Advice about Zoozey

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emchic

emchic

Member Since 2012
1st condo: viewtopic.php?f=28&t=100589
2nd condo: viewtopic.php?f=28&t=101062

Wendy suggested that I post here because Zoozey's numbers have been strange of late. Zoozey's bg numbers started to go up about five weeks ago, which was a week after we all came home to my parents' house for the summer. He had been fairly consistent bg wise for months. I went back to Arlington for a week and left my mom to take care of him. I expected some increase in bg because she was a bit nervous about taking bg readings, and that makes him nervous. Because he was high, I had planned to do a small dose increase to 1.75u when I got back. The day after I leave, his bg shoots up past 400, which was concerning, but he's negative for ketones. yHe's acting completely normal. Nothing is out of the ordinary. He's displaying no signs of stress. His tail is high, he wanders around the house, looks out the window, playfights, etc. He's eating, pooping regularly, peeing regularly, purring, playing, and he preens himself and my other two cats. Since I wasn't there, I told my mom to take him to the vet to check for any signs of infection. Her regular vet was out of town so there was another guy there. Since he didn't have any signs of infection or ketones, the vet upped his dose from 1.5u to 4! My mom didn't know any better, so she went ahead and gave him that dose. His numbers still didn't go down, so visiting vet told her to up his dose to 5u. Again, his numbers didn't go down. When I got back we took him to the vet again once my mom's regular vet returned. Zoozey still wasn't displaying any signs of infection. Dr Crum, the regular vet, agreed with me that the dose increase was too much, so he suggested lowering his dose to 3u because I couldn't just lower his dose from 5u to 1.5u. He also gave Zoozey an antiobiotic shot in case he had an infection brewing that just hadn't manifested itself. That was Thursday. His numbers started to come down a little. I even got a blue reading for the first time in weeks yesterday evening. I wanted to see what his cycle was doing, so I did a curve today (I haven't done pmps yet. He's got another 30 minutes to go). All the numbers were in the three hundreds except for one: amps 329 +2 381 +4 330 +6 313 +8 299 +10 308. He's still feeling fine, which I'm glad about. He's playing right now. If Zoozey is sick or stressed, then he's being really ninja-like about it. I can't find any signs of either in his behavior, and I've been watching him closely. I'd like to do a pm curve on him, but I have problems falling asleep, so once I go to bed I have to stay there, but I stay up as late as I can to get pm mid cycle readings, which are usually lower. He does seem to be trending downward, which is relieving, but I'm still concerned about seeing numbers in the 300s.

Any idea what's going on with him?

I'm headed back out of town on Thursday for a conference in California (which I can't back out of because the English dept picked me to go and my university is paying the $1100 fee for the for the conference) and I won't be back at my parents' until Aug 12. I won't be as available to my mom while I'm gone because I'm going to be in sessions all day long. I just don't want something bad to happen.
 
Have you ruled out any dental issues? Often gingivitis or tarter causes an inflammation that effects BG numbers. The fact that an antibiotic had some effect suggests that there may be some infection or inflammation and often dental issues don't result in a change in blood work.

I'd also strongly encourage you to get some spot checks. Given that previously Zoozey's numbers were in the blues at pre-shot, it's entirely possible that Zoozey's numbers dropped lower than what you've seen at test time.
 
The reason i suggested she come over here was to discuss the impact of the sudden dose increase of 1.5 to 4 units. Are we seeing some kind of glucose toxicity now or resistance as a result of going too high too suddenly? Thoughts?

Wendy
 
I am taking a look at Zoozeys SS but also helping a few other members with lower numbers.

Be back soon....others may have ideas as well.
 
I do think his dose needed to be increased but I wouldn't have increased it more than .25u.

I don't think you are seeing glucose toxicity or insulin resistance because the dose was raised too quickly. I think you saw increased bouncing because he was likely going too low mid cycle and bouncing back up.

While I wouldn't be surprised if he might need more insulin, before you increase the dose, I would suggest you be sure and get spot checks every single cycle and see if you can catch lows.
 
OF COURSE The day after I leave town Zoozey's bg does something different. Except for one reading (which I do have written down--in a notebook in Houston), I've got everything up through his last reading.

I told her to check him at +6, but she said she didn't want to disturb Zoozey because he was sleeping. I told her to wake him up and take a reading, but she didn't. Aargh! Then my mom called this morning and told me Zoozey's amps this morning was 80. She was wondering whether or not to shoot. She needed an answer right then since she had already fed him, and I told her not to shoot. I'd shoot 1.5u if his reading was 80, but I was concerned that 3u dose might make him hypo if his amps was 80. He also only ate half of his food. She checked him again at 8 and his +1 was 86. His +2 was 111 and she said he decided to eat the rest of his food after the +2 check. She's at work right now, so she can't check him again until she gets home at 2:30, which will be +7.5

I'm hoping he doesn't need a dental right away because I can't afford one until the end of the year. And one of my other cats has breath that smells like death, so I might get his done first.

I'm leaving for a conference tomorrow at 6am, and I'll be traveling from 8-2:30 (central time), and I won't be as available to talk once I get to the conference because I'll be in sessions all day every day for the next seven days. She is not terribly tech savy, but I'll give her my login info and and try to convince her to fire up her computer (which she hardly ever does). You guys know way more than I do anyway. She's been quite ill lately (and her recovery is going to take some time) and she works most days during most of his am cycle (so she can get a +2 or +2.5 and a +7.5. but nothing in between), I'll be limited as to the readings I can get and she goes to bed at like 7:30 so she can't do any pm checks past his pmps. I hate not being there to keep an eye on him, but this is the best I can do until next Monday evening.
 
Barbi --

Think about what you would be comfortable with as a "no shot" number. If I had someone else caring for Gabby, I wouldn't have asked them to shoot an 80 if they couldn't monitor closely either. You know you're mom and what she is able to do, especially given a recent illness. We can help to discuss options with you and figure out what would be a good strategy.
 
So I have some questions then. What is a good no shot number in this case? 80? 90? Less than 100? If I had been with him, I might have shot since I would be able to monitor him closely. I told her to lower the dose to 2.75u if she sees numbers below 100 for 2-3 days in a row at any point that she checks him. I hope she can do it. I have perfectly fine near vision and it's hard for me get the stopper just halfway between the the half unit markings on a 3/10 syringe. Would a .5u reduction be okay since the dose is 3u? If he's a 80 for a ps shot reading, should she give him high carb food? I told her not to since she had to be at work and couldn't monitor him. Is this a good way to go?

When she's home all day (Saturday, Wednesday and Thursday), I told her to check him at +6, which is about 1pm. If she can only do one am mid-cycle reading is +6 a good time? Is +7 okay for the other days? She's at work Monday, Tuesday, and Friday from 10-2, so the first reading she could do would be at +7-+7.5. Sunday she can only do ps readings because she's at work from 9-6. I'm asking a lot of her, she's been so sick, and she's still working! (she's 63 and she's a greeter at a home improvement store, so she's on her feet next to a door in the hot Texas weather. Despite being ill, she's only missed like one or two days of work!) and the doctor said it's going to be a couple of months before she's really over this. Most days she is completely exhausted by the time she gets home. I'm thinking the best I can hope for is 1, maybe 2, am mid-cycle readings unless he's giving really low or really high numbers.
 
Would it help to give your mom a printout of the AAHA guidelines to help her understand more?
 
It can't hurt. Can someone post a link so I can email it to her?
His pmps this evening was 275, so he did get his shot this evening. Hopefully he'll back to a more normal number tomorrow morning.
 
Here are the AAHA Guidelines.

That 80 is the reason I wanted you to get some more spot checks before you increased the dose so I'm glad that little green number popped up.

I might be tempted to reduce his dose to 2.5u just to keep him safe and make it easier for her to dose consistently. It's hard for me to suggest a no shoot number because there just isn't any data for me to know what he does. If you had some recent tests some time during the cycle, it would be easier for me to feel comfortable suggesting a no shoot number. So I think you are going to have to decide based on what you know about him and your mom. But, IMHO, 100 or below is a little low considering that neither you nor your mom can likely communicate with us for help and I'd hate for her to be stuck by herself. Especially if she doesn't want to test if he's sleeping. I think I'd be thinking of a higher number.

One possibility is to give her a number you are comfortable with and if he's below or near that, have her stall and test every 30 mins until he comes up. It doesn't mean he won't come back down, but he would probably be safer and she could feed a little extra food.
 
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