5/29 Max AMPS 389+6=262PMPS 216 Increase+2=225+3=224

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tiffmaxee

tiffmaxee

Member Since 2013
YESTERDAY'S CONDO:
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Starting off in pink again. I don't know if it's the insulin. I am getting 3 pens from my friend this afternoon so we will see what happens. She mailed them USP yesterday late afternoon and they are to arrive between 1-5 today. I'll use the old syringes for the next couple of days but they will run out soon and then I switch to the terumo. I'll likely find he is already getting more than the 2.25 units I think I am giving him. I just hope it works and he isn't resistant.
 
Re: 5/29 Max AMPS 389

Hi Elise,

I can feel the frustration in your posts - I'm so sorry that Max is hard to regulate but I do agree with the others that your intervention is helping more than hindering. Although I can't give you any advice, I can offer encouragement and support. Please know that we are all rooting for you and Max and hoping he'll soon surf more consistently.

Good luck with determining whether it's the Lantus or the syringes - a systematic approach, as Marje suggests, is a good idea in helping you make that determination.

Have a great day Elise! Anne
 
Re: 5/29 Max AMPS 389

I hope the new pens do the trick for Max. You ARE making progress...it might not seem that way, but you are. Sometimes it takes a while to hit that breakthrough dose, but when it happens you are then off and running.

I'm curious to see what Max thinks about Young Again. I was toying with the idea of trying it, too, as I had heard fairly good stuff about it....but holy moly it must be laced with gold 'cause that stuff is pricy! I'm going to request a sample, too.

I hopy you guys are having a great day!
 
Re: 5/29 Max AMPS 389

Initially I was disappointment that remission didn't happen quickly like it does for so many. That was followed by frustration that he didn't regulate. Now I just feel fear that regulation won't happen. I know my original Lantus was likely past usefulness but I doubt that the second one was no good after reading that being out of the fridge so several hours should not hurt the insulin. The new ones are being sent with a cool pack but I don't know how long it lasts. Apparently it isn't shipped in coolers from the manufacturer.

Thanks for the support and encouragement.
 
Re: 5/29 Max AMPS 389

I can understand your frustration...I am having the same issues with Spot....he used to be nice and regulated and then at the beginning of the year...something changed. I hope the new insulin/ syringes work for Max.

I just received a new shipment of Lev from Canada. It came with a cold pack and by the time I got it, it was melted, but still cool....and it came in a bubble envelope.
 
Re: 5/29 Max AMPS 389+4=327+6=262 Increase+new pen?

With numbers like this, is there any reason not to both increase and use the new pen when it arrives? My gut is telling me it is Max and not the insulin but my gut is not often right when it comes to diabetes. Or should I increase and see what happens before using the new pen? Or should I just use the new pen? confused_cat
 
Re: 5/29 Max AMPS 389+4=327+6=262 Increase+new pen?

I would use the new pen for one cycle first to see if there is any drastic difference, then follow with the increase if there isn't. Good luck with the new juice/increase combo. Trying both for the night cycle is a way for Max to prove you wrong. :roll:

Max - time to get your blue suit out of the closet and put it on!
 
Re: 5/29 Max AMPS 389+4=327+6=262 Increase+new pen?

Personally I agree with Wendy...I always try to change only one thing at a time, so I know for sure what is and isn't working. If you're pretty positive the old pen is toast, I would be inclined to hold the current dose for a cycle or two but use the new pen.

I'm sure others have different thoughts, though!
 
Re: 5/29 Max AMPS 389+4=327+6=262 Increase+new pen?

That is the problem. I am certain my original vial was toast. I started a new vial 5/21. It was given to me by my mom's visiting nurse. It was never opened and in the box. She stored it in the refrigerator but it was out from an hour to possibly several before she got to my mom's house. It doesn't expire until 9/14.

The 3 pens don't expire until some time in 2015.

I have 4 more days before I change syringes to the terumo ones. So my choices:

1. Increase dose with vial I opened 5/21
2. Use new pen tonight wasting a potentially whole good vial of insulin

Forgetting about wasting insulin, which makes the most sense? I am so indecisive about this.
 
Re: 5/29 Max AMPS 389+4=327+6=262 Increase+new pen?

Given those options, I would be inclined to increase with the current vial. Since it was brand new before you started using it, it SHOULD be fine - unless the visiting nurse somehow shook it up like crazy or anything like that.

I know how hard it is to make these decisions. Despite what I would do, I would also recommend you go with your gut...if you're more comfortable with the new juice, then that is the way to go.

I'm sorry....all of that was no help, was it :roll: ....?
 
Re: 5/29 Max AMPS 389+4=327+6=262 Increase+new pen?

Hi Elise, I also feel as frustrated with not being able to regulate Rocky. It is still hard to look at say, Marje and Wendy's condos and see numbers consistently falling between 50 and 200, for most of the time. Their cats rarely visit the 300s. I have to wonder if it is really because so much time as passed and the cat's pancreas has finally healed a bit, or if there isn't something else actually happening.. I'm not saying that they are doing anything else different than you and I, but maybe there IS something different about the way that their cats are using the insulin.. It's just a thought.

Anyway, hang in there.. Rocky is likely going to get a bump up in insulin too, after we stop setting back his shot time to an EARLIER time. I think the only reason he is not seeing as much pink is because of the insulin overlap..

Actually, while writing this to you right now I am wondering if Rocky might be one of those cats that does BETTER with an 8 hour insulin cycle to even out and make his cycle more flat... In other words, maybe Rocky would stop visiting those outer-space high BGs and those bottom-dweller lows.. I do believe that he might be using his insulin fairly quickly.

To do that 8 hour cycle shot cycle it might involve giving a smaller amount of insulin. I think I'm going to pose the question in this forum and see what folks here tell me. I'd much rather try that than switching Rocky to a different type of insulin.
 
Re: 5/29 Max AMPS 389+4=327+6=262 Increase+new pen?

i don't think for a moment that Max is a high dose cat. 2.25u isn't much at all. really. not just saying this to make you feel better. If we thought he had some unusual problem, you know we'd tell you. I think he's bouncy.

it doesn't help to compare one cat to another, tina, but if you want to compare to Wendy or Marje's cats, you've got to look at the spreadsheets from their first year. they have worked hard to figure out what to tweak to get their cats into these good cycles. you can't look at the current spreadsheets, because those reflect literally YEARS of their efforts to get their cats regulated.

Elise, in Max's case, i look to his pancreatitis history. In that same PDF, there is a section about pancreatitis and how it makes regulation difficult. He's also got the high blood pressure. It just seems to me that many of the cats that are difficult to regulate (not impossible, but difficult) have a concurrent condition - Irritable bowel, asthma, some kind of virus, pancreatitis, hyperthyroid, the list goes on.

I read your comment from the other night about the vet saying that Max shows signs of being insulin resistant. I'm wondering what exactly he means by that. He doesn't have anything that says to me that he's got iaa (insulin auto-antibodies), cushing's disease or acromegaly. There is the possibility of glucose toxicity (there is a post on it on the NEw to the Group sticky, scroll to the bottom where there are single topic links). The "cure" for that is to get them into better numbers and keep the cat there - which you are trying to do.

I'm also wondering why he is suggesting a lower/no carb food. Sometimes cats here who are on lowest/no carb food are the best at diving. Especially with a bouncy cat, i wouldn't go that direction.

In Max's situation, I still think giving slightly higher carbs to raise his nadirs so you can give slightly more insulin might be helpful. Not sure if you're trying that anymore. I also think Lev is a good insulin and am not sure why the vet is rejecting it without trying it.

I think your new vial of Lantus is working fine - i see a green in there on the 25th after you increased. I'd go ahead and keep using that and give the increase as you planned.

It is frustrating - you have lots of good company. It just takes time and patience, and continuing to try things that might help - that's what i did with punkin.
 
Re: 5/29 Max AMPS 389+4=327+6=262PMPS 216Still Increase?

Okay. This is strange. He was 262 at +6 but is now 216 at PMPS. Should I still increase tonight or hold off until the morning? Is he clearing a bounce?

The pens arrived later than expected and were room temp. They were on the truck since early this morning. Hopefully they weren't damaged. I'm going to use the vial tonight anyhow.
 
Re: 5/29 Max AMPS 389+4=327+6=262PMPS 216Still Increase?

Julie, what the vet said was that it looks like there is variable insulin response or resistance. He thinks that is likely due to pancreatitis and that is why he suggested antioxidants to help with inflammation. He also mentioned that Max's high BP could be white coat syndrome which I have worried about the whole time myself since he isn't CRF or hyper-t. I wonder if that is why he sleeps so much. If he is low at home that isn't good for him but I don't know how to find out for sure. confused_cat
 
Re: 5/29 Max AMPS 389+4=327+6=262PMPS 216Still Increase?

is the blood pressure kit something the vet would teach you to use and let you borrow to check him at home?

Looks like he's clearing a bounce, but it's not like he's diving with a lot of momentum. i think i'd still increase, personally, but it's up to you. You could wait til morning to increase so you can see how low he gets tonight with the bounce cleared. that might be a good idea.
 
Re: 5/29 Max AMPS 389+4=327+6=262PMPS 216Still Increase?

I went ahead with the increase. I haven't had to be up all night with him for quite a while, LOL. I just hope this doesn't lead to another bounce. That is my fear. Or that he will go under 50 and immediately need a reduction. I guess that wouldn't be so bad.

I can't take the BP machine home. I wish I could. I considered buying one but they are very expensive. If I did my vet would let me bring it in to show me how to work it and check it with his but a good one costs a couple grand. He is so sleepy that I really wonder if he even has high BP and if it goes low at home that is dangerous. However, the cardiologist didn't see any signs of heart disease at least. My friend has a vet BF that left his practice and moved to L.A. He took a job at a practice. I wonder if they have more than one machine and if he would take one home. I have to ask her. I haven't even met him yet. Hmmm.
 
Re: 5/29 Max AMPS 389+4=327+6=262PMPS 216Still Increase?

we had punkin's BP checked at the vet's at one point before we took him to colorado, and it wasn't a big machine. it's was a fairly little thing, if i remember right, kinda like a little human bp monitor, only really small. i wonder if there is more than one kind.

how about a mobile vet coming to your house to check it?
 
Re: 5/29 Max AMPS 389+4=327+6=262PMPS 216 Increased

Yes, the machine is small but the price is HUGE. It's often a topic on the CRF lists. Cheaper ones just don't work. It's amazing but you wouldn't believe how many vets don't even have one!!! To me that is just not right because most charge every time they take a reading so they can pay it off in no time. I called around at one point and the mobile vets expect a fee for a check-up plus the BP reading. Also, Max hides when anyone comes over and is afraid so I don't know if it would even be accurate. The list vet asked if Max could be in a dark room for a long time and calmed that way. My vet is much too busy for that. I try to arrange to go there when one of his partners is in surgery and wait in his office but that doesn't always work out. Sometimes we wait in the reception area with all the dogs. A few months ago this woman kept letting her dog wonder close to Max's cage until I finally told her to reign in her dog. She was an older woman and didn't take a hint.
 
Re: 5/29 Max AMPS 389+4=327+6=262PMPS 216 Increased

Good luck with the increase. I hope this is what it takes to bring Max back into good numbers.

If you look at Neko's 2012 SS in May (6 months after her diagnosis which is where Max is now), her PS were primarily red or black. It hurts my eyes to look at where she was then. It took a year and a half before red stopped being common on her SS. She still sees pink often. Three things have helped Neko level out; time, doses where she sees green regularly and Levemir. I have to keep her at a dose where she sees green or she gets really bouncy and I won't linger too long on a dose if she stops seeing nadirs within my target green range. But acros are different - I was able to hold a dose for almost three months last year because it kept giving me nadirs I wanted.

I don't know if you've seen this article on insulin resistance in cats. When they list the underlying conditions, pancreatitis is the first one listed. But that doesn't mean it's impossible to get regulated. Muffin(Anne) had chronic pancreatitis, went OTJ, but occasionally would need some insulin support after a flare-up. It didn't help that she had a thing for french fries. :lol:
 
Re: 5/29 Max AMPS 389+6=262PMPS 216 Increased+2=225

Hi Wendy. Interesting article. I hadn't read that one. I have read that pancreatitis can lead to resistant diabetes and it is always in the back of my mind. Neko was treated for acro, right? It can't be cured I guess. Thanks for hanging in there with me as I struggle to accept and get used to all this. Words can not express my appreciation for you, Julie, Marje, and all the other wonderful people that hold our hands and guide us.
 
Re: 5/29 Max AMPS 389+6=262PMPS 216 Increased+2=225

His noises were much softer. I made a You Tube video but I don't know how to change the name on it. Until I figure that out it is marked private. Thank goodness it hasn't happened again. I think it might have been congestion. I sure hope he isn't acro.
 
Re: 5/29 Max AMPS 389+6=262PMPS 216 Increased+2=225

Flat yellows - blues next?

Max's SS does not say acro to me, just bouncy. The pancreatitis makes it harder, but not impossible to get regulated. Neko did have stereostatic radiation therapy (SRT) with neuters the tumor cells. It definitely helps, but SRT is new enough that there isn't a definitive answer yet on what to expect.
 
Thank you, Wendy. Do you think I need to test again tonight? In looking at your earlier ss I saw you mentioned the yowling and meowing that Max does often around 4:30-5:30 when he gets hungry. It's impossible not to feed him something as he won't let up. Any ideas?
 
Thank you, Wendy. Do you think I need to test again tonight? In looking at your earlier ss I saw you mentioned the yowling and meowing that Max does often around 4:30-5:30 when he gets hungry. It's impossible not to feed him something as he won't let up. Any ideas?
 
Thank you, Wendy. Do you think I need to test again tonight? In looking at your earlier ss I saw you mentioned the yowling and meowing that Max does often around 4:30-5:30 when he gets hungry. It's impossible not to feed him something as he won't let up. Any ideas?
 
Thank you, Wendy. Do you think I need to test again tonight? In looking at your earlier ss I saw you mentioned the yowling and meowing that Max does often around 4:30-5:30 when he gets hungry. It's impossible not to feed him something as he won't let up. Any ideas?
 
I can't remember if you've tried setting an auto feeder for that time? I try to feed Neko a bit just before I go to bed. And I have to make sure that the curtains are closed in the east facing rooms (sunrise) or else if it's too bright out she thinks it's daytime and time to get up. :roll: She's a lot better now than she was 2 years ago regarding food.

Looking at Max's SS, it looks like he let's you know by +3 if he's planning on going deep into the lagoon. He might hit blues. I'd say you are safe for the night.
 
Thanks, Wendy. I don't think Mr. Max would react well to a feeder. He's afraid of everything. You should have seen him when I got a flat screen TV. It took him six months to finally use his pet bed. It looks so comfy but instead he would lay in the corner on the floor.I'm going to try freezing some food and see if that works. That was Julie's suggestion and worth a try. I don't mind getting up to feed him. I just thought I wasn't supposed to feed him so late in the cycle.
 
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