11/22 Methos pmps 207; +2 225; +4 155; +5 147; +6 144; +8 125; +9.5 173; +10.5 197

[SmallestSparrow]

Last thread: https://felinediabetes.com/FDMB/thr...331-4-382-8-356-pmps-305.295894/#post-3222386

Hopefully this works and Methos gets off the rollercoaster. we’ve been trying to try 2.75 for some time, because at 2.5 nothing happened but at 3 and above he would have permanent bounce with reduction numbers at PS, needing to be tested and fed at least hourly, and then be high for days—with the lows getting lower and the highs higher. but at first I needed different syringes, then he became hyperkslemic so had to go off his tumor meds, then one got reduced and another increased, while meanwhile he kept getting increases for high nadirs despite having sub90 occasional numbers that technically call for a reduction.
The internist consultant pointed out going up for the nadir being high probably wasn’t going to work, especially in light of the 75s he was also having. But by then his ketones were high along with his BG so not a good time to experiment.
The stars may have aligned. Bounce is breaking, ketones are normal, and pmps is on a downward slope so he gets to try 2.75–if it works he can try it for a week, if it fails he goes back to 3 and this is at least more insulin than a fur shot would have been.

 

[Christie & Maverick]

It does indeed look like he is breaking the bounce from the greens. I like the idea of trying to stick to a dose, gather the data and see how he does. Good luck with 2.75u and this evening’s cycle.

 

[JL and Chip]

so he gets to try 2.75–if it works he can try it for a week, if it fails he goes back to 3

Define “if it works.” Please tell me that you’re going to stick to 2.75u for multiple cycles and not just one or two. You won’t really see the impact if you evaluate the 2.75u dose too soon. You need consistency, the depot needs to stabilize, etc. Maybe give it the old college try and wait for a week before making a decision.

 

[Wendy&Neko]

I think we can find a supply of 2.75 unit patience pants for you. I hope it works out. As JL said, the first few cycles may show the influence of the 3.0 unit depot.

 

[Staci & Ivy]

Sending lots of good wishes for this dose to be a success for you and Methos. We are sending big hugs and love, wishing you both some rest and recovery, Colleen

 

[Madeline528]

Last thread: https://felinediabetes.com/FDMB/thr...331-4-382-8-356-pmps-305.295894/#post-3222386

Hopefully this works and Methos gets off the rollercoaster. we’ve been trying to try 2.75 for some time, because at 2.5 nothing happened but at 3 and above he would have permanent bounce with reduction numbers at PS, needing to be tested and fed at least hourly, and then be high for days—with the lows getting lower and the highs higher. but at first I needed different syringes, then he became hyperkslemic so had to go off his tumor meds, then one got reduced and another increased, while meanwhile he kept getting increases for high nadirs despite having sub90 occasional numbers that technically call for a reduction.
The internist consultant pointed out going up for the nadir being high probably wasn’t going to work, especially in light of the 75s he was also having. But by then his ketones were high along with his BG so not a good time to experiment.
The stars may have aligned. Bounce is breaking, ketones are normal, and pmps is on a downward slope so he gets to try 2.75–if it works he can try it for a week, if it fails he goes back to 3 and this is at least more insulin than a fur shot would have been.

Hi Colleen.
Good luck with the 2.75 dose. Sending you and Methos positives vibes.
Wishing you both a nice, relaxed night and a safe surf, Methos!

 

[SmallestSparrow]

I think we can find a supply of 2.75 unit patience pants for you. I hope it works out. As JL said, the first few cycles may show the influence of the 3.0 unit depot.

Well, I need those pants but part of it is my vet is not entirely sure we should have lowered his dose, and I don’t think she’s inclined to let it go a long time at a dose that’s been lowered just because I feel like it really should be a lower dose. She has the same dilemma you do because she wants to follow dosing rules and he refuses to follow the rules as she says “he ‘s special“

 

[SmallestSparrow]

Define “if it works.” Please tell me that you’re going to stick to 2.75u for multiple cycles and not just one or two. You won’t really see the impact if you evaluate the 2.75u dose too soon. You need consistency, the depot needs to stabilize, etc. Maybe give it the old college try and wait for a week before making a decision.

Depends on his bg, ketones, and my vet. She had a hard time I think lowering without him earning it. I pointed out he’s unlikely to earn if I test and feed him hourly 20 out of 24. She’s said before it would be nice to see how low he’d go—and I totally understand. She’s gone way off label for my boys esp methos so I try to give up a little control when I can

edit: when she wistfully says it be nice to know how low he go, I laugh and go yeah no

 

[SmallestSparrow]

I fell asleep and missed +7 and he’s still dropping and won’t eat low carb. I probably screwed this up but he happily ate about 1/4 to 1/3 of a can of proplan. Otoh I don’t want to see an amps of 75 either.

a visual of us hoping off the roller coaster near the low point (hopefully) but I’m afraid we will be climbing again

And the 2 days prior

 

[Heike & BInie]

Hi Colleen,

good luck with 2.75 IU! He had such a nice cycle last night and I see he was coming up for the shot. So great!

I thought about the libre and what to do to protect your hands. First of all, I think even though there are a lot of things one can do to make the installation less aggressive for the skin (Staci gave great advice yesterday), it is quite a lot for the skin, especially for fragile skin. Binie usually takes it quite well but two times she had a light inflammation. So I feel I would rather not try it on a cat with very fragile skin like Methos.

You said you are washing your hands twice before testing and put on band-aids where you touch the strip. I wonder if washing hands once and not band-aids would be enough. I understand we don't want the strip contaminated with any glucuse on our fingers (from the delicious toast with jam 5 minutes before testing or anything else). But washing your hands once should be enough for that, right? After washing hands I try not to touch the test-field of the strip but especially with the glucose strips I can not always prevent that, because I have to fish them out of a box with one finger and the test-field is pointing up. I think they would not have done it like that if touching with a washed finger is a no-no.

Maybe you can find aspects where you can make your routine a bit easier for yourself. Poking is difficult enough, you should not have to do this with your fingers hurting.

I am so sorry you are going through all these difficulties. You are really a heroine to do all this for sweet Methos.

I send you hugs!

 

[SmallestSparrow]

Hi Colleen,

good luck with 2.75 IU! He had such a nice cycle last night and I see he was coming up for the shot. So great!

I thought about the libre and what to do to protect your hands. First of all, I think even though there are a lot of things one can do to make the installation less aggressive for the skin (Staci gave great advice yesterday), it is quite a lot for the skin, especially for fragile skin. Binie usually takes it quite well but two times she had a light inflammation. So I feel I would rather not try it on a cat with very fragile skin like Methos.

You said you are washing your hands twice before testing and put on band-aids where you touch the strip. I wonder if washing hands once and not band-aids would be enough. I understand we don't want the strip contaminated with any glucuse on our fingers (from the delicious toast with jam 5 minutes before testing or anything else). But washing your hands once should be enough for that, right? After washing hands I try not to touch the test-field of the strip but especially with the glucose strips I can not always prevent that, because I have to fish them out of a box with one finger and the test-field is pointing up. I think they would not have done it like that if touching with a washed finger is a no-no.

Maybe you can find aspects where you can make your routine a bit easier for yourself. Poking is difficult enough, you should not have to do this with your fingers hurting.

I am so sorry you are going through all these difficulties. You are really a heroine to do all this for sweet Methos.

I send you hugs!

Thank you so much! I hate dictating. The handwashing twice is because I have to wash his ear off so the system right now is I test him so I wash my hands I test him I wait to make sure I’m not gonna be knocking off a scab and make him bleed again and then I wash his ear so that it’s ready for the next time I’m going to test. Which isn’t a problem if I’m just testing him two or three times a day but this 12 times a day is getting old. With this much testing, you think he was a tight control cat instead of start low go slow. Despite my best efforts high today so I think there’s just no way around this for every blue square there’s going to be like half a day of pink. Oh well, it is what it is.
I’m afraid meat doesn’t think I am a hero, he and moose are both upset with me, he’s upset because I’m stuck his ear so many times we both lost track, and moose just kept pestering me for attention so I yelled at him three times yesterday because he was getting in the way while I was trying to test meet those. So they’re both sulking somewhere and I’m going to nap

I hope Binie ‘s numbers are better today and thanks for your good advice on the Libre.

 

[SmallestSparrow]

see he was coming up for the shot. So great!

Well about that… he spent the night trying to go down and I kept holding him up with low-carb food until I fell asleep and he said oh and went down again and wouldn’t eat low-carb food so he came up for the shot because of a third of a can of medium carb food. Bad cat mom

 

[Christie & Maverick]

Inquiring minds want to know…what did you shoot this morning?

 

[SmallestSparrow]

Inquiring minds want to know…what did you shoot this morning?

2.75

edit: thanks. Severely sleep deprived. Going to wash his ears off and nap for 30before getting his +8.

he may not get to remain a 2.75 cat but we shall see

 

[SmallestSparrow]

Actually we’re both sleep deprived

 

[Christie & Maverick]

Methos looks like a good cuddler. FWIW I’d give him a pokie break until evening preshot. Happy napping

 

[SmallestSparrow]

Methos looks like a good cuddler. FWIW I’d give him a pokie break until evening preshot. Happy napping

I’ve been considering that.

 

[Staci & Ivy]

Actually we’re both sleep deprived
View attachment 71499​

He’s soooo precious

 

[Wendy&Neko]

I’ve been considering that.

Good idea, it would be good for both of you.

 

[Heike & BInie]

Thank you so much! I hate dictating. The handwashing twice is because I have to wash his ear off so the system right now is I test him so I wash my hands I test him I wait to make sure I’m not gonna be knocking off a scab and make him bleed again and then I wash his ear so that it’s ready for the next time I’m going to test. Which isn’t a problem if I’m just testing him two or three times a day but this 12 times a day is getting old. With this much testing, you think he was a tight control cat instead of start low go slow. Despite my best efforts high today so I think there’s just no way around this for every blue square there’s going to be like half a day of pink. Oh well, it is what it is.
I’m afraid meat doesn’t think I am a hero, he and moose are both upset with me, he’s upset because I’m stuck his ear so many times we both lost track, and moose just kept pestering me for attention so I yelled at him three times yesterday because he was getting in the way while I was trying to test meet those. So they’re both sulking somewhere and I’m going to nap

I hope Binie ‘s numbers are better today and thanks for your good advice on the Libre.

Hi Colleen, I read that sometimes the brother- and sister-cats of a diabetic cat get jealous because of the attention and treats the diabetic sibling gets while being tested and injected. Some people do fake tests on the brothers and sisters and fake injections. Maybe Tammuz would like that too? A bit fumbling his ear, holding the handheld there, make beep and give him a treat.

The picture of Methos is super sweet. He really looks tired. I hope you both can get a loooooooong nap without poking.

So your hands get a break too. I hope you have a good hand creme.

Many hugs and calming vibes for you and the boys!

 

[JL and Chip]

he may not get to remain a 2.75 cat but we shall see

I’m proud of you for sticking to the 2.75u despite the higher numbers. It’s hard to do, I know, when every fiber of our being wants to react and increase the dose (the “itchy trigger finger” syndrome, lol). A gazillion years ago a seasoned member told me to “sit on my hands” when I have those urges. I still hear those words in my head today.

Here’s hoping you can hang in there for a few more cycles at 2.75u. You’ve come this far — let’s see it through.

 

[SmallestSparrow]

I’m proud of you for sticking to the 2.75u despite the higher numbers. It’s hard to do, I know, when every fiber of our being wants to react and increase the dose (the “itchy trigger finger” syndrome, lol). A gazillion years ago a seasoned member told me to “sit on my hands” when I have those urges. I still hear those words in my head today.

Here’s hoping you can hang in there for a few more cycles at 2.75u. You’ve come this far — let’s see it through.

Too late. I had a long debate at 0315 this am. I hate bothering my vet on her day off but will confess to her later this am and see what she wants me to do. When we’d discussed dropping his dose, even though he hadn’t earned it, she was skeptical and said if his ketones go back up the experiment was over but I didn’t define “up”. I figured 0.3 was close enough to 0.2 but the 0.4 and a steady rising in BG I wasn’t so sure I just wasn’t seeing “shouldn’t have decreased” vs bounce.

anyway got 3 (all my bad decisions tend to be when I’m unsupervised) and she may leave him there or chastise me and we will be back at 2.75

edit: technically he’s getting tested a dozen times a day (sadly) and only on low carb wet so he’d fall as easily into TR as he does SLGS and would be overdue for an increase. He’s not TR because (a) he has no business going below 100 and (b) my goal is to NOT be testing more than 4x per day.
He is, as my vet says, “special”

 

[Heike & BInie]

Hi Colleen, these nasty ketones.... I hate them too. I hope you will see better numbers and less ketones too. You really have so many things to navigate with Methos. I can't say it often enough. He is so lucky to have you on his side. I send you many hugs!

 

[SmallestSparrow]

Hi Colleen, these nasty ketones.... I hate them too. I hope you will see better numbers and less ketones too. You really have so many things to navigate with Methos. I can't say it often enough. He is so lucky to have you on his side. I send you many hugs!

Im sure i made a mistake doing 3…but I can’t tell if bounce or just not enough insulin
Going to text my vet in another hour or two but he was getting so dehydrated and I was just too anxious. Hopefully i didnt mess him up too much. I see Binie has a nice long stretch of blue and green—fingers and paws crossed she stays there!

 

[Heike & BInie]

Im sure i made a mistake doing 3…but I can’t tell if bounce or just not enough insulin
Going to text my vet in another hour or two but he was getting so dehydrated and I was just too anxious. Hopefully i didnt mess him up too much. I see Binie has a nice long stretch of blue and green—fingers and paws crossed she stays there!

Hi Colleen,
you had good reasons for your decision and you choose safety and what you thought was best for him. Don't be hard on yourself. Maybe it was not wrong and if so, you can learn.

Why was he dehydrated? He pees more than he drinks? Can you make his water more attractive for him? When Binies ketones have been so high, I flavoured the water. I think that helped her to drink more.

I hope you have a good conversation with your vet. Many, many hugs!

 

[Heike & BInie]

Actually we’re both sleep deprived
View attachment 71499​

I can't stop looking at his sweet face!

 

[SmallestSparrow]

Hi Colleen,
you had good reasons for your decision and you choose safety and what you thought was best for him. Don't be hard on yourself. Maybe it was not wrong and if so, you can learn.

Why was he dehydrated? He pees more than he drinks? Can you make his water more attractive for him? When Binies ketones have been so high, I flavoured the water. I think that helped her to drink more.

I hope you have a good conversation with your vet. Many, many hugs!

He drinks but he pees A LOT. he’s on a diuretic so that and the high sugar and he’s pretty much drinking, peeing, or eating nonstop. If he sleeps he gets behind on fluids. Even if he doesn’t sleep he falls behind some. Poor guy he stands at his fountain forever, then to the box, back to the fountain, to his bed for a few minutes and repeat. So 2-3x per week he get up to 100 ml help from mom

Back to you and binie

 

[cecile & bella]

You know, at some point I told my vet I could manage the dosing and just needed prescriptions, she was more than OK with that. I think they want to be sure people can manage at first, but are happy to let you do it rather than micro-manage your cat, since you are the one doing the testing and everything. I would bet I am not the only one here who does not report more than "yes, she's doing well, no, no need for fructosamine, do you want to see her numbers?' once a year or so. Just my 2 cents

 

[Heike & BInie]

He drinks but he pees A LOT. he’s on a diuretic so that and the high sugar and he’s pretty much drinking, peeing, or eating nonstop. If he sleeps he gets behind on fluids. Even if he doesn’t sleep he falls behind some. Poor guy he stands at his fountain forever, then to the box, back to the fountain, to his bed for a few minutes and repeat. So 2-3x per week he get up to 100 ml help from mom

Back to you and binie

Oh..... I am so sorry you have this additional concern. That is quite a lot. And poor Methos, having to drink all the time. Now I understand even more, why you try everything to ge this blood sugar down. I hope your sweet boy sees better numbers soon.

 

[Staci & Ivy]

He drinks but he pees A LOT. he’s on a diuretic so that and the high sugar and he’s pretty much drinking, peeing, or eating nonstop. If he sleeps he gets behind on fluids. Even if he doesn’t sleep he falls behind some. Poor guy he stands at his fountain forever, then to the box, back to the fountain, to his bed for a few minutes and repeat. So 2-3x per week he get up to 100 ml help from mom

Back to you and binie

Sweet Methos. Boy I just love his sweet face. I want to give him kisses.
You’re the best Mom ever, Colleen.
We are rooting you and your sweet boy so much

 

[SmallestSparrow]

Thank you @Heike & BInie @Staci & Ivy and @cecile & bella ! I’d bet my vet would love for me to leave her alone but I need her so I don’t kill my poor boy. She said to leave him at 3 and we will hope he doesn’t go too low (which of course now makes me anxious). Maybe I can split the difference and be just under 3 (just over 2.75)? It seems like he’s coming down and of course bc I screwed up this am no way to tell if bounce breaking or if he needed more insulin. It just seems like under 3 isn’t enough and 3 and above is too much. If I can just get him through to week after next we can get another cortisol level and decide if he can do 15 BID of vetoryl. I think if he was getting the same dose am and pm he might even out his BG. Maybe that will help. It will also help bc I can move his vetoryl back to first thing in the am. I had to shift it two hours later so they are open for drawing his blood so his pill pockets come later in the cycle. I’m so tired and I’m so afraid it will be another long night. After his pm shot I’m definitely going to try for a 2 hour nap…
So stressful
Thank all of you (also @JL and Chip @tiffmaxee @Wendy&Neko a d anyone else in my sleep deprived state I’ve forgot …new condo tonight

c

 

[Heike & BInie]

Thank you @Heike & BInie @Staci & Ivy and @cecile & bella ! I’d bet my vet would love for me to leave her alone but I need her so I don’t kill my poor boy. She said to leave him at 3 and we will hope he doesn’t go too low (which of course now makes me anxious). Maybe I can split the difference and be just under 3 (just over 2.75)? It seems like he’s coming down and of course bc I screwed up this am no way to tell if bounce breaking or if he needed more insulin. It just seems like under 3 isn’t enough and 3 and above is too much. If I can just get him through to week after next we can get another cortisol level and decide if he can do 15 BID of vetoryl. I think if he was getting the same dose am and pm he might even out his BG. Maybe that will help. It will also help bc I can move his vetoryl back to first thing in the am. I had to shift it two hours later so they are open for drawing his blood so his pill pockets come later in the cycle. I’m so tired and I’m so afraid it will be another long night. After his pm shot I’m definitely going to try for a 2 hour nap…
So stressful
Thank all of you (also @JL and Chip @tiffmaxee @Wendy&Neko a d anyone else in my sleep deprived state I’ve forgot …new condo tonight

c

Such a good idea to take a nap after the pm shot! I hope he comes down very gently tonight and you don't have to stay up too long. It is a lot you are going through with so many complex issues all influencing each other. I have so much respect for what you are doing. I am glad you have a vet who knows Methos well and you can ask any time. On the other hand you have the board with many experienced people. I know that having more than one opinion doesn't always make things easier. But I am sure that every day you become more of an expert for what Methos needs and how you can handle it. But equally important - don't forget to breath, sleep and eat.

 

[Staci & Ivy]

Thank you @Heike & BInie @Staci & Ivy and @cecile & bella ! I’d bet my vet would love for me to leave her alone but I need her so I don’t kill my poor boy. She said to leave him at 3 and we will hope he doesn’t go too low (which of course now makes me anxious). Maybe I can split the difference and be just under 3 (just over 2.75)? It seems like he’s coming down and of course bc I screwed up this am no way to tell if bounce breaking or if he needed more insulin. It just seems like under 3 isn’t enough and 3 and above is too much. If I can just get him through to week after next we can get another cortisol level and decide if he can do 15 BID of vetoryl. I think if he was getting the same dose am and pm he might even out his BG. Maybe that will help. It will also help bc I can move his vetoryl back to first thing in the am. I had to shift it two hours later so they are open for drawing his blood so his pill pockets come later in the cycle. I’m so tired and I’m so afraid it will be another long night. After his pm shot I’m definitely going to try for a 2 hour nap…
So stressful
Thank all of you (also @JL and Chip @tiffmaxee @Wendy&Neko a d anyone else in my sleep deprived state I’ve forgot …new condo tonight

c

Could you possible split the difference between the 2 doses to see if that would work better for him? (Do you use a calipers?)

 

[SmallestSparrow]

Such a good idea to take a nap after the pm shot! I hope he comes down very gently tonight and you don't have to stay up too long. It is a lot you are going through with so many complex issues all influencing each other. I have so much respect for what you are doing. I am glad you have a vet who knows Methos well and you can ask any time. On the other hand you have the board with many experienced people. I know that having more than one opinion doesn't always make things easier. But I am sure that every day you become more of an expert for what Methos needs and how you can handle it. But equally important - don't forget to breath, sleep and eat.

You are so kind!
You are actually going through just as much if not more with poor Binie—we all have complicated cats I’m afraid.
I’m open to suggestions from the forum as well—2.75 was floated as a potential dose but some (rightly) pointed out he hadn’t earned it yet.
Of course like you with Binie today, I’m sure there were days he’d have earned a reduction but I don’t want him going below 100 and will move mountains to prevent it. It’s so confusing as sometimes I see people told “those numbers mean he needs more insulin” and others it’s called a bounce —all I know is he can’t afford ketones or to get too dehydrated. While I can give him fluids I also worry about his bad lungs and old heart and less than stellar kidneys the entire time I’m doing it.
I have such a sleep deficit now that I nod off despite lots of coffee etc and always wake up in a panic that I missed an important test or meal. I found some numbers were off on food I use from a chart I’d found (I don’t think the one used here) so tonight will be recalculating all of the tiki food.
As
Soon as he gets out of his box time to test and feed. Gosh he’s peeing a lot. Record even for him. I was hopeful his kidneys were getting a break but I think he just didn’t want to get out of bed