12/10 Mikey PMPS 208 +2 41, +3 78 +4 71 after snack..Ideas??

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MikeysMom

Member Since 2011
After working with my vet, her partner, and another vet by phone, Mikey started insulin again tonight. The partner vet was much more amenable to starting at a lower dose (I was glad I saw him today!), so we started at .25U. I can increase if I need to, or decrease, but I had to start somewhere I'm ok with. I've practiced drawing the dose, and if anything, I'm erring on the skinny side. I split his dinner in half and am going to give the rest at +1 and snacks at +2 and +3 if needed. I don't expect fireworks tonight because the shed should be about empty, but this is Mikey, after all, so send us good vibes for no craziness!

We also figured out the mystery of the meter. I got a new one, a Relion Micro this time, bit it uses the same strips. I took a BG right before we left for the vet and got 273. Got to the vet and they pulled blood; we tested on their Alphatrak and my Micro. The Alphatrak read 233, the Micro...144. We tested again, same thing. Then, by chance, I said something to the vet about if there could be a difference between capillary and venous blood, because I'd tested his ear. He didn't think so, but we decided to try an ear test. Alphatrak: 293, Micro 285. Retest, same. Vet actually goes to the computer to check on this, because the difference was marked. Hmmmmm.... Vet finally came to the conclusion that the venous blood was reading low because of the anticoagulant in the vial. This is good news for me because I can feel confident that my numbers are accurate. It's also good for them because they were getting false lows as well. So hopefully that is solved.

Now fingers crossed for a successful regulation this time!
 
Re: 12/10 Mikey PMPS 208...Take Two! Cross your paws for us

ALRIGHT MIKEY!!!!!!!

VERY important meter information!!!! Glad you figured it out. All paws crossed here too...

Hugs,
 
Re: 12/10 Mikey PMPS 208...Take Two! Cross your paws for us

I was glad to have the meter issue solved. If we hadn't done the ear sample, they would have sent him home with no shot again, when I knew that wasn't quite right.

It might also make a difference for another cat, so I'm extra glad. Now just hoping this time we can get his numbers right and head toward OTJ for real! And that I can get to the store Monday to print the photos I'm giving for Christmas gifts this year!
 
Re: 12/10 Mikey PMPS 208...Take Two! Cross your paws for us

Good luck! I wonder if they make an essence of insulin? Just a wiff for Mikey!
 
Re: 12/10 Mikey PMPS 208...Take Two! Cross your paws for us

I'd also suggest you post this info in the thread the Dr. Lisa started on BG readings. It's very good information to have.

Good luck tonight. Please post so we can lend a hand if you need one.
 
Re: 12/10 Mikey PMPS 208...Take Two! Cross your paws for us

Great info. on the meters/ blood! Thanks so much for persisting with the vets until the plausible answer popped up. Good luck with your new dose and here's hoping Mikey will do well with his new regime.

Enjoy the rest of the weekend,

Ella & Rusty
 
Re: 12/10 Mikey PMPS 208...Take Two! Cross your paws for us

I posted it over there-I don't know if it's exactly what she's looking for, but my vet felt it was important enough to put a note with the Alphatrak in the office to check a direct sample not from the vial.

Keep your fingers and toes crossed for our +2 BG check coming up! So far Mikey's looking good. He's zonked on the couch, but that's not uncommon for this time of night, and going to the vet wipes him out. I am going to gigure this out for him. He was feeling so much better on insulin (and did well on his hiatus, but was drinking a bit more today), is playing more than he has in a while (though his new laser pointed gets some of the credit for that!) but he needs to gain some serious weight (if anyone has any ideas about how to stuff him with maximum calories, let me know!). So we need to get him on the right road.
 
Re: 12/10 Mikey PMPS 208...Take Two! Cross your paws for us

Paws crossed for Mikey!

And thanks for the meter info. We have been using the alpha trak for 9 months and as soon as our latest stash of strips is gone, we are switching to the relion micro which has been our back up meter. We really like the alpha trak but with as much testing as we do with Zener we can cut our monthly costs in half with the relion meter and arkay strips from ADW.
 
Re: 12/10 Mikey PMPS 208...Take Two! Cross your paws for us

And, at +2...41. How did he DO that?! He shouldn't have had anything in the shed! Gave a HC snack and will keep testing. He's not showing symptoms, so will keep testing.

I'm wondering, should I maybe dress his PS meal with a little HC to give the insulin more to work with? I'm definitely dropping him to .1 in the AM. I don't care WHAT the vet thinks.
 
Re: 12/10 Mikey PMPS 208...and low AGAIN +2...WTHeck?!

+2.5, back up to 51, and acting fine. I think this is going to be something I need to deal with with feeding? It's weird that he reacted so quickly to just .25U after three days with no insulin, but it must just be him. I hope I can get it figured out because i can't stay cooped up in the house all day, every day.
 
Re: 12/10 Mikey PMPS 208...and low AGAIN +2...WTHeck?!

+3 at 78, so all is good for now. I hope I didn't overdo the HC, just a large spoonful. Hoping he can surf...but could he be bouncing from being off insulin, then on? I don't get it...

Any ideas about giving a teaspoon of HC with his PS meal then LC at +1 and +2? It makes sense to me, but you all know SO much more than i do at this point!
 
Re: 12/10 Mikey PMPS 208 +2 41, +3 78 after snack...Ideas??

Personally, I'd go with 0.1u. Mikey is clearly insulin sensitive.

What % carb is Mikey's food? It may be that going to an overall higher carb food will help level things out -- although mixing in some HC will have the same effect.
 
Re: 12/10 Mikey PMPS 208 +2 41, +3 78 after snack...Ideas??

I haven't yet had to deal with low numbers as we are still trying to find the magic dose that brings Weezer down, so I can't give you any advice. But I must say, you handled that whole episode masterfully! You are learning very quickly just how Mikey responds. Even the best advice in world can only lead you to make those discoveries, because as you keep hearing, ECID. CONGRATS! You are truly getting it!
 
Re: 12/10 Mikey PMPS 208 +2 41, +3 78 after snack...Ideas??

He gets several varieties of FF, all under 5%, I believe. Unfortunately I can't afford anything better, like Merrick, on a regular basis.

Also, I worry about him hitting bottom so early (actually, I don't know when his true nadir is, but if it's this early, it means he's rising early also. Is there anything else I can do? If I can't figure out anything else, I'll ask about Levemir, but again, can't afford another new vial just now.
 
Re: 12/10 Mikey PMPS 208 +2 41, +3 78 after snack...Ideas??

+4 71. Hoping he holds here. He had his usual LC snack (smaller b/c he had one earlier). Hopefully he'll keep a decent number without shooting up or dropping again.

Come on...surf, baby, surf...
 
Re: 12/10 Mikey PMPS 208 +2 41, +3 78 +4 71 after snack..Ide

Mikey may just have an early nadir. So does Gabby. Take a look at her SS. Her nadir is usually somewhere between +2 and +4. This is why I test when I do. You may want to get a +1 so you can catch the drop a little earlier and use food to level things out.

FF is fine. You may want to find a flavor that's around 8 - 10% carb. Maybe before you go out and buy more food, you could try to add some gravy to Mikey's food early in the cycle.
 
Re: 12/10 Mikey PMPS 208 +2 41, +3 78 +4 71 after snack..Ide

Hi again, Amy,
Rusty loves FF Turkey & Giblets and I am told that it is about 7 or 8% (even though the charts say 2%). I feed it as a snack and as a way to bring up his bgs without resorting to MC or HC. I sometimes mix it with his "staple" food, Wellness Turkey (4%). I have taken to giving Rusty a FF T&G snack every night at bedtime, just a teaspoon, mixed with water. He really looks forward to it! (I also feed a mini meal of Wellness turkey at bedtime, because he is used to free feeding; he doesn't usually eat it all at once.) If he looks like he will go really low at night, I put another teaspoon of FF T&G into his auto feeder and set it to open at PMPS+8.5

You are doing a great job with Mikey. Enjoy the rest of the weekend.

Ella & Rusty
 
Re: 12/10 Mikey PMPS 208 +2 41, +3 78 +4 71 after snack..Ide

He actually gets the turkey & giblets quite often...I'm trying to avoid the fish flavors more than once a week or so (he LOVES them, so a treat).

If he's having an early nadir, will it be impossible for him to get to normal all the time?
 
Re: 12/10 Mikey PMPS 208 +2 41, +3 78 +4 71 after snack..Ide

Good question! ECID. I guess that if you can minimize the bounces, he may stay in the normal range most of the time and have those good, "flat" curves, and then you can gradually decrease the dose until it is zero. I've never had to deal with this!!!!! Rusty is on Levemir, but he did not live with us when he was on Lantus, so I don't know what his patterns were then. With Lev., onset usually begins for Rusty at about +4.5 and the nadir comes somewhere between +7 and +9, but sometimes as late as PMPS.

You just have to experiment, I guess. Part of the challenge of FD!

Ella
 
Re: 12/10 Mikey PMPS 208 +2 41, +3 78 +4 71 after snack..Ide

+5 103. I need to find a way to bring the low numbers up without starting this climb so early. It's not terrible in that I feel like if I left for a bit or go to bed, I'd be safe (I hope, because i plan on going to bed after the rodeo finals), but it's going to make it harder to regulate him. Hopefully his body will figure it out. I think I will drop to .1 tomorrow and then try to keep it there for at least 3 days, preferably a week, and go from there. I may give a teeny bit of gravy on breakfast as well, to see if that slows this curve down!
 
Re: 12/10 Mikey PMPS 208 +2 41, +3 78 +4 71 after snack..Ide

good job handling all of that tonight. you're starting to sound like a pro! :-D

this is a great example of how every cat is different and our main task in the weeks of using insulin is figuring out how our own cat responds to lantus. mikey is definitely walking to the beat of his own drum!
 
Re: 12/10 Mikey PMPS 208 +2 41, +3 78 +4 71 after snack..Ide

Ugh. +6.5: 142. I was kind of hoping the rise was the gravy talking...on the way back up too early!
 
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