7/25- Lucky- not sure where to go from this point

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all4mymarine

all4mymarine

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Okay, so I did some reading on the link that Joanna posted on DKA and I feel that maybe I need to just start over with 1u and stick with that for a couple of days. I've been looking over Lucky's SS and it's all over the place. I need to start over at the beginning dose and stay with it for a few days to see what happens (unless he gets a PS under 200 of course). I know we haven't changed doses increments by that much but he seems to react a lot to even small dose changes. I just feel very uneasy with him continually being in the pinks or even high 200's. I know it takes time but his SS is just a mystery to me at this point and I'm left feeling unsure of which way to go. To either stay the course with a particular dose or make small changes based on PS and nadir.

I'm not so sure what he needs right now, a smaller dose or a larger dose? He seems to go too low on the higher doses and too high on the lower. Is he really doing that well on ProZinc? It doesn't seem to last a full 12 hours sometimes. I'd love to try Lantus but the Vet doesn't recommend. I have a goal, and that is remission. If he won't go into remission, then I'd like him to at least be regulated. Exactly how long does it take for regulation with ProZinc? I'm so tired of worrying about him, emotionally and physically!

The Vet finally called me today to check up on Lucky. I told her he's doing well and that I've had to increase and decrease the dose a few times because his #'s. She didn't seem to approve but I think she thought I was increasing by 1u increments because she sent me home with U40's. But I don't know how she could expect me to leave him on 1u all this time and not adjust dose based on his #'s. I didn't tell her I switched to U100's. I told her it was time for his dental, I didn't want to wait any longer and she said that was fine. Maybe he'll be easier to get regulated after his dental? Man, I hope so!

You guys have been SO great with suggestions and advice. If it were your sugar cat and you were looking at my SS, what would you think and what direction would you think about heading?
 
The first thing that I notice is the time factor and then I need to get back to work!

You haven't been doing this very long and it is natural in the beginning to question everything. This is normal. He is using very little insulin and for beginning numbers, they are not that bad if you don't just look at PS#'s. He can drop low you can't be messing with his insulin too much but his nadirs are nice and the rest not all that bad.

THE HARDEST part of having a sugar kitty is patience and remembering Lucky is learning new stuff too, give it time. Keep up on everything and watch like a hawk but it is hard to know what direction is needed, that's why we keep a SS and keep all this data.

But the fact that it bothers you is good .... keep searching and questioning, the answers will come. I think using small changes are the best, he is sensitive to insulin and that is good!

I know you want someone to say there is a sweet spot, here it is ..... but so many things play into the dose. He needs a dental? maybe that will help? but you have the cat, you know him better than anyone .... don't look at the #'s like a foreign language, which we all do in the beginning, try and get a feel of what he does on a certain dose, what does he do when this happens? You will learn this ... it is a steep learning curve but it will come.
 
He actually is doing really really well for this stage in the game. He is responding well to the insulin, and you are seeing consistent U-curves, which is what you want with PZI. I think you did the dose reduction test, even just going back to 0.9, and got your answer - that doesn't work for him. So I think you can stay on top of the dose, of course reducing if you see numbers that are truly low.

One thought I just posted in the other thread - if you aren't getting back to the good numbers you were seeing before on 1u, you can jump start it with a slightly higher dose to get back to the good numbers, then pull back quickly. Just a sneaky shortcut. ;-)

I think you are doing well b/c you aren't getting scared off by the good numbers, and you are having a healthy fear of the higher numbers, so I think you got the right attitude..... high 5! lol

If you get back to a point where he is dropping a little more than seems safe early in the cycle, I would experiment next time around with feeding him some early cycle to see if that keeps the numbers a little higher, rather than lowering the dose a little like I suggested this time (since that didn't seem to work great for him). We have seen some cats do really well with early cycle feeding, though it doesn't work for every cat.

Overall though he is doing well and the 1u you went back to YAY is getting better numbers, so I think you are in a good place - it's just fine-tuning it to get more good numbers safely.
 
I know we are still pretty new to all this but it feels like it's been forever so it's hard to remember that it is still new!! lol And to have someone tell me his "sweet spot" would be FABULOUS! LOL Too bad no one can!

Just reading that thread on DKA got me thinking and concerned, really, that we need to be in lower #'s and that cats can stand more insulin than what we think. But at the same time, I read about people who were having trouble with a higher dose and when they dropped down, even .25, the #'s got better and the cat went into remission faster. I think this is why I'm so confused LOL Do I increase the dose to combat those high #'s or do I drop it to potentially get nicer #'s. And then the thoughts of maybe needing a new vial or the dental confuse things even more because maybe those are two factors in why the lower dose isn't working so well anymore and why I'm having to increase the dose back to where it was.

I don't know if the Vet is going to agree with the amount of testing I've been doing or that I'm using U100's and tweaking doses. I want her to be supportive and she agrees with home testing and such but she had made the comment that she doesn't want "tight regulation". I think it's really up to me, but I want to keep her support to let me do what I feel is necessary! She wants to see the SS when I take him in and I'm afraid of what she'll say! I worry a lot....can you tell yet???!!! LOL!

So I'll stick with 1u and increase on higher #'s and feed him about an hour after his shot to try to keep his # higher instead of decreasing the dose, thanks for the suggestion, Joanne! I just hear a lot of advice on here and one thing was to keep the dose the same for several days (even the Vet said that) and I don't want criticism either. I'll wait a few days and see how this new approach goes. I'm going to start a new thread for today :-D
 
LOL, I think I have worried about everything you said at one time or another. Welcome to the club! If it's any consolation (probably not ohmygod_smile ) a lot of it is confusing even for those of us who have done this for a longer stretch. It's a confusing illness IMO. We make it more so perhaps by overthinking & overanalyzing things, but at the same time like you said, for every cat that responds to one thing, there's another one where that didn't work and they responded to something else.

:dizcat
 
Yup! That's my problem, over thinking and over analyzing! I'd rather be in a club than standing alone, so that makes me feel a bit better LOL
 
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