6/14 Pumbaa AMPS/318

[Pumbaa]

Pumbaa's shed should now be down to the 2.0U level, and I can't say that I'm happy with having him in yellow and blue instead of in blues and greens for his lows. Well, if I have to increase him back to 2.25U, so be it. I just sure wish his bounces would level off! But, as I've been told, they bounce until they don't. *LOL*

Suze

 

[BJM]

Maybe a fat 2.0 rather than 2.25?

 

[Pumbaa]

A fat 2.0 is sounding good to me!

UPDATE:
Okay...Pumbaa went up to a fat 2.0U tonight. I've been giving him sardines (packed in water, no salt) as an appetizer right after his AM and PM tests, then I've been feeding Beck (the drooler) and waiting to feed and shoot Pumbaa for about 15 minutes so he has some food in his system before his injection. Also, I think I am going to start giving the cats lower-carbed FF Classics in the morning, and higher-carbed Friskies pates at night, to try to slow down those evening dives which keep me up half the night. I'm not happy with his pink numbers, but am happy that we haven't seen a red in the last four days.

Suze

 

[tortie58]

Good luck with the dose crease!

 

[Dale 'n' Chip]

That bounce is a bummer, but not as bad as Chips.

Is Pumbaa's vet involved in this? I mean does the vet know about the dosing? Where did you get the idea to try Lantus?

 

[Dale 'n' Chip]

I have no clue why Pumbaa has stayed up in the 300s for over two entire cycles. He's been clearing bounces quicker than this, his food hasn't changed, and it doesn't appear to be the new insulin pen as once I started the new pen he was still getting low numbers. Color me confused!

Suze I noticed you seem to start new pens pretty often. How much is left when you do that? Do you suspect the old one is bad? I was wondering about my pen from the flat pink surfing, but when I saw how fast he bounced to black, that seems to suggest insulin potency.

I've gotten much better at drawing, so as to avoid bubbles and waste less, compared to early on. My first pen is only half gone in 24 days. Good to the last drop?

 

[Pumbaa]

Good luck with the dose crease!

Thank you, Helen!

 

[Pumbaa]

That bounce is a bummer, but not as bad as Chips.

Is Pumbaa's vet involved in this? I mean does the vet know about the dosing? Where did you get the idea to try Lantus?

Chippendale's:

Pumbaa's vet is involved to a point. They used to call me for weekly updates, but they have a link to Pumbaa's SS, so they don't have to call me anymore. I had Beck in at the same vet two weeks ago, and talked to Dr. Orr about Pumbaa at the same time, and she's pleased with what I've been doing and how Pumbaa has been reacting, and she's really impressed that I am able to test him and shoot him this much, considering her one experience with him was his biting me and their having to muzzle him to draw blood and get a urine sample. Dr. Orr is available if I need to call her and ask questions, and I feel comfortable that she would call me if she saw anything out of the ordinary on his SS. I feel very lucky that Dr. Orr was not opposed to home testing, and was impressed with the research I had done when I went in for our consultation meeting and treatment plan the day after his diagnosis was confirmed.

Re: Insulin. Dr. Orr wanted to put Pumbaa on ProZinc, but from everything I had read on these boards and other research, Lantus seemed like the insulin of choice if potential remission was the goal, which it is. Dr. Orr had heard of glargine/Lantus, and had no problem prescribing it.

But were you asking where I got the idea to try Levemir instead of Lantus to even out Pumbaa's bounces and dives? By reading posts here by people who has switched their cats. I'm still not sure that Lantus is the right insulin for Pumbaa, and might have already made the switch had I not read further updates about how not all cats smooth out and react the same way to Levemir, and how the onset is later, which could cause many more sleepless nights. Now that I think about it, though, I don't recall any posts about people who have switched from Levemir to Lantus. I might have to pose that question. We might both be interested in the answers.

Since humans react differently to different drugs that do the same thing, it makes sense that cats would also react differently to different insulins, even though they are supposed to do the same thing. I know my mom reacts differently to generic versions of some of the drugs she takes, than she does to the originals.

Suze

 

[max&emmasmommie]

Glad to see you have had no reds for 4 days! That is great!

I am curious how many people have switched from Levemir to Lantus, too. I don't want to switch to Levemir either, but I may have to try it -- that or PZI.

 

[Pumbaa]

Chippendale's:

At least with ProZinc, you dose based on preshot numbers and can react to dives/bounces better.

My brain is open to the best insulin for Pumbaa, no matter what anyone else states, because ECID! May you and I find the best treatment for Chip and Pumbaa!

Suze

 

[Dale 'n' Chip]

Chippendale's:

At least with ProZinc, you dose based on preshot numbers and can react to dives/bounces better.

My brain is open to the best insulin for Pumbaa, no matter what anyone else states, because ECID! May you and I find the best treatment for Chip and Pumbaa!

Suze

I really wanted U40 Prozinc (actually BPC PZI) for the more accurate microdosing using U100 syringes. But I went for Lantus because of all the hype about "time is running out" on the window of opportunity for the 84% remission rate. I could have done well with prozinc and it takes less attention and test strips daily.

But weren't you just today telling me to "Give Lantus a chance" :lol:

 

[Pumbaa]

But weren't you just today telling me to "Give Lantus a chance" :lol:

Yes, because now that Chip is on Lantus, you might as well see how he does with it.

Pumbaa has been on Lantus for 2 months now, and while I'm not thrilled with his bounces and dives, I don't know that it's the Lantus causing them. Maybe he would do the same thing on Levemir or ProZinc, I don't know. I'm just hoping that "they bounce until they stop" becomes a reality soon, and Pumbaa stops this soon.

Suze

PS: I think I meant that post to go to the other Dale, Max and Emma's mom. You two confuse me. *LOL*

 

[Pumbaa]

Glad to see you have had no reds for 4 days! That is great!

I am curious how many people have switched from Levemir to Lantus, too. I don't want to switch to Levemir either, but I may have to try it -- that or PZI.

Dale,

So far no responses on that thread. That's interesting. Does that mean that no one has switched from Levemir to Lantus?

Oh, you spoke too soon...we had a big whopping red this morning. *LOL*

Suze

 

[Squeaky and KT (GA)]

I swear Pumbaa and KT are brothers....both of them are TERRIFIC divers - if they were SUPPOSED to be diving, they'd tie for the gold...

HUGS!

 

[Pumbaa]

Lyresa,

KT certainly is a good little diver, too! *LOL* At least he no longer bounces up into the reds after a good dive.

I you and I need to train our kitties to play this in the middle of the night when they go into a dive to alert us: http://www.youtube.com/watch?v=u95E__3TSN0.

Suze

 

[Dale 'n' Chip]

...So far no responses on that thread. That's interesting. Does that mean that no one has switched from Levemir to Lantus?



Suze

I don't think many have (there may be 1) but that's not why they aren't touching it.

It's not about the L's it's more of a poltical/religious type of issue.

That entire thread is revealing. We're just a bunch of outcasts. ;-)

 

[MommaOfMuse]

Well technical you are correct we are a bunch of outcasts. We are the select few that realize that life can go on without testing every 3 hours everyday and that we will not kill out cats, we can have a life without sacrificing sleep unless there is good reason to, etc. And that we also have brains enough to look at what is happening and discuss it among ourselves, get everyone's opinion and then decide what is right for our particular cat, not wait for a select few to log in and tell us what to do next.

From my understanding, long before I joined the boards, TR protocol was the outcasts, the start low and go slow was the norm. How or when it became the all powerful being that it has become, I have no clue and really at this point don't care to know. I do know that Maxwell went OTJ without TR, and I do know that I do not lose sleep with Autumn nor do I test her 500 times a day and she is thriving just fine. Yes, I lost Musette, but it wasn't because she was diabetic or that her diabetes was unregulated, every vet that has ever looked at her spreadsheet was amazed how well she was doing. I lost her because she was misdiagnoised and was losing red blood cells faster than her body could make them. Which I still have no idea why or how long it was happening to her, it could have been part of why I struggled with her for as long as I did to get her as close to OTJ as I did.

No, I haven't been around a lot lately to help out with you guys, there is a lot going on in my personal life right now that doesn't leave me much time to be here. For that I am truly sorry. I wish I could be here more than I am. Hopefully one day my life will again give me the time to do what I truly have a passion for doing, and that is helping the kitties that come here and the people that love them.

Mel, Maxwell, Autumn & The Fur Gang

 

[BJM]

I also came to this forum because I will think outside the box and believe there may need to be alterations to "The One True Way (tm)" for managing a specific cat's diabetes.

I believe you really have to find what works for your cat, trying feeding schedules, food types, insulin types/shot amounts/times, using a supplemental insulin for the spiking cat, and so on, until you find the combo which works best for you.

 

[Pumbaa]

No, I haven't been around a lot lately to help out with you guys, there is a lot going on in my personal life right now that doesn't leave me much time to be here. For that I am truly sorry. I wish I could be here more than I am. Hopefully one day my life will again give me the time to do what I truly have a passion for doing, and that is helping the kitties that come here and the people that love them.

Mel, Maxwell, Autumn & The Fur Gang

Mel, you have helped me more than I could ever thank you for. Even while you have been dealing with major changes and stress in your life. I can't thank you enough for that! (((HUGS)))

You keep taking care of Autumn and your furry crew, and Jon, and yourself. And if you have anything left over after this, you can then help the rest of us.

I know you are still hurting about Musette, but you did everything you could for her, you went above and beyond what many of us could do, and it was simply a fact of a poor diagnosis from the get-go, which you have now alerted the rest of us to, and which could save many more kitties lives. In Musette's honor.

You are a wonderful, caring woman, Mel. So don't ever sell yourself short or apologize for not being SuperWoman at times! (((HUGS)))

Suze

 

[Pumbaa]

I also came to this forum because I will think outside the box and believe there may need to be alterations to "The One True Way (tm)" for managing a specific cat's diabetes.

I believe you really have to find what works for your cat, trying feeding schedules, food types, insulin types/shot amounts/times, using a supplemental insulin for the spiking cat, and so on, until you find the combo which works best for you.

Yes! I totally agree that it's all about the cat, and not about being so hung up on any protocol that you ignore how the cat is reacting.

ECID! (((HUGS))) to you! Because I have been trying many different things with Pumbaa based on your "thinking outside the box" suggestions, and I so appreciate those suggestions!

Suze

 

[Dale 'n' Chip]

So Catwoman and SuperWoman.

What does that make BJM?

(all rebels with a cause)

 

[BJM]

So Catwoman and SuperWoman.
What does that make BJM?

A finagler.

 

[Carl & Polly & Bob (GA)]

Chippendale's:

At least with ProZinc, you dose based on preshot numbers and can react to dives/bounces better.

My brain is open to the best insulin for Pumbaa, no matter what anyone else states, because ECID! May you and I find the best treatment for Chip and Pumbaa!

Suze

I really wanted U40 Prozinc (actually BPC PZI) for the more accurate microdosing using U100 syringes. But I went for Lantus because of all the hype about "time is running out" on the window of opportunity for the 84% remission rate. I could have done well with prozinc and it takes less attention and test strips daily.

But weren't you just today telling me to "Give Lantus a chance" :lol:

Sorta, but not really... you still need to know the nadir numbers and when it occurs, along with the pre shot numbers to figure out the doses with the P insulins.
You can react to the cycles more quickly if needed by adjusting the dose on a cycle by cycle basis, but it's not that simple. You still get dives and bounces, but sometimes the best course of action is to change nothing and let things clear.
Dale, two things about BCP PZI. One, it's getting harder to come by. And two, you aren't likely to get 12 hours out of a dose. It's more of an 8 -10 hour insulin. Prozinc lasts a little longer- 10 to 14 hours.
I disagree with the less attention and fewer test strips thinking too. Check out a few P spreadsheets...
If anything, managing the P's can be more difficult, because there isn't a published protocol to follow.
Carl

 

[Dale 'n' Chip]

...Dale, two things about BCP PZI. One, it's getting harder to come by. And two, you aren't likely to get 12 hours out of a dose. It's more of an 8 -10 hour insulin. Prozinc lasts a little longer- 10 to 14 hours.
I disagree with the less attention and fewer test strips thinking too. Check out a few P spreadsheets...
If anything, managing the P's can be more difficult, because there isn't a published protocol to follow.
Carl

I studied it for months and looked at lots of spreadsheets when I was going to do that. After using NPH on and off for more than a year it is clear to me U40 BPC PZI would have helped him (microdosing) when he was OTJ. Certainly before I got into the NPH bouncerama that immediately proceeded this last month of Lantus which is a continuation of the wild bouncing. With Chip and NPH there was no regular need to test before each shot, just spot checks and a curve a week, or more when things might be changing. Significantly less test strips. Every thing I learned with each NPH curve applied in some way going forward, unlike with Lantus just banging around each day only to find out where you are for the moment, with very little to learn in the way of forward reaching implications. Seems like lots of Prozincers who didn't OTJ right away are going to Levemir and I wish I could do that with Chip. But his chances to OTJ again are probably gone now and we'll likely just have to make the most of NPH since it's the only thing that comes close to fitting the budget. The next most affordable being the BPC PZI which seems to still be available from BPC. Might be worth a try (free vial of U100) as an upgrade over NPH, but it still requires going back to the vet again. Even if I can swing more Lantus, I can't affort to keep up with this level of test strips. That's if we could survive the 6-10, 15-25 pokes each and every day and nightmare.

Carl I sure hear you, but this experience has been so disruptive and expensive it has me questioning the wisdom of keeping kitties indoors. :-|

 

[Pumbaa]

Even if I can swing more Lantus, I can't affort to keep up with this level of test strips.

Chippendales, what meter are you using again?

I got the Relion Confirm Micro at WalMart for about $9.00, and ordered 250 test strips from American Diabetes Wholesale for $70.00 which brought the price down to $0.28 each instead of $0.36 each when you buy them at WalMart.

Suze

 

[MommaOfMuse]

If you think PZI would be better for Chip you are his mom...make the switch. It is that easy, there is no right or wrong insulin in and of itself. The correct insulin is the one that works for your cat. They all have their pluses and minuses. What works well for one cat may or may not work well for the next one. And after using NPH, Lantus and Levermir of the 3 the one that I would be testing more often and not less often would be NPH and here is why, it is harsh it does it's job quickly and it wears off quickly. But there have been some cats that have done great on it..My Muse did not, in fact it killed her, because she went hypo overnight and passed away before I found her.

I wasn't testing her at that point because I had just barely found this board and she had been dxed only a week before and I had only gotten her home 3 days before she passed. I know I did what I thought was best for her, that I followed my vet's instructions, but I still have to live with the guilt that I held the syringe that killed my best friend. That she trusted me that night to make her better and she died because of something I did to her. I wasn't testing her because it was a holiday weekend when she came home from the clinic and I couldn't get a meter. That will always haunt me, so if I ever have another cat on NPH that cat's ears would be pin-cushions, or I would be switching insulin as quickly as humanly possible.

There are no guarantees that any insulin will not cause dives and bounces this isn't an exact science, if it were we wouldn't test at home at all, because things like stress, activity level, food, or all the other biochemical reactions in the cat's body wouldn't play a part in the equation, all of them would go OTJ when their diets get changed or the infection cleared up etc. But these aren't test tubes we are talking about, they are living, breathing, feeling and thinking creatures that have moods and emotions that change day to day.

My mother is also diabetic, and has been for 30 years, she can't predict how her BGs are going to react anymore than I can Autumn's on any given day, which is why she tests before every meal and before every injection. It also took her going through 5 different insulins before she found one that worked the BEST for HER. If it was a one size fits all this board wouldn't exist.

Mel, Maxwell, Autumn & The Fur Gang

 

[BJM]

.. With Chip and NPH there was no regular need to test before each shot,

If you make a decision to go back to NPH, please promise to test before each shot to make sure it is safe.

And due to the short duration, optimal control may require TID dosing (every 8 hours).

 

[Dale 'n' Chip]

If you make a decision to go back to NPH, please promise to test before each shot to make sure it is safe.

And due to the short duration, optimal control may require TID dosing (every 8 hours).

Of course. Actually that is where we recently came from but the dose was too high. If I'd used a spreadsheet that would have been obvious. Maybe I'll have to post here in Relaxed Humulin N?

I'm hoping DCIN can help swing some Levemir but if I do need to tide over or switch to NPH I have plenty of data. For Chip it's very predictable, but I will be careful in light of Muse. I'd never heard of such a thing.

Oh and BTW for those who haven't been around the block and think that was two of Charlies Angles, think again.

No spoiler alert:
(its The Bionic Woman and Wonder Woman)