2/27 Ozzy AMPS 265 PMPS 312 Dosing Guidance??

[Ozzy Pawzbourne]

I have been so slammed at work so not able to post as frequently. We have been testing Ozzy regularly and our SS is up to date.

I'm not sure what we are doing wrong here or what Ozzy is up to. He has been described as being a 'dramatic' kitty in regards to how he responds to insulin.

We upped his dose to .75U 7 cycles ago and I'm not sure what to make of his progress. He surprised us with a blue preshot yesterday and I am assuming he is bouncing. I'm not sure. I don't even know what to consider a bounce anymore or how long to keep him on a particular dose anymore. Is he due for another increase? I really am losing confidence here and feeling deflated. Any advice is welcome.

Thank you.

 

[julie & punkin (ga)]

Sometimes it helps to have fresh eyes look at our kitties! I still go back to looking at the most recent 3 days and finding the low point, then comparing it to the Tight Reg guidelines:

INCREASING THE DOSE:

• Hold the dose for 3 - 5 days (6 - 10 consecutive cycles) if nadirs are less than 200 before increasing the dose by 0.25 unit.
  • if your cat is new to numbers under 200, it is recommended to hold the dose for at least 8-10 cycles before increasing.
  • when your cat starts to see nadirs under 100, hold the dose for at least 10 cycles before increasing.

• After 3 days (6 consecutive cycles)... if nadirs are greater than 200, but less than 300 increase the dose by 0.25 unit.

Ozzy got to 132 at yesterday's amps, and you've got 7 cycles at the 0.75u. I think I'd give him one more cycle (total of 8) at 0.75u and then increase if you don't see green by then. If you're following Tight Reg, then green is your goal. If his nadirs were lower than the 132, then I might wait the full 10 cycles.

Hang in there - this is called a Sugar Dance for a reason. Two steps forward, one backwards - is the norm. It's common to dance around a dose with a kitty. When I was starting and Punkin was diagnosed with acro, people told me that the important numbers are the blood sugar, not the size of the dose. I tried to keep that in mind whenever I got discouraged that his dose was increasing.

Hope some of that helps.

 

[Ozzy Pawzbourne]

Another issue we are dealing with that I forgot to mention: Ozzy has been chewing himself a rather large spot on his back.. Just within reaching distance of a kitty's exorcistic reach around of their head. I assume it's a hot spot. He does have a history of getting caught up on one particular spot and continuing to lick and lick and lick. A lot of times I feel at a loss as to how to treat it but I'm more particularly concerned now that he is diabetic (infections as such).

He has been going at this one spot for over a month now. Sometimes if we let it go, he will just give up and leave it alone and it will heal. However this one has been going for a good amount of time and I'm ready to nip it in the bud. When we were at the vet's a month ago, he had just started on this particular spot and the vet prescribed him some type of topical steroid/antibiotic. Others on this advised/warned not to use it so we really have not. Now that this has gone on so long and I feel desperate, I've tried the steroid/antibiotic spray for the last 2 days. I also just noticed (nice how we are so smart to read labels) that it is prescribed for dogs. I assume it's ok for kitties as well since the vet is the one who gave it to me. We got so desperate tonight that we pulled at the torture chamber (the cone) and put it on for an hour to try to let some of the medicine sink in and heal. As soon as we took it off, lick lick lick. I mean immediately. Does this sound like a normal hot spot or do you think something else is going on? We also just noticed today that Ozzy has started up on a new spot on one of his front paws as well. Ozzy has always been a very nervous and anxious kitty (my poor sweet boy), so I don't know if this is stress related (though I have a hunch it is).

We have a feliaway plug in. Waste of money in my opinion.

All thoughts/comments/feedback are welcome.

Thanks.

I'm so tired...this is all so exhausting.

 

[Chris/China (GA)/Garfield]

Have you ever tried a different kind of e-collar? I know it's not a cure, but if it keeps him from being able to get at the spots, they may heal faster

Here's a couple that are more comfortable for most cats

https://www.chewy.com/kong-ez-soft-collar-dogs-cats-small/dp/47833

https://www.chewy.com/kong-cloud-collar-dogs-cats-large/dp/47474

 

[Ozzy Pawzbourne]

Sometimes it helps to have fresh eyes look at our kitties! I still go back to looking at the most recent 3 days and finding the low point, then comparing it to the Tight Reg guidelines:

INCREASING THE DOSE:

• Hold the dose for 3 - 5 days (6 - 10 consecutive cycles) if nadirs are less than 200 before increasing the dose by 0.25 unit.
  • if your cat is new to numbers under 200, it is recommended to hold the dose for at least 8-10 cycles before increasing.
  • when your cat starts to see nadirs under 100, hold the dose for at least 10 cycles before increasing.

• After 3 days (6 consecutive cycles)... if nadirs are greater than 200, but less than 300 increase the dose by 0.25 unit.

Ozzy got to 132 at yesterday's amps, and you've got 7 cycles at the 0.75u. I think I'd give him one more cycle (total of 8) at 0.75u and then increase if you don't see green by then. If you're following Tight Reg, then green is your goal. If his nadirs were lower than the 132, then I might wait the full 10 cycles.

Hang in there - this is called a Sugar Dance for a reason. Two steps forward, one backwards - is the norm. It's common to dance around a dose with a kitty. When I was starting and Punkin was diagnosed with acro, people told me that the important numbers are the blood sugar, not the size of the dose. I tried to keep that in mind whenever I got discouraged that his dose was increasing.

Hope some of that helps

Yes, thank you Julie. Sometimes I just need some validation that we are doing the right thing or at least headed in the right direction. I tend to be one of the ones (tsked tsked by a recent thread for newbies) on asking the same questions...but sometimes I keep having the same questions because it doesn't seem like what we are doing is working and I need confirmation/validation again and again that we are going about this the right way. I guess I'm a hard learner.

I keep seeing kitty after kitty going OTJ on this board and part of me is starting to get so jealous and desperate that maybe we are not doing the right thing. I also seem to see a trend (maybe I'm crazy) that those folks are giving their kitties higher doses that I am and maybe we should be more aggressive with our dosing approach. I also notice that many folks on here don't have full time jobs and have more time to monitor which we just don't have the luxury of doing so we have to take safety into consideration when not being able to monitor.

I'm trying my best. I just want what is best for my sweet kitty. I have literally rearranged my life for this cat and his too so I just want to see some progress for all this effort. I also am so tired of poking my poor kitty's ears. He is a champ when it comes to taking insulin shots, but he lets out a small tinky cry everytime we do an ear test. It breaks my heart and I really just want to stop this part so bad but I know how important it is. On one ear, he has developed a couple bumps and I'm not sure if they are scar tissue or what. His poor ears are just wrecked. Yes, we put antibiotic ointment on them every night.

Sorry for the venting.

 

[Ozzy Pawzbourne]

Have you ever tried a different kind of e-collar? I know it's not a cure, but if it keeps him from being able to get at the spots, they may heal faster

Here's a couple that are more comfortable for most cats

https://www.chewy.com/kong-ez-soft-collar-dogs-cats-small/dp/47833

https://www.chewy.com/kong-cloud-collar-dogs-cats-large/dp/47474

Thanks so much Chris for these suggestions. I'm seriously amazed at what the folks on this board come up with. I have never seen either of these and will look into a soft e-collar. Thank YOU!

 

[Chris/China (GA)/Garfield]

You're really still new to the sugardance too......It was like 4 months before China's numbers started to have any kind of pattern

If you don't believe me, check out her Profile page!.....the first 3 years of her treatment are there!!

Some cats are just lucky in that they can go into remission quickly.....others may never do it, so your goal should just be better control to prevent any more damage.....and since we've been here, I think the longest I've seen was one cat that had been on insulin for 8 years....and still went OTJ!

So never give up!....Where there's life, there's hope!

 

[Ozzy Pawzbourne]

Thanks Chris. I know you and China have been at this for quite sometime and I can't imagine the hurdles you have been through...so your support means all that much more to me personally. Thank you.

 

[Barbara & Uncle (GA)]

Sorry to hear the stress in your post and I'm sorry that the chewing issue is happening again. In the 5 months I've been at this, there have been more than a few cycles of optimism and discouragement. You guys are doing a great job and Ozzy is much better off will all the treatment you've been giving him so far (OBVIOUSLY!). I love Julie's very clear suggestion. It's easy to lose perspective on dosing and, well...everything come to think of it! It was helpful for me to reread the TR guidelines on increasing, I was just wondering about that for Uncle tonight as well. Also, I just want to say that I've caught myself feeling discouraged when I've had to increase and I know it's because it makes me feel like we're drifting away from the shore of remission. I keep reminding myself sometimes you gotta go up to go down and I've seen that in action.
Well, I'm going to try to get a few hours in before another test tonight. Hang in there. We'll all get through this together.

 

[Tricia Cinco(GA) & Harvey]

{{{Jo}}}

It's so easy to get discouraged in this dance. Especially when you see other kitties going OTJ. Keep in mind that it isn't just a saying that ECID. There are lots of reasons cats get FD, and some of them are more easily resolved than others. Just because Ozzy doesn't look like he's headed for a trial, don't think you are failing. He is doing relatively well and as Barbara pointed out, much better off than he was when you started this. Some kitties take longer to figure out.

Sorry for the venting.

Don't apologize. That's why we're here. This is the place you can get all that out and know that those who are reading your post understand.

His poor ears are just wrecked. Yes, we put antibiotic ointment on them every night.

After you poke him and get the sample, do you hold a tissue or cotton ball over the spot and apply gentle pressure? That can help. Also, are you using a new lancet each time? Somewhere on this site there are pictures of what a needle looks like after one poke, five pokes, etc., and you would be horrified if you saw it. We used to reuse the same lancet all day until I saw that. We also alternated ears and tried to vary the spot a bit.

I'm sorry about the hot spots. I know too well how aggravating they are, both to you and to Ozzy. Cinco was prone to them, too. A few we were able to trace the cause, but others we never did figure out. He spent way more than his fair share of time in a cone (which is a special kind of torture for a blind cat and for his bean). For the ones on his body, we used a doggy shirt or a Coverme to keep him away from them. The one on the paw, unfortunately, probably needs the cone.

Hang in there. You and your DH are wonderful, loving beans and Ozzy is very lucky to have you in his corner.

 

[carfurby (GA)]

I'm sorry things are so stressful right now. Try to remember that Ozzy is more than his numbers. It's easy to get discouraged, but what you're doing is helping him feel better and get healthier. There is always hope. Furball went OTJ after 3 1/2 years. Don't give up.

 

[Kris & Teasel]

Jo, I really empathize. I've been at this over a year with Teasel and he defies all attempts at any sort of regulation. I used ProZinc for 10 months and learned how to make micro changes in dose in hopes of reducing bouncing but had little success. I've just finished 3 weeks on Lantus and am seeing some progress - by my standards. To many others Teasel's data is terrible. Maybe it's because I've been struggling with this so long that I've reached a place of "acceptance". I just don't have the mental energy to worry as much about his numbers and whether I'll get to regulation. It is what it is. This isn't the voice of defeat - I still work at his dosing, test as much as needed and enjoy the signs of progress as meager as they might seem. The acceptance has given me much more peace of mind.

 

[Ozzy Pawzbourne]

@Tricia Cinco(GA) & Harvey

After you poke him and get the sample, do you hold a tissue or cotton ball over the spot and apply gentle pressure? That can help. Also, are you using a new lancet each time? Somewhere on this site there are pictures of what a needle looks like after one poke, five pokes, etc., and you would be horrified if you saw it. We used to reuse the same lancet all day until I saw that. We also alternated ears and tried to vary the spot a bit.

Yes, we apply pressure with a gauze pad every time we do an ear poke and we have never used the same lancet more than once. We also alternate ears and try to vary the spot. I just think if you keep poking the ears over and over and over and over again, there is bound to be some scar tissue or something. One of my friends is a diabetic and uses the exact same human meter I have and she told me she thinks it's awful that I am poking my kitty so many times per day. She said the BG tests are so painful on her fingers that she sometimes won't even test herself to give her hands a break. I'm pretty sure fingers probably have more nerves that ear tips, but still.... can't be good long term to keep up this aggressive of a routine with ear pokes. I saw one member on here who literally tests her cat almost every hour of every day. I mean...that's overboard, no??

For the ones on his body, we used a doggy shirt or a Coverme to keep him away from them.

Checked out the coverme and oh my gosh...it's kind of so fricken adorable. But my kitty (and my Hubby) would probably kill me if I put Ozzy in one of those things. How did your kitty handle it? Hubby would probably never let me live it down if I put Ozzy Pawzbourne, our prince of darkness kitty is a jammie onesie! Hahah!

 

[Tricia Cinco(GA) & Harvey]

I'm pretty sure fingers probably have more nerves that ear tips

They absolutely do. Fingers are crammed with nerve endings. Ears, not so much. I was a testaholic (check out my spreadsheets), and Cinco's ears never looked like they had been touched. Harvey's looked a little rough,but they looked rough before he became diabetic. Sorry, I have no more ideas for you. ECID, and I guess that applies to their ears, too.

How did your kitty handle it?

He didn't seem to mind it. Cinco was a very mellow cat. I actually liked the dog version better than the cat, as it snapped down the back and made it easier to give insulin. I did have to put him in a small, even though he was a pretty big cat, as he could get out of the medium.

Hubby would probably never let me live it down if I put Ozzy Pawzbourne, our prince of darkness kitty is a jammie onesie! Hahah!

Ahhh, but would he rather have her banging around and miserable in a Cone of Shame???? There are other brands available on the internet, but this was the only one I could find when I was looking. I tried using a baby onesie, but it just didn't fit right.

 

[Ozzy Pawzbourne]

Thanks for the tips Tricia!