5/14 Eegie AMPS=425; +3=402;+7.5=328; PMPS=305;

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Sgans and Eegie - GA

Member Since 2015
Changed injection location this morning - from flank to below armpit near chest. Hopefully, that'll have more effect. Gonna switch sides to opposite of sub-q's since that's just about where sub-q gravitates. Just... seems I can't use lower flank, and there's no real pinch area near stomach to get a tent.
 
The other day, I tried the flank area for injection (I usually rotate between side of shoulders and between/below shoulders... Not the scruff) Kitty didn't like the flank much. Kept trying to sit down when I tried to shoot. That got me thinking about if there is an absorption difference, and low and behold you posted a question about it. I've been following your post from yesterday and am really curious about that image that was mentioned as well. I hope the new spot works out for you!
 
@missMeows - The shoulders were doing okay until we had an issue that was only partially related. An experienced friend suggested alternate sites, because of the sub-q going in the same location as the shots. The easiest place to get was the flank, although she suggested more like what I just switched to (my concern is that that's the area the sub-q falls to). But, clearly, that flank wasn't working for Eegie. Might do wonders for you though! My cat.... he wakes up trying to find ways to vex me, I think! :)
 
shooting spots for insulin-cats.jpeg


Sorry...meant to come back and post the picture for you but got tied up with China
 
What?! Your cat takes priority?! How is that POSSIBLE!!! :p

Sienne and Gabby posted the link in my last condo, but this is great - thank you, @Chris & China !

Guess you'd call what I'm using as of now, "Side of Belly". If that doesn't work in a few days, it may be time for upping the dose?

Poor Eegie - he must be exhausted... I'm finding myself tired ALL the time now...
 
His +3 isn't great - okay - it's terrible. How long do you think I should give the new injection site before I maybe consider upping his dosage? Of course, dosage upping would happen in the morning, so I'd still be at 1u tonight at least... Any input?
Or, could this all be just leftover garbage from my air shot 2 days ago?
 
After a furshot, the "shot clock" starts over....so if you're doing Tight Regulation, that means 6 cycles

However, every time you change anything, it can effect other things, so it's also important that each time you make a change to diet, shot location, meds or dose, you don't change anything else for at least 6 cycles so you can tell what changes are doing what
 
You've got 4 shots at this dose. I'd give it 2 more cycles and then re-evaluate and decide then if you should increase.

Some people shoot different locations with every shot (Marje/Gracie is one) and I don't think that would cause a need to wait 6 more cycles to evaluate the dose from now. I agree that generally speaking, it's usually a good idea to make one change at a time so you know what's causing what, but I don't think I'd hold a dose longer than necessary because I'd changed locations. As far as I know, you can change location as much as you want. In my opinion, that 6 cycles idea only applies to dose increases.
 
Thank you, guys. I just talked to the doctor. He suggested keeping the same dose, but going back to the shoulder location where we'd been getting the best reactions, but staying at 1u for at least a couple more days. Idea being I use alternate sides from where the sub-q was. Then, he suggested if things don't go back down (they're SO high right now), THEN he suggested trying 1.5u. I'd been thinking he'd suggest 1.25.... Of COURSE, I'd do any dosage change during the day... when I can watch.

BTW - not doing tight regulation, can't monitor at night, so doing the slow... whatever method, modified a bit.

Do you guys think that 1.5'd be a big jump? Seems big to me, if the time comes.....
 
From the SLGS:

Hold the dose for at least a week
  • Unless your cat won’t eat or you suspect hypoglycemia
  • Unless your kitty falls below 90 mg/dL (5 mmol/L) if kitty falls below 90 mg/dL (5 mmol/L) decrease the dose by 0.25 unit immediately.
After 1 week at a given dose perform a 12 hour curve, testing every 2 hours OR perform an 18 hour curve, testing every 3 hours
Note
: Random spot checks are often helpful to "fill in the blanks" on kitty's spreadsheet.

  • If nadirs are more than 150 mg/dl (8.3 mmol/L), increase the dose by 0.25 unit
  • If nadirs are between 90 (5 mmol/L) and 149 mg/dl (8.2 mmol/L), maintain the same dose
  • If nadirs are below 90 mg/dl (5mmol/L), decrease the dose by 0.25 unit
  • As your cat's blood glucose begins to fall mostly in the desired range [lowest point of the curve approaching 100 mg/dl (5.5 mmol/L) and pre-shot value around or below 300 mg/dl (16.6 mmol/L)], do lengthen the waiting time between dose increases. If you decide to change another factor (e.g., diet or other medications), don't increase the insulin dose until the other change is complete (but do decrease the dose if your cat's glucose numbers consistently fall below 90 mg/dl (5.0 mmol/L) as a result of the change). Don't be tempted to rush the process along by increasing the dose more quickly or in larger increments-- no matter how high your cat's blood glucose is! Rushing towards regulation will cost you time in the long run, because you may shoot past the right dose.
Lather, Rinse, and Repeat!
You can see there's nothing there about increasing by 0.5u. Even with the Tight Reg protocol, the only time a 0.5u increase is suggested is when everything is over 300 on a human glucometer. In other words, no, I wouldn't increase by 0.5u with Eegor's spreadsheet looking like it does right now - you've been seeing tests in the 100's on this dose.

Increasing in too big of an increment doesn't help. Your vet probably doesn't think 0.25u is measurable - I don't think I've ever heard anyone report that their vet suggested anything less than a 0.5u increment change in dose, but as you've already seen, you can adjust by 0.25u increments and it is a large enough increment to make a difference in blood sugar.
 
@julie & punkin (ga) - that's what I was thinking - but the only difference is that it's been SOME time since I've seen any real numbers in the blues. I'm sure it's about the air shot, and not getting the hoped-for results of the injection site change. I too feel more comfortable going back to the shoulder site (right tonight, because sub-q was on the left), and giving it through tomorrow night (that'd be 7 continued cycles at 1u). Then, if his numbers aren't improving (as hoped by going back to the original site) - I mean... today was MISERABLE), going up .25u. He did see the difference between .75 and 1 (he sees my spreadsheet too), but I couldn't get why he'd suggest such a high increase - except that Eegie's numbers are higher than ever...

You're agreeing with my gut though - and I'm starting to develop a gut on this. Not MUCH of one, but some, nonetheless. Thank you for the feedback and response. I feel better.

BTW - with all of Eegie's issues- I'm not doing a "True" SLGS either - it's a modified SLGS. With Eegie's issues, it's been discussed with a few outside specialists that along with this as a support forum, there're are certain modifications and changes that need to be made with him that are a bit out of the norm. I agree with much of what they're giving me as feedback and what I get here- and am balancing it all out, watching Eegie and his reactions as well as I can.

Thanks again!
 
OH! @julie & punkin (ga) - I think I realized why he says .5!!! We had a prednisolone shot on the 5th (LAST Tuesday), and his body got weird after that (as expected). I wonder if he suggested that amount in response to the jump from the Depo Medrol! If that's the case, doesn't .5 seem to make more sense?

We KNEW we'd have to adjust once the pred took effect! Perhaps this was his plan with the pred....

Do you think that makes sense? Anybody else want to chime in with what they had to do after a Depo Medrol shot?
 
I don't know the shot. I have pills.

I just wanted to add that the only difference in where you shoot is the absorption rate.
When I first started, I did the flank and absorption seemed to be quicker there than in the scruff.
I thought it was the better place to shoot, but learned later on that it's all good as long as your kitty isn't objecting.
Mine didn't like the flank and now I just shoot all around the scruff area.... pinch and shoot....
 
The shot sometimes takes a few days to take effect and can last from as short as a week, to as long as 3.5 weeks, in our experience. It DEFINITELY. Increases blood sugar. Just remembering that, I feel better about an entire .5 u increase, maybe Saturday, when I'm home to watch and test. Y'think I'm nuts?

If it's just absorption then, that kinda holds the theory that he definitely needs increase, and I'm sure it's the depo, since no other things have changed that could raise BG.

thank you, @rhiannon and shadow - DO you think I'm crazy? To me, that half unit makes sense now, at least until the depo weakens.

The positive is that he made 2 pretty poops yesterday, and is responding to pepcid for acid. The idea of the shot was to put him in position for his regular meds to work.

Poor boy is such a balancing act!

Thank you.. Good night.
 
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