12/28 Ozy AMPS-468,PMPS-365

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Re: 12/28 Ozy AMPS-468 highest reading ever

Ouch!

No cliff jumping please - Ozy needs you . Take a deep breath - and as the saying goes:
'Keep Calm and Carry On'

In case you did not see my very late night post in yesterdays condo:
To help keep on top of IAA you will need to learn the safe use R and how to best use it for Ozy.

First, some information on IAA I believe to be very important:

*Injected insulin first gets bound to the antibodies. Any insulin that does not get bound goes toward metabolizing sugars. How much goes to antibodies and how much goes to metabolizing sugars is anybody’s guess and a moving target
*IAA can retard the initial rise of available insulin after an injection.
*IAA can lead to an increase in the half-life (the time it takes the body to get rid of half a dose) of free (unbound) insulin in circulation because some bound insulin gets released into circulation. The increase in half-life can lead to prolongation of action.
*The release of insulin from the antibodies can happen at inopportune times

FWIW I found all of the above to be the case with BK. As with all things, ECID.
Click to expand...

I see a dose of 6.5 this morning - is that a typo?
 
Re: 12/28 Ozy AMPS-468 highest reading ever

That is not a typo. Totally freaked out. Regretting changing to Levemir. Convinced I am just training antibodies to take his numbers higher.
 
Re: 12/28 Ozy AMPS-468 highest reading ever

I think in the long-perspective, the move to Lev was the best thing for him. you are going to be injecting even larger doses into him and if the Lantus was stinging before it would've become even more of an issue than it was.

Ozy will get better, donaleen. be confident. the saying that this is a marathon, not a sprint, is perhaps even more appropriate for those of us with high dose kitties. Ozy has been diabetic with this problem for quite some time. it's not going to resolve immediately.

just checking in on you today. btw, it was awesome to meet you, DH and Ozy yesterday. you are delightful! :YMHUG: and thank you for the fabric - i will do something fun with it! in fact, it might want to become part of a kitty quilt. :-D :-D

Sandy, what point are we looking to start the R at? right now, he's 24 hrs into a bounce. i'm assuming not trying it from the top of the bounce, just in case it's extra-effective at 0.1u. what part of the cycle would you suggest?
 
Re: 12/28 Ozy AMPS-468 highest reading ever

You are training the antibodies. They are just trying to show you who is boss but it is not them. I really freaked when Harley.got 500's but you keep pushing on. I might have stayed with the 6u to see what he does. The 468 could be partly bounce and the antibodies. You might not feel like it, but u are doing well.

Pattie
 
Re: 12/28 Ozy AMPS-468 highest reading ever

thanks, Julie. I need some heavy drugs... for me. But your words helped. I can't do anything. I can only fret.

It was great to meet you, too.
 
Re: 12/28 Ozy AMPS-468 highest reading ever

Donaleen,
I can't help much with dose.
But if you jump off a cliff, I will try to catch you.
Hugs,
Carl
 
Re: 12/28 Ozy AMPS-468 highest reading ever

Thanks Carl and Pattie. I am THE most freaked out about this I have EVER been. Poor dear Ozy.

Usually I am curious to test him. Now I am afraid to test him.
 
Re: 12/28 Ozy AMPS-468 highest reading ever

Give Lev a fair chance - you can always switch back. I recommend holding this dose for at least 4 cycles. The depot needs a chance to expand/adjust. Remember, Lantus and Lev are not designed to shoot down an ugly number - that's a job for R.

How is Ozy? Have you checked for ketones?
 
Re: 12/28 Ozy AMPS-468 highest reading ever

I checked yesterday. I have him shut in a room with me with a cat box but he isn't peeing. I ordered a test meter that tests for ketones but I don't have it yet and won't for a week. I ordered better syringes because the Walgreen's syringes suck at small doses. But those won't be here for a week either.
 
Re: 12/28 Ozy AMPS-468 highest reading ever

Good move on the ketone meter. The strips are pricey, but it will give you piece of mind. I used a nova-max plus with Bob. Getting a drop of blood is so much easier than trying to catch him in the act of peeing, especially if he's a fan of LB privacy.
 
Re: 12/28 Ozy AMPS-468 highest reading ever

I do the urine strips but Harley never peed on command. I then started watering down his ff. 1/2 can with 1/4-1/3 can water. Peed great after that

Pattie
 
Re: 12/28 Ozy AMPS-468 highest reading ever

Sandy... how is Ozy. He is sleeping. He sleeps when he feels bad. Unless he feels REALLY bad and then he meatloafs with a look of awful pain in his eyes.

Pattie.... I tried adding water to his food and he doesn't like it. He pees copiously but is hard to catch with the ketone strips.

All this time, struggling with this, at least he didn't go into RED numbers much and never black numbers. That was my one comfort. And now it is gone.
 
Re: 12/28 Ozy AMPS-468 highest reading ever

couple of questions:

are his meals fed to him (either by you or a timed feeder) or does he graze? In general, is his appetite good?

any flea problems?
 
Re: 12/28 Ozy AMPS-468 highest reading ever

No flea problems. Fleas aren't as much of a problem in Portland as they were in Massachusetts. Also, none of the cats goes out, although I have seen a cat who doesn't go out get fleas. I comb him occasionally with a flea comb. I've never found a flea on any of the cats here in Portland.

His appetite is good, though a little off lately. When he had his dental, I took some food for him and they commented that he eats more like a dog than a cat. He is starving when his numbers are high, less so when they go down to blue and green. He has had no appetite only twice; both times his numbers were in the 60's, he was extremely lethargic and quite out of it 11/07 and 12/15)

We feed him. No timed feeder. The food is left out for a bit. Generally he eats most of it pretty quickly. I put the other cats' leftover food on the counter where Ozy can't get to it.... non cat people are appalled. Too bad.

He gets 5% carb Wellness grain free turkey and salmon with occasional meat treats, mostly chicken thighs. I note his food on the SS. Capital W means 1.5 ounces, small w means one ounce. I have been trying to limit his food some but not so much when he is really high. I think of the food as helping keep away the ketones.
 
Re: 12/28 Ozy AMPS-468 highest reading ever

Couple other pee suggestions from my vet. Fill the box with a minimum amount of litter. When cat pees it pools, does not get absorbed. She also suggested pushing a small cup, like top of medicine bottle under kitty while peeing. Both worked well for me

Pattie
 
Re: 12/28 Ozy AMPS-468 highest reading ever

Thanks, Pattie. I use one of those plastic lids for canning jars and slip it under him. He does okay with that as long as I wait till he is well situated to move in. Otherwise he will leave the box and look indignant that I bothered him. The tricky part is catching him in the act.

We have a cat box that we put out in the room where we spend a great deal of our time (where I am right now). The other cats have already availed themselves of the convenience. Ozy usually goes right after he eats. But either I missed it or he didn't do that this time.
 
Re: 12/28 Ozy AMPS-468 highest reading ever

Please tell me when to test him today. I don't want to face those high numbers any more than I have to.
 
Re: 12/28 Ozy AMPS-468 highest reading ever

If you were here, you wouldn't say that, Pattie. I am comatose with fear. Can't read. Can't eat. Can't do anything except this. I put him on the sofa beside me because I can't stand for him to be out of sight.
 
Re: 12/28 Ozy AMPS-468 highest reading ever

I understand the reluctance, but every time u test, you are gathering more information and learning. I use to test every 4 hours or so. I don't think you learn much by only testing before each shot. That is just my opinion. I wanted to know as much about Harley's numbers as I could.

Pattie
 
Re: 12/28 Ozy AMPS-468 highest reading ever

I've always felt that way about Ozy's numbers, until today. I always want to know. I have been told I test too much but not too little.

Today I don't want to know. So please, tell me when to test him today.
 
Re: 12/28 Ozy AMPS-468 highest reading ever

I keep forgetting the 2 hour time difference. I know that I would test to see what is going on. If you want to hold off, test at +4 but we need to see what he is doing with the new dose

Pattie
 
Re: 12/28 Ozy AMPS-468 highest reading ever

Do you want me to test him every two hours? Every four hours? I will do what you say.
 
Re: 12/28 Ozy AMPS-468 highest reading ever

i would test him again now.

if i were there, i would tell you that Ozy will not suffer from hitting the 400's this morning - it's surprising he hasn't been there before. He will likely hit the 500's and possibly the yucky black HI before you are through this. Short term in the high numbers doesn't cause permanent damage. He will go up, but he will also come down. and then he will do it again.

These 400's are the price for the lovely 194 yesterday morning that was cause for celebration.

and after i said all of that i would add a :YMHUG: this is harder for you than it is for him. he's just having a little nap.
 
Re: 12/28 Ozy AMPS-468 highest reading ever

Sandy took the words right out of my mouth. Lantus and Lev aren't the kind of insulin that is most effective at squishing a high pre-shot number. Lantus and Lev are like steering an ocean liner. You turn the wheel and eventually, the ship's direction changes. They are not nimble like a sail boat. What you sacrifice in potency and immediate responsiveness, you gain in gentle action and long duration.

There may be times when feeling like jumping off a cliff is warranted. Right now, frustration is an understandable reaction. This isn't a time for panic or jumping off of high places. So..... Take a deep breath. If you were doing anything that put Ozy in jeopardy, one of us would be jumping up and down in Ozy's condo. You're doing great. It takes a while to understand how to approach FD and dealing with a high dose condition makes it feel like your brain is leaking out of your ears. We're all here to help and we come equipped with nets if you feel like you're going to jump!! Years ago, Miriam/Putty would talk about taking a lawn chair and sunning herself on a ledge. We've all been there so we understand the feeling. I find it helps to remember that I'm not in control of Gabby's FD. She is. She's leading the dance. It's my job to follow.
 
Re: 12/28 Ozy AMPS-468 highest reading ever

i just looked back at punkin's ss - and i noticed that throughout 2012 punkin hit an over 400 every week or so. he made it just fine through those and came back down. it's just part of the process.
 
Re: 12/28 Ozy AMPS-468 highest reading ever

Thanks, Julie and Sienne. I tested him... 379 and I got a negative ketone test. The bupe is taking effect and he is awake and playing with Pippin. Nice to see.

I think my blood pressure just dropped a little.
 
Re: 12/28 Ozy AMPS-468,+2-379 highest reading ever

i like the comparison of the boat steering - it's a good one. and i also like the reminder of who is in charge - we do what we can, but the sweet little kitty body is the one directing the show.

glad to see Ozy came down a lot. that's really pretty significant, so i'd probably get another test in another couple of hours.
 
Re: 12/28 Ozy AMPS-468,+2-379 highest reading ever

Well, the thing is, steering Ozy is like steering a barge. SLOW moving. Maybe slow moving insulins aren't a good match.

I am hunting for my lawn chair, unfortunately no sun.

Well, Julie, it upsets me to do things that take a bad situation and make it worse. And THAT is what I feel I have done. I have enabled his antibodies to get ever stronger.

I prefer dealing with 40's rather than 400's. Ketones scare me more than hypos.
 
Re: 12/28 Ozy AMPS-468,+2-379 highest reading ever

Donaleen,

I totally understand your fear about those high numbers. Cobb has been in the 500, even 600, range since he was diagnosed in April. We had an entire day when he was 600+ for more than 12 hours. No ketones, although that doesn't mean we should be complacent. We didn't see any lower numbers until I joined this board in late November. Higher numbers, in the short term, are safer than lower numbers. I know all too well how yucky those high numbers are though!

Don't stress too much!! His number is coming down. That's a good sign!

~Suzanne
 
Re: 12/28 Ozy AMPS-468,+2-379 highest reading ever

Thanks Suzanne. I can do something about low numbers. Your Cobb sure is a cutie.

Are you testing for iaa/acromegaly?
 
Re: 12/28 Ozy AMPS-468,+2-379 highest reading ever

donaleen and Ozy said:
Thanks Suzanne. I can do something about low numbers. Your Cobb sure is a cutie.

Are you testing for iaa/acromegaly?
Click to expand...
Thank you! Like most of us, Cobb and I have been through a lot, including numerous doses of prednisone when he was younger due to him licking his paws raw. :roll:

I understand. I wish there was something we could give for the high numbers too. But you're doing the right thing now.

Cobb was actually diagnosed a year before we started insulin. The vet at that time told us we could control it through diet, including a dry diabetic food. We now know different. When we visited another vet this last Spring his BG test came back at 564. Who knows how long it had been that high?! I say that to say, while those high numbers aren't good, you can step out of the house and not constantly monitor him like you would have to if he was below 40.

Yes, we will probably end up getting the tests done. He's not good with getting blood drawn, so as his mom it upsets me to cause him that much stress.
 
Re: 12/28 Ozy AMPS-468,+2-379 highest reading ever

donaleen and Ozy said:
Well that makes us alike in that Ozy was diabetic a long time before being diagnosed. Doesn't that mean they both suffered from glucose toxicity? What does that mean to them at this point? It's a burning question I've been wanting to ask.

I have this link Julie did

http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=62944
Click to expand...
I don't know the answer to that question. I think you can look at that as if it were a sunk cost, ie you just put new tires on a car you're now trading in. You're not going to get any of that money back, and you can't do anything about it.

If they were suffering from glucose toxicity, there's nothing you can do about that now, so why worry or feel guilty about it? You're treating the problem you do know about. That's all you can do. I'm sure we all wished our cats had raised their paw when they became diabetic and said, "need some help here please," but cats are notorious for covering their symptoms. All you can do is what you're doing now. Collecting a lot of data and treating what you know is the problem, which you're doing.

I believe the glucose toxicity goes away once their numbers are normal and the liver/pancreas is healing. (but if I'm wrong, someone please correct me!)
 
Re: 12/28 Ozy AMPS-468,+2-379 highest reading ever

Morning Donaleen. Sorry you and Ozy had such a yucky start this morning. I remember well a year ago in the late spring when Neko started getting into blues/greens and her body sending her soaring into the highest numbers ever. For her it was blacks and that dreaded Hi. I'm pretty sure I posted condos where I felt like jumping off a cliff, or maybe it was beating my head against a wall. :YMHUG:

The ugly numbers are so frustrating, but it (eventually) helped me to think of those high numbers as the resistance fighting back against us successfully starting to get Neko into lower numbers. They fought a valiant battle, but eventually we beat them back. We haven't won completely, but they don't take her as high any more. It took us a long time before Neko stopped including red in her regular palette.

That +2 is very encouraging, he hasn't reached onset yet on this cycle so that +2 could be the nadir from his previous cycle.
 
Re: 12/28 Ozy AMPS-468,+2-379 highest reading ever

(((donaleen)))

I just wanted to lend you my support and some thoughts having switched from lantus to levemir. When we switched, Jill told me that sometimes it takes weeks or longer for a kitty to even get where they were before the switch. Not all cats, mind you, but some. Of course, Gracie was one of them and you can look and see for yourself. I switched her in Sep, 2011. I believed she would do better on levemir and just waited....the patience was hard for me because I like instant gratification :-D :-D :-D But Jill was right and in a few months, Gracie started looking much, much better and she has done phenomenally better on levemir.

I know this might sound trite and I do apologize but my saving grace in the sugar dance is meditation. I subscribe to yogaglo.com ....you can try it for a week free and then it's $18/month. They have some phenomenal meditation classes that I use in conjunction with my yoga. They will teach you how to focus and accept what is....if you will let it happen. Does that mean I don't occasionally get cat(2)_steam cat(2)_steam when Gracie does what she does (like today)? No...but then I step back and realize it's one number, one cycle and I can always increase the dose. Yes....your journey will be a little more challenging because of the IAA but just try to think of it as one number, one cycle. Don't focus on what might or might not be in the future or how long the journey takes. Ok...zen lesson over. Ommmmmmm :-D BTW, when I first started meditating, I was lucky to be able to do 30 seconds without my mind going crazy. I just stuck with it and went for longer and longer times although I haven't been able to do more than 30 minutes and that's because I think the cats feel the vibrations (I also chant sometimes) and then they start crawling all over me :lol: :lol: :lol: :lol:

You've got the best help you could have here and an enormous cheering section. Step away from the edge. :YMHUG: :YMHUG: :YMHUG: :YMHUG:
 
Re: 12/28 Ozy AMPS-468,+2-379 highest reading ever

Hi, Wendy. So glad to hear from you. Levemir is a new game for me. I don't "get the cycles". I know Levemir cycles are likely to overlap. If that is his nadir, how long are his cycles? Or hasn't he been on Levemir long enough to tell.

I knew I couldn't expect onset for quite some time and that was part of what freaked me out about the very high number at AMPS. Just yesterday he was a lot higher two hours AFTER AMPS.... in fact since Levemir he has been higher at +2 every time I checked.

Oh, Marje, I saw your post after I wrote this one. Thanks so much for stopping by. I am always glad to see you. I've never had much luck with meditation. They tell me to concentrate on my breathing and then I am not sure I know how to breathe and that makes me feel claustrophobic. I do have one kind of meditation that works for me. That is this one.

http://www.breathing-zone.com/

I think the visual part really helps me. I haven't done it in quite some time and I don't know if I COULD in the state I was in. I couldn't do much. But I think it would be good for me to do it some more. Thanks for the reminder.

Weeks???? to get back to where we were? I better get some heavy drugs. I expected to lose some ground but I did NOT expect it to be worse than it had ever been.

Ozy is playing with his mouse.... so good to see. He is pretty feisty this morning. Julie got to see his feisty side last night, though these days feisty is very toned down compared to how he used to be. He was always good with other cats, though. I think he used to be with people who didn't like him much and he had to learn to like people. We are an acquired taste.

It was REALLY nice to meet Julie yesterday. I thought that would be the focus of my condo today and then I got that high number. For one thing, it was nice to stand around and discuss feline diabetes in person with other people who get it. I can't explain, but I think it was really good for John. He doesn't talk to anyone but me about this so I think it was really a good thing for him.

Thanks everybody for being there.
 
Re: 12/28 Ozy AMPS-468,+2-379 highest reading ever

:-D

i used to look at punkin's numbers and think "oh that's what YOU'RE going to do today." it's not all about what we do, it's not the sweet kitter's fault or anything, but they do what they do, sometimes regardless of what we do.

Ozy is worth every bit of the effort you're putting into him. i could see how sweet he is and how much he loves you. he soaked up your snuggles when you tested him like he was made for that.

and yes, the glucose toxicity is a temporary condition. it means that they've gotten used to a higher level of numbers and it can take more insulin to get the numbers down. but they will come down!
 
Re: 12/28 Ozy AMPS-468,+2-379 highest reading ever

Yes, Ozy is worth the effort. He just needs a better bean.

Back up above 400 again... He has been above 400 three readings in the last 24 hours. Before that in the last six months he had only 10 readings over 400, spaced far apart from one another.

Michelle, are you out there? I hope Levemir is better to you.

Going for a walk...
 
Re: 12/28 Ozy AMPS-468,+2-379 highest reading ever

Levemir is a new game for me. I don't "get the cycles". I know Levemir cycles are likely to overlap. If that is his nadir, how long are his cycles? Or hasn't he been on Levemir long enough to tell.
Click to expand...
It took me a while to get Neko's cycles on Lev too, and I still don't totally get them. Sometimes her onset is later than others, but it seems to be tied to her numbers. If she's higher, it's later. The onset variability seems to be an IAA thing. One of the things Sandy posted:
IAA can retard the initial rise of available insulin after an injection
Click to expand...

The same variability happens with nadir and duration. Again from Sandy:
IAA can lead to an increase in the half-life (the time it takes the body to get rid of half a dose) of free (unbound) insulin in circulation because some bound insulin gets released into circulation. The increase in half-life can lead to prolongation of action.
Click to expand...

I did find it easier to start seeing Neko's patterns on Lev once she started seeing some lower numbers, or at least more of a range of numbers. It took Neko a few weeks to settle into Lev, but she did see some better numbers before then. Ozy's mostly flat right now. He could be seeing some NDW. We are all paws crossed here for Ozy on this new dose. And Donaleen, he does have a great bean. :YMHUG:

BTW: Walks are great - I live just a few minutes from a trail head and found that mini hikes were great for my stress recovery.
 
Re: 12/28 Ozy AMPS-468,+2-379,+4-386,+6-404 highest reading

I can honestly say I have absolutely no idea what you're going through, but it doesn't stop me from feeling for you!! It's nice to see Ozy has dropped a bit. i just wanted you to know I'm praying for you...and your sanity!! :-D I hope you're able to have a good weekend!!
 
Re: 12/28 Ozy AMPS-468,+2-379,+4-386,+6-404 highest reading

Yes, Ozy is worth the effort. He just needs a better bean.
Click to expand...

Somehow, I seriously doubt that. Cat's pick their caregivers for mysterious reasons known only to them. Obviously, you were smart enough to listen.

So here's my prediction. In a couple of months when things settle down, you'll look back at this condo and ask yourself, "What was I thinking?" That will be particularly the case when there's someone new who's going through the same self doubt and you find yourself providing them support and talking about what your experience was like. The front end of the learning curve is monumental. You know already from your experience that it does get easier. (You know about the importance of what you feed, home testing, using a spreadsheet, where to get supplies, etc. -- all of the things you didn't know the day you signed on to FDMB.) Right now, you've just been handed an extra ball to juggle. You'll get the hang of it. (After all, you're not juggling a running chain saw!!!!)
 
Re: 12/28 Ozy AMPS-468,+2-379,+4-386,+6-404 highest reading

Question.... what do you think of giving Ozy some fluids? Will it help his body? Is there any reason not to?

I know I've pushed the envelope a bit with my increases. I am going to test him every two hours.

And thanks Sienne and Carla. You must have been typing when I was. I think Zukie and Ozy decided that one. Zukie, my dali llama, he picked Ozy and Ozy was okay with it.
 
Re: 12/28 Ozy AMPS-468,+2-379,+4-386,+6-404 highest reading

I think Ozy has a great bean too. You're doing everything you can for him. Hang in there. You're getting some great advice from people here. :YMHUG: :YMHUG: :YMHUG:
 
Re: 12/28 Ozy AMPS-468,+2-379,+4-386,+6-404 highest reading

I'm not a big fan of giving fluids unless there's a medical necessity. You can cause problems by giving fluids unless Ozy is dehydrated. Too much fluid can put a strain on the heart -- it's called hypervolemia.

This is a time to remember that what ever goes up, comes down. You are trying to push the numbers. It's like trying to push the ocean. Good luck. Right now, let Ozy be Ozy. One side benefit with higher numbers is you get a good night's sleep. Trust me. You'll be wanting that sometime soon.
 
Re: 12/28 Ozy AMPS-468,+2-379,+4-386,+6-404 highest reading

Thanks. He has been drinking a lot and his breath smells so he may be dehydrated.

I hear what you are saying. But a lot of this stuff isn't making sense in my mind. The fact that he has IAA AND is having his highest numbers EVER... well, I am deeply afraid he may never come down. It all swirls in my head and, like a magic 8-ball, I can shake that 8-ball and get a different answer every time. I remember when YOU warned me of the dangers of glucose toxicity; that was some months ago. And recently Julie said IAA is like glucose toxicity on steroids.

You really think it is safe for me not to test tonight?
 
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