2/2 - Sami - PMPS 283; +2 317;

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Tina & Sammy

Tina & Sammy

Member Since 2010
Yesterday's Condo

I am so confused and disappointed by the numbers last night. Could someone please tell me what might have caused the higher numbers. I was somewhat hopeful that with the higher dose she would get back into the yellow. Am I just freaking out? Do I just need to wait to see how she does? I know everyone continues to say that sometimes it takes up to 6-10 cycles to see what a dose will do. I am getting concerned that I maybe I should take her back in to the vet to be checked again.

I do see the progress in her spreadsheet from the last week or so where she was mostly black and red, now she is mostly pink with a sprinkling of red, but still those numbers are still way too high.
 
This is totally normal for her to come down like this. As you go up in doses, the #s will come down. The #s may be still too high, but the upside is.. they ARE coming down. You mentioned that you are starting to see an improvement from last week's #s. This is very positive. :) Don't be too discouraged... She IS seeing improvement, and is definitely showing less red and black. :) You're doing a wonderful job. You both are. :)
 
@Angela & Blackie & 3 Others Thank you so much for the support. I feel like I am doing something wrong when the numbers are not responding like I expect them too. I just don't understand why she was in remission for 5 years, and even with a couple bouts of high BG during these 5 years she regulated within a couple of doses of insulin. Now it is a struggle again.
 
I called the vet for her input. As I expected she wasn't really happy about me taking the dose up, but honestly, it worked for Sami last time so I am really trying to stick with the tight protocol. I am going to do a curve today to see how she does. I have to go back to work tomorrow so I need to have an idea of what is going on with her before I leave her for several hours.
 
New Dose Wonkiness can affect the first couple of cycles after an increase. Sometime Neko would wait until the 4th or 5th cycle to give me a hint of want the increase would do. It's very frustrating, but nothing you can do but wait. Plus, Sami is getting awfully close to yellow today. :) Come on Sami, work that juice!
 
Hi Tina,
Yes, it is frustrating, but it seems like Sami is coming down slowly. And that is a sign that you are doing everything right. FD is a mysterious condition. You may never know why Sami's blood-glucose numbers got high after 5 years of remission. I haven't been following your condo, but assume that Sami has been to the vet and had all the blood tests, etc. So if all was OK with regard to her health, it seems that she just has to return to insulin. The flat-pink numbers that she is getting on the increased dose may signify that you will soon see some downward action. It would be nice to see some sort of a Lev. curve!! I hope Lev. will work well for Sami.
Keep on truckin'!

Ella & Rusty
 
@Wendy&Neko It is so frustrating when I can't figure out why sometimes she is so sensitive to insulin and regulates after a few shots, and now she has been high for more about a month.

@Ella & Rusty & Stu(GA) Sami is actually on Lantus, but I am still expecting some sort of curve, or at least a significant drop during her cycle to show that the insulin is doing something.
 
Tina & Sami said:
As I expected she wasn't really happy about me taking the dose up,
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Was her thinking that LESS insulin would get better results?? Gotta wonder where some of these vets got their degrees!

You're doing everything right....for whatever reason, she's just going to be more difficult this time (I think it's in the Cat Bible..."thou shalt not be predictable")

Getting a 2nd remission is really rare and it looks like you've gotten Sami into remission several times!
 
@Chris & China The vet was a little disappointed that I went up to 1.0 unit instead of the .75 unit that we discussed earlier in the week. She was also disappointed that I increased again after 6 cycles. She knows that I follow this board and I mentioned that this was in line with the tight protocol. She said that usually they like to watch a cat on the same dose for 2 weeks before changing, but I am sure it is not their goal to get the cat into remission which is what I suspect the tight protocol is trying to do. After talking to her for a bit she did agree that even at the 1.5 unit dose it is a small dose for Sami's size 12.8 pounds. I don't know what that means, but maybe someone her would understand. The vet is going to watch Sami's spreadsheet today as I do the curve and she will call me later.

My biggest concern is if I can't get her to remission. It would mean that I can never go on vacation or would be constantly worried about her while I was gone. How do you all do it that have been dealing with this for years? What do you do when you go on vacation? I can't even really rely on my husband because he thinks I am totally nuts and overreacting, over testing, and being over dramatic. I really do need to sit down with him and explain the situation because I am hosting a twelve day retreat in just over 2 months and if we can't get Sami regulated by then his is going to have to take over while I am gone.
 
Tina & Sami said:
at the 1.5 unit dose it is a small dose for Sami's size 12.8 pounds
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Not sure what she's thinking other than the same thing we see a lot of vets think! We see so many start them too high in the first place!

Lantus has a starting formula of [weight in Kgs x .25] = starting dose. For Sami that would have been 1.45 unit, but here, we always like to start a little lower and slowly work up so we don't pass a "best dose" and it keeps kitties safer
 
Hi again, Tina,
Sorry, I had Sami confused with Milo (who is on Lev.).
As to your question about vacations, etc., these are things that have to be worked out and well planned in advance. Hopefully you can find a good cat sitter who will follow your instructions. Some people have been able to get vet techs to come to their house. If you husband can be "educated", he would be a possibility. Or at least someone would be there and the vet tech could simply come to give the shots. When Sienne has to be away for a few days she lowers the dose because Gabby will not tolerate anyone else giving tests (but will tolerate the shots). But 12 days is a long time to go with a reduced dose. Perhaps you could take Sami with you? We take Rusty everywhere. My DH is legally blind and cannot test or give shots, but the few times I was called away on emergencies, a friend came over to do the shots and my DH was there all the time to keep an eye on Rusty and make sure that he ate his food.
It is true that living with a diabetic cat can put a crimp in one's lifestyle, but over the last 11 years we have evolved a modus operandi and manage to do all the things we like to do. (Rusty is our second feline diabetic, and we adopted him as a diabetic.)

Hang in there. It will all work out!

Ella & Rusty
 
I have considered taking Sami with me as a last resort. The problem is we are going to a 3600 sq ft cabin and there is at least one person that is allergic to cats. I would be forced to keep Sami locked up in my bedroom the entire time. I would also have to confirm that having Sami in the room would not disturb my other roommates. Again, I would consider this as a last resort, but it is an option if she still needs strict monitoring by then. I am still hopeful that we can get the numbers down. I am also still convinced that this round of high BG is almost entirely caused by stress over a several month period. The doctor keeps telling me that she doesn't think that case, but I am not totally convinced yet. I keep telling myself that if we can get her back in the green her body will respond. We just need to remind her pancreas what the levels are suppose to feel like. I have 71 days to make it happen.
 
Wendy&Neko said:
It's your choice whether you want to increase tonight (fast track) or tomorrow morning (regular protocol). He's in high enough numbers that you can fast track. For anyone else reading, Milo has come out of remission, and we try to be a bit more aggressive with kitties coming out of remission, so this is a suggestion for Milo only.
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@Wendy&Neko , In Milo's condo you mentioned it was okay to fast track him because he was coming off remission. It is hard to compare Sami's spreadsheet to Milo's, but I am wondering since Sami is also coming off remission should we be fast tracking as well, or are her numbers coming down enough to stick to regular protocol? We will probably know more by the end of this curve cycle.
 
I have no advice Tina but wanted to send HUGS to you and headbutts to extra sweet Sami. Your roommates might enjoy having a four-legged roommate! They'll remember it forever... :)
 
I think Sami would be a good candidate for fast tracking too

You test more than enough to keep her safe and she's staying higher than we'd like to see her

Once she starts to get blues, we'd want to slow her back down

There's really no need to do hourly blood glucose tests right now. I suppose her ears might be getting a little sore.

Hopefully Wendy (or some of the others) will chime in and give their opinion too, but even fast tracking, you wouldn't go up until tomorrow night at the earliest
 
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@Squeaky and KT Thank you for the support.

@Chris & China The only reason I am doing the hourly is because we just wanted to make sure that she wasn't dipping down and spiking back up in the few hours between tests. I will go back to every couple of hours tonight. She has been so good with the testing, I couldn't ask for a better patient.
 
I am very happy to report that Sami broke into the 200's late in her cycle this morning. She was toying with it for much of the day, but it finally happened.

I don't know if I mentioned, but I didn't leave the food out for grazing all day, but I did dish out specific servings throughout the day up until +9, she didn't have any food after +9 AMPS. I made notes on the spreadsheet. I gave her anywhere from 1 tsp to 2 tbsp at each serving.

I gave another 1.5 unit shot this evening and will test at +2 to see where she is, and then determine further testing based on the +2. I would love to see her go a bit lower tonight.

Is it normal for a cat to have a lower so close to the end of the cycle, after being about the same at +6? I am assuming each cats curve is a bit different. This isn't the first time that Sami was still dropping at the next PS. Could this mean that the insulin is still at work or could it also mean that her body is producing it's own insulin?
 
Hopefully it means that this dose is going to get her into better numbers!

One of the things that makes Lantus such a good insulin is because it can last longer than 12 hours, so there's some "overlap" from one cycle to the next.
 
Yeah for a yellow preshot! Paws crossed she's over NDW and starting to work this dose. Sami could have been getting over a bounce today, hence the lower PMPS. When Neko was on Lantus, she'd often keep dropping to the end of the cycle. And I even once caught her low point at +13. But she has a variable nadir at the best of times.

Let's see where she is toward end of day tomorrow, and after her fourth cycle on this dose before deciding if she needs to fast track.

As for vacations, we've had a number of people go the petsitter route, usually with a slightly reduced dose for safety, depending on whether the sitter would test. Maybe now is the time for your DH to step up to the plate - in interests of saving money of course. ;) Once my DH decided he could test (he could shoot from day 1), it made life much easier for the two of us. I had a friend go to England for a month with a local vet tech come in twice a day to do preshot testing and shoot with a reduced dose, so it can be done. It's not perfect for the cat, but when you consider the vast majority of people do not home test their cats and shoot blind, its a heck of a lot better than that.
 
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