1/13 Blackie - amps 592

[Ele & Blackie (GA)]

I don't know what's going on. confused_cat From an amps of 147 on Monday to 592 on Wednesday. I emailed Blackie's spreadsheet to the vet with questions. Obviouisly we bumped up the dose, but why are his numbers swinging so much? I don't know if I need to get tests done, switch him to Lantus, or what. He seems to feel okay, eating, no vomiting, no change in behavior. If you have any ideas, I would love to hear them.

We are still in our cold snap. It is day 21 of less than freezing temperatures. I think we may break some records around here.

(edited to remove attempt at smilie in subject.)

 

[Sarah and Buzz]

Re: 1/13 Blackie - amps 592 :sad:

Oh my gosh, that is a huge #!! I am so sorry to hear that.

I know he's been getting his urine checked, but when was his last bloodwork? I have a feeling it wasn't too long ago, but I could be thinking of someone else. Someone here told me that if even the gums are inflamed, it can cause BGs to rise but no infection would show in BW. Maybe there is something going on in his mouth? Those are my only ideas, unless the vial of PZI is somehow gone bad.

If you can rule out all possible health issues, then I would think about switching insulins (unless your vet has any other ideas), either to Lantus or ProZinc. I know you already have the free Lantus, so that could sway your decision (it certainly did mine). It's scary to switch, at least it was for me. It's just so different than what you've known and I felt overwhelmed. There are plenty of people to help you, if that is what you decide to do.

If I were you, I would post over in LL and see what they think. I did that a few times before I actually switched, and they were really nice and helpful. Of course they all think that Lantus is the best insulin, so you will get lots of "yes, switch!" but if you ask people to specifically look at Blackie's SS and advise based on YOUR PARTICULAR CASE, they will do so (at least they did for me) and give you some more concrete reasons as to why it would be good FOR BLACKIE as opposed to just the general stats, which we know already.

I am sorry you are going through all this trouble and I hope that something can be found and you will not have to switch.

 

[Gator & H (GA)]

Hey Ele,

I noticed that Blackie vomited grass - so that means Blackie goes outside? Any chance Blackie is finding alternate sources of food? If I remember, I think you said that you do not have any nearby neighbors?

I just have to give you much kudos on all of your testing [even at night!!!]. For sure no shortage of effort.

 

[Terri and Lucy]

I wonder what would happen if you shot a consistent 2.4 or 2.6 unit dose for 1-2 weeks (unless he dropped too low). You've got some data that indicates that dose can bring him down from highs and isn't too much on a low preshot. While a sliding scale works for some cats, others do better with consistency.

 

[Ele & Blackie (GA)]

Terri, I really want to have a dose and stick to it, but I've been afraid when his bg gets so high. So are you saying that I should try, say 2.6, and stick with it even with high numbers and only reduce if he goes low? I can try it, but it's going to be hard. When I see those high numbers, I freak out.

Gator, Blackie does go outside, but believe me there is no grass alive outside right now. I have a pot of cat grass that's available to all of my kitties and occassionally it will make them sick. We don't have any close neighbors and there is no dry cat food in the house, so I really don't think he's getting into anything.

Thanks for all your feedback. I hope we can find a solution soon.

 

[Joanna & Bix (GA)]

Wow, that is a shocker!

I'm wondering if maybe when you get back in good #s you should hold the dose for longer before reducing. When I look back at the last round of 2.6u and he was getting good results, I'm thinking maybe the 2.4u dose reduction was premature (not meaning to criticize! just brainstorming). With Bix, I found if he was zoomy and I reduced it was a disaster. Sometimes it was just a few more cycles before it was crystal-clear a reduction was needed, but somehow waiting made all the difference. I guess because the zoom proved it was reduced, vs. me hoping it was reduced. Not sure if that is the case with Blackie, but could be.

[ETA: Looking at his last round at 2.6, my instinct is not to reduce unless there is a nadir < 50, or a PS a little lower, maybe <130 or something. I'd count the PS at 147 or so as ideal, suggesting it was the right dose, rather than too high. That is just my non-expert 2c though, and I know you are WAY more familiar with his #s and patterns than I am. Disclaimer, disclaimer, disclaimer. ]

Hope things get steadier soon. If it were me, I'd probably be toying with trying a different insulin too. Seems like it has been a lot of stuggle for you lately on PZI. Not to say that it can't work out successfully, but at some point the convenience factor has to weigh in, if it's a constant struggle to keep the #s good.

There's definitely a benefit in my mind to being able to shoot on lower PSs without having to worry so much about the drop. I think sometimes that's a block for PZI. I know with Bix we are in this place where he's a little high, but not high enough to feel comfortable shooting - sometimes I think with a different insulin it might be easier. But he's doing well enough that I'm not going that my route myself unless & until my PZI vial runs dry, but if he were in Blackie's shoes...? Hard to know what to do.

I have found it helps to set some timeframes - if I can't get this working in, for example, 6 weeks (whether it's the insulin, or user error), I will move on. That approach has helped me take some of the agony out of trying to decide what's best, and just put it in a results framework instead.

 

[Terri and Lucy]

are you saying that I should try, say 2.6, and stick with it even with high numbers and only reduce if he goes low?

Yes, that is what I'm saying. Remember, Blackie is a cat. It's his job to baffle and confuse you. When you respond, you reward his mischievous behavior. :lol:

As for the insulin change suggestion, I'd give the consistent dose at least a week and a half to work unless he truly zooms up and stays there (or goes too low). During that time, I'd be trying to define the problem: does he consistently get 12 hours of coverage, does he get too big of swings from preshot to peak, etc. If at the end of the consistent dose experiment, you believe that you can't make PZI work, I'd look into Levemir. I have little to no faith in Lantus working for cats who have been on PZI for more than a few months, based on the PZI to Lantus cats I've followed over the past year or so.

 

[Ele & Blackie (GA)]

Thank you Terri. I will try that before I give up on PZI. Unfortunately, I could not find a vet in my area that would support Lev. I even gave my new vet info I got from Lev folks, but he is not comfortable with it. As it is, I may have found the only vet in my area that will prescribe Lantus. Most vets here only use Vetsulin or PZI (now ProZinc).

 

[Ele & Blackie (GA)]

I forgot to say, that yes, Blackie seem to love baffling us. And he does it with a straight face, "What's up, Mom?"

We're getting some late action on the 3.2 we gave this morning. When I get his numbers down to something "normal", we're going to stick with 2.6 for a week and a half and see what happens.