12/6 Silver - OTJ Trial Day 5 - Looking good so far

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KittyMom777

KittyMom777

Member Since 2014
Okay so he came out of his bounce pretty quickly. Had to make a decision to shoot or not shoot on my own. No-one online this early in the morning.
Did I make the right decision....gone to work for 12 hours so I did not feel comfortable giving him anything and going out.
BJM and Mel, I think you are right - he just doesn't want to do this dance for long.

Can someone weigh in on what they think was going on with those high numbers yesterday? I was sure that 0.25 was not enough insulin. He peed on the floor this morning and I was expecting a high number as he only does that when his BG is high.

Juliet and Silver
 
Re: 12/01 Silver AMPS 82.8 - No shot

good morning Juliet!

You did right by not shooting this morning since you can't be home to monitor

What was going on yesterday was a "bounce"....The low numbers he got on the PM cycle Saturday caused his liver to "panic" and release stored sugar and hormones to bring him back up to where it's become accustomed to living lately

Looks like he's cleared that bounce quickly though!! It could have taken up to 72 hours to clear, but he's done it within 2 cycles...Woo Hoo!!

Be a good boy Silver while your mamabean has to go to work
 
Re: 12/01 Silver AMPS 82.8 - No shot

totally agree, I would have not given a shot on that number either. Silver is doing great, and so is his bean, have a great day at work.
 
Re: 12/01 Silver AMPS 82.8 - No shot

Thanks Chris and Linda,
let's see what tonight brings.....

Juliet and Silver
 
Re: 12/01 Silver AMPS 82.8 - No shot

Nope wouldn't have shot that number either and according to protocol that earned him a dose reduction. :-D Time to learn how to shoot a fat zero. To do that you want the bottom of your plunger just resting above the zero line on the syringe. At the rate Silver is going he'll have you shooting a drop in no time and then after that the last place to reduce is off. :thumbup

Mel and The Fur Gang
 
Re: 12/01 Silver AMPS 82.8 - No shot

How can he be due another reduction when he just got one on Saturday and hasn't settled into that new dose yet. His numbers were so high all day yesterday and didn't someone tell me about NDW and it takes time to settle? I need to understand why the reduction. Now before anyone jumps down my throat, I'm not saying I won't reduce, but I need to understand. My vet is calling me this week as the ten days she said she would leave me alone are up. I will need to give an explanation for my dosing choices and I don't mind doing that - but I need to understand it for myself.

Juliet and Silver
 
Re: 12/01 Silver AMPS 82.8 - No shot

Well he was high all day yesterday because of the lows of the day before. I highly suspect that he went much lower than the 61 that night. That's a bounce. If you look at Autumn's spreadsheet she is bouncing at the moment as well, once from hitting as 39 and then trying to clear that one and dropping hard and fast yesterday. A bounce happens for one of 3 reasons. Dropping into hypo range, dropping hard and fast, and from going lower than they are use to. Now Autumn has seen a lot of blues and greens since being started on insulin so for her to get into that range doesn't cause her to bounce anymore, but oh could she bounce when she first started to see even pinks after being in the black and red for over a year with her previous owner without treatment. Then she would bounce at a yellow, then a blue or green. Now those don't phase her but going from pink to blue quickly will send her over the moon again. As will dropping into the 30's

Now for why the dose reduction, because he has given you a preshot that is too low for you to shoot given that you can't be around to monitor during the day, if you need to skip a shot because the preshot is too low to shoot then the dose needs to be reduced. Most vets are happy if the cat stays under 250 for an average, we hold them tighter than that normally.

Now if you were around to monitor, then 82 is a perfectly shootable number and would be shot under Tight Regulation but we would also be on you to be testing every few hours to make sure he is surfing safely. Since you can't do that we want him in regulated numbers rather than tightly regulated numbers. Regulated is Mid to low 200's at preshot with a nadir below 150 but above 50 while on insulin, while tightly regulated would be spending the entire cycle in the 50-120 range while on insulin.

Mel and The Fur Gang
 
Re: 12/01 Silver AMPS 82.8 - No shot

Oh one other thing that I want to address about the peeing outside the box, especially since you will be talking to your vet shortly. When was the last time Silver was checked for a UTI? When I have one not using the box that is the first thing I try to rule out, then I start looking for other reasons as in box not clean enough, I clean all of mine twice daily and sometimes 3 times depending on use. The next and this is a biggie here, not enough boxes for the number of cats in the house hold. For 2 cats there should be 3 litter boxes. (1 for each cat and a spare). This is very important when one cat is ill, as the others will often times pick on the sick one, or the sick one will not use the same box as the others. This is something nature hard wires into them, because predators hunt by smell, and they can tell by smell that there is a sick and weak one in the family. Sick and weak equals an easy dinner, so the sick one is seen as a threat to the healthy family members, so they are either driven out of the family group or they will remove themselves from the family group. The old sacrifice of the one, for the good of the many.

Now it is more than likely that at least part if not most of Silver's box problems are from his legs being bad right now, but it also never hurts to investigate other reasons why he is peeing outside the box.

Oh yeah is he just peeing outside the box or is he both peeing and pooping outside the box? If just peeing I would then seriously have him checked for a UTI or other urinary tract problems. Many male cats that have lived on dry food most of their lives will develop blockages and urinary crystals that will cause them to stop using their litter boxes because peeing hurts.

Mel and The Fur Gang
 
Re: 12/01 Silver AMPS 82.8 - No shot

Ok. Thanks for the explanation. I understand it.

Not sure he really went lower than the 62 though as I set the alarm to test him two hours later and he was over 100.

I will try and shoot lower tonight if I can get that "fat zero" figured out.

Juliet and Silver.
 
Re: 12/01 Silver AMPS 82.8 - No shot

MommaOfMuse said:
Oh one other thing that I want to address about the peeing outside the box, especially since you will be talking to your vet shortly. When was the last time Silver was checked for a UTI?
Mel and The Fur Gang
Click to expand...

He was checked two weeks ago and was clear. I notice the pattern than he only pees outside the box when his numbers have been high. Its the first time he's done it in a week. I have four boxes and two cats and I live in a very small apartment so I clean them twice a day.

Likely I will be ignoring my vet's call when I see that it is her calling. I don't want an argument regarding dosing and I don't plan on bringing him in to see her anytime soon.

When he does pee in the box - he doesn't poo in the box. A year ago, I went though a season where did just did not poo in the box. Peeing yes, so I knew he had no problem getting in the box. Then all of a sudden, he went back to using the box again and I have no idea as to why he stopped or started again. Same right now with the peeing. We go days with him using the box, then a few with not using the box. I don't have an explanation but its not a UTI as we already ruled that out. I cant keep taking him to the vet every couple weeks to check either.
 
Re: 12/01 Silver AMPS 82.8 - No shot

I thought he had been checked fairly recently, but sometimes all the cats begin to blend together, so wanted to make sure it was Silver that had been recently checked.

And yep sounds like there are both enough boxes and they are clean enough, so hopefully once his legs get stronger again he will go right back to using the box again.

Oh one other thing although probably not a problem if he was and now isn't, but has there been a change in litter? I have one girl here (Autumn in fact) that will not use the box if the texture of the litter isn't to her liking. Right after we got her, because she had ketones that I needed to keep an eye on I changed her litter to the non-clumping kind, so I could get a urine sample easily, she wouldn't go anywhere near it after the first step on this new chunkier litter, she wants hers to be very fine sand like, anything with large gravel in it ain't happening with her, and the same goes for anything with a heavy perfume scent to it. So while I love the smell of one brand of litter we don't use it because I would rather smell the litter she likes than the smell of cat pee on the floor.

Mel and The Fur Gang
 
Re: 12/01 Silver AMPS 82.8 - No shot

No change in litter either. And ketones testing - never seen any change to the strip color.
 
Re: 12/01 Silver AMPS 82.8 - No shot

May I suggest you find a few old syringes.... and experiment with trying for that 0.1 u dose.
Microdosing is difficult.

When I was on that dose, I found that with my particular syringes, that supposed one drop had nothing coming out of the syringe.
I had to play with it until I felt I had something coming out of the syringe.

There is a technique we have for determining how many drops are in one unit ( or a half unit) for our own particular syringes.
You can use water in an old syringe.
Hold the syringe with needle pointed to the ceiling and twist the plunger slowly....
You should get a drop beading up on the needle.
Continue doing that until empty.
Count those drops.....each one as it rolls down the needle.

count how many drops you have in your 0.25 dose..... so that you can determine what one drop really looks like.

The reason we continue dosing even for that one drop of insulin is to continue supporting the pancreas as long as we can and hope
for a stronger remission.
 
Re: 12/01 Silver AMPS 82.8 - No shot

Thanks Rhiannon. Yeah, I just got used to getting the 0.25u just right. Less than that is going to be a challenge.
 
Re: 12/01 Silver AMPS 82.8 - No shot

he's going to be OTJ in no time Juliet. :RAHCAT :RAHCAT :RAHCAT :RAHCAT
 
Re: 12/01 Silver PMPS - Dipped in the water - 24 hrs no shot

24 hours with no shot and he's barely touching the water. I tried REALLY hard to get a "fat zero" I counted 4 drops in 0.25 and I squeezed out two. But after I gave him the shot again, I practiced filling one unit and counting drops - and got six. So who knows what he actually got tonight. I am pretty sure it was less than what I usually give at 0.25 but I've only been giving that dose for one day.
 
Re: 12/01 Silver PMPS - Dipped in the water - 24 hrs no shot

Honestly I would not have shoot at all on a 101 preshot after 24 hours without insulin. Since that is still within normal range. But since you did shoot that, watch him closely tonight, you maybe in for another long night. Because if he does what he is famous for he is going to dive early in the cycle.

Normal range for a cat on a human meter is 40 (2.2) to 120 (6.6)

Mel and The Fur Gang
 
Re: 12/01 Silver PMPS - Dipped in the water - 24 hrs no shot

Hi, yes I was wondering about that but as I'm home, I will watch him and test hourly.
 
Re: 12/01 Silver PMPS - Dipped in the water - 24 hrs no shot

If he's not shootable in the morning and you have 2 hours, do a food test You feed him, then 2 hours later, test to see if the glucose has gone up or down. If it goes down, that is a good clue his pancreas is starting to kick in.

He's almost there!
 
Re: 12/01 Silver PMPS - 100.8; +1 84.6

Thanks BJM - but I dont have 2 hrs... I test, feed and shoot at 6:30 am and I am out the door by 6:45am. I wont shoot lower than 150 but if at 150 or above I'll give the same 2 drops I gave tonight.

By the way - on that second point - I fed him and gave 2 drops an hour ago...tested him and he went down. Usually he goes UP after food and his dose for the first hour.

Juliet and Silver
 
Re: 12/01 Silver PMPS - 100.8; +1 84.6

KittyMom777 said:
... I fed him and gave 2 drops an hour ago...tested him and he went down. Usually he goes UP after food and his dose for the first hour....
Click to expand...

I think that is encouraging, though he may keep you up a bit tonight.
 
Re: 12/01 Silver PMPS - 100.8; +1 84.6

KittyMom777 said:
By the way - on that second point - I fed him and gave 2 drops an hour ago...tested him and he went down. Usually he goes UP after food and his dose for the first hour.
Click to expand...

This is exactly why if they are under your current No Shoot number at preshot. You stall without feeding and retest in 30 minutes to see if you have a rising number or a still falling one. Because when the pancreas decides to fire back up it doesn't come with a flag waving. There is no warning sign to tell you that you have a functioning pancreas again. Same is true with a cat on insulin that decides to run a 13 hour cycle instead of a 12, you don't want to shoot a still falling number.

Handling lower than normal preshots

And yep he is probably going to have you up late tonight and I expect a bounce

Mel and The Fur Gang
 
Re: 12/01 Silver PMPS - 100.8; +1 84.6; +2 66.6

Thanks...I cant stall feeding though when he's been without food for 12 hours. His +2 is 66.6 so I did what I know to do and have done three times before in same circumstances and fed him two teaspoons of regular food to slow him down a bit.

My no shoot number is 150 for the mornings when I cannot be here to test but I have shot low blue five times previously in the evenings when I am here.

He is doing well...at least be pleased about that.
 
Re: 12/01 Silver PMPS - 100.8; +1 84.6

BJM said:
I think that is encouraging, though he may keep you up a bit tonight.
Click to expand...

Very encouraging, thanks BJM. He just ran after his sister just now - last month he was barely able to walk let alone run. He is doing good.
 
Re: 12/01 Silver PMPS - 100.8; +1 84.6; +2 66.6

I am pleased he is doing so well, in fact I still shudder to think about what would have happened if he was still on 2u and you had to leave him for 12 hours during the week.

But I am also concerned that he is headed for danger because it feels like you under estimate just how powerful of a hormone you are working with. Insulin is a very powerful hormone and a mere drop can have a huge impact that can be potentially fatal. Plus a hypo even if you can pull them out of a bad one with food and sugar can still cause brain damage. Silver's safety is my first concern.

A hypo on Lantus or Levemir can last up to 16 hours because it is a depot insulin.

Mel and The Fur Gang
 
Re: 12/01 Silver PMPS - 100.8; +1 84.6; +2 66.6

MommaOfMuse said:
I am pleased he is doing so well, in fact I still shudder to think about what would have happened if he was still on 2u and you had to leave him for 12 hours during the week.
Click to expand...

Yes I am glad he is not on 2u either - he would be bouncing around from blacks to reds and into blues uncontrollably. Either that or he'd be dead.

MommaOfMuse said:
But I am also concerned that he is headed for danger because it feels like you under estimate just how powerful of a hormone you are working with. Insulin is a very powerful hormone and a mere drop can have a huge impact that can be potentially fatal. Plus a hypo even if you can pull them out of a bad one with food and sugar can still cause brain damage. Silver's safety is my first concern.
Click to expand...

Yes I know that, and I appreciate that you are concerned about Silver. I don't underestimate how powerful insulin is though. I have read Felix condo and seen how powerful just one drop is. I have taken every single dose reduction advise that has been given, even if I don't understand it or agree with it. I also know that you said at one point that we do a combination of SLGS and TR. I would never shoot a green and go to work and leave him. I would also never let him go below 3 (54 for you I think) - ever....as soon as I see him getting close to that I have fed him up. I have set my alarm in the middle of the night to take tests to make sure he is on the way UP again before I sleep. I have never gone to bed and left him on a falling low number. I do care about Silver and will not put him in jeopardy.
 
Re: 12/01 Silver PMPS - 100.8; +1 84.6; +2 66.6

I know you love him and that is why I worry. I know what it is like to feel like you killed your best friend, because I carried that guilt for a long time after losing my Muse. Because it was my hand that gave her the dose that killed her overnight. Now granted I was still in the very very early days of caring for a diabetic cat, she had only been home from the hospital about 4 days, and because of a long holiday weekend I had a meter but didn't have strips for it yet and everything here was closed. I did the best I could by her with what I had to work with and had stayed up with her late the night she died. But she still went into hypo after I finally closed my eyes and was gone when I woke up 2 hours later. She had gone into seizures and passed away.

Mel and The Fur Gang
 
Re: 12/01 Silver PMPS - 100.8; +1 84.6; +2 66.6

So what is it I am doing that is wrong? I did not know I was not supposed to give him a dose tonight - you had said earlier to give a fat zero which I did.

I have often shot below 150 and you've not said I should not have done so. In fact you've talked to me about shooting green before although I have only done that once. I've been shooting below 150 the entire time since he stopped getting the vet prescribed 2u. Why the change and I am not to do that anymore???

Obviously I don't want him in danger but can you understand why I get confused here?

I just did a +3 and its the same as his +2 despite having given him 2 teaspoons of his low carb food. Should I bring out the hypo kit?
 
Re: 12/01 Silver

Gave him two teaspoons of gravy FF at +3...about to do a +4 and can stay up to do a +5.
 
Re: 12/01 Silver

Okay let me try to explain. There is shooting low to stay low when the data supports the decision to be able to do it safely. Problem here is there isn't enough data to support it because since getting him off dry food Silver has been trying to walk right off insulin. And he just went a complete cycle in normal numbers without insulin. If he had been high tonight then shooting should have been reasonably safe. It's that he didn't rocket back into diabetic numbers after a skip that has me worried about giving insulin tonight.

Mel and The Fur Gang
 
Re: 12/01 Silver

MommaOfMuse said:
Okay let me try to explain. There is shooting low to stay low when the data supports the decision to be able to do it safely. Problem here is there isn't enough data to support it because since getting him off dry food Silver has been trying to walk right off insulin. And he just went a complete cycle in normal numbers without insulin. If he had been high tonight then shooting should have been reasonably safe. It's that he didn't rocket back into diabetic numbers after a skip that has me worried about giving insulin tonight.

Mel and The Fur Gang
Click to expand...

Ok...so next time he's in normal numbers for an AMPS and I see normal numbers again at PMPS then I don't shoot?

I tested him at +4 just now and he's at 90. I will wait til he's over 100 before I go to bed.
 
Re: 12/01 Silver

Depending on if he keeps dropping you may be up much later than +5.

I am staying on until I know he's back in safe numbers. Kind of the golden rule around here is we stay with a cat until we are sure they are safe.

Do you have plenty of test strips? This could be a long night if he keeps dropping

Mel and The Fur Gang
 
Re: 12/01 Silver

He's rising - he's gone up 30 pts in the last hour.

What is safe numbers?

Yes I have a lot of strips..

But I do need to get to bed as I have to get up in 5 hrs...

I can hold another hour then I must go.
 
Re: 12/01 Silver

Well he is rising now because of the High carb food but that isn't going to last long, in a perfect world I would like to see him above 90 without food propping him up. So let's see where he is at +5.

And if he drops again after the food wears off then you are going to need to stay with him and keep feeding him up so that he doesn't dive again. Sleep is something that sometimes gets sacrificed to keep them safe. Like I said earlier because of the nature of a depot insulin a hypo watch can go on for up to 16 hours and yes, sometimes that means staying with them for 16 hours and testing every 30 minutes if you have a severe overdose. Doubt that Silver will stay low that long but it can happen.

And yes, if you have a normal number that is too low to shoot in the morning and by that evening he is still in normal range don't shoot.

Mel and The Fur Gang
 
Re: 12/01 Silver

I nearly lost my job last week because I was so sleep deprived I was making mistakes.
That cant happen.

If need be, I will set an alarm and get up in a couple hrs but I am going to bed in half an hour. I have to. In 16 hrs time I am at work. So no 16 hr watches are possible.

I was told by someone else that 2 hrs after the food is usually a good indicator that its not a food rise only.

I am thinking of Silver - but I am also thinking of my health and my job. My health is not good as I am sure you have seen in my condo.
 
Re: 12/01 Silver

I can't change the nature of how Lantus works. Nor can you get it back once its shot. If they hypo they hypo and its either stay with them and feed them up or get them to the vet asap. Hypo can kill quickly. It doesn't play by work and sleep schedules. Trust me I didn't stay up until 4 a.m. by choice this weekend with Autumn. I stayed with her because she was too low.

Mel and The Fur Gang
 
Re: 12/01 Silver

I hear you...and I understand....but I really don't think Silver is in danger tonight.. he is purring happily beside me and his numbers are safe.

There is a limit to what the human body can accomplish. I have a 14 hr day ahead of me and staying up late or getting up in the middle of the night is not an option. If I lose my job then I cant care for Silver. I am sure you have seen that in aircrafts, when the plane is coming down, they tell the people to put the mask on themselves before their dependent or else they do not have the oxygen to help and both die. My friends are against me - they think I should have euthanised weeks ago. My pastor and my doctor are worried about my health and my job is in jeopardy. No matter what you or anyone else says....I cannot do the all nighters.

I will do another test in 15 mins then its lights out.
 
Re: 12/01 Silver

Juliet

I know you need to sleep (I have a sleep disorder - I really know!).

You may need to abort the cycle and feed him enough high carb to get him up to safe numbers and then some, so you can sleep knowing he is safe. Yes, it will likely make him high in the morning. I think you can trust he'll come back down and not shoot, even if he is high in the morning. He's been busy proving he can come down to you ... and keeping you up!
 
Re: 12/01 Silver - Lights Out 111.6

Ok...his +5 is 111.6 two hours since food.

Thanks for staying up with me ....I believe he is okay now.

Thanks for your message BJM - but let me just get this straight before I go to bed as no-one is online when I am ready to shoot in the morning. Time difference and all. As far as I am aware, I'm not on "no shoot" orders tomorrow unless he is under 150. Correct?

If he is over 150 then I shoot the "fat zero" (2 drops)that is his new dose.

If thats wrong, please someone post before I have to shoot in the am.

Thanks and goodnight.
 
Re: 12/01 Silver - Lights Out 111.6

Given that you'll be away at work and how much he has been dropping, I think I'd see how he does for 12 hours without insulin.

Maybe if he is over 200, i.e. bouncing, I might give a single drop. I just have a feeling he's ready to try going off the juice.
 
Re: 12/01 Silver - Lights Out 111.6

I do too...Mel do you concur - no dose in the morning no matter the number??

Although - when he bounces BJM - its usually in the 400s.

fyi - this is what I sent to my vet just now.

Hi,
Here is Silver's spreadsheet.

https://docs.google.com/spreadsheet/ccc ... YM3c#gid=5

He's now been on the Start Low Go Slow protocol for two weeks. I think you can see he has been doing very well. There's only been five days when he has not been in normal numbers.

He's had a few high bounces when I dose change or fur shoot, and I'm expecting another one in the morning (Dec 2nd) as he's now on only 2 drops dose. Apparently from everything I have read so far, the AMPS is the last to come down.

Planning on continuing with this protocol and believing he will be OTJ (off the juice) shortly.

Juliet
 
Re: 12/01 Silver - Lights Out 111.6

Just a single drop if he bounces over 200 mg/dL. You might push the plunger all the way in, insert the needle into the container, release, and it will draw up a tiny bit. Visually check that it is still a small dose, or test how many drops you can get from that, then repeat and adjust if necessary.

I think he will be able to come down on his own if he's under 200 mg/dL.

His pancreas may sputter a bit and you may need to chase the numbers, that is, only shoot if he goes up over 200 mg/dL.
 
Re: 12/2 Silver - AMPS 124.2 Second morning no dose

Gave no dose this morning as under 150 for second morning in a row. He's only had 2 drops of insulin in the past 36 hours and he didn't need those 2 drops.
 
Re: 12/2 Silver - AMPS 124.2 Second morning no dose

Silver is showing us he is done with being messed with. No more insulin, thank you, he says.

I would stop all insulin for at least 3 or 4 days, see what he can do. Even if he bounces up a bit, lets see if he can settle on his own. My money is on him.

At this point, what you are looking for is overall trends, over time. Is he generally in good numbers on his own? A fur ball or a cat fight can bring numbers up a bit, but the question is overall how well is the pancreas doing keeping kitty feeling well. Also, remember that "normal numbers" is a range. Some of us likely run a tiny bit high ourselves, yet are not diabetic. Some of us are low.

My point is while doing a OTJ trial, dont let little blimps on the radar get you discouraged. Look at the big picture.
 
Re: 12/2 Silver - AMPS 124.2 Second morning no dose

HI HO SILVER!!!!

Let's see if this kitty can give us another OTJ party! Alska loves to party....

You are doing a great job being so attentive.
 
Re: 12/2 Silver - AMPS 124.2 Second morning no dose

way to go Juliet & Silver.
hope we get an OTJ Party.
dancing_cat flip_cat dancing_cat flip_cat dancing_cat
 
Re: 12/2 Silver - AMPS 124.2 Second morning no dose

Thanks Tibbs and Robin....was so expecting a bounce this morning...it may still come.

If it does, should I give the one drop - or wait see if he can bring himself down?

Juliet and Silver
 
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