2/20 Sid update on day 3 TID

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Lydia & Sid & Jake(GA)

Lydia & Sid & Jake(GA)

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Good suggestion to start a new thread, Laurie. I was thinking the same thing. :-D

Sid's lowest level last night was 285. At PMPS +6.5 when he was HI, I gave him a fat .25U of R and it only brought him down to 331 and only lasted about 2 hours. I think I should have given him an entire unit but I was worried about what might still be going on from the Prozinc. I still don't know exactly how he is handling that. I do know that once he is HI nothing except more insulin brings him down. (AND both the internal specialist and my regular vet were very adamant that when he is HI, 1U of R will NOT make him go too low and it never has but it is also true that is if no other insulin might still be active so I have to keep that in mind.)

Last night as his numbers were high, he was pretty lethargic though he did eat the small meal I gave him with the R and he ate his usual 3/4 can this morning at AMPS.

I will be able to monitor him all day as I have a holiday from work (happy President's Day). I hope I get some clue as to what his levels might do during the week when I'm at work!






Last Condo: http://www.felinediabetes.com/FDMB/viewtopic.php?f=24&t=63996&start=50
 
Just letting you know you have an audience, following Sid's progress. :-D

Fingers and paws crossed here for Sid, and for momma bean! cat_pet_icon
 
Good Luck!

I have been following along, but I have no advice other than traditional tid experience. I do think you can and will find a way, to use Prozinc's flexibility to get Sid into better numbers.
 
I understand. :-D

Every day I am so grateful for the folks here. They truly are lifesavers! Some just taste better than others. :lol:
 
Sid started out pretty good and I was hoping for some better numbers. No luck because at AMPS +4.75 he is 453 :sad:
I am going to wait a little bit before giving him the next dose because I think this is too early.
 
Good morning, Lydia. How are you holding up? I peeked in around 4:30 (giving Mr T a mini meal) to see if you had updated...I hope you got some sleep! Yay for holidays!

I think I would be cautious about giving large doses of R, because when he drops too much too quickly, he will bounce hard. We're trying to get him off that roller coaster. The way I have seen others use R is to just get a moderate drop, not try to get down to green numbers. Just my thoughts FWIW.

I see you gave fluids....was that before or after you tested him? When do you give the pred? I'm just trying to get a feel for how other things are interacting. If you can note the meds, etc on the SS that will help.

I would get another test in 30 minutes or so and see which way he's going. He does sometimes go up and then go back down.

ETA: I meant 30 minutes from the last test, not 30 minutes from now.
 
Good morning ~O) OK, I see what you mean about the R. I will go back and try to see if I can find any clues to Sid's SS before the new SS. I am now wondering if 0.8 of PZI is too low? Let's see how your little guy does today. Hugs to you both! You're doing great, Lydia. I know it's a lot to takein and it gets crazy at times. I am glad to hear that you're open to the Meridian therapy etc. Since you have today off. Maybe find some time to just sit with Sid and visualize his pancreas healing and maybe give him, some catnip. What helped my Prudence was giving her some catnip when I knew she wasn't feeling so well. It could help keep their mind off of how crappy they are feeling ;-)

I also made sure I took her outside to play and get fresh air. She was an indoor kitty, but I really felt the outside helped. We have a fenced in backyard. I am not sure if you're able to do that, but if you can maybe give it a try.

Sending Sid good numbers & a catnap for you! I'll check back in awhile.
 
I know that typically SQ can lower BG but I don't believe it always works that way with Sid. I checked again at 5.5 and he was at 362. I do get what you are saying about a large bounce with R. He does a pretty good job of bouncing without any R influence but I agree that dropping too fast even not going low isn't the best thing to happen. I usually only give SQ when he is over 400 but I can update the SS for the exact times. Some of the times are already noted. I am checking into getting budesonide prescribed thanks to a suggestion by Patty though my vet thinks pred is fine.
 
I was thinking that it might be a good idea to increase the dose to 0.9u. I would usually want to wait a bit longer, but with Sid's situation, I don't think it's wise to sit on a dose that isn't producing good numbers for too long...and his duration is lousy, an increase might lengthen his cycles. Also, you are home to monitor, so I think I would do it today. That's just MHO.
 
Catnip is a really good idea. We can't go outside though. It is too cold and I don't have a fenced in yard. It is sunny though. When Jake (GA) was on hospice we spent hours outside because he would go on a leash. Sid is nervous and easily spooked so I don't think he would take to a leash.

Ok I will increase to 0.9. That would be about 2.25 on a u100.
 
Looking at Sid's SS why did you go to 0.8 from 1.25? Looks like 1UR & 1.25 P was trying to help there for awhile? Now, I am thinking that jump from 1.25 to .8 set you back. I would of dropped to 1.2 or 1.0 and it looks like Sid needs more mini meals.
 
Lydia & Sid & Jake(GA) said:
I know that typically SQ can lower BG but I don't believe it always works that way with Sid. I checked again at 5.5 and he was at 362. I do get what you are saying about a large bounce with R. He does a pretty good job of bouncing without any R influence but I agree that dropping too fast even not going low isn't the best thing to happen. I usually only give SQ when he is over 400 but I can update the SS for the exact times. Some of the times are already noted. I am checking into getting budesonide prescribed thanks to a suggestion by Patty though my vet thinks pres is fine.
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Actually, I was wondering if the SQ fluids raised his numbers....ECID, so I try not to make assumptions. ;-) It also could be stress from the actual administration of the fluids spiking his numbers a little.

Regarding the Budesonide...no experience, I'm no help with that. That's what this board is about, sharing experiences to help each other. :smile:
 
@Laurie - you could be right. SQ stresses Sid a lot and his heart starts racing while I administer :sad: Afterward he is fine and comes right back up to me for pets.

@Michelle - Sid was getting 1.25 BID and so when I went to TID, I added the BID and divided by 3. That is how I came up with 0.8 TID. I am trying to cut back on the R use because of the steep drops it causes and because I do not fully know how it affects the Prozinc. I agree that he did have some better numbers with giving R in combination with Prozinc; however, he would still spike to Hi and then I would give him another dose of R to bring him down. We were on a bad rollercoaster (that it still seems we are on now...) I'm not sure I agree about the meals though. Food spikes him up pretty fast. But I only fed a mini meal at MPS so I can give him a tbs or two later in the cycle to see if that helps in any way.

At 11:00 (+6.5) he was 562 so I gave 0.9 Prozinc along with a small meal.
 
Hey Lydia, I agree with Laurie about logging everything. It makes it easier for us to look for patterns etc. I like how you were doing that on 2/18 under the date. Log when Sid has food, meds etc. I am trying to wrap my head around the old SS and if it makes a difference to give R at the same time of PZI? need more coffee ~O) :-D

Well, lets log food so we can see exactly how it effects him. Food will spike numbers but should bring those numbers down 4 to 5 hours later. We want to get his pancreas working again. That's just MHO, but again you know your baby better than I do. I am here to support you no matter what you decide, ok. :YMHUG:
 
Lydia & Sid & Jake(GA) said:
@Laurie - you could be right. SQ stresses Sid a lot and his heart starts racing while I administer :sad: Afterward he is fine and comes right back up to me for pets.

@Michelle - Sid was getting 1.25 BID and so when I went to TID, I added the BID and divided by 3. That is how I came up with 0.8 TID. I am trying to cut back on the R use because of the steep drops it causes and because I do not fully know how it affects the Prozinc. I agree that he did have some better numbers with giving R in combination with Prozinc; however, he would still spike to Hi and then I would give him another dose of R to bring him down. We were on a bad rollercoaster (that it still seems we are on now...) I'm not sure I agree about the meals though. Food spikes him up pretty fast. But I only fed a mini meal at MPS so I can give him a tbs or two later in the cycle to see if that helps in any way.

At 11:00 (+6.5) he was 562 so I gave 0.9 Prozinc along with a small meal.
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Lydia,
quick question: what size ga needles are you using for SQ?

I ask because most vets give you the 18ga needles and they are like HARPOONS and are quite uncomfortable.
I have found that 20ga are a bit better, but my Shadoe most prefers 22ga UTW .... yes, they are slow to drip in but at least she does not try to slink away from the needle.
Needle size can make a huge diff in the feel for the cat.... I never cared if it took 20min instead of 8min; Shadoe was calmer and it was a nice time for bonding with her.
 
@Gayle - I use 21g. Actually I do not use a bag and line either. I draw up the SQ in a 60 ml syringe (means I use 2 needles each time - 1 to draw out the fluid and 1 to go into Sid). I learned how to do this when I volunteered at a sanctuary because this is how they give fluids to the majority of the cats there. Using the syringe means I can give an exact amount of fluids and do it in about 1 minute or less. It works so much better than a line. The only draw back is that the most I can give at a time is 60ml, but that is ok as I divide up the SQ into 2 doses. The 100 ml syringes are extremely hard to find but I know they are out there.


@Michelle, I appreciate yours and everyone's advice. I'm just trying to find something that works for Sid and I honestly do not care what it is. I just wish I would start to feel like I am making some progress. Everytime I make a little or I think I do, he slides right back up to Hi for no apparent reason. I am hoping that replacing the pred with the budsonide might help but I haven't heard back from the specialist about that yet and my regular vet doesn't like the idea. One way or another, I am going to get that for him.

I am working on getting the food/meds updated in his SS. Right now I have them as comments in the little squares so if you hover over you can see them, but if it is easier, I can make a new row. I think having the info in a new row is easier - I just didn't know if others thought it cluttered up the SS.
 
I missed Michelle's post...I agree that he lost momentum. I see you shot 0.9u, see how that goes. I would defer to Michelle on dose, she's got the experience with TID. I'd pick a dose and stick with it for a day or two though, let it settle (I think Michelle agrees, but feel free to correct me! ;-) )....barring any change in ketones, eating, etc. He's been up and down, and with the R in the mix, it makes predicting a "good" dose based on past data problematic.

I think it will take a bit of time and experimentation for you to figure out what works for Sid (PZ dose, timing, food, meds, etc) but you are doing great. The most important thing is to keep his ketones in check and keep him stable as you work toward that goal. I know it's frustrating, but you really have no other option but to try things and see what works, and what doesn't. We've had complex kitties on the board before, and it's a balancing act. The more input you get from people with experience/knowledge with all of his issues/meds as well as the insulin, the better!

However you want to make the notes on the SS is fine with me, I don't really have a preference as long as the data is there. Do what works best for you. :YMHUG:
 
Hi Lydia,
The extra line for comments is a good idea. The only access I have to the board currently is on my phone, so hovering isn't possible for me. I haven't had much to say because I have no experience with TID. I get the concept but have never done it. I am thrilled to see the help you are getting from folks with lots of experience with it! All I can help with is the sub-q fluids and the IM shots, and you already have that under control. I am watching and following along and wanted you to know that. My time on the board is just very limited and random at the moment.
Thanks to all who have been helping you and Sid out! You are all angels.
Carl
 
For everyone o:-)
happy_cats-picsay.jpg
 
Lydia & Sid & Jake(GA) said:
Catnip is a really good idea. We can't go outside though. It is too cold and I don't have a fenced in yard. It is sunny though. When Jake (GA) was on hospice we spent hours outside because he would go on a leash. Sid is nervous and easily spooked so I don't think he would take to a leash.

Ok I will increase to 0.9. That would be about 2.25 on a u100.
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Lydia, what size syringe are you using?
 
I use a conversion chart to convert for U40 insulin so that I can use the U100 syringes, which I prefer. I use 3/10cc 31g 8mm (5/16") shorts.

Check his SS because now at MPS +4 he is up to 526 again. That is a spike of 200 points in about an hour. Checked ketones and they are negative.

This is not the kind of response I was hoping to see from dosing TID. I would like him to get that momentum back that he had before - having his numbers stay so high for so long makes me very nervous.
 
Yes, I see the high number. Looking back when you were doing 12/12 I think it was 1.25 plus R at the same time... that seem to hold him at least to +8? I have to go back and look at that. Since PZI usually doesn't hold the full 12 hrs and ppl have better luck going TID... Just trying to figure out whats best for your baby boy. How did yo feel personally about giving the 1U of R during shot time? I've got to get out of this message and go back and look, Be right back, ok
 
I've been thinking about this. When Sid was hospitalized, the doctor increased his insulin to 1.5 and about 6 hours later he got down to 30 and had a pretty bad hypo episode. That could have been prevented with food. I don't think he is getting enough insulin right now. I"m thinking that I should go back to BID and increase his dose. But be prepared to offer him food when he gets to 120 or so. I still think the food spikes him up too much to offer it at +1 +2 +3 +4. Today I gave him a tablespoon and he went from 269 to 321 in about an hour - maybe that wasn't from the food as he hasn't come back down yet.
 
I am so with you as far as not wanting Sid to be on this seesaw, but if it were me... I'd probably give R now and hope that by +8 you could give shot and R again.

Food will spike no matter what them bring them down about 4 to 5 hours later.
 
@Michelle, I don't like giving a full 1U of R. I was thinking give him 1.5U of Prozinc and see how he does on that. If he gets Hi at +8 maybe give him a bit of R to tide him over until the next dose. Either that or increase the amount he is getting TID. I'm not sure. I know we have not gotten near any hypo numbers though.
 
Lydia, do what you feel, ok. I am here to help you through this. I was thinking to only give half the R now to hold him over to +8 this way you can try to stay on schedule and then give .9 plus 1UR to see if that will hold him to +7ish... just my thoughts, ok

It just seems that the .9PZI w/out R at the same time is not getting him to +7 or +8
 
I'm going to recheck him in about 15 minutes and see where he is at.
What about waiting until 6 pm (+7 since the last dose) and giving him 1.25 or 1.5 and no R and seeing what happens on that?
 
I would get numbers @+6 / +6.5 / +7 to see where he's at. It's just me, but I wouldn't jump that high because it throws the numbers all out of wack. maybe go to 1.0, but it's your call. You normally would sit on a dose for a few days to let it settle in, but in Sid's case. Those really high numbers I don't like.
 
Yes... Sid, Get the memo! haha You're doing great, Lydia :smile: have you tried to give SQ right b4 shot time. I think with all the in between stuff.. it's making this such a challenge, but hey... that's what we're here for :-D Just a thought again... Just keep in mind about food will spike his numbers.. that's normal.
 
Lydia, your data from the beginning of the cycle is very helpful...here's my take on the food....

PS 567 1/8 can
+1 536 no food spike...pretty steady
+1.5 359 <whoa, that's a huge drop in 30 minutes....look out for the bounce that's coming!
+2 269 <there's another big drop in 30 minutes....1 tbs food
+3 321 <food effect? or bounce starting?
+4 521 <bounce!

Based on this, I would try feeding like you did at PS (that was good, he didn't spike way up) then feed again at +1 to try to counteract the fast drop that's coming. I know Gayle suggested feeding PS, +1, +2 and +3, we commonly suggest that with kitties that love to dive fast and early on Lantus/Lev because it does help to slow them down and reduce bouncing. That schedule is a starting point, and then each bean adjusts it as necessary for their kitty. I think it would be good to try it. You might want to try feeding PS, +1, +1.5 and +2...he really zooms down fast, and that might work better for Sid, but you'll have to experiment.

I did not feed that way with Mr T on ProZinc, I fed at PS and +3, and added other snacks as needed, but I used a variation on that schedule with him on Lantus....PS, +2, +3, +4. It does help with dive-and-bouncers.

I know you worry about the food spikes, but if you can use the food strategically, you can use the food spike to your advantage to flatten him out....we call it "feeding the curve" because that's exactly what you are doing...feeding to counteract the drop.
 
I would not give R....he's on enough of a roller coaster, that's only going to add to it. He's bouncing enough just from the PZ. I also would not increase the PZ....I would stick to 0.9u, and try the food manipulation.

The R you gave last night dropped him way too fast. As long as he keeps dropping so fast, he's going to zoom right back up. You need to slow the drops.

ETA: I just saw the post about going back to BID and raising the dose....you could do that, but either way, you are going to need to feed those drops and slow them down. If you can slow the drops, you'll reduce the zooming up. JMHO

ETA again: Lydia, I know the high numbers freak you out, and I don't blame you....but rather than react by shooting more insulin, using R, etc, it makes sense to analyze what's going on and try to fix it. He's on a roller coaster, let's get him off the roller coaster, ok? More insulin is not always the answer.
 
I know Laurie knows more about Lantus and now looking at what she means about the food, I have to agree she's on to something there. But I also feel you're right about Sid not getting enough insulin. The 0.8 just wasn't cutting it to me. When I look back at 2/4 he had 1UPZ by his 2nd shot of 1U PZ he had some really good numbers, but you didn't get numbers after +5, so that brought the next days all out of wack. On 2/5 I do not see where you gave his 2nd shot? I am assuming it's where the White box is? he had good numbers there as well and if you could of caught the +7.5 mark.... I really thing the next day would of been better.

I have to run out for awhile, but I'll keep checking back.

I suggested the R early this evening to see where he would be at +7ish. My gut says the Prozinc just isn't enough to hold him to +7 or +8 With that said, If it were me... I'd start 1.0 Prozinc then feed again like Laurie suggested at +1 or +2 Give his SQ around shot time too, so you have nothing messing with his numbers. Hold food back til his next shot. At this point I almost want to suggest 1.2 Prozinc because if you're trying to get away from the R... you need to make sure the prozinc is enough to carry him to at least +7ish I hope that made sense.
 
I think that you need to BREATHE, ok? :YMHUG: Rome was not built in a day, and reacting impulsively will only serve to to make things worse. One thing at at time.....no ketones, right? How is Sid acting? Whole cat report?

He may need more insulin, BUT at this point, all that will do is make his curves STEEPER and produce more bouncing. You just changed his dose, I would suggest leaving that variable alone for the moment, and work on the food slowing the drops.

You need to flatten the curves. You do that by adjusting the food. Use the food to help to flatten the curve, then increase the insulin to bring the WHOLE RANGE down. One step at a time.

Throwing more insulin at him is not going to work without dealing with the speed of the drops (and the resulting bounces). You've tried that in the past, and it doesn't work, he just ends up too low in the middle, and then way high again. Let's try a different strategy....flattening the curve and getting off the roller coaster.

You can do this, Lydia, you just need to approach it systematically.
 
@Laurie I know what you are saying about the R and I do understand how the bouncing leads to more high numbers. I'm sorry but I didn't see your post suggesting that I not give him more R. I gave him literally a drop of it at +5.75 when he was 553. Now an hour or so later he is at 401. That is a drop but not as bad as last night. What I will do later at the PMPS is give 0.9 and try giving him a very small amount at PMPS and then +1, +1.5 and +2 just to see what happens with that schedule.
I appreciate all of your advice about the feedings. When he was on lantus, I did feed him more frequent small meals using the feeder dishes - I fed at shot time and then usually at +2 and +4 but the specialist was very adamant that with Prozinc I should only feed him twice per day. He told me I was feeding Sid way too much and that contributed to his problems. So I didn't realize that feeding might help even him out Prozinc but part of me also felt like I was not helping him by feeding him more frequently. What I'll do is divide up the 3/4 can he eats into 4 portions like I stated earlier.

@Michelle 2/5 does have a second shot - I gave R more frequently on that day because that is the day after we came home from the hospital and he had moderate to high ketones.
 
@Michelle - I agree that I might need to go to 1.0 and then feed the small meals. I have the feeling that I will give him 0.9 and then feed the smaller feedings and he will still be high later and I hate that thought. I don't see any evidence that the 0.8 x3 was even close enough to making him go too low.

@Laurie I do understand your point about Rome not being built in a day :-D but it's very hard to remember that when I pet Sid and all I feel is skin and bones and I look at his numbers and he is higher than he should be. I would like it all fixed right now please :-D He is pretty much the same with the Ps as yesterday...
 
in an effort to keep things on the board, here's a copy and paste of my response to lydia's PM:

Sienne suggested I contact you... just out of curiosity as I have no plans to switch Sid to lantus or levemir at any time but I am data gathering right now. I am going to give the Prozinc a fair chance unless it becomes really obvious it isn't working. Is it possible to do a TID (if necessary) with lantus or levemir? Has anyone tried that?
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hi lydia. i hope you don't mind, but i'm sending copies of this PM to laurie, libby, and sienne. just so we're all on the same page. if they see flaws in my thinking, they'll speak up.

yes, shooting TID with lantus or levemir has been done before. successfully.

i've found one of the most difficult concepts for caregivers to wrap their heads around when shooting TID is that you may not always be shooting every 8 hours.

for example, depending on the numbers... sometimes you'll be shooting at +7 and sometimes you may not be shooting until +10. this goes for any insulin. not just lantus or levemir. you really have to take your cue from the cat. this method is very hard on the caregiver which is why we don't recommend it unless it's obvious shooting BID is not working.

i just read your thread in PZI. i very much agree with laurie about feeding the curve to prevent sid from dropping. you'll have to experiment to see what works best for sid.

fwiw, alex experiences huge food spikes. in order for me to get enough insulin into her to control those food spikes i feed to keep her numbers up... rather than letting her drop and having to decrease the dose by default. we employ the same method with kitties who like to dive. in essence, what we're doing is using food to prevent the drop into low numbers. hope that makes sense.

i also agree with laurie about the use of R causing sid to bounce. R is only supposed to take the edge off a high number... something the basal insulin can grab onto to. it's not supposed to cause a huge drop. laurie's suggestion to withhold R at this time is a good one. without R clouding the picture, you and everyone else helping you will be able to get a better feel for whatever prozinc dose is needed. my best guess at this time is the basal dose will have to be increased, but the only way to get a better picture is to ditch the R for now. others who have used prozinc (i haven't) will offer dosing advice.

~ jill
 
I understand about you giving the R before you saw my post, Lydia...and I really do understand your frustration. I know you guys have been through the wringer, and I know you want it fixed right now...I wish I could wave a magic wand and make it happen! I'm doing my very best to help you, as is everyone else. I would hate to see you going around and around in circles and wasting more time.

Please don't get discouraged if the feeding schedule I suggested does not work perfectly, as Jill (and I) said, you will need to experiment to see what works for you and Sid. It's a starting point, nothing more. Sometimes it takes some time for kitties to adjust to the change, too.

Yes, you may need to increase the PZ dose, that would not surprise me at all! I think that it makes sense to not tinker with it again right away since you just increased the dose...but that's just my opinion. It's your decision, I will support you no matter what you decide. :smile: We are all trying to help you.
 
I had to go out to a dinner and I got home as quick as I could. I ended up shooting about 45 minutes later than I wanted. But, I am thankful that he was not Hi when I got home. He was 438. I was pretty happy about that. When I left he was 364 so maybe the drop of R I gave him helped steady his rise a little - something helped because usually he is HI. I do agree about not using R because we will not be able to get an accurate depiction of his response. I only gave him 1/4 of his usual amount of canned food and will give him more at +1, +1.5, and +2. I also gave him the pred and his SQ fluids early rather than mid cycle.

Thanks to Jill for responding publicly because I agree that all information might help someone else so it should be shared. I have no plans of switching Sid to levemir or reswitching to lantus anytime soon even though I've had many people suggest it :-D But I like to know what all of my options are as far as BID, TID, etc etc. I like having him on an insulin that doesn't build a shed because I *think* I get a better handle on his numbers that way because he has so many things going on. (I could be wrong of course about that.)

Like I've said before, I will increase the amount of Prozinc he is getting before switching insulin.
I am considering switching him to budsonide instead of prednisolone. I believe I mentioned that already. I called both his vets today and neither called me back. :evil:

Sid had another solid poop tonight :RAHCAT
He did not like his bandage change on his feeding tube. You know he is feeling pretty good when he fights me with all of his 4 pounds :lol:
 
I hope dinner was nice! Have you gotten any sleep, Lydia? You have to be exhausted....

I'm glad to see he is starting out lower than he has been. Hopefully, he won't bounce from the R and the PZ will continue to pull him down at a reasonable rate with the food applying the brakes on the drop...keeping my fingers crossed! That's the plan, Sid...please cooperate, ok?

I prefer to keep things public too. It can help others, and peer review is a good thing....it allows others to weigh in with alternative opinions or correct something that someone else missed.

I think PZ allows for more flexibility, which may be helpful in Sid's case, but all of them (Lantus, Lev and PZI/ProZinc) are excellent insulins for cats. The best fit depends on the cat and the situation. It's nice that we have so many good options. :smile:

Yay for solid poop and feistiness! Good signs! :thumbup
 
Hi Lydia,

I've been watching with a lot of interest as you work on Sid's numbers. I really think TID could be a great solution for Sid, especially if you can be aggressive and shoot early if you see his numbers heading up fast late in the cycle. I also think learning to feed the curve is going to go a long way toward helping flatten Sid out. As Laurie said, take your time and learn what works best for him. Learn to feed to control the drops, THEN increase the insulin if needed. I'm getting the impression that Prozinc is like Lantus in that if you try to rush things too much, you just end up making the numbers even wonkier, so take your time.

I do want to try to point out why I have concerns about R. You know that with Sid's Prozinc curve, once he starts upward after +6 or +7 he zooms up fast, right? So looking at yesterday's cycle, when he was HI at +6 you know he would normally keep going up, up, up. You gave 0.25u of R, and he went DOWN over 300 points in 45 minutes! That is at a time when he would normally be going up and there was probably little or no Prozinc still working in his system. That is way too fast - any cat would bounce like crazy from that! With R, you are aiming for about a 100 point drop over a couple of hours. Any more drop than that is asking for bouncing. Today the drop was 150 points in 45 minutes on one drop of R. That is telling me that even one drop of R is too much for Sid. I think your best bet is to put the R back in the fridge and concentrate on getting the Prozinc dose right. If he starts getting ketones again, then another strategy will be in order, but right now I think the R is hurting more than it helps. I do totally understand WHY you are using it, believe me. You're trying your best to keep the ketone monster at bay, and I can't blame you for that.

(((((Lydia)))))
 
I hope you enjoyed your dinner. I am so happy Sid didn't go sky high tonight :smile: Sounds like a good plan, now make sure he gets the memo! haha

Do you know if you'll be able to get numbers at +7? I think that's about 4am your time. If you can catch him before those high numbers show up... I think tomorrow could be a good day. I hope you were able to get some rest today too. I will check back soon.
 
Yes, dinner was good (Italian :-D ) but of course I spent the whole time worrying about Sid going HI even though I did my best not to. I am a worrier - I can't help it. I generally have a bad habit of not getting enough sleep even when all my cats are healthy. I figure I will make up for it someday (hopefully not in my grave either :lol: )

I agree that we are so lucky to have so many insulins to debate about!! Jake(GA) was on so many during the 8 years he was diabetic - including 3 different kinds of PZI (blue ridge, Idexx, and a compounded one locally) along with lente, NPH, vetsulin, and lantus. They all worked at different stages of his life and I'm grateful I had the choices. (I did not know about R with him but I didn't need to as he was *easy* compared to Sid.) Cats are successfully gone OTJ or just controlled on all of them! So they are all good - ECID.

@Libby Agreed that the bounces from R are not good and he has had some major ones too. I hope that spacing out the food will help avoid this. I will also remember in the future if I ever encounter a situation where I have to use R that possibly food will help slow bounces there too. Yes, it is back in the fridge and I keep the box taped shut so I don't accidentally dose him with that instead of the Prozinc (wouldn't that be a horrible disaster). You are right too in that I am just doing whatever I can to avoid ketones. I'm just hoping that Sid's intestinal disease is a little bit better under control now and maybe that will give me a chance to get the insulin levels figured out before there is another ketone crisis or even better to avoid another crisis.

So I gave him the feedings at +1, 1.5, and 2 plus I saved a small amount (1/8 can) for +3. I will see how the evening progresses.
 
@Michelle - yes, I plan to be up to catch him early, I'd probably have to get up at 3. That's my plan and I will have at least 2 alarms set to help make sure I do it. :-D
 
Lydia & Sid & Jake(GA) said:
@Michelle - yes, I plan to be up to catch him early, I'd probably have to get up at 3. That's my plan and I will have at least 2 alarms set to help make sure I do it. :-D
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I just wanted to say that you are my hero. You're working so hard for Sid, and I know he knows it. ((((Lydia))))
 
I know it's hard not to worry. Please don't let yourself get too exhausted, ok? You can't take care of Sid if you don't take care of you.

I'm glad Libby posted. :smile: She always explains things so clearly...my brain is mush today.

I see the numbers up to +2, I know he's higher than you want, but he is also dropping at a more controlled rate...about 40 pts an hour. That's much better. :-D

I'll check back later...I'm an insomniac, so I'll probably be up about when you shoot in the AM. ;-)

ETA: I told you my brain was mush....that's about 80 pts an hour, not 40....a bit fast, but not terrible. @-)
 
i've been wondering how you and Sid are doing, so ventured off to PZI land to find you. I see you surrounded by the best possible people from throughout FDMB Land who have experience to help you. I don't know enough to offer advice, but i am sending you lots of good wishes, and one very helpful cat! ;-)

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