall/drop hard at the front end of cycles, then bounce right back up; some people have tried to use food to 'guide' the numbers.... something like feeding 1tsp every hour for the first 4 hours after a shot may be just enough to slow the drop, and with a slower, more gentle drop, you may be less likely to see the crazy HI's.

To address the food - there's no need to mess with calories and amounts of food until your cat is closer to regulated. The cat's not able to utilize the food you are feeding well, so it's OK to feed a bit more if needed.

The comment about overdose on the 2/5 entry is unlikely..... the numbers as well as the reaction of extreme hunger and thirst is telling you not enough insulin.

I don't know what dose you would feel good to give.... something between 1u and 1.5u would be good, then hold it and see what numbers you can get.... juggle around the food snacks, and consider giving some MC around +4 or so because you are getting drops that you want to slow down.
I think the .5u dose can be dangerous, and you may end up at the vet with a very sick cat.
The recipe for DKA usually includes not enough insulin, not enough food, and infection.

Blue

You act like she just took her dose from 3u to .5u, when in fact this is only a .25u drop...and she is testing often for ketones, which is noted in her spreadsheet. All that is happening here as I see it is she is taking Lucian back to the first possible dose and per TR protocol holding for 3 days to see if she can get him flat, then will be raising slowly so that she can drop his overall curve.

Yes the recipe for DKA is Not enough food + not enough insulin + infection. This is a cat that is eating well, being tested often for ketones and has no known infection. If any of those factors change within those 3 days that he is on .5 then the dose will be raised immediately.

This is not Tight Regulation this is Start Low and Go Slow, that is what I see happening here, she is making absolutely sure that she didn't miss the best dose. Ironically no one had a heartattack when she rolled back a full unit but a quarter of a unit brings threats of DKA?

Am I a Lantus expert?....nope....just someone with 2 diabetic cats one in remission for 2 years and 1 headed that way, after going 10+ months without any treatment after she was dxed.

Mel, Maxwell, Autumn & The Fur Gang