PMPS 277 - Normally over 300+. Do I shoot same dose? Shooting within hour. Please advise. Thanks!

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Kris & Teasel said:
Ozzy has had a DKA episode so he's proven to you that he can develop ketones if BG stays too high. You want to keep this in mind when Ozzy gets stuck in higher numbers either because a dose is too low and is held too long or if a drop triggers bouncing that puts him up on the ceiling. Hence, small dose increases as needed but not too much to avoid bouncing.
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Kris, so far on only 1U he goes lower for a few hours and then is back in the pinks before every preshot. Last night and this am were his first yellow preshots. I gave him a little smaller dose because he tends to drop fast on the vestulin. If I get another yellow preshot tonight, do you think I should do the 1U or .75U? I am curving him this afternoon so will have more data by this evening.

Just tried to get him to pee for me again so I could test his ketones (camera in hand this time). But nope.... I think he's secretly peeing without me knowing! Haha!
 
Ozzy Pawzbourne said:
he tends to drop fast on the vestulin
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Ozzy Pawzbourne said:
so far on only 1U he goes lower for a few hours and then is back in the pinks before every preshot.
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That's the nature of the insulin, Joanna. Typically you'll see that pattern of rising up again in the last part of the cycle regardless of BG range or dose; Vetsulin typically doesn't have sufficient duration of effect in cats. Increasing the dose may produce a wider, steeper swing, not a longer, steadier low period (and the swings can make a cat feel crummy).


Mogs
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Critter Mom said:
That's the nature of the insulin, Joanna. Typically you'll see that pattern of rising up again in the last part of the cycle regardless of BG range or dose; Vetsulin typically doesn't have sufficient duration of effect in cats. Increasing the dose may produce a wider, steeper swing, not a longer, steadier low period (and the swings can make a cat feel crummy).
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I don't like the sound of this.. Why do they give kitties vestulin then? Am I missing something????I think you said it was originally meant for dogs. I don't want my kitty to have such crazy BG swings and feel crummy all the time. Who wants to live like that? I know things are still early on and I want to give it some time, but I really am interested in looking into another type of insulin that can be gentlier on Ozzy and not have him on the mountain and in the valley constantly every day. That sounds awful. :blackeye:
 
Ozzy Pawzbourne said:
I don't like the sound of this.. Why do they give kitties vestulin then? Am I missing something????I think you said it was originally meant for dogs. I don't want my kitty to have such crazy BG swings and feel crummy all the time. Who wants to live like that? I know things are still early on and I want to give it some time, but I really am interested in looking into another type of insulin that can be gentlier on Ozzy and not have him on the mountain and in the valley constantly every day. That sounds awful. :blackeye:
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I think Vetsulin is prescribed because it's relatively cheap and vets are more accustomed to it because dogs get it. Some vets have a hard time distinguishing between cats and dogs when it comes to FD. :confused:
 
Mogs- will you get to see the lunar eclipse on tonight's winter solstice from your area in the UK? Tonight celestial event is supposed to be very rare and it will be one the longest and darkest nights in history. :woot:
 
Response to any insulin varies with the cat, Joanna (hence my italicised 'typicallys').

Some cats do just fine on Vetsulin - and may get better dose duration. Some cats achieve remission on Vetsulin.

Monitoring of BG and clinical signs will help you to determine how well Ozzy does on his current insulin. A good thing to monitor is whether or not he develops a pattern of unusual lethargy/sleepiness for most of the time the Vetsulin is at peak effect but then perks up in the couple of hours before the next dose is due. Another thing to watch during peak period of effect is withdrawal behaviours or low mood. These clinical signs may indicate that Vetsulin doesn't agree with a cat. If Ozzy remains 'himself' and has normal levels of activity and rest during the cycle then the only sticking point would be the dose duration (assuming that his BG readings continue to show it petering out in the final third of the cycle).


Mogs
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Critter Mom said:
Some cats do just fine on Vetsulin - and may get better dose duration. Some cats achieve remission on Vetsulin.

Monitoring of BG and clinical signs will help you to determine how well Ozzy does on his current insulin. A good thing to monitor is whether or not he develops a pattern of unusual lethargy/sleepiness for most of the time the Vetsulin is at peak effect but then perks up in the couple of hours before the next dose is due. Another thing to watch during peak period of effect is withdrawal behaviours or low mood. These clinical signs may indicate that Vetsulin doesn't agree with a cat. If Ozzy remains 'himself' and has normal levels of activity and rest during the cycle then the only sticking point would be the dose duration (assuming that his BG readings continue to show it petering out in the final third of the cycle).
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Thank you. This is extremely helpful advice, especially what to look for in his clinical signs during peak times. I will start taking note. He normally sleeps a lot, don't all cats? So how can you tell the difference between normal cat napping and lethargy?
 
BG 160 at +3.5. Tried to get him to pee again. Nope. He looks grumpy and unhappy. Putting him in front of his food bowl. Be back soon to retest.
 
Looks like I won't be hearing back from my vet until sometime in January. He is off this week until Christmas Eve. Not sure I will be hearing from him then so probably will have to wait until after the holidays. Looks like I'll be looking here (like I have been since day one!) for some guidance when needed.
 
Critter Mom said:
Looks like some time under the renal threshold today. Ozzy seems to be responding well to his insulin.
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Reading up on the links you and Larry sent me. :bookworm:Maybe this is the reason I can't get him to pee for me today (yet). He probably just doesn't need to urinate as much as he was before.

I'm convinced he peed in secret at some point today though. Just doesn't want his mama behind him with a strip looking like a wierdo!:confused:
 
Ozzy Pawzbourne said:
Reading up on the links you and Larry sent me. :bookworm:Maybe this is the reason I can't get him to pee for me today (yet). He probably just doesn't need to urinate as much as he was before.
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This is excellent news! I'm glad you posted this, Jo, because I meant to ask how Ozzy was doing in terms of water consumption and urine production. Reduction in thirst and urine output are key clinical signs pointing to improvements in regulation. (Some people rely exclusively on water consumption to monitor their cat's regulation status - but it's a very crude metric since it only points to BG levels being under the renal threshold.)

Here's another very helpful petwikia article which explains the mechanics behind polyuria (excessive urination) and its consequence, polydipsia (excessive thirst):

http://petdiabetes.wikia.com/wiki/Polyuria


Mogs
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Critter Mom said:
This is excellent news! I'm glad you posted this, Jo, because I meant to ask how Ozzy was doing in terms of water consumption and urine production. Reduction in thirst and urine output are key clinical signs pointing to improvements in regulation. (Some people rely exclusively on water consumption to monitor their cat's regulation status - but it's a very crude metric since it only points to BG levels being under the renal threshold.)

Here's another very helpful petwikia article which explains the mechanics behind polyuria (excessive urination) and its consequence, polydipsia (excessive thirst):

http://petdiabetes.wikia.com/wiki/Polyuria


Mogs
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Thanks Mogs. I will read and bookmark that one next.

Should I also be testing for glucose in the urine? I am only testing for ketones now. Looks like that might be important, too?
 
May not have mentioned this before, but Ozzy's tests on his pancreas both before his DKA episode and a week after were normal. So he did not/does not have pancreatitis. He did have one slightly elevated liver test that improved after his DKA episode, but the vet said the number was elevated slightly and he was not concerned. So...I assume his liver and pancreas are not damaged. With this info, how likely is it that he might be able to go into remission????? Down the line of course....not like tomorrow.
 
Ozzy Pawzbourne said:
Should I also be testing for glucose in the urine? I am only testing for ketones now. Looks like that might be important, too?
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Urine glucose monitoring isn't really necessary when one is regularly monitoring blood glucose levels at home. However when a kitty's not yet regulated it can be helpful to use urinalysis strips which test for both glucose and ketones. (Keto-diastix or similar - I use Bayer Multistix 10SG strips because, in addition to panels for glucose and ketones, they have panels for protein, pH, and a number of other markers).

When home testing BG the sole advantage of also testing for presence of glucose in urine is to get an idea of the approximate value for that particular cat's renal threshold. (Renal threshold varies from cat to cat.)


Mogs
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Ozzy Pawzbourne said:
May not have mentioned this before, but Ozzy's tests on his pancreas both before his DKA episode and a week after were normal. So he did not/does not have pancreatitis. He did have one slightly elevated liver test that improved after his DKA episode, but the vet said the number was elevated slightly and he was not concerned. So...I assume his liver and pancreas are not damaged. With this info, how likely is it that he might be able to go into remission????? Down the line of course....not like tomorrow.
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I am beyond pleased for you that Ozzy tested negative for pancreatitis! :D

If the pancreas isn't inflamed it has to be a good thing all round. I've not done any research into it but I would imagine that beta cells would have a better time of it in a non-inflamed pancreas. (Speculating here - never searched for evidence to prove or disprove such a tentative hypothesis.) It is worth noting that it is possible for cats with chronic pancreatitis can and do achieve remission.

Cats in DKA have seriously messed-up metabolic functions so I'd imagine that it might well take a bit of time for things to settle down.

For general info, occasionally Saoirse might have very slightly elevated liver markers but our main vet said it was not something which he was really concerned about. She seemed fine in herself at the times the test samples were drawn.


Mogs
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+7 = 212. He is on his way back up now. So much for that below the renal threshold. That's over now for the next 8 hours.
 
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Ozzy Pawzbourne said:
+7 = 212. He is on his way back up now. So much for that below the renal threshold. That's over now for the next 8 hours.
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Jo, you remind me so much of what I was like when Saoirse was on Caninsulin (UK brand name for Vetsulin)! I'd have these schizophrenic moments in the second part of a cycle where half of me would be hacked off at seeing higher numbers on my Alphatrak and the other half would be sighing with relief that Saoirse was in no danger of going hypo. (There's just no pleasing some folks ... :rolleyes:)


Mogs
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Ozzy is over his nadir and he did not get below 150 today even with a yellow preshot. I'm thinking go back to the 1U. What do you guys think?
 
Critter Mom said:
Jo, you remind me so much of what I was like when Saoirse was on Caninsulin (UK brand name for Vetsulin)! I'd have these schizophrenic moments in the second part of a cycle where half of me would be hacked off at seeing higher numbers on my Alphatrak and the other half would be sighing with relief that Saoirse was in no danger of going hypo. (There's just no pleasing some folks ... :rolleyes:)
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No Kidding!! Sorry if I sound crazy! :eek: It seems we go on top of the mountain and down in the valley along with them, I guess. See what happens when you're home for the holidays and have nothing to do....you spend all day on FDMB, researching FD, and turn your kitty into a science experiment!! I should go bake some cookies :woot:or finish my Christmas shopping, or something!!!;)
 
Ok- saw Ozzy finally head to the kitty box so I ran after him with ketone strip and camera in hand and got the 15 sec test with photo. I am going with negative on this one.

I seriously have turned into a mad woman! :nailbiting:
 

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Chris & China said:
Here's the Food Chart
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Chris- this was really helpful. I finally had some time to look the whole thing over and grabbed all the kitty food out of my cupboard so I could do a comparison. I noticed one of the FF (roasted chicken) is a little too high. I will give that to Figgie (non-diabetic) until it's gone and not reorder. Shame- they both LOVED it. No wonder. Also another FF -turkey and giblets was not on the list even though it was listed as a classics on the can. I found it on the list under the "GRAVY" versions but it doesn't say that on the can so will probably skip that one from now on, too.
 
Ozzy's PMPS was 341 so the celebratory yellow PS will have to end for today. Hoping for another one tomorrow though. Going to go ahead and give the 1 U. Shoot in about 30 mins.
 
Well.... Ozzy started out with another pink PS this am and he has stayed in the yellows (no healing blues so far this cycle) for the last 7 hours. He's been a total sweetheart all day though, looking and seeming to be very happy and content and very lovey dovey - so that is good. He's been surfing in yellows all day though and not really having too much of a drastic drop or rise so far, so I guess that part is good. Who knows, maybe he'll surprise us and end in a yellow pre-shot tonight.

I know it's a marathon, not a sprint. I'm just jogging along side my cutie right now.

It has been so very helpful to look at other people's charts and see the gradual dips in pinks, to yellows, to blues, and then greens. It's like you can literally see their kitty getting well before your eyes. I'm really hoping for this for Ozzy, too. :cat:

I have spent a little time in the Vestulin forum and am feeling a little better about Ozzy being on this type of insulin. Lots of folks had good things to say about it and that it worked really well for their kitty. The comment that was most interesting to me was from someone who said their kitty went low and fast early on and the insulin would poop out around 6-8 hours- just like we are seeing in Ozzy's reaction. But overtime, their kitty normalized on the insulin and had a smoother curve and the insulin would last longer. Their kitty eventually ended in remission.

Ooohh...don't I wish I had a crystal ball!!! :nailbiting:
 
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