16/12/13 Errol PMPS 6.2 (112) +2 2.8 (45)

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Michele&Errol

Michele&Errol

Member Since 2013
Hello FD Friends ~O)
I am in somewhat of a quandry as to what to do next with Errol's insulin. He's on .025 and his numbers have been pretty good for a few days. I haven't managed to a curve yet and am working flat out so am not able to even do a whole lot of BG tests during the day. At night I am so tired it's really difficult to be able test a lot too, as I get up at 05h00 and that doesn't leave much time for sleep. I am someone who needs to get a decent amount of sleep or I cannot function. Anyway, explanation for not a lot of testing aside, last night's +2 was LOW.

1. My big worry is, if the PS # is shootable, and then suddenly drops on a +1 or +2, I am in trouble because if I'm not around to check I would rather forgo the shot to be safe. However, I do not want the tank to empty and be back at square one.
2. Is it at ALL possible, that Errol doesn't have ''genuine'' diabetes but it was caused by an infection and he has 'recovered'?
3. What are his chances if any of ever going OTJ and how would I steer him in that direction?

Your opinions, ideas & comments will be much appreciated. I am NOT trying to jump the gun and take him off insulin - far from it. I just don't want to do anything ignorantly and cause a relapse or a permanent issue.

Thanks :smile:
 
yikes, michele with a LOW last night and a 45 tonight, Errol's telling you he really needs attention! i so understand tired, but LOW doesn't show up in some meters til you're less than 20 or less than 30, depending on the meter. it means there's not enough sugar to measure. that's an emergency. many non-diabetic cats are in the 40's and anything less than that is really too low. when we give insulin, we treat the 40's too, because there's just no room for error with insulin and numbers that low.

did Errol show signs of hypoglycemia? that's really concerning. after a hypo event, cats often will be extra sensitive to insulin. with a 45 at +2, we might expect him to still be on the way down tonight, so you've really got to keep monitoring him.

he needs a dose decrease - don't give the 0.25u again. let me get back to you on a dose. we usually go to 0.1u first, but if you can't monitor it might be safer to do a trial of no insulin for him.

i understand the exhaustion, but it looks like errol might be a short time on insulin and off, and we just want him to be safe. i'm so sorry no one saw this post earlier tonight. if you see this would you retest and repost . . . just so i don't worry! :YMHUG:
 
Michele,

The SS says 50, but your subject says "45". But the 2.8 comes out to 50.4, so the SS I assume is the right number.

Did you feed Errol when you saw that +2?

1. My big worry is, if the PS # is shootable, and then suddenly drops on a +1 or +2, I am in trouble because if I'm not around to check I would rather forgo the shot to be safe. However, I do not want the tank to empty and be back at square one.
Click to expand...
It isn't the easiest thing to do, but can you count how many drops of insulin make up that .25u dose? And maybe squeeze out one drop to skinny up the dose a little?

2. Is it at ALL possible, that Errol doesn't have ''genuine'' diabetes but it was caused by an infection and he has 'recovered'?
Click to expand...
Usually, just an infection of some sort wouldn't cause all the symptoms that lead to a diabetes diagnosis. I don't know Errol's history, or what kind of tests were done to diagnose or verify the "diabetes" conclusively. Sometimes, after getting steroids, a kitty can become diabetic. And many times, that is a "short-time" thing that goes away once the effects of the steroids are gone, especially if a cat is switched over to an all-canned low carb diet.

3. What are his chances if any of ever going OTJ and how would I steer him in that direction?
Click to expand...
Based on his spreadsheet lately, I'd say the chances of him going OTJ are really good. He's getting really nice numbers on a really small dose.
 
Michelle - Errol is looking great right now! We do try to keep cats on insulin as long as safely possible, to support a healing pancreas. With the skip of 2 shots and still great numbers and that 2.8/50 tonight, he definitely wants less insulin. In our protocol, we try to go to .1U before stopping insulin completely.

You can see examples of fine doses with BD syringes here. Some people push the plunger in as far as possible when putting the syringe into the vial/cartridge and then letting go. What insulin goes into the syringe is what they shoot. You might want to try twisting the plunger to see how many drops are in the .25U dose you are giving now, and seeing if there is a way to cut that in half.

If you are ever worried about low numbers and have to go out, leave out food for Errol to eat. You can choose a medium or high carb food if the numbers are quite low, or even his regular low carb if that will bring his numbers up. If you can't get a +1 or a +2, could you get a +11 from the previous cycle? That will tell you if the PS is a dropping number and likely to be a lower cycle.

Some cats just need a little time on insulin before their pancreas starts working again. I've seen some cats on insulin less than a week. It could be the combination of going to low carb food and a little insulin is what Errol needed.
 
hi michele - a little clarification. when you said Errol was "LOW" did you mean the meter read "LOW" or "LO" or do you mean that the 2.8 (45) was a low number? My heart attack was thinking you meant the meter read LOW, but Wendi is thinking you mean he's in lower numbers (2.8) than he has been.

If there isn't enough blood glucose to measure, the meters will read LOW/LO instead of a number - which is a crisis. now i'm thinking Wendi understood what you meant.

so if you could clarify for us, that would be awesome! :-D
 
julie & punkin (ga) said:
hi michele - a little clarification. when you said Errol was "LOW" did you mean the meter read "LOW" or "LO" or do you mean that the 2.8 (45) was a low number? My heart attack was thinking you meant the meter read LOW, but Wendi is thinking you mean he's in lower numbers (2.8) than he has been.

If there isn't enough blood glucose to measure, the meters will read LOW/LO instead of a number - which is a crisis. now i'm thinking Wendi understood what you meant.

so if you could clarify for us, that would be awesome! :-D
Click to expand...

Hi Julie
I'm so sorry, I didn't even think (exhaustion :-| ) when I wrote LOW. I meant I thought his BG of 50 +2 last night was ''low''. The meter didn't read LO or LOW. Sorry about the stupid mistake and for worrying you.
 
julie & punkin (ga) said:
yikes, michele with a LOW last night and a 45 tonight, Errol's telling you he really needs attention! i so understand tired, but LOW doesn't show up in some meters til you're less than 20 or less than 30, depending on the meter. it means there's not enough sugar to measure. that's an emergency. many non-diabetic cats are in the 40's and anything less than that is really too low. when we give insulin, we treat the 40's too, because there's just no room for error with insulin and numbers that low.

did Errol show signs of hypoglycemia? that's really concerning. after a hypo event, cats often will be extra sensitive to insulin. with a 45 at +2, we might expect him to still be on the way down tonight, so you've really got to keep monitoring him.

he needs a dose decrease - don't give the 0.25u again. let me get back to you on a dose. we usually go to 0.1u first, but if you can't monitor it might be safer to do a trial of no insulin for him.

i understand the exhaustion, but it looks like errol might be a short time on insulin and off, and we just want him to be safe. i'm so sorry no one saw this post earlier tonight. if you see this would you retest and repost . . . just so i don't worry! :YMHUG:
Click to expand...

Hi again Julie, just to answer this post : no he didn't show any signs of being off at all, in fact he was quite chipper and ''normal''. This AM (we are +-7hrs ahead of the East coast of the USA on average) he and Sylvester (my tuxedo boy) were rough housing as usual. Errol is not sleeping this morning, as he has for so many other mornings since diagnosis. I stupidly left the verandah door open when I went to get something and the little piglet snuck in and 1Tablespoon ful of Sylvester's contraband Hills Light. I am depressed about that because he hasn't had a bite of dry food for days now. I am trying to get Sylvester on wet as well but he is convinced it's poison so am battling a bit. Then we won't have any more of these ''mistakes''.
So now when I take his +2 I'm expecting numbers to be up from the HC TS of Hills :evil:
 
Thanks for the clarification Michelle - our recommendations would be different if Errol's BG read Lo. I've been there - it's scary. As an aside, it you ever do get a Lo reading, retest right away. That's what I did and came up with a much better number the second time.
 
Re: 16/12/13 Errol PMPS 6.2 (112) +2 2.8 (50)

Wendy&Neko said:
Michelle - Errol is looking great right now! We do try to keep cats on insulin as long as safely possible, to support a healing pancreas. With the skip of 2 shots and still great numbers and that 2.8/50 tonight, he definitely wants less insulin. In our protocol, we try to go to .1U before stopping insulin completely.

You can see examples of fine doses with BD syringes here. Some people push the plunger in as far as possible when putting the syringe into the vial/cartridge and then letting go. What insulin goes into the syringe is what they shoot. You might want to try twisting the plunger to see how many drops are in the .25U dose you are giving now, and seeing if there is a way to cut that in half.

If you are ever worried about low numbers and have to go out, leave out food for Errol to eat. You can choose a medium or high carb food if the numbers are quite low, or even his regular low carb if that will bring his numbers up. If you can't get a +1 or a +2, could you get a +11 from the previous cycle? That will tell you if the PS is a dropping number and likely to be a lower cycle.

Some cats just need a little time on insulin before their pancreas starts working again. I've seen some cats on insulin less than a week. It could be the combination of going to low carb food and a little insulin is what Errol needed.
Click to expand...

Hi Wendy
Sorry, I corrected the subject to ''50''.
aha, now I understand the +11 's importance.

Last night, when I saw the +2 50, I gave him a tablespoon of MC wet food with gravy. I was quite panicked when I saw that # but he seemed perfectly fine. However, I know that is not enough to go on as with humans some people do not realise they're set for a hypo until it's too late.
I kept an eye on him all night, though couldn't update the ss at the time as I was doing it from my phone which I can't access the ss on.

I'll count the insulin drops. I tried it with orange squash (juice) so I could see better, and it seems that 2 1/3 drops orange squash make up .25u. I did it about 5 times, and that seemed to be what it always turned out at.
 
Wendy&Neko said:
Thanks for the clarification Michelle - our recommendations would be different if Errol's BG read Lo. I've been there - it's scary. As an aside, it you ever do get a Lo reading, retest right away. That's what I did and came up with a much better number the second time.
Click to expand...

I got a ''LO'' last week, but I knew off the bat that there was not enough blood on the strip, so retested immediately at it was normal. My heart did race for a bit though :shock:
 
Carl & Bob (GA) said:
Michele,

The SS says 50, but your subject says "45". But the 2.8 comes out to 50.4, so the SS I assume is the right number.

Did you feed Errol when you saw that +2?

1. My big worry is, if the PS # is shootable, and then suddenly drops on a +1 or +2, I am in trouble because if I'm not around to check I would rather forgo the shot to be safe. However, I do not want the tank to empty and be back at square one.
Click to expand...
It isn't the easiest thing to do, but can you count how many drops of insulin make up that .25u dose? And maybe squeeze out one drop to skinny up the dose a little?

2. Is it at ALL possible, that Errol doesn't have ''genuine'' diabetes but it was caused by an infection and he has 'recovered'?
Click to expand...
Usually, just an infection of some sort wouldn't cause all the symptoms that lead to a diabetes diagnosis. I don't know Errol's history, or what kind of tests were done to diagnose or verify the "diabetes" conclusively. Sometimes, after getting steroids, a kitty can become diabetic. And many times, that is a "short-time" thing that goes away once the effects of the steroids are gone, especially if a cat is switched over to an all-canned low carb diet.

3. What are his chances if any of ever going OTJ and how would I steer him in that direction?
Click to expand...
Based on his spreadsheet lately, I'd say the chances of him going OTJ are really good. He's getting really nice numbers on a really small dose.
Click to expand...

Hi Carl

Yes, I gave Errol some medium (?) carb wet food which he demolished.

This AM I checked with orange squash, but I'm thinking I will use actual insulin to compare to be 100% sure.

When he was diagnosed it was done purely on BG levels at the vet (403), and my observations of him drinking and urinating excessively. After 1 week of no real appetite where all he would eat was Hill Light or Royal Canin Feline Diabetic, the vet put him a 5 day course of Synulox (amoxicillin) and after that his appetite was great. He's never been to the vet apart from 1st check up as a kitten, being neutered, and once when he was little and ate a lizard's tail and I thought he was dying :lol: Never been on any steroids or other meds.

Just done his morning +2 (we're 7 or so hours ahead of the USA) and it's 3.9 / 70 - not what I was expecting after his little splurge on HC dry.
 
I've seen a few kitties here who developed a urinary track infection that threw them into diabetes. One cat that I know of had this happen twice and both times, Hagrid was on insulin for a few weeks and went into remission.

I want to encourage you to grab a test whenever you can. There's a good chance that Errol is going to need a dose reduction soon and you want to be able to catch it. In addition to numbers dropping below 50, you can reduce if he's in mostly green numbers for 7 days. (Please let Errol know that if he stays away from your other cat's food, he may not need to be poked. Maybe he'll listen!!)
 
I hope Errol will keep surfing safely for you. It is hard to get those mid cycle test when working full time and needing sleep. I need sleep to function too. Are you able to get a +11 test? I changed my schedule just a little (getting up 10 minutes earlier) to grab an early test for Furball to see if she's going up or down. I test as soon as I get home from work too. Errol is looking good. Hopefully he won't have to keep taking insulin very long.
 
Michele --

It may be a matter of splitting hairs if Errol was at 50 and given your concern about his dropping into lower numbers if you're not home or can't test, what would you think about reducing Errol's dose to 0.1u?
 
michele, thanks for answering all the questions! sorry for panicking on you last night! you did everything right - i just misunderstood what you meant. When you said "last night" i was thinking the low was 24 hrs before the 45, with no dose reduction in between. in any case - all is well! :YMHUG:

i agree with sienne's suggestion to just go ahead and reduce the dose to 0.1u. errol looks like he's not wanting to have insulin for long and it could be the infection, etc., that was just too much for him, but is resolved now.

The pics for tiny dosing are in the New to the Group sticky here.
 
Hi Michele!!
Congrats on the Reducie! :-D Errol looks great, two skipped shots in a row and still in decent numbers...wow!
I noticed on your ss that you mention how Errol is not drinking much if any water from the bowl. I noticed that with my cats once they went on wet food only. There is such a high moisture content to the canned food, they really seem to get all the water they need from that. I still fill the bowls fresh everyday, so they have the option, but it usually looks like they were completely untouched :smile:
 
Dyana said:
I see your +2 is 70, even after eating some dry food. I hope he surfs along nicely.
Click to expand...


Thanks Dyana :-D I was so cross with myself for that slip up, but thank heavens it didn't seem to make too much difference (I hope). I can't wait til they're all on the same food, I think much of my stress at the moment will be eradicated if I don't have to worry all the time about hiding contraband. Molly (DSH torbi rescue) is almost eating wet food totally now, but Sylvester is being picky. Despite being on a tiny amount of Hills Light for a year, he still has a big belly so hopefully when I get him on wet only that will go.
 
Sienne and Gabby said:
I've seen a few kitties here who developed a urinary track infection that threw them into diabetes. One cat that I know of had this happen twice and both times, Hagrid was on insulin for a few weeks and went into remission.

I want to encourage you to grab a test whenever you can. There's a good chance that Errol is going to need a dose reduction soon and you want to be able to catch it. In addition to numbers dropping below 50, you can reduce if he's in mostly green numbers for 7 days. (Please let Errol know that if he stays away from your other cat's food, he may not need to be poked. Maybe he'll listen!!)
Click to expand...

That is encouraging Sienne! :-D

I'll definitely try and get some +11's. Considering how much he dislikes being poked, though he is an angel and all the reward he wants is kisses and cuddles, hopefully he will listen ;-)
 
carfurby said:
I hope Errol will keep surfing safely for you. It is hard to get those mid cycle test when working full time and needing sleep. I need sleep to function too. Are you able to get a +11 test? I changed my schedule just a little (getting up 10 minutes earlier) to grab an early test for Furball to see if she's going up or down. I test as soon as I get home from work too. Errol is looking good. Hopefully he won't have to keep taking insulin very long.
Click to expand...

Thanks carfurby :smile: Phew, yes, it's holiday time here for some until the new year, not me! I'll do some +11's in the AM, when I get up.
Yes, I really hope so..
 
julie & punkin (ga) said:
michele, thanks for answering all the questions! sorry for panicking on you last night! you did everything right - i just misunderstood what you meant. When you said "last night" i was thinking the low was 24 hrs before the 45, with no dose reduction in between. in any case - all is well! :YMHUG:

i agree with sienne's suggestion to just go ahead and reduce the dose to 0.1u. errol looks like he's not wanting to have insulin for long and it could be the infection, etc., that was just too much for him, but is resolved now.

The pics for tiny dosing are in the New to the Group sticky here.
Click to expand...

Hi Julie :-D No problem, I'll be more careful with my wording ;-) I have dropped to 0.1u so holding thumbs!!! Thanks, I'll go and check them out!
 
Kim & Twice said:
Hi Michele!!
Congrats on the Reducie! :-D Errol looks great, two skipped shots in a row and still in decent numbers...wow!
I noticed on your ss that you mention how Errol is not drinking much if any water from the bowl. I noticed that with my cats once they went on wet food only. There is such a high moisture content to the canned food, they really seem to get all the water they need from that. I still fill the bowls fresh everyday, so they have the option, but it usually looks like they were completely untouched :smile:
Click to expand...

Thanks Kim! I was wondering if he should still be urinating quite a bit? I was adding a bit of water to his wet food to make it easier to eat, perhaps this could account for it? So today I added less and will see I guess.
 
Adding water to Errol's food -- all your kitties' food, actually -- is a good thing. It's good for their urinary health. Cats typically don't drink all that much. It's one of the many reasons that canned food is better than dry -- higher moisture content. Errol shouldn't be flooding his litter box, though, since his numbers are looking so good.
 
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