99 PMPS stalling

JOJI and Kit

JOJI and Kit

Member Since 2019
http://www.felinediabetes.com/FDMB/...rs-kit-is-a-bouncy-kitty.226581/#post-2543442


Deb says our thread was too long, so alas, a new one.

@Deb & Wink So, on your suggestion we were trying to stick to one food to see if it would help us regulate Kit. It was a spot on idea, but Kit's digestive system decided that it really does not like Weruva Paw Lickin' Chicken.
Sad, because she did like it and now we have yet another stash of canned food to add to the others that have been kicked to the curb.

We've never seen a reaction in her like that before, so we pulled her off it and her stools came back to normal.
But now we think it's time to increase her insulin since she's been riding high for over a week. We did inch up starting yesterday to a fat 1.5, but really think a 1.75 is warranted.

If you're around, would love your input!
 
JOJI and Kit said:
We did inch up starting yesterday to a fat 1.5, but really think a 1.75 is warranted.
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Agreed. The 1.5U dose is simply not enough to bring Kit's BG levels down into the blue range at mid-cycle.

From the protocol for SLGS and Prozinc:
"If nadirs are more than 150 mg/dl (8.3 mmol/L), increase the dose by 0.25 unit"

Wish you had thought to take a BG test last night at +4, when you said she was "super hungry." Might have shown you why she was so hungry. Next time she's still telling you she is hungry, grab a BG test first, then feed her.

p.s. Are you 2 ok? Both Jo and JW? Just checking up on folks, during this covid-19 panic.
 
Hi Deb,

Thanks for the reply. New info came in today. Our vet called with results of Kit's urinalysis from last week. So even though she's
not showing any outward signs of a UTI, they did find bacteria and we need to do an antibiotic again. The convenia is "convenient" but the more I read about it the less I'm sure it's the safest route. (thank you catinfo.org!) We are also thinking that if she has had this underlying infection that her BG numbers have likely been impacted.

Now we are deciding whether to go the Convenia route or oral antibiotic, and whether or not we should hold off on any insulin dose changes.
Do you have any thoughts on any of this?

PS thanks for asking about our wellbeing. Yes, it is quite the moment in time. Surreal. We're doing okay and trying to stay smart and make sure everyone around us - family, friends and community are doing the same. Anxiety? Yes! (it definitely puts feline diabetes in perspective!!) How about you??? How are you? Thanks for being here and being our Kit lifeline.:kiss: (JW just alerted me that I had mistakenly given you a stick out the tongue emoji instead of a kiss!) all better now
 
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JOJI and Kit said:
Now we are deciding whether to go the Convenia route or oral antibiotic, and whether or not we should hold off on any insulin dose changes.
Do you have any thoughts on any of this?
Click to expand...
If going the oral antibiotic route, try to get one without any added sugars. UTI's can be more stubborn in a diabetic cat, because the excess sugars spilling into the urine provide a "nutrient rich" environment for bacteria. "Oh yummy! Sugar, lots of sugar! Just what I need to grow and have ten zillion generations of descendants."

Also, the bacteria can be a bit resistance to any antibiotic since Kit has already been on an antibiotic and that did not kill them off. So you need to have a C&S (culture and sensitivity) to identify the main bacteria and then find an antibiotic to fight those specific bacteria, like a Ninja would. "Hey karate chopped that one, kicked that one to the curb, headbutting another one, only a few more to take out." Kit may also need to be on an antibiotic longer than the standard 10 days, because of that glucose rich urine environment.
JOJI and Kit said:
(JW just alerted me that I had mistakenly given you a stick out the tongue emoji instead of a kiss!)
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I love all the different emojis! Doesn't matter to me which one you use. ;) My fave, in honor of my sugardude Wink.

Surreal is the perfect word to use for this situation.

p.s. I'm fine. Staying home, no big deal for me since I'm retired. Kitchen stocked with food, plenty of cat food, treats and litter. Doing a bit of cooking to have things ready to heat and serve just in case I get sick. I've always enjoyed solitude, and the perennial gardens are starting to green up, so I'll get to go outside and play if it stops raining.
 
How is Kit doing?
Are Jo and JW ok too?

I see from Kit's SS that she is still running in really high BG levels. I think it's time to increase to 2U.
 
Deb & Wink said:
How is Kit doing?
Are Jo and JW ok too?

I see from Kit's SS that she is still running in really high BG levels. I think it's time to increase to 2U.
Click to expand...

Hi Deb, So were considering this as well, but she just had a Convenia injection this past week for a UTI. I think I read somewhere that underlying infections can cause elevated BGs. I can't find where I read this, of course....Do you have any insight into this? And given this, do you still think we should increase? Thanks! J and J
 
Yes, underlying infections can cause elevated BG's.

But Kit is still not getting BG readings below the middle yellow range. At least, not that you have caught with a BG test.

You don't want insulin resistance to develop. So yes, I do think you need to increase the dose.
 
150 is a shootable pre-shot with Prozinc. Monitor though. A +2 is good. To tell you which direction she is headed. You need to learn to shoot those low numbers sometime.

New protocol has 150 as the new threshold for giving Prozinc insulin. Kit is a steep diver, so get out those medium carb foods for her, just in case.
 
Ok, that 148 and 159 are within meter variance. Less than 7% difference. Well within meter variance which is 15-20%.

Here's the thing. If I tell you to go ahead and shoot, our convention is that the person that tells you to do that stays up with you. I can't do that. Too exhausted. I kept thinking today was Monday.

Can you stall for another 20 minutes? Retest?
 
Sorry, yes 1U. And I'd stay up to monitor and get that +2, and I'd stay up and/or set an alarm to wake me at +6.

p.s. you can tell I'm tired. Forgot to say how much insulin for Kit.
 
With a reduce dose like that, half the normal amount of insulin, expect a high BG in the morning.

If so, then the full 2 U dose again. This reduced shot tonight was a "safety dose".
You probably would have been ok to give Kit the full 2U dose tonight. But being a champion diver, the reduced dose was safer, so you could get some sleep tonight.
 
Deb & Wink said:
champion diver
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ok, that made me at least smile bc it conjures the image of her on the high board at the pool. i'm sure there's a kitty gif of that someplace on the web .... but it'll have to be a search for another time.

:bighug:thank you so much for being here. especially during these crazy, exhausting times. :bighug:

kit is asking what she can possibly do to thank you enough.:kiss:
 
JOJI and Kit said:
kit is asking what she can possibly do to thank you enough
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Help the next person. Emotional support is so needful for everyone. Pick one member and give them some help. Someone here in the Prozinc forum would be just fine.

Getting ready poolside.
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Hi J & J.

Kit has a very nice surf in the lower to mid-blue range today, 3/27/20 AM cycle. Nice and safe. She could even have gone down to the greens and have been safe, but then the bounce would have probably be higher tonight.
I see you fed her at +4 and +5. That probably helped her stay in those nice blues.
 
Deb & Wink said:
I see you fed her at +4 and +5. That probably helped her stay in those nice blues.
Click to expand...
is that what you call "feeding the curve" ?

we usually feed her up to 3 times before +4 (main meal plus 1 or 2 smaller ones).
but today at the +5 she was acting hungry so we "topped her up" a bit.

Deb & Wink said:
You need to learn to shoot those low numbers sometime.
Click to expand...

and have been meaning to follow up on what you said earlier in the thread about learning to shoot low numbers sometimes.

does the learning mean to shoot and feed the curve? or something different?

trying to anticipate what might be waiting for us at the PM pre-shot
+8 at 170
^jw
 
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JOJI and Kit said:
s that what you call "feeding the curve" ?
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Yes, that is "feeding the curve." Feeding the curve, the curve being the BG tests plotted on a graph, the curve being like a smile shape, or maybe a steeper V shape some times.

If you can feed, and keep the dives from being too steep, you can stop some of the bouncing, or maybe I should say, keep the bounces from being so severe.

JOJI and Kit said:
and have been meaning to follow up on what you said earlier in the thread about learning to shoot low numbers sometimes.

does the learning mean to shoot and feed the curve? or something different?
Click to expand...
It means shooting a low pre-shot BG number, lower than you have shot before, and monitoring the BG numbers and feeding when needed to keep the numbers from dropping too low.

If you never learn to shoot lower BG pre-shots, the BG levels will stay too high.
If you never learn to shoot lower BG pre-shots, and instead always skip the insulin dose, the BG's will simply bounce back up later in the cycle. Maybe within a couple of hours.
If you do learn to shoot lower BG pre-shots, and know how to stall and look for a rising BG number before you shoot, you keep Kit more on track, and give her insulin to process her food.
If you do learn to shoot lower BG pre-shots, and even after stalling, the number is still a bit low, but you give a reduced dose of insulin, say around half the normal dose, you keep Kit more on track and she has some insulin to process the food that she eats.
If you learn to shoot lower BG pre-shots, and feed the curve, you can level out the bouncing and the bounces will clear faster.

You've got enough test data, you monitor, so you should be able to shoot pre-shots of 150 now, giving Kit the full dose. It will be scary. The numbers may drop into the greens. As long as you can "feed the curve" and know when to give Kit a bit of food, either her low carb Tiki Cat, some medium carb or when to pull out the big guns and start to give her syrup/honey and some high carb food, she'll be ok because you know what you need to do to keep her safe from a hypo.
 
thinking ahead to today's PM dose.
kit was 92 at AM+5. after that, we fed a small amount
92 is greater than 90 :)
but alphatrak2 has a meter variance which is 15-20%.
so, not sure how to interpret that 92 wrt dose reduction, or not.
at AM+6 she is 107. after that, we fed a small amount.

thoughts?
 
You could consider the 92 to be close enough to the 90 to do a dose reduction.
Maybe only to a skinny dose. but you could try a 1.75U dose. I could go either way.

Kit is bouncing, up to those reds at pre-shot, from the lower numbers the day before. Yuck!
 
hope you are feeling a little better today, deb

Deb & Wink said:
Maybe only to a skinny dose. but you could try a 1.75U dose.
Click to expand...
cool. those were the options we were thinking.
we did a skinny 2 last night bc lowest pre-shot we'd ever done.

Deb & Wink said:
Kit is bouncing, up to those reds at pre-shot, from the lower numbers the day before. Yuck!
Click to expand...
i not sure there's been a time was kit was *not* bouncing :(
 
weird day for BG's but we are above our 150 number with a
166 PMPS
s2U here we come.
all ready for monitoring this evening.
here we go ....
^jw
 
JOJI and Kit said:
so that 99 would qualify her for a dose reduction if we make it to 150 tonight?
Click to expand...
Not technically, but I think Kit is aiming for one.

With those blacks yesterday (blacks = bouncing), I think she is clearing the bounce tonight. If you shot the full S2U dose, or even a reduction of 1.75U, I think you could be up for quite some time tonight, monitoring.

Are you able to stay up and monitor, if she dives low tonight?

Technically, you want the BG <90 for a reduction, but with an Alphatrak, and her not rising much so far, I'd go for a reduced dose tonight. Maybe 1U or a fat 1U or 1.25U. Something in that range.
 
Nope, number is not rising much at all, so stick with the lower dose of f 1U.
With that low, you are going to have to stay up and monitor. Please get a +2 and then proceed from there.
 
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