1/20 Ozy AMPS-408,+6-347,PMPS-336

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donaleen and Ozy

donaleen and Ozy

Member Since 2013
http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=111918

We are losing the battle here. He is on the verge of red and mostly flat for the past two cycles. We had thirteen good days and now this.

The thing is, he doesn't mostly shoot up. He is just high and flat. And I think this is the worst his numbers have ever been.

I've read and read about R. But it doesn't seem to cover how Ozy is.

I want to shoot R this morning. Help.

Jill said this in Ole's condo a couple of days ago.

"btw, yet another way to use R:
using R to pull numbers down enough for lantus or lev to "grab onto" appears to have been a forgotten technique in this group as of late. it's a method which is not restricted to high dose kitties. jojo, my mentor here on the FDMB, likened R to walking into a jungle and using the R as a machete to cut through the dense undergrowth. this will allow the lantus or levemir an easy entry into the dense jungle of high numbers. it's a method i've used and used successfully to pull alex's numbers down when she's sick or when i've had to skip shots for one reason or another. well documented examples can be seen on her spreadsheet over the last couple of years."
 
Re: 1/20 Ozy Help with R

Hi guys .. I'm sorry ozy is so high .. I know that is sad to see .. I don't have any experience with R myself but I hope others who do will stop by soon .. Hang in there guys, you'll get it figured out .. have a great day!
 
Re: 1/20 Ozy Help with R

It is possible that Ozy is still bouncing from that blue on 1/18. But he's pretty high. I don't want to see him come down fast and start a dive/bounce so if you decide to give it, you need to give only a tiny bit.

If you decide to try it, Why don't you pull up 0.1u R and let's see what his AMPS is....it will probably be the same or close. You can give the R when you give the levemir but be sure you give it in a different location in the scruff.

Also...be sure you pull up the doses separately and keep track of them...you can mark the levemir insulin syringe with a black marker but you want to be sure you do not draw up 6u of R and 0.1u of lev.

You will need to check him every single hour.

What do you think?

Eta: while I agree with what you quoted as being true....that R can be used to bring numbers down in a sick cat (and I listed that as a reason on the same condo only I was more specific and referred to DKA), I think a member using R for the first time needs to be very cautious about using it to pull numbers down. By cautious, I mean they need to have experienced eyes on the SS to make sure there is not something else possibly going on. And that is why I am letting you know, he could potentially be in a bounce but as long as you are there to monitor the numbers and you give him just a tiny bit, it's your decision.
 
Re: 1/20 Ozy Help with R

I think I want to ....

I think Ozy's body is not even allowing yellows now.

I gave him R on the 12th.
 
Re: 1/20 Ozy Help with R

Hi Donalean,
I have been away and am not up to speed. For Harley, if the 400 did not go down much, I would give 0.1 R. I will let others weigh in, but that might help him. Let's see what amps brings.

Pattie
 
Re: 1/20 Ozy Help with R

Hi Donaleen,

Just be vigilant like you were the first time. Reread that condo to help you pass the time and re-familiarize yourself with how Ozy responded and what Sandy and the others said in response to Ozy's response. You're only shooting a drop, right?

I have no experience with R just yet, but I'll be online and check in for moral support! I followed his first dose pretty closely. :-)

~Suzanne
 
Re: 1/20 Ozy Help with R

Thanks, Suzanne :-D

donaleen....I also see from his SS that if you give him 6u this morning and tonight, that will be four cycles at 6u. If you are thinking about increasing by 0.5u tomorrow to 6.5u, I would think closely about whether you want to give R today. If you give the R, just keep in mind that we will then need to be sure we thread out what is R action and what might not be and that you "might" have to delay an increase. Or you might not but we have to be flexible.
 
Re: 1/20 Ozy AMPS-408

Ok. I am not meaning to overwhelm and I apologize if I did.

If you shot R, please be sure and get the hourly tests and post if you need help.

I found a quote I was looking for that I couldn't put my fingers on fast enough earlier that goes back to my above comments on shooting R today and dose increase tomorrow.

Jill and Alex said:
those of you who are making dosing recommendations have to juggle the use of R with results from using R in your dosing decisions. for instance, ole saw R induced blue numbers yesterday. by protocol standards, you'd hold this dose for now or at the very best... increase by 0.25 unit. julie's calling for an increase of 0.5 unit. careful thought will have to be given when increasing the dose while using R and in absence of a confirmed high dose condition.
Click to expand...
 
Re: 1/20 Ozy AMPS-408

Hi -

I don't know if you caught the last few posts yesterday on Ole's thread, but I'm one of the ones who suggested using R to "jump-start" his preshots. With ProZinc, we based our dose and any use of R on the preshot. With Levemir, it's based more on the nadir. So if you're staying flat in the upper pinks and reds, I would suggest either aggressive dosing until you start to see real movement, or using R. As has been noted, you should NOT use R unless you'll be around to test hourly for the first 4-5 hours. I was VERY reluctant to use it, but it became my friend and was one of the many tools we use to help regulate our kitties. If I can offer any coaching if you decide to go that route, I'll be glad to offer my experience.

It was suggested to me that it would be better to discuss here, rather than in PMs. That's fine. What I actually meant was to have a phone conversation, like I had with another R user a few months before I actually started using it. The phone seemed to be a more efficient means of doing so, but I understand the need for transparency here. I didn't mean to break any rules. Sorry.

Lu-Ann
 
Re: 1/20 Ozy AMPS-408

just checking in on you, donaleen. :YMHUG:

i think you have enough data and enough experience to give him the 0.1uR. i would say based on his spreadsheet, that sooner is better than later if you want to do it today.

What happens from that will give you data that you can use to decide on future Lev increases, ie, if this pulls him down you might not want to increase the lev just yet.
 
Re: 1/20 Ozy AMPS-408

Thank you Devon, Marje, Patty and Suzanne. I appreciate your time and your thoughts.

I had a good cry. It may not be over.

First, John and I have agreed we are raising his Levemir dose tomorrow morning, and intending to increase every four cycles until he gets a decent green nadir (and I don't mean a 97). I suspect we will have to go above his highest dose of 6.5 to get there. And I don't want any false nadirs caused by R.

Since he is pretty flat and the R could muddy the waters, we aren't giving R right now after all.

I still find R confusing. Is it only for faster bouncing cats than Ozy? Especially on Levemir, Ozy is flat a lot.

I don't understand how to with pancreatitis attacks. What more could I have done to control his numbers then?

And I am still terrified of ketones....

Looking back at his SS, I don't think we should have reduced beyond 5.5.... so easy to see in retrospect and so hard to see when I REALLY needed to.

edit: Thanks, Julie and Lu-Ann.
 
Re: 1/20 Ozy AMPS-408

((((Donaleen)))) no, it's not over.

What you have noticed with Ozy can happen to ANY cat, regardless of whether or not they have IAA. If you take a bunch of reductions in quick succession, often you'll get to a point where the reductions will not hold, the cat loses momentum, the numbers go back up. Look at my Lucy's spreadsheet. Her highest dose was 4.25u, she broke through, earned a lot of reductions down to about 1u very quickly. Then all of a sudden the high numbers were back and I had to work my way back up to 4.25u to get another breakthrough. It was frustrating as all get out. I cried, I blamed myself. I bought new test strips, new meters, new syringes, new insulin. It wasn't any of those things, she just needed to go back up in dose and give it another try. That happens with most cats.

I was lucky that Lucy only needed one more try and she went all the way OTJ. Others go up and down in dose for a while, but it's nothing that you did wrong. You have no choice but to take reductions when the cat needs them, all you can do is be responsive when they suddenly start needing more juice again. Give him whatever he needs and don't let that make you feel bad.
 
Re: 1/20 Ozy AMPS-408

(((Donaleen)))

I couldn't agree more with what Libby said. You may read in other condos that, "Sometimes you need to go up (in dose) before the numbers come down." Gabby was doing great at 0.75u and then pink. I've steadily increased her dose and we're seeing better numbers again. For as long as I've been at this, I still feel like maybe I missed something, held the dose too long, etc. when I see a consistent change in Gabby's numbers. We all really care about our kitties and know that we have taken on the responsibility for a life. If you didn't care and didn't want to do your absolute best for Ozy, this would be so much easier!
 
Re: 1/20 Ozy AMPS-408

Hi Donaleen -

I've spent MANY MANY hours studying spreadsheets of several of our Acros/IAA kitties for how they went OTJ. I never had problems with the increases for Grayson, though I freaked a lot of people out along the way, but decreases were another story. And one of the spreadsheets that I spent countless nights studying - Perry's Sooty, the most infamous highest-dose acro, was most helpful. I saw how he waffled up and down as he was decreasing. So it's not uncommon for a kitty to drop dose, then climb again, only to drop again. Looks like a sine curve with a gradual decline.

You are not doing anything wrong! As their caregivers, we have control over three things: their food, the insulin, and any other meds/treatments that they need. The other variables, like how their body is responding to these, is completely out of our hands! Unfortunately, they can't tell us what else is going on, so we end up playing this game with them, and trying to make the best decisions we can along the way.

That's part of the value of this board - others that have been in your shoes, and the wisdom share & support given. Since the kitties don't give up all their secrets, it sometimes takes a while to make some sense of it all. You WILL get there. Sometimes it just takes time. I've said it a million times, but Rome wasn't built in a day. Just meet each day as it comes, and know that (other than the shed), the next cycle is just 12 hrs away!

Lu-Ann
 
Re: 1/20 Ozy AMPS-408

((((donaleen))))

Actually, the faster a cat clears it's bounces, the less you want to use R.

You could have used R during the pancreatitis attacks to bring the high numbers down. While he seemed to do ok on numbers during his attack, there were other times you could have used it. For instance, I might have shot it at +9 on 1/17 and then waited to see what it did before increasing the dose.

One thing I would encourage is to not increase the dose after only two cycles. If he's red and pink, you can increase after every four cycles if you aren't using R. If you are using R, then we just need to carefully determine when you should increase the dose.

Hindsight is always best for all of us. As the others have said, we've made decisions on reductions or increases that maybe weren't the best or didn't go the way we had hoped. But we did what we thought was best and then we monitored.

I have faith that Ozy will do well again under your management of his Fd and your love for him.
 
Re: 1/20 Ozy AMPS-408,+3-407

Thanks Marje, Libby, Sienne, and Lu-Ann.

I was terrified of what his +3 BG might be. Now I am terrified of +6.

Still don't understand R.
 
Re: 1/20 Ozy AMPS-408,+3-407

these high numbers could be just New Dose Wonkiness. It's common to see higher numbers the day after a dose increase as the insulin depot adjusts to the new dose size (and it was a good sized increase, so it's not completely unexpected that the NDW could be fairly good sized too). If this is NDW, the numbers should start to come down tonight or maybe tomorrow. My suggestion at this point is to wait and see what happens tonight, and tomorrow morning decide what to do based on that.
 
Re: 1/20 Ozy AMPS-408,+3-407,+6-347

Thanks, Libby. It looks like he is coming down a bit. This is usually his high and he is down 60 points. Happy to see pink. On the other hand, not happy to be happy to see pink, if you know what I mean.
 
Re: 1/20 Ozy AMPS-408,+3-407,+6-347

Donaleen, hang in there. You're doing your best and you're getting some great advice. Unfortunately there will always be ups and downs. :YMHUG: :YMHUG:
 
Re: 1/20 Ozy AMPS-408,+3-407,+6-347

Just when we were breathing a sigh of relief, Ozy threw up violently. He threw up newly eaten food and further digested food and clumps of hair.

He was feeling very good. He was lying on John's chest purring and kneading. And then he got violently ill and doesn't feel so good. I hope this doesn't signal an acute attack of pancreatitis.

He has had really violent attacks of pancreatitis but not for a long time.
 
Re: 1/20 Ozy AMPS-408,+3-407,+6-347

It might be a hairball. Do you have any Pepsid AC in the house? 1/4 of a tablet might help to settle Ozy's tummy and it won't be a bad thing to give if this is pancreatitis.
 
Re: 1/20 Ozy AMPS-408,+3-407,+6-347

Thanks, Sienne. We gave him a quarter tab of Pecpcid AC. And I loaded some bupe but was going to space them out a little.

I don't think he is digesting well. I recognized clearly the chicken I gave him 6 hours before he threw up. He had a second violent episode but there is nothing left to throw up except a yellowish liquid. I hope to hear back from my favorite vet tech soon. His vet is not in today.

If it is an acute pancreatitis attack, he hasn't had one since March 2013. He was sick a lot with those in the summer of 2012. But once we got him on a good diet, he seemed to stop having those.

Five days ago I started giving him a little curcumin for inflammation. Maybe that wasn't such a good idea. It was only a small amount.
 
Re: 1/20 Ozy AMPS-408,+3-407,+6-347,+9-358

i don't know much about curcurmin, so i looked it up after you mentioned you were giving it to him. looks like it's great for diabetes! i hadn't heard of it. it doesn't seem to have much in the way of carbs in it - i was wondering if it could explain the past few days of his BGs being higher.

but it still could be a factor. Five days ago is when this unusual run of pinks and higher numbers began. Look at his spreadsheet and compare the past 5 days with the 5 days prior. Since he's sick, i'd be even more suspicious. i think i'd stop giving it and see if he improves.

poor little guy. i hope he feels better soon. hugs to you too! julie
 
Re: 1/20 Ozy AMPS-408,+3-407,+6-347,+9-358

Hi there :cool:

I wanted follow up on something you mentioned a while back-when Ozy had the follow up to his dental. . .
If memory serves there was one area or spot that was still a bit red.

Has it resolved?

BK went from 13.5uL plus 12u R (or so ) per cycle down to 3u Lantus and no R in the 4 months or so following his dental.
Then the pink an red reappeared. It was like having the rug pulled out from under me.
We had to start steadily increasing. in around 5 weeks we were up to 5.25u with the occasional 0.5u R.

We naturally assumed it was the IAA, the condition that no other LL kitty (that we are aware of) had. Now what?
It looked and felt hopeless.

Long story short - a few more of his back teeth were going bad and gingivitis had returned.
It was another trip to the dentist.
After that it was a trip to the Falls.

eta-I agree with Julie - since it wont do any harm to do so - eliminate the curcumin. It's a recent addition and an unknown variable.
You can always add it back.
 
Re: 1/20 Ozy AMPS-408,+3-407,+6-347,+9-358

Thanks Julie and Sandy and Marje for checking on us. Ozy seems to be doing better. He ate. He had his bupe and has perked up.

As to his teeth, I talked to the vet about it. She thinks he is okay.

We are pretty exhausted.
 
Re: 1/20 Ozy AMPS-408,+3-407,+6-347,+9-358

so glad he's feeling better tonight!

the only good thing about his high numbers - you get to sleep. he's giving you the night off. :YMHUG:
 
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