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Sergei

Member Since 2020
As always, many thanks in advance for reading and for any insight.

We are scratching our heads here and pretty concerned.

Last night (Monday) and tonight (Tuesday) Sergei's PMPS BG levels were 11 (198) and 8.3 (155), respectively.

We did not give him insulin last night and we certainly are not planning to do so this evening either. This morning we cut his dose by 0.5U from 2.5 to 2.

TODAY:
7:30 AMPS BG 24.7 (445)
7:45-8:30 Feeding
8:30 Caninsulin injection 2U
10:30 Snack
12:30 (+4) BG 16.6 (299) This is the expected BG Nadir
19:30 PMPS BG 8.3 (155) How can this be?

Anyone have any thoughts on why we might have dropped so much from the expected nadir at +4 to PMPS? After 12:30/1:30 shouldn't BG be rising on a short acting insulin like Caninsulin? Sergei has not had insulin for 12 hours and his value is lower at 12 hours after insulin than it was at 4 after insulin.

I don't feel comfortable injecting, obviously, but I also don't want him to go without insulin.

Thanks so much,

Scott & Sergei
 
I asked about the absence of preshot tests for this very reason. The few black PS tests you've managed to catch are pointers to Sergei having dropped fast and far at the beginning of the cycle and/or going low/too low at nadir time. By focusing almost exclusively in your testing on trying to catch the AM cycle nadirs it means that you've only got a patchy picture of how Sergei is reacting to the Caninsulin dose.

It is possible that the low PMPS BG is down to Sergei having cleared a bounce that gave you the red AMPS this morning. It's also possible that the 2.0IU dose might be too high. I'm really sorry but it is impossible to say with any certainty what is happening because there's just not enough data available to make a reasonable assessment.

I understand and appreciate from the post on your previous thread that you are fitting your testing in with your day-to-day schedule. With feline diabetes unfortunately it's not possible to determine the full effect and safety of any given dose of any given insulin without sufficient, appropriate tests. Without a solid assessment of how the insulin is working, it's not possible to optimise treatment in order to enhance chance of remission. It is for you to determine the treatment path that you can manage and are comfortable with.


Mogs
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In future, if the preshot is under 200 stall without feeding, test, and if necessary stall a second time and then test again. Dealing with lower preshot numbers is discussed in the FDMB Caninsulin/Vetsulin guide.


Mogs
.
Thanks for all of your helpful thoughts and suggestions and links to information along the way. I feel like you've now made your feelings and opinions about our testing regimen adequately clear. We're doing what we can, as I expect most people who find themselves in this unfortunate circumstance are. The intense pressure about testing sometimes acts as a big deterrent against posting. I don't think that's really the intention, but I wonder if others don't sometimes feel that way too. That would be a shame, especially for those people who are new to this disease and are trying to keep everything together. I appreciate your thoughts and experience, so thanks. But honestly, I feel a bit judged. I just wanted to hear if anyone had had similar experiences and what such numbers can hypothetically point to. In future, I'll limit my posts to the emotional journey of feline diabetes. Cheers, Scott
 
I don't think Mogs is judging you at all.
It's really important to get pre shot tests, Vetsulin hits hard and fast
We ask for more testing so members here can help you.

Understand if you both work and cannot test that much during the day,
so more night time tests would be helpful.

Everyone is in different time zones so putting down times of testing doesn't help at all.
+2. Two hours after giving insulin
+3. Three hours ditto and so on.

Is there any reason you will not post your spreadsheet and what you are feeding,
that we have to request it?

Members here are only trying to help Sergei
Without seeing a spreadsheet it's impossible for any member to give you advice

Wishing you and your kitty all the best
 
Oh gosh, I hope this is sorted and that there are no hard feelings on anyone’s part. It is not uncommon for people to say they feel a bit judged, and that’s a perfectly natural response to being on the receiving end of a lot of information which is only intended to be helpful - not the slightest bit judgemental. All of us here have been on a learning curve, some steeper than others, and there’s no doubt that it can feel pretty overwhelming - and that can make us sensitive and defensive. But there is no need to feel that way - you are not being judged.

Mogs has a wealth of experience, a huge heart, and gives a lot of time and effort helping people here. I for one would listen to everything she has to say and try to take it in the spirit in which it is given. We all do our very very best, and more, for everyone here. Scott, you’ve come a long way in a short time and I hope you’ll feel able to respond to others in similar situations also seeking advice and reassurance. That’s what FDMB is all about. It’s what we do.
 
Oh gosh, I hope this is sorted and that there are no hard feelings on anyone’s part. It is not uncommon for people to say they feel a bit judged, and that’s a perfectly natural response to being on the receiving end of a lot of information which is only intended to be helpful - not the slightest bit judgemental. All of us here have been on a learning curve, some steeper than others, and there’s no doubt that it can feel pretty overwhelming - and that can make us sensitive and defensive. But there is no need to feel that way - you are not being judged.

Mogs has a wealth of experience, a huge heart, and gives a lot of time and effort helping people here. I for one would listen to everything she has to say and try to take it in the spirit in which it is given. We all do our very very best, and more, for everyone here. Scott, you’ve come a long way in a short time and I hope you’ll feel able to respond to others in similar situations also seeking advice and reassurance. That’s what FDMB is all about. It’s what we do.
Hi Diana, thanks so much for your thoughts and concerns. I apologise for my reaction, genuinely, and especially to Mogs. I know she was very generously trying to help. I've seen many of her posts and I know she's tirelessly dedicated. I recognise that all the things you've said about her are true. I've been feeling like s**t all day about my petulant post yesterday. I'm just completely exhausted and feel like I'm reaching the end of what I can do for my dearest friend Sergei. It's overwhelming to feel all of this fear, sadness, frustration and anxiety. All the small resentments that grow up around this illness eventually just start to leak out and find voice in the world. I'm not a confrontational person at all, but last week I snapped at someone for letting her dog menacingly bark and lunge at a cat on the sidewalk. I stood there thinking why are you letting your dog drive that poor cat's BG level up. FD has become this all-consuming subject at the moment.

It just feels like nothing with this disease is ever enough, be it knowledge, testing, or duration of action of the inferior caninsulin that I'm stuck with (sometimes literally). I desperately want to get Sergei to remission but I feel hopeless about it because I'm sort of stuck with the weak tools (Caninsulin, limited veterinary motivation) available to me where I live. I openly confess I hate testing. I hate the anxiety I feel waiting for the sip of blood, the beep, the countdown, and then the way the number appears after all that useless anticipation, always depressingly high or nervewrackingly low--just further evidence of my incompetence at this whole thing. Plus it's expensive, it's messy, and it's demanding. And I hate even more that all the testing in the world is not going to put Sergei into remission or make any of this one iota easier, even if it helps me better understand what's going on with his body. I never wanted to have to understand. So yeah, testing has become just another thing to resent. We've really struggled to get to the number of tests we are currently doing, against all the petty hatreds I have of testing, against the advice of our vets (if it were up to them, we'd take him in once every two weeks for a test), against Sergei's resistance, and against my dread of needles and blood.

And now I'm just starting to discover for myself the logic behind testing. I'm seeing it. Really, until today, I heard everyone's insistence on testing as criticism and just didn't see the importance of it with Caninsuiln. I've now learned firsthand why it is necessary and useful. Today I desperately wish I had a better picture of what's been going on at different points in Sergei's cycle--how we reached a too low to shoot number at PMPS yesterday and Monday, way below the number we were getting at what we were told would be nadir. Before these weird numbers, I was able to live in uneasy comfort that our expected nadirs were mostly okay, a few low lows here and there but generally we were not in dangerous territory. All that came to an end this week when we got the bizarre readings that led me to post yesterday. I felt uneasy shooting this evening. Because we've now experienced firsthand an absolute need to know the PS values, we've now started adding AMPS and PMPS tests and are unhappily having to think about adding other points in the cycles that we never wanted (or thought we needed) to know about... until now. Ptnr is also starting to see the need for AMPS and PMPS and agrees other points will yield potentially useful info.

Many thanks for your intervention. Sincerest apologies to Mogs. I'm not really operating with great reservoirs of clarity and patience at the moment. I posted here last night because our vet is closed (one of their workers tested positive for COVID) and we had those strange readings at nadir and I felt a bit panicked about it all. I realise that nobody can solve these problems for us, that this is a very lonely disease, but I also know everyone here cares and does their best to help and I appreciate it. So, thanks. And even more especially on behalf of Sergei. Sorry for my long reply and the impulsive frustration of my post yesterday.
 
Hi Diana, thanks so much for your thoughts and concerns. I apologise for my reaction, genuinely, and especially to Mogs. I know she was very generously trying to help. I've seen many of her posts and I know she's tirelessly dedicated. I recognise that all the things you've said about her are true. I've been feeling like s**t all day about my petulant post yesterday. I'm just completely exhausted and feel like I'm reaching the end of what I can do for my dearest friend Sergei. It's overwhelming to feel all of this fear, sadness, frustration and anxiety. All the small resentments that grow up around this illness eventually just start to leak out and find voice in the world. I'm not a confrontational person at all, but last week I snapped at someone for letting her dog menacingly bark and lunge at a cat on the sidewalk. I stood there thinking why are you letting your dog drive that poor cat's BG level up. FD has become this all-consuming subject at the moment.

It just feels like nothing with this disease is ever enough, be it knowledge, testing, or duration of action of the inferior caninsulin that I'm stuck with (sometimes literally). I desperately want to get Sergei to remission but I feel hopeless about it because I'm sort of stuck with the weak tools (Caninsulin, limited veterinary motivation) available to me where I live. I openly confess I hate testing. I hate the anxiety I feel waiting for the sip of blood, the beep, the countdown, and then the way the number appears after all that useless anticipation, always depressingly high or nervewrackingly low--just further evidence of my incompetence at this whole thing. Plus it's expensive, it's messy, and it's demanding. And I hate even more that all the testing in the world is not going to put Sergei into remission or make any of this one iota easier, even if it helps me better understand what's going on with his body. I never wanted to have to understand. So yeah, testing has become just another thing to resent. We've really struggled to get to the number of tests we are currently doing, against all the petty hatreds I have of testing, against the advice of our vets (if it were up to them, we'd take him in once every two weeks for a test), against Sergei's resistance, and against my dread of needles and blood.

And now I'm just starting to discover for myself the logic behind testing. I'm seeing it. Really, until today, I heard everyone's insistence on testing as criticism and just didn't see the importance of it with Caninsuiln. I've now learned firsthand why it is necessary and useful. Today I desperately wish I had a better picture of what's been going on at different points in Sergei's cycle--how we reached a too low to shoot number at PMPS yesterday and Monday, way below the number we were getting at what we were told would be nadir. Before these weird numbers, I was able to live in uneasy comfort that our expected nadirs were mostly okay, a few low lows here and there but generally we were not in dangerous territory. All that came to an end this week when we got the bizarre readings that led me to post yesterday. I felt uneasy shooting this evening. Because we've now experienced firsthand an absolute need to know the PS values, we've now started adding AMPS and PMPS tests and are unhappily having to think about adding other points in the cycles that we never wanted (or thought we needed) to know about... until now. Ptnr is also starting to see the need for AMPS and PMPS and agrees other points will yield potentially useful info.

Many thanks for your intervention. Sincerest apologies to Mogs. I'm not really operating with great reservoirs of clarity and patience at the moment. I posted here last night because our vet is closed (one of their workers tested positive for COVID) and we had those strange readings at nadir and I felt a bit panicked about it all. I realise that nobody can solve these problems for us, that this is a very lonely disease, but I also know everyone here cares and does their best to help and I appreciate it. So, thanks. And even more especially on behalf of Sergei. Sorry for my long reply and the impulsive frustration of my post yesterday.

I hear you, Scott. You’ve very eloquently described how a lot of people feel. Many of us here have been just where you are. I think what you have to remember is that you’re doing all this out of love - love for a precious little animal who cannot help himself so relies on you to do your best for him. It is tough, nobody is denying that - but by reading and absorbing and learning, things start to fall into place and you will feel better and more in control. Knowledge is power.
Everyone here loves cats, some don’t even have a diabetic cat any more, but we’re here because we want to pass on our experiences to benefit others at the start of their journey. These are very tough times for each and every one of us and emotions do spill over. We’re all in this together.
 
Scott, see that (GA) after many screen names? Thats not because we are all from Georgia. GA here means "Gone Ahead or Guardian Angel" Yet here we are. We are ALL dedicated to helping anyone who needs help. We hope you will not become a stranger.

I remember the first time I felt "piled upon" . I was so hurt and angry but I Now know I NEEDED it. Trouble was on NPH insulin just about as bad as it gets for cats. With the diligent and dedicated people helping us Trouble went into remission. I owe that to everyone here. So I try to pay it forward. One of the best pieces of advice I got here is "DONT FORGET TO BREATHE"
:bighug::bighug::bighug:
A hug for each of you!
jeanne
 
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