Bella’s FD journey part 2

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Bellasmom said:
I have a thought, can his insulin be given in smaller doses 3x a day wonder
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Yes, it can but it's extremely hard on the owner because you have to test a lot to track what one dose is doing before you give the next. If one dose lasts a bit longer than usual it'll overlap the next dose and maybe drop the BG too much, etc. It's not something I'd want to do myself.

I'm guessing that your vet's thinking is: change insulin --> keep cat several days to track first dose level and see how cat tolerates insulin --> do a curve to assess dose --> change dose based on curve done in clinic --> send cat home. This often ends up with a kitty being overdosed because of stress elevated BG at the clinic. He might want to do this to be very cautious in making any change. If Bella was new to insulin and you a new care giver it might make sense but he isn't and you aren't. However, I don't want to get in the way of your relationship with your vet. If you really like him, you don't want to create a problem.

Just keep this idea of another insulin in the back of your mind for now. You might be able to do something different down the line. :)
 
Bellasmom said:
I am not crazy about him
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Well then! If you have a notion to change vet sometime down the road you could call around to see how much experience they have treating diabetic kitties and/or take Bella in for a "meet and greet" where you go armed with a good list of questions. There's a good list here on FDMB somewhere. This is expensive so you want to get your dollar ducks in a row. :) A couple of visits to "test out" a vet or two should give you a feel for their manner, level of FD knowledge and most important of all their willingness to work collaboratively with you on treating Bella's diabetes.

Please don't think I'm twisting your arm - I'm not. I truly understand the financial constraints involved in treating FD. It just seems that you might have an opportunity here to rethink this. A vet that works with you and knows you can monitor at home, know how to adjust doses, etc. can save you money because that vet won't require expensive stays at the clinic for curves, etc. Food for thought ... :)
 
Bellasmom said:
When you get time will you look at Bella’s spreadsheet, and hubby forgot to take before insulin, I’m sorry and I did tell him how important it was to do it
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Don't worry - mistakes happen. It looks like this cycle is similar to others recently. Is there a reason why the dose was dropped a bit to 1.75 u? Was it because of no PMPS? Not a problem - just go back to 2 u tomorrow AM, numbers permitting.
 
Kris & Teasel said:
Don't worry - mistakes happen. It looks like this cycle is similar to others recently. Is there a reason why the dose was dropped a bit to 1.75 u? Was it because of no PMPS? Not a problem - just go back to 2 u tomorrow AM, numbers permitting.
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Is that what I put, omg, I’m wrong, it was 2, sorry, just tired
 
Any chance of a test before +8 today or a little later this evening? We need some data from those areas to see what the dose is doing. You can't tell with only the PSs - eg. on Feb 24 you would not have known how low he went if you only had PS numbers.

You're getting close to 2.25 u where he had some green action a while ago. He might not this time but I suggest you keep 2 u until your next day off and do a full curve so we see how he's responding to it. Are you off this weekend?
 
Kris & Teasel said:
Any chance of a test before +8 today or a little later this evening? We need some data from those areas to see what the dose is doing. You can't tell with only the PSs - eg. on Feb 24 you would not have known how low he went if you only had PS numbers.

You're getting close to 2.25 u where he had some green action a while ago. He might not this time but I suggest you keep 2 u until your next day off and do a full curve so we see how he's responding to it. Are you off this weekend?
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He only has to go in for a meeting from 11 to 3 today so I’m having him do 1 at +3
 
Bellasmom said:
I’m also going today and get a human meter and strips after I get off work, will have to change my spreadsheet, is there a certain way I need to do that
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I'm not sure. We usually refer these techie things to @Marje and Gracie to fix. Maybe @Chris & China can help. She sets up SSs for people. Really, all that changes is the automatic colour coding cutoff for lime green. It'll be lime green for anything below 50 on the human meter version whereas it's below 68 on your pet meter version. I'm not sure if it would hold onto the colour if you manually changed any number between 50 and 68 to dark green on the SS you're using now.

Are you going to buy a Walmart ReliOn meter? Very popular and strips are fairly cheap for the models that take only a tiny blood drop (Micro or Confirm). We have Walmart here in Canada but they don't carry those meters - don't know why. I use a Freestyle Lite but its strips are pricey in the US. All meter strips are expensive here - it's the human insulin like Lantus that's a lot cheaper - and I can buy it OTC.
 
Kris & Teasel said:
I'm not sure. We usually refer these techie things to @Marje and Gracie to fix. Maybe @Chris & China can help. She sets up SSs for people. Really, all that changes is the automatic colour coding cutoff for lime green. It'll be lime green for anything below 50 on the human meter version whereas it's below 68 on your pet meter version. I'm not sure if it would hold onto the colour if you manually changed any number between 50 and 68 to dark green on the SS you're using now.

Are you going to buy a Walmart ReliOn meter? Very popular and strips are fairly cheap for the models that take only a tiny blood drop (Micro or Confirm). We have Walmart here in Canada but they don't carry those meters - don't know why. I use a Freestyle Lite but its strips are pricey in the US. All meter strips are expensive here - it's the human insulin like Lantus that a lot cheaper - and I can buy it OTC.
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Yes Walmart and I will check with Chris and China if I need help thanks so much
 
Bellasmom said:
One more thing how much are they off from one another, or somewhere close
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You'll have to get used to seeing a different range of numbers. Human meters read lower than pet meters but the difference is much bigger at high numbers and less at low numbers. The array of colours on your SS will change - reds will be pinks, pinks will be yellows, etc. There's no easy conversion between pet meter numbers and human meter numbers so it's best to just shift your focus to human meter numbers and forget the pet meter all together. Too high is too high on either meter. The important number is the "take action" number where you want to give a little snack to prop up the BG. It's 50 on a human meter whereas it's 68 on a pet meter. Almost everyone here understands human meter numbers if you ever need help quickly.
 
Kris & Teasel said:
:D:D:D:D:D I'm so glad you caught those tests today!! Good info to have to assess this dose.
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He has appointment next sat with another vet, there are multiple vets and 2 are real good with diabetic cats, office visit is cheaper and they are open 7 days a week
 
Bellasmom said:
He has appointment next sat with another vet, there are multiple vets and 2 are real good with diabetic cats, office visit is cheaper and they are open 7 days a week
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My goodness! you certainly didn't let the grass grow under your feet! ;) I hope one of the new vets is someone who'll work with you and understand that you're perfectly capable of being hands on with Bella's treatment.
 
I explained what I wanted and the vet tech I talked to, I didn’t want to talk to receptionist lol he said they do work with you in his treatment so we shall see
 
Kris & Teasel said:
My goodness! you certainly didn't let the grass grow under your feet! ;) I hope one of the new vets is someone who'll work with you and understand that you're perfectly capable of being hands on with Bella's treatment.
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Oops I forgot I have a question,so Bella’s number was good this afternoon, so if I go home and take it and it’s back to over 400, what makes it jump like that it can’t be food
 
Bellasmom said:
Oops I forgot I have a question,so Bella’s number was good this afternoon, so if I go home and take it and it’s back to over 400, what makes it jump like that it can’t be food
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It can jump up for a few reasons:
  • Novolin isn't lasting a full 12 hours so the AM dose peters out well before the PM dose time
  • he's rebounding from the much lower blue number - the drop from 439 in the AM to 132 at +8 is a big one
  • the way Novolin works: it starts to work quickly, can drop BG fairly low and can poop out before the 12 hour mark. Those are the characteristics of this insulin in cats. That's why I brought up the subject yesterday.
The faster acting in-and-out insulins (meaning they go in, get used up and nothing is carried over into the next cycle) like Humulin N, Novolin N (human insulins) and Vetsulin, a veterinary insulin (originally for dogs) all have this type of action. It's in their nature to give a deep BG curve after a dose and they tend to have less than 12 hour duration.

ProZinc is a veterinary insulin that is mostly in-and-out in its action but there can be some carry over of a dose into the next cycle, so good duration. It's slower in onset and gentler in action so it can produce a shallower BG curve after a dose. Some cats till react fairly dramatically to it though.

The two depot insulins, Lantus and Levemir, are the slowest in onset, gentlest in action and tend to have longer duration. They still have to be given every 12 hours. What the "depot" means is that a little of every dose you inject is stored under the kitty's skin and is released slowly somewhat like a time-release medication. That means there's always a little bit of insulin doing some work and one dose blends into the next quite smoothly. That can reduce ups and downs in BG and result in a much flatter BG curve in a cycle. This effect will be more pronounced in some cats than in others. Really bouncy cats (like mine!) will still bounce.
 
Kris & Teasel said:
It can jump up for a few reasons:
  • Novolin isn't lasting a full 12 hours so the AM dose peters out well before the PM dose time
  • he's rebounding from the much lower blue number - the drop from 439 in the AM to 132 at +8 is a big one
  • the way Novolin works: it starts to work quickly, can drop BG fairly low and can poop out before the 12 hour mark. Those are the characteristics of this insulin in cats. That's why I brought up the subject yesterday.
The faster acting in-and-out insulins (meaning they go in, get used up and nothing is carried over into the next cycle) like Humulin N, Novolin N (human insulins) and Vetsulin, a veterinary insulin (originally for dogs) all have this type of action. It's in their nature to give a deep BG curve after a dose and they tend to have less than 12 hour duration.

ProZinc is a veterinary insulin that is mostly in-and-out in its action but there can be some carry over of a dose into the next cycle, so good duration. It's slower in onset and gentler in action so it can produce a shallower BG curve after a dose. Some cats till react fairly dramatically to it though.

The two depot insulins, Lantus and Levemir, are the slowest in onset, gentlest in action and tend to have longer duration. They still have to be given every 12 hours. What the "depot" means is that a little of every dose you inject is stored under the kitty's skin and is released slowly somewhat like a time-release medication. That means there's always a little bit of insulin doing some work and one dose blends into the next quite smoothly. That can reduce ups and downs in BG and result in a much flatter BG curve in a cycle. This effect will be more pronounced in some cats than in others. Really bouncy cats (like mine!) will still bounce.
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+12. 172, no insulin???
 
Bellasmom said:
+12. 172, no insulin???
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Whoa! That's amazing! No shot for sure because you have no data on giving insulin at a low PS like this. I see the yellow at +2. Did you feed him before that?

He'll probably be high tomorrow AM but I suggest dropping the dose back to 1.75 u.
 
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