22 Jan, Rocky, back to the beginning

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Marlena

Marlena

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http://www.felinediabetes.com/FDMB/threads/911-rocky-low-pm-bg-dosing-advice-needed.151369/
Rocky's PSPM BG was maybe too low to shoot the full dose, I was scared to take risks and decided to give him a token dose. Expected high BG this morning, number might also be influenced by feeding him about two hours prior to test.
I think I'm back to the beginning with the dose of 0.5u. My thinking is if 0.75 u was sending him too low too quickly and he was bouncing maybe 0.5 will give us less bouncing. But only time will tell.
Unfortunately I was "bouncing" myself from the start of FD journey so I'm going to try again. Poor Rocky.
No, actually he seems quite well. It's me who is not right - ugh...
 
Hi Marlena,

You seem to be having a rough time at the moment, you poor thing.

Did you get any more tests done last night? Did you test him before you gave him the 0.25u in the end?

Do you think you can get any more tests in today to see how he responds to his 0.5u?

Yes, you are right, feeding him 2 hours before his test is going to give you a very distorted picture of his condition thismorning. Hopefully you can get more data today to see what is happening.

Mahoosive hugs.
 
Hi Marlena

Just as Dr Schrodinger said, the higher AMPS could very well be a bounce from lower evening numbers, which Rocky' body is not used to or from feeding too close to testing time. When a kitty has been in higher numbers for a period of time their body "thinks" this is normal and sees the lower numbers as a "problem" and will release stored glucose to try to bring it back to "normal" Rocky's nadir (the lowest number of the cycle) seems to be later in the cycle so it is totally possible that he could have dropped lower during the night. If you look at my spreadsheet you will see that my Tuxie started off today at a whopping 27.7 mmol/L because of a lovely run of lower numbers yesterday, which his body is not used to.

The best thing if possible is to get more tests in, especially towards mid cycle when his drop seems to be most active. I don't know your home/work schedule, but it would be good to try to get some mid-cycle tests at night as well. Sometimes I feel like I haven't had a good sleep in over a year :( , but my Tuxie seems to like to do his drops more so at nighttime. I am using a different insulin than you but every cat reacts different to different insulins.

Fingers crossed for some good numbers today without any scary numbers :bighug:
 
Dear Juliet,
thank you again. Last night his BG was a bit low so I tested him again after half an hour and it was just ever so slightly lower (12.1) so I was too scared to give him full dose hence 0.25u.
At +2 his BG was 15.9 so rising but he had his shot already - missed opportunity.
At +4 BG is 21.
Please Juliet, don't feel sorry for me as I'm a creator of my own very bumpy road with Rocky's diabetes as I was so confused and stressed from the start that I failed to understand ins and outs of the whole process. That's why I am going back to the starting point - 0.5u for some days and observe. If I had listened maybe I wouldn't be in that situation now.
What do you think about that?
Once again thank you so much for looking after us, this help is invaluable!
MarlenaXXX
 
Tuxedo Mom said:
Hi Marlena

Just as Dr Schrodinger said, the higher AMPS could very well be a bounce from lower evening numbers, which Rocky' body is not used to or from feeding too close to testing time. When a kitty has been in higher numbers for a period of time their body "thinks" this is normal and sees the lower numbers as a "problem" and will release stored glucose to try to bring it back to "normal" Rocky's nadir (the lowest number of the cycle) seems to be later in the cycle so it is totally possible that he could have dropped lower during the night. If you look at my spreadsheet you will see that my Tuxie started off today at a whopping 27.7 mmol/L because of a lovely run of lower numbers yesterday, which his body is not used to.

The best thing if possible is to get more tests in, especially towards mid cycle when his drop seems to be most active. I don't know your home/work schedule, but it would be good to try to get some mid-cycle tests at night as well. Sometimes I feel like I haven't had a good sleep in over a year :( , but my Tuxie seems to like to do his drops more so at nighttime. I am using a different insulin than you but every cat reacts different to different insulins.

Fingers crossed for some good numbers today without any scary numbers :bighug:
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Dear Mary Ann,
thank you so much for your kind comment.
I will keep testing as much as I can, on some days I can test often, on other days less so. See how it goes from now on.
MarlenaXXX
 
Marlena said:
Dear Mary Ann,
thank you so much for your kind comment.
I will keep testing as much as I can, on some days I can test often, on other days less so. See how it goes from now on.
MarlenaXXX
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You do what you can..life does not always allow for doing constant testing but whatever you can do adds more information as to how Rocky responds to the insulin.

I have a hard to regulate kitty because of other health issues so I have been "doing the sugar dance" for 14 months now. It can be very frustrating and draining, especially in the beginning when you are just learning the ins and outs of feline diabetes. And since it is obvious that none of our kitties have ever read the manuals for how they are supposed to respond, it leaves you wondering what the heck is going on sometimes. I can't even count the number of times that I have had emotional meltdowns over the months...this is all "normal" for us caregivers. You are doing great and with the guidance of the wonderful helpers you have, Rocky is on the right road. :)
 
Tuxedo Mom said:
You do what you can..life does not always allow for doing constant testing but whatever you can do adds more information as to how Rocky responds to the insulin.

I have a hard to regulate kitty because of other health issues so I have been "doing the sugar dance" for 14 months now. It can be very frustrating and draining, especially in the beginning when you are just learning the ins and outs of feline diabetes. And since it is obvious that none of our kitties have ever read the manuals for how they are supposed to respond, it leaves you wondering what the heck is going on sometimes. I can't even count the number of times that I have had emotional meltdowns over the months...this is all "normal" for us caregivers. You are doing great and with the guidance of the wonderful helpers you have, Rocky is on the right road. :)
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Thank you my darling for your message, this helps me a lot.
All the best for you and Tuxie
Marlena XXX
 
Don't blame yourself for Rocky's bouncing, lovely lady. Kittehs often don't like a change in the status quo (same as us!), so it may be a question of easing him down into those lower numbers instead.
Your decision to go back to a lower, but consistent dose may give his liver & pancreas more chance to get used to the idea of behaving themselves. Time will tell...
Give him a tickle & a bbrrroooaw from me & Milo, please?
 
Dear Juliet,
thank you.
Let's hope that this new strategy will give us a clearer picture.
I'm trying very hard to be less emotional about it and just accept that it can be unpredictable.
This cat is so tough, I keep experimenting on him, his BGs are all over the place but he seems to be unaffected by all of this and frankly I don't see him to be in a bad way.
Sending lots of hugs to you and Milo,
Marlena&Rocky XXX
 
Marlena,

It might help to think of something someone said here long ago: this sugar dance is a marathon, not a sprint. Their bodies need to adjust to the insulin and the diet and those things need to work together. Our Oliver went OTJ in six months and that was considered a short time. We do see a number of kitties who go off insulin very fast, but that is unusual, not the norm.

Otherwise how is Rocky doing? Does his coat look better? Is he playing and keeping himself clean? Does he seem happier? Is the litter box less full? Is he eating well and enjoying his new food? It can be hard to look past the diabetes and the numbers sometimes, but I hope he is improving in other ways too.
 
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Dear Sue,
many thanks for taking time to read about my struggles with Rocky's diabetes and giving some feedback.
Finally I managed to log in my head that trying to regulate your diabetic cat is a marathon, not a sprint - well said!
Rocky is doing well, you could not tell that he is not quite healthy: his coat is really nice, he grooms himself and eating very well, he is playful too. He can be grumpy sometimes (I think when he is hungry) and takes on his big brother Rottweiler/GS cross, poor dog is scared of him! I have a big problem to observe his urinating and poohing habits as he refuses to use the litter tray, always going to do his business in the garden. Sometimes I find myself stalking him with a torch!
Rocky has been on raw home-made species-appropriate diet since his diagnosis about 18 months ago.
The only problem I see clearly is drinking more water than he did when he was healthy and he is less active.
I'm going to be more patient now and hopefully we will start seeing some improvement soon.
Best regard,
Marlena
 
Marlena said:
Finally I managed to log in my head that trying to regulate your diabetic cat is a marathon, not a sprint - well said!
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Good day Marlena


Sue said it so well with the analogy of a sprint, not a marathon. Our kitties are so much more than a number on a meter. Each day they seem healthy and active and just being a cat is a reason for celebration. My kitty was diagnosed in November 2014 and has never reached remission and because of other health issues probably never will. I have learned to take each day as a blessing...if he is eating (his favourite past-time ;)) grooming, playing purring and doing his litterbox duties then it is a good day regardless what numbers he gives me. The only times I worry is if I see very low numbers or consistently high numbers for days on end. Other than that it is a good day if Tuxie is happy. If Rocky is doing well then it is a good day!
 
@Tuxedo Mom - that's a beautiful insight. I wish I had that clarity. Every day!

@Marlena - Rocky seems to be settling in, doesn't he? He seems quite comfortable in his pinks & yellow (Battenberg cat!). After 3 days of cruising at this altitude, I would be tempted to try & nudge him down a little bit towards the green zone.
Tomorrow morning, how do you feel about giving him a 'fat' 0.5u & seeing how he goes on that?

Hope you are doing a little better in your world.

Thinking of you all.

xx
 
Dear Juliet,
Many thanks, funnily enough I just thought about that strategy - so not to shock Rocky's system I'm going to very gently raise the dose to fat 0.5.
Maybe that's what I need to try - fingers and paws crossed.
Your watchful eye is a blessing - really grateful.
Marlena XXX
 
Morning Marlena,
How are you holding out?
I'm looking at Rocky's numbers again & he's refusing to budge, isn't he? No significant drop in BG post-insulin, however his pre-shot numbers are down a bit, aren't they?
How do you feel about increasing his dose to 0.75u again?
Give him a tickle from me.
xx
 
Good morning Juliet,
You're right, Rocky does not drop from pink numbers.
I think it would be worth trying slightly fatter dose of 0.75.
Many thanks for your suggestion, let's hope this is going to work.
Best regards for you and Milo
Marlena XXX
 
Dr Schrodinger said:
Morning Marlena,
How are you holding out?
I'm looking at Rocky's numbers again & he's refusing to budge, isn't he? No significant drop in BG post-insulin, however his pre-shot numbers are down a bit, aren't they?
How do you feel about increasing his dose to 0.75u again?
Give him a tickle from me.
xx
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Dear Juliet,
Rocky is giving me more yellow numbers with 0.75u so I'm more inclined to call him Battenberg cat now but hopefully not for long as we want to see blue and greens as soon as possible.
Rocky sends his love to you and Milo,
Marlena XXX
 
Hi Marlena,

I see we had a drop last night!
The data on Rocky's SS (the falling numbers prior to the shot) did point to the possibility of that happening.
Remember, with Hypurin the overlap can have a sort of accumulative effect so it seems likely that the .75 you gave in the morning was already starting to 'tip the balance' before you gave another .75 in the evening...

Giving insulin on a 'falling number' can be very tricky (I gave Bertie his first hypo that way...). So it's generally advisable to ensure that the BG is rising (or relatively stable) before giving the shot.
An option is to 'stall'; ie. wait a little while, without feeding, to ensure that the number is rising (or at least isn't dropping any further).
If the numbers stop dropping, but are still remaining relatively stable, it's still advisable to exercise caution if you're looking at a 'lower than usual' preshot number. (In some instances a reduced dose may be appropriate).

I know it can be a bit puzzling....:confused:
But the work you've been doing by holding the dose and then very gradually increasing has produced some very useful data. :cat:

Sunday hugs to you, Marlena. :bighug:

Eliz

PS. I think the expression 'Battenburg cat' could apply to a fair few kitties on this forum! :p:):p:):p
.
 
Dear Eliz,
thank you for you input.
I think last night I acted impulsively - thinking Ok, sticking to the dose for few days! I was so happy to see the blue numbers that I was desperate to get some more but I should have maybe given him just 0.5u or maybe wait a bit and test again to see if the number is still dropping.
It looks like though that 0.5u is not doing anything and 0.75u is dropping him too much or there is more overlap with this dose.
I hope that as long as Rocky is not bouncing back to very high numbers (black) and does not drop too much into the very low numbers he is not in dangerous position - just a thought. I have to be careful with PM shots, maybe his PM dose should be lower and AM ones higher?
Anyway, we have a bounce today so what should I do tonight if he is still in that bounce which I think is very likely?
Hugs to you and all your kitties
Marlena and Rocky XXX
 
Hi Marlena,
Looking at Rocky's SS this evening that .5 you gave looks like a good idea given the falling preshot number...(maybe he dropped out of that bounce earlier than is typical for him...??? Or maybe he will swing up high again....?) Will be interesting to see what happens...
I DO hope you get some decent sleep. (I think you have work tomorrow...?)

Sending positive vibes that Rocky has an unchallenging cycle, and that you get some serious and much-needed Zzzzzz's.... ;-)
.
.
 
Good call, Marlena!

It seems that 0.5u doesn't even touch the sides, but 0.75u gets him low, and when he goes low, he's low for quite a while, isn't he?!! What a tricksy little beastie!

Totally agree that he may have to have a larger dose in the morning, and a smaller one in the evening.

How is he doing in himself?

xxx
 
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