another night - also need dosing advice

[Carol & Murphy (GA)]

Murphy's pmps is again shockingly low - 224 stall then 228
(similar to yesterday's) I gave him 0.5 cc last night only to have his amps almost 600
I gave him 3 units this morning, but I was thinking of giving him 1 unit tonight
I will not be able to check him mid cycle as I am ill and could barely do his pmps - do you think 1 unit is too much? why is the insulin lasting so long all of a sudden?

 

[Carol & Murphy (GA)]

update just rechecked him about 30 minutes after eating and glucose down to 211 - will not give him anything tonight - have no idea what is going on with him

 

[Carol & Murphy (GA)]

update just rechecked him about 30 minutes after eating and glucose down to 211 - will not give him anything tonight - have no idea what is going on with him

although I really hate the thought of not giving him any insulin

 

[Bobbie And Bubba]

Hi Judy, so sorry you are sick. I am not really comfortable giving dosing advice as of yet as I still need it but if it were me, I would probably give a taken dose at least since you can't check through the night , but go with your gut.

 

[Carol & Murphy (GA)]

Hi Judy, so sorry you are sick. I am not really comfortable giving dosing advice as of yet as I still need it but if it were me, I would probably give a taken dose at least since you can't check through the night , but go with your gut.

Thanks Robin but I think that he is continuing to go down more than 12 hrs after his morning dose - don't know how long it takes for food to take effect

 

[Rachel]

Sorry I wasn't around earlier, Carol...get some rest tonight! We'll revisit dosing tomorrow...I'm not sure why he's going down after eating, but sometimes that happens. I think 1 unit would have been okay, but we'll see where he's at tomorrow. It's more important that you get some sleep and aren't worried when you're so sick. If possible, I might try to get a ketone test in tomorrow, though. Just to check.

 

[Merlin]

Since 10/2, your numbers look like Merlin's i.e. Murphy is running higher in the AM. If it continues and to try and even the AM/PM numbers out, you may want to shoot 12.5 hours during the day and 11.5 at night. That way, you are shortening the length of time at night and hopefully catching the AM number a little more earlier before it climbs into the reds/blacks. So for example, if you shoot at 6am/6pm, then you would shoot 6am/6:30pm. Once you can get that even out, you can concentrate on getting lower numbers at mid-cycle.

 

[Carol & Murphy (GA)]

Since 10/2, your numbers look like Merlin's i.e. Murphy is running higher in the AM. If it continues and to try and even the AM/PM numbers out, you may want to shoot 12.5 hours during the day and 11.5 at night. That way, you are shortening the length of time at night and hopefully catching the AM number a little more earlier before it climbs into the reds/blacks. So for example, if you shoot at 6am/6pm, then you would shoot 6am/6:30pm. Once you can get that even out, you can concentrate on getting lower numbers at mid-cycle.

thanks that's a good idea

 

[Carol & Murphy (GA)]

Today Murphy's nadir was about 4-6 hrs - didn't hang around until pmps - don't get how it can change so much from day to day

 

[Bobbie And Bubba]

Today Murphy's nadir was about 4-6 hrs - didn't hang around until pmps - don't get how it can change so much from day to day

Carol, I have the same thing with Bubba. His nadir is constantly changing too. Sometimes it is +4-7 and other times he continues to go down @ +8-10 . It makes figuring out a pattern or lack of one very difficult. I feel your frustration.
ETA: I hope you are feeling better.

 

[Sharon14]

I'm having the same problem with Colin too. I was hoping the Levemir would be different.

 

[Bobbie And Bubba]

I'm having the same problem with Colin too. I was hoping the Levemir would be different.

How long has he been on the Levemir now?

 

[Bobbie And Bubba]

I just realized that I called you Judy and had to chuckle because the post below you called me Robin. Do you think we are sleep deprived???

 

[Sharon14]

Started Lev 9/25. One week of that is when I had him on those over the counter ear drops that I later found out were full of glucose! Vet said give him 5 days to get it out of his system. I guess he was right. Yesterday was 5 days and he had his first yellow. Of course that means pink today! That's what he does...I'm so tired this AM. Paula, woodsywife, had a hypo episode last night. Got down to 48.

 

[Carol & Murphy (GA)]

I just realized that I called you Judy and had to chuckle because the post below you called me Robin. Do you think we are sleep deprived???

Hah!! thanks, I am feeling a little better - think I may be one of the season's first flu cases (at least it feels like that) As far as the cats go, I often harken back to the post I wrote a few weeks ago - "having a meltdown" I don't know what to do regarding dosing - I feed him 1/4 of his food pre-shot, but it's his MO to only eat some of that and come back within the hour to finish it off, but I can't really be sure he's going to do that today his amps was again in the 500s

 

[Carol & Murphy (GA)]

Started Lev 9/25. One week of that is when I had him on those over the counter ear drops that I later found out were full of glucose! Vet said give him 5 days to get it out of his system. I guess he was right. Yesterday was 5 days and he had his first yellow. Of course that means pink today! That's what he does...I'm so tired this AM. Paula, woodsywife, had a hypo episode last night. Got down to 48.

Sharon I admire your courage - I would have been afraid to give the 4 unit dose with a yellow - that's probably why I am having such a tough time of this I need to push the doses harder but then I never know what his response will be to it

 

[Bobbie And Bubba]

Started Lev 9/25. One week of that is when I had him on those over the counter ear drops that I later found out were full of glucose! Vet said give him 5 days to get it out of his system. I guess he was right. Yesterday was 5 days and he had his first yellow. Of course that means pink today! That's what he does...I'm so tired this AM. Paula, woodsywife, had a hypo episode last night. Got down to 48.

Wow, so getting off the ear drops really helped!

 

[Carol & Murphy (GA)]

Wow, so getting off the ear drops really helped!

I know - I was skeptical

 

[Sharon14]

Sharon I admire your courage - I would have been afraid to give the 4 unit dose with a yellow - that's probably why I am having such a tough time of this I need to push the doses harder but then I never know what his response will be to it

They say with Levemir, it's the nadir you look at(of course I have no idea when that is!). Since he's never even had a blue, I'm not supposed to lower his dose at all. I was going to give him the full 4.25, but had a big air bubble, so it came out to be 4.

 

[Bobbie And Bubba]

Started Lev 9/25. One week of that is when I had him on those over the counter ear drops that I later found out were full of glucose! Vet said give him 5 days to get it out of his system. I guess he was right. Yesterday was 5 days and he had his first yellow. Of course that means pink today! That's what he does...I'm so tired this AM. Paula, woodsywife, had a hypo episode last night. Got down to 48.

What was the ear drops for? Mites?

 

[Sharon14]

Wow, so getting off the ear drops really helped!

I guess. I was hoping vet was right, I never know I guess we'll see if Colin gets back on track, whatever that is...

 

[Bobbie And Bubba]

Sharon I admire your courage - I would have been afraid to give the 4 unit dose with a yellow - that's probably why I am having such a tough time of this I need to push the doses harder but then I never know what his response will be to it

Maybe look back on the SS for the same Preshot number or close to it and see how that took him. If he didn't reduce enough, maybe shoot .2 higher at that number, if it worked looked and he dropped 50% of his preshot, stick with that dose.

 

[Sharon14]

What was the ear drops for? Mites?

Yeast infection. It's drops I've used before, Zymox, and they work well, just keep them away from sugar babies! Lesson learned-read ingredients on everything!

 

[Bobbie And Bubba]

Yeast infection. It's drops I've used before, Zymox, and they work well, just keep them away from sugar babies! Lesson learned-read ingredients on everything!

Yep... and it makes you wonder why the hell would they put glucose in ear drops?? What the??

 

[Sharon14]

It's just so confusing. Like the other day when you started in the 500's then ended up hypo that night. Woodsywife had a similar thing happen last night.

Yep... and it makes you wonder why the hell would they put glucose in ear drops?? What the??

All I know is they've worked in the past for other kitties and cheaper than vets stuff..

 

[Sharon14]

BTW, glad you're feeling better Carol!

 

[Bobbie And Bubba]

It's just so confusing. Like the other day when you started in the 500's then ended up hypo that night. Woodsywife had a similar thing happen last night.

Oh no for Paula! And yeah, how confusing is it goig form 582 to 50 in 15 hours!??? In retrospect, the 582 was because he was in such GI pain ,gurgling and squeaking so that contributed to that. And I really think the diarrhea interfered with the insulin, perhaps too much of his diet was exiting and the insulin was to high then. Just a thought but then, this dance is anyone's game!

 

[Rachel]

@Carol C remember that Levemir is dosed completely different from ProZinc. I'm not saying we don't push with ProZinc but we do it differently. Lev is a depot insulin, so changing the dose frequently can cause problems. I can't say much about it since I never used it. ProZinc is in and out so we can change dose. We don't have to worry about whether the dose will affect the depot, since there isn't one.

Remember that you've been feeling ill so you haven't been able to monitor as much...which means that you've been inclined to give safer doses to ensure Murphy stays in safe ranges. I think that was a good choice...you have to take care of yourself and you can't if you are up and down constantly.

 

[Carol & Murphy (GA)]

@Rachel

@Carol C remember that Levemir is dosed completely different from ProZinc. I'm not saying we don't push with ProZinc but we do it differently. Lev is a depot insulin, so changing the dose frequently can cause problems. I can't say much about it since I never used it. ProZinc is in and out so we can change dose. We don't have to worry about whether the dose will affect the depot, since there isn't one.

Remember that you've been feeling ill so you haven't been able to monitor as much...which means that you've been inclined to give safer doses to ensure Murphy stays in safe ranges. I think that was a good choice...you have to take care of yourself and you can't if you are up and down constantly.

Hi Rachel - I would have tagged you but I don't know how - any thoughts on these wildly changing nadir times a few of our kitties are showing

 

[Rachel]

Haha, no worries Carol! I only figured out how to tag about a week ago...I had to spend some time reading up on it and practicing. I'm hopeless with technology!

I don't think Murphy's nadir is changing much. It looks to me like his nadir is roughly +6/+7. The one day it was earlier was the day he dropped low and you steered with food, which naturally brought him up. Remember, there is a variance with meters...so if you see 276 and 288 like yesterday...it's really the same number. That's what his nadir looks like to me for the last several days at least. I know that 10/6 tells a different story, but that was a weird day. I can't really explain WHY the number went so low for that preshot...but other than that, roughly +6 seems to be your nadir. We'll know more as data collection continues. I'll keep an eye on your SS for the next few days and see if we can get a pattern figured out. We'll get you there!

As for Bubba....well as @Bobbie And Bubba knows, I can't figure him out! He's an interesting dude. But we'll just keep doing what we've been doing...the best we can! Both of you are doing an excellent job. We'll figure out something to help out, even if nadirs are constantly shifting.

 

[Carol & Murphy (GA)]

BTW, glad you're feeling better Carol!

@Sharon14 congratulations on the yellow amps!! looks like progress

 

[Sharon14]

Thanks! I hope so, although now I'm worried he may be getting a UTI. I caught him about to pee on the dining room table. He did that last time he had a UTI. Won't be able to get it checked until Monday. Hope I'm wrong.

 

[Sharon14]

BTW how's Murphy doing?

 

[Carol & Murphy (GA)]

Thanks! I hope so, although now I'm worried he may be getting a UTI. I caught him about to pee on the dining room table. He did that last time he had a UTI. Won't be able to get it checked until Monday. Hope I'm wrong.

someone on a forum - I think in Health forum - thread title is about a cat with a UTI getting a dental - someone mentions something called D-mannose that you can get at a health food store that is good for UTI prone cats - Murphy is doing ok - still really congested - ragweed is off the charts here now - saw vet yesterday - he's lost an ounce or two nothing major She was happy with his progress

 

[Sharon14]

Thanks, will check out that thread and the D-mannose. Sorry Murphy is still congested, but glad he is otherwise doing well. I think I read somewhere that you are attempting the canned food again? If so, how's that going?

 

[Bobbie And Bubba]

Thanks! I hope so, although now I'm worried he may be getting a UTI. I caught him about to pee on the dining room table. He did that last time he had a UTI. Won't be able to get it checked until Monday. Hope I'm wrong.

Oh no! Doesn't he know this is your birthday and he is supposed to do every thing perfectly??? If it were a UTI from infection, I would think his numbers wouldn't be going down, probably going up. Wouldn't you think?

 

[Sharon14]

I would think so, but what do I know?! Part of me hopes it's a UTI, not that he just wants to pee on my table!

 

[Carol & Murphy (GA)]

Thanks, will check out that thread and the D-mannose. Sorry Murphy is still congested, but glad he is otherwise doing well. I think I read somewhere that you are attempting the canned food again? If so, how's that going?

I got some Royal Canin novel protein Venison - I'm such a coward -he went through one can already - one tablespoon a day! Now I'm bumping it up to 1/8 can a day - he loves it and would only eat that I'm sure I'm just so afraid of precipitating a 2 day bout of not eating from the canned - and as you said, if he will only be able to tolerate 1/8 or 1/4 can a day - that's better than nothing Is this your birthday? If so, happy birthday

 

[Carol & Murphy (GA)]

I would think so, but what do I know?! Part of me hopes it's a UTI, not that he just wants to pee on my table!

I agree with you-- I got some of those urine strips that check everything from glucose to ketones to bilirubin - they also check for blood and WBC (white blood cells) which would be present if there were a UTI

 

[Sharon14]

You're not a coward. Murphy has a history of problems with the canned food, so you are being smart! Hope it works out this time.

I agree with you-- I got some of those urine strips that check everything from glucose to ketones to bilirubin - they also check for blood and WBC (white blood cells) which would be present if there were a UTI

What is the name of these strips and where to get them?

Yes it's my birthday, thank you

 

[Rachel]

HAPPY BIRTHDAY!!!! @Sharon14

@Carol C Sharon is right...you're not a coward. Taking it slowly and a little at a time is the way to go. In the end, you only do what you can do.

 

[Merlin]

@Sharon14 , today is your birthday so Happy B-day to you,
It sounds like you are surrounded by a little furry zoo.
All of the kitties, so colorful and cute you know,
When you look at them, it just makes ya' wanna glow.
One is very special and his name is Colin,
We all can see that he keeps you pop'in.
But we all know the truth and that truth is,
That you are the special one, you are the true whiz.
Colin and all the kitties, are so lucky and blessed,
We are all in awe of you, you have definitely passed this diabetic test.
So take the day off; relax, enjoy and put your feet up,
And don't forget to have your favorite cup.
So from all of us; the Prozinc crew,
To you Sharon...Happy Birthday to you!

Oh and by the way, here is a link on UTI. http://www.catinfo.org/?link=urinarytracthealth

 

[Carol & Murphy (GA)]

You're not a coward. Murphy has a history of problems with the canned food, so you are being smart! Hope it works out this time.



What is the name of these strips and where to get them?

Yes it's my birthday, thank you

they are the old urine test strips diabetics used to use before the blood based testing became available - they used to be in every drug store, but now they might be hard to find - if a drug store doesn't have it, they could get for you (or you can order on line -I got mine from amazon - you would ask for the 10 parameter urine reagent strip (old urine glucose strips ) I've attached photos and Happy Birthday!!

 

[Carol & Murphy (GA)]

@Rachel or anyone who can chime in When you get a chance, could you look at the spreadsheet - his pmps number was lower or the same as his +7 number - I'm having trouble dosing his pm insulin. I gave him a skinny 2 last night but was so nervous that it was too high a dose. Then he went into the blues after midnight and I didn't know where it was heading so I gave him some food - this morning he is 554 - not sure bounce or the food. I don't know why his am insulin is lasting so long and his am isn't. I also am very unsure how to do the pm dose when the pmps is relatively low

 

[Sue and Oliver (GA)]

Carol, it looks to me like he goes a little lower at night and bounces from the blues. In the am, he has a longer way to drop from the amps, so he isn't as low. Maybe think of it like percentages. If he drops 50% from 500, he'll be in the 250s. If he drops 50% from the 270s , he'll be in the 100s I like your sliding scale - a little more insulin in the am, a little less in the pm. Except for that ugly black, he is staying below the renal threshold most of the day and night, which is great and will help his pancreas heal.

I like his current cycles much better than the ones book ended by blacks.

 

[Carol & Murphy (GA)]

Carol, it looks to me like he goes a little lower at night and bounces from the blues. In the am, he has a longer way to drop from the amps, so he isn't as low. Maybe think of it like percentages. If he drops 50% from 500, he'll be in the 250s. If he drops 50% from the 270s , he'll be in the 100s I like your sliding scale - a little more insulin in the am, a little less in the pm. Except for that ugly black, he is staying below the renal threshold most of the day and night, which is great and will help his pancreas heal.

I like his current cycles much better than the ones book ended by blacks.

thanks so much for the feedback - why do you think I should have given him the skinny 2 units last night, or something a little lower

 

[Sue and Oliver (GA)]

He certainly didn't go too low last night - he was in safe blues. I think it was a good dose. Yes, he bounced but maybe we should figure the Blues were worth it?

 

[Carol & Murphy (GA)]

He certainly didn't go too low last night - he was in safe blues. I think it was a good dose. Yes, he bounced but maybe we should figure the Blues were worth it?

I got nervous and fed him last night at +4 and +5 so I really don't know how low he would have gone - I need to let him go blue and not panic - its' just so difficult in the wee hours of the morning and I am still not confident about what is insulin is doing I am going to try to not be nervous in the blues

 

[Sue and Oliver (GA)]

Easier said than done. When you are used to pinks, blues seem so much lower. But yes, his numbers last night were fine. The more blues you see, the less you worry.

 

[Rachel]

HI Carol! Sorry I wasn't around at my normal time. Today is a sleep in day for me...

I think Sue is spot on (as always!). I totally get the worry...I remember the first time Gypsy was at a too low number for preshot (90 I think). I knew that was too low to shoot, but I got on here and begged for advice. I was so scared to shoot or not shoot that I panicked. When you normally see higher numbers, you worry about hypo. You'll get more used to it as time goes on.