4/19 - Gryphen AMPS @ 176 / Alphyne AMPS @ 333 - feeling defeated

[bobjoh]

(previous) https://felinediabetes.com/FDMB/threads/4-19-alphyne-pmps-323-2-288-bouncing.246240/

Good morning, all.

I'm just feeling defeated today.

I feel like nothing I'm doing for my girls is working. When I look back at the spreadsheets, I know that's not the case, but I'm just feeling bad.

With both of the girls, it's obvious the starting dose was too high.

But now, Gryphen is stuck in the blues (no matter the dose), and Alphyne is bouncing everywhere.

I feel so bad for them, and for my other cats, who obviously aren't getting as much attention as the sugarcats.

I feel like we are never going to get this under control. I know it has only been a few months, and they may never go into remission. I'm ok with that, as long as they feel better. I wish they could talk, and tell me how they are feeling.

Sorry to be a downer today; it's just been a rough morning.

 

[JaxBenji]

Hi Bobbi Hang in there Feline Diabetes has so many ups and downs and we're all doing the best we can.

I read on your old condo that you felt tied to the vet for diabetes advice due to the insulin prescription - totally understandable but, if you haven't considered it, take your next prescription to Mark's Marine Pharmacy (Canadian Pharmacy with the absolute nicest staff!) - once they have a prescription on file, they don't ask for another (at least that was my experience and I've read it was the experience of others). I ordered the 5 pen pack from them and it ships to your doorstep. Here's a post on Mark's and their website is: https://rxcanada4less.com/ (see the website for current pricing as the post I linked is from 2018).

Hope that helps a bit - just know all your emotions have been had by all of us. It comes in waves - or at least it did for me. Hugs.

 

[bobjoh]

I read on your old condo that you felt tied to the vet for diabetes advice due to the insulin prescription - totally understandable but, if you haven't considered it, take your next prescription to Mark's Marine Pharmacy (Canadian Pharmacy with the absolute nicest staff!) - once they have a prescription on file, they don't ask for another (at least that was my experience and I've read it was the experience of others).

You must have ESP! I actually just looked at my insulin this morning and needed to order a new vial, so placed an order just a bit ago from Mark's! Wow...the price difference is crazy...that was a nice surprise!

Thank you for responding; it's nice to know I'm not alone!

 

[JaxBenji]

vial

Hurray! glad you knew to order from Marks! Did you get a vial or pens? Even with two kitties, you may be better off to get the pens. I'm sure you could call them and change to pens if you ordered the vial. The pens are great because you use them to the very last drop - and less worry if you drop them as they are plastic. And you just draw up the insulin like you do from the vial.

Hope you have a wonderful day!

 

[bobjoh]

Did you get a vial or pens? Even with two kitties, you may be better off to get the pens.
Hope you have a wonderful day!

My prescription is for the vial, so I ordered that. Maybe next time I can try the pens.

I remembered Mark's from this board; otherwise I wouldn't have had a clue! Ha!

I hope you have a great day, too!!

 

[Sienne and Gabby (GA)]

Bobbi --

I think this is the first time I've visited so clearly, I don't know your cats. From what Suzanne posted above, it sounds like you've been tied in to your vet for dosing advice. Many of us don't adhere to our vets when it comes to managing our cat's diabetes but I can understand feeling stuck.

Is there a particular reason you have switched meters? The AT gets to be pricey given the cost of strips. In addition, our dosing methods are based on using a human meter.

Looking at Gryphen's spreadsheet, my first reaction is that his numbers are good from the standpoint that he's below renal threshold. If you look over the dosing methods we use, you are dosing pretty consistently based on SLGS. However, I do think you were holding the 0.25u dose for too long between late March to mid-April. Even if your goal is regulation, you may want to see more greens.

Alphyne is a bit more of a challenge. One consideration is that it generally takes 6 cycles for the Lantus depot to stabilize. If you change a dose sooner than that, you can end up with wonky numbers. That may be why you're seeing some of the less than lovely variability. I would not have reduced from 1.25u to 0.75u. It was too large of a reduction and the numbers you're currently seeing reflect that. One other thought - is there any chance that Alphyne needs a dental cleaning? Dental issues are a pain in the neck source of elevated BG numbers. The tartar causes gum inflammation that causes a rise in BG numbers.

(Perhaps Gryphen can have a discussion with Alphyne about more stable BG numbers? Pointing out that colorful is not better might help!!)

 

[JaxBenji]

My prescription is for the vial, so I ordered that

FWIW, my prescription was too - Marks will switch you to the pens no problem if you want to

 

[bobjoh]

Is there a particular reason you have switched meters? The AT gets to be pricey given the cost of strips.

I would not have reduced from 1.25u to 0.75u. It was too large of a reduction and the numbers you're currently seeing reflect that.

One other thought - is there any chance that Alphyne needs a dental cleaning? Dental issues are a pain in the neck source of elevated BG numbers. The tartar causes gum inflammation that causes a rise in BG numbers.

I switched back because I needed to give my vet numbers, and doing one poke, two meters (when needing to give the vet numbers) was stressing us all out. If I can cut the vet cord I'll switch back to human. But honestly, I'm also more comfortable with the pet meter, since the numbers are more accurate. You are 100% correct, though...the AT2 strips are ridiculously expensive.

That .5U reduction was me listening to the vet. You can see I originally reduced to only 1U...I won't make that mistake again.

Alphy just had her yearly checkup in Dec, and her teeth are perfect. I had them cleaned a few years ago, and since then she's been good. Not that I want her to need additional medical treatment, but it just seems to me like there is something else happening other than the diabetes. Maybe I'll take her back in for full bloodwork.

I agree...even if they can't talk to me, I wish they'd talk to each other and come up with a plan for a less 'colorful' journey!!

 

[bobjoh]

Looking at Gryphen's spreadsheet, my first reaction is that his numbers are good from the standpoint that he's below renal threshold. If you look over the dosing methods we use, you are dosing pretty consistently based on SLGS. However, I do think you were holding the 0.25u dose for too long between late March to mid-April. Even if your goal is regulation, you may want to see more greens.

I completely agree with this. But, Gryphen never stayed in the greens, so I actually lowered the reduction point to 70 (with some help from people here) to try to keep her in the greens longer. She just really likes blue and hates green, I guess. Her nadirs, right now, are still between 80-150, so she really doesn't want to move at all.

 

[Sienne and Gabby (GA)]

I agree -- having to test for both meters is annoying. One solution is to get a big enough drop of blood to accommodate both meters and scrape the drop on to your fingernail. That way you only have to poke once. However, it doesn't resolve the cost factor.

I think the only thing that's going to get Gryphen into greens is more insulin. You're generally testing enough to consider Tight Regulation providing you are willing to eliminate the Young Again. With TR, a cat can't be on any dry food. TR is more aggressive. Once you are able to get the numbers into a greener range, you could always switch back to SLGS.

If I can make a suggestion... Please note in your signature that Gryphen's reduction point is a 70. That way, people like me won't be bugging you about what you're doing. We can't be helpful if we don't have any idea about your dosing strategy. (I'm also presuming that you mean 70 on a human meter. A 70 on the AT is pretty close to a 50 on a human meter.)

 

[bobjoh]

I think the only thing that's going to get Gryphen into greens is more insulin. You're generally testing enough to consider Tight Regulation providing you are willing to eliminate the Young Again. With TR, a cat can't be on any dry food. TR is more aggressive. Once you are able to get the numbers into a greener range, you could always switch back to SLGS.

If I can make a suggestion... Please note in your signature that Gryphen's reduction point is a 70. That way, people like me won't be bugging you about what you're doing. We can't be helpful if we don't have any idea about your dosing strategy. (I'm also presuming that you mean 70 on a human meter. A 70 on the AT is pretty close to a 50 on a human meter.)

The kibble is the problem. Gryphen throws up if she doesnt eat for several hours (always has). With 4 cats, I can't leave wet out overnight, or someone else eats it; Gryphen would never get any. And I have tried every type of feeder there is. I dont have that issue with the dry; the others will leave it alone. I'm really stuck.

The reduction point of 70 was on the human meter, we lowered it from the 90. I'm using a reduction of 80 on the AT2. I'll put it more clearly in my signature line.

I appreciate your advice!

 

[Sienne and Gabby (GA)]

The feeder option may be one that only opens to Gryphen provided she has a microchip. I have one of those feeders -- they are not cheap. I got it so my older cat stops muscling the kitten out of her food since she's more of a grazer. She's also a scardy cat and is terrified of the feeder. Best intentions plans that went awry. (The kitten will jump onto the kitchen counter whereas the older cat won't so at least I can relocate her food when necessary.)

 

[bobjoh]

The feeder option may be one that only opens to Gryphen provided she has a microchip. I have one of those feeders -- they are not cheap.

I tried those...the SureFeed microchip feeders. They were a bust. Luckily, I was able to return them. I have a storeroom full of others I couldn't return.