11/10 Chianti amps 405, why worse?

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itzj

itzj

Member Since 2014
Chianti's numbers just seem to be ratcheting up with every dose increase. I don't understand why.

I feel totally lost and like I'm doing more harm than good. Neither one of my vet options feels right - one feels loosey goosey and the other feels like while she could be good, hasn't had any diabetic patients in a long time (had no idea what levemir was when I asked about it). My husband is great at testing and shooting, but is doing no research or thinking on any of it. I am stressed out with homeschooling/parenting, so I feel like Chianti isn't getting top priority and it is hurting him. Neither vet is addressing my questions properly.

I'm splitting his meals into 7am, 11am, 3pm, 7pm, and sometimes 12am to minimize him going to the other cats' food. If I don't feed him frequently he begs for it. Some days he is perky, others sleepy but perks up when you go to him.

I just have no idea what I am doing. :?:
 
Okay very first step BREATHE!!!! That's right nice long i-n-h-a-l-e and now slowly e-x-h-a-l-e. There now don't you feel better?

Okay if the numbers only get worse as you go up in dose then there is only one thing to do and that is turn around and go down in dose and see if each step back down the dosing scale doesn't give you better and better numbers.

What I would do if he was one of mine is I would drop back to 1.25 (basically cut the dose in half). Make sure I got preshots, and any random spot checks I could but wouldn't stress myself out for them on those days when your juggling 500 plates in the air. Then take a day where you can set aside the time and run a complete curve where either you or your husband or both of you, grab a test every 2 hours between one shot to the other. Right now the problem is you don't have a lot of mid-cycle data to figure out if he's dropping too low or too fast and just bouncing like a rubber ball or if it just isn't enough insulin yet. If you do decide to drop back and see if that helps, at least try to get frequent ketone tests in, if not actual bg checks.

Mel and The Fur Gang
 
Would it be better to immediately cut the dose or get some mid testing in over the next 2-3 days? It is easier to get mid numbers in the evening than the day. I would wait until the weekend to just curve him to see what's up, but these numbers keep climbing and that makes me nervous too.

Let's say I cut the dose in half but he does need the higher dose, what happens health wise to him? Do I risk any kind of emergency situation? And, is BG testing more important than the ketones? I haven't added that to our monitoring, in part because I almost never see him go to the litter box and because we have 11 cats.

Can I ask what are the different factors that cause bouncing? I know too low causes it, but is there other stuff too?

Sorry for so many big feels (big infj here). It's just so disheartening to see his numbers going up instead of down. I stupidly assumed that his numbers would improve from where we first were but it just seems to be the opposite, we're creeping up. Every single time we got a nicer preshot number then bamo bounce up stay up.

Thank you so much for your help and for trudging through my worrying. I don't really have anywhere else to get support at the moment.
 
I remember that sinking feeling when looking at high numbers. :sad: I can't help on the dosing stuff, but I can send you one of these ------> :YMHUG:
 
Okay things that can cause a bounce.. Dropping dangerously low. Dropping too fast as in going from 400 at preshot to 200 in a couple hours, or going lower than they have been in awhile. I kind of liken it to when you first go on a diet and even though you in your head know that you just finished a meal of healthy size portions and you should be full because that is what a person of normal weight eats to maintain a healthy weight because your body is use to being fed more at a sitting your stomach is still growling at you telling you that you are hungry. But the longer you stay eating that normal size meal your stomach starts to adjust and you slowly start feeling more and more full on the same size portions. That is kind of what their bodies are doing, they have gotten so use to running in the high numbers that even lower high numbers makes them feel like they are about to go into hypo range (still hungry in the diet metaphor) so it kicks out stored sugars to jack the numbers back up, the longer we keep them down the less they bounce back up.

In the high numbers ketone test are vital. Anything over a trace is an immediate trip to the vet's. While ketones themselves aren't terribly dangerous they can quickly turn into DKA which is life threatening. So which is more important ketones or blood sugar testing BOTH!! They are equally important when the cat is still unregulated and in the sky high numbers. Once the cat is staying in the 200 or below range then ketone testing isn't quite so vital as they seldom happen in the lower numbers but they can happen at anytime especially if you get the perfect storm of not enough insulin + not enough food + infection because that can easily turn into DKA, which is not only life threatening but extremely expensive to treat as it usually requires 24 hour care at a vet hospital usually an ER facility where the cat can be monitored 24 hours a day.

I would try for both as far as testing goes regardless of if you drop back in dose or not just yet. But if he was mine I would drop back in dose either tonight or tomorrow morning and then try to get in as many spot checks as I can, then on a free day this weekend run a curve to fill in some of the holes in the spot checks that I didn't get during the week. If that makes sense.

Mel and The Fur Gang
 
Ok going to mull all this over for a few hours. And of course this morning his amps was 259. I'm going to try to test him at lunch when he begs for food to see what is going on.

Mel thank you for all the one on one help you are giving me. I hope that someday when I am experienced enough in all this, that I can pass this kindness along as well.
 
Aw shucks hon,

You already have experience to share with others...Okay so you haven't been at this dance as long as I have been. But you are doing it, you are treating Chianti, you have learned to test, you have gotten over your fear of poking ears and sticking needles in your best friend. You have changed his diet. You got a spreadsheet up. You've lost the glazed over deer in the headlights look and the racing heart that comes with hearing the words "Your Cat Is Diabetic" You are now experienced in those areas.

And those areas of experience are of value to share with the next generation of scared stiff newbies. Because if it wasn't for those of you that have at least gotten that far in this dance then the old-timers like myself would be spending all our time over on Health holding hands with the newbies walking them through how to test, when to test, how to get a spreadsheet up, helping with diet change tips and tricks instead of where we are, over here in the ISGs guiding the second year class on the more complicated dance moves of getting your kitty regulated, then tightly regulated and possibly into remission.

You are the ones that can talk the new sugar-cat parent off the ledge...Why? because it wasn't that long ago that you were right in their shoes. When I first arrived here, my first girl didn't last more than a few days after she was dxed before earning her wings. But I hung around, just I stayed pretty much on Grief, because I knew I couldn't help with the whole Sugar Dance, but I did know the gut wrenching pain of losing my best friend. I could offer words of understanding and comfort there. And then the urgent plea to save Maxwell came in and I stepped up for him. And again he spoiled me rotten by going OTJ quickly. Now I had experience to be over on Health..I knew how to change diet in a multicat household, I knew how to test, I knew how to inject insulin etc so I moved from Grief to Health and even with Maxwell going strong in remission I hung around, then again the Universe sent me Musette, and Oh Boy! did we dance in that year we had together, she broke every sugar cat rule there was. But she taught me well. So now I have Autumn and Cassanova. I very easily could have picked up my toys and gone home after Musette went to the Bridge, but I didn't because it seemed wrong to take what I knew and not honor Muse and Musette and even Maxwell by not adopting another extra sweet kitty. And when Autumn or any of the other members of the current Fur Gang earns their wings, they too will have their spot on the bed and couch filled by another extra sweet kitty.

Mel and The Fur Gang
 
MommaOfMuse said:
Aw shucks hon,

You already have experience to share with others...Okay so you haven't been at this dance as long as I have been. But you are doing it, you are treating Chianti, you have learned to test, you have gotten over your fear of poking ears and sticking needles in your best friend. You have changed his diet. You got a spreadsheet up. You've lost the glazed over deer in the headlights look and the racing heart that comes with hearing the words "Your Cat Is Diabetic" You are now experienced in those areas.

And those areas of experience are of value to share with the next generation of scared stiff newbies. Because if it wasn't for those of you that have at least gotten that far in this dance then the old-timers like myself would be spending all our time over on Health holding hands with the newbies walking them through how to test, when to test, how to get a spreadsheet up, helping with diet change tips and tricks instead of where we are, over here in the ISGs guiding the second year class on the more complicated dance moves of getting your kitty regulated, then tightly regulated and possibly into remission.

You are the ones that can talk the new sugar-cat parent off the ledge...Why? because it wasn't that long ago that you were right in their shoes. When I first arrived here, my first girl didn't last more than a few days after she was dxed before earning her wings. But I hung around, just I stayed pretty much on Grief, because I knew I couldn't help with the whole Sugar Dance, but I did know the gut wrenching pain of losing my best friend. I could offer words of understanding and comfort there. And then the urgent plea to save Maxwell came in and I stepped up for him. And again he spoiled me rotten by going OTJ quickly. Now I had experience to be over on Health..I knew how to change diet in a multicat household, I knew how to test, I knew how to inject insulin etc so I moved from Grief to Health and even with Maxwell going strong in remission I hung around, then again the Universe sent me Musette, and Oh Boy! did we dance in that year we had together, she broke every sugar cat rule there was. But she taught me well. So now I have Autumn and Cassanova. I very easily could have picked up my toys and gone home after Musette went to the Bridge, but I didn't because it seemed wrong to take what I knew and not honor Muse and Musette and even Maxwell by not adopting another extra sweet kitty. And when Autumn or any of the other members of the current Fur Gang earns their wings, they too will have their spot on the bed and couch filled by another extra sweet kitty.

Mel and The Fur Gang
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well said...I am still very much a new sugar cat parent on the edge - but not quite as close to the edge as a month ago!
 
So we are still haven't cut the dose yet. Our house got hit with a stomach bug so that's been fun. And DH called the vet and she freaked out about cutting the dose and thinks we should raise it again. We are talking about having the traveling vet possibly come out because he has started grooming the fur off of his belly.

Anyhow, we ran a 12 hour curve testing every 2 hours for that span. That was the best we could manage amidst the puking toddler. I've put those numbers into his chart.

Tonight his pmps was 240 after all these crappy numbers. I'm expecting a bounce in the morning because of it.

Dh wants to raise him. I am afraid to raise him and afraid to lower him.
 
Amps 410 as I predicted. So frustrating that he can't stop wigging over a nicer number.
 
Well I'm going to have to side with the hubby and say raise him again. I just looked at his spreadsheet and he is staying pretty flat regardless of the dose at the moment. Yes, he's had a few really high highs and a few decent numbers but overall it still looks like just not enough insulin. Lantus is kind of tricky that way, as it doesn't do a lot until you get close to a good dose and sometimes you just have to keep going up in dose to come down in dose. They get almost like a wall built up and you have to find a dose that breaks that wall, before they start giving decent numbers consistently.

Once you break-through that wall often times then their doses start falling again.

Mel and The Fur Gang
 
Is there anything I can do on my end to help him tolerate the lows better so that he might not bounce so much?

Feeling a little sad about raising the dose. With each ratchet up he is fighting the shots more. Ear pricks he is a saint, but we are getting torn up at shot time.
 
itzj said:
Is there anything I can do on my end to help him tolerate the lows better so that he might not bounce so much?

Feeling a little sad about raising the dose. With each ratchet up he is fighting the shots more. Ear pricks he is a saint, but we are getting torn up at shot time.
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I don't know when you're giving the shot - but I give mine to Silver when he is eating....he's too busy eating his food, he doesn't even look up when I give him the shot. I am even putting his methyl pill right into his food and he eats it like its candy. Maybe my cat is just a greedy boy, but if its food - he's happy. (hmmm, wonder what you do with a diabetic cat who loves ice cream???!)

Juliet and Silver
 
Bounces I'm afraid just happen until they stop. Sadly. The other option would be switching to levemir as it doesn't sting like Lantus. Autumn was extremely sensitive to the Lantus sting and tore me up at shot time moved her to Lev and now she doesn't even blink.

Mel and The Fur Gang
 
We've tried shooting during food, holding the food as a reward, etc. First he hates having his skin messed with. Second ever since we hit 2 units he's really balked at the shots.

Mel was switching to levemir a big procedure?
 
Ok so I guess we'll up the dose and see what happens again. I hope at some point we get out of this bouncy land.
 
It wasn't too hard for me, to switch Autumn since at the time my mom was still alive and diabetic on Levemir so I just asked to borrow one of her pens to see if it made a difference to Autumn. Overnight I had a different kitty, so just went into my vet and told them I wanted to switch insulins. They didn't have a clue about Levemir but wrote the script anyhow, since I already had good luck with it in Musette. And had a ready supply of insulin through my mom.

Since they are both depot insulins you can give one in the morning and the other one in the evening when switching over, just be aware that you will have two sheds for a few days so you usually reduce the dose on Lev to about 75% of what the Lantus dose was.

Autumn was a nightmare on Lantus, she was down right violent. On Levemir she is sweet and oh so cuddly. On Lantus I was seriously thinking about either rehoming her or having her put down. She was dangerous to me and to the other animals on Lantus, on Lev she loves everyone.

Mel and The Fur Gang
 
MommaOfMuse said:
It wasn't too hard for me, to switch Autumn since at the time my mom was still alive and diabetic on Levemir so I just asked to borrow one of her pens to see if it made a difference to Autumn. Overnight I had a different kitty, so just went into my vet and told them I wanted to switch insulins. They didn't have a clue about Levemir but wrote the script anyhow, since I already had good luck with it in Musette. And had a ready supply of insulin through my mom.

Since they are both depot insulins you can give one in the morning and the other one in the evening when switching over, just be aware that you will have two sheds for a few days so you usually reduce the dose on Lev to about 75% of what the Lantus dose was.

Autumn was a nightmare on Lantus, she was down right violent. On Levemir she is sweet and oh so cuddly. On Lantus I was seriously thinking about either rehoming her or having her put down. She was dangerous to me and to the other animals on Lantus, on Lev she loves everyone.

Mel and The Fur Gang
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Why do you need a script for insulin in the US? We don't here.
 
We need a script for just about everything cat and dog medicine wise in the US. It's weird because we recently got goats and I can run to the supply store for all sorts of medications and vaccines. But for the cats you have to spend oodles just to get the script.

I updated my signature, hopefully his chart is now there.
 
I hear ya, when I had my horses I could get my hands on just about anything over the counter meds wise for them but a dog or cat, not so much. Although they won't tell you this, most of your vacs you can do yourself in most states. Only exclusion is rabies and in some states Nebraska being one of them you can do those too. I give all my own shots, because I can't see taking in 17 animals just for rabies and other vaxs. And less drama and trauma all the way around for everyone. We can get some insulins OTC here like NPH or R but not the longer lasting ones like Lantus and Levemir. That is why we have so many folks if they live close enough that go border hoping to Canada for insulin. That is where mine came from as I had a friend that was running up to get hers and offered to grab some for me as well and then ship it out to me. Another trick if you live in the States and can find a member in Canada, have them find out the price there, then send them the money, have them pick it up and mail it to you. That was how I originally went rogue and got Levemir for my first kitty that I switched over. Had a friend on the board in Canada, send her a check, she got the Lev without a script there and sent it to me, I used it on Musette, kept very detailed records and when it was time for more, just handed over my notes and spreadsheet marked when she was on Lantus and how it changed on Levemir. Then didn't really ask so much as told the vet, this is what she is on and its working, so I need a script to keep her on it.

Of course I'm not much of a shrinking violet type personality either. I want what I want and I have the data and research to back it up. Guess Debate squad in High School is still paying off..lol

Mel and The Fur Gang
 
Shame there is no "like" button for posts! Maybe I should go into business shipping insulin to you guys in the US haha. Canada does have it's benefits but please take some of our snow!
 
If the shots keep going how they went last night I might consider trying the levemir. Last night was bad. Still need to find out how the morning ended up going. I'm just praying my husband's company doesn't send him out of town. I can do the testing but we were waiting to get me to try the injections till he calmed down a little and so far he hasn't. I need to find a way to practice that is not on a cat first. Idk if I can practice on some fruit or get some saline and do myself or what. Before I did the BG I practiced on myself first.
 
Jenny

When I learned to give shots (long before my first FD cat) I practiced on an orange. Of course back then it was to give shots to horses, but same general principle. I also know of one woman that practiced with a pot holder, because she could fold it likes she was pinching up a tent to shoot. So maybe you could try one of those techniques to get it down.

Although what you have described on how Chianti reacts to his shots reminds me very much of how Autumn use to react to her shots when on Lantus. Does he also seem really high strung and tense a couple hours after injection? Kind of like he is on high alert and easy to startle?

Mel and The Fur Gang
 
I'm not sure how he is in the am (dh shoots him earlier than I am up). After the evening shot he hangs around me in the kitchen while I cook. He mostly either begs for more food or wants to play on his box that's on the floor with some rolled up newspaper. He really just seems frisky and perky. You can pet him right after the shot just fine, it's just during it he is not happy at all.

I think I will try to practice to see if maybe I can be more gentle than dh. I have tiny hands, maybe I could tent the skin better.

In other news I tested him last night a smidge early because he was begging for food and got 212.
 
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