10/17 - Newly Diagnosed Bear - PMPS 148, +2 89, +3 74

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I'd suggest a drop dose if you can monitor again, hypo kit, plenty of strips, the usual.

It's where you push the plunger all the way in as hard as you can, while holding it down insert in vial, then release. Result is one drop of insulin, not even visible.

When you give the shot you do the same - hold down as firmly as you can without hurting cat, for 10 seconds so it has time to absorb
 
155 and 147 are essentially flat

Was he by chance on steroids at all recently? No other health stuff in past year?
 
FrostD said:
155 and 147 are essentially flat

Was he by chance on steroids at all recently? No other health stuff in past year?
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He was Sick at the beginning of the year with a unknown cause fever. They thought he was diabetic then but two vets wouldn't or couldn't diagnose. This was in March. He was given antibiotics and 2 other things that I cannot think of. he came out of it a week later. other than that he's been fine. He and the new cat piggy get along some of the time but mostly ignore each other.

Ill go with your advice and do the absorb method.
 
Sorry for multiple replies, just wanted to get you an answer before finishing my thoughts.

Hopefully the drop dose will work, but this is definitely a little unusual for a newly diagnosed diabetic cat.i suspect the yellows you saw were bounces because 1U was too much, his body dumped sugar into bloodstream to protect itself.

If the drop dose also takes him lower than you prefer (that's relative... personally, if I had to be gone all day I'd be aiming for nadir of 80 or 90 )...then you have 2 options. A switch to Lantus that may or may not do the same thing, or just let him hover in these ranges without insulin but keep an eye so they don't creep up
 
FrostD said:
Sorry for multiple replies, just wanted to get you an answer before finishing my thoughts.

Hopefully the drop dose will work, but this is definitely a little unusual for a newly diagnosed diabetic cat.i suspect the yellows you saw were bounces because 1U was too much, his body dumped sugar into bloodstream to protect itself.

If the drop dose also takes him lower than you prefer (that's relative... personally, if I had to be gone all day I'd be aiming for nadir of 80 or 90 )...then you have 2 options. A switch to Lantus that may or may not do the same thing, or just let him hover in these ranges without insulin but keep an eye so they don't creep up
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while I test him tonight whats a number thats dangerously too low?
 
Biggietoms said:
He was Sick at the beginning of the year with a unknown cause fever. They thought he was diabetic then but two vets wouldn't or couldn't diagnose. This was in March. He was given antibiotics and 2 other things that I cannot think of. he came out of it a week later. other than that he's been fine. He and the new cat piggy get along some of the time but mostly ignore each other.

Ill go with your advice and do the absorb method.
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Ok let's see how that works. This isn't typical diabetic pattern/trend which is why I asked
 
FrostD said:
Ok let's see how that works. This isn't typical diabetic pattern/trend which is why I asked
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The vet told me he was at 1000 when they ran the blood last week....I dont know what that was about. I since started him on a wet diet and 255 has been the highest number ive seen.
 
Biggietoms said:
while I test him tonight whats a number thats dangerously too low?
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It's moreso the drop that indicates whether to intervene. If he'll let you I'd actually try a +1 tonight, if he's dropped more than 25 pts give a little LC (he should stay flat or get a food bump at +1, a drop likely indicates a fun time ahead).

But for sure a +2. If he's around 100 I'd give 1 tsp MC plus little bit LC. 90 or lower, 2 tsp MC no LC.

I should be around to help, minus getting kids to bed
 
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Biggietoms said:
The vet told me he was at 1000 when they ran the blood last week....I dont know what that was about. I since started him on a wet diet and 255 has been the highest number ive seen.
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Raising my eyebrows at that. Diet changes can have significant impact, but 1000??
 
FrostD said:
No, you likely did. This is actually good. This is a food bump from his dinner, what we want to happen.

+2 should hopefully be about even with PMPS or a little lower
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without the drop dose would the 193 be higher?
will return at +2.
 
Biggietoms said:
without the drop dose would the 193 be higher?
will return at +2.
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Little hard to say. Onset is when the insulin starts working, for ProZinc is usually +2 or +3 (but can vary).

The reason I asked for +1 was because he had such a big drop by +2 last night...so it either meant (1) dose was too high (2) he onsets earlier than most or (2) combination of the two. Tonight's +1 ruled out the early onset, but that's not to say it won't happen some cycles.

With the testing we try to build the whole picture over time - so we want to find trends for onset, nadir, and duration.

Bear seems to be a different case altogether, but the trends help us keep the cat safe when we get to lower numbers/aim for remission, or know that perhaps a change in insulin is needed (sharp drops, not enough duration). You just kind of got thrown in the deep end from the get-go.

Edit: I'd refer you to my spreadsheet but it's not exactly a textbook example. Last year was a waste of bad vet advice. This year he was diagnosed with a pituitary tumor, which in effect causes his diabetes. His onset and nadir were never truly predictable, so we just had to spot check him anyway. Then we started medicine for the tumor and he crashed into remission.
 
FrostD said:
Little hard to say. Onset is when the insulin starts working, for ProZinc is usually +2 or +3 (but can vary).

The reason I asked for +1 was because he had such a big drop by +2 last night...so it either meant (1) dose was too high (2) he onsets earlier than most or (2) combination of the two. Tonight's +1 ruled out the early onset, but that's not to say it won't happen some cycles.

With the testing we try to build the whole picture over time - so we want to find trends for onset, nadir, and duration.

Bear seems to be a different case altogether, but the trends help us keep the cat safe when we get to lower numbers/aim for remission, or know that perhaps a change in insulin is needed (sharp drops, not enough duration). You just kind of got thrown in the deep end from the get-go.
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I noticed that his numbers we no where as high as other ss I’ve seen on other recently diagnosed. Not that it means that all cats are the same it just popped out to me that he was only a 255 at the first test I had ever given him and not as high as I thought they would be after the “1000” level test I was told by the vet.
 
Biggietoms said:
I noticed that his numbers we no where as high as other ss I’ve seen on other recently diagnosed. Not that it means that all cats are the same it just popped out to me that he was only a 255 at the first test I had ever given him and not as high as I thought they would be after the “1000” level test I was told by the vet.
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Tuna comes to mind as a sort of similar case. I suspect he had the pancreatitis brewing, and/or possibly some other underlying inflammation/infection that were elevating his numbers - combined with too high of a dose causing swings. Then once that was taken care of you can see it was night and day.

I'm curious to see what happens with Bear. There's a niggling thought in my head he may not be permanently diabetic, and this is hopefully just a blip in the radar.

Whenever you get a chance, and no rush, would be interested to see whatever recent lab results you have.
 
FrostD said:
Tuna comes to mind as a sort of similar case. I suspect he had the pancreatitis brewing, and/or possibly some other underlying inflammation/infection that were elevating his numbers - combined with too high of a dose causing swings. Then once that was taken care of you can see it was night and day.

I'm curious to see what happens with Bear. There's a niggling thought in my head he may not be permanently diabetic, and this is hopefully just a blip in the radar.

Whenever you get a chance, and no rush, would be interested to see whatever recent lab results you have.
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I will reach out and see if I can get a copy and I’ll upload it here.

could it be stressed induced? He really hasn’t been the same since his companion cat passed last November. I got another cat but they haven’t clicked. They ignore each other or chase each other around. There has been a few fights.

Bear does have some of the symptoms. Constantly peeing, weak back legs etc.
 
Biggietoms said:
I will reach out and see if I can get a copy and I’ll upload it here.

could it be stressed induced? He really hasn’t been the same since his companion cat passed last November. I got another cat but they haven’t clicked. They ignore each other or chase each other around. There has been a few fights.

Bear does have some of the symptoms. Constantly peeing, weak back legs etc.
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I'm not sure unfortunately. Stress definitely affects BGs, how long have you had the new cat?

Has anyone ever mentioned B12 for the neuropathy? See this post.
 
Ok I see the +2. It's either that the drop dose wasn't done right, or it's not enough. Do your syringes have half unit markings?

You have two options:
1. Try drop dose again tomorrow, both cycles. See what happens. I'd use 150 as shoot/no-shoot.
2. Try 0.1U. That can be difficult to eyeball...at these low doses some people use calipers. You could also buy U100 syringes, but the conversion between the two can be a little complicated (for example, a 0.1U U40 dose is drawn roughly to the 0.3U marking on a U100 syringe). I would not attempt 0.1U unless your syringes have the 1/2 unit markings.

I suppose option 3 is try 0.25U again but only in PM cycle.

Option 4 is different insulin, but that may not solve problem.

Anyway...I'd catch a +4 just to be on the safe side, but I think he'll stay in blues.
 
FrostD said:
Ok I see the +2. It's either that the drop dose wasn't done right, or it's not enough. Do your syringes have half unit markings?

You have two options:
1. Try drop dose again tomorrow, both cycles. See what happens. I'd use 150 as shoot/no-shoot.
2. Try 0.1U. That can be difficult to eyeball...at these low doses some people use calipers. You could also buy U100 syringes, but the conversion between the two can be a little complicated (for example, a 0.1U U40 dose is drawn roughly to the 0.3U marking on a U100 syringe). I would not attempt 0.1U unless your syringes have the 1/2 unit markings.

I suppose option 3 is try 0.25U again but only in PM cycle.

Option 4 is different insulin, but that may not solve problem.

Anyway...I'd catch a +4 just to be on the safe side, but I think he'll stay in blues.
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ok I’ll get a +3 and a +4.
I’ll see where he’s at tomorrow morning and decide then. I’m gonna go over these posts again.

edit: I have the Merck U40 syringes. They only have the full unit markings.


Thanks again.
 
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