Beau - 8/1 update & question

Status
Not open for further replies.
alicia.1771

alicia.1771

Member
Hey All

It sure has been a crazy weekend for me and Beau. We survived our first hypo episode thanks to everyone's support and advise here, and a special thanks to Nancy and Deb for staying up with me into the wee hours of the night until Beau's BG is in the safe zone. Really couldn't have done it without every single one of you!

Beau's BG continue to be elevated since his vet visit (nadir at vet is 68 but most likely much lower than that in reality given the stress factor) and the hypo episode (40 at + 2.5) on Saturday night. Yesterday I gave a reduced dose of skinny 0.8U BID and PM +4 dipped to 72, probably an ok # but given his tendency to go low I fed him a little bit of Fancy Feast Gravy just so we don't repeat the night before. I was supposed to get up to check his +6 but slept through the alarm being so tired. I was so relieved to find him still alive this morning outside my door when I woke up! (bad mommy....)

I don't know quite how to interprete his BG curves since his vet visit on Friday and it almost seems that at 0.8U it is still too much insulin for him. I emailed my vet his spreadsheet this moring and she called to said she thinks the elevated BG is due to rebound and that Beau may be on the way to remission (!?) and may no longer need insulin or as much insulin as we have been giving him. She is consulting with a specialist but may not hear back until tomorrow.

In the meantime, I was instructed to NOT give him his PM insulin tonight (even if it's a high #) and if she didn't get back to me today I was to give him just 0.5U tomorrow morning. Anyone want to chime in their thoughts???

Beau seemed a bit mellow today and need a bit of coaxing to eat. But we are seeing that 1st half of a "smile" curve today.
I missed catching his urine by 30 sec (sneaky cat!) so didn't get a ketone reading, but will keep trying. I was told there is a kind of strip that works with urine in the cat litter, anyone know what brand???

By the way, since last night's PM shot was delayed to 9:15pm, his AM shot today was at 8:50am so the +2, +4, +6 readings are according to his AM shot time.
 
I hardly know where to begin! After he cleared his bounce yesterday morning, he actually has shown a pretty decent pattern on 0.8U. He didn't dip that low today, but you kept feeding him so he didn't really get a chance to get to nadir. I don't see that 0.8U is too much -- it looks about right, actually. If he were dropping too low that would be one thing, but 72 isn't a bad number. You actually want to get some greens at the low point, just not really low ones! I don't know how your vet could say that Beau is on his way to remission after just a half month on insulin. :shock: He may be able to drop his dose with the right mix of food and some time and eventually get off insulin entirely, but three weeks would be a pretty fast miracle cure! If you don't give him insulin tonight then he'll just be really high tomorrow. Seeing if he could get by on less is fine I suppose, but if you cut too much (or eliminate insulin entirely) then you lose momentum. It sounds like your vet has little experience at all treating diabetics and I wonder whether I'd be comfortable having her treat my cat regularly as a result. If she had to consult with someone else constantly, I don't know....

Hopefully some of the more experienced members will chime in soon.
 
Hi Wendy - you are right she doesn't have much experience treating diabetic cats but she was honest and told me that in the beginning of his treatment. I like that at least she's consulting with a specialist. I was hoping to work out with her but if everyone here thinks what she's recommending me is not very good then perhaps it's time I seek 2nd opinion...
 
Alicia,
You've been getting your "2nd opinion" all week, and best thing? It's free.
What time is Beau's PM shot tonight?

Carl
 
If you decide you want to shoot (totally your call), people will be here.
I'm with Wendy. Not a fan of skipping entirely providing Beau is eating okay, and he gives you a shootable number of course. I'm more comfortable with a reduced dose than no dose at all.
I only skipped once with Bob when he's numbers were in the 200 range because he threw me a low hundreds. Next morning he was high again. Bob was different though. I had to dose him much higher than you've had to do, and he didn't get as much bang for the buck with his insulin doses as most other kitties seem to get. And Bob was in much worse shape at three weeks in than Beau is.

Carl in SC
 
Carl & Wendy - I too am on the fence regarding his PM shot. I just tested his +8 and we're seeing the 2nd half of the smile today :) For his funky curve these past few days I'm leaning towards too stressful a day at the hospital for his curve that pushed him over the edge and he is recovering from that (also from the terrible brusings... :cry: ). But I'm a little concerned because he is so mellow today and sleeping most of the time and not eager to eat on his own. I know I probably shouldn't keep feeding him but since he has lost so much weight in such a short time (from 14.19lb to 13.3lb in 1 week) I'm trying to get as much nutrition in him as possible! But I do try to hold off feeding after +8 so it doens't mess up his next PS #.

As of now I'm leaning towards giving him either a skinny 0.8U or less depending on his next readng. But I'm hoping to get more voice of agreement before I do that since it's going against my vet's advise...
 
I was actually going to suggest .5. I'm concerned that if you don't dose at all, Beau's going to be high in the AM, and that .5 she said to give isn't going to help as much as he might need.
Then if the vet says anything, you could say (OHHHH, I thought you meant to start that tonight).

Carl
 
Ok, I'll weigh in.

First off Harley went off insulin within 3 weeks after his initial dx so it is possible, he was diet controlled for almost one year until he had to be boarded at the vet clinic and came out of remission.

In looking forward to tonights dose, it does look like the .8u is a good dose, but you fed the 72 last night and today may be a little bounce from the 72 so I think I would go with a .6u depending on if your PMPS is high enough. I would definately not skip the shot unless he was really low. You have to wait and see what his PS is to decide.

You are doing great.
 
Hi Alicia! What comes to my eyes is her feeling admission he might be going into remission, no shot tonight but if she doesn't call, give him insulin tomorrow? Which is it? I don't think Beau is there yet but who knows? my question is the stop/start thing ......

at the top of the posts is a section called, Is your cat in remission? you should read it. I think it is possible but I'm not sure.

If it were me? I followed some vets advice right into DKA. In fact Payne is only doing so well because I questioned and learned and said, "No, that won't work!" She finally started getting better when we started dosing 3x a day (t.i.d.) which was against all the vets advice.

I don't know, I know we want to do what our vets want us to do but most vets don't know a lot about feline diabetes .... so I think it is a balance. We work as partners. "That doesn't make sense to me, what about this?" I have a vet that doesn't believe Payne is still alive, much less thriving! He just keeps saying, "keep doing what your doing!"

Beau is your cat, what do you think? Read about remissions and post back ....

Nancy and Payne
(who is sleeping on the light over the birdcage, probably thinking it's great being a cat!!)
 
Hi Nancy - ok, I will take a look a the remission post shortly.

Oh, I just remembered I left something out of the conversation, my vet said that she thinks Beau could be going into remission such that he may only need to be on 1x/day or no insulin, so that's why the 0.5U for tomorrow monrning. Sorry about the confusion.
 
Kitties need twice a day insulin because their metabolism is so much higher. You would lower the dose and still shoot twice a day.

Once a day dosing can lead to DKA, ask Kim and Kitty.
 
I just want to respond about "going against a vet's advice"

Kitty and I came here in Feb. My vet started Kitty on 2 units of Prozinc once daily (sid). I posted a thread everyday and included her results on once a day dosing. Each day the people here encouraged me to split the 2 units--- and give 1 unit twice a day (bid). But, I couldn't do that---could I? I mean my vet told me once a day was okay. So, I went to my vet and "begged" for her blessing to go to twice a day dosing. I took my SS and tried to show her how Kitty was only getting a curve for 12 hours each day and and the other 12 hours she was staying high (300s). My vet, said "No" she only needed insulin once a day........that I was one of the lucky ones.

So, to the disapproval of everyone here--- I followed my vet's instructions. I mean afterall, she is a vet.....she must know best!

One month later, Kitty was in DKA from too little insulin. Kitty is better now, but she has never fully recovered--- she now get 10.5 units of Prozinc a day.

I now question all advice my vet gives me!
 
WOW, what timing...I had no idea you were encouraged to dose once a day. TRUST ME.....BIG Mistake!!!! Please look at my spreadsheet ---Kitty SS. Please learn from my mistake!
 
I would probably try 0.5 or 0.6 tonight and see where that lands you by morning. It is a big drop to go from over 1u to no insulin, or 0.5 SID in just a few days, and most cats we have seen do not go OTJ that way. Typically they seem to do well if you keep the dose as high as they will tolerate without going too low, and gradually reduce it as needed when they earn the reductions, like Beau is doing so far. A few just pop off insulin altogether, but that happens when you get PSs that are too low to shoot, and it just happens. If the PSs are above 180 or 200, I would go ahead and give at least a small dose.

Particularly combined with what you said about his behavior and eating dropping off some - those both suggest he needs more insulin, though I wouldn't increase the dose on the numbers you are seeing. Could just be an off day for him, but it could be that he still needs something close to 0.8 twice a day.

The 72 at +4 is a little steep, but still a good number and a good sign, so from that I would think even something like 0.7 might be what he needs right now. I'd try 0.5 or 0.6 though just so you don't have to be scared by lower numbers for a 3rd night in a row. :-D
 
p.s. if he isn't eating great, please be sure to check regularly for ketones. Even in lower numbers, low eating is a trigger apparently.
 
I just got off the phone with the vet and she still thinks that Beau is getting too much insulin and we need to wean him off to once a day (!). She was pointing to the few low nadir #'s we got on his SS and also the low 69 at 7/28's AMPS, which leads her to think the insulin is having an effect longer than 12 hrs. I questioned her on how I read cat metabolism is fast and they do better on lower dose BID vs. SID. But she said that some cats do well on SID and that she'd rather his #'s go a little high than too low. I looked up ProZinc site and even they recommend twice a day for most diabetic cats! She further told me NOT to test him any more until Thursday (what!!!) while giving him either 0.8U or 1.0U once a day in the morning and watch for signs of hypoglycemia and if I think he's not doing well to take him to emergency.

Ok, that 2nd opinion is sounding really good right about now....

Anyway, thank you all that have chimed in thus far. His +10 is at 294 so we're on a good smiley curve today. I am more conifdent now that he needs insulin even if it's a lower dose. I do feel he may be on the way to remission but I don't think we are there yet despite how much I want that day to come.

I plan to give his shot at 8:30pm PST so we can slowly move him back to schedule. Do I need to do another reading before the shot? The only reason I'm asking is he has been poked sooooo many times these past 3 days and if the #'s on today's curve are good enough I really want to give him a little break. I am leaning towars 0.6U or even 0.5U tonight so I can get some sleep without worrying. At a reduced dose, is one test at +4 good enough?
 
Your vet sounds a lot like mine regarding sid---my vet thought we were getting longer the 12 hour duration.

If you have not read about my experience with sid, please read it. If I could change one thing that I have done in Kitty's 6 month dance---the sid dosing would be it. Please don't go to sid......
 
Hi Kim - I haven't read your Kitty's experience yet, just your post on how bad that turned out. So no, I will not go with SID at this point, or ever if it's that terrible. But just curious are there ProZinc users on this board whose kitty is on SID and did well???
 
alicia.1771 said:
I just got off the phone with the vet and she still thinks that Beau is getting too much insulin and we need to wean him off to once a day (!). She was pointing to the few low nadir #'s we got on his SS and also the low 69 at 7/28's AMPS, which leads her to think the insulin is having an effect longer than 12 hrs. I questioned her on how I read cat metabolism is fast and they do better on lower dose BID vs. SID. But she said that some cats do well on SID and that she'd rather his #'s go a little high than too low. I looked up ProZinc site and even they recommend twice a day for most diabetic cats! She further told me NOT to test him any more until Thursday (what!!!) while giving him either 0.8U or 1.0U once a day in the morning and watch for signs of hypoglycemia and if I think he's not doing well to take him to emergency.

Ok, that 2nd opinion is sounding really good right about now....

Anyway, thank you all that have chimed in thus far. His +10 is at 294 so we're on a good smiley curve today. I am more conifdent now that he needs insulin even if it's a lower dose. I do feel he may be on the way to remission but I don't think we are there yet despite how much I want that day to come.

I plan to give his shot at 8:30pm PST so we can slowly move him back to schedule. Do I need to do another reading before the shot? The only reason I'm asking is he has been poked sooooo many times these past 3 days and if the #'s on today's curve are good enough I really want to give him a little break. I am leaning towars 0.6U or even 0.5U tonight so I can get some sleep without worrying. At a reduced dose, is one test at +4 good enough?
Click to expand...


I dosed Bob once a day for several days (against my vets advice, or actually, I never asked for her opinion). It was when he was getting really close to not needing insulin anymore. The doses were puny, and I think I did them more for "me" than for "him". I was just too scared to "not shoot". Then one day, I split the dose, gave him half in the am, the other half in the pm. That was the last time I gave him any shots. The reason I'm telling you this - like I said, at the time I was doing this, he probably didn't need any insulin. I was just afraid to stop, figuring he'd zoom like crazy if I did. You will get to the point where you feel that Beau doesn't need juice anymore. Thanks to the good advice you got here, you won't go to the one-a-day shots like I did. And Beau will be better for it.
I wish all vets could just be forced to spend a couple hours every day doing nothing but reading this board. No posting allowed - just read and absorb all the amazing stories and see how successful the members of FDMB have been in getting their sugarcats beyond this disease. Maybe then they wouldn't dispense bad advise like the advise you got today from your vet.

To answer your question, yes, I think that the +10 reading is enough for today. You can see he's been rising since +6 (114). You're not "shooting blind". Give Beau a break. Give yourself a break too. I'm with you on the .5 or .6 reduced dose too.

Carl
 
Just to clarify - I am not, nor would I ever, recommend anyone dosing one a day on PZI or any other insulin.

Carl
 
In my 6 months on the board, I have never seen another Prozinc user that has tried sid dosing.

Kitty did not have really bad numbers when we were dosing sid and she had a great response to the insulin. But, she had a 12 hour period with no insulin. DKA is created by too little insulin. Ginny's cat Alex, just went into DKA and his bgs were running in the 200s---but, he was getting very little insulin. You do not have to have high bgs to go into DKA----you must have insulin in the cat's body. I knew nothing about DKA prior to Kitty's crash. I had no idea we were flirting with danger. I can't tell you how big of a mistake it would be if you tried sid----just please take my word for it! It is the single biggest mistake I have made with Kitty's treatment.
 
kse said:
In my 6 months on the board, I have never seen another Prozinc user that has tried sid dosing.

Kitty did not have really bad numbers when we were dosing sid and she had a great response to the insulin. But, she had a 12 hour period with no insulin. DKA is created by too little insulin. Ginny's cat Alex, just went into DKA and his bgs were running in the 200s---but, he was getting very little insulin. You do not have to have high bgs to go into DKA----you must have insulin in the cat's body. I knew nothing about DKA prior to Kitty's crash. I had no idea we were flirting with danger. I can't tell you how big of a mistake it would be if you tried sid----just please take my word for it! It is the single biggest mistake I have made with Kitty's treatment.
Click to expand...

Kim,
You illustrate one of the points I was trying to make. I'm now quite sure that when I dosed BOB SID for a few days, he didn't need the insulin. I guess that's why there was no bad result for Bob like there was for you and Kitty. After being here for 2 months, and starting to understand a lot more about the way this disease and treatment works, I'm astounded that Bob is doing as well as he is. I am so damned lucky...
Carl
 
We had a couple others who showed up shooting SID - Angela & Henry, and I think someone else too. We did a lot of talking people out of SID that month, lol ;-)

Once Bix got regulated he got like 16 hour duration on PZI Vet, and didn't zoom, so for a while I shot SID out of convenience since my goal at that point was just to maintain things, not trying for OTJ. But if anyone wants their cat to go OTJ, you would only go SID if the numbers dictate it. That's what I think the vet is missing - if the numbers go over 180 or 200, that's too much to ask their pancreas to do, so why not help with a little insulin? My view is the opposite of the "wean them off" view. From what I have seen if you lower the dose too fast, you delay regulation or OTJ and have a set back. If you can stay on top of the dose, it seems to give their pancreas that extra time to heal.

One thing people sometimes do is a food test. If you got a PS like 150, you can feed them some and see if they bring the numbers down themselves in a few hours. We've seen some do that and 3 hours or whatever after a snack with no insulin their cat will be at 75, and then you know they didn't need the shot. But if you test after a few hours and they are up to 180, and then 200, etc, etc, then all you are doing I think by not shooting is wearing down their pancreas when it's not quite ready to take over.

I think vets sometimes have this mentality that is based on people *not* hometesting. Sure, if you are not testing, hypo is probably a bigger risk, so as a vet their responsibility is to have you lower the dose at this point. But you *are* hometesting, and I just don't think they are taking that into account.

I'm glad you raised back to the 0.8, the 0.5 looks too low to me. You're getting a good drop on the 0.8 - it looks to me like a good dose to come down from higher numbers, but possibly a little stong on a lower PS. I would probably shoot 0.6 if you got something under maybe 250, and a skinny 0.8 around 300. Just ballpark, shoot what makes the most sense to you, and gather data like you are doing!
 
just for clarity, I'm not recommending you try the food test - to me that is more something to do when their dose gets under 0.5u, or in some cases where the curves are wonky and you suspect they are eat & divers
 
Thanks Joanna for your feedback!

With his current BG readings I'm just not comfortable giving Beau SID as my vet suggested, so I made an appt with Cindy's vet tomorrow afternoon to get a 2nd opinion and hopefully put some concerns to ease.

Beau seems to be doing pretty good around 0.8U. I gave him 0.5U last night because I really needed to not have to worry about him for one night so I can get some needed sleep :lol: But I was quite surprised to see his AMPS at 407! We have not been in the 400's since the 5th day into treatment so I felt comfortable giving him 0.8U. I'm going to try to stick close to 0.8 for now if his #'s call for it, and drop down a bit like you suggested so he doesn't go too low, especially for his PM dosing.

I think I am slowly getting a hang of things and hopefully we will see some great smiley curves in the near future again.
 
Status
Not open for further replies.
Back
Top