Buddy's SS up and going 8th part about dosing

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I think either Saturday or Monday would be fine. You have enough data to be pretty confident that he'll still be in safe numbers with the increase, so I think you could go ahead with it on Saturday if you want....or wait until Monday if you're more comfortable.
 
Djamila said:
I think either Saturday or Monday would be fine. You have enough data to be pretty confident that he'll still be in safe numbers with the increase, so I think you could go ahead with it on Saturday if you want....or wait until Monday if you're more comfortable.
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I was also thinking of using a u40 syringe and raising him tomorrow to 4.5u. After several doses if numbers are not moving in the right direction, then go back to u100 and raise him to 4.6. What are your thoughts on this.
 
I think those tiny changes are significant if you're dose is small, but at higher doses, I don't think it matters as much. If you were giving him 1u, then the difference between 0.9u and 1.0 units is 10%. But the difference between 4.5u and 4.6u is only about 2%. I also get nervous about switching between syringes just because it's so easy to get them mixed up and give the wrong dose. That being said, it is always up to you to decide what you think is best, and what you're comfortable with. I think going from 4.4 to 4.6 would be safe though, if you feel okay with it. If you're not comfortable with that, I think it's fine to go up by the 0.1u change.
 
wolfey said:
I was also thinking of using a u40 syringe and raising him tomorrow to 4.5u. After several doses if numbers are not moving in the right direction, then go back to u100 and raise him to 4.6. What are your thoughts on this.
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For simplicity's sake I'd stick with the U100s and try 0.4 u increases if you feel that 0.2 u isn't doing much. I also agree that you can increase either on Saturday or Monday.
 
Kris & Teasel said:
You'll get there! :) Those blues that poke through are good signs.much
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How long should I stay on a dose before upping it and that is if I don't see much of a change in Buddy's numbers. I have seen somewhere where it said to do 6 doses before changing. Since Buddy is insulin resistant, I have not always gave 6 doses before I upped his dose. Do you know anything about Vitamin E & Selenium helping to get over insulin resistance. I have looked for Vitamin E before and all I could find was gel capsules in a larger dose. I did not know we would get so many smiles.
 
wolfey said:
How long should I stay on a dose before upping it and that is if I don't see much of a change in Buddy's numbers. I have seen somewhere where it said to do 6 doses before changing. Since Buddy is insulin resistant, I have not always gave 6 doses before I upped his dose. Do you know anything about Vitamin E & Selenium helping to get over insulin resistance. I have looked for Vitamin E before and all I could find was gel capsules in a larger dose. I did not know we would get so many smiles.
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For ProZinc you can increase after 3 cycles if the dose isn't effective. I think those cycles where you aren;t getting any blue are mild bounces.
 
Kris & Teasel said:
For ProZinc you can increase after 3 cycles if the dose isn't effective. I think those cycles where you aren;t getting any blue are mild bounces.
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Tonight at PMPS his reading was 311, at AMPS his reading was 361. He is eating the same as before, I must admit he does not get any exercise. At his next increase he will be at 5u, this is getting scary. I am afraid of all the damage this is doing to his body. I guess the only thing I can do is just keep up with the increases and hope we finally reach the right amount.
 
He would be doing worse if you weren't doing anything, Teresa :bighug:. We're here with you and Buddy :cat:. I think you're on the right patch with those sneek-peak blues :)
 
Yong said:
He would be doing worse if you weren't doing anything, Teresa :bighug:. We're here with you and Buddy :cat:. I think you're on the right patch with those sneek-peak blues :)
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I know he would be doing worse if he did not get the increases in insulin. Have you heard of giving Selenium and Vitamin E to help with insulin resistance. I like the smiley faces.
 
I can do my thing tomorrow for you :bookworm::bookworm::bookworm:. I'll get back to you :). The smiley faces help me soften my words. I can be very straightforward blunt, usually with good intentions but can be hard to detect without them ;)
 
Yong said:
I can do my thing tomorrow for you :bookworm::bookworm::bookworm:. I'll get back to you :). The smiley faces help me soften my words. I can be very straightforward blunt, usually with good intentions but can be hard to detect without them ;)
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I have never felt like you were straightforward blunt, sometimes people do not get that this is serious. If I am not on line, please go ahead and post. Thank you.
 
I'm really curious about the missing part of his pancreas and the impact of that. Yong, maybe you could do your research magic on that topic, too. What I've found about it is that depending on how much and which part was removed, it could mean that he is just fine and can still produce insulin on his own (with healing time), or it could also mean that he isn't going to produce any insulin on his own anymore. Which could indicate that he's going to need higher doses than some of the other kitties around here. I wonder if your vet could shed some light on that -- what exactly did he remove, and what does he expect the outcome to be from that? Knowing that might impact how he's dosed, and even which insulin would be best for him.
 
I'm glad Yong will research this because I think that might well be affecting Buddy's need for insulin. He is responding but the dose might end up being higher as a result of the surgery.
 
Djamila said:
I'm really curious about the missing part of his pancreas and the impact of that. Yong, maybe you could do your research magic on that topic, too. What I've found about it is that depending on how much and which part was removed, it could mean that he is just fine and can still produce insulin on his own (with healing time), or it could also mean that he isn't going to produce any insulin on his own anymore. Which could indicate that he's going to need higher doses than some of the other kitties around here. I wonder if your vet could shed some light on that -- what exactly did he remove, and what does he expect the outcome to be from that? Knowing that might impact how he's dosed, and even which insulin would be best for him.
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Buddy on 2/3/2017 had the tail of his pancreas removed and surrounding tissue. I asked his vet if he thought this removal would make a difference in his insulin need, he told me he did not know. He is aware of what insulin Buddy takes because one of the other doctors at his clinic prescribed it for him at time of diagnosis. The only reason I have not called about this is because he will want me to bring him in for a curve. Maybe I do need to call just to see what his ideas are, but all the doctors always want him to take a huge amount of insulin. At one time one of the doctors jumped him from 3u to 5u of ProZinc while doing a curve, when he came his BG was 41. This was before the removal of his pancreas. I am at a loss here, tonight I am raising his dose to 5u. I must be out of the house today, or I would call the doctor. Hopefully, maybe Yong will find something.
 
I decided to stay at home and call the doctor. He was with patients and is double booked, they left him a message to call me. I thought maybe Buddy needed to be checked for infection or some other problem. I don't like to take Buddy to the vet and leave him, because the first vet he saw at this clinic had me bring him in for a curve, she told me he would be there all day and he ended up being there 3 days and 2 nights. The original dose of insulin she had Buddy on was 3u. When I went to pick Buddy up she told me that Buddy was taking 5u of insulin. I was a little upset because she kept him so long, when we got home having a problem never entered my mind. At that time I had not been home testing because Buddy would try to get away from me, I had a few times ran a BG test on him but his doctor had told me most people do not check cats, so I did not either. For some reason that evening I wanted to run a BG test on him, he ran from me, hid under the furniture and did everything to keep me from testing him. Some how I managed to run a test after wasting lots of test strips, and lots of trying to get away. His number came back as 41, I thought something was wrong with the monitor, so I called the phone number on the box and they ran some testing with me, they said monitor is working, that is a correct number. I about flipped out, being scared to death and knowing nothing about feline diabetes. I managed to get Buddy and check him again this time his number was 35. I called the clinic's number and got the vet Buddy sees now, he told me what to feed him and if he got up to a certain number how much insulin to give him. He said if he got to 120 to give him to 2u of insulin, which I did not do. He is a very good doctor, but they all want to over dose the insulin. The next day I started posting on FDMB. I have not went to the doctor about insulin questions because of their dosing, he did however operate on Buddy. When I picked Buddy up I asked him if the surgery would change his insulin needs, at that time he did not know. When we talked about this surgery he seemed to say it was not uncommon to have this surgery and he had done this surgery on a small dog earlier in the week. He was back home within 4 days. From that time on I have relied on FDMB.
 
Hi Teresa,
You're getting more yellow PSs overall and that's progress. There might not be a definite answer about the effect of Buddy's surgery on his insulin dose. I think your gradual increases will get somewhere eventually and you can't let the size of the dose worry you. He needs what he needs. Some of the high dose kitties here get 20+ units of insulin per dose.
 
Kris & Teasel said:
Hi Teresa,
You're getting more yellow PSs overall and that's progress. There might not be a definite answer about the effect of Buddy's surgery on his insulin dose. I think your gradual increases will get somewhere eventually and you can't let the size of the dose worry you. He needs what he needs. Some of the high dose kitties here get 20+ units of insulin per dose.
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I was afraid that maybe he had a health issue going on that was causing his insulin resistance. His litter box is in the room with my computer and his urine smells really strong. So I thought maybe his doctor needed to check him out to see if everything else is alright, especially since we had the wetting on the floor for a while.
 
wolfey said:
I was afraid that maybe he had a health issue going on that was causing his insulin resistance. His litter box is in the room with my computer and his urine smells really strong. So I thought maybe his doctor needed to check him out to see if everything else is alright, especially since we had the wetting on the floor for a while.
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Those could be signs of a UTI and that can raise BG. Maybe a vet check is a good idea.
 
Initial findings: I have more :bookworm:
For partial pancreatectomy, can result (or cause) in a cat, dog, or human being mildly to moderately diabetic. Animals may be less likely to go into remission BUT it's still possible. More important to stay with low carb diets.
Initial findings for Supplements:
http://www.felinediabetes.com/FDMB/...icity-insulin-resistance-antioxidants.176712/
Looking good for supplements Vit E and Selenium :)
 
Yong said:
Initial findings: I have more :bookworm:
For partial pancreatectomy, can result (or cause) in a cat, dog, or human being mildly to moderately diabetic. Animals may be less likely to go into remission BUT it's still possible. More important to stay with low carb diets.
Initial findings for Supplements:
http://www.felinediabetes.com/FDMB/...icity-insulin-resistance-antioxidants.176712/
Looking good for supplements Vit E and Selenium :)
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Thank you, he was diabetic before the pancreatectomy. I will check this out, I am taking him to see the vet tomorrow to make sure everything is alright.
 
23 January AMPS and 6 February PMPS was the only time he's had a similar number but that was a while ago.

It's possible you found the breakthrough dose :cat:
 
Not gone for the night yet. Sorry I would've been on a little earlier but had to talk to the neighbour. I'm trapped on my back porch due to some construction and had to ask them to put my recycling down with theirs lol. I don't think it would have gone well if I tried to throw it :D
 
Yong said:
23 January AMPS and 6 February PMPS was the only time he's had a similar number but that was a while ago.

It's possible you found the breakthrough dose :cat:
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Would that not be wonderful, I am going to give him 2.5 tonight. I am so glad you answered, I thought you had logged off for
Yong said:
Not gone for the night yet. Sorry I would've been on a little earlier but had to talk to the neighbour. I'm trapped on my back porch due to some construction and had to ask them to put my recycling down with theirs lol. I don't think it would have gone well if I tried to throw it :D
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I understand we all have other things going on, I appreciate your help.
 
Also, more of what I did today :bookworm:. Wasn't able to find much on effects of partial pancreatectomy but here's what I have for that and the vitamin supplements:
"Canine and Feline Endocrinnology" by Edward C. Feldman
Most diabetic cats can be regulated with insulin doses (Lantus / Levemir / Prozinc: Intermediate / long-acting insulin's) between 0.5U and 3.0U BID.

In cats, insulin resistance is most commonly caused by severe obesity, chronic renal failure, chronic pancreatitis, stomatitis/oral infections, hyperadrenocorticism, and hypersomatotropism (acromegaly). Latter two have potential of the most severe insulin resistance.

Tests beyond physical exams: BCB, serum biochemical panel, lipase / fPLI serum T4 concentration, Insulin-Like Growth Factor - 1 (IGF-1), urinalysis and urine culture, and abdominal ultrasonography are next steps.
*Glucose targets should be set less tight, and the insulin dose chosen with the aim of avoiding hypoglycemia, very severe hyperglycemia, and DKA.

Selenium can facilitate in improving Hyperlipidemia (High cholesterol)

"A Feline Model of Experimentally Induced Islet Amyloidosis"
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1885761/
Margarethe Hoenig,* Gregory Hall,* Duncan Ferguson,* Katherine Jordan,†‡ Michael Henson,§ Kenneth Johnson,†‡ and Timothy O’Brien†

In reference to a partial pancreatectomy: The insulin release pattern was the first to change. First phase insulin release became delayed and smaller, whereas second phase became more exaggerated.

"The Journal of Metabolic Research Vol.1" Edited by Frederick Madison Allen
"Effect of selenium and vitamin E supplements on tissue lipids, peroxides, and fatty acid distribution in experimental diabetes."
Douillet C1, Bost M, Accominotti M, Borson-Chazot F, Ciavatti M.

In diabetic rat liver, a significant drop in triglycerides and phospholipids (P < 0.05) was observed; this was modulated by Se + vitamin E supplementation. Se + vitamin E supplementation also inhibited the decrease in 18:2n-6 and the increase in 22:6n-3 observed in liver of diabetic rats, changes which reflect altered glycemic control.

http://www.petcathealth.info/supplements-for-cat-diabetes/
“Combination of chromium, vitamin E, and selenium have proven benefits against feline diabetes. Chromium stimulates insulin action. Insulin must initially mingle with chromium in order to effectively release the tissues to glucose and the production of energy. There are experiments that show that insulin is nearly ineffective devoid of sufficient chromium to create energy. Processed cat dry food is typically deficient in chromium. Studies also reveal that chromium supplementation reduces blood sugar.

Vitamin E and selenium are valuable antioxidants that can help care for the blood vessels and other tissue from accelerated corrosion impairment caused by lofty blood sugar levels.”

Good forms are chromium nicotinate, chromium histidinate, chromium picolinate and glucose tolerance factor chromium (GTF).
 
Yong said:
Also, more of what I did today :bookworm:. Wasn't able to find much on effects of partial pancreatectomy but here's what I have for that and the vitamin supplements:
"Canine and Feline Endocrinnology" by Edward C. Feldman
Most diabetic cats can be regulated with insulin doses (Lantus / Levemir / Prozinc: Intermediate / long-acting insulin's) between 0.5U and 3.0U BID.

In cats, insulin resistance is most commonly caused by severe obesity, chronic renal failure, chronic pancreatitis, stomatitis/oral infections, hyperadrenocorticism, and hypersomatotropism (acromegaly). Latter two have potential of the most severe insulin resistance.

Tests beyond physical exams: BCB, serum biochemical panel, lipase / fPLI serum T4 concentration, Insulin-Like Growth Factor - 1 (IGF-1), urinalysis and urine culture, and abdominal ultrasonography are next steps.
*Glucose targets should be set less tight, and the insulin dose chosen with the aim of avoiding hypoglycemia, very severe hyperglycemia, and DKA.

Selenium can facilitate in improving Hyperlipidemia (High cholesterol)

"A Feline Model of Experimentally Induced Islet Amyloidosis"
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1885761/
Margarethe Hoenig,* Gregory Hall,* Duncan Ferguson,* Katherine Jordan,†‡ Michael Henson,§ Kenneth Johnson,†‡ and Timothy O’Brien†

In reference to a partial pancreatectomy: The insulin release pattern was the first to change. First phase insulin release became delayed and smaller, whereas second phase became more exaggerated.

"The Journal of Metabolic Research Vol.1" Edited by Frederick Madison Allen
"Effect of selenium and vitamin E supplements on tissue lipids, peroxides, and fatty acid distribution in experimental diabetes."
Douillet C1, Bost M, Accominotti M, Borson-Chazot F, Ciavatti M.

In diabetic rat liver, a significant drop in triglycerides and phospholipids (P < 0.05) was observed; this was modulated by Se + vitamin E supplementation. Se + vitamin E supplementation also inhibited the decrease in 18:2n-6 and the increase in 22:6n-3 observed in liver of diabetic rats, changes which reflect altered glycemic control.

http://www.petcathealth.info/supplements-for-cat-diabetes/
“Combination of chromium, vitamin E, and selenium have proven benefits against feline diabetes. Chromium stimulates insulin action. Insulin must initially mingle with chromium in order to effectively release the tissues to glucose and the production of energy. There are experiments that show that insulin is nearly ineffective devoid of sufficient chromium to create energy. Processed cat dry food is typically deficient in chromium. Studies also reveal that chromium supplementation reduces blood sugar.

Vitamin E and selenium are valuable antioxidants that can help care for the blood vessels and other tissue from accelerated corrosion impairment caused by lofty blood sugar levels.”

Good forms are chromium nicotinate, chromium histidinate, chromium picolinate and glucose tolerance factor chromium (GTF).
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You have been a very busy lady, I really appreciate all of your help. You do not need to look any more, it will probably take me a year to check this all out.
 
Sorry I was teaching a class tonight...just got back to a computer. Glad you and Yong got it all sorted!

A friend of mine is all about naturopathic pet care and she suggested the chromium and selenium for Sam too. Lazy me never went and found it, but I also have a book that lists it. Might be worth checking out!
 
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