03/23 Ducia 1.25U increased: pmps +8 328, +12 155,+12.55 114 ,1.25U, +1 155

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Tanya and Ducia

Tanya and Ducia

Member Since 2017
Hello,

Ducia is in her 4th cycle since the Lantus dose increase to 1.25 Unit.

As you can see in her SS there is not much progress has been achieved so far and I do not know what I do wrong. She still has high 300s.With the same dose of insulin and the same amount of food given her AM and PM readings look as if recorded after two different cats.

I was told that she was “bouncing” but it’s been going on for too long now. Then there was a suggestion that Lantus may not be for her but she does well in the AM cycles. And then there is her food which I might mismanage. She gained weight significantly.

Currently Ducia eats 1 ½ of 5.5 can of Friskies Classic Pates LC or Nature Variety Instinct Grain Free LC. She has ¼ of a can every 4 hours. The AM cycle meals are given in smaller portions .The PM meals are mostly given in full size every 4 hours because she sleeps thru that time of night.

If someone can look at Ducia’s SS and give me some idea as to why is she stuck in this situation and/or what do I do wrong/ or can do to improve on it I’d be very grateful. Thank you !
 
Good morning Tanya!

I'll wait for the real spreadsheet gurus to weigh in to give you some specific pointers, but I just want to reassure you, you aren't doing anything "wrong". I actually think Ducia is doing very well so far-- she's getting to greens pretty regularly, and it's still very early in the whole process. We have a saying here about feline diabetes-- it's a marathon, not a sprint. We don't know how long Ducia has been diabetic, and she's definitely been through a lot in the last few weeks. It's just going to take some time to get her diabetes under control, but she's doing well so far. Others here who have more experience may have some more detailed observations about specific aspects of her food and dosing routine that may help.

One thing that I can suggest is that you look at the two dosing protocols (Start Low, Go Slow and Tight Regulation) used on this board and explained in the yellow "stickies" at the top of the forum to figure out which one is right for you and Ducia. You definitely do enough testing for Tight Regulation, but it is up to you which one you feel more comfortable with. Both are designed to get your cat to the "right" dose of insulin, and to do so in a systematic and safe way.

It is great to see all the safe greens and blues on her spreadsheet! How is she feeling/acting these days?
 
Ducia is getting good nadirs on this dose. I would hold the dose for now.

Tanya and Ducia said:
I was told that she was “bouncing” but it’s been going on for too long now.
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Sorry, but this just cracks me up.:p Some cats are bouncier than other. Five years after I started Neko on insulin, she would occasionally still bounce to pink, though most of the time it was just to yellow. it's up to Ducia's body now to learn that green is good. You are doing nothing wrong, except maybe testing too much. If she starts pink at PMPS and it still pink four hours later, go to sleep. Get some much deserved rest. :bighug:
 
Hi Tanya,
I think she's doing well. I wouldn't worry too much about the bouncing when she still gives you lovely greens. I agree with Wendy that you can take a break from testing as much. Both you and Ducia need that. How has she been feeling? Is the feeding tube still in place? Any idea when it will come out?
 
Hey Tanya, Ducia is doing great and you are doing great too. Some kitties are bouncier than others so try to focus on how low the insulin takes her each cycle rather than the higher bouncy preshot number.

As far as the food, it is wonderful that she has gained back some weight and you did what you were supposed to do by feeding her more calories post DKA so she could gain back some weight and so you could get more insulin into her to stop the ketones. Is she at her ideal weight yet?
 
Good morning ,
how god to see you here!
Ducia, in general, is improved a lot.
She gained significantly her weight from 6.5 lbs (at the clinic) on March 1st to (approximately, weighted at home on human scale) 8.2 lbs yesterday. Litter box visits a pre-Dx frequency, good appetite, daily routine of patrolling and marking the "territory" restored, ketones are rather negative than minimal Trace amounts.

I do not know her ideal weight. She is not a big girl. She used to be overweight prior to 2015 at 13.6 pounds and was to put it simply a Fatty.

We have a vet whom I hesitant to call "our" vet. Ducia is strictly indoor cat and never had medical issues until her FD Dx on Febr 24th, 2017. In 2015 Ducia had small skin infection and I took her to this vet because of his good Google reviews and his office being close to home. He is certified in trauma/recovery not internal med or FD.

I am not sure which of the protocols would suit us all the best. I am able to stay home and monitor closely as TR requires. I will reread both protocols guidelines.

Add thing that I wanted to point out is that Ducia is uncomfortable in Greens. She does behave her best at low 100s. Too anxious below 90. If I am not misinterpreting this behavior of hers, which of the protocols in your opinion is better for her?

The feeding tube is still in place and per vet in ER we can keep it for some weeks to come. It is great tool to supplement water intake and meds, although Ducia now is med-free.

Ducia seems to have late nadirs, often around +8 in the AM cycles. It could be as low as 65.

Her new unpleasant to me habit is to drop late in the cycle.

I am sort of glad to hear that you all think she is bouncing still. I began to suspect something worse then that. I had patience pants somewhere in the house.

Thank you so much for talking.
 
Hi,
Ducia just shown me a falling BG at pre-shot
PMPS +8 328, +11 182, +12 AMPS 155.
I didn't shot.
What should I do?
She is hungry.
 
Ducia BG at AMPS (+12) is 155, she tried to vomit, nothing came out.
I am holding the shot because I am not sure I should give an increased dose to the lowering still numbers.
She looks ok, peed, Ketones Negative.
What should I do?
 
Wendy&Neko said:
Ducia is getting good nadirs on this dose. I would hold the dose for now.


Sorry, but this just cracks me up.:p Some cats are bouncier than other. Five years after I started Neko on insulin, she would occasionally still bounce to pink, though most of the time it was just to yellow. it's up to Ducia's body now to learn that green is good. You are doing nothing wrong, except maybe testing too much. If she starts pink at PMPS and it still pink four hours later, go to sleep. Get some much deserved rest. :bighug:
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I am willing to hold the dose but right now at +12 she is 155, lower from +11 182.
I am not confident to shoot.
She also is hungry.
Should I feed her?
Or should I wait another hour and test?
She doesn't look to happy any longer.
 
Bobbie And Bubba said:
Hey Tanya, Ducia is doing great and you are doing great too. Some kitties are bouncier than others so try to focus on how low the insulin takes her each cycle rather than the higher bouncy preshot number.

As far as the food, it is wonderful that she has gained back some weight and you did what you were supposed to do by feeding her more calories post DKA so she could gain back some weight and so you could get more insulin into her to stop the ketones. Is she at her ideal weight yet?
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Hi, I am not sure it is ideal weight yet. But she is gaining.
I need advice on her current readings: +11 182, + 12 155, she tried to vomit, she is hungry, I am holding the shot but I am not sure what to do.
 
Hi Tanya--

I'm sorry, it's lunchtime for me here and I was away from my desk for a while.

Are you still stalling? How long are you now from your usual shot time? Have you fed at all?

I would go ahead and shoot if I were you, especially as Ducia is (very) willing to eat. She'll probably come up after eating, and if she stays low you are able to monitor and can give her food to bring her up if necessary.
 
A note on the trying to vomit: some cats produce excess acid when they are anticipating a meal, and will vomit a little clear liquid just before their usual mealtimes. It's always possible that Ducia has something else going on, but I think it's likely just this that caused her vomiting this morning.
 
Still stalling.
Half an hour past regular shot time at 10 am pacific.
She ate at +8 about less than 1/4 7% LC.
WHat should I do, do you think?
 
Did you see my post above about trying something like baby food, canned tuna or something different than her regular food. If you don't have any of those things, do you have dried oregano? Sprinkle some on top of her food; it always worked with Bubba. I think because it smells a little like cat nip does.
 
Ah, I thought you said she was hungry earlier.

The longer she goes without eating, her BG will likely continue to drop, so the key is to get her to start eating something now. Try some of Bobbie's tricks to start...
 
Bobbie And Bubba said:
Did you see my post above about trying something like baby food, canned tuna or something different than her regular food. If you don't have any of those things, do you have dried oregano? Sprinkle some on top of her food; it always worked with Bubba. I think because it smells a little like cat nip does.
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I think that she would eat, but I am not sure about lowering numbers. If it means that the prior insulin shot is still working how can I add another dose (increased dose) to a cat who like to dive?
 
Yes, I second Nan's feed and shoot. A DKA issue is much more of a serious thing than a hypo and you know now how to steer with HC food if you need to.
 
Bobbie And Bubba said:
I would shoot the full dose if you can monitor her and maybe start her off with some higher carb food to boost her up before onset kicks in.
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She ate slightlu more that 1/4 can of 8% Soulistic.
I will shout the full dose, test at +1, offer some 9% snack. Is it a plan?
I have FF MC from +14 to +17 but will keep it for steering the lower ##.
I'd rather she stays below 10% unless it is a drop.
Do you agree?
 
Bobbie And Bubba said:
I would shoot the full dose if you can monitor her and maybe start her off with some higher carb food to boost her up before onset kicks in.
Click to expand...
She ate slightly more that 1/4 can of 8% Soulistic.
I will shout the full dose, test at +1, offer some 9% snack. Is it a plan?
I have FF MC from +14 to +17 but will keep it for steering the lower ##.
I'd rather she stays below 10% unless it is a drop.
Do you agree?
 
Tanya and Ducia said:
She ate slightlu more that 1/4 can of 8% Soulistic.
I will shout the full dose, test at +1, offer some 9% snack. Is it a plan?
I have FF MC from +14 to +17 but will keep it for steering the lower ##.
I'd rather she stays below 10% unless it is a drop.
Do you agree?
Click to expand...

Sounds like a plan, if at the +1 she is dropping more, bring out the higher carb food . I will look in on you in a bit.
 
:bighug::bighug::bighug:
Thank you for checking!!

Are you absolutely sure I can skip the +2?

If yes, should I offer her some more small snack? She used to do dops, quick and by a lot of points.

Should I give, let's say a Tbs of 9% at around +2 and then test at +3?

Last AMt she was sleeping peacefully and I didn't disturb her with testing but she went from 336 @+1 to 143 @+4. Over 200 points and that worries me a lot.
 
Tanya and Ducia said:
336 @+1 to 143 @+4. Over 200 points and that worries me a lot
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When they are in higher numbers like that, they have bigger drops. Since she started off in blue, she shouldn't drop that severely, and she did give you a little food bump. If it makes you more comfortable to test again at +2, then do it. I was thinking of Ducia and giving her a little pokey break but, truth be known, I would probably test again at +2 also. :cat:
 
Bobbie And Bubba said:
When they are in higher numbers like that, they have bigger drops. Since she started off in blue, she shouldn't drop that severely, and she did give you a little food bump. If it makes you more comfortable to test again at +2, then do it. I was thinking of Ducia and giving her a little pokey break but, truth be known, I would probably test again at +2 also. :cat:
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Thank you! I would be much more comfortable to test again at +2. And offer a reward snack.
I hate to torture her ears but when she is sleeping I have no other way of knowing where her BGs are. Letting her sleep, waiting until she is up and then discover that she is below 90 will finish me right here.
I am relieved to hear you'd do the same in my shoes.
Please keep checking on us.
:bighug::bighug:
 
I just peeked at the SS and she is surfing along nicely. :cool: I know you will be keeping a close eye on her. Tanya are you following TR or SLGL?
 
Bobbie And Bubba said:
I just peeked at the SS and she is surfing along nicely. :cool: I know you will be keeping a close eye on her. Tanya are you following TR or SLGL?
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Thank you Bobbie. I gave 2 tsp 8% snack at +2.5. Next test is at +4, I think, her usual up time.

About the protocols: I don't know. :bookworm:.

What I think I do at the moment is trying to get her to stay between 100 and 215 for a prolonged time. To get her angry liver to relax and rely on steady insulin and food supply. No success so far, look at the PM cycles. Infection, vomiting and other things muddied the waters lately.

TR: I can test frequently and administer food by increments to support the "surf" in Blue ( or at least I am learning it now) . I am less afraid of lowering numbers, like today, but still need someone to look at the SS and tell me I am not killing her yet. That makes me less reluctant to increase the dose when needed although bloody hypo event traumatized me in very real sense (sorry to bring it up again, but when I panic my mind shuts along with my English language skills, it is a factor to consider, I become not-the-sharpest-tool in the box). All of it, I believe are the TR per-requisites, right?

Regardless of the data that I collected for her SS I am still very confused about her reactions - her nadirs, her late drops, her totally response-less PM cycles, etc., and I feel myself very incompetent in making decisions about dosage and food. Thus I do not know what protocol is the best.

We are still arguing at home about her weight - I like that she is gaining but my hubby, the human medic, is saying that I am making her Fatty again and will always have her insulin dependent. He thinks I do wrongly when I feed her BG 300+. He also think it is ok to shoot larger dose in the PM cycle but lower dose next morning, depending on the number at hand.

Pleases let me know what you think about it and what protocol you think is best for Ducia.
 
Tanya and Ducia said:
He also think it is ok to shoot larger dose in the PM cycle but lower dose next morning, depending on the number at hand.
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Lantus is a depot insulin and like consistency in dosing the same dose in a 24 hour period ( of less of course if she goes to low and you have to reduce)
Most cats go lower in the PM cycles but Ducia is doing things her way with going lower in the AM and bouncing in the PM.

How about at her next vet visit ask the vet if she is at a good weight and proceed from there.
 
That's exactly what i wanted to do - ask the vet about optimal weight. But the earliest I can see the vet is on the 1st of April, 9 days from now. Is it too late?
 
Tanya and Ducia said:
What I think I do at the moment is trying to get her to stay between 100 and 215 for a prolonged time. To get her angry liver to relax and rely on steady insulin and food supply.
Click to expand...
It's much harder to get a kitty to stay in the 100-215 range than it is to keep them in a range that goes a little lower. It's not like you can get them used to blues, then get them used to greens. With my Neko, if she was seeing the 70's, then she would bounce as high as low yellows, but she would bounce higher if she wasn't seeing green, at least a little bit. Most cats are nervous the first time they see greens, if it's been a while. Neko used to hide under the bed at first, but she got used to them over time.

As for her ideal weight, could you just call the vet's office and see if they'll answer the question of idea weight without seeing her? Are you weighing her regularly?
Tanya and Ducia said:
He also think it is ok to shoot larger dose in the PM cycle but lower dose next morning, depending on the number at hand.
Click to expand...
That works for some types of insulin, but with the methods we used here we find it's better to shoot the same dose AM and PM. And you absolutely want to feed the 300's while she is in DKA recovery mode.
 
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