1/27 - Sami - PMPS 470

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Tina & Sammy

Tina & Sammy

Member Since 2010
Good morning all.

Sami is doing okay this morning. I left food out during the night, and made sure that it was taken away about 3 hours before I did her AMPS. I will be leaving food our for her again during the day.

Over night she didn't move much. At PMPS last night she was 390 and I gave her .5 unit. At +2 she was 454 and at +5 she was also 454, at +9 she was 425, and that is when I took the food away.

I hope she has some better numbers today, but I am now realizing that it is very possible that her spike of yesterday morning was probably due to the roller coaster ride on Saturday. I know I need to be more patient, but knowing her history I want to get her to OTJ as quickly as possible. I do know this isn't the best way to do it and I just need to step back and think instead of react.

I am so glad I decided to come back to this forum. I will be spending some time checking out the other posts and reading the suggestions in hopes that it will help me to get back on track.

Do many of you let your cats graze throughout the day and pull the food 2-3 hours before shot time? I seem to remember before that they were suppose to eat only twice a day just before the shot. But I also think grazing would be less impact on the blood sugar. Any thoughts on this would be greatly appreciated.

Thanks everyone for being there for me last night.
 
Tina & Sami said:
Do many of you let your cats graze throughout the day and pull the food 2-3 hours before shot time? I seem to remember before that they were suppose to eat only twice a day just before the shot. But I also think grazing would be less impact on the blood sugar. Any thoughts on this would be greatly appreciated.
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My cats, I have three now, were always grazers before Polly's diagnosis last April. They'd get canned and I'd just leave the plates down 'til the next meal. They'd eat a "meal" and then throughout the day snack.

Now, everyone's on low carb/low phos food, I feed at AMPS. Pick up plates a half hour later; they're off grooming indicating they're done for the moment! Then I test at AM+3, feed again. Those plates stay out until early afternoon when I get home from work. Sometimes someone eats; sometimes no one does. I try to keep Polly off food during the last several hours before PMPS...advice I once got suggested no food during the last half of the cycle when the insulin was waning. Doesn't always work for us, but I do keep everyone off food at least three or four hours before PM test time.

That's just us. ECID. And I think we all have to figure out what works best for our households. Small, grazing type feeds to tide everyone over between meals seems to work for us.

Marilyn and Polly
 
Max gets a little food at amps to chase his gel cap of amlodipine. Then I put out some canned which he eats between then and +2-2.5. Depending on those numbers and if he ate I feed him again then and the rest depends on his numbers. He is done eating by +6 unless he is low and I need to feed him to keep him from getting lower. He's been a grazer since he got chronic pancreatitis 5 years ago.
 
I just went home for lunch to test Sami, and she was at 499 at +5.

I am seriously wondering if I need fresh insulin. I know there have been some that have used a vile up to 6 months, but the product isn't even guaranteed after 28 days. I would love to know how long most of you use your insulin. I a really freaking out because of the numbers and I really don't want to wait another week or more to determine if the insulin I have is less or ineffective.
 
tiffmaxee said:
Both my vials lasted 5 months. By 6 I questioned their strength and stopped using.
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Thanks. I am just concerned because the couple of times that Sami has needed insulin since she went OTJ back in February 2010, she had two shots and then naturally regulated.
 
Plus, both times that she has needed insulin were when other feline family members were ill or had just passed.
 
Here's the link to yesterday's thread for Sami. We like to include those links in case people want to go back and see what was previously suggested.

I think Sami is just bouncing today from seeing blue yesterday. Bounces can take 6 cycles to resolve, although Sami got over the last one in 3 cycles. Time for patience. Stay the course.

By the way, we've often seen cats that come out of remission look quite different from the first time(s) they were on the juice.
 
Wendy&Neko said:
Here's the link to yesterday's thread for Sami. We like to include those links in case people want to go back and see what was previously suggested.

I think Sami is just bouncing today from seeing blue yesterday. Bounces can take 6 cycles to resolve, although Sami got over the last one in 3 cycles. Time for patience. Stay the course.

By the way, we've often seen cats that come out of remission look quite different from the first time(s) they were on the juice.
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Hi Wendy,

Thanks for the reminder about "Yesterday's Thread" I forgot about that. I am probably just going to get fresh insulin tonight because I still think that might be some of the problem. I guess if I see the same results with the new insulin than I will know for sure, but WONDERING is driving me CRAZY.

When you say 6 cycles, that would be 3 days, RIGHT, or is a cycle a full day (two shots)?

So much of this is coming back to me, but I have been re-reading all the information to refresh my memory on what I have forgotten. There is just so much information.
 
You might want to think about getting pens this time. That way if one goes bad, it's less insulin being thrown out. It's a slightly different way of getting the insulin out. There's a video in the Insulin Storage and Handling Sticky.

And yes, one cycle per shot, so 6 cycles is 3 days. There sure is lots to read and learn over again. ;)
 
Wendy&Neko said:
You might want to think about getting pens this time. That way if one goes bad, it's less insulin being thrown out. It's a slightly different way of getting the insulin out. There's a video in the Insulin Storage and Handling Sticky.

And yes, one cycle per shot, so 6 cycles is 3 days. There sure is lots to read and learn over again. ;)
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Yes, I am planning on getting the pens this time. That way if she takes two shots and then doesn't need it for a few months I won't waste an entire vile. It is more expensive in the short term, but much more cost effective in the long term. I have already watched the video on how to draw from a pen. I am sort of nervous because I haven't done that before, but I am sure it will be much like the vile.
 
Hi everyone, I am wondering if there is a time frame either before or after insulin that it is appropriate to give Sub-Q fluids. Honestly, I don't think Sami really needs them while her BG is so high because she is drinking a lot of water, but we have had her on a fluid regiment for some time and I would like to continue with it. Could someone let me know if I give her fluids 2 hours before her shot is that okay?
 
fluids help flush ketones, so if her glucose is high, I'd keep going with them, just to be cautious.
The most important thing is to shoot the insulin someplace away from where you gave fluids. If you gave them in front, shoot near the hip, for example.
 
BJM said:
fluids help flush ketones, so if her glucose is high, I'd keep going with them, just to be cautious.
The most important thing is to shoot the insulin someplace away from where you gave fluids. If you gave them in front, shoot near the hip, for example.
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So it doesn't necessarily matter about timing, but just about location of each. I typically give Sami her fluids between her shoulder blades, and her insulin off to the side of where I give fluids. Maybe I need to give the insulin more in the rear instead.
 
I gave punkin fluids at +3 when he was eating his second dinner and had his face buried in his bowl. So 3 hrs between the shot and the fluids - and I gave both around the scruff/shoulder area.

As long as they are separated by either time or place, i suppose it's probably ok. I don't KNOW that though, i just know you don't have them together. Maybe someone else will have more to add about it.
 
how old is your insulin? I see the note in 11/14 that the insulin was opened more than a year before. Then it looks like you opened a new vial right after that. It should still be ok from november.
 
julie & punkin (ga) said:
how old is your insulin? I see the note in 11/14 that the insulin was opened more than a year before. Then it looks like you opened a new vial right after that. It should still be ok from november.
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The current insulin that I have been using has been opened since November 24, 2014. If you look back at the spreadsheet September 10, 2013 was the first time Sami needed insulin since she went OTJ. This was just 10 days after one of our other cats died, and Sami and he were close buddies. Sami got two shots of 1 unit and was naturally regulated.

Then in November 2014 she started to read high again and I was using the same insulin that was opened in September 2013. There wasn't any floaties, so I gave it a shot. But after a couple of shots she didn't improve we took her in and got fresh insulin. Within two shots she was regulated again. There was suspect that she had an infection at that time, but I would think if the high BG was because of an infection it would have taken a bit longer to regulate her.

When she started to need insulin again in January 2015, I was still using the same vial from November. Because she has regulated so quickly in the past I was very much concerned that I had not stored the insulin properly, so I got 5 fresh pens today. Now I won't have to wonder.
 
Some people have seen lower numbers after fluids have been given, some don't. You might want to try giving them in the last half of the cycle.
 
well, that will relieve your mind, but i suspect it's not an issue of the insulin as long as you had it in the fridge. One way to test it out is to go ahead and start the new pen, but if you don't see a significant change in the BGs you know it's not an issue of the insulin being bad. Then if you want, you can go back and use the vial longer, then return to the pen.

just one option if you want it. most of the time when we suspect insulin, it's not it, it's just a matter of adjusting the dose. but once in a while it is bad insulin.

i suspect she may have been in higher BG numbers more than just the recent few days and her body's gotten used to them. It looks to me like she's bouncing from BGs in the 100's. I would hang on to this dose and give it longer for the bounce to clear, just as wendy suggested. If you're not familiar with bouncing, there is a description of it in the second post here.
 
Tina & Sami said:
Could someone let me know if I give her fluids 2 hours before her shot is that okay?
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The timing when giving sub-q fluids depends on the cat. It's one of those ECID things.

Some cat's BG numbers will decrease considerably after receiving fluids so you might not want to administer fluids when numbers are low or when onset occurs. OTOH, if your kitty's BGs are high and kitty drops after fluids, time giving fluids to work to your advantage.

Others kitties don't seem to be affected by fluids at all. My cat was one of them. I gave her fluids 15 minutes before shot and meal time. Some kitties will eat better after receiving fluids... something to keep in mind if kitty isn't eating well.

You do want to administer fluids away from where you're giving or have given the shot, but it can be as simple as shooting on the left and and giving fluids on the right.
 
Wendy&Neko said:
Some people have seen lower numbers after fluids have been given, some don't. You might want to try giving them in the last half of the cycle.
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Well, Sami dropped from 520 at +10 to 470 at PMPS after fluids at +10.5. I don't know if this was a drop from the fluids or the fact that she had not eaten for two hours. If it was from fluids I would be happy to give her fluids every day to see some drops like that.
 
julie & punkin (ga) said:
well, that will relieve your mind, but i suspect it's not an issue of the insulin as long as you had it in the fridge. One way to test it out is to go ahead and start the new pen, but if you don't see a significant change in the BGs you know it's not an issue of the insulin being bad. Then if you want, you can go back and use the vial longer, then return to the pen.

just one option if you want it. most of the time when we suspect insulin, it's not it, it's just a matter of adjusting the dose. but once in a while it is bad insulin.

i suspect she may have been in higher BG numbers more than just the recent few days and her body's gotten used to them. It looks to me like she's bouncing from BGs in the 100's. I would hang on to this dose and give it longer for the bounce to clear, just as wendy suggested. If you're not familiar with bouncing, there is a description of it in the second post here.
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That is what I figured. I used the new pen tonight. My thought is because she has been high for about 20 days now she may not regulate after just a couple of shots on new insulin, but I am still hopeful. The past two times I caught it early and she might have only been high for a day or two before I noticed the water drinking and tested her. Which I think played a big part in getting her back off insulin so quickly.
 
Jill & Alex (GA) said:
Others kitties don't seem to be affected by fluids at all. My cat was one of them. I gave her fluids 15 minutes before shot and meal time. Some kitties will eat better after receiving fluids... something to keep in mind if kitty isn't eating well.

You do want to administer fluids away from where you're giving or have given the shot, but it can be as simple as shooting on the left and and giving fluids on the right.
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Thanks I will definitely keep that in mine if she is not eating well enough. I just bought a bunch of new foods today that I want to work into rotation. I split the dish tonight with some of the new food and some of the old. Sami has a bad habit of turning her nose up at the better food options. I have been struggling for weeks trying to get her fulling back on Wellness, but she pretty much won't eat it. I guess I will keep trying.

I administered the fluids between her shoulder blades, and then when I shot I shot down more at the base of her rib cage on the right side. I hope that was far enough apart. I might try to get a couple extra readings at +1 and maybe +2 tonight just to see how much the fluids do effect her. Plus, the new insulin was given tonight too, so I am very curious to see if that helps her numbers as well.
 
the quicker the cat gets back into normal numbers the better the chances are for another OTJ. My understanding is that when a cat comes back out of remission, you have to be more aggressive if there is any chance of getting them back into remission again. Maybe you already know that, but just in case you don't, i thought i'd mention it.
 
julie & punkin (ga) said:
the quicker the cat gets back into normal numbers the better the chances are for another OTJ. My understanding is that when a cat comes back out of remission, you have to be more aggressive if there is any chance of getting them back into remission again. Maybe you already know that, but just in case you don't, i thought i'd mention it.
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I didn't know that, but know I am really wondering if I should have increased to .75 unit. Since I am starting on new insulin it is probably best to keep it at .5 and see what happens. As I look back at Sami's Spreadsheet from November she regulated back to normal after two shots of one at .5 and one a little less than .5. So maybe she will be okay at this dose, but again she has been high for 20 days and I am worried.
 
julie & punkin (ga) said:
the quicker the cat gets back into normal numbers the better the chances are for another OTJ. My understanding is that when a cat comes back out of remission, you have to be more aggressive if there is any chance of getting them back into remission again.
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Exactly. Julie's right. The sooner you can safely get Sami back into normal numbers the better.

Also, don't be surprised if you have to surpass the highest dose Sami was ever on last time to cause a break through this time. Alex went OTJ in 2006 after 3 months on insulin, went back on insulin in 2009, went into remission 8 weeks later for the the second time, and then back on insulin in 2010 because of liver and kidney disease. Each time she went back on insulin I ended up having to give her larger doses than she had before in order to cause a break through. We've seen this happen over and over again. It's all recorded on her spreadsheets if you're interested...
 
Jill & Alex (GA) said:
Exactly. Julie's right. The sooner you can safely get Sami back into normal numbers the better.

Also, don't be surprised if you have to surpass the highest dose Sami was ever on last time to cause a break through this time. Alex went OTJ in 2006 after 3 months on insulin, went back on insulin in 2009, went into remission 8 weeks later for the the second time, and then back on insulin in 2010 because of liver and kidney disease. Each time she went back on insulin I ended up having to give her larger doses than she had before in order to cause a break through. We've seen this happen over and over again. It's all recorded on her spreadsheets if you're interested...
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Thanks I will definitely take a look at that tomorrow. I am off to bed because I want to get up a couple times during the night to check Sami.
 
BJM said:
The most important thing is to shoot the insulin someplace away from where you gave fluids. If you gave them in front, shoot near the hip, for example.
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ECID, and this is exactly what I had to do with Trix's fluids when she was on insulin. No matter how much time I had in between the two, if I shot both fluids and insulin in her shoulder, she dropped like a rock...it was pretty scary. The one thing that did prevent the big drops was doing the fluids over her shoulder, and insulin on her flank. She didn't love the flank shots, but got used to them.
 
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