11/6 Crushy pmps 393 +2 446 +7 572 dose question

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Michele M

Michele M

Member Since 2013
previous http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=107563&p=1138959#p1138959

This dose is not cutting it I dont think. I was holding him here longer than I usually would because I was hoping for some blues and yellows instead of bouncing from green to red, but it seems that he is just as likely to bounce off yellow numbers to high reds.

He was super high all night last night. (493 at +8) he bounced off the yellows yesterday

He did go to the vet this morning so I think today's numbers are higher then they would have been if he hadnt. And I know the time change is messing with things a bit too.

Any thoughts on dosage? He would be going back up to 1.25 for the THIRD time if I increase 1/4 unit. The last two times he has been at that dose he has hit 30s.

(btw he was at the vet this morning as a preliminary teeth cleaning appointment. He is scheduled to have his teeth cleaned for the first time on the 19th. The vet says there is only a little tartar and they dont expect there to be any extractions. I wanted to rule out any resorbed teeth (his littermate has them and they are genetic) Ive been reading the teeth cleaning advice on this list and I think Im pretty well prepared for this. I might have some questions as it gets closer though.

He has been doing pretty well overall. Very purry and appetite is good. (a little too good...he needs to loose some weight apparently)
 
Re: 11/6 Crushy amps 388 +6 234 dose question

hi michele!

i don't think he's bouncing off the yellows - i think this is all one bounce from the greens on the pm cycle of 11/3. a bounce can wobble around within the high numbers. it looks like he went straight up to that 532 the next morning, then wobbled around, really all staying high but with some movement, since then. it can take 72 hrs for a bounce to clear, which would be tonight's cycle.

the protocol says to hold the dose for 10 cycles when your cat starts to see nadirs under 100. i've bolded the part below.

Increasing the dose:
Hold the dose for 3 - 5 days (6 - 10 consecutive cycles) if nadirs are less than 200 before increasing the dose by 0.25 unit.
if your cat is new to numbers under 200, it is recommended to hold the dose for at least 8-10 cycles before increasing.
when your cat starts to see nadirs under 100, hold the dose for at least 10 cycles.
After 3 days (6 consecutive cycles)... if nadirs are greater than 200, but less than 300 increase the dose by 0.25 unit.
After 3 days (6 consecutive cycles)... if nadirs are greater than 300 increase the dose by 0.5 unit.
Click to expand...

because this is a bounce, if he were mine, i would hold the dose for now. hopefully he'll clear it tonight. you don't want to increase on a bounce because then when it clears you can run into trouble.
 
Re: 11/6 Crushy amps 388 +6 234 dose question

thanks Julie! its good to have more eyes on his chart!

Im not seeing the forest for the trees I guess

so do you hold the dose for 10 cycles STARTING when you first see the nadir under 100? or starting when you changed the dose? and is fattening a dose considered a dose change?

its weird how many times I can read that protocol and get something different out of it.



Ive HAVE noticed that right about the time I get completely fed up and ready to change the dose...thats when he dives into lower numbers. (that should be a clue for me ;-) )
 
Re: 11/6 Crushy pmps 393 +2 446 dose question

these night time red numbers are KILLING me!!

are we SURE this is still a bounce???

To me it looks like he bounces every night into red from the daytime yellow numbers
 
Re: 11/6 Crushy pmps 393 +2 446 dose question

Bounces can take up to 6 cycles to clear. Give Crushy another cycle and then evaluate where he is tomorrow.

Fattening a dose is considered to be a dose change. Jill made some changes to the protocol recently, so that may be why it reads a bit different to you this week. I know the high numbers are frustrating, but the time change for standard time can also have an impact. On the up side, you get a good sleep tonight.
 
572 at +7!!!!
there is something WRONG here!!!!!
Still think this is a bounce from 3 days ago????
looks like a new bounce to me!!!
 
hi michele. just wondering how things are going.
it looks like crushy has been coming down some today. how did the rest of the day go?

i noticed it says you started feeding 200 calories on his spreadsheet. is that more or less calories than you have been feeding? i've also noticed you've tried feeding mini-meals at different times. what have you observed about different feeding schedules and what were the results?

can't wait to see what crushy does with the slight dose increase!
 
he came down into pink numbers today but his pmps was 428 (his pattern is usually to go lower in EITHER the am OR the pm, then bounce higher the following cycle) For the last few days he has been lower during the day and going sky high at night. Im expecting it to be higher again tonight.

200 calories is less than what he was eating. All the vets Ive been to say he needs to loose weight. He weighs 18 lbs (that sounds huge but he really does have a very large frame) One vet I talked to wants him at 15 lbs but I think that is too thin. I figure Id shoot for 16 lbs. I was advised by them to limit his calories. Its hard because I know he feels like he's starving when his #s are so high but I dont know what else to do. He lives to eat but if his weight is contributing to his diabetes It needs to come down, no?

Crushy was 19 lbs for a very long time then dropped to 17 lbs with the diabetes onset, but as soon as we got him on insulin he shot back up to 18 lbs....even though he is not regulated and his #s are usually so high he still gained weight. The vet I saw the other day for his teeth cleaning pre appt thought it was odd. Ive been limiting his food the whole time, just apparently not enough. I think the treats for ear pokes and shots was where he was getting too many calories. I just crunched all the numbers for all his food today and came up with a 200 calorie diet. (I was initially advised to do 180 calories so I feel like Im being a little generous)

I fed him at PS, +1, +2, and +3 for about 2 weeks to see if it would help flatten his curve a bit and I didnt notice anything from that. I recently switched him back to feeding at ps +3 +6 +9 because I saw some improvement when I initially started him on that schedule on 9/24. Im not sure if the improvement I saw then was just from him getting small meals or having them spread out in those particular increments, but Im fairly sure small meals work better than 2 big ones though ....

thanks for looking at his chart. Any thoughts you have would be really appreciated
 
Hi. So glad you are getting some more eyes on Crushy. I know you are sick of these horrid numbers.

I forgot to ask what the treats were you were feeding and how many calories?
I give hank freeze dried chicken treats like many folks here and those are low-cal. I feed the dog version of Pure Bites. They are the same as for cats but come in a bigger size bag so cheaper. I checked and those say 9 calories per treat. But the dog ones are big so i usually break each on into 2 or 3...so next to nothing for cals. Does Crushy like those? I also boil natural chicken breast and they get pieces of those for treats and love them.

Paws crossed we can get him on the right road soon. I know its so hard to sit by when you know he is not ok and want to do something to make it better.
 
food/feeding can often be an important part to regulating kitty's diabetes. thank you for answering my questions.

someone asked libby/lucy and me to take a look at crushy's spreadsheet to see if we could help. it's late and my brain is turning to mush, but we'll both take some time to really study crushy's ss. will you do us a favor? going forward, will you please place an asterisk in the corresponding cell on his spreadsheet every time you feed him? it's a small thing, but when we analyze spreadsheets it tells us at a glance how food may be affecting BG numbers. it's what i do with alex. you can look at her ss for an example.

you're doing everything you can do and doing it right. as libby told me tonight, "Crushy isn't the easiest cat to figure out, but it doesn't look like he will be the hardest either."

hang in there, ok? you're not alone.
 
thank you so much Jill!!
I really appreciate it.
Ive been tearing my hair out over here
Ill put the * on the chart as you suggested

Betty, I WAS dehydrating ground chicken and beef as treats (I have a dehydrator I use all the time, it seemed easy and cheap) problem is you can easily feed a lot more food than you think you are because its been shrunk down so much. I switched to baked/boiled chicken breast or thigh. the pieces are bigger because all the moisture is still in it so it actually makes him think he's eating more ;-)
 
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