8/16 Sushi: PMPS~65 |+.25~55 | +1.5~42 |+2~49|+3~60

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Sushi (GA 5/05-3/14)

Sushi (GA 5/05-3/14)

Member Since 2011
Hello!
So I decided to go ahead and give Sushi a .5u increase. His nadir was 99!! Wahoo!!

Just want to ask/clarify one more time about something I posted Sunday/Yesterday:
I have been giving injections between the shoulders. Is that the scruff? Or do I need to move up a bit to right behind the neck? There isn't as much skin there as between the shoulders...just want to make sure I'm doing this right! : )
 
Re: 5/16 Sushi: AMPS~323 | +3~247 | +5~190 | +6~99 | +7~146

Between the shoulders is fine! You don't want to shoot into the scruff (which is the skin on the back of the neck) because of the poor blood supply there. I shoot between Bandit's shoulders or into the skin on his flank.

I saw yesterday that you've had trouble with feeders. Bandit destroyed 3 auto feeders before I found one he couldn't crack. It's this one: http://www.amazon.com/Automatic-Fee...nics/dp/B00450DTJA/?tag=felinediabetesfdmb-20. I've had it for 4 or 5 years now.
 
DOSE ADVICE? 5/16 Sushi: AM+5~190 | +6~99 | +9~104 | PMPS~65

Arg! PMPS was 65 and 59--our lowest #s ever!! Is that too low to shoot?
**KEEP IN MIND THAT THIS IS OUR FIRST DAY OF A .5U DOSE INCREASE.
 
Re: DOSE ADVICE? 5/16 Sushi: AM+5~190 | +6~99 | +9~104 | PMP

Just tested again at 6:50 and got 55
The above tests were taken at 6:30

...I need to leave in the next few minutes. I'll be gone for an hour and then I'll be home for the rest of the evening.
PLEASE ADVISE!!!
 
Re: DOSE ADVICE? 5/16 Sushi: AM+5~190 | +6~99 | +9~104 | PMP

I would wait. The 0.5 increase might have been too much too soon (shed probably wasn't refilled after the skipped shot on 8/13 - remember bigger doses have bigger sheds) so I'm not confident saying this is shootable until we see if he is finished dropping.

I would wait 30 minutes (without feeding) and retest to see where he is.
 
Re: DOSE ADVICE? 5/16 Sushi: AM+5~190 | +6~99 | +9~104 | PMP

Stall and test again now, (I think its about 30 minutes later, right?) Don't feed! We want to see that number rising without food influence.
 
Re: DOSE ADVICE? 5/16 Sushi:+9~104 | PMPS~65 |+.25~55 | +1.5

Okay...just got home (it's 8) and took another test. We're at 42!! :shock:

He's just ready for dinner and now he's playing with his little mouse! Seems perfectly okay!
 
Re: PLEASE ADVISE-#s DROPPING PMPS~65 |+.25~55 | +1.5~42

This is not a shootable number. You do not have the data to shoot this low. Can you afford to continue to stall?

I'm curious -- why did you opt to increase by 0.5u. With numbers below 300, the typical increase is 0.25u.
 
Re: PLEASE ADVISE-#s DROPPING PMPS~65 |+.25~55 | +1.5~42

Personally, I would suggest feeding a small meal at numbers this low. I know you are stalling to see if the numbers rise and don't want to shoot a number that was influenced by food... but low 40's ... to me, say "feed kitty."
 
Re: PLEASE ADVISE-#s DROPPING PMPS~65 |+.25~55 | +1.5~42

I can continue to wait, but it will make our schedule realllyyy unmanagable. I'm not sure I can stand to do that right now!! I start my new job in Baton Rouge Thursday, which will involve an hour+ commute and I will be gone all day. We just arrived at our targeted time of 6:30 after bumping dose times for a few days now.

I increased by .5u because his numbers have been in the 200-300s. The protocol says "if nadirs are greater than 300 increase the dose by .5u."
Should I move him back to 5u for our next dose?

What is our next step here? When can I feed him? When do I give him his meds? How much do I give?
 
Re: PLEASE ADVISE-#s DROPPING PMPS~65 |+.25~55 | +1.5~42

Just tested again at 8:45pm - 49

So go ahead and feed?

...we're at a point of no return with messing up our schedule. Should I just skip?
 
Re: PLEASE ADVISE-#s DROPPING PMPS~65 |+.25~55 | +1.5~42 |+

It's not much of a rise... try feeding a teaspoon of regular carb food (LoCarb). Test in 15 minutes.

Your dose this morning was 5.50u, correct? The numbers tonight call for a reduction to 5.25u. I know you probably want to skip this dose but I think a better option might be to shoot a token dose when Sushi gets within shootable range. But a BG of 40-50 is not shootable in my opinion.

It would be better if he was at least in the 80s in my opinion. What do you feel comfortable with shooting?
 
Re: PLEASE ADVISE-#s DROPPING PMPS~65 |+.25~55 | +1.5~42 |+

You are now over 2 hours past shot time, and still too low to shoot, so I would skip. We usually don't stall more than 2 hours.

That way you can stick to your good schedule as well.
 
Re: PLEASE ADVISE-#s DROPPING PMPS~65 |+.25~55 | +1.5~42 |+

Ah, if you are that far off schedule then I suppose it would be safer to skip and let the shed drain.
Tomorrow Sushi might bounce to higher numbers due to the lows this evening AND from the skipped shot.

Please don't over-react and shoot too much tomorrow. I would take the reduction to 5.25u. :-D

Call it a fur shot and start over tomorrow. :mrgreen:
 
Re: PLEASE ADVISE-#s DROPPING PMPS~65 |+.25~55 | +1.5~42 |+

I too think this is too low to shoot. If you are past the point of no return, then maybe it is best to skip the shot,. it's not something I really like to do, but it may be the best for your schedule etc. In any event the 40's are just too low for you to shoot....
 
Re: PLEASE ADVISE-#s DROPPING PMPS~65 |+.25~55 | +1.5~42 |+

his numbers have been in the 200-300s. The protocol says "if nadirs are greater than 300 increase the dose by .5u."
Click to expand...

Nadir is the LOWEST number in the cycle and Sushi's lowest numbers have been around 250 so he should still have been in the .25u increments. Please take the reduction tomorrow since he went below 50 today. And yes you can be pretty much assured he will bounce because of that low number. Hold the reduction for a full 3 days.
 
Re: PLEASE ADVISE-#s DROPPING PMPS~65 |+.25~55 | +1.5~42 |+

:YMSIGH: okay, thank you all so much for your advice!! This is SO stressful!!!!
I just fed him 1 TBS and he ate about half of it. I don't have the patience for this right now!!!

So should I go back to 5u or 5.25u tomorrow??

Okay, I need to have a moment. I really want to get Sushi regulated and as healthy as possible, but I'm approaching a point where I just need things to be stable. I know that ECID and unpredictable, but in 2 days, I will be starting a job with a 1+ hour commute that will require me to be gone about 10 11 hours straight every day. I will be too far to do BG levels or anything. I also need to be looking for a place to live, and I can't do that without staying in Baton Rouge over 12 hours, making me unavailable to give Sushi his medicine consistently.
I'm just really frustrated. My current circumstances alone require that I skip doses, but having to skip doses because of Sushi's wonky levels feels like too much for me. How much skipping is too much? For example, I skipped Saturday PM, Tuesday(today) PM, and I may have to skip Friday AM. Also, the vet tech that helps me is not able to come at a consistent time every day. She can come at 7 Thursday PM and 5:30 Friday PM. Due to the nature of my previous job and just life, I don't really know a soul in this little city. I really need someone to help me out with Sushi while I make the transition and move back to Baton Rouge!! How the heck to I find someone!? And find someone in 24 hours?? How can I do this when neither I, nor any vet or vet tech, is available to give doses at a consistent time every 12 hours? UGH!! And what am I going to do when I start working and I have to get out the door at a certain time and Sushi's levels go all wonky? I can't wait around and be late for work!
I'm sorry, I just feel really overwhelmed and frustrated right now. If someone could just spell out what the consequences are exactly with all of the skipping, how much skipping is too much, etc...

Thank you all for everything!! You're so wonderful and I appreciate you!!
 
Re: PLEASE ADVISE-#s DROPPING PMPS~65 |+.25~55 | +1.5~42 |+

...I hope I didn't drive everyone away with my Negative Nancy moment.

One more question.: does this mean that Sushi's ideal dose is somewhere between 5 and 5.5u? In other words, can I kind of count on the fact that he won't ever need any more than 5.5u per dose?? That would be GREAT news!!
 
Re: PLEASE ADVISE-#s DROPPING PMPS~65 |+.25~55 | +1.5~42 |+

You are doing a GREAT JOB. You have Sushi into green numbers, which mean he is healing and recovering. Today was a great day, and you should be feeling very happy.

Yes, those green numbers can also be very stressful, but they should also be very rewarding. Enjoy them for a minute.

Here is Mr Green to help: :mrgreen: :mrgreen: :mrgreen:
 
Re: PLEASE ADVISE-#s DROPPING PMPS~65 |+.25~55 | +1.5~42 |+

You have a lot of complications facing you, but you are doing better than so many kitty owners that just shoot blindly. Ok? Pat yourself on the back for that first. :-D

Now for tomorrow, I'd probably like to see you try the 5.25u dose. Sushi clearly showed that 5.5 was too much and the 5.0 wasn't quite enough. Things change all the time so that dose may have to be reduced soon or even increased. But for now, if this was my kitty, I would try the 5.25u for a while.

Your scheduling will be a challenge. But you can only do the best you can. I would be nice if you never had to skip, but sometimes you just can't shoot a number like tonight's. And as you go along you will try to find compromises with as consistent dosing and shooting times as you can for your work schedule.

I hope some others that have had similar complications can give you some suggestions. :? Lots of good people with some good ideas here. :-D
 
Re: PLEASE ADVISE-#s DROPPING PMPS~65 |+.25~55 | +1.5~42 |+

Let me make a suggestion.

Getting all of the details of diabetes management alone (e.g., testing, which food, etc.) is pretty overwhelming. Mastering the protocol in a straightforward way, let alone the nuances, is overwhelming. How about posting and asking about whether or not to increase a dose and by how much before you decide to increase? The numbers tonight are the result of your not interpreting the protocol correctly. Sushi's dose should not have been increased by more than 0.25u. This is not a matter of what his ideal dose is or isn't. You gave him too much insulin and his numbers dropped. There is no way to know what Sushi's ideal dose is. What may look like a good dose may change. Look at Gentle's SS. Look at my cat's SS. Look at any of our SSs. Good doses can change. There are no absolutes or guarantees and it sounds like that's what you want.

As far as skipping, skipping any shot is not a good idea. If it were me, I'd bite the bullet and get a cat sitter who can test and shoot if you're not or can't be around. I said this previously -- having a diabetic cat is like having a sick child. You do the best you can but you also need to understand the consequences. If your goal is tight regulation/remission, then you have to aggressively manage Sushi's diabetes and that means doing what's ever possible to shoot on time and to not skip (unless the numbers dictate skipping). If tight regulation/remission is not your goal, that's fine -- you have more flexibility.
 
Re: PLEASE ADVISE-#s DROPPING PMPS~65 |+.25~55 | +1.5~42 |+

Thanks for your answers and encouragement!

Just took a +3 test and got 60. He's eaten maybe 1 TBS so far, and I'm running around doing all sorts of tricks trying to get him to eat more. He's eating right now.


Sienne, in retrospect you're right that I should have "posted and asked about whether or not to increase a dose and by how much before you decide to increase" I could have sworn someone advised me to do that in a previous post; that was another reason I did so.

I'm also trying to "bite the bullet and get a cat sitter who can test and shoot if you're not or can't be around". The main reason for my frustration tonight is that said cat sitter is not available at a consistent time every day. I finally decided to "bite the bullet" and when I did it didn't work out. So I basically have one day to find someone else who not only knows how to give injections but also knows how to home test (I had to train the cat sitter I usually use) and I feel completely lost at how to do so in such a short amount of time.

Tight regulation/remission is certainly my goal, but I'm questioning whether it's feasible over the next few weeks while I move and transition to Baton Rouge. Once we're moved it will be much much easier to tightly regulate and have Sushi on the road to remission (hopefully!), and that is without a doubt my goal.
 
Hi
I thought I would pop by and give you another ss to have a look at.
Max is a fine example of a totally non-predicatable cat.
His dose kept going up and up to over 6u and then one day he just decided to break.
We could not reduce his dose fast enough. He came flying down the dsoing ladder.
Now our reductions were totally unconventional and I was out of town at that time so we had to reduce
quickly to keep him safe.
You just never know what our kitties will do. the best is just to go along with their dance.
You guys are doing great!!
 
You may need to consider using more than one person for giving Sushi his shot. You may also need to educate the catsitter. Many sitter's are used to having an hour window on either side of shot time. They are not knowledgeable about the need for greater consistency with Lantus. It may be worth trying to sort out whether the issue is a knowledge deficit or a legit scheduling problem. Also, if you need to fudge by approx. 30 min., that's fine.
 
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