8/4 Michael AMPS 434 +5 326 PMPS 309 +3 365

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Re: 8/4 Michael AMPS 434

Bounces happen. I know they're hard to see. Just give the 0.75 dose and put on your patience pants.
 
Re: 8/4 Michael AMPS 434

Yes Paula I would think they would have it. Or even petsmart on McKinley by Walmart would have them also.
Its good to see that Michael is getting somewhere with the insulin. And you yourself have come along way since we met at the vets. You and Michael have a great day.
 
Re: 8/4 Michael AMPS 434

I don't know what you're talking about having it ? But, I am so glad that you two met up. Paula has come a long way :thumbup
 
Re: 8/4 Michael AMPS 434

Darin & Dyana thanks for the Kudos.
I gave 1 unit thinking it looked like .75. I just can't do the .75. I have no way of knowing if it is.5 or 1.0.
We were referring to the pill pockets. and yes, I'm glad we met too. It's nice to know that someone is close by.
Who would have ever thought we would end up going to the same vet.
Darin, how is Lola? doing better I hope.
I'm so frustrated. Just when I think things are starting to work, he bounces. If he can't be regulated, what happens?
I'm really worried.
Everyone here has been very helpful and I appreciate it very much. I guess I will go and put on my Patience Pants.
Paula.
 
Re: 8/4 Michael AMPS 434

Lola is actually doing super super super good but I'm not sure if its her that's doing the good or if it's the injections that they gave her on Saturday time will tell.
 
Re: 8/4 Michael AMPS 434

That's great! I have a Vet appt. on Thurs. hope all goes well.
Have a good day!
Paula
 
Re: 8/4 Michael AMPS 434

Paula

It's always hard at the beginning when they bounce so much. Don't worry right now about whether he can get regulated. Most of them do. Focus on how he's feeling and improving and we will just keep dealing with his numbers and dose. FD is a roller coaster do you just have to be along for the ride ;-) :-D
 
Re: 8/4 Michael AMPS 434

bouncing is normal. it just says that his body has "forgotten" what normal blood sugar feels like and he's reacting to to it as though it's a perceived hypo. the more he gets into normal numbers, the more his body will accept it as normal.

Hopefully the new terumo syringes, plus your magnifying glass will help you be able to see well enough to adjust by quarter units. it's a tiny amount - just do your best. :-D

hang in there! the beginning of this sugar dance is the hardest. we all get it.
 
Re: 8/4 Michael AMPS 434

Thanks for the replies & encouragement.
My Monoject Syringes are 29gx1/2" 3/10cc with 1/2 markings. Some of you use Terumo syringes 31gx3/8" what is the difference?
Julie, M doesn't want to stay in normal #'s. Does that mean his body will never get use to "normal" #'s?
Thanks,
Paula
 
Re: 8/4 Michael AMPS 434

not at all. i'd assume he'll get regulated. most cats do - newly diagnosed have the best chance of going off of insulin and becoming diet-controlled. Newly diagnosed is defined as being less than 1 year since diagnosis. But we've had even long-term diabetics like Trixie go off.

Getting the cat into normal numbers, 50-120, is important. But you can't do much to rush that - shooting lower numbers (over 50ish) if you have the opportunity definitely helps. I just posted in Simmie's condo today about that, if you want to read a little more. Bouncing does lessen and stop for most cats, and we've definitely had cats that don't stop bouncing but still work off of insulin. Michael's doing fine - people here like to say this is a marathon, not a sprint. He didn't become diabetic overnight and he will take some time to get controlled, but there's no reason not to think that he will get regulated.

Having hyperT can make it a little more difficult, but if his thyroid is fairly well regulated, i think it's still quite possible.
 
Re: 8/4 Michael AMPS 434

sorry, i got off on one part of your question and missed the other.

the 31g are a thinner needle (larger number means smaller needle) and the terumos are 3/8" versus 1/2" with the Monojects. So the Terumos are slightly thinner and shorter needles. To me, the gauge of the needle (thinness) and length of the needle didn't matter. it does to some people, they prefer one or the other.

Another big difference with the Terumos is that the plunger glides really smoothly. like you barely touch it and it's going to plunge the contents out. so you have to be a little careful. I used Monojects for a while and if i remember correctly, the plunger is a little stiff. that may take some getting used to.

Marje is a scientist and she did a comparison between various syringes to see which markings were the most accurate. What she found was that none of the brands are perfect, ie, 1.0u markings don't all measure exactly 1.0u. So within a box, if you compare 5 syringes and where the markings are, you'll find they vary. And from brand to brand there are differences also - she found as much as 0.5u difference in the amount, i think when she was measuring 1.0u. so it's a significant amount when we know that changing a dose by a quarter unit is enough to make a difference in a cat. Terumo markings were the most accurate, but even those weren't 100%.

Some people use calipers to dose because of that. i'm not sure if that would be helpful to you or not, but here is a post on calipers. if you think they might help you, you could try that before switching syringes. just depends on what works for you.

The goal with any cat is to be consistent in the amount you dose so that you can tweak it to tweak his blood sugar.
 
Re: 8/4 Michael AMPS 434

Simmie/Lydette are also new to TR - today's condo has a lot of good info on it about working with your vet. I encourage new people to read other people's condos - you will learn a lot that way and some of it will apply to you and Michael.

and you're welcome. there's so much to wrap your head around in the beginning. every little bit helps!

a little bit of chocolate doesn't hurt either. :-D
 
Re: 8/4 Michael AMPS 434

Paula

I've used Relion, BD, Walgreens, Monojects, and now Terumo syringes. I like the Terumos the best. The problem with the MJs is that they have a hub at the top and the needles are inconsistent in how far they extend so you are likely getting extra insulin from the hub. When I did my experiments using a micropippetor (the most precise way to measure small volumes), the MJs were off by as much as 0.5u!. For many cats, and especially my little Gracie, that is a huge difference. So dosing inaccuracy is pretty large with those MJs. Even if you use calipers, you still can't measure how much insulin is in the MJ hub.

I like the Terumo 31g because it's a tiny needle. Gracie "meeped" even with the 30g needle and I also wanted to reduce her chances if developing any scar tissue...plus I rotate injection sites daily. I also like the 3/8" needle because it is in between the short and long ones. The long needles (1/2") might possibly increase absorption because you get further into the subq but they also greatly increase the chance of a fur shot. The short ones are fine but it's possible to see a little less absorption. The Terumo 3/8" are right in the middle and you get the pros of both and, as far as I can see, no cons. They do take some getting used to because they really slide. You don't have to prime the plunger with these.
 
Re: 8/4 Michael AMPS 434

Marje, thank you for the info the syringes.
What is priming the plunger? If the termos slide too easily, I'm afraid I won't be able to control them. Due to the fact I have a balance problem and holding my hand steady is a challenge. I don't want to order a box and not be able to use them. In 2011 had 3 brain aneurysms which affected my balance, sight and hearing, and a weak left side. (Much like a stroke) Taking care of my Michael is really a challenge which I have mastered very well. He is everything to me, and without him I have nothing. This "D" is really complicated and thanks to this great forum its getting easier!
Paula
 
Re: 8/4 Michael AMPS 434

Julie, I read Simmie's condo. Thanks for suggesting I read it.
I have a vets appt. on Thurs. and that information will help me a lot.
I think my Vet is willing to work with me, but how much I don't know.
This forum has a ton of information. I don't know that I can absorb it all. My head is swimming.
Paula
 
Re: 8/4 Michael AMPS 434

You're welcome, Paula.

Priming the plunger means that in many syringes, you have to move the plunger up and down a few times before you draw the dose in order to spread the silicone so the plunger glides easily when you shoot. However, the Terumos glide just fine without doing that. They syringes come with the plunger pulled back just a tad so you just push it in and draw the dose.

If you will PM me your mailing address, I'll mail you some of the Terumos so you can check it out before you buy.....will that work?
 
Re: 8/4 Michael AMPS 434 +5 326

paula, it's overwhelming for everyone to start out with a diabetic cat. the site can be hard to navigate, although i think this insulin support group forum yellow starred stickies at the top are the best. everything is pretty much in one of those 5 stickies, but at the beginning it can be a little hard to find what you're looking for.

those of us who help out are a patient lot. so don't hesitate to ask what you should do next, and don't hesitate to ask the "whys" if you want more of an explanation. you don't have to understand or absorb it all now. it gets infinitely easier - eventually it become routine.

in a month you'll think you've gotten an amazing knowledge of how FD works and how to take care of Michael. there's just a lot there.

in the meantime, take it one step at a time. every 3 days it's good to re-evaluate his dose, and you can ask here if someone will help you do that. you don't have to remember it all and you don't have to go it alone.
 
Re: 8/4 Michael AMPS 434 +5 326 PMPS 309

Thanks Julie.
I just give M his pmps I think I got .75u. I turned the syringe on its side and it looked like it was between the 1/2 mark and the 1 mark. (I hope)
I hope things do get easier I would feel a lot better. If M would quit playing bouncy ball we both would feel better. I know, keep wearing my pretty patience pants. (they are the colors of his SS.)
Btw it looks like he is on his way down from this mornings bounce. I hope so. If I'm right, I think I am beginning to understand this a little. (although I don't feel that I am.)
Paula
 
Re: 8/4 Michael AMPS 434 +5 326 PMPS 309

just be patient with yourself. you'll get there! yes, he might be coming down from his bounce. you've got a straight line down from this morning's amps 434-326-309. if he keeps going down, then you'll have confirmation of it.

a bounce overrules the normal cycle.
 
Re: 8/4 Michael AMPS 434 +5 326 PMPS 309

Julie.
What do you mean by a bounce overrules a normal cycle?
Paula
 
Re: 8/4 Michael AMPS 434 +5 326 PMPS 309

from the "new to the Group" sticky:

NOTE: Until kitty is pretty well regulated, the description below is NOT not what you'd consider a "typical" Lantus cycle. It takes time and patience for kitty to achieve a "typical" cycle! The example below is what you're working towards (a nice shallow curve). A relatively flat cycle is the ultimate goal.

Example of an ACTIVE, but NOT necessarily typical Lantus cycle:

+0 - PreShot number.
+1 - Usually higher than PreShot number because of the last shot wearing off. May see a food spike in this number.
+2 - Often similar to the PreShot number. You'll probably see an active cycle if the +2 is the same/similar or lower than the preshot number. Continue testing!
+3 - Lower than the PreShot number, onset has started.
+4 - Lower.
+5 - Lower.
+6 - Nadir/Peak (the lowest number of cycle).
+7 - Surf (hang around the nadir number).
+8 - Slight rise.
+9 - Slight rise.
+10 - Rising.
+11 - Rising (one of the quirks of Lantus/Levemir: some cat's blood glucose numbers dip around +10 or +11... not to be confused with nadir).
+12 - PreShot number.
Click to expand...

so basically the "normal Lantus cycle" is a flattened U shape on the spreadsheet. Michael doesn't have much of that yet - 7/27 is probably the best example of a normal cycle. He was 300 at amps, went down to 219 +5, and back up to 299 at pmps. it's high overall, but it's a curve.

when you have a bounce, the body lets loose counterregulatory hormones and stored sugars to counteract what it perceives as a hypo. Michael's not used to normal numbers at the moment, so yesterday when he hit around 109 at +9, his body responded as though it was hypoglycemia. from that 109 he's gone straight up - pmps 131, pmps+2 156, and then instead of going down into a curve, he kept going up resulting in the amps of 434 this morning. The rest of today he's been bobbling around high 326, pmps 309. he may be starting to come down now, as i said, if he's down further in a couple of hours that might say that the bounce is resolving.

sometimes cats can have their blood sugar bobble around high for a couple of days - it's not at 400 anymore, and it moves a little - say 300-240-200-300, but it doesn't come back to the range that triggered the bounce.

the way you know it's completely resolved is when he gets back around 100 again, where he started yesterday.

bounces can last up to 3 full days. as a cat gets used to normal numbers, their bounces will get less intense, ie, they might only bounce to 250 or even 200, and they won't last as long. sometimes bounces can only last one cycle.

that's long, but maybe that helps explain it a little better.

when a cat is better regulated, they'll have a flattened u shape to their curve on the spreadsheet for most cycles. Michael might be a little different with his meds, too, if they increase his BGs. It's not a problem, just something to be aware of.
 
Re: 8/4 Michael AMPS 434 +5 326 PMPS 309

Thanks!
That helps to see this a little better.
Guess he is still bouncing. I just tested +3 365. Don't understand why he is going up when he use to go down at night.
 
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