6/8/18 New Question/Answered- Dose (jaxa)

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Djamila said:
It's really up to you. Given that she ended up yellow this morning, and your +4 looked pretty safe, I would think you could likely give 0.5u tonight. However, there are no guarantees on that. If her pancreas decides to kick in, you might have a long night. You could try 0.25, or 0.1 (just past the first line, but not as much as 0.25), or you can skip. It's always a tough call on those numbers. You know you can keep her safe through feeding, it's a matter of how much you can stay up and disrupt your sleep. Sometimes we can, sometimes we can't, and that's okay. You have to take care of yourself in all of this too.
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My main issue tonight is that she has not eaten anything since I first tested her and she is mad at me for making her come inside (we are about to have a huge thunderstorm and the sky is already green/gray). I am about to test- gave it an hour this time.

*Paused to test and she is at 104. I decided to try giving .25, but to be honest I don't really know if I got anything in there at all- I don't want to try again though. Will see I guess.
 
Those tiny doses are so weird. It definitely feels like giving nothing. Ah, how i miss those days! :oops: The thing about eating is that if they do start to drop and you bring out the carbs, they always eat. Kitties love their carbs! Kind of like us: I can be stuffed from dinner, and yet still somehow find room for dessert :smuggrin:. When I'm nervous that Sam doesn't want to eat at shot time, I give some extra treats. If he's happy eating those, then I know he'll be okay and just isn't ready to eat right then.

Good luck with that storm! Are you in a tornado area?
 
Djamila said:
Those tiny doses are so weird. It definitely feels like giving nothing. Ah, how i miss those days! :oops: The thing about eating is that if they do start to drop and you bring out the carbs, they always eat. Kitties love their carbs! Kind of like us: I can be stuffed from dinner, and yet still somehow find room for dessert :smuggrin:. When I'm nervous that Sam doesn't want to eat at shot time, I give some extra treats. If he's happy eating those, then I know he'll be okay and just isn't ready to eat right then.

Good luck with that storm! Are you in a tornado area?
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She is eating fine now; I think she was just mad at me for not letting her stay outside. We had one strip of storms cme through already, supposed to get more over night. I'm in Northern MN, not many tornados, but we get bad straight-line winds- lost a lot of trees two summers ago and I got stuck at work over night (I was baking for a summer camp that summer and the only road out had a tree go down across it).

Not much change in tests for her +3, but this is the time of day when it is hard to get away from the 30-60 minute post eating spikes since she eats pretty much every hour.
 
That also gives you some indication that at least for now, you can shoot pretty low and still be safe. Some cats can do that on Prozinc, and some can't. If you look at last year for Sam, or if you look at Caitlin's spreadsheet (Pita's Dosing Party) you'll see a couple of other cats that can shoot low safely on Prozinc. One significant difference though is that Sam and Pita are both long-term diabetics, so we don't have to worry about the pancreas suddenly kicking in. You will have that extra caution with Jaxa, so when you shoot low, you'll still need to monitor her.

Glad you're not in a tornado-y area! Stay safe tonight!
 
Decided to try .75u this morning; I asked for an extra day off and can monitor today a little better. I just want to see if we are at the cusp of a really good dose; 1u or slightly lower.
 
Glassgoblin said:
Every time things go well I expect something bad to happen; but so far so good. Got a nice +3 (117), and she is being very chirpy and affectionate this morning. Not used to me being home at this time of day.
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I, too, suffer from the "waiting for the other shoe to drop" syndrome. Causes me a lot of unnecessary stress ... :confused:
 
.75u seems like a good dose today; at +6 we are at a very nice 64mg/dl. I hope she has a good +9 and a healthy PMPS for a shot. She was not happy that a service person came for a short time, but took a nap, ate some food, and is now napping again. Not lazy at all, lol.
 
What a lovely cycle today! Can't ask for much better than that! And I would do just about anything to take a nap, eat some food, and take another nap today....:coffee::coffee::coffee:
 
We ended up with a +10 instead of a +9, but she isn't too bad for numbers still. She does seem to go up more slowly than she goes down, but that probably makes some sense as her body uses the insulin. I'm hoping she continues up a little more and we may go for the 0.75u again tonight.

*I shouldn't be surprised that her PMPS test was @114 when she didn't eat between tests; fed and gave 0.25u just so we wouldn't skip the shot completely. Will watch (as always). It is super hot right now, and she ate a little but not a huge amount- am hoping she will want more after being outside under the deck (cool dirt).

A little spike at +3, but that is probably because she ate twice in the 30 minutes before I tested her, and I think she found something the dog missed from the treat ball this evening too. I bought Orijen dog treats but those do not fit in the treat ball, and are too expensive for that too I think. Will be looking for more ideas for the puppy since she turns 1 yr old in July and needs a bday present anyway.
 
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Okay, how about this- 118mg/dl for this AMPS. Gave .25u (or as close to that as I could get). She ate twice around 3am, about an hour before the food was officially put up, so I know she was eating her usual amount last night. Kinda tempted to skip the shot tonight if she is under 120; to see what would happen, if it would be the same as last time.
 
No shot tonight. At 102 for PMPS; she doesn't seem to go up much in the hour just after feeding, so I'm going to see how we do this evening and what our AMPS looks like. We will probably go up a little at +3, like she has lately, but we start at such a good number it seems more noticeable after the third or fourth time she has eaten in those three hours. She probably could have had .5u this morning; good numbers numbers but a little flatish in the middle. I almost wish I could test hourly to see exactly when the lowest point is, but she would protest that for sure.
 
We had a slight rise last night with the +3, but not much, and she was only at 135mg/dl this AMPS. I thought we would try .5 this morning to see if her +6 will be under the 90s.

*Got a +2 out of curiosity this morning- 168mg/dl. I'd be interested in know when she is at the peak of her post-meal spike after the shot, and why sometimes she goes up and sometimes down for +3.
 
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Going up after a meal can mean a few different things:
1. not enough insulin.
2. cat early in the process who is not yet regulated
3. cat being given food that is too high in carbs
4. other health issue (anytime there is another health issue, the "rules" and "typically"s dont' apply)
5. cat with a late nadir - it takes them longer to start using the insulin

Things get tricky though in a cat who is still short-term diabetic (under six months since beginning treatment) and who has been going down the dosing scale (Jaxa) because the pancreas tends to wobble around as it heals. Some days it does more and other days it does less. That being said, most of the cycles where we can clearly see an up or down after the shot, there is something of a correlation with the dose. The higher the dose relative to the cycles around it, she tends to go down. The lower the dose in relation to the cycles around it, she tends to go up. There are a couple of exceptions in each direction which is why I emphasized that it's a tendency and not a consistent pattern. So the ups indicate that you could probably be a smidge more aggressive with the dosing, however, I think the way you're doing it (a slightly more cautious approach to dosing) is appropriate given your work schedule during the week. The doses you're giving right now are keeping her in really nice numbers, so there's no need to be overly aggressive at this point: she's still making good progress.
 
Djamila said:
Going up after a meal can mean a few different things:
1. not enough insulin.
2. cat early in the process who is not yet regulated
3. cat being given food that is too high in carbs
4. other health issue (anytime there is another health issue, the "rules" and "typically"s dont' apply)
5. cat with a late nadir - it takes them longer to start using the insulin

Things get tricky though in a cat who is still short-term diabetic (under six months since beginning treatment) and who has been going down the dosing scale (Jaxa) because the pancreas tends to wobble around as it heals. Some days it does more and other days it does less. That being said, most of the cycles where we can clearly see an up or down after the shot, there is something of a correlation with the dose. The higher the dose relative to the cycles around it, she tends to go down. The lower the dose in relation to the cycles around it, she tends to go up. There are a couple of exceptions in each direction which is why I emphasized that it's a tendency and not a consistent pattern. So the ups indicate that you could probably be a smidge more aggressive with the dosing, however, I think the way you're doing it (a slightly more cautious approach to dosing) is appropriate given your work schedule during the week. The doses you're giving right now are keeping her in really nice numbers, so there's no need to be overly aggressive at this point: she's still making good progress.
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Can they have a different nadir from am to pm? She always seems to be lowest late in the day, but early in the evening. She also likes to eat half way between her whole hour test times- so in the morning especially (when I am home) she seems to always be eating about 20-30 minutes before I want to poke her ear. She is contrary like that.

We do seem a bit higher today; under the 200s, but I was hoping with such good numbers on .25u yesterday that .5u would be better not worse. I probably would have been safe with .75u but it is hard to guess. I just hope, every day, that we don't have another pancreatitis flare.

She is not happy today; wet and rainy and the puppy has been jumping on her back.
 
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Glassgoblin said:
Can they have a different nadir from am to pm? She always seems to be lowest late in the day, but early in the evening. She also likes to eat half way between her whole hour test times- so in the morning especially (when I am home) she seems to always be eating about 20-30 minutes before I want to poke her ear. She is contrary like that.
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Yes, Sam hits nadir somewhere in the middle of the cycle during AM (I haven't been able to test enough to really know when), and around +3 or +4 at night. Sounds about the same as what Jaxa is doing. I wouldn't worry about the continual snacks. We only recommend the two hour fast window before the shot times, the rest of the time, you just let them do what they want to do and test anyway.

Hopefully they'll be a break in the weather soon!
 
127 tonight (we are always a little early on Sundays); going to stick with the .5u for the evening, see what she is at when I get home around her +4/5. She won't be alone though- the puppy and my mother will keep and eye on her and might take her outside for a bit now that the sun is out.
 
I don't know if anyone has mentioned it, but somewhere here is a conversation chart for using a U100 syringe with U40 insulin. That makes it easier to give those tiny doses. You just have to be careful with following the chart. I have been able to give Callie as little as .2 u. You want to use syringes with half unit markings. One half unit with a U100 syringe gives you .2u of U40 insulin.
 
donnalea said:
I don't know if anyone has mentioned it, but somewhere here is a conversation chart for using a U100 syringe with U40 insulin. That makes it easier to give those tiny doses. You just have to be careful with following the chart. I have been able to give Callie as little as .2 u. You want to use syringes with half unit markings. One half unit with a U100 syringe gives you .2u of U40 insulin.
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Yep, I think it was mentioned. I still use the u40 needles at the moment because I can get them from my vet and use my CareCredit card. I have the conversion chart bookmarked for if there is a chance to switch though.
 
Not bad blues today; I went up to .75, but didn't get to see how she did during the day. Will be checking on that same amount tonight. I think she is eating too much though; I am adding about 1/4c to her free feeding bowl at both shot times; she grazes and it is always kept at a certain level so it is hard to measure exactly what she eats (but she is still gassy). I need to stop adding more than 1/4c for the whole day, and then see if we are gradually getting the dish empty.
 
I think I should have stuck with the .5, ugh. At +3 we are already at 55mg/dl tonight. Not as bad as some other nights, but I don't like being so low this early in a cycle.

*and 45 at +4, gave some treats and she has eaten some normal food.
 
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Whoa, Jaxa! Up! Up!

Looks like she's done with the 0.75u dose for now. I'd stick with 0.5u in the morning, no matter how high she is, and if she's lower than 150, I think I'd drop to 0.25u. Better safe than sorry when you're gone at work.

Looks like you're going to have a long night: :coffee::coffee::coffee:
 
Oops: I meant if she's under 140 I'd drop to 0.25u. Got a little carried away with the typing there....o_O
 
Djamila said:
Whoa, Jaxa! Up! Up!

Looks like she's done with the 0.75u dose for now. I'd stick with 0.5u in the morning, no matter how high she is, and if she's lower than 150, I think I'd drop to 0.25u. Better safe than sorry when you're gone at work.

Looks like you're going to have a long night: :coffee::coffee::coffee:
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Usually it seems if she is going up by +5 she will continue staying level or go further up in the evenings, so we just have to get there and then check again at +6. She seems fine; eating, alert, but hating the pokes on her ear.

And yep on the under 140s; can never just look at what was last week and hope it goes the same anymore.

*Going in the right direction, +5 @59, and she is a littler perkier. The comb helped with that though. Will wait and get a +6 too, to be sure she is going up at a good rate. I always grab the honey, but haven't used it since the first time; I never trust that she won't crash again after the first spike.
*+6 @77, so I think we are going in the right direction, and she is eating her regular food again too. I did add a little liver and some orijen treats to the mix, but I do that fairly often anyway.
 
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A little higher this AMPS; 182, gave .5u. She seems well rested even if am not, and is eating her food and bisque/b12.
 
That may just be a little inflated from going lower last night. Hopefully she'll flatten out a little by tonight.
 
Djamila said:
That may just be a little inflated from going lower last night. Hopefully she'll flatten out a little by tonight.
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Not too bad for PMPS; 138mg/dl. I gave about .33u. She was feeling well enough to slap the puppy this afternoon and hunt bugs. She has been very vocal and clingy in the last week; she was always like this during the first year after I adopted her. Very chatty.
 
We are having some nice mid-100's PS tests the last day or two; safe enough to give a small shot. Jaxa seems energized too; getting me up at 5am so we can keep our slightly earlier schedule from Sundays all week.

*My vet has only had u40 needles; if I get a package of u100 (I bookmarked the conversion chart); which size is the best? VetRxDirect has like four sizes, but for our little doses I don't know which is best or if it matters- is it the needle length they are talking about or the # of units it can hold? I like the u40 needle length (1/2 inch at least- Jaxa has thick skin).
 
Glassgoblin said:
We are having some nice mid-100's PS tests the last day or two; safe enough to give a small shot. Jaxa seems energized too; getting me up at 5am so we can keep our slightly earlier schedule from Sundays all week.

*My vet has only had u40 needles; if I get a package of u100 (I bookmarked the conversion chart); which size is the best? VetRxDirect has like four sizes, but for our little doses I don't know which is best or if it matters- is it the needle length they are talking about or the # of units it can hold? I like the u40 needle length (1/2 inch at least- Jaxa has thick skin).
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You need 0.3 cc (mL) total capacity - I don't think there's anything smaller than that, half unit marks, whatever needle length you prefer (I use 1/2 inch) and 29 - 31 gauge. I believe many U40s from the vet are 28 gauge. My U100s are 29 gauge, a tiny bit thinner. Many people like 30 - 31 gauge but they can bend very easily, especially if kitty is thick-skinned.
 
I am hoping for some nice numbers tonight- we are in the high greens at +3, so maybe this is what we could have had instead of the lime on Monday night; better dose on a similar number. Will check a +5 at least though before I relax completely.
 
Djamila said:
Jaxa sure is looking good these days!
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She is doing great, but I am screwing up; she was at a nice low green at her +5, so I gave some treats, she ate more food and I was going to test at +6 to see if she was steady/etc. and I fell asleep until past her +9. And then I got the food up later than usual by at least 30 min this AM. So I'm not sure if her higher AMPS is because of bouncing or because she was at the food dish when I grabbed it, or both. Less than 5 hrs of sleep a night is probably not a good thing; I sleep right through my alarm clocks when over tired.

*U100 needles have been ordered and are on their way so hopefully that will make these tiny doses easier when my brain starts working again.
 
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And I think we are skipping the shot tonight. She seems good, but she is at 81 in one ear, and that seemed unusual so I tested the other and got 110.

I worry that when I don't get to see numbers in the middle of the day that she might be in hypo numbers and I just don't know. Typically during days when I am home she stays low in the later afternoon to our PMPS, and then has a faster drop in the evening to rise steadily to a higher AMPS it seems, but I hate not knowing... I need something that she can wear on a blood vessel so I can get hourly tests, ha. She ate and already wants back out so she can continue stalking a chipmunk in the garden. It was swearing up a storm at her minutes ago.
 
I think NS is a good choice for tonight. You can try her at 0.25 or 0.1 (you have to just guess at that amount -- something smaller than 0.25) this weekend and make sure she's okay during the day. It is so hard when we have to work during the day!

Has she ever caught something as large as a chipmunk?
 
Djamila said:
I think NS is a good choice for tonight. You can try her at 0.25 or 0.1 (you have to just guess at that amount -- something smaller than 0.25) this weekend and make sure she's okay during the day. It is so hard when we have to work during the day!

Has she ever caught something as large as a chipmunk?
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She caught a chipmunk one morning when I had left the patio door open as I got ready for work- she brought the live chipmunk into the house and let it go right in front of me in my bedroom. I had to go to work with the poor critter hiding under a bookcase, and it was still there when I got home- managed to chase it out the back door again without too much trouble though. Jaxa loves to catch and release rodents; I've had several mice in my room, and even when sick she cornered an ermine under my shoe rack this last winter .

*Really glad we skipped the shot tonight- at +3 she is @91mg/dl and that is after getting treats and eating (grazing) three times.
 
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Not a bad AMPS for a no shot last night; gave .25 or as close to that as I could. I can't wait to get the other syringes- tracking says Monday.

She was trilled because I dumped the last crumbs in her Tundra treat bag over her food this morning. She loves it when I dust the liver treats too, and now we've been on the 1/8 tsp AM and PM of the YA Immune/Digestive support enzymes she has been eating all the food with that coating on it first. Jaxa isn't spoiled at all, lol, laying on her window perch washing her little paws this morning as the birds chirp out in our trees.
 
:eek::eek::eek: I can’t imagine what I would do if there was a rodent in my house!!! You sound much calmer about that than I would be! (I live in a tall condo building far from any critters)

Jaxa’s doing great!
 
Djamila said:
:eek::eek::eek: I can’t imagine what I would do if there was a rodent in my house!!! You sound much calmer about that than I would be! (I live in a tall condo building far from any critters)

Jaxa’s doing great!
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I live in northern MN; surrounded by trees, fields, etc. We have an overgrown sand-mound (flat- it is the drainage field for the septic tank) that is covered in thistle, milkweed, wild roses, raspberries and native grasses, plus a few small trees and shrubs with berries. In it good habitat for rodents, birds, rabbits, chipmunks, etc. We have a family of foxes and the deer come through our yard a lot for the apple trees in front. There was a little fawn that ran through a few mornings ago. Right now I am super excited about a trio of baby chickadees in my split rail fence. The parents sit in the lilacs and watch me if I get to close when mowing but the three babies are so sweet. We just have to make sure our pets are not unsupervised too long because the eagles and larger owls will try for small animals, and they are never out at night because the fox is hunting at that time. Every year as things grow a little more wild we get new species of birds and other animals- the ermine and stripey gophers are new from last year, and we saw American Redstarts for the first time this spring.

I got a +2 because she was hanging over the water bowl a bit, but I think it is mostly the food spike (she finished her bisque a little bit ago).
 
That sounds really lovely! (except for the eagles/owls/foxes part - although I imagine it's amazing to see them as part of your environment as long as they leave Jaxa alone!). I can't imagine things growing more wild. I live in an area that just keeps developing and getting more and more crowded with buildings and cars. I've been starting to look for a house outside of the city as it's all getting to be a bit much for my taste lately. Where you live sounds absolutely magical!

I wouldn't worry too much about that +2. It is a sign that she isn't ready to go off insulin yet, but it's certainly not a terrible amount to rise early in the cycle.
 
Her +5 was a little flat too- almost the same as her AMPS, still not bad in comparison to a few weeks ago, but I hope it will be easier to get precise doses soon.

*Not too bad for our PMPS- 128, so I gave the same as this AM, .25u. She was not out as much today but was away from food longer- slept under a bed where it was cool. Her lip is mysteriously dirty from something she was just doing outside though. I hope she wasn't eating dirt, but maybe a bug that was under the deck in the dirt. Now it is going to rain so even more inside time, but that makes it easier for me to test her when I want tonight. Got her flea and tick treatment today too which she is not fond of at all.

*It is funny how her +3PM has been at the same number (or extremely close) the last three nights even though the shot/no shot has been different. Am going to try for a +5, but it depends on how long we stay up.
 
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huh....that is funny that those +3's are so similar. I guess she likes those numbers! I think we all share that lack of fondness for flea treatments. Nasty little chemical! Sam's BG always runs high for a couple of days when he gets his (thankfully I only need to treat him in the spring/summer around here).
 
Nice low AMPS; I decided to give a teeny shot anyway since I'm home for the day and can watch. Though she is already outside eating grass and watching the birds.

*+3 at 113, not bad. This last week we have been a bit more even since I just kept the Sunday schedule all week and we have stopped pushing back and retesting on low numbers in the evening; she seems to like being tested and fed right after I get home in the PM instead of waiting an hour, and she gets me up super early every day anyway to sit in the window.
 
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No shot tonight- just tested and she is at 80. We are about ten minutes earlier than our usual so I can get to my regular Sunday thing, but that doesn't usually seem to make much difference for her. She didn't eat as much in the middle of the day today- hot and sunny and she was outside for quite a bit. Hungry right now and scarfing down some food, but we will skip the shot, test when I get home and see how she does.

She was at 95 at her +9, so maybe the fasting in the late afternoon is why she always seems to be lower? Some days she eats right before the food is up, other days she doesn't eat for almost four or five hours before the food goes up; today she ate about 2.5 before this test though.

+4 and she is still (or is again) at 80. I tested the same drop and got 79 just to be sure there wasn't a mistake with the strip. Just ate again, seems to be feeling good, was playing and begging for attention. Will see how tomorrow's AMPS is I guess.
 
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Oops. I meant to add: if your schedule allows, try feeding her at +9. When a kitty is getting close, a pre-shot snack around +9 can sometimes cause that dip you saw tonight and give them that little nudge lower that they need to skip shots.
 
Similar AMPS to our one after the last NS; 145, gave a tiny shot and hopefully she will have a good day.

I can try the +9 snack; I think my mother usually tries to get her to eat before the food is put up during the week days; she is going in and our of the house a lot during the day because the dog wants in and out, and then in and out of her room with the food as she desires.
 
PMPS is 105; I think I want to skip the shot again tonight. We did get the u100 needles, but I don't like giving even .2 if we are under 120 right now. Maybe after a few mornings with the needles I will be a little better at that, but 105 just makes me hesitate.
 
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