Andy update & dosing question

[Yvonne & Andy &BJ (GA)]

Andy has been doing much better with most preshots in yellow for a while. He appears to have stopped bouncing so much. I sent his chart to the vet and he wants him under 250 so we are very close. I know I need to increase slightly but have had some low numbers with his current dose. Can I use his preshot numbers now to determine how much insulin? I.e., if over 250 maybe give 1.4u and 1.2u or less as needed if under 250. Thanks in advance for any advice.

 

[Sue and Oliver (GA)]

Andy is looking good!

If I were you, I would continue to get nadirs and preshot numbers whenever you can. My thinking is that today he had a yellow preshot of 265 and he went down to 90 midcycle. The 90 may or may not have been his lowest point. 80 is the number where we tell AlphaTrak users to pay attention and watch for lower numbers and potential hypo. So his nadir was great today if it was the 90. If he was, say, 20 points lower before or after that, he earned a reduction in dose.

IMHO, the picture is still murky. Is he bouncing just a bit from a green up to the yellow preshot? Would a smidge less insulin keep him flatter? (We look for around a 50% drop. He dropped quite a bit more than that).

More data would give you some answers. I know - we are ALWAYS asking for more data. A curve would show you how low he goes, when he is lowest and give us a better idea of whether a pink pmps is a bounce or does it require more insulin? Maybe this weekend?

 

[Yvonne & Andy &BJ (GA)]

Andy is looking good!

If I were you, I would continue to get nadirs and preshot numbers whenever you can. My thinking is that today he had a yellow preshot of 265 and he went down to 90 midcycle. The 90 may or may not have been his lowest point. 80 is the number where we tell AlphaTrak users to pay attention and watch for lower numbers and potential hypo. So his nadir was great today if it was the 90. If he was, say, 20 points lower before or after that, he earned a reduction in dose.

IMHO, the picture is still murky. Is he bouncing just a bit from a green up to the yellow preshot? Would a smidge less insulin keep him flatter? (We look for around a 50% drop. He dropped quite a bit more than that).

More data would give you some answers. I know - we are ALWAYS asking for more data. A curve would show you how low he goes, when he is lowest and give us a better idea of whether a pink pmps is a bounce or does it require more insulin? Maybe this weekend?

Hi Sue - I have not been testing too much since his ears had looked sore and I thought he needed some time to heal. I can't curve tomorrow but maybe Thursday will work. Today I had to go away for a few hours so decided to test at 6+ when I usually give a snack. I then gave him 1/4 can EVO and 1 1/2 T DM dry. He was up to 113 within the half hour so I felt comfortable leaving. At pmps he was only 298 which surprised me since he had such a big snack. A few weeks ago he would have been in the high 300's-400's. And as you said, 90 may not have been his lowest.

He seems to have "delicate" ears. I had used some generic Neosporin but it made his ears bright red. What would be good to help soothe his ears?
Thanks again!

 

[Bobbie And Bubba]

Hi Yvonne, I have used aloe vera sunburn relief on Bubba's ears. The aloe heals and it also has lidocaine in it to numb the soreness. I alternate between that and the Neosporin.

 

[Carol & Murphy (GA)]

Hi Sue - I have not been testing too much since his ears had looked sore and I thought he needed some time to heal. I can't curve tomorrow but maybe Thursday will work. Today I had to go away for a few hours so decided to test at 6+ when I usually give a snack. I then gave him 1/4 can EVO and 1 1/2 T DM dry. He was up to 113 within the half hour so I felt comfortable leaving. At pmps he was only 298 which surprised me since he had such a big snack. A few weeks ago he would have been in the high 300's-400's. And as you said, 90 may not have been his lowest.

He seems to have "delicate" ears. I had used some generic Neosporin but it made his ears bright red. What would be good to help soothe his ears?
Thanks again!

Hi Yvonne - Murphy had a terrible allergic reaction to neosporin (search the thread in the health forum called "red ears") A few others chimed in to say that their cats also had red ears from the neosporin You can use either vasoline or someone told me about an ointment for pets made by Halo called "cloud nine" I use that for Murphy - it's all natural ingredients

 

[Yvonne & Andy &BJ (GA)]

Hi Sue - I have not been testing too much since his ears had looked sore and I thought he needed some time to heal. I can't curve tomorrow but maybe Thursday will work. Today I had to go away for a few hours so decided to test at 6+ when I usually give a snack. I then gave him 1/4 can EVO and 1 1/2 T DM dry. He was up to 113 within the half hour so I felt comfortable leaving. At pmps he was only 298 which surprised me since he had such a big snack. A few weeks ago he would have been in the high 300's-400's. And as you said, 90 may not have been his lowest.

He seems to have "delicate" ears. I had used some generic Neosporin but it made his ears bright red. What would be good to help soothe his ears?
Thanks again!

Curve is off for today. Yesterday after testing and giving his am shot, we discovered Andy had vomited overnight and then would not eat his breakfast. So we had a frantic day of monitoring him. He took a nosedive but we were able to avoid a hypo. He was back to his normal self later in the day and then ate his normal supper. This am, we tested and tried to feed but he was not interested in eating his normal Instinct breakfast. So I gave him a small amount of FF and he nibbled that and after about 20 min finished that so gave him more and later his shot. So we'll be watching him for a few days - hopefully this clears up soon or a trip to the vet will be in order! Grrrr.....

 

[Robin&BB]

Yesterday after testing and giving his am shot, we discovered Andy had vomited overnight and then would not eat his breakfast. So we had a frantic day of monitoring him. He took a nosedive but we were able to avoid a hypo.

Hi, Yvonne. Just took a peek at your SS; noticed you don't have any numbers posted midcycle after his AMPS yesterday. So ... what # did he nosedive to, and when?

 

[Yvonne & Andy &BJ (GA)]

Hi, Yvonne. Just took a peek at your SS; noticed you don't have any numbers posted midcycle after his AMPS yesterday. So ... what # did he nosedive to, and when?

Robin - he ate nothing for breakfast but we had already given his shot. He got down to 139 and still had not eaten at +1 so I mixed 1/2 tsp Karo with 1tsp water and gave 1/2 tsp via syringe. At +1.5 he was at 137 so repeated the Karo water. At +2, he was 202 and ate 2 tiny pieces of chicken and abt 2 tsp broth. At +2.5 he was down to 181 but ate more chicken and broth. At +3 he was up to 196 and ate a few more pieces. Then +3.5, 217; +4, 232. At +5 he ate his normal snack. Then at pmps he was 281, ate normally and got his normal shot. I have not figured out how to post all this on his sheet yet.

This morning, we tested (231) and fed but he did not want to eat again. He usually devours his Instinct but turned up his nose. He did not vomit this am. We waited 1/2 hr and replaced his Instinct with FF and he was interested but only ate 1/3. We gave .8u and within 1/2 hr he ate the rest of his food. At +5, he was 148 and got his usual snack which he ate well. At +6, he was 201. He is acting normal all day.

He is usually voracious since he is not yet regulated so this is unlike him not to eat. None of our other cats were sick so I don't think it is anything going around.

 

[Yvonne & Andy &BJ (GA)]

Robin - he ate nothing for breakfast but we had already given his shot. He got down to 139 and still had not eaten at +1 so I mixed 1/2 tsp Karo with 1tsp water and gave 1/2 tsp via syringe. At +1.5 he was at 137 so repeated the Karo water. At +2, he was 202 and ate 2 tiny pieces of chicken and abt 2 tsp broth. At +2.5 he was down to 181 but ate more chicken and broth. At +3 he was up to 196 and ate a few more pieces. Then +3.5, 217; +4, 232. At +5 he ate his normal snack. Then at pmps he was 281, ate normally and got his normal shot. I have not figured out how to post all this on his sheet yet.

This morning, we tested (231) and fed but he did not want to eat again. He usually devours his Instinct but turned up his nose. He did not vomit this am. We waited 1/2 hr and replaced his Instinct with FF and he was interested but only ate 1/3. We gave .8u and within 1/2 hr he ate the rest of his food. At +5, he was 148 and got his usual snack which he ate well. At +6, he was 201. He is acting normal all day.

He is usually voracious since he is not yet regulated so this is unlike him not to eat. None of our other cats were sick so I don't think it is anything going around.

I forgot to mention all of this happened on a day I had appointments - fortunately, hubby could stay home and keep an eye on him.

 

[Robin&BB]

Hopefully, he was just dealing with a bit of a tummy upset; from what you've said about how he's behaving today, sounds as though he may be getting over that.

Robin - he ate nothing for breakfast but we had already given his shot.

I don't know what your schedule normally is (if you were trying to get out the door to go to work yesterday morning, etc.), but if you can't get him to eat and you have a pre-shot BG# like the one you had, would be far better to wait until after he's eaten something before you dose.

While I've heard it said that it may be acceptable to give a token dose if the BG# is high (i.e., half the usual dose or less when the BG # is well up into the 300s or higher), the manufacturer of ProZinc does not recommend dosing with ProZinc when a cat hasn't eaten. So anybody who chooses to give a token dose to bring down really high BG at a time when a cat hasn't eaten really MUST to be around to closely monitor the cat's BG throughout the cycle. (Kudos to you for the way you monitored and brought Andy's #s back up. Good job!)

Here's why I'm not a big proponent of shooting ProZinc when kitty hasn't eaten: While ProZinc is not a "fast-acting" insulin, some cats' BG #s do drop faster than the "usual" +4 to +6 nadir time. (My cat, for example, typically nadirs @ +3.5 - with a full meal in her belly.) And without any food on board before dosing, giving insulin can be risky business no matter what your kitty's usual nadir time is - because maybe your cat will eat after that dose ... and maybe he won't. And if he doesn't eat, that means the insulin can hit that much faster and harder. As one of the oft-used FDMB sayings goes: "Better too high for a day than too low for a moment."

All in all, it looks to me like Andy is making really good progress - and especially this past week!
So am sending all good wishes that his tummy trouble is over and done. Stay the course; you're doing fine, Yvonne!