? 3/13 Markies PMPS (383) + 3(369) +6 (352) INSULIN NOT WORKING???

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@Kris & Teasel thank you for your message.

Iam using the new thread as I was asked for, so I copied a sentence that I am interested if you can explain a little more of if you can link it to were I can read information on that so I can learn how to do it.

high enough Levemir dose along with proper use of food to steer as needed might well get you to a better place than trying to force BG down with R.

How can I help with food in order not to cause spikes? We never had a food schedule here, he eats on demand or when I can, but its kind of frequent since I work at home. And they eat raw and Markies used to eat canned whiskas which is the only canned food in ARgentina but since his numbers started to be high, I took it away. He is only eating raw or half cooked meat, organs, meaty bones, egg yolks, tunna with watter, etc.. so almost no carbs at all.
 
Thanks for starting a new thread. :) Since he is eating almost zero carb raw, he shouldn't be getting much in the way of a food spike. Any higher numbers early in the cycle after preshot might just be th natural rise of numbers before the insulin onsets. Neko's Lev onset was +5 so her numbers would usually go up a bit until then.

Sometimes people will use steering with slightly higher carbs to prevent big drops, which can also cause bounces.

And I agree with others yesterday, getting to a good Levemir dose is better than relying on R, so keeping it in the fridge for now is a good plan. As long as Markies has no ketones.

@manxcat419 April, sorry I didn't get back to your tag last night, I was asleep. :) But when looking at what is a good dose, we typically don't look back more than two weeks. Cats insulin needs change over time. Since we don't see a good dose in the last few weeks, it's best to test as needed to evaluate a dose and increase as fast as safely possible until he gets to good numbers again.
 
No worries @Wendy&Neko - I figured you were probably asleep by then. I agree with usually only going back a couple of weeks - it's a bit more tricky with Markies because all of the recent numbers had some influence from the R. I think @Silvina is actually planning to keep the current Lev dose to see how things settle without the R and then take it from there...it seems reasonable as a starting point as it's the same dose of Lev that he's done well on previously.
 
dears Im rushing to my mom´s house. I will not feed Markies now despite hes is beggin (obviously I feel a bitxxxx)

his +6 is 352 typical of this days.... his curves are on the 300s.... I don´t see nadirs... even though I changed for a new levemir pen.

See you later. Ill be back probably in three hours. or little less. This is a roller coster.. I was happy since he didn´t go up after food (even though he doesn´t eat carbs he does do a spike after eating). But now Im upset since numbers are not mooving.

see you later... I will read all your messages when Im back.

bye bye.

Silvi
 
I think it's likely that he will need a dose increase in a couple of days. We had exactly the same situation with Roxi for quite a while - we would increase the dose and she would come down maybe 10 points overall, but still be high and flat all day...until we reached her optimal dose at that time. As soon as we hit that, she dropped from the upper 100s and 200s into the 40s and earned a reduction. I would still stick with the Lev only, wait it out another 3 cycles and then, if he's still running higher, increase his dose to 1.5u. He will come down, but it will be gradual. The good thing about the numbers coming down gradually is that it's less likely to throw him into continual bounces.
 
manxcat419 said:
I think it's likely that he will need a dose increase in a couple of days. We had exactly the same situation with Roxi for quite a while - we would increase the dose and she would come down maybe 10 points overall, but still be high and flat all day...until we reached her optimal dose at that time. As soon as we hit that, she dropped from the upper 100s and 200s into the 40s and earned a reduction. I would still stick with the Lev only, wait it out another 3 cycles and then, if he's still running higher, increase his dose to 1.5u. He will come down, but it will be gradual. The good thing about the numbers coming down gradually is that it's less likely to throw him into continual bounces.
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Thank you dear, Im back.

He still is in 300s. 342 at +9. Nadir has gone into vacations.

I left for dinner and now is his dinner time so I expect a spike, I hope he stays in 300s... cross fingers.
 
I think it's likely that you're going to find the 1.25u isn't enough for him at this point. But he is at least flat in the 300s...he hasn't gone all that way up to 500 or even HI from dropping the R. Try to just be patient - even if he does have a food spike, it will come back down again as he digest the food. And even seeing these flat numbers in the 300s, if they continue the same way tomorrow, will give a good indication that increasing his L is the right thing to do.
 
manxcat419 said:
I think it's likely that you're going to find the 1.25u isn't enough for him at this point. But he is at least flat in the 300s...he hasn't gone all that way up to 500 or even HI from dropping the R. Try to just be patient - even if he does have a food spike, it will come back down again as he digest the food. And even seeing these flat numbers in the 300s, if they continue the same way tomorrow, will give a good indication that increasing his L is the right thing to do.
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ok so tomorrow night would be the right day to increase the dose if things stay the same?
 
Kris & Teasel said:
If you see his BG is dropping fast - eg., much lower only 2 hours after a dose, you can try slowing the drop by feeding a little food that's higher in carbs than his normal diet. This can sometimes prevent or lessen a bounce that's created by a fast drop.
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oh I used to do that but in other circumstances, when Markies had low numbers and had to prevent bouncing.. I remember it had a name in English or maybe Im getting confused with the expression "shoot through the bounce" that it was when the body bounced and you shot the same dose to help the body deal with the bounce but the next cycle you decrease the dose". I don´t remember this one´s name...

In this case as Im still not so familiar with what is a big drop (what number is consider big drop, and also that the drop could not take the cat too low but still if the drop is big the cat could bounce, etc) I was not thinking that this was a situation that could create a bounce. I know now for next time.
 
Wendy&Neko said:
Thanks for starting a new thread. :) Since he is eating almost zero carb raw, he shouldn't be getting much in the way of a food spike. Any higher numbers early in the cycle after preshot might just be th natural rise of numbers before the insulin onsets. Neko's Lev onset was +5 so her numbers would usually go up a bit until then.

Sometimes people will use steering with slightly higher carbs to prevent big drops, which can also cause bounces.

And I agree with others yesterday, getting to a good Levemir dose is better than relying on R, so keeping it in the fridge for now is a good plan. As long as Markies has no ketones.

@manxcat419 April, sorry I didn't get back to your tag last night, I was asleep. :) But when looking at what is a good dose, we typically don't look back more than two weeks. Cats insulin needs change over time. Since we don't see a good dose in the last few weeks, it's best to test as needed to evaluate a dose and increase as fast as safely possible until he gets to good numbers again.
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Ok I understand. Do you think we are ready to do an increase of Leve or should we wait a some cycles to let Markies body settle after some mess using Rapid plus Levemir in different dose? My spreadsheet will tell you the mess that has been done.
 
Silvina said:
ok so tomorrow night would be the right day to increase the dose if things stay the same?
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You want him to do 4 cycles without any R at all before you increase. The minimum time between increases needs to be 4 cycles (6-10 being the more usual interval) and as removing the R is effectively a dose change, I think you should give the full 4 cycles for him to settle before you change anything else.

Silvina said:
oh I used to do that but in other circumstances, when Markies had low numbers and had to prevent bouncing.. I remember it had a name in English or maybe Im getting confused with the expression "shoot through the bounce" that it was when the body bounced and you shot the same dose to help the body deal with the bounce but the next cycle you decrease the dose". I don´t remember this one´s name...
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Shoot through the bounce is when a reduction has been earned, but the cat bounces high at the start of the next cycle when the reduction would normally have been given. You can then give the dose without giving the reduction to help bring them down from the bounce. If you do that, you give the reduction on the next cycle.

Feeding to control the drop is something I've most often seen referred to as "feeding the curve" where you adjust the amount of food given to help control how fast the cat is dropping. Or maybe if you don't want Markies to earn a reduction on a particular day, maybe because he already just earned one, you might give a slightly higher carb food if it looks like he's heading for a very low number instead of waiting for him to drop under 50 and then bringing him back up.
 
Even if he's in the 400s, I would not give R at this point. If you can, then test for ketones, but please try to hold off on the R - it makes it very difficult to work out what to do for the best with his L dose if you add another insulin into the mix. And the ideal would be to get his numbers under control with just the L.
 
OK dear I will do my best, but if he goes above 500 or so I would die.. I wont be able not to hold myself.. but I will try..
First of all I will try to post here in case there is a 500 or +500. DKA.

By the way, I tested and he is 358, no spike... fuu... I breath again.

thank you for all you are helping me!!!! and all your patience!!!!:bighug::bighug::bighug:
 
Remember a daily ketone test is important. The results will help guide your choices :cool:

eta- ketones in the blood is what can lead to DKA and Ketones formation can happen at BG 250 the same as BG 500. The only way to know if ketones are developing is to test for ketones. No ketones = No DKA.
 
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A lot of cats go above 500 from time to time and, as long as there are no ketones, it is still OK not to give R. Many of us have brought those numbers down gradually with one of the L insulins. 358 is fine - he's been really very flat all day, but there's no massive food spike there so all is good for now. :)

And I completely agree with @Sandy and Black Kitty - please do test daily for ketones. If he does develop ketones, then controlling things with L would take second place to getting the numbers down fast to prevent full blown DKA. Just keep letting us all know on here and we'll get you through this. :bighug:
 
Sandy and Black Kitty said:
Remember a daily ketone test is important. The results will help guide your choices :cool:
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yes dear, I just put a plastic spoon in his litter since yesterday night can´t catch his pee, when I put the long spoon he left (I have a long spoon wich let me grab some pee without putting the stick there).

Now I put a plastic spoon.

If any of you have any good idea on how to catch some pee let me know. he usually let me, but now as Im very much into him pocking his ear all the time he tends to run. Also I some times put the stick in the litter stones but some times work sometimes not.

Now he is going to the litter let me see!!
 
You could try either putting some clingfilm over the litter in his box, or using clean aquarium gravel instead of litter for him - that way the pee won't be absorbed by anything and you can just test it after he's done.
 
manxcat419 said:
You could try either putting some clingfilm over the litter in his box, or using clean aquarium gravel instead of litter for him - that way the pee won't be absorbed by anything and you can just test it after he's done.
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Good. Yesterday I tried putting film, but then he didn´t use it. I have to be more aware of were he urinates. Well, today I spent almost the whole day in bed. Tomorrow will be another day.

THANK YOU THANK YOU AND MORE THANK YOU!!!!!
 
Sandy and Black Kitty said:
Remember a daily ketone test is important. The results will help guide your choices :cool:
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;)
Sandy and Black Kitty said:
eta- ketones in the blood is what can lead to DKA and Ketones formation can happen at BG 250 the same as BG 500. The only way to know if ketones are developing is to test for ketones. No ketones = No DKA.
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:woot:
GOOD POINT!!!

I will do my best then this thread is so so important for me, so informational, really I trully apreciate all your help.
 
Silvi

When I want to catch urine from one of my cats, I take them to the litter box very first thing in the morning as they are likely to need to pee. It usually works and as they squat, I stick the spoon under their bums.
 
Oh, that's great news! :) I know he's still not in the numbers you'd like, but at least he hasn't spiked over 400 repeatedly today. I think that's a very good sign that he can and will regulate on just the L with some dose adjustment.
 
let´s cross fingers... tomorrow little less pocking... Ive been lucky that Ive received a big donation of stripes.. thats another issue.. so I have plenty...Im happy for that too... I was blessed for that.. A lady gave me twice 4 boxes of 50 stripes!! her husband is diabetic and seems that he doesnt use them all so she gives them to me..

so she saves my but!! lol..

good nights dear.. thank you for being there!!! going to bed much more relaxed than yesterday...

:cat::bighug:
 
I noticed your spreadsheet - it does make it easier to find the right place for me to look at. Thank you for doing that. :) And yes, hopefully tomorrow you can test a little less.

I'm so glad you're feeling more relaxed tonight. That's the plan! :bighug::bighug::bighug:
 
manxcat419 said:
You want him to do 4 cycles without any R at all before you increase. The minimum time between increases needs to be 4 cycles (6-10 being the more usual interval) and as removing the R is effectively a dose change, I think you should give the full 4 cycles for him to settle before you change anything else.


Shoot through the bounce is when a reduction has been earned, but the cat bounces high at the start of the next cycle when the reduction would normally have been given. You can then give the dose without giving the reduction to help bring them down from the bounce. If you do that, you give the reduction on the next cycle.

Feeding to control the drop is something I've most often seen referred to as "feeding the curve" where you adjust the amount of food given to help control how fast the cat is dropping. Or maybe if you don't want Markies to earn a reduction on a particular day, maybe because he already just earned one, you might give a slightly higher carb food if it looks like he's heading for a very low number instead of waiting for him to drop under 50 and then bringing him back up.
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yes that!!! lol
 
Ok, finally red cam again and I cant open the spread sheet. Internet is not working at home and at mom´s house I don´t know how to open the ss.

Markies PMPS was 468 or something like that. I shoot 1.25L gave egg yolk with watter and left with mom.

I will see when Im back.
 
Silvina said:
Ok, finally red cam again and I cant open the spread sheet. Internet is not working at home and at mom´s house I don´t know how to open the ss.

Markies PMPS was 468 or something like that. I shoot 1.25L gave egg yolk with watter and left with mom.

I will see when Im back.
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Don't worry about that red. I think someone said on here that you should try 1.5 u soon.
 
manxcat419 said:
Oh, that's great news! :) I know he's still not in the numbers you'd like, but at least he hasn't spiked over 400 repeatedly today. I think that's a very good sign that he can and will regulate on just the L with some dose adjustment.
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didn´t last much :(

PMPS 468
I cant update ss, can´t log.
Just shoot and left, previous gave egg yolk with watter. when he reached the yellow number I gave som little carb but I screwed it up.

well continue later.. have to leave with mom to the doctor..
 
You didn't screw it up. You're learning how to help him control his numbers and that isn't going to happen overnight. And yes, once he has 4 cycles with no R, I think you can increase to 1.5u L. I'll move over to your new thread now, but please don't worry about that red number - it takes time to get everything under control for him, and he's only had one red number in 2 cycles, which is OK. I think maybe next time you could try giving a little extra food without adding the carbs to it if he gives you a yellow number so that he has food on board to use but not enough carbs to spike his number.
 
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