Hi Angela (right?),
I spent a good amount of time this a.m. reading some of your earlier posts when you arrived here at FDMB, thought a lot about you and Josie today, and now want to sit down to share some thoughts with you. I hope that is ok.
First to answer your protocol questions:
I dont know how to know what is a bounce and what is real.
It is hard to tell at times with most cats, especially in the beginning phases of treatment. Most likely when you see an unusually high number, or numbers increasing instead of decreasing after giving insulin you might assume it is a bounce. In Josie's case it could be a bounce OR a spike from the kibble. A bounce can last up to 72hrs (3 cycles), but not always. Sometimes it may just be one cycle. I know this does not answer your question regarding whether she is bouncing or just high. I don't think anyone can know for sure under the circumstances.
One example of what 'could' be a bounce in Josie's case is Dec 11th-14th. On the 11th she went under 200. She stayed in the high 200's and into the 300's for the next 3cycles. You woke up on the 14th to a blue amps. That 'could' have been her breaking through the bounce.
I dont understand why she has been going up instead of down midday.
Assuming you feed after you test, the kibble is possibly bringing her numbers up around +3 to +6. For some cats it will stay in their system longer than others. This would account for higher mid day readings. The other possibility is that she is going into the 100's (or lower) over night and bouncing the next cycle, only to clear it in time for the evening cycle.
I dont understand how she can have totally different results at the same dose, weeks apart.
Body chemistry changes, diet, mood/stress, other illness or pain. Us humans may think nothing has changed in their world because we have not changed it for them (ie/schedule, food type, attention, etc). They are still living beings. They have ever changing needs, just like us.
I hope my responses help a little.
From reading your other posts, I understand you are Josie's only caretaker. I was the only one who cared for Latte. She had multiple health issues for years, often requiring special feedings, monitoring, and other medications aside from the insulin. I COMPLETELY understand how difficult it is. When we got the FD diagnosis I thought for sure it was the end. I could do no more. I was stretched soooo thin. I had nothing left to give ...emotionally, physically, financially. I had that feeling often the last 9 months of her life. I worked multiple jobs and still did not have money. At times I used the food shelf so I would have money for some of her medical supplies. She has been gone about 1.5yrs now and I still feel like Im trying to get MY life back. Yet, I have absolutely no regrets. I would do it all again (for HER) in a heartbeat. She showed me how much strength I really did have. I want you to know I am not sharing this with expectations that you should/shouldnt put similar dedication into Josie. I am sharing to let you know I get it. I understand what it is like to feel so overwhelmed and well...helpless at times. We all have a threshold for stress, that is for sure!
I know you love Josie. You have had her 14yrs? You took her to the vet when something was wrong. You found this board. You are testing and asking questions. I can also tell you are worried about her. I really do believe you want to help her.
It is clear as a bell that you are not interested in changing Josie's food.
Finances are tough. UG! Do I ever get that one! Some of what you can do for Josie is limited due to funds, am I correct?
You wanted to take the start low/go slow approach because you felt you could not test as much as necessary in order to follow a tighter protocol.
You are feeling extremely frustrated due to the unreliability of her BG numbers.
Here are my thoughts:
If the financial constraints could be lifted a bit, would you be less stressed about your situation? nbbbbb<----- (sorry foster kitty forcing herself on my lap and wanted to contribute :lol: ). There are resources out there to help you. Would you like some information on those options?
You do not have to do daily curves by any means. Would you be able to do 1-2 curves each month? This would mean testing every 3-4hrs, 2 days out of the month. You could do one daytime (movie day!) and one evening (call it a kitty slumber party! :mrgreen: ). This would help give YOU a better idea as to when you should increase or lower the dose. It may be a time commitment, but in the end take up less time because you are not consumed with trying to figure things out and being stressed.
Marking on the ss about food as Gayle suggested is a great idea! That is how I learned when Latte was spiking from food and when it would end. I know you have multiple cats, so it may make it more challenging. Gayle has multiple cats too...maybe she can offer more ways to go about it so you know you are monitoring Josie's food and not the other kitties, too?
I did notice Josie has possibly been sitting right around renal threshold for a while now. I wonder if it is possible Josie's UTI is recurring? When a kitty hits renal threshold, sugar is dumped into the urine. Sugar+urinary tract = increased possibilities of infection. Infections can cause BG's to be high or all over the board.
Finally, I am wondering what your main goals are with Josie. We all want a healthy, happy kitty. Im pretty sure I am safe in assuming this! Are you hoping for remission? Are you ok with giving insulin the rest of her life? Is there a certain BG range you would like to see her in on a regular basis? Is there a better way the members of FDMB help you with your goals?
My greatest hope for you is that you can go back to enjoying Josie. I bet you two have exchanged a great deal of love over the last 14yrs. Give that cutie a kiss on the head for me, will ya?
