Asher 1/16/11

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donnahc

donnahc

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Hi everyone!

Yesterday we switched Asher up to 2 units PZI.

His amps was 339 today and his + 4 was 274. His SS is current.

He’s a happy and playful dude today, not that he hasn’t been otherwise, but he has been letting us sleep thru the night without being pesty, which is a huge blessing.

Any thoughts on numbers and dosage? I guess he should stay here at 2units for a bit, but curious about what you guys think about when we should raise his dose and how much. (I am guessing his BG is still too high yet).

I did get the U100 syringes so they are here if we need them.

Thanks,

Donna and Asher
 
I think an increase tomorrow morning would be fine if you don't see improvement in his numbers, or a lower preshot. But I wouldn't go up in half units. If you feel comfortable with the u100 syringes, I'd increase to 2.2 and hold there for at least 3 cycles, or if you're more comfortable using u40's then go up to 2.25 u. Just my opinion, though. You want to make sure you don't overshoot Asher's optimal dose.
 
I think that is a good suggestion of not overshooting his number.

I have enclosed here a pic of the U100 syringes we got.
There seems to be 4 lines between the big numbers.

I did d/l the chart you guys have here on the site of the U-40 to U-100 conversion chart.

So if indeed we arrive on shooting 2.2 units for Asher tomorrow, on the U100 we would do a 5.5, so would the insulin be between the two center lines on this syringe?
I really want to be super sure I don’t make a dosage mistake.

-donna
 

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What I just said can’t be correct, I guess 5.5 would be between the 5 and the next line up. Something tells me I just got the wrong syringes... :sad:

-donna
 
I cannot see the other side of the syringe but it looks possible to me that there are not 1/2 unit marks.

Also the ones you got are 50 unit syringes or 1/2ml or 1/2 cc. You want 1/3 cc or 1/3ml syringes with half unit markings.

Many here have found Wal-Mart to be VERY unreliable about the syringe they will give you. You have to inspect before you buy. Many have given up and just order from Hocks using the link in the PZI Sticky.

Print this out and take with you to Wal-Mart - do not leave until you get one of the following:

U-100, 31 gauge, 1/3ml, 5/16 inch short needle, with 1/2 unit markings syringes
or
U-100, 30 gauge, 1/3ml, 5/16 inch short needle, with 1/2 unit markings syringes

Ask to speak with the pharmacist or the pharmacy manager.
 
Damn, I guess I won’t be able to do a 2.2 unit shot tomorrow then.
Ideas on if I should try increase him to 2.5 units or try to eyeball a 2.25 with the U-40s?
Like it was mentioned earlier, I don’t want to overshoot what he needs.
I guess I’ll post his pmps tonight and amps tomorrow to see what folks think.
-donna
 
If the needle is pointing up you always measure to the "top" of the line - so the very tippy of the plunger is at the "top" of the line. So I figure if you measure to the bottom of the line in those syringes that might be a quarter the way between each unit of U100 insulin.

On the other hand, you probably want to return those syringes so not using them would probably be a good idea.

Your choice. But I'd probably try to eyeball .25u in the U40.
 
Thanks tons Gator!

I am gonna post his numbers tonight and tomorrow morning, but we’ll pencil in a 2.25 tomorrow.

(i hate to race out on a sunday night and get the wrong thing again too)

-donna
 
Call ahead and ask for the pharmacy manager. Find out who they are and when they leave. Ask them if they carry the above. Tell them you are coming. Make friends. Get results. Take no prisoners. :lol:

Some here here have even had to demand they go though every box. :roll:
 
Well, it’s always interesting..

What do you guys think about this...

We moved up yesterday to 2 units. We were going to do 2 units tonight then bump him up to 2.25 tomorrow morning.
Just now we got a pmps of 178.

Any suggestions on what to do? Keep him at the 2 units tonight ?

-donna and asher
 
Aah, one of those thorny dilemmas, Donna. Great number by the way.

Can you wait 30 minutes and test again? If it is going up, and you will be around this evening to test at nadir, you could shoot 1.5 or 2. I am cautious and I would lean toward 1.5. It is just such a delicate balance between wanting to keep the progress going, and wanting to keep the kitty safe..... But don't forget. It is a nice problem to have!
 
Sue:
Hope I am not adding another dilemma...we just fed him. He was really hungry so that is why we tested now. I have been testing, then posting what his number is, feeding him, then by the time I get a few opinions, he is settled in his bed and we shoot.

We are here all night and I don’t have to leave the house tomorrow, so I could get up and check on him tonight if need be. Don’t want to flirt with disaster tho....

-d
 
Ok I guess we are winging it since my understanding is we have to shoot within a half hour after we feed him. I am thinking a shy 2 units or a rich 1.75.
-d.
 
You don't have to shoot at any time period after feeding. That is only with the harsh insulins that take the cat down low. It is hard to know what his actual number is now, because the food can take it up. And you do want to be sure you are shooting on a rising number, not on a food rising number.
 
I don't know about having to do any of that. Though I am not a mind reader [sometimes it would be nice though ;-) ] I'm thinking Sue maybe has in mind that you should A) be cautious because the PS was lower than your no-shoot AND B) it is night time and you do not seem to be testing at night [which is acceptable]. So to hopefully avoid an all nighter then I would go with what Sue recommended and lean towards caution.

If you ever get a PS that is below your no shoot then do read your options at no shoot here:
http://felinediabetes.com/FDMB/viewtopi ... 24&t=32652

What Sue was talking about - "waiting and testing" is covered in that topic.
[Sue was instrumental in writing that actually :smile: ]

Since you fed then you are in option 1 or 3 now and it sounds like Sue has in mind option 3 for you tonight which seems like it should be fine.

AND then you can post here and perhaps hold off the feeding until you get a number above your no-shoot.
 
Thanks Sue and Gator, we went for the "hair over the 1.75" units...so option 3 on the list. We will be up late tonight so will test him a couple of times, at least at +3.

I’ll post what we get. We have never tested him at night so it should be good info.

As I look at his spreadsheet, it seems for 3 days now he starts high in the morning and decreases each reading throughout the day. Don’t know if that shows anything or not.

On an unrelated topic, the other day we talked about ketones, and since Asher isn’t regulated, I started to worry that maybe I should test him. A few minutes ago the opportunity presented itself, Asher didn’t seem to mind company at his box, so I did it. Much to my relief the test strip showed negative. How often should we test him with the strips?

You guys are so great. Thanks for all this valuable info!!!!

-Donna
 
As long as he is running with good numbers - not high- and seems well and happy, I would say once a week or so. Good job on stalking there!

Will watch for numbers tonight.
 
Great pmps number!! I'm interested to see what he does with the 1.75u dose and where he'll be in the morning. I'm glad he was cooperative with the ketone testing- that makes it much easier if kitty doesn't mind an audience! Charlie isn't pee-shy either, thankfully!
 
LOL, I finally got Asher’s spreadsheet link to look like I know what I’m doing ;)
Small steps.....

-donna
 
So Asher's +3 tonight is 153. I don't know if that's good, bad should I keep testing or what. He just got some chicken treats for the test. Should I feed him or should I be happy???
Donna
 
That's a nice +3, not super low. I would try to get a nadir also.

You get nervous when you see numbers 50 and below, and then need to intervene.
 
We have only ever attempted to run a full curve on him once and you'll see on the SS when we hit the 54 at +4, we went into full alert mode...so I don't know what his nadir would be. Could you guess an estimate on when I should test him next? I can set my phone alarm to make sure I'm awake :)

Donna
 
Hard to tell, Donna, since it was +4 once, but today - who knows? I would try for a +6 if you can wake up. :razz: If not, he will probably be fine. Leave out some food just in case.
 
Thanks Sue:
I so appreciate you holding my hand thru this.
I will set my alarm for +6 and leave out some food too.
He is sleeping right next to me so I'll have one eye checking ;)

Peace,
Donna
 
I just want to note that with [the limited testing I did] the old PZI Vet seemed to nadir at reliably +6 with H. But with ProZinc I was never really able to zero in on when nadir would happen. You can try to find nadir by repeatedly testing +5, +6 & +7 and find when the lowest happens. Then verify it if the nadir actually happens at +5 or +& by testing the hours before and after that. So if in the first set you think it's happening at +7 then you would again repeatedly [not just twice] test +6, +7 & +8.

Nadir with ProZinc seemed to me to be more dependent on the dose [too high or low]. But that is just me and I really have no proof of that.
 
The +6 is 195. We just gave a snack and it's time for beddie-bye. Thanks again for everything.

Donna
 
So I guess we shouldn't have lowered the dose tonight. :( I guess we go back up to 2 tomorrow and see if we need more from there?

Donna
 
Yes that's very true. And it was worth a little less sleep to add two more numbers to the puzzle. :)

Donna
 
What a great way to look at it! I too notice that charlie's nadir bounces around between +5 to +8. I wish it'd be more consistent. That'd make everyone's lives do much easier!
 
The AMPS was high and I am bummed :( AMPS is 490 this morning.

Do we shoot 2 units or more? (We were gonna bump him up to 2.25 yesterday but got a lower PMPS)

It was prob the reduced dose last night. Wonder if midnight snack bumped it up too.

-Donna
 
Seems like at that AMPS, you could certainly do the 2 units. Also, you should probably start a new thread for today so people can follow. Hope today brings better numbers!
 
Thanks Kristen. I am moving thread now. Sleepy from going to bed so late last night ;)
Wild life we kitty mommas live....

-donna
 
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