Experienced PZI users only please...

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Jena4277

Member Since 2017
hi. THis is a long story. NOt sure how to link previous threads but it is called “Help PM Dosage advice needed”

Anyway, my cat has been diagnosed with diabetes since last July and has been on Vetsulin and switched to PZI in January. On my swag spreadsheet it is marked with the redline. For weeks she had been vomiting white liquid foam so I tried cerenia and acid reflux meds. It helped a little bit. Then last week she had another bought of pancreatitis and I brought her into the vet for blood work and they diagnosed her with pancreatitis and hyperthyroid. She just started on the cream for at the hyperthyroid is on cerenia for pancreas.
This weekends numbers have been very off. Other senior users advised me that her dose should have been reduced when her numbers went below 60 which was a while back so I am afraid that I have been giving her the wrong dose of insulin for a while. Can any experienced pzi users look at my spreadsheet and help me out with the dosage and numbers? (With the understanding also that pancreatitis can cause an increase in blood glucose numbers because of the inflammation ) my plan is to reduce to a fat 1.0, and get evening tests this week after work, and then curve her on Saturday. Maybe that will help get the pre-shots down? If the evening numbers are still high like today, I would like to be able to communicate with someone with experience this week that can help me out and provide advice.thanks.
 
hi. THis is a long story. NOt sure how to link previous threads but it is called “Help PM Dosage advice needed”

Anyway, my cat has been diagnosed with diabetes since last July and has been on Vetsulin and switched to PZI in January. On my swag spreadsheet it is marked with the redline. For weeks she had been vomiting white liquid foam so I tried cerenia and acid reflux meds. It helped a little bit. Then last week she had another bought of pancreatitis and I brought her into the vet for blood work and they diagnosed her with pancreatitis and hyperthyroid. She just started on the cream for at the hyperthyroid is on cerenia for pancreas.
This weekends numbers have been very off. Other senior users advised me that her dose should have been reduced when her numbers went below 60 which was a while back so I am afraid that I have been giving her the wrong dose of insulin for a while. Can any experienced pzi users look at my spreadsheet and help me out with the dosage and numbers? (With the understanding also that pancreatitis can cause an increase in blood glucose numbers because of the inflammation ) my plan is to reduce to a fat 1.0, and get evening tests this week after work, and then curve her on Saturday. Maybe that will help get the pre-shots down? If the evening numbers are still high like today, I would like to be able to communicate with someone with experience this week that can help me out and provide advice.thanks.
You have a good testing plan. Just post here daily or more often if you like and we’ll see it. We can certainly guide you through this. The regulars here check this forum daily but if we don’t see regular posts from a member we assume everything is OK.
 
Arg! I just posted on the old thread too! So here it is again so we can get onto this one:

How many hours between your PM shot time and your bedtime? I'm curious where Abby goes tonight, but don't want you to start the week sleep deprived!
 
Arg! I just posted on the old thread too! So here it is again so we can get onto this one:

How many hours between your PM shot time and your bedtime? I'm curious where Abby goes tonight, but don't want you to start the week sleep deprived!

a solid 5. Im in CT (EST) so she gets 5am and 5pm shots and #teacherlife equals bedtime @10pm, 11 at the latest. :coffee:
 
Perfect. If you can grab a test as you're about to climb in bed, +5 is definitely far enough into the cycle to see how she's doing.

And you have some magical superpower because in my #teacherlife bedtime is at 9! (I'm old though :rolleyes:)
 
Then I would say to keep the dose in the morning since you'll be gone, but depending on what we see, I might suggest an increase for tomorrow night.
 
ok. I can get a +3 and +5 no prob, +6 if I am awake because of The Walking Dead :banghead:

Also, no apology necessary for thinking you hurt me - getting a huge wallop of a dx this week (x2) has thrown me, my mom is recovering from major surgery and yesterday was my dad's bday who died in 2012 so it has been an emotional weekend, wiping tears away in the grocery store today while filling up 20 fancy feast cans in my carriage because the deal is 20 for $12:p ...Will post numbers tonight.

Random question - I know this shot wasnt a fur shot bc i smelled it and touched it gently to see if any liquid was there....this has been a habit since I did my first fur shot! But can insulin be absorbed almost too quickly and dissipate if for example the shot was too close to the outer layer of the skin and not deep enough into the tent?
 
Yes, every once in awhile a dose will be injected into the "wrong" place and either hit faster than normal, or seem to do nothing at all. Unfortunately, there isn't really any way to know if it's in a bad place until you see the numbers. That's part of why we try to consider more than a single cycle in making decisions. I read a super interesting research article about that once - apparently the insulin pushes into little channels and looks like a tree and the shape of the tree and spread of the branches impacts the absorption and use of the insulin which is part of why numbers can vary from day to day. Are you thinking it might be something like that more than the p-titis?

Speaking of the p-titis, how does she seem? Is she sleeping in funny positions? lethargic? hesitant to jump up or down from furniture? Or does she seem normal and up and playing?
 
Also, Jena, I'm so sorry you've had such a tough week. Anniversaries are so hard, and it sounds like there has been a ton of other stuff going on for you too.

Sending you comforting vines and virtual hugs...:bighug::bighug::bighug:
 
She is sleeping in normal positions - extended, or snail-like, or sitting as the breadloaf. She had been pretty alert and normal the last few days. Today she has been super sleepy. They took blood from her bad leg and she seemed sore for a while, and it does take her a minute to get ready to jump up or down which is unusual. Unfortunately she doesn't play anymore but when she is feeling well she is super social on the couch with the crowd and she has been a bit secluded today and yesterday until about noon when she was hungry. She has been with me on the couch grading papers since.
 
Yes, you've had an awful lot to deal with lately. :bighug: Apologies if our responses seem perfunctory (I'm more guilty of that than Djamila is - science nerd here ... o_O). Sometimes we don't have all the details of a person's situation front and centre of our mind.
 
Are you thinking it might be something like that more than the p-titis
yes. Because she is only 6lbs there is not much to grab anymore near her scruff so I have worked my way down to in between the shoulder blades which gives me less of a pain reaction from her, many times no flinch or meow at all...perhaps I haven't been jabbing her in a good spot as I have been doing it with eyes barely open...
 
yes. Because she is only 6lbs there is not much to grab anymore near her scruff so I have worked my way down to in between the shoulder blades which gives me less of a pain reaction from her, many times no flinch or meow at all...perhaps I haven't been jabbing her in a good spot as I have been doing it with eyes barely open...
Does she have loose skin along her sides? If so you can try pulling up a tall tent of skin there, feel for a good tent door with your finger and shoot there. I find that Teasel prefers that area and the more taut the skin the more painless the poke.
 
sorry super blurry but current situation LOL
 

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Does she have loose skin along her sides? If so you can try pulling up a tall tent of skin there, feel for a good tent door with your finger and shoot there. I find that Teasel prefers that area and the more taut the skin the more painless the poke.

Will try!
 
Is she using any bupe for the pancreatitis, or pain meds for the arthritis? If not, I wonder if that might help? Meatloafing positions and hesitance to jump are two of the signs that Sam is having a flare up. He sits meatloaf style naturally, but there is something different about it when he's having pain. And the effort to jump up and jolt of jumping down make him avoid either action. I don't think anyone looking at him would know he was in pain, but it's little things I've learned to recognize over the past few months.

I haven't dealt with arthritis, but I think Adequan is often used. I wonder if that might help with both types of pain? It could be worth asking on the Main forum to see if one or the other might be best to manage inflammation from both conditions.

I've also been using CBD for Sam's p-titis pain and I know that helps with arthritis as well. This one is recommended from a number of kitty health forums:
https://www.cwhemp.com/all-charlottes-web-cannabinoid-hemp-cbd-supplements/everyday-extract-oils

PS My kitties love fleece-y blankets too! That one looks extra soft!
 
Is she using any bupe for the pancreatitis, or pain meds for the arthritis? If not, I wonder if that might help? Meatloafing positions and hesitance to jump are two of the signs that Sam is having a flare up. He sits meatloaf style naturally, but there is something different about it when he's having pain. And the effort to jump up and jolt of jumping down make him avoid either action. I don't think anyone looking at him would know he was in pain, but it's little things I've learned to recognize over the past few months.

I haven't dealt with arthritis, but I think Adequan is often used. I wonder if that might help with both types of pain? It could be worth asking on the Main forum to see if one or the other might be best to manage inflammation from both conditions.

I've also been using CBD for Sam's p-titis pain and I know that helps with arthritis as well. This one is recommended from a number of kitty health forums:
https://www.cwhemp.com/all-charlottes-web-cannabinoid-hemp-cbd-supplements/everyday-extract-oils

PS My kitties love fleece-y blankets too! That one looks extra soft!
I tried adequan and she wont eat it even in super 007 disguise mode.
Will read about the CBD - thanks!

This is grandmas banket which is a no-no place but bc she is feeling ill, she is getting a break from scolding!
 
so little :( Hopefully this Rx ear gel for h-thy will help. Vet said in 3 - 4 weeks we should see a little weight gain and better bloodwork numbers...(insert pray hands emoji here)
My mom's elderly kitty has been on this form of thyroid med for a very long time. He's quite old and has other issues but the gel has put his thyroid levels back into normal range. She had to increase the gel dose v-e-r-y slowly because he didn't react well to it at first - nausea, vomiting, etc. The vet wanted to double the dose too soon but we said no, designed a plan to slowly increase over many, many weeks/months and finally got him there. He's now at his recommended therapeutic dose and tolerates it with no problem.
 
I tried adequan and she wont eat it even in super 007 disguise mode.
Will read about the CBD - thanks!

This is grandmas banket which is a no-no place but bc she is feeling ill, she is getting a break from scolding!
Adequan can be given as a subQ injection.
 
@Djamila @Kris & Teasel I just tested her PM post food and shot - 269. Thoughts??
PS When I picked her up to test her, which I usually dont but she was downstairs and my equipment is up, she screamed....she is in pain. Will talk to the vet tomorrow about pain med.
 
@Djamila @Kris & Teasel I just tested her PM post food and shot - 269. Thoughts??
PS When I picked her up to test her, which I usually dont but she was downstairs and my equipment is up, she screamed....she is in pain. Will talk to the vet tomorrow about pain med.
It's not showing on your SS. To clarify: was this after her evening meal and shot? How long past the shot? What was her pre shot test number with no food for 2 hours beforehand? That's what I need to judge this.

Re pain: do you think it's abdominal or joints?
 
It's not showing on your SS. To clarify: was this after her evening meal and shot? How long past the shot? What was her pre shot test number with no food for 2 hours beforehand? That's what I need to judge this.

Re pain: do you think it's abdominal or joints?

OOOOPSSSSS - i meant to say her PM PRE-shot. I didnt shoot her yet, but she is eating now.

Gosh idk about the pain, she is usually very vocal when anyone picks her up but she is probably more annoyed bc she doesnt feel well. I did have to pick her up by her stomach and not chest/feet which I usually do to prevent any additional pain. I will keep an eye on her.
 
OOOOPSSSSS - i meant to say her PM PRE-shot. I didnt shoot her yet, but she is eating now.

Gosh idk about the pain, she is usually very vocal when anyone picks her up but she is probably more annoyed bc she doesnt feel well. I did have to pick her up by her stomach and not chest/feet which I usually do to prevent any additional pain. I will keep an eye on her.
Abdominal pain goes along with pancreatitis. Pain meds might help her be more comfortable. Give the same dose tonight as per Djamila's recommendation.
 
Oh, sweet baby girl! I'm so sorry to hear Abby is having pain. I had to do a little convincing to get my vet to give me bupe for him. I ended up showing him this article as it recommends pain management even in the absence of obvious signs of pain. Sam's fits in the "chronic" category at this point, so he uses sublingual buprenorphine, as do most cats around here. It's the easiest to adjust and administer since you don't have to pill the cat, nor give a shot (not that those of us with FD cats mind giving shots!).

https://idexxcom-live-b02da1e51e754...pec-fpl-treatment-for-feline-pancreatitis.pdf

Hopefully your vet will just give you some without needing to be convinced!
 
Yep I had to do some convincing too. My vet didn't want to give bupe, but then I took Tigress in once and saw a different vet in the practice...and she has a cystitis kitty (that's why Tigress has bupe) too. I asked for pain relief and she immediately agreed to give me a prescription for bupe. She told me it was the best pain management for cats and agreed that she needs it during a flare up. I hope your vet will be as agreeable as that...but remember that YOU are the advocate for your kitty and if they don't want to give you something, I'd push a little...gently of course.

I hope Abby feels better soon! Sending you vines!
 
Whoa! So apparently 1.25 is enough insulin, and the p-titis is not propping up her numbers. Good to know.

Give her a snack of regular low carb food. Not too much. Maybe a tablespoon or so.
 
Okay, now for the longer explanation:

The low carb food is to try to slow the drop. She's still perfectly safe, and it would be great if she would surf (surf: stay in roughly the same ranges for a number of hours). Feeding her low carb food can slow the drop and help her do that. If you give her higher carb food it can send her numbers up. We don't want her to go up, but we also don't want her to go down, or at least not by much more.

The one tablespoon: If she does decide to keep dropping, then you're going to need her to be willing to eat higher carb food later. If she gorges herself on regular food, then she might refuse to eat at a time when you need her to eat. So we use small amounts in order to make sure there is room for more.
 
Why do I always post and then remember one more thing?!?!

Also, please do another test at +4 so we can see where she's heading.
 
Perfect. I'd give her another tablespoon of food if she'll take it. You still have a little ways to go until a typical nadir, but it looks like she's surfing now instead of dropping. If she holds around these ranges until +5, I think she'll be good for the night. Just keep her snacking on the low carb. Are you up for one more test at +5? I'm so sorry to keep asking you to test. Is Abby doing okay with it?
 
Perfect. I'd give her another tablespoon of food if she'll take it. You still have a little ways to go until a typical nadir, but it looks like she's surfing now instead of dropping. If she holds around these ranges until +5, I think she'll be good for the night. Just keep her snacking on the low carb. Are you up for one more test at +5? I'm so sorry to keep asking you to test. Is Abby doing okay with it?
So now she is fast asleep. Not sure if she will eat. Usually she does get up herself at 10 which is in 30 minutes. She is fine with blood testing. But I’m just nervous bc of the cream application. I have to remember which ears I can an cannot touch. Will test and repost at at +5 and reduce tomorrow like you said. Talk soon! Thanks!
 
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