1/9-Flame AMPS=312, PMPS=320, +3.5=307

[Donna and Flame]

Morning,
Same as PMPS last nite. Back to stinky pinks. Beginning to wonder what's up here. Almost tempted to open a new pen of Lantus.

I bought this insulin from someone who posted in the supply closet, who is not a member here, but was using this insulin for himself till his DR changed his insulin. He found out about this board and said he wanted the insulin to go to good use and he's an animal lover. I picked it up from him myself and met the guy so it wasn't shipped or anything. The boxes were unopened, kept refrigerated and have an expiration date of 2/1019 so everything looked good to me.

The first day or so, I did shoot some bubbles and insulin back into the pen, but it doesn't look funky at all.

Maybe I'm grasping at straws, but just can't understand why his numbers are not moving at all.

Have to run... of to TBP...

Have a good day all!!

 

[carfurby (GA)]

To me it doesn't look like you have bad insulin. You usually see numbers all over the place if it's bad insulin. You are seeing more yellow now and less pink. Flame is slowling making progress. I know it's hard to be patient, but the best thing you can do is follow the protocol. You don't want to rush things and miss a good dose. Hang in there.

 

[Donna and Flame]

Thanks Carla. I really do appreciate the encouragement. Sometimes this sugar dance is very hard on both the kitty and the human who loves them so much.

 

[carfurby (GA)]

Yes it can be. We have a saying around here: It's a marathon, not a sprint.

 

[Doodles & Karen]

I agree with Carla but Flame is going to need more juice so I'd increase when you can. Is there a reason you're following SLGS instead of TR?

 

[DebG]

Donna I see progress.... I agree with the others don't think anything is wrong with the pen.
Sometimes it takes longer to see better numbers. Remember with Flame on oral pred, you will see higher numbers till you reach a point where the dose of insulin balances out the numbers from pred. Like Karen mentioned when you can increase and monitor I'd increase.

 

[Donna and Flame]

@DebG I started the Flovent. I have to speak to my vet about how long he should be on it twice a day before we start weaning him off the pred and also how to go about weaning him. He is on 2.5 mg per day now.

Deb, I know you said that it take about 2 weeks of twice a day treatments to really see an effect from the Flovent, but at what point do you start to wean the pred? He is still fighting the mask, but I have been able to do it and get him to take the required number of breaths... although he does get out of the mask a few times and I have to put it right back on.

@carfurby If I am going to start weaning him off the Pred, I need to be careful with dose increases. This dance will get even more touchy and interesting and I'm away at work all day with no one to check on him and too far away to go home at lunch, etc.

 

[carfurby (GA)]

@carfurby If I am going to start weaning him off the Pred, I need to be careful with dose increases. This dance will get even more touchy and interesting and I'm away at work all day with no one to check on him and too far away to go home at lunch, etc.

You have special circumstances with the pred for Flame. You do need to be careful. You may have to remind us that you are weaning him off the pred. If you are planning to start soon, I'd hold the dose for now.

 

[DebG]

Donna hopefully within 2 weeks you should see Flames asthma settled down I mean no more coughing attacks you won't hear any congestion or wheezing. Most cats need to be bumped up to the 220 Mcg. but it's always better to start with the 110 Mcg. as if that's all it takes to manage the asthma. It's really important to have the Albuterol on hand.
When you start to taper off the steroids you will have to slowly lower the insulin.

 

[Donna and Flame]

@DebG Because he's been on the 2.5 mg of Pred daily since before Christmas, his breathing is fine now. No coughing, no wheezing, no congestion, nothing. So, I've been just starting the Flovent for the past 2 days in preparation for weaning off the pred, but am not sure if I'm supposed to start weaning him off slowly immediately upon starting the Flovent or after he's been on it steadily for a week or how this whole weaning process is supposed to work.

I'm very nervous about this because I'm not home during the day to monitor.

 

[DebG]

I would take it slow when your able to get both the am and pm puffs in for a minimum of 7 days slowly taper Flame off pred. Are you giving 2.5 pred morning and night 12 hours apart? or is it a total of 2.5 mg per day? I'd taper to 1.5mg for a week then 1mg for a week then 1mg every other day for a week then off. That is how I do Fritz. They need the Pred more at night than during the day so the last week on one dose a day I always do it at night.
You can talk to your vet too. Any way you can use a video camera in the home to monitor and watch from your cell phone live?

 

[Donna and Flame]

Hi @DebG ,
I am currently giving him 2.5 mg Pred only once a day in the AM. If I have 5 mg pills, how do you get 1.5 mg or 1 mg? I tried cutting those little pills in quarters when we were trying to reduce his dose and even with a pill cutter, they did not cut evenly so the dose was not exact. I've never heard of Pred pills in those strengths (1.5 or 1 mg).

I'd certainly entertain the idea of a video camera, but even if I had one and he was in trouble, it would take me a minimum of 45 minutes to get home if I dropped everything right at that second at work and ran out the door, so I'm not sure I could get home in time to even help him.
It's an awful feeling not knowing what's going to happen when you leave him. Right now, his numbers have been high so I don't worry so much about hypo, but I am worried about that when I start weaning him. My stomach is in knots even thinking about it.

Thanks for all your help!!

 

[DebG]

I am worried about that when I start weaning him. My stomach is in knots even thinking about it.

Fritz gets liquid. Is it possible to switch to liquid? I get it from Walmart and have a special applicator syringe that you shake it up tip upside down and draw out the exact amount.
As far as weaning him off and watching his BG you might have to give BCS (Big Chicken Shots) do you know how he responded before when he was on insulin? I know Fritz 's patterns on his cycles.
Example if Fritz is on 8 units and I know the depot is building and I have to be away and can't monitor I give less insulin and you would need to leave plenty of food out. Do you have a cat food dish that can be chilled and that opens at specific set times? A lot of the beans use them for both day and nights.

Is Flame a pretty predictable cat with his numbers? Do you know how he reacts? Fritz numbers are pretty flat till the depot builds then I know I better be there for him.

Hopefully others will be able to respond to this too!

I know all this brings on uncertainty but your doing awesome. Bad his numbers are high but this is a good time to learn how his cycles go.

I'm more familiar with the TR protocol, but I'll read the SLGS protocol.

Any way he can go to work with you on the days your wondering if he'll go low? Just a thought?

 

[Donna and Flame]

@DebG ,
Vet suggests staying on 2.5 mg daily pred for 1st 7 days of Flovent, then taking him down to 1.25 mg daily, then down to 1.25 mg every other day for 5 days, then off if he's doing OK. She has 2.5 mg tablets which I can break in half to get the reduced dose. I will likely begin to wean him off the pred either starting Thur evening or Friday AM since I work at home on Friday and can monitor over the weekend. Even if I have to go out for a few hours over the weekend, I can still get mid-cycle checks.

It was a long time ago (8 years), but as I remember he always had pretty flat cycles. I was always very cautious because I had to leave him, so didn't shoot low (below 150) or gave a reduced dose (BCS) when I couldnt' be here.

I just can't figure out any pattern with him right now. I look at his SS and it seems he does a 'little' better for the 1st couple cycles at a new dose and then goes back up. You would think it would be the opposite since it takes a few cycles for the depot to build. His cycles have been so flat that I can't even identify onset and nadir really. I'm just not getting it.
Would love if some more experienced members could take a look at his SS and tell me what they see.

Unfortunately, no. I wish I worked in a pet friendly company, but I'm an IT project manager and work in a professional office, so bringing him to work is not an option. However, there is an old FDMB member that lives not too far away and she is out of work right now. Her cat, now GA, was on insulin around the same time as Flame last time. I am thinking of talking to her to see if she'd be willing to stop by during the day for a few weeks to a month if I pay her since she knows how to test and what to look for. That is the only option I can think of right now to keep him safe while I am at work.

Held off on testing tonite till +3.5 hoping to catch onset, but still pretty flat and in the pink.

Have to go to bed if I have any hope of making my early meeting tomorrow AM.

Night night to all the kitties and beans. Sweet dreams and safe surfing....

 

[Wendy&Neko]

I just can't figure out any pattern with him right now. I look at his SS and it seems he does a 'little' better for the 1st couple cycles at a new dose and then goes back up. You would think it would be the opposite since it takes a few cycles for the depot to build. His cycles have been so flat that I can't even identify onset and nadir really. I'm just not getting it.

It's early days yet. Things like onset and nadir will become easier to identify when he starts getting into better numbers and has more of a curve. Some kitties will respond to an increase right away, see some lower numbers, then bounce. Which may make it look like he's going back up. To me it just looks like he probably needs more insulin. And insulin isn't like medicine where you add more and see incremental improvement. It's a hormone. Sometimes you'll see frustratingly little progress with each increase until you that that dose where things finally start to happen. Hang on, you'll get there.

 

[Donna and Flame]

Thanks @Wendy&Neko for the encouragement. I'm holding the dose for now because I plan to start weaning him off the pred in a few days since he's on the Flovent now. Don't want to increase dose again and wean off Pred at the same time. I'm hoping that's the right thing to do.