Blaze 506 AMPS, +6 257, PMPS 289, +1 314, +3 345

[Sarah and Blaze]

Blaze's BG was 506 this morning. I won't be able to come home on my lunch today to check his BG, no his next test won't be until this evening for PMPS. Is that okay?

 

[MrWorfMen's Mom]

That's fine. He's high enough he'll be OK. That high looks like it may be a bounce from last night. While Blaze didn't go really low last night, he did drop off a fair bit relatively quickly and may have dropped a bit more than you are aware of and that can set off a bounce.

 

[Sarah and Blaze]

That's fine. He's high enough he'll be OK. That high looks like it may be a bounce from last night. While Blaze didn't go really low last night, he did drop off a fair bit relatively quickly and may have dropped a bit more than you are aware of and that can set off a bounce.

What does all this mean exactly? I’m sorry, I’m still learning.

 

[MrWorfMen's Mom]

Bounces are a natural phenomenon that occurs when kitty's BG drops quickly, drops lower than they are use to or drops too low. How low BG has to go to trigger a bounce is relative and different for every cat. It a defense mechanism that protects the cat from BG dropping too low but in our diabetics, they have become so accustomed to higher BG that the defenses go off pre-maturely. The goal is to get kitty's BG down to lower more normal levels so their body learns it's Ok to be in those lower numbers again. Bounces can last up to 6 cycles. They can be frustrating but all we can do is wait them out.

Blaze went down into the yellow range in under 3 hours last night, a drop of roughly 100 points. That is a substantial drop for that period of time and likely set off his defense system a bit.

Does that help?

 

[Sarah and Blaze]

Yes that’s makes sense. So this drop is “normal” in the beginning of starting insulin, right? Until his body figures things out, he will likely do this drop for a while? So I shouldn’t freak out when he has a 500 number BG in the morning?

 

[Nan & Amber (GA)]

Yes that’s makes sense. So this drop is “normal” in the beginning of starting insulin, right? Until his body figures things out, he will likely do this drop for a while? So I shouldn’t freak out when he has a 500 number BG in the morning?

Yes, exactly. This is one reason why we're so cautious about increasing dose based on one or two high numbers. You really need to step back and see the pattern over several days to be able to distinguish a not-enough-insulin high number from a bouncing-from-going-low high number.

 

[MrWorfMen's Mom]

Yes it's all normal and no need to freak out. With time, most cats level out more but frankly the very quick action of Novolin makes bouncing a little more likely and often more dramatic than an insulin like Lantus. Because Novolin kicks into action so early in the cycle and often doesn't last the full 12 hours, kitty is on a bit of a roller coaster. I'd definitely check into Lantus as I think you'd find that would give Blaze a much smoother cycle.
Just be sure to check ketones especially while numbers are still high.

 

[Sarah and Blaze]

Yes, exactly. This is one reason why we're so cautious about increasing dose based on one or two high numbers. You really need to step back and see the pattern over several days to be able to distinguish a not-enough-insulin high number from a bouncing-from-going-low high number.

Okay, that makes sense. A little more time will tell. Thank you!

 

[Sarah and Blaze]

Yes it's all normal and no need to freak out. With time, most cats level out more but frankly the very quick action of Novolin makes bouncing a little more likely and often more dramatic than an insulin like Lantus. Because Novolin kicks into action so early in the cycle and often doesn't last the full 12 hours, kitty is on a bit of a roller coaster. I'd definitely check into Lantus as I think you'd find that would give Blaze a much smoother cycle.
Just be sure to check ketones especially while numbers are still high.

Okay, I'm going to call my vet today and see if I can get a Lantus prescription. Do I just ask for Lantus or do I need to ask for Lantus pens if I'm wanting to get the pens? The Lantus pens from Canada seem like the most cost effective choice.

 

[MrWorfMen's Mom]

I'm not sure if the script needs to specifically be for the pens but it wouldn't hurt to have the vet specify. If the vet gives you any push back, point out that the pens are more cost effective because there won't be a pile of waste from the insulin going "stale". Insulin from Canada is definitely the way to go from a cost perspective and most US folks on the board order from Marks Marine. Don't forget the syringes with half unit markings too if you need a script for them in CA.

 

[Sarah and Blaze]

I'm not sure if the script needs to specifically be for the pens but it wouldn't hurt to have the vet specify. If the vet gives you any push back, point out that the pens are more cost effective because there won't be a pile of waste from the insulin going "stale". Insulin from Canada is definitely the way to go from a cost perspective and most US folks on the board order from Marks Marine. Don't forget the syringes with half unit markings too if you need a script for them in CA.

Okay, I will give my vet’s office a call today. I hope she writes with new prescription without giving me any flack. I want to get Blaze on the better insulin so we can get home stable.

 

[Chris & China (GA)]

Do I just ask for Lantus or do I need to ask for Lantus pens if I'm wanting to get the pens? The Lantus pens from Canada seem like the most cost effective choice.

One of the nice things about using Marks is that if your vet writes for the vial, all you have to do is call and tell them you want the pens instead. Since insulin is OTC in Canada, the pharmacist can legally do that.

Another nice thing is once Marks has a script on file for you, you never have to get another one. In the US you have to get a new script once a year. I was able to refill China's from Marks for 4 years without a new script.

I'm so glad I found Marks and everyone continues to use them!! I was so happy because I was to the point where I was going to have to take China off Lantus because I just couldn't afford it anymore. I'd been searching for someplace else for months but all the places that showed up on my searches were those "website pharmacies" that had lousy reviews. About 3 weeks before I would have had to switch to something cheaper, Marks popped up in my Google search. I called them and talked with the pharmacy manager for at least 2 hours. Then I asked a friend of mine that lived in Vancouver about them and if they were really a real pharmacy (they are!)

The thing that really convinced me they were legit was that they refused to even take my payment information until they had the script on file.

After my first order went through without a hitch and arrived safely, I started spreading the word!

 

[Chris & China (GA)]

I hope she writes with new prescription without giving me any flack.

Don't mention that you're buying from Canada....some vets get weird about that. Just say you're going to do some shopping around for the best price (which is technically true!)

 

[Sarah and Blaze]

One of the nice things about using Marks is that if your vet writes for the vial, all you have to do is call and tell them you want the pens instead. Since insulin is OTC in Canada, the pharmacist can legally do that.

Another nice thing is once Marks has a script on file for you, you never have to get another one. In the US you have to get a new script once a year. I was able to refill China's from Marks for 4 years without a new script.

I'm so glad I found Marks and everyone continues to use them!! I was so happy because I was to the point where I was going to have to take China off Lantus because I just couldn't afford it anymore. I'd been searching for someplace else for months but all the places that showed up on my searches were those "website pharmacies" that had lousy reviews. About 3 weeks before I would have had to switch to something cheaper, Marks popped up in my Google search. I called them and talked with the pharmacy manager for at least 2 hours. Then I asked a friend of mine that lived in Vancouver about them and if they were really a real pharmacy (they are!)

The thing that really convinced me they were legit was that they refused to even take my payment information until they had the script on file.

After my first order went through without a hitch and arrived safely, I started spreading the word!

I called and left a message for my vet that I wanted to switch Blaze to Lantus pens because I have been researching and talking to several people with diabetic cats and everyone says it's a much better insulin for cats than the Novolin that he's on now and that it would be more cost effective for me. I didn't mention buying from Canada though. I hope she calls me back and agrees to this. I want the best for Blaze and don't want him on this harsh Novolin long term! Thank goodness you found this amazing pharmacy that's helping so many kitties!

I will keep you posted on if the vet calls me back. I will call again tomorrow if she doesn't return my call It seems so much easier to order through Mark. Fingers crossed my vet is on board with switching!

 

[Sarah and Blaze]

Every day this week so far, I didn't think I would have time to come home on my lunch to test Blaze's BG, but every day so far, I have been able to come home to test! his +6 BG was 257. Is everything looking okay so far?

 

[Nan & Amber (GA)]

Wow... that is a pretty big drop from this morning!

Yes, it's OK in the sense of 1) it's still a very safe number, and 2) he's likely at or past the peak action of the insulin and isn't likely to drop much more from here. That said, with dives like that, I'm really glad you are trying to switch to Lantus! He may be a naturally bouncy kitty anyway and still do some swan dives/bounces on Lantus, but it's much easier to manage safely than with Novolin.

 

[Nan & Amber (GA)]

Should also add: it's a good sign that he's getting down into the 200's on the 1U-- he's definitely responding to insulin!

 

[Sarah and Blaze]

Wow... that is a pretty big drop from this morning!

Yes, it's OK in the sense of 1) it's still a very safe number, and 2) he's likely at or past the peak action of the insulin and isn't likely to drop much more from here. That said, with dives like that, I'm really glad you are trying to switch to Lantus! He may be a naturally bouncy kitty anyway and still do some swan dives/bounces on Lantus, but it's much easier to manage safely than with Novolin.

Okay here come some questions.
Is it ideal to have a lower AMPS number to start with and a +6 number like he has today, at 257?
Is it u safe for him to bounce like that?
Is there anything I can do to help with the big drops/bouncing?

The vet has not returned my call about Lantus yet

 

[Sarah and Blaze]

Should also add: it's a good sign that he's getting down into the 200's on the 1U-- he's definitely responding to insulin!

Oh thank goodness, this makes me feel some relief. Especially because the vet had us start at 2U! But he seems to be doing well with the 1U, now that I’m able to test his BG. He seems so much better than last week, he stopped eating and was so lethargic. He’s eating well this week and much more lively!

 

[MrWorfMen's Mom]

That is a big drop today albeit a safe one but it highlights why starting with a lower dose is ideal because a higher dose could have pushed that mid cycle BG down further. Ideally you want pre-shots lower but when BG drops that low and that quickly it sets off a bounce and that causes a roller coaster effect. Part of that is because Novolin works quickly and doesn't last long enough for most cats. Blaze still has lots of room for BG to come down but he's getting a good drop so while you are transitioning him off the dry diet, better to have him run a bit higher so any natural drop from the diet change doesn't lead to BG dropping too low.

I think perhaps Blaze dropped further last night after you got that 295 reading and that caused a bounce to that 500+ this AM. Bounces are not dangerous....they're just a frustrating PIA you can't do anything about except wait them out!

Fingers crossed your vet is on board switching to Lantus!

 

[Chris & China (GA)]

I think perhaps Blaze dropped further last night after you got that 295 reading and that caused a bounce to that 500+ this AM

I agree....anytime you get a big dive like that so early in the cycle (even with Novolin), I'd try to get at least 1 other test in to make sure he wasn't continuing to drop that much, that quickly.

Dropping 100 points in 2 hours is a pretty significant drop

 

[Sarah and Blaze]

I agree....anytime you get a big dive like that so early in the cycle (even with Novolin), I'd try to get at least 1 other test in to make sure he wasn't continuing to drop that much, that quickly.

Dropping 100 points in 2 hours is a pretty significant drop

Last night was hard to get another test in because I needed to go to bed because of work in the morning. Is 1U possibly too much if he has big drops like that?

 

[MrWorfMen's Mom]

Blaze started off lower last night so if he gives you a lower pre-shot again, then you can reduce the dose to avoid having to stay up to monitor. He's still in high numbers overall though and with his usual pre-shots I don't think the 1u is too high.

 

[Sarah and Blaze]

Blaze started off lower last night so if he gives you a lower pre-shot again, then you can reduce the dose to avoid having to stay up to monitor. He's still in high numbers overall though and with his usual pre-shots I don't think the 1u is too high.

I just did PMPS and he’s at 289

 

[Sarah and Blaze]

Blaze started off lower last night so if he gives you a lower pre-shot again, then you can reduce the dose to avoid having to stay up to monitor. He's still in high numbers overall though and with his usual pre-shots I don't think the 1u is too high.

Not sure if I should stick with the 1U for his PM dose tonight? The last two days when I wake up and test him, he’s in 500+ but I don’t want him to get too low tonight while I’m asleep.

 

[MrWorfMen's Mom]

WOW! You're not pulling my leg are you? I'm totally shocked. Expected it to be higher than that. Have you fed Blaze yet? If not then don't just yet.

 

[MrWorfMen's Mom]

I wonder if that has anything to do with the withdrawal of the dry food even if it is only a small reduction so far. If you haven't fed Blaze, hold off 20 minutes and retest him (sorry!). We call that a stall and we do it to see if BG is rising on it's own, staying steady or dropping.

 

[Nan & Amber (GA)]

Gosh, Blaze! Got a few tricks up your furry little sleeve, huh?

 

[Sarah and Blaze]

I wonder if that has anything to do with the withdrawal of the dry food even if it is only a small reduction so far. If you haven't fed Blaze, hold off 20 minutes and retest him (sorry!). We call that a stall and we do it to see if BG is rising on it's own, staying steady or dropping.

I fed him! I didn’t see these messages because my vet finally called me back. He didn’t eat a whole lot though

 

[Sarah and Blaze]

I wonder if that has anything to do with the withdrawal of the dry food even if it is only a small reduction so far. If you haven't fed Blaze, hold off 20 minutes and retest him (sorry!). We call that a stall and we do it to see if BG is rising on it's own, staying steady or dropping.

I leave dry food out still during the day, I just don’t think he’s super interested in it because he likes the wet food.

 

[Nan & Amber (GA)]

So, when he ate just now, was it just the wet food, or was there any dry mixed in? If just the wet, it may not make a huge difference to the BG in 20. Either way, we can take it into account with the re-test number, just adds some uncertainty.

 

[Sarah and Blaze]

I’m not sure what to do

 

[Sarah and Blaze]

So, when he ate just now, was it just the wet food, or was there any dry mixed in? If just the wet, it may not make a huge difference to the BG in 20. Either way, we can take it into account with the re-test number, just adds some uncertainty.

No dry food in it, just wet. So re test him then?

 

[MrWorfMen's Mom]

Did he eat enough that you normally would have given him his insulin or less? If he will eat if offered something he likes, you could try a dose of 0.25u or 0.5u but if he is eating less than normal and only wet, might be better to skip tonight.

 

[Nan & Amber (GA)]

No dry food in it, just wet. So re test him then?

Yep. It's been about 20mins now.

 

[MrWorfMen's Mom]

I know you have to work tomorrow and I think if there is any question about his appetite, better to err on the side of caution and skip. Lucky you with a cat who basically took himself off the dry food. My eyes are far greener with jealousy now than usual!

 

[Nan & Amber (GA)]

Have to say, I like the idea of skipping. Would give you a peaceful night-- and I'll be curious to see where he is in the morning!

 

[Sarah and Blaze]

Did he eat enough that you normally would have given him his insulin or less? If he will eat if offered something he likes, you could try a dose of 0.25u or 0.5u but if he is eating less than normal and only wet, might be better to skip tonight.

He usually eats a whole can of wet food before insulin and he didn’t finish it tonight

 

[MrWorfMen's Mom]

Skip tonight then and we'll see where he is in the morning. If he isn't eating the dry food and BG is less than 250 in the morning - NO shot. If BG is over 250 and you can test mid cycle, then I'd try a dose of 0.25u as long as he is eating OK. Maybe the lower BG is leaving him less hungry because he's utilizing what he's eating better. This is all good.

 

[Sarah and Blaze]

Yep. It's been about 20mins now.

Okay let me re-test

 

[Sarah and Blaze]

Skip tonight then and we'll see where he is in the morning. If he isn't eating the dry food and BG is less than 250 in the morning - NO shot. If BG is over 250 and you can test mid cycle, then I'd try a dose of 0.25u as long as he is eating OK. Maybe the lower BG is leaving him less hungry because he's utilizing what he's eating better. This is all good.

Okay it took me three times of trying but it’s 314 now

 

[MrWorfMen's Mom]

Well he certainly isn't zooming up. That is a pretty normal food bump. Skip tonight and see post #39 for tomorrow. I may not be around when you are ready to shoot tomorrow.

 

[Sarah and Blaze]

Skip tonight then and we'll see where he is in the morning. If he isn't eating the dry food and BG is less than 250 in the morning - NO shot. If BG is over 250 and you can test mid cycle, then I'd try a dose of 0.25u as long as he is eating OK. Maybe the lower BG is leaving him less hungry because he's utilizing what he's eating better. This is all good.

I’m not sure if he’s eating any dry food, I have been leaving a little out all the time while we were figuring out his BG and didn’t want to take it away too quickly and drop his BG too low. But with him and the other two cats, I don’t knew who is nibbling on it during the night and when I’m at work. Should I take it away completely?

 

[Sarah and Blaze]

Well he certainly isn't zooming up. That is a pretty normal food bump. Skip tonight and see post #39 for tomorrow. I may not be around when you are ready to shoot tomorrow.

Okay I get up at 5:00 am tomorrow so I will test then. I’m pretty sure I won’t be able to make it home on my lunch to test tomorrow though. Any advice?

 

[MrWorfMen's Mom]

I wouldn't pick up all the dry food just yet. If he is still eating a bit of it we don't want to make a sudden change especially if you aren't available to monitor him more closely. He may have made the change himself which is fine and we can just deal with him conservatively for now. Will your other kittes be OK without the dry?

I'll check in tomorrow morning before I go out. What time do you normally shoot?

 

[Sarah and Blaze]

I wouldn't pick up all the dry food just yet. If he is still eating a bit of it we don't want to make a sudden change especially if you aren't available to monitor him more closely. He may have made the change himself which is fine and we can just deal with him conservatively for now. Will your other kittes be OK without the dry?

I'll check in tomorrow morning before I go out. What time do you normally shoot?

Okay, I will leave a little dry out then, just in case he needs some tonight or tomorrow while I’m at work. He’s pretty much waiting for me every morning and every night to feed him his wet food, even if there’s dry food out. The other kitties would be fine without the dry food too, they want the wet food just as much as Blaze! But I will leave some dry out until I can watch him more closely, like Friday when I’m off work.

I get up at 5 tomorrow morning so I will test shortly after that. Is there a certain number I should look for that would warrant me not giving his AM dose? I leave for work at 7:20-7:30, should I test a second time before I leave for work?

 

[MrWorfMen's Mom]

Ok. I left instructions in #39 on this thread. See if that helps.

If you test at 5, then I assume you shoot around 5:30/6:00? If so then, I'll check in around 8 my time (it's 11:10pm here now). If I'm guessing times wrong, let me know.

 

[Sarah and Blaze]

Ok. I left instructions in #39 on this thread. See if that helps.

If you test at 5, then I assume you shoot around 5:30/6:00? If so then, I'll check in around 8 my time (it's 11:10pm here now). If I'm guessing times wrong, let me know.

Okay sounds good, if BG is under 250 in the morning no shot. If BG is over 250, give 0.25 ONLY if I can test mid cycle?

I don’t know if I will have enough time on my lunch but I will try my hardest to get home and test him. I live about 20-25 minutes from work so with an hour lunch, it makes it hard. But I really want to get a test in at noon if I can.

It’s 8:15 Pm herein California.

 

[Sarah and Blaze]

I will test at 5:00 am, feed him and shoot around 6:00 am tomorrow and I will go off your advice in #39 post. Thank you so much for your help, I'm sorry I have so many questions and need so much help right now! I really appreciate it. I'm going to do one more test at 9:00 pm tonight to see where he's at.

 

[MrWorfMen's Mom]

Ok I'll check on you in the morning around 8/8:30 my time to see what Blaze is up to.

I think it would be great if you could test at lunchtime tomorrow only because we're not sure about dose yet. The 0.25u should be conservative enough but he's still a bit of a puzzle. Once the diet change is over, it will be easier. For now leave some dry but you can leave out wet food too.
I use to freeze wet food in ice cube trays and leave cubes out to thaw during the day so my girl could eat as needed.

It's my pleasure to help and no apologies for questions is needed. Ask away and ask for clarification if anything is not clear. We all want you to learn so you can feel confident looking after Blaze.