5/3/17 Misha: how low can we go?

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Squeakycats

Member Since 2017
I'd appreciate advice from anyone who has a second to look at my kitty's spreadsheet. What do you do when .1 has gotten a cat into the normal range at +12? I don't know how I can give a lower dose, but with numbers <100, I'm nervous about doing even .1. I'm going to do a curve this weekend when I can watch him very closely--any other ideas? I don't think I can change his diet further; everything he gets is very low carb.
 
I vote you continue the dose for a bit longer, but those are very good numbers. I'm sure a more seasoned person will come along.

Remind me again... Did you change Misha's diet before or after starting insulin?
 
Is there any way you can grab at least one additional test each cycle? It can be an 'out the door' test or a 'before bed' test or a 'since I'm up to use the bathroom middle of the night ' test. Knowing what is going on between shots is key and will ease your decision making.
 
I do think I could get more tests on non-weekend days--I guess I was thinking the only really useful ones for determining a safe dose were likely to be between maybe +6 and +10, which is where I'm guessing the nadir is, and of course I'm at typically at work then. But maybe it would be helpful to just have more data, period! And I can try to teach my husband to do the testing. He's not wild about needles and blood, but he loves our cats, so I know he'd be willing to try.

I changed Misha's diet at the same time we started insulin. Most of what he was eating before was actually really similar, but there was a fair bit of Natural Balance L.I.D. green pea & venison dry food in the rotation--we were focusing on his apparent allergies and were so happy to find something he'd eat consistently that didn't seem to be triggering them. I'm not sure re: the carbs in that food, but I'm guessing they were unacceptably high.

I guess I'll continue with giving .1 any time he's above 100 and skipping when he's below until I can get more info--at which point maybe I'll try doing the .1 even when he's in the 80s or 90s, if that seems safe based on what I see in the data? I'm also going to check in with my vet, though I'm guessing that she'll think the .1 thing is crazy/impossible and that we can just go ahead and try him off the insulin now that his numbers are always in the 100s. But maybe she'll surprise me! I was really happy with how quickly she went from "I know you want to test at home, but we really need to do curves here regularly" to "your cat hates being here; you should do the curves at home," and with how she accepted my saying "Nope, not gonna give him the prescription food--what else can you suggest?"

Thanks, y'all!
 
Definitely see if you can get him on board with testing mid-cycle. :) It looks like Misha is trying hard to be OTJ (off the juice) and this 0.10u dose is usually the last stop for insulin. We just like kitties to have strong remissions :)
 
Yes!!!! Strong remission is where it's at!!! He's pretty chill about being tested--I hate it when I bruise him, but he comes back for more, knowing he'll get a treat.
 
Jones case is a little different with the continued pred issue, but he is at a dose of 0.1u less 7 drops! It is a little more then just a drop, which we did for awhile.

Those mid cycle tests are nice as they tell how low they are going on the dose - which is what you would really like to see.
 
There's one last dose that you can try-- the "whisper of Lantus" dose. Here, you squeeze the syringe plunger as hard as you can, then release after you have inserted it into the pen, so that the vacuum draws up just a drop. It doesn't feel like you could possibly be pulling anything up, but if you try it, you'll see that you are!

The other option is to count drops-- I was never very good at that and never felt like I was getting a consistent dose of the really small doses, though. The "squeeze and release" dose was the only one I felt confident about the consistency.

Side note to @Squeakycats and @Tracey&Jones : your kitties look so similar in your avatars I did a double-take reading this thread!
 
I have done several draws and check of the number of drops as an experiment one afternoon. Yes I know, I have no life.

I have done the 1 drop which sounds like the whisper dose you are talking about. I have found the whisper - 1 drop - is really 1 drop to 1.5 drops. I found the thing with that is you need to keep the plunger pushed as you withdraw the syringe or you may end up with a tiny drop at the end still "in" the needle.

The 0.1u - I found can be any where from 5-10 drops. There has been a couple of time I tried to squeeze out 7 drops and I am done - I am down to nothing in the syringe. I throw it out and start with a new one.

It is 1 drop compared to 3 drops (roughly) that he is getting. I hope to be just back to the whisper 1 drop soon.

The difference is really in the needles themselves, without calipers you just will not be accurate but if I do the same methodology, I hope to be at least consistent enough for the depot to even things out.

Grey Cats are very Cool!
 
This is great--it would not have occurred to me to try the "whisper" method--and as you say, Tracey, having a consistent methodology seems like the most reasonable goal possible in this situation.

This is probably a very dumb question, but how do you count drops? Are you drawing the insulin, putting it in another container, and then drawing it back up somehow?

Our kitties do look extremely similar! I love the silvery sort of sheen they sometimes have on their heads and paws.
 
Yeah, I love the sticky--the pictures are so helpful! I just don't know how the drop gets back in the needle--if you pull the plunger back, is it sucked back in? I will have to experiment tonight!
 
Yeah, I love the sticky--the pictures are so helpful! I just don't know how the drop gets back in the needle--if you pull the plunger back, is it sucked back in? I will have to experiment tonight!
They unfortunately don't "go back in", so the insulin popped out is gone. :(
 
Oh, I am not explaining this well--I guess what I mean is just that I don't know how to measure drops. I can look at the picture and squirt out a drop of the appropriate size, based on the picture...but then what do I do? Is this just something I do as part of the process of figuring out where the plunger has to be in order to get a certain amount of insulin--like, draw up some water and experiment with different plunger settings until you get one that produces a drop of the right size, and then you'll know that's where you have to get the plunger to when you draw the insulin? I'm having a hard time imagining how to be that precise in terms of the plunger location. I'm probably still not explaining this well--sorry--what I mean is, if what I'm trying to do is give Misha a drop of a certain size (like in the picture with the pinhead), how do I make sure I have a drop of that size in the syringe?
 
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I apologize if this is an idiotic question! I may be seriously overthinking this.
 
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how do I make sure I have a drop of that size in the syringe

You don't really know the size of the drop doing the whisper 1 drop method. You just press the plunger as hard as you can, insert and let go. That is your dose - no checking each time. What I did, because the curiosity got the best of me like you, was blow through a bunch of syringes and insulin to figure it.

but how do you count drops

For the 0.1U less X drops? I do the normal checks to get to the .1u draw. Once comfortable with that, I then very gently, roll and press the plunger at the same time until I get a drop at the end. I bounce it off and start over...until I get the required # out. Some or bigger, some or smaller. Again, keep the same methodology and hopefully with the depot any little variances are kind of covered.
 
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