11/25 Webster +11=270 +2=436 +4=240 +6=169 +7=208

[Websterthecat]

Yesterday: viewtopic.php?f=9&t=128931

I haven't seen Webster so active since before his DKA falling out! He's roaming the house, chasing moths (his favorite pastime) looking out windows eating, cleaning himself nicely, pooping, and peeing well, etc. His numbers have been stable, although higher than they should be.

He's starting the day out at 270 (+11) so I'm hoping to see him surfing somewhere in the blue range today. I believe that the complete switch to grazing on wet food (from grazing on dry food) and his increased appetite has really helped to stabilize his BG throughout the day.

I've been weighing out 3.66 oz servings of food on the scale and giving it to him twice a day after taking his BG and before giving his shot. I've found it to be easier to test 1/2 hour to 1 hour before insulin and then feed afterward before giving his shot. The remainder of his food is left out and he tends to return between +1 & +2 to grab a small bite and then returns here or there throughout the day. He has recently been finishing up all of his food on his own so that's a good sign.

Many of you guys have advised on his feeding but I'm still not sure If what I am doing is okay. The vet says feed 2 times a day only, take away food after 15 mins and the general consensus here seems to be that the feeding should be spread out. I agree with everyone that spreading the feeding makes a lot more sense so that's what I'm sticking with. Is it okay to allow him to graze as long as he doesn't go over his calorie intake for the day?

 

[Ella & Rusty & Stu(GA)]

Re: 11/25 Webster +11=270

Absolutely he can graze. Many of our cats are grazers. The only thing you have to remember is that he shouldn't have food during the 2 hours before AMPS and PMPS. Food will raise his bgs and you need to get readings that are not food-influenced before shot times. (This is a safety thing. You need to know if it is safe to give the shot). (the rest of the time it doesn't really matter, so let him graze; you will gradually learn his patterns and have an idea of what to expect. But of course you always have to factor in what the cat has decided to do!)

Looking good here!

Ella & Rusty

 

[Websterthecat]

Re: 11/25 Webster +11=270

Absolutely he can graze. Many of our cats are grazers. The only thing you have to remember is that he shouldn't have food during the 2 hours before AMPS and PMPS. Food will raise his bgs and you need to get readings that are not food-influenced before shot times. (This is a safety thing. You need to know if it is safe to give the shot). (the rest of the time it doesn't really matter, so let him graze; you will gradually learn his patterns and have an idea of what to expect. But of course you always have to factor in what the cat has decided to do!)

Looking good here!

Ella & Rusty

Excellent. Thank you for the confirmation!

 

[Websterthecat]

Re: 11/25 Webster +11=270 +2=436??

I just checked his +2 and he is climbed to 436?! This was the opposite of what I was expecting.

Any ideas what may be going on?

 

[tiffmaxee]

Re: 11/25 Webster +11=270 +2=436??

He's either still bouncing which can take 6 cycles to clear or else the reduction from .50 to .25 didn't hold. You just have to wait it out to see if he comes back down or needs more juice I would think. One of the dosing advisors will be on to help you decide. With the DKA they might want you to increase but I am not experienced with that and can't even guess what they will say. One year and Max is still full of surprises like his dive this morning!

 

[Suzanne & Cobb(GA)]

Re: 11/25 Webster +11=270 +2=436??

The +2 could be a food spike. The food has some carbs in it, which will affect his BGs. That's why Ella suggested (and many of us) don't feed within 2 hours of shot time. You see how the food can spike his BG, and you wouldn't want to see a "safe" shoot number due to a food spike, shoot and then get caught in a spiral of falling BGs.

As for grazing, I absolutely agree. Smaller meals throughout the day are much easier on Webster's pancreas than a big meal twice a day.

 

[tiffmaxee]

Re: 11/25 Webster +11=270 +2=436??

Max also gets as many as 6 or 8 small meals. He gets more if I have to feed low BG. I actually started feeding small amounts often when he got p'itis the first time and never stopped.

 

[Websterthecat]

Re: 11/25 Webster +11=270 +2=436??

He's either still bouncing which can take 6 cycles to clear or else the reduction from .50 to .25 didn't hold. You just have to wait it out to see if he comes back down or needs more juice I would think. One of the dosing advisors will be on to help you decide. With the DKA they might want you to increase but I am not experienced with that and can't even guess what they will say. One year and Max is still full of surprises like his dive this morning!

Absolutely. I went from being concerned about him dropping too low to concerned that his numbers are going too high and he might be producing ketones. I have been trying to catch him in the act today but had no luck. He tested negative yesterday.

The Protocol says:

"Kitties experiencing high flat curves or prone to ketones may want to increase the starting dose after 3 days (6 consecutive cycles)."

it further reads:

"After 3 days (6 consecutive cycles)... if nadirs are greater than 200, but less than 300 increase the dose by 0.25 unit."

So if the numbers continue as they have been and are still in the 200 - 300 range around nadir today, are we looking at a 0.25u increase after tonight or would it be safer to increase it at his next shot later this evening?

I understand that making the call after 5 cycles is premature but I'm now concerned about these higher number and ketones.

 

[Websterthecat]

Re: 11/25 Webster +11=270 +2=436??

The +2 could be a food spike. The food has some carbs in it, which will affect his BGs. That's why Ella suggested (and many of us) don't feed within 2 hours of shot time. You see how the food can spike his BG, and you wouldn't want to see a "safe" shoot number due to a food spike, shoot and then get caught in a spiral of falling BGs.

As for grazing, I absolutely agree. Smaller meals throughout the day are much easier on Webster's pancreas than a big meal twice a day.

I'm thinking that his healthy appetite today has caused a rise in these numbers. On one hand, I'm very glad that he's eating well on his own. On the other hand, eating well with not enough insulin can't be good.

 

[Suzanne & Cobb(GA)]

Re: 11/25 Webster +11=270 +2=436??

The +2 could be a food spike. The food has some carbs in it, which will affect his BGs. That's why Ella suggested (and many of us) don't feed within 2 hours of shot time. You see how the food can spike his BG, and you wouldn't want to see a "safe" shoot number due to a food spike, shoot and then get caught in a spiral of falling BGs.

As for grazing, I absolutely agree. Smaller meals throughout the day are much easier on Webster's pancreas than a big meal twice a day.

I'm thining that his healthy appetite today has caused a rise in these numbers. On one hand, I'm very glad that he's eating well on his own. On the other hand, eating well with not enough insulin can't be good.

Eating well is always good! He may not have held the reduction, which can be common. Sometimes the pancreas kicks back to life, but isn't quite ready to handle it all on its own yet. You may find you're having to bounce between those doses...or maybe Webster's ideal dose is really .35, not .25 or .5. Does that make sense?

For now, let's see what some of the people helping you out think about his dose. I'm guessing, given his ketones, they'll encourage you to go back up, but they may see something I don't. So...hang tight! I joined this time last year and LOVED that I joined right at Thanksgiving because SO many people were around. I hope that's a repeat this year.

 

[Sienne and Gabby (GA)]

Re: 11/25 Webster +11=270 +2=436??

When I see that big of an increase, I'm inclined to re-test just in case it was a wonky test/bad strip. I will do this any time I see a test that seems out of context. For example, last evening, Gabby's PMPS was 94 and she was in the low 200s when I left for the day. I re-tested. The number was right. There have been times, though, when my second test was vastly different than the first.

Mike -- are you testing at +11 and not at pre-shot? I'm not sure what others think, but I'd encourage a test at pre-shot.

 

[Websterthecat]

Re: 11/25 Webster +11=270 +2=436??

The +2 could be a food spike. The food has some carbs in it, which will affect his BGs. That's why Ella suggested (and many of us) don't feed within 2 hours of shot time. You see how the food can spike his BG, and you wouldn't want to see a "safe" shoot number due to a food spike, shoot and then get caught in a spiral of falling BGs.

As for grazing, I absolutely agree. Smaller meals throughout the day are much easier on Webster's pancreas than a big meal twice a day.

I'm thining that his healthy appetite today has caused a rise in these numbers. On one hand, I'm very glad that he's eating well on his own. On the other hand, eating well with not enough insulin can't be good.

Eating well is always good! He may not have held the reduction, which can be common. Sometimes the pancreas kicks back to life, but isn't quite ready to handle it all on its own yet. You may find you're having to bounce between those doses...or maybe Webster's ideal dose is really .35, not .25 or .5. Does that make sense?

For now, let's see what some of the people helping you out think about his dose. I'm guessing, given his ketones, they'll encourage you to go back up, but they may see something I don't. So...hang tight! I joined this time last year and LOVED that I joined right at Thanksgiving because SO many people were around. I hope that's a repeat this year.

I did notice an increase in food consumption soon after lowering his dose from .5u to .25u. Perhaps the intake increase was caused by him feeling better? Now with the increase in food/carbs/calories he doesn't have enough insulin to combat the new carb load. Maybe, as you said, his ideal dose is somewhere in the middle.

I'm willing to risk another long stretch of fast drops (restless nights) by increasing the dose tonight rather than deal with ketones again. Experts in dosing - what are your thoughts?

Suzanne, what do you mean by "so many people around at Thanksgiving". You mean on this message board?

 

[Suzanne & Cobb(GA)]

Re: 11/25 Webster +11=270 +2=436??

Suzanne, what do you mean by "so many people around at Thanksgiving". You mean on this message board?

Yes, I felt like everyone was online!! Could have just been a fluke, but maybe people were home and had the page open. Just my personal experience.

Diabetics don't process their food properly and are literally starving. So the increased food consumption was probably because the dose was lowered. Don't know. I know Cobb was ravenous until he regulated. Now he eats fairly regularly and doesn't beg for food, which means his food consumption is pretty stable.

 

[Websterthecat]

Re: 11/25 Webster +11=270 +2=436??

When I see that big of an increase, I'm inclined to re-test just in case it was a wonky test/bad strip. I will do this any time I see a test that seems out of context. For example, last evening, Gabby's PMPS was 94 and she was in the low 200s when I left for the day. I re-tested. The number was right. There have been times, though, when my second test was vastly different than the first.

Mike -- are you testing at +11 and not at pre-shot? I'm not sure what others think, but I'd encourage a test at pre-shot.

I will retest next time to see if perhaps it's an equipment issue. I'm about to retest at +4 to see whats going on.

I really want to test preshot but the routine sometimes takes forever. Testing, feeding, and insulin was taking about 40 mins to complete when he wasn't eating easily on his own. Now that he's eating well on his own I can likely get it done in 15 mins or less. I just like to start early so that if I have a lower than expected number I can post here and get feedback before dosing. I suppose I do it to keep my shots consistent, exactly 12 hours apart even if we run into an issue.

I'm going to make an effort to speed up the test-feed-shoot process. Hopefully do it all in less than 5 mins. Learning curve I suppose..

 

[Suzanne & Cobb(GA)]

Re: 11/25 Webster +11=270 +2=436??

Learning curve I suppose..

You can definitely cut down the time. I test, feed and shoot while Cobb is eating. The whole process takes less than 5 minutes. I've never had an issue with getting him to eat though. He's a pig. :lol:

 

[Websterthecat]

Re: 11/25 Webster +11=270 +2=436??

Suzanne, what do you mean by "so many people around at Thanksgiving". You mean on this message board?

Yes, I felt like everyone was online!! Could have just been a fluke, but maybe people were home and had the page open. Just my personal experience.

Diabetics don't process their food properly and are literally starving. So the increased food consumption was probably because the dose was lowered. Don't know. I know Cobb was ravenous until he regulated. Now he eats fairly regularly and doesn't beg for food, which means his food consumption is pretty stable.

The holiday thing makes sense..

I was just looking at Cobb's ss. Holy Moly! He was on a really high dose of Lantus at one time. At 40u+ per day, a vial must not have lasted more than 3-4 weeks.

 

[Suzanne & Cobb(GA)]

Re: 11/25 Webster +11=270 +2=436??

He got up to 31u per shot, so 62u per day. Yes...we flew through the vials for awhile there. That whole 6 months for a vial thing is a foreign concept to us! He is insulin resistant, and when we switched to Levemir, we have been able to make some really good headway.

 

[Websterthecat]

Re: 11/25 Webster +11=270 +2=436??

He got up to 31u per shot, so 62u per day. Yes...we flew through the vials for awhile there. That whole 6 months for a vial thing is a foreign concept to us! He is insulin resistant, and when we switched to Levemir, we have been able to make some really good headway.

Those numbers look beautiful! The numbers after the switch to Levemir really jump out at you. His dose is on a steady decline and his Bg's are looking better than ever! That's awesome

 

[julie & punkin (ga)]

Hi Mike,

Yesterday you asked about locations to give shots. I always gave punkin his shots in the scruff. Always. Some people rotate them around the body, some have favorite spots. I'd say the best spot is the one that works for you. In whatever area you use, you do want to move the injection site slightly. I saw one suggestion to have the vet shave a 2 inch spot, then think of it as a clock face, moving the needle 1/2 hr with each shot so it's not exactly the same spot all the time.

I would hold the dose just a tiny bit longer. He had that dramatic day in greens and blues on the 22nd. He bounced from it and you reduced the dose at the same time. I would let the bounce clear before I decided to increase the dose back up. Bounces can last up to 6 cycles, so I'd say if you don't see a green number by tomorrow morning, then you could increase back to 0.5u. I wouldn't increase before then.

As you get better with the routine, you'll have it down to 5 minutes or less. I agree with Sienne, I think it's really important to always get the +12/preshot test in. Numbers can change from the +11 to preshot and while it hasn't been a problem for you yet, it could become one.

 

[Websterthecat]

Hi Mike,

Yesterday you asked about locations to give shots. I always gave punkin his shots in the scruff. Always. Some people rotate them around the body, some have favorite spots. I'd say the best spot is the one that works for you. In whatever area you use, you do want to move the injection site slightly. I saw one suggestion to have the vet shave a 2 inch spot, then think of it as a clock face, moving the needle 1/2 hr with each shot so it's not exactly the same spot all the time.

I would hold the dose just a tiny bit longer. He had that dramatic day in greens and blues on the 22nd. He bounced from it and you reduced the dose at the same time. I would let the bounce clear before I decided to increase the dose back up. Bounces can last up to 6 cycles, so I'd say if you don't see a green number by tomorrow morning, then you could increase back to 0.5u. I wouldn't increase before then.

As you get better with the routine, you'll have it down to 5 minutes or less. I agree with Sienne, I think it's really important to always get the +12/preshot test in. Numbers can change from the +11 to preshot and while it hasn't been a problem for you yet, it could become one.

Thank you so much Julie. The vet did shave him in 4 different areas on the side and I've been trying to rotate based on which side he is laying on at the moment of his shot.

I'll hold the dose and see what happens tomorrow.

I'm going to try for that PMPS today. Hopefully everything goes smoothly.

Thanks for responding! :smile:

 

[julie & punkin (ga)]