hi kristen. someone asked me to stop by and check out your SS and recent threads.... well i read yesterday's thread in which you asked for opinions, any opinions, even from those of us that have used PZI in past but do not normally post here, and my concern for such a recent DKA survivor being at the numbers he has been voted down my normal 'i don't post in that forum' rule and i'll venture an opinion here. (i hope post will be received with the spirit in which it was written,
solely out of concern for this cat).
here is the thing~
newly dx'ed diabetic cats bounce.
it is normal and totally fine. however, imho, it is not wise to lower insulin dose to the point where bouncing stops and you are left in flat numbers alright, but ones just way too high for my comfort in a cat that survived DKA not that long ago.
there are a few ways to proceed~
fact: he is a low dose cat.
implication: he might very likely go off insulin one day if things are handled correctly and his pancreas has the capability.
for his pancreas to heal he needs time in lower numbers. there are a few ways to achieve that.
1- [manipulate time]. tid/shoot the rise with set dose is one way. and an effective way. especailly with such a low dose cat, the worry if you make an error is not anywhere near that as if you were attempting that with a hefty sized dosed cat. it really is not as difficult as it sounds, i know you are new and just handling what you have been is overwhelming, but you're a sharp cookie, i bet you can do it. remember you have room for error in what pam/layla described, ya got that whole pre-onset time for number to rise more as a safety net. also remember you are not shooting large doses of insulin, and you are armed with a meter and a hypo tool box(
viewtopic.php?f=14&t=2354),
you are in total control and are not gonna harm your cat. you can change any low number that makes you nervous, you've seen that already. yeah it is not fair that the newly dx'ed cat with the 'overwhelmed with having to process all this info on a topic that not long ago s/he knew nothing about' owner has to be the one that has the greatest possibility of awesome benefits from running the cat in green (the door to remission is open widest for the newly dx'ed), would be nice if there was time for you to hang out in higher numbers and get comfortable with all this, but since you have a cat that recently had DKA and
have to get his numbers down anyways, might as well go for that door and think about seeing if you can get some pancreatic activity happening by running him in lower numbers for as many hours a day as possible. kwim?
2- [manipulate food]. if shooting tid/the rise freaks you out too much~btw it is not something one has to do forever, just until either a working pancreas starts peeking its head around or until cat stops bouncing and word 'regulated' and 'sam' can be used in same sentence or at least until more time has passed putting greater distance between him and the DKA episode. many have done short term tid/rise shooting for a while and then stopped, it
is a lot of work, and they discontinued it when certain goals had been achieved~however you can try this (this meaning spending more hours in lower numbers) with bid shooting, the good old 12/12 with set dose, and manipulate numbers more with food and % carbs. like raising insulin dose to one that can produce some green numbers and softening drop with some bites of higher carb food and feeding lowest possible carbs when in the bounce part of cycle. like say you have a lower PS, then would feed higher % carbs as meal with that so when onset happens insulin can play with that and let cat stay in range you want. there will be less hours in range you want but this
is a new diabetic here, plenty have gotten to goal w/o resorting to tid/shooting the rise way of handling things. totally your choice on how you want to proceed here with sam. as time goes by the bounces will get shorter and less extreme and every green number won't be followed by a red one and he'll surprise you with a way flatter curve.
3-[manipulate dose]. you can also try using a sliding scale approach, however that is the one i least suggest, the "see a number/shoot a number" style of working your insulin is one that it is too easy to miscalculate and end up either undershooting or overshooting, and just seen have too many end up wasting time chasing numbers all over their SS. to me that style feels like one is reacting to what has happened rather than shooting for what is gonna happen, always one step behind.
anyways the point of what i am trying to pass on to you here kristen it that sam is going to bounce, that is a given and not "the most horrible thing ever in the world of feline diabetes", just a normal stage of the process and there are things you can do to work around or with that and i feel strongly that this lowering the dose to stop the bouncing is not the safest way to proceed for your cat.
hth~
jojo
ps. as an extreme example of bid shooting w/ a long time bouncy bouncy cat (no, so not saying that your time frame will be
anything like theirs!) go check out barbara and tuffy's SS~ different insulin but a great example of a very bouncey cat (that wore on owner's patience), but then suddenly body finally 'got it' one day and the bouncing stopped. once that happened, the cat was able to spend long hours in pancreatic healing range and tada!~ went OTJ.
the formula for whole feline diabetes thing is:
insulin + food + time + cat: the unknown variable in the equation = BG number on meter.
you can learn to control the first 3 variables there and will end up once
you know your cat to pretty much knowing what number is gonna be on your meter at any given time. see how one day instead of being surprised by number on meter you can cause it? no more 'hoping for a good number'~ you create it!
