Lewie running high... giving 0.5 "fat" with u100 syringe

PMPS=503
It was another Black Pink Black day. :(
I think I need to go up again tomorrow morning. I made an appt for Lewie, but it's not until Tuesday. I don't know that the bottle is bad... expiration date is Nov 2019 and it's been refrigerated except for a couple of times that I left it out on the counter for an hour or so. Should I try to get another bottle of insulin tomorrow? My vet is out of town until Monday, so I'm not sure if the office will give me another bottle before the appt.
Thoughts? What do you think about his numbers?
Thank you.:blackeye:
 
Everything I've read says to wait 3-4 cycles before increasing again; however, I hope that someone with more experience will weigh in. Perhaps things are different if/when the numbers are high, although I don't recall ever reading anywhere that that makes a difference.
 
Jenna Josie said:
Everything I've read says to wait 3-4 cycles before increasing again; however, I hope that someone with more experience will weigh in. Perhaps things are different if/when the numbers are high, although I don't recall ever reading anywhere that that makes a difference.
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It's just so painfully hard to wait when nothing is happening. Ug. Thank you for your reply.
 
Kathy4Lewie said:
Should I try to get another bottle of insulin tomorrow? My vet is out of town until Monday, so I'm not sure if the office will give me another bottle.
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I'd call and see if they'd sell you one. It wouldn't hurt to get a new bottle and rule out that the insulin lost its efficacy before your appointment on Tuesday.
 
Kathy, first off, I GET it. Watching those numbers sit up high like that is hard. We love our sweet babies so much and we want to do what it takes to make them feel better sooner rather than later.

Now with that said, no i would wait to raise the dose. I know you want to just up it as soon as you can, but I don't recommend raising the dose that fast. I always give it 3-4 cycles at a minimum because sometimes they need a little time to settle in to a dose. I think Lewie has some glucose toxicity going on and just needs the dose raised until we hit whatever dose suddenly works...and makes him run back down the dosing scale. I've seen it time and time again on here. Why not give it today and see what happens? If he's still high tonight, you can raise the dose either tonight or tomorrow morning. That's just my opinion...you have to do what makes you feel best, but that's how I feel. :)

How long have you had this bottle of insulin?
 
Thank you for encouraging me... I called the clinic and just confidently said I'd like to stop by this morning and pick up a new bottle of insulin for Lewie. They said no problem. Yay. Thank you for also telling me to sit tight. I'm encouraged that we might reach a dose where he will go back down the dosing scale. He's doing the panic eating so I know he's not feeling good glucose-wise.:confused: This morning's AMPS=471

I've had this bottle since the end of August... so just over 3 months. Is that old?
If yes, what dose should I give him? If my current bottle has lost its efficacy, giving a dose of the fresh bottle might make him go too low?
:bookworm:
 
Kathy4Lewie said:
Thank you for encouraging me... I called the clinic and just confidently said I'd like to stop by this morning and pick up a new bottle of insulin for Lewie. They said no problem. Yay. Thank you for also telling me to sit tight. I'm encouraged that we might reach a dose where he will go back down the dosing scale. He's doing the panic eating so I know he's not feeling good glucose-wise.:confused: This morning's AMPS=471

I've had this bottle since the end of August... so just over 3 months. Is that old?
If yes, what dose should I give him? If my current bottle has lost its efficacy, giving a dose of the fresh bottle might make him go too low?
:bookworm:
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No, it isn't that old but it's worth trying a new bottle. You were at a significantly higher dose when you had a lot of blue and dark green. I think you need to continue the cautious dose increases every 3-4 cycles to break the glucose toxicity.
 
Kris & Teasel said:
No, it isn't that old but it's worth trying a new bottle. You were at a significantly higher dose when you had a lot of blue and dark green. I think you need to continue the cautious dose increases every 3-4 cycles to break the glucose toxicity.
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Just got back from the vet with a new bottle of insulin... same expiration date of 11-19.
I have 2 options:
1.) Give the old insulin tonight and give the same dose of the new bottle in the morning. This way I don't have to worry all night. That means he will be on the 1.2u for 5 cycles. OR...
2.) Give the new insulin tonight and then do a +2 test.

Since it's probably glucose toxicity, it may be better to do option 2, with the odds being pretty low for the "old" insulin to be bad.

How damaging is it to Lewie's body to be sitting in the blacks, reds and pinks for a week?
:bookworm:
 
Kathy4Lewie said:
Just got back from the vet with a new bottle of insulin... same expiration date of 11-19.
I have 2 options:
1.) Give the old insulin tonight and give the same dose of the new bottle in the morning. This way I don't have to worry all night. That means he will be on the 1.2u for 5 cycles. OR...
2.) Give the new insulin tonight and then do a +2 test.

Since it's probably glucose toxicity, it may be better to do option 2, with the odds being pretty low for the "old" insulin to be bad.

How damaging is it to Lewie's body to be sitting in the blacks, reds and pinks for a week?
:bookworm:
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A spell in highs isn't a big problem but those steady small dose increases should shift him eventually.
 
Whichever option works best for you is fine. A lot of people prefer increasing during the day so they can keep an eye on things. One cycle won’t hurt if you’d rather wait.
 
JL and Chip said:
I'm just doing a fly by ...
If it were me, I'd change one thing at a time. So I'd probably go with 1.2u this cycle, get some tests, and go from there. Others may differ, that's just my two cents.
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Thanks. I saw your message and shot the 1.2u with the new bottle for this cycle and I'll get some tests today. If the numbers are looking the same, I'll up the dose to 1.4u tonight.
 
Well, it wasn't old insulin... Lewie is still running high today with the new bottle of insulin. I had one glimmer of hope when +6=295.
AM+10=522
So, tonight I will up him to 1.4u and follow Kris & Teasel's protocol in post #64.
 
Update: PM+2=341
100 points lower than PMPS of 443 so his body noticed the increase from 1.2u to 1.4u
And this is using the "old" insulin.
 
Kris & Teasel said:
Just continue those 0.2 u increases every 3-4 cycles until you see blues and greens mid cycle. Ignore the PS highs. Bouncy cats will try to fool you with those! :confused:
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It's like you knew what was going to happen! Bouncy cat Lewie was High (600+) this morning after his dose increase to 1.4u. Your message was very timely! Thank you!
 
I took Lewie in for a checkup today and everything looks good except that he's lost more weight. The vet said that I should be free-feeding him. The vet was also irritated that I'm checking his numbers at home and insisted that I bring him in once a month for testing.
Survey: How often does your vet require you to bring your kitty in for a glucose check to continue receiving vet care and insulin?
 
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Kathy4Lewie said:
I took Lewie in for a checkup today and everything looks good except that he's lost more weight. The vet said that I should be free-feeding him. The vet was also irritated that I'm checking his numbers at home and insisted that I bring him in once a month for testing.
Survey: How often does your vet require you to bring your kitty in for a glucose check to continue receiving vet care and insulin?
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My vet doesn't expect that. She knows that I'm completely in charge of Teasel's diabetes treatment. He's on Lantus and I'm able to buy it OTC here in Ontario.
 
My vet doesn't even want me to bring Sam in since in-office numbers are higher and therefore less accurate. He just takes a peek at the spreadsheet whenever I need a new vial so he can put the right dose on the label :)
 
Kathy4Lewie said:
How often does your vet require you to bring your kitty in for a glucose check to continue receiving vet care and insulin?
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Vet said I don't need to get a fructosamine test if I'm already doing the same thing at home. Previous vet was the same as yours: didn't want me home testing and just to come in every month or 2 weeks to get a test. I know it feels bad to go against your vet but... I trust that what we and you are doing here is what's best for our babies.

I'm glad Lewie seems to be going down a bit :)
 
Crista & Ming said:
I know it feels bad to go against your vet but... I trust that what we and you are doing here is what's best for our babies.
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Yes, I've been "down in the dumps" all day. If I didn't have this group and if I wasn't home testing... and dosing 2x per day without testing as instructed, Lewie would have had some big time crashes.

I'm glad Lewie seems to be going down a bit :)
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Today is much better! He is feeling better, too. Nothing like seeing outstretched paws making biscuits when I walk into the room!
:joyful:
 
Yay4Lewie!! (See what I did there? :cool:)

Kathy4Lewie said:
Yes, I've been "down in the dumps" all day.
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Tell me about it. I feel insane and tired and sad and relieved and okay all at once ... I didn't think it was possible but it is to feel all those things at the same time. o_O If it makes you feel any better, you can look at Ming's SS. It might make you go, "Well, here's one cat that's MESSED. UP." LOOOL!!!!

I also found it really helpful and inspiring to peruse other member's kitty's SS from the beginning. Everyone seemed to have their ups and downs but eventually, made it.

Also, definitely try to distract yourself or do something you enjoy even if it's just for half an hour. I found it hard to focus when I was super worried about Ming but I forced myself to unplug and reminded myself that he's still here. He's breathing and eating and alive. And I'm doing everything I can to help him.
 
Yes my vet just let me call when I needed more insulin. She saw my SS and realized I knew what I was doing and let me take control from there.

I agree with Crista. You need to do something nice for yourself. I strongly encourage going out for a walk or going to dinner with a friend on occasion. Just getting out of the house and relaxing can help you feel a lot better!
 
A reading of 134 at +7 really had me excited, but he popped up to 550 at +10. I was checking him to make sure he wasn't going too low and imagine my surprise! First reading was 569 so I took a second reading and it was 536 so I took an average to get 550. This pop up to the 500s kinda looks like a pattern for him. Poor guy... he's really tired today... hopefully he will perk up. He did climb up to the top of the couch and hung out there for a few hours. Mom (me) was scared that he'd fall off, but I gotta let him live a little!
 
Poor guy! But hey that 134 is super exciting! He probably doesn't feel great from those wild swings, but he will get better in time.
 
I'm wondering where he was at +4 through +6 and whether he went significantly lower than 134 and was already on his way back up. That could help explain the skyrocket to black.

In the past, before this little side trip to high nbers possibly in part to an old bottle of insulin, he used to show some pretty significant drops early in the cycle. There's no guarantee he's still inclined to do that as a cat's response can change over time, but it looks to me like he's having some pretty active cycles on this higher dose. Your PM +3 was notably lower than PS last night so I'm really wondering where he bottomed out. I myself would try to get an additional test in when you see a significant drop by +2 or +3.
 
I didn't see a blue today. Test at +4=308, and +8=354.
Question: Lewie is hungry now and it's an hour until shot time. I need to get as many calories in him as possible and it seems cruel to make him wait for his dinner. Since I know that he will be high enough to shoot at +12, must I keep him waiting for his food? Can I feed now and shoot in 1 hour? If I offer more food in an hour, I know he will eat more.
:bookworm:
 
Sorry Kathy, we weren't here! Obviously, at this point you can feed and shoot if you haven't. In the future, go ahead and grab a +11 and then if he's high enough, you can probably feed and shoot in 1 hour. Just make sure you mark down on the SS that you fed 1 hour before shot time so your PMPS is a +11.
 
Rachel said:
Sorry Kathy, we weren't here! Obviously, at this point you can feed and shoot if you haven't. In the future, go ahead and grab a +11 and then if he's high enough, you can probably feed and shoot in 1 hour. Just make sure you mark down on the SS that you fed 1 hour before shot time so your PMPS is a +11.
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Awesome! I'm glad to know that I can feed an hour before shot time! I'll be sure to take a +11 when I do this. Thanks!
 
I'm thinking about shooting 1.5 hours early tonight and need your input. I have the opportunity to go out to dinner and I will need to leave 1.5 hours before shot time. The dinner is to listen to a musician and it will be over at 10pm so I would be home by 10:30, which is 2.5 hours late. Lately, Lewie has been Black at +10 and Red at +11.
What do you think about shooting 1.5 hours early?
:bookworm:
 
Kathy4Lewie said:
I'm thinking about shooting 1.5 hours early tonight and need your input. I have the opportunity to go out to dinner and I will need to leave 1.5 hours before shot time. The dinner is to listen to a musician and it will be over at 10pm so I would be home by 10:30, which is 2.5 hours late. Lately, Lewie has been Black at +10 and Red at +11.
What do you think about shooting 1.5 hours early?
:bookworm:
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You could try shooting early.. He'd likely be OK at the 1.5 u dose but you could shave a little off (0.25 u)?) if that makes you more comfortable.
 
Kris & Teasel said:
You could try shooting early.. He'd likely be OK at the 1.5 u dose but you could shave a little off (0.25 u)?) if that makes you more comfortable.
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Ok. Thank you. He seems to be running a little high again these last 2 days. I'm wondering about this morning's high... he ate a ton of food at midnight and then it was lights out, and even for humans, it's not good to eat that late.
 
I like Kris' idea about shaving the dose if you shoot early. I really wonder whether you'd have even reached 1.6 u if you had started the new insulin bottle earlier. Maybe. Maybe not. But he sure looks like he bounced and they stayed high and flat yesterday as a result. Who knows what happened overnight last night.

As for not being good to eat late at night ... I don't think it matters for cats. They are nocturnal creatures, even if they adjust to our schedules, and they often prefer to "graze." I wouldn't worry too much about that other than if he's eating late in the cycle and it's influencing his PS.
 
To recap last night, I shot 1.5 hours early so I could do something social! :) I went ahead and shot his regular 1.6u because his AM+10.5 value was 497. I grabbed at PM+6 and he was 257 so I thought he was having a good cycle. I tested and shot this morning at PM+13 and he was HIGH. I shot 1.6u.
I guess we are back to running high in the mornings. Does "running flat" mean that he is being insulin resistant?
:bookworm:
 
JL and Chip said:
I really wonder whether you'd have even reached 1.6 u if you had started the new insulin bottle earlier. Maybe. Maybe not. But he sure looks like he bounced and they stayed high and flat yesterday as a result.
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After about 20 days of reds and blacks in the morning, Lewie has a blue AMPS=179 so I'm stalling a little bit.
Do you think he's finally settled in to the 1.6u or could this be just a fluke?
 
Lewie!!! :cool::cool::cool::cool: Cool blue this morning!

It's possible that he has settled in to the dose...anything changed about today? Food or anything? Let's hope it's a settling in and not a fluke!
 
Rachel said:
Lewie!!! :cool::cool::cool::cool: Cool blue this morning!

It's possible that he has settled in to the dose...anything changed about today? Food or anything? Let's hope it's a settling in and not a fluke!
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(sorry for the delay... I forgot to hit send!) Nothing has changed since we went to the 1.6u dose. He's had a good day today!
 
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