9/29 Jack AMPS 413 / PMPS 171 then 41 @ +2

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JacksDads

JacksDads

Member Since 2010
Yesterday's Condo (9/28)
Yesterday, Jack went from smooth surfing during the day to riding a sugar-tidal wave at night. No dip in last nights curve (not even a small one - just steady numbers going up) means I must have done something wrong in administering the shot, right? I know it wasn't a "fur" shot, as I saw the needle all the way in his skin - but maybe when I squeezed out the air bubble, the insulin got squeezed out too? I dunno. :? In any case - it's a new day today :cool:

Other sugar news:

We really like our ReliOn Meter, thanks for the recommendations everyone! The biggest draw back for using ReliOn for us is the 1 hour round-trip drive to and from the closest Walmart. With Walgreens rights around the corner, I knew there had to be another option... and I found one! I called the manufacturer of the ReliOn Meter (Arkray Inc. based in Japan), and discovered that they make an identical meter called GlucoCard. The only difference they say is that ReliOn is branded for WalMart and GlucoCard is not. This was great news for us, because it means that we can now get our test strips at the local pharmacy instead of driving to another city or paying for delivery from walmart.com They've told me that even though the meters are identical, the strips are not interchangeable - so GlucoCard customer support is even sending me out a free meter and pack of test strips, too! I'm going to do a comparison test when the GlucoCard does arrive, to see if they actually are the same.
I did a search for GlucoCard on the boards, and it doesn't look like anyone knows about them - Is there a place or person where I can pass on this info to reach other people that might really like using ReliOn, but aren't close to a Walmart? There's a special National Drug Code number that your local pharmacy needs to stock the GlucoCard strips, and I have the direct number to the GlucoCard rep that will set it all up for you, too.

I'm also working on making a chart where you can input your daily BG readings, and see them on a graph (including +/- 20% accuracy curve, too) - has someone already made one of those? I don't want to reinvent the wheel...
 
Re: 9/29 Jack AMPS 413

What you saw yesterday is exactly what Lantus is known for -- a flat curve. When the numbers are lower, it's easier for the Lantus to "grab on" and keep them low and flat. If I can find it, there was a graph on the Sanofi/Lantus site showing how a Lantus curve differs from that of other insulin. It was a beautiful run of numbers and you did everything exactly right! Today, you're seeing a bounce.

Good detective work on the strips. You could post on Health to let people know and you might also want to link the information in the Supply Closet forum. Health gets a good amount of traffic and there are people there who use a variety of different types of insulin. I might suggest waiting until you do the comparison, though. The other thing to consider, though, is whether Walgreens (etc.) stock the strips on a regular basis. I've found with the Contour strips, Walgreens prices are over double what I would pay on-line (e.g., over $60 for 50 strips vs. $26 on-line). You may find that they jack up the cost of the GlucoCard strips to the point that getting the Relion strips from Walmart or the GlucoCard strips on-line is way cheaper even if you pay for shipping.
 
Re: 9/29 Jack AMPS 413

Ok Jack....a few kitties are in the running for the most dramatic response to lower numbers previously...nice try...not sure who is highest today. Actually Jack, the prize is for the lowest number...not the highest!! So, don't linger up there on that ugly red floor, okay?
 
Re: 9/29 Jack AMPS 413

What a bounce Jack! Hope he comes down from there soon!

The GlucoCard test strips look EXACTLY like the relion confirm/micro test strips..... I wonder if they would be interchangeable even despite what they say...... a quick google search shows that amazon carries them for around $21 per 50.
 
Re: 9/29 Jack AMPS 413

Good Morning Jacksdads - I looked at glucocard's website, the vial the strips come in looks exactly like the relion vial of strips, the website refers to the mini, which looks exactly like my relion micro and in the photo of the strips, they also look identical. Keep us posted on your results when you do your comparisons. very interesting, as others on this site have mentioned not living close to a Walmart. way to go, Sherlock Holmes.
 
Today - Jack gets the nickname Skittles - because he got to "taste the rainbow"...

Do we have a any special code word on the board for when our cat has spent
time on every glucose floor with every color in one day? rb_icon

Just before +2 PMPS, Jack went to his usual spot on the sofa where he likes going after getting shot. But he was extra "sleepy" - and was INTENSELY purring and trying to be playful - but looked as if he had a heavy weight on him... hmm, sign of hypo? yep - as his +2 revealed 41 mg/dL. Let's see if 1/2 can of FF brings his numbers back up...
 
Couple of things...

I'd suggest feeding about a teaspoon of food -- some LC + gravy or just HC. You don't want to over feed. You'll want to retest in 20 min. And, you may need to feed more. If Jack is full after 1/2 can, he may refuse food and his numbers could still be low. A teaspoon or 2 of food and retest in 20 min. intervals gives you greater control over the numbers.

Also, the rainbow icon has a very special meaning. It signifies a cat who has passed (i.e., is GA -- a guardian angle) and crossed to the Rainbow Bridge. If you read Stu's condo, you will see the references.
 
update, please?

I see more numbers on your spreadsheet, can you let us know where Jack is now?

Also, you should take a dose reduction to 0.25 units BID.
 
After 1/2 can of Fancy Feast (at +2.4) - he's still hovering in the 40s. So at +11.8, I gave him a full can before I read Sienna's note.

On a separate note - Any chance there's some helpful insight when a cat starts drinking a bunch of water? Does it mean their body is trying to absorb the glucose - or get rid of it - or maybe there's no such correlation like that (?)

~Yoshi
 
are you giving high carb Fancy Feast, or regular? If you have something with gravy, I would give that. Keep gravying and testing every 15-20 minutes until he is out of the 40's.

Some people have noticed their cats drinking more when they are low. It might be an individual thing.
 
Sienna,

I took off the Rainbow Icons - I had no idea. And I haven't had a chance to look at Stu's info right now - but my sympathy to you. We're barely keeping our 2nd cat with renal failure alive. As long as Sawyer's still active, purring, and playing - we're committed to the extra effort - I hope when the day comes when he can't keep going on - it will be obvious that he's in pain, so when know we're making the right decision. (a few weeks ago, we took him to the vet to put him down, but had a change of heart when we realized we could keep him alive at home with Mirtazapine and SubQ)

Libby,

I'm not sure which of our Fancy Feasts are regular and high carb - I just knew they were higher than his regular raw food. We have a bunch of different flavors of the Elegant Medley's. I'll go over which are high and regular with Jose tomorrow. He just finished a can of White Meat Chicken and Cheddar Cheese Souffle with Garden Greens.

Testing him now...
 
good. :smile:

Try to bump him up higher than that before bed. More food would be helpful. You want to get him high enough that if he dips again as nadir approaches, he still has room to do that without being too low.

I don't know the carb % of those foods. I think the Elegant Medleys are more like medium carb, but don't take my word for it, I'm not sure. For high carb, I've heard that the new Fancy Feast Gravy Lovers foods have lots of good goopy stuff. I have some in the pantry, but haven't had an opportunity to use them yet.
 
Exhaustion

Regarding the carbs in the Fancy Feast - yeah, we look at all our Fancy Feast as "medium carb" - we've got corn syrup/kibble/wet/dry food on hand right now... and even when Jack gets down to 30 or 40 - he still gets excited to eat and gobbles it up. And if it comes down to it, we have a full hypo kit ready, too.

I'll be up for a while longer I guess - until Jack get's back to 80? 90? in the blue? As you see in our chart - hopefully the super-all-the-time testing will give us a data rich record that can show us what Jack's dips look like. Where can I read more about nadir? I know that typically a cats curve will drop to it's lowest point at +6 - but for the past two days, Jack didn't have a "curve" but just steady declines and steady rises.

And now tomorrow morning, I have to try and measure out 0.25u!? Sorry. ::sigh:: I'm really frustrated with myself, because I feel like I'm complaining about silly things. It seems like I don't think of life now in hours of the day anymore (like 4:00 pm and 11:00 am), but in +2's and +5's and time since PMPS. At +2 today I was hoping to get an hour of practicing my violin in - but it's now 12:30... how did just a few spot checks and feeding the cat turn into 1 1/2 hours? :sad: Libby, is this your normal schedule? (Are you usually up this late?) This whole diabetic care process is a learning/growing experience - but it's really draining! That being said, I know putting hard work in now, should make it easier when Jack's curve starts normalizing on a regular dose.

Is there a post I can go to that explains all the icons so I don't make a mistake like using the rainbow again?
 
Jack's cycles look the way they do because he's bouncing. It's hard to discern a nadir when it's like this. In fact, once a cat starts getting regulated on Lantus, you really don't look at each 12 hour cycle separately anymore. You look at several cycles at a time. Jill described it as seeing "waves" on the spreadsheet and that makes sense to me. It's a big sweeping curve, not a 12 hour one. I love working with spreadsheets that have tons of data. It makes it easy to see patterns.

I would keep testing until you get 2-3 rising numbers at least in the 60's. I think you're almost there. And I think we all start speaking in + hours instead of clock hours. I've caught myself doing it at work before. :roll:

You play violin? I'm a clarinetist. Haven't played in a few years, though, since I moved to SC. I'm picky and haven't found an amateur group that is up to my standards.

Here is a picture of 0.25 units: http://www.flickr.com/photos/29764149@N ... otostream/

And me? My sleep schedule is screwed up these days. I blame FDMB! :lol:
 
0.25u - omg.

Wow - thanks for the 0.25u picture! :-D
Measuring out 0.5u already felt iffy - and I at least had a line to go by on the needle gauge. The 'margin of error' in these small doses is upsetting.

<<Yoshi's soap box>> pc_work
Is there really not a single medical company that is willing to make a more precise syringe? Maybe not an insulin syringe, but a needle that's used for some other medical purpose with a more precise gauge? If anyone has any leads on a company that would be remotely interested in making them, I would love to talk to them about what's the barrier to actually making them... What about other countries - are their any nationally recognized vets that have taken on feline diabetes as a cause? Do they care about smaller syringes?

Or is the smaller syringe a non-issue for most people and a Lantus specific problem, because other insulin types can be combined/converted into bigger doses, so precise minuscule measurements aren't needed? Any idea if the makers of Lantus know there are cat owners that use their product and would love to have a smaller syringe?
<<Yoshi steps down from soap box>>

Ah - okay.. back to violin practice. It looks like I'll be awake until nadir. I just joined a local community orchestra outside of Boston. I haven't been in an orchestra since my college days more than 5 years ago. Luckily Jose is a heavy sleeper (I think) I-)
 
Yoshi...
JacksDads said:
Yesterday, Jack went from smooth surfing during the day to riding a sugar-tidal wave at night. No dip in last nights curve (not even a small one - just steady numbers going up)
Click to expand...

We deal with the same thing- constant bouncing. Hang in there, we can both get it under control!!!
 
Evening Yoshi - I think the number of cats on insulin is miniscule compared to humans and humans don't have doses this small. Medical supply companies and esp. drug companies are all about the bux and our numbers are so small, I suppose that is why no one has come out with a syringe that works for FD needs. Sometimes I browse thru other SS and see cats that are getting a few drops each dose, can you imagine? :-D Anyway, soapbox away. lots of sympathetic listeners around here who can relate. I hope Jose is feeling better.
 
Yeah I sure wish they would make syringes for our kitties. When a drop of insulin makes a difference, there's far too much room for inconsistency here. Especially when it often seems each syringe is slightly different - the way the plunger lines up, the thickness of the lines, etc etc. Great job with Jack tonight!
 
Thanks Anne!

Kim,

I asked Jill about more precise syringes, and she said she read somewhere that someone has syringes marked with 1/4 doses - so I'm still hopeful on hunting them down :twisted:

A few very good things to remind myself when I'm complaining about low doses...
1. Low doses means less money spent on insulin
2. Jill pointed out that in some countries, they don't even have syringes with 0.5 markings
3. Low doses means closer to OTJ! (right?)

Jose's gettin' a good nights rest (hopefully) - he should be finally better tomorrow :-D
 
Smaller Syringe

While hunting online for a micro-measurement syringe that would suit our cats low dose needs - I know I need to be careful to recognize that the small syringes that I do come across have been manufactured for specific purposes that don't have anything to do with my cat. That being said, there's some initial finds that I came across that I was wondering if they could be adapted for our use...

One neat feature on micro-syringes is that they produce "zero dead volume" - the plunger pushes all the liquid all the way through the tip so every last drop is expelled from the needle.

Hamilton
So - I think this is Hamilton's finest measurement syringe. <<<That syringe is tiny, it's true - but the syringe we ended up trying out was THIS ONE
[The crossed out syringe above] measures down to 0.05 uL (<What does that mean in Lantus measurment?)
Reason Unusable: The needle is too big. If the needle is not removable (I have no idea how glass syringes work) - then this model is out. Questions: It says needle size "KH" - is there a correct "code" for the needle size I'm looking for (like Small RH or something like that?) It's available with 2 different "point styles" for the needle.
More cons: * Overseas distributor * Priced in Euro - very expensive.
And also not good - it has a 25 gauge needle (< It's my understanding that the higher the gauge number, the smaller the hole the needle will make, right?)

Chromatography Manufacture in Taiwan
Here's another small syringe producer

World Precision Instruments, based in Florida
* The needle on this one looks a lot smaller
* Their product was developed based on eye injection technology
* Being marketed for use with small animals
I've sent them an e-mail inquire if they have a syringe that will accurately administer 0.25u / 0.1u of insulin into a cat.

Cost Factor
Using the prices from World Precision Instruments - Reusable syringe = $95 / 2 pack of reusable needles = $85. With BID we are using about 60 needles a month - so if it's $20 for 90 needles - disposable needles cost $160 a year. Without factoring in the cost of cleaning solution (and maybe some other accessories needed with a product like that) It would take at least 1 year and 3 months to break even on the cost of a reusable syringe (how long do those things last, anyway?)

Insurance
Has anyone had any success with getting any type of insurance coverage for your animal diabetic supplies?

Digital Read-out
Just $1,024 :-x to solve all your small dosing problems
Simply buy a Digital Read-out. It only costs :evil: $1,024 :lol:

Actually, I bet there's a good chance this digital read-out would still have problems with less than 1u - ha.
 
wow - that's a wicked looking syringe. I wonder what they use that one for. It must have a medical application since it is autoclavable. I looked up that company - they are for "scientific research." wonder if they use those things on lab rats or something. yowza!

off to bed, I'll catch up with you guys tomorrow. ni ni
 
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