New Cat New Year.......

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Hershey has been bouncing around for a the last month. It has been frustrating. He has given up a few blue readings, but mostly stayed in the 200's....He has bounced a lot and since I don't "technically" understand this, I would like someone to explain to me what I may be doing wrong. After studying his spreadsheet I have determined that he does drop into the high 100's at a dose of 1.25 units. I know that I this is the dose that gets him down. I guess I feel a little scared of this dose, and have had difficulty "shooting" that amount when he comes in lower. I work all day I'm gone 12 hours, he can't really be monitored. I will be attempting some nadirs this weekend, now that the holidays are over and we are getting back our normal routine. I noticed that he has gotten into the dog's kibble on several occasions and even sits by the bag in the pantry that he closed with a clip. We NO longer leave kibble in the dog's dish (poor dog). I use to give him Young Again as a deviation, but feel he gained weight on it and unfortunately my non-diabetic cat ate it like candy.

Just looking for some opinions, ideas, information that can help me through this time. He was diagnosed last May, and had hoped he would be in remission, and if not remission at least stability by now. I guess there are so many variables, this may make this impossible. Feeling frustrated in Tennessee with my sweet boy :(
 
Hi Judy,

He has had some nice numbers and then not so good. Some observations

You definitely can shoot lower preshots, particularly at night when you could get a before bed test. For example, on 1/4 the pmps of 196 is close enough to the 200s you shot at one unit on other cycles. That lower dose may have set you up for the higher amps the next morning.

The amps of 142. Do you have enough time in the mornings to stall without eating and let him rise until you are comfortable shooting? It would be much better to avoid skipping if possible, although he didn't jump up for the pmps, which was good. I think you could consider shooting consistently at lower numbers. You need to decide what number is the lowest you want to shoot. A weekend is a good time to experiment with this. And find a dose you feel okay shooting for a lower number. The .75 you gave for 175 looked good.

The 1.25 does look good. You might get a curve on it this weekend to see what his nadir is.

I don't see a whole lot of bouncing like he did earlier, which is great.

And no more dog food!
 
Hi Judy,

He has had some nice numbers and then not so good. Some observations

You definitely can shoot lower preshots, particularly at night when you could get a before bed test. For example, on 1/4 the pmps of 196 is close enough to the 200s you shot at one unit on other cycles. That lower dose may have set you up for the higher amps the next morning.

The amps of 142. Do you have enough time in the mornings to stall without eating and let him rise until you are comfortable shooting? It would be much better to avoid skipping if possible, although he didn't jump up for the pmps, which was good. I think you could consider shooting consistently at lower numbers. You need to decide what number is the lowest you want to shoot. A weekend is a good time to experiment with this. And find a dose you feel okay shooting for a lower number. The .75 you gave for 175 looked good.

The 1.25 does look good. You might get a curve on it this weekend to see what his nadir is.

I don't see a whole lot of bouncing like he did earlier, which is great.

And no more dog food![/QThanks for your input Sue. I guess you are right, I have to be able to determine what I feel comfortable with shooting at if his numbers are in the low 200's or upper 100's. I just wish I could be home to monitor, will try and get some testing this weekend. I just tested him now before bed, at +7 and he is at 104. Low, fed him his low carb wet. He wasn't super hungry. He had roasted chicken for dinner, so I think he was still full. I guess I am just terrified of him going hypo. Even this number made me feel like he is low. I guess because I have never really tested him at different times, I don't really know, but then even if you do test them at these other times, will they always pan out the same.....time for bed. His 5:30 a.m. shot comes soon... thoughts are so appreciated.
 
And that is the choice for you to make. What do you feel safe doing? If it is shooting at a little higher level during the week and then planning to get nadirs and being a little more aggressive on weekends when you can monitor, then that is what you do.

Your 107 is a very safe number for +7 especially if it was his low point for the cycle. If you were sure about it being the nadir, that might make you feel better about upping the dose a smidge. (Hence the weekend testing)

If I were you, I'd get some numbers midcycle this weekend and see how he looks. If his nadir isn't below 50, we might think he is on a pretty even keel overall and could take a smidge more insulin. His preshots do look very even during the week - I don't see any big jumps for preshots which might suggest low nadirs. But getting that info for yourself would be invaluable.

And you don't have to make big increases. Adding 0.2 could be fine. Are you using U100s? If so, you can increase by0.1 if you want when you want to increase and can't get midcycle numbers.

I understand. Not being home to monitor when we are talking low yellow and blue pre shots can be scary. Maybe getting an idea of what he might do will help. And as always, leaving out some food is good insurance so he could bring himself up if he dips low. Do you have an automatic feeder that you could set for nadir?
 
And that is the choice for you to make. What do you feel safe doing? If it is shooting at a little higher level during the week and then planning to get nadirs and being a little more aggressive on weekends when you can monitor, then that is what you do.

Your 107 is a very safe number for +7 especially if it was his low point for the cycle. If you were sure about it being the nadir, that might make you feel better about upping the dose a smidge. (Hence the weekend testing)

If I were you, I'd get some numbers midcycle this weekend and see how he looks. If his nadir isn't below 50, we might think he is on a pretty even keel overall and could take a smidge more insulin. His preshots do look very even during the week - I don't see any big jumps for preshots which might suggest low nadirs. But getting that info for yourself would be invaluable.

And you don't have to make big increases. Adding 0.2 could be fine. Are you using U100s? If so, you can increase by0.1 if you want when you want to increase and can't get midcycle numbers.

I understand. Not being home to monitor when we are talking low yellow and blue pre shots can be scary. Maybe getting an idea of what he might do will help. And as always, leaving out some food is good insurance so he could bring himself up if he dips low. Do you have an automatic feeder that you could set for nadir?
Thanks Sue, I will try and get some reading this weekend. Say later ones? ie. +6, + 7 +8? I guess the only way I will know what is true nadir is, is if I test all those times, but of course it could fluctuate? The needles the vet started me on are the U-40-1/2 cc - 29 gauge x 1/2", the needles do not have those tiny increments in between, maybe I should switch?

My mom is home during the day, and she does feed Hershey and my other "Miss Piggy (Jezzy)" Non-diabetic cat, on a schedule, 11 and 3. So I guess if she is doing that I would be ok? I guess these feedings would take care of any hypo issues? So Hershey gets fed at 6:00 a.m., 11:00, 3:00 and 6:00 p.m. Then usually a small amount of food before bed around 10:00. He is a grazer he doesn't eat a lot at one sitting. In fact I only go through 2 small cans for both cats daily. I supplement this with the freezedried chicken (pure bits), but I get a bigger package for $10/at my local Pet Store that only sells high end food, it is a better value.

Anyway, I will get some more readings, and then if he gets into the low 200's and high 100's I will still shoot, but like you said previously go with .50 or .75. I'm trying not to make this complicated, sorry.
 
Lots of ProZinc users use U100 needles and the conversion chart so they can make smaller adjustments. If you want to try them, you want 1/2 unit U100 needles. The conversion chart is here:

http://www.felinediabetes.com/insulin-conversions.htm

You are not making anything complicated at all. If your mom is home, she should be able to help.

@Robin&BB has great ideas about diet. How much are you feeding him overall? Do you think he is under/over weight or just right?
 
Lots of ProZinc users use U100 needles and the conversion chart so they can make smaller adjustments. If you want to try them, you want 1/2 unit U100 needles. The conversion chart is here:

http://www.felinediabetes.com/insulin-conversions.htm

You are not making anything complicated at all. If your mom is home, she should be able to help.

@Robin&BB has great ideas about diet. How much are you feeding him overall? Do you think he is under/over weight or just right?
Thanks Sue, I'm half way through this last box, will try the new one, will have to look at conversions, might make it easier to make smaller increments. He just came in at 72 at +8, I'm trying not to freak. Quite a drop from 304 at 6:00 to 72 at 2:00 p.m......
 
Don't let yourself freak out! You're using a human meter, so a 72 isn't a bad number...it's low, sure, but not hypo range. Just keep an eye on him. Can you get some more testing in this afternoon? Just to make sure he doesn't drop further.
 
Don't let yourself freak out! You're using a human meter, so a 72 isn't a bad number...it's low, sure, but not hypo range. Just keep an eye on him. Can you get some more testing in this afternoon? Just to make sure he doesn't drop further.
Hi Rachel, I fed him, he is happy, and ate a good amount. His PM test is at 6:00, so we are only 3 hours out. I'm pretty sure if I test him again at +9 he will be up because of the food..... should I wait say until +10? Low numbers are great, but I just don't want him to go hypo on me.
 
On a human meter, you're looking for two weeks without insulin. Numbers in the normal range of 50-120, with most numbers below 100.
 
When Bob was in remission, he tested between 60-80 normally.
 
To me it looks like you've been making good choices on dosage, and I think it's great that you are shooting lower doses on the blue preshots rather than skipping. I think the mid-cycle tests are going to help you understand better what's going on. Overall, nice numbers on low doses, so that's a good thing!
 
Hey Judy - if you are getting U100's syringes which I think would be great. You can really make some incremental small increases which is really nice. I see that you have a Relion Confirm. If you got that at Walmart, you can also get the U100's at Walmart too. Here is what you ask for at the pharmacy desk. Relion 3/10 mlcc, 31 gauge, 8mm length. It is in a white box with a purple strip. The syringes will have orange caps instead of the red ones like the U40's. Don't forget to use the conversion table that Sue gave you.
 
I'm wondering if Hershey doesn't have a late nadir. That 72 surprised me so late in the game...any way you could maybe run a curve tomorrow? Might help us really catch when the nadir is and help figure out more of what's really going on. :)
 
I'm wondering if Hershey doesn't have a late nadir. That 72 surprised me so late in the game...any way you could maybe run a curve tomorrow? Might help us really catch when the nadir is and help figure out more of what's really going on. :)
It looks like late nadir could be a possibility, at least lately. A couple months ago, it looks like early nadir.
But from the Prozinc study I've read, the data showed that as time went on, the mean nadir time became later...
 
Hey Judy - if you are getting U100's syringes which I think would be great. You can really make some incremental small increases which is really nice. I see that you have a Relion Confirm. If you got that at Walmart, you can also get the U100's at Walmart too. Here is what you ask for at the pharmacy desk. Relion 3/10 mlcc, 31 gauge, 8mm length. It is in a white box with a purple strip. The syringes will have orange caps instead of the red ones like the U40's. Don't forget to use the conversion table that Sue gave you.
Thanks, I will have to get use to it, and check the chart provided earlier. Hopefully these are cheaper, my VET charges $24/box for the ones I use now.
 
It looks like late nadir could be a possibility, at least lately. A couple months ago, it looks like early nadir.
But from the Prozinc study I've read, the data showed that as time went on, the mean nadir time became later...
Hi Bob, I will test his nadir as late as I can tonight, and see where he is at, good thing I just ordered 100 ct strips online!! I'm just trying to figure out what's going on with him. We are down to the last of the dry food that my other cat is on then cold turkey for her, wet food only. I feel bad in a way she is only 1 year old, and will only be on wet, worry a little about her teeth, but feel it will help her in the long run, then there won't be anymore begging from Hershey for the dry....!!!
 
I might add he came in at 194 at his PM test. I gave him .75 unit insulin He has been happy, playful and now sleeping. Will test him before bed.
 
Hi Bob, I will test his nadir as late as I can tonight, and see where he is at, good thing I just ordered 100 ct strips online!! I'm just trying to figure out what's going on with him. We are down to the last of the dry food that my other cat is on then cold turkey for her, wet food only. I feel bad in a way she is only 1 year old, and will only be on wet, worry a little about her teeth, but feel it will help her in the long run, then there won't be anymore begging from Hershey for the dry....!!!
Judy,

It's a myth that dry food is "good for their teeth". Sort of like saying that rather than brush their teeth, kids should just eat hard candy.

Cat's teeth are not shaped for "crushing" food. Few molars, and their jaw can't move side to side like humans can. Their teeth are designed for tearing meat.

This is a great site that explains it. Actually tons of good info can be found there!
http://maxshouse.com/feline_nutrition.htm

Great PMPS tonight for Hershey!
 
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