We are still here. Need advice.

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Susan and Timmy

Susan and Timmy

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Hello, It has been quite some time since I have posted. Life took a turn for my family and we have had 4 unexpected deaths in our family over the last 7 months. My father being one of them. I am so not okay. That being said, I was hoping to have some eyes on Timmy's spreadsheet. He is in high numbers and I need some advice.

Timmy started going outside the litter box about 6 days ago. On Wednesday I took him to the vet. Urine was tested and was negative for infection, crystals, etc. Blood work came back yesterday and that was negative as well. His overall exam was normal. I will get the lab value report from the vet later today and post. I did change the brand of litter about 2 months ago to Arm and Hammer Slide, but that was 2 months ago and he just recently started going outside the litter box. He is eating and drinking and acting like Timmy otherwise.

Vet visit with new vet went better than in the past, but still upsetting to hear that I am "testing too much and overthinking Timmy's diabetes" What?! In any case this vet wants me to send Timmy's curves to help him monitor. I can do that, at least it will save having to do fructosamine tests and curves in the office.

Vet also said that where I give him his injections has scar tissue and that could be causing an absorption problems with the insulin. He said to start injecting on the flank, but if that is the case then the 2.3 units that I am currently giving him will be too much.

Lantus is in our future, but for right now I need guidance with the Prozinc. I need to increase Timmy's insulin again. He is a very bouncy kitty. This grief has me questioning my decisions though. Thoughts?

There is so much more to say, but for now any advice would be so very much appreciated.
 
OMG - I must be telepathic, Susan! I was just now wondering what was going on with you and that sweet faced boy of yours. I'm so sorry you've had so many deaths in so short a time. Let's see what we can do for your boy, shall we? :bighug:

My thoughts:
  • peeing outside the litter box could be related to ongoing high numbers or it could be idiopathic cystitis that can be triggered by stress in his environment, including your own stress
  • he's not really bouncing
  • numbers are too high still
  • yes, do try injecting along his side somewhere but keep the 2.3 u for now untli you see if there's a lowering of his BG due to better absorption
  • probably some glucose toxicity from being in high numbers for quite a while so I'd suggest some dose increases after you've done the shot site test
  • your ProZinc is a new vial so let's see what we can do with it for now
  • if you're thinking Lantus go do some advance reading on that forum's yellow info stickies - it's a whole new world over there.
Re Vet: your cat, your call wrt testing, etc. There's no good reason for vet curves or fructosamine tests unless it makes you feel better.

Does this help?
 
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Thank you so much for your reply, Kris. It helps so much to have a game plan. So to begin with, Timmy's injection tonight will be at 2.3 units somewhere on his side. I believe I saw a picture of a cat, this was a good while ago, that showed the different alternative injection sites to the neck. I will look that up to better educate myself. As for peeing outside the litter box, it makes me feel horrible that Timmy could possibly be picking up on my sadness/stress, but perhaps that is what is happening. I'm hoping that it is due to the higher numbers, that's feels so wrong to say, but something to consider and work on correcting.

I'll search the site for glocose toxicity/glucose intolerance so I can get a better feel for this. Over the next week, and once I have a better handle on Timmy's numbers, I will start doing my "homework" with Lantus.

Again, thank you for your reply and advice.
 
Have a read. My vet gave me this way back when because Teasel used to have frequent bouts of idiopathic cystitis.
http://www.thecatclinic.ca/uploads/new-medical-support-item/Feline Idiopathic Cystitis Client Handout.pdf?lbisphpreq=1

Insulin shot sites:

upload_2018-3-2_14-2-41.png


Glucose toxicity: http://www.felinediabetes.com/FDMB/threads/feline-diabetes-and-glucose-toxicity-links.62944/

And a whole lot of other good stuff: http://www.felinediabetes.com/FDMB/threads/where-can-i-find-________.127890/
 
Hi Susan! I’m so sorry to hear things have been tough lately. Losing 4 people has to be hard on you!

2 of my girls gave idiopathic cystitis...I do think it’s more common than we think. I work on controlling my stress as best I can to help...and just do the best I can. Do make sure you’re cleaning with some sort of enzyme cleaner...otherwise he might just be going there because it smells like the bathroom spot to him! You could also try simply placing a box wherever he frequently goes and he might use it. Higher numbers can cause this behavior but if it IS cystitis just know you’re not alone...and it’s manageable if not super fun. :bighug:
 
Hi Susan! We've missed you around here! Kris and Rachel are taking good care of you, so I just wanted to say hello and send you some love. I'm so sorry for your loses! Please know that we are always here for you and happy to help in any way we can! :bighug:

Here is a link that contains a zillion other links about glucose toxicity. I know there is a thread around here with a more succinct description and discussion, but I'm at work right now and having trouble finding it from my phone. It might be in think tank somewhere.....?

http://www.felinediabetes.com/FDMB/threads/feline-diabetes-and-glucose-toxicity-links.62944/
 
Djamila said:
Hi Susan! We've missed you around here! Kris and Rachel are taking good care of you, so I just wanted to say hello and send you some love. I'm so sorry for your loses! Please know that we are always here for you and happy to help in any way we can! :bighug:

Here is a link that contains a zillion other links about glucose toxicity. I know there is a thread around here with a more succinct description and discussion, but I'm at work right now and having trouble finding it from my phone. It might be in think tank somewhere.....?

http://www.felinediabetes.com/FDMB/threads/feline-diabetes-and-glucose-toxicity-links.62944/
Click to expand...
Beat you to it, Djamila. I gave Susan that link. ;)
 
Rachel said:
Hi Susan! I’m so sorry to hear things have been tough lately. Losing 4 people has to be hard on you!

2 of my girls gave idiopathic cystitis...I do think it’s more common than we think. I work on controlling my stress as best I can to help...and just do the best I can. Do make sure you’re cleaning with some sort of enzyme cleaner...otherwise he might just be going there because it smells like the bathroom spot to him! You could also try simply placing a box wherever he frequently goes and he might use it. Higher numbers can cause this behavior but if it IS cystitis just know you’re not alone...and it’s manageable if not super fun. :bighug:
Click to expand...

Hi Rachel, thank you for your kind words. It has been so incredibly and unbelievably hard. That Elton John song called "I'm Still Standing" has been replaying in my mind during all of this, kind of like my mantra. I have to try to snap out of it and realizing that Timmy is in trouble with these numbers may help. I just have to get these numbers down.

I have been using an enzyme cleaner and I keep scrubbing and cleaning and spraying. I have taken the top off the liter box and am moving this litter box to where he is currently going. He isn't interested in using the other litter box in the laundry room now at all. Crazy kitty! I did spend some time with him just playing today thinking that may help. I spend time loving him always, but haven't just played together in a long while. It did us both good. :)
 
Djamila said:
Hi Susan! We've missed you around here! Kris and Rachel are taking good care of you, so I just wanted to say hello and send you some love. I'm so sorry for your loses! Please know that we are always here for you and happy to help in any way we can! :bighug:

Here is a link that contains a zillion other links about glucose toxicity. I know there is a thread around here with a more succinct description and discussion, but I'm at work right now and having trouble finding it from my phone. It might be in think tank somewhere.....?

http://www.felinediabetes.com/FDMB/threads/feline-diabetes-and-glucose-toxicity-links.62944/
Click to expand...

Thank you for your kind reply. It helps a lot. I appreciate the link. I have been doing a lot of "homework" today with these links trying to get myself knowledgeable about what is happening now with Timmy. I have more to go, I just have to get him down as quickly as I can.
 
I gave 2.3 units on his side. He was fine with it, so that's a relief. In less than an hour I will be coming up on +3. I will post tonight as I test. If he doesn't go too low tonight, what dose should I give him tomorrow. I have plenty of lancets and testing strips and medium carb food and high carb food and honey. I'm ready to go tomorrow. ;)
 
Susan and Timmy said:
I gave 2.3 units on his side. He was fine with it, so that's a relief. In less than an hour I will be coming up on +3. I will post tonight as I test. If he doesn't go too low tonight, what dose should I give him tomorrow. I have plenty of lancets and testing strips and medium carb food and high carb food and honey. I'm ready to go tomorrow. ;)
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You can fast track dose changes after three cycles with ProZinc. If you’re using U100 syringes (I’m guessing you are based on your fractions), why not jump to 2.6 u tomorrow AM, hold that dose 3 cycles, then go to 2.8 u for three, then up to 3 u.
 
Susan and Timmy said:
And...he is 122 at +3. I am up to steer if I need to, but could his high numbers indeed be an absorption problem?
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Hard to say with only one shot in the new area. If this happens again it might be a logical conclusion. Maybe hold off on a dose increase for a couple of cycles while you test this out. I suggest a small snack of regular food now to see if you can reduce his drop rate.
 
I just tested him at +5 and he is 358. I'm going to give his ears a rest until PMPS. I injected on his side again this morning. I was really surprised he was so high this morning, I shouldn't have been surprised since this is Timmy after all. He did have some good hours in lower numbers last night, which is so great. It is a shame though that I'm not getting any data today with that 2.3 units on the side. I had to steer him quite a bit last night, but I'm thinking that I should go ahead and keep the 2.3 units again tonight providing his preshot number isn't crazy low. With this new injection site I am basically starting over with my data collection.

He used the litter box for both late last night and so far today. I'll take every little victory I can get. :)
 
Susan and Timmy said:
I just tested him at +5 and he is 358. I'm going to give his ears a rest until PMPS. I injected on his side again this morning. I was really surprised he was so high this morning, I shouldn't have been surprised since this is Timmy after all. He did have some good hours in lower numbers last night, which is so great. It is a shame though that I'm not getting any data today with that 2.3 units on the side. I had to steer him quite a bit last night, but I'm thinking that I should go ahead and keep the 2.3 units again tonight providing his preshot number isn't crazy low. With this new injection site I am basically starting over with my data collection.

He used the litter box for both late last night and so far today. I'll take every little victory I can get. :)
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I agree with keeping the dose for a couple of cycles until you've sorted out the injection site effect and yes to giving his ears a rest too. :smuggrin: And hurray for litter box activity!!
 
Kris & Teasel said:
I saw your note about a possible fur shot. Heck! We all do it though ... :confused: Early results suggest the new injection site is having a positive effect.
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At +3 he was 276! I was frustrated with myself with that possible fur shot this morning, but it seems like some insulin went in and is doing something. So maybe not a total loss in getting some data. :) I now know that I have to be quicker with giving his injection on the side, otherwise he doesn't cooperate entirely.
 
Susan and Timmy said:
At +3 he was 276! I was frustrated with myself with that possible fur shot this morning, but it seems like some insulin went in and is doing something. So maybe not a total loss in getting some data. :) I now know that I have to be quicker with giving his injection on the side, otherwise he doesn't cooperate entirely.
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I inject in a number of places along Teasel's side. I have to fiddle a bit to get his loose skin positioned just right so when I pull it up to make a tent I can feel a very obvious tall "tent door" for the needle to go in. If his skin isn't "arranged" well and I don't get a good tent door happening the needle pinches more. He's very patient but he'll react.
 
This is shaping up to be a classic ProZinc curve even though it a bit higher than ideal. Maybe try 2.4 u or 2.6 u tomorrow? I think you have enough data to know that the injection site is a factor.
 
Okay. I am super excited about Timmy's numbers today. We didn't go into blues for long or low enough, but we were there. It felt a little wet on his fur after his injection this morning, fur shot, so I thought today was going to be a bust with data collection. :D
 
Djamila said:
Wow! That's pretty good for a possible fur shot! Maybe it got in after all?

I inject whatever part of Sam he'll let me grab while he's wiggling all over the place and trying to get me to hurry up with the post-injection treat! :rolleyes:
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I have never done a post injection treat. I always inject him while he is eating his fancy feast and he is happy as a lark, but after this morning I might need to start doing this.
 
Susan and Timmy said:
I have never done a post injection treat. I always inject him while he is eating his fancy feast and he is happy as a lark, but after this morning I might need to start doing this.
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Actually, as good as Teasel is for tests and shots, I give him an extra special stinky freeze dried salmon or shrimp treat for shots. Test treats are Orijen freeze dried Original (mostly chicken) or Wild Boar. Spoiled boy ... :smuggrin:
 
Susan and Timmy said:
I have never done a post injection treat. I always inject him while he is eating his fancy feast and he is happy as a lark, but after this morning I might need to start doing this.
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He growls and bites if I try to inject him while he eats. He's a feisty little guy! Knowing the treat is coming keeps him from running away, but pretty much nothing will get him to hold still!
 
I just corrected it. That would have been an enormous jump. :eek: I was hoping to have a yellow PMPS number, but not a bad day at all. I'm just surprised and encouraged that changing the injection site could make such a difference!
 
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