Java, elder cat

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Lois and Java said:
Oh Rachel, IAA etc. came up simply because another cat owner that I was chatting with at the vet last week told me his cat was getting 8 units of prozinc twice a day, and I was asking here, yikes! isn't that an awful lot?
Reduce tonight's dose to 1 unit, monitor every 2 hours starting with +2.
I normally test around 8 p.m. my time and shoot 15 to 25 minutes later after FF.
I'd like to advance that to 7 pm., Should be okay?
Kris?
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Yes, try 1 u tonight with the new insulin. You can move your dose time to 7 pm.
 
My vet also slaps a HUGE rx sticker on the vial. Drives me nuts. I've asked for them not to but they said it's protocol. I asked them to fold the label in half and only stick it on with just the edge of the sticker. They said on the next vial to remind them when they call.
Chuck is currently getting 6.8-7 units twice a day. Looking into the testing for Acro and IAA next week.
437 and 461 are essentially the same number so don't worry too much. You might see a drop starting at +3 or +4.
 
Lois and Java said:
Huh. It went up at +2. Well, it came down later this afternoon with the old PZI.
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It's still really high. 437 PMPS, 461+2, 460 at +4.5. He *is* scarfing down FF, a lot of it.
I'll check him in middle of night but the good news is it doesn't seem like a hypo could happen, and he's out of 500s and 600s.
For the am shot...1.25 U?
454 at +6. Odd that there's no real nadir, right?
He gets 125 ml of Ringers subq tomorrow.
 
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Kris & Teasel said:
I agree with Rachel. If the AMPS permits, try 1.25 u of the new insulin today but be prepared to monitor.
Click to expand...
544 AMPS, gave 1.25, will monitor.
Edit: First time in, like, ever, that he hasn't wanted to go out in am, but houseguest arrived late last evening, so, tired I hope? He seems comfortable.
544 AMPS
506 +2
+3 - 125 ml Ringers
He definitely does not care to go out.
+4 - 450
Okay, so some movement, yay.
Edit: I took him outside, and he was mildly interested and walked around, but mostly he wants to sleep.
+7 - 409
I wonder what to use tonight?
My house guest asked if I could be shooting him into fat, which could make the difference in that he wouldn't get the insulin. A friend of hers discovered that that was a problem with her own diabetes.... Might that translate to felines? Kris, you saw the photo where I often shoot him. Let me put it up again.
We are going for a walk but I wanted to put this out here for the East Coast.
 
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It makes me nervous to dose Java without running it by here!
I'll be doing the PMPS soon.
I'll shoot 1.25 again in the absence of different advice.
He's high all the time and I'm not sure why.
Would love advice, thanks.
 
454 PMPS, 1.25 U.
It's kind of flat, in black and red, not sure why, since insulin had worked on a curve before.
Maybe the snow is keeping people off the board? Electricity out?
Hope to see your pixels in the morning, thank you.
 
I'm sorry! I just got home from work a little bit ago, and tested Hermione & gave her insulin before I turned on the computer.

It looks like Java can use a dose increase when you're able to monitor him. Unfortunately the ideal insulin dose can be a bit of a moving target.
 
In case any one's up, on, yay, it's moving again. Is now 127 at +5. Debating feeding him some FF, or not. Soooo nice to see a blue. Middle of night, I'd like to sleep from now on. Hmm.
 
Lois and Java said:
544 AMPS, gave 1.25, will monitor.
Edit: First time in, like, ever, that he hasn't wanted to go out in am, but houseguest arrived late last evening, so, tired I hope? He seems comfortable.
544 AMPS
506 +2
+3 - 125 ml Ringers
He definitely does not care to go out.
+4 - 450
Okay, so some movement, yay.
Edit: I took him outside, and he was mildly interested and walked around, but mostly he wants to sleep.
+7 - 409
I wonder what to use tonight?
My house guest asked if I could be shooting him into fat, which could make the difference in that he wouldn't get the insulin. A friend of hers discovered that that was a problem with her own diabetes.... Might that translate to felines? Kris, you saw the photo where I often shoot him. Let me put it up again.
We are going for a walk but I wanted to put this out here for the East Coast.
Click to expand...
When I pinch Teasel's skin like that I also lift it up high off his side and feel for the little depression (the "tent door") and that's where I insert the needle, angling it very slightly down.
 
That's a nice blue from last night, Lois. It's nowhere near the danger zone on a pet meter (around 68) so you could try 1.5 u this AM if you can be around to monitor. Yes, he's bouncy but he also needs an increase I think.
 
Kris & Teasel said:
That's a nice blue from last night, Lois. It's nowhere near the danger zone on a pet meter (around 68) so you could try 1.5 u this AM if you can be around to monitor. Yes, he's bouncy but he also needs an increase I think.
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Glad to see a blue in the middle of the day today. I was surprised at how much it went up between + 10 and PMPS.
Out of curiosity, why was it so flat and high for several days? Was it a function of too low a dose of insulin?
Thanks very much for all your experience and dosing information.
 
I thought of another explanation this morning. His pancreas might have been sputtering into working with the priming of a little insulin, and now maybe it isn't working at all.
He wanted to go out this morning and he is out tromping around in the yard! This is good news. He's feeling better, he's acting like himself.
 
Crum?!! He is acting what seems like a perfectly normal to me, and his BG has gone up to 626 in +2!!! I won't be able to test him again until about +6. I hope it is going down by then.
 
Looks quiet on the board. Happy St. Patrick's Day.
207 + 11, and 300 even at PMPS.
Quite low compared to the way things have been for the last couple of weeks.
So. I spent 1.25 hours re-reading all of my thread and several of the stickies.
My conclusion is that 1.5 is too much, and a fat 1 is too low. So, 1.25, and I'm around to monitor.
Edit: well I may regret not going with 1.5.
At +2, 409.
At the time I shot, though, he hadn't eaten much FF during the day. Shortly after shooting, he was voracious for his FF.
At +3, 357.
 
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Lois and Java said:
Looks quiet on the board. Happy St. Patrick's Day.
207 + 11, and 300 even at PMPS.
Quite low compared to the way things have been for the last couple of weeks.
So. I spent 1.25 hours re-reading all of my thread and several of the stickies.
My conclusion is that 1.5 is too much, and a fat 1 is too low. So, 1.25, and I'm around to monitor.
Edit: well I may regret not going with 1.5.
At +2, 409.
At the time I shot, though, he hadn't eaten much FF during the day. Shortly after shooting, he was voracious for his FF.
At +3, 357.
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I really don't think that 1.5 is too much, Lois. In fact, at this point in time, it seems he might need a bit more than that. You know you're getting to good dose range when you see dark green on the SS. With a very bouncy cat like Java that can be hard to achieve because bouncy can also mean unpredictable. Instead of dark green he might throw in a lime green or two. Teasel's like that. All you can do is persevere - and try 1.5 u this AM.
 
Looking closely at your SS I see that you began having very high PSs once the dose got above a fat 1 u. I wonder if the problem is the dose you're on now is too high and is provoking more extreme bouncing. The only way to find out is to drop the dose back to a fat 1 u for a couple of days to see if things calm down. When something isn't working you have to try something else.
 
Kris & Teasel said:
Looking closely at your SS I see that you began having very high PSs once the dose got above a fat 1 u. I wonder if the problem is the dose you're on now is too high and is provoking more extreme bouncing. The only way to find out is to drop the dose back to a fat 1 u for a couple of days to see if things calm down. When something isn't working you have to try something else.
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I would like to try something different, so thank you for saying that. These high numbers are very distressing. I wasn't expecting any response tonight, so I've already shot 1.5. In the morning, I'll start with fat 1s.

Is there anything else that I can do for him to moderate bouncing?

On the positive side, in the middle of the day when the numbers are low, Java seems well and content, given his age and this medical condition.
He is losing weight, not good, and he's modified his behavior to accommodate his weaker hind legs.
Edit: if you'd like me to wait, to converse, in the am, let me know. I try to get insulin in him as quickly as I can after getting food in him, to bring #s down as soon as possible, so if I should check here before shooting, I need to know that before I do the AMPT. Thanks!
 
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This was posted in a different thread.
http://www.prozinc.us/videos_and_su...wToVideos_PreparingTheSyringe_Branded_USA.mp4
I've been rotating my vials side-to-side, figure 8, without shaking, to prevent air bubbles, after reading that you want to keep air away from prozinc because the presence of air degrades the insulin, because it is particles suspended in a liquid, and the air will glom onto the particles, which degrades them. I don't have a quote on air/degrading, maybe it was in the written instructions? It's quite late, I can look up a link later.
This video indicates that you should be injecting air into the vial. Really? Do you do that?
 
I do inject the amount of units of air into the vial. I have forgotten a few times but when the tech taught me at the vet we didn't do that because we practiced with fluids instead of insulin. It was in an IV type bag that didn't need air to "equalize" the pressure/vacuum. So they said... I inject the air while it's right side up so it doesn't make bubbles through the insulin.
 
StephG said:
I do inject the amount of units of air into the vial. I have forgotten a few times but when the tech taught me at the vet we didn't do that because we practiced with fluids instead of insulin. It was in an IV type bag that didn't need air to "equalize" the pressure/vacuum. So they said... I inject the air while it's right side up so it doesn't make bubbles through the insulin.
Click to expand...
I've wondered why the u40 needles come not collapsed but with one unit pulled back, does that make sense? I wonder if that has anything to do with it. so when you inject as much air as you're taking out in insulin, you have the vial upright and you put the air into the air pocket in the vial?
 
Yes I put the air from the syringe into the air pocket in the top of the vial. I'm drawing up 7 units each time so it makes sense in my mind. I'm not positive but I think the plunger being pulled out a bit might be a quality thing. I'm not sure but I figured it was so the plunger didn't stick to the top while being stored before use. I've never confirmed that idea so it could be completely off the wall crazy. Haha.
 
It can also be a way to tell if it's been used or messed with... It's not a common habit to pull the plunger out a little after giving an injection... Well for me it isn't.
 
I do mine, mostly how the video does, but flicking the syringe never moved any air bubble so I stopped doing that part after bending syringe needles lol. I clear them with the first pull of insulin so the "real fill" doesn't have any bubbles. At least none that my eyes can see :).

Like Steph, I don't pull the plunger back after injection either.
 
Lois and Java said:
I would like to try something different, so thank you for saying that. These high numbers are very distressing. I wasn't expecting any response tonight, so I've already shot 1.5. In the morning, I'll start with fat 1s.

Is there anything else that I can do for him to moderate bouncing?

On the positive side, in the middle of the day when the numbers are low, Java seems well and content, given his age and this medical condition.
He is losing weight, not good, and he's modified his behavior to accommodate his weaker hind legs.
Edit: if you'd like me to wait, to converse, in the am, let me know. I try to get insulin in him as quickly as I can after getting food in him, to bring #s down as soon as possible, so if I should check here before shooting, I need to know that before I do the AMPT. Thanks!
Click to expand...
Are you going to go down in dose today? I hope you don't feel I've mislead you. It's that the accumulating data starting saying maybe too high a dose was being given. It's always about amassing data and evaluating it, never one number.

Steering the numbers with food, keeping dose changes small and being patient are the only techniques for controlling bouncing and they're not that effective in bouncy cats. I should know! Actually, being patient and waiting to see some settling of numbers is about the only thing that might be worthwhile ... ;)
 
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Lois and Java said:
This was posted in a different thread.
http://www.prozinc.us/videos_and_su...wToVideos_PreparingTheSyringe_Branded_USA.mp4
I've been rotating my vials side-to-side, figure 8, without shaking, to prevent air bubbles, after reading that you want to keep air away from prozinc because the presence of air degrades the insulin, because it is particles suspended in a liquid, and the air will glom onto the particles, which degrades them. I don't have a quote on air/degrading, maybe it was in the written instructions? It's quite late, I can look up a link later.
This video indicates that you should be injecting air into the vial. Really? Do you do that?
Click to expand...
When I was using ProZinc I always injected a little air into the air space of the vial when it was sitting upright before inverting to draw my dose.
 
Lois and Java said:
I've wondered why the u40 needles come not collapsed but with one unit pulled back, does that make sense? I wonder if that has anything to do with it. so when you inject as much air as you're taking out in insulin, you have the vial upright and you put the air into the air pocket in the vial?
Click to expand...
I think that's done so the end of the plunger doesn't get stuck inside to the part of the barrel where the needle attaches.
 
StephG said:
Yes I put the air from the syringe into the air pocket in the top of the vial. I'm drawing up 7 units each time so it makes sense in my mind. I'm not positive but I think the plunger being pulled out a bit might be a quality thing. I'm not sure but I figured it was so the plunger didn't stick to the top while being stored before use. I've never confirmed that idea so it could be completely off the wall crazy. Haha.
Click to expand...
Not crazy at all, Steph. I think that's the real reason.
 
Kris & Teasel said:
Are you going to go down in dose today? I hope you don't feel I've mislead you. It's that the accumulating data starting saying maybe too high a dose was being given. It's always about amassing data and evaluating it, never one number.

Steering the numbers with food, keeping dose changes small and being patient are the only techniques for controlling bouncing and they're not that effective in bouncy cats. I should know! Actually, being patient and waiting to see some settling of numbers is about the only thing that might be worthwhile ... ;)
Click to expand...
Kris, I would like to try going down in the dose today yes. Been staring at the spreadsheet and trying to figure out how expert people read it and wondering if it wasn't better with more yellows and Blues a couple of weeks ago anyway, and I would have started asking about that soon. I defer to you guys gladly, because things have a more order than they did when I was winging it.

I will check back before shooting. I stayed up way too late I'm having a terrible time getting up comma but Java is up eating ya and I have to test him and get some insulin right away soon soon.
 
Kris & Teasel said:
Are you going to go down in dose today? I hope you don't feel I've mislead you. It's that the accumulating data starting saying maybe too high a dose was being given. It's always about amassing data and evaluating it, never one number.
Steering the numbers with food, keeping dose changes small and being patient are the only techniques for controlling bouncing and they're not that effective in bouncy cats. I should know! Actually, being patient and waiting to see some settling of numbers is about the only thing that might be worthwhile ... ;)
Click to expand...
Oh, I did wonder if it was necessary to step it down to 1.25 for while. Or can I just go to fat 1?
 
Kris & Teasel said:
Are you going to go down in dose today? I hope you don't feel I've mislead you. It's that the accumulating data starting saying maybe too high a dose was being given. It's always about amassing data and evaluating it, never one number.

Steering the numbers with food, keeping dose changes small and being patient are the only techniques for controlling bouncing and they're not that effective in bouncy cats. I should know! Actually, being patient and waiting to see some settling of numbers is about the only thing that might be worthwhile ... ;)
Click to expand...

He is at 545 at AMPT this morning.
I need to feed him first to get some food on board, so there is a little time to check back. In the absence of any quick replies advising me to go to 1.25, when he is done eating I will shoot a fat one.
I still stare at the spreadsheet and wonder how to read it expertly, but I had been wondering if he wasn't doing better at a flat one, when I first started with the protocols here?
 
Lois and Java said:
Thank you! I'm going to go with a fat one As soon as he is done with this fancy feast.
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Hi Lois,
I was out. I think a fat 1 is(was) fine. I encourage you to do more studying of Java's SS and make your own judgments. We're always here to help but it's good to build your autonomy. As far as reading a SS goes, it's a mix of experience, knowledge of the insulin, a particular cat's responses and a big dose of guesswork. Over time, the guesswork gets better.
 
Love the pic of Java with his paw in his water bowl. Does he often drink that way? BTW - I wasn't trying to put you off by saying it's good to learn how to judge doses for yourself. I truly understand how hard it is to "read" the SS of an inconsistent kitty. You'll get there ... :)
 
He often checks to see that it's really water/locate the surface, I think. That day, he put his whole paw in the water and stood on it in a couple of different bowls.
He's losing weight and looks so frail and is so skinny in the hips now. Doesn't seem to feel good this am. I wish I could make it better, work better for him.
Edit, 676 this morning. ☹️
 
He really does not feel well this morning. He threw up several times, and had a long pee in the Box.
He wanted to go outside and he sat in his favorite places, which was encouraging. Then he disappeared and I found him hunkering down between the compost box and the fence. Didn't look like a good thing.
I don't think he has any food in his stomach now after this morning's insulin. He's turning his head away from water and food. His BG at 2.25 is 573, down from 676.
Well, he's safe he's warm he's dry. I'm going to yoga, got to keep doing the things that keep me sane.
 
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