Been Lurking for Awhile..Joined in November

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Angela&Henry

Angela&Henry

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Hello; I joined FDMB and PZi support group in November.
My cat, Henry, was diagnosed on October 28, 2010.
We started at 2-21/2 U PZ twice daily. He continued to have higher and higher AMPS and PMPS even when increasing dose. He was up to 4.5- 5U BID at one point. Then he was >200 at AMPS in November, but had high mid cycle numbers. My vet said to try SID dosing which has been since late November. He still would remain high at AMPS but started getting better numbers at mid-cycle. He is still high in AM but just in last few weeks has been in 400's instead of 500's at AMPS and has nice drops at 4 and 6 hours, recently in 100's. I have tried several times to get him back on BID dosing, but each time, at +11. +12, +13 he is sometimes at lowest point of day around 200<. My vet says for now to stay on SID dosing . She is not opposed to BIB dosing, he just has weird numbers at time to give a PMPS so we have not been able to. Sometimes he gets pretty steep drops by +4 and +6.
He was just at vet on Tuesday because of weird wobbly walking, I thought it was diabetic neuropathy, but she suspected not and did series of xrays, he has disc disease in mid spine. He had injection of Metacam to ease inflammation and to see if it helped, when it wears off, he will start on 1/2 baby aspirin every 3 days.
His other health issues are Glaucoma in both eyes, he gets 2 different eye drops, one 3x day and other 1x day.
He had some ketones when he was first diagnosed, but not DKA and has had two urinary tract infections when he was diagnosed and once after a few months ago. All his other blood work was normal in November (complete panel) other than BG. His kidney and liver function were tested again on Tuesday before injection at vet and were normal. He was also tested for ketones and had none.
He eats no dry food, just mainly FF classics 3-4 cans, 1/2 can at a time, spread over day: occasionally Wellness or Merrick's and freeze dried chicken treats once a day.
He was weighing 18-19 pounds before diagnosis, at end of October, when he was in for Glaucoma pressure check he was down to 15 lbs., was 15.9 in December and 14.8 lbs on Tuesday, vet not concerned because of diet change, (less food and no dry)and because he has no ketones. In January 2010, he had complete blood panel and his BG was 112. We think the diabetes was caught early, he dropped the weight in prior 1-2 months before diagnosis. He currently gets 4.1 U PZ SID
I have been lurking here for some time and read posts daily.
Anyone that would like to comment about Henry or his spread sheet I would appreciate. (On spread sheet, right after diagnosis when we were shooting twice a day, I accidentally deleted PMPS and amount of insulin, and did not have it written down anywhere else to re-enter)
Thanks.
Angela & Henry
 
Also wanted to mention that my vet is very supportive and open. She has been our family vet since 1984. She encourages me to call her each day with Henry's BG readings which I have done since day one and encouraged home testing. She also realizes our financial situation, unemployed and out of UC. She gave us the first bottle of Prozinc, syringes and sharps container.
 
Welcome Angela,

It sounds like you and Henry have been through the mill. I am so glad you decided to come over and post.

In general, we recommend that you give PZI twice daily. And looking at Henry's chart, it does look like that is the issue. He does go down in decent blue numbers during the day, but is way high again the next morning after 24 hours without insulin. Generally, when you get a late nadir which you have gotten, it is because the dose is too high. So both problems may be helped by dividing the dose and giving it twice daily.

If your vet is okay with that, it is certainly what I would suggest. If you do it for a few days and post here with your numbers, we should be able to help with suggestions. This forum is small (but friendly) and is busiest in the morning and at night, so check back at those times for answers on your thread.
 
Hi Angela and Henry! Nice to see you here :)
It does sound like you guys have been thru a lot. There are many kind and supportive people here, and very smart too, so I am sure you will get lots of help by being here.
All the best to you and Henry :YMHUG:

Donna and Asher
 
Just wanted to say hi and welcome. I'm a newbie and still learning so have no advice except that Sue's plan sounds good. It will give you a chance to gather info on the numbers if you decide to try Henry on BID again.
 
Thanks everyone for the warm welcome.
We are going to try BID starting on the weekend will be 2U or 2.1U. I want to wait to see if Henry will start baby aspirin on Friday. Vet was agreeable to try again just said not to shoot if he's under 200 at AMPS or PMPS. If so feed take again in hour and call. just tested him again +10 130BG. These are his BG's for day: AMPS 447, +4 270, +6 170, +10 130
 
I like this plan, Angela. I agree with your vet - no shot under 200. But if you feed him, it is likely that the food will cause his bg level to rise. That might mean you are not really shooting a rising number, but you are shooting a food induced number. We usually say hold off on the food except for a few lo carb treats until you test again in 30 minutes.

I'll be interested in see his numbers with the new dose. Be sure to get those mid cycle numbers too.
 
Hi and welcome Angela & Henry,

I really glad you will start twice a day dosing. I think Henry will start to feel much better very soon.

You're vet is right about not shooting if his bg is under 200. Sue is right about not feeding until you test again.

Come back and ask any questions you have.

Robin
 
Tried Henry on 2U yesterday: Here are results Sat. Feb. 19,
AMPS: 473, gave 2U PZ, +4 314, +6 280, +11 141, PMPS, 120, no shot, +13 from AMPS, 123

today: 02/20: AMPS 441, +4 241
 
So by saying no shot last night did your vet agree to do twice a day dosing?

A dental will help Henry out alot. I know how expensive it is, Harley just had one and lost 3 teeth but his bg's are lower now that he isn't in pain anymore and the infection is gone.
 
Yes the vet agreed I could try 2x daily injections but I did not shoot last night because he was in 120's. I did cut the 1x daily dose in half to try giving 2 daily injections, so he had 2U instead of his usual 4-4.1 at AMPS yesterday and today. I am going to check his +6 in a few minutes. This is what has happened before when I tried to get him back on 2x daily injections, he would be his lowest point of the day most times when I checked his PMPS BG.
Yes, he does need a dental but after spending 340.00 of income tax refund at vet last Tuesday for xrays, injections, blood work and exam I have to put it off a little longer. The vet did not want to do the dental when he was up in the 500's at AMPS. But since he has been down in 400's AMPS and getting nice drops in the afternoon, she thinks it will be safe now to do the dental.
He also had a urine culture sent off on Tuesday when I was at vet's and she called yesterday to say it is positive for gram negative bacteria. He had UTI when first diagnosed with FD and had antibiotic shot then and had another antibiotic shot on Tuesday, even though their lab showed no infection, the culture sent off did. So now she told me the type of antibiotic shot he had would not help this gram negative bacteria. I have to call tomorrow to either get pills or a liquid she will order of a different antibiotic. Makes me wonder if perhaps he has had a low grade infection for awhile affecting BG values.

Just checked: +6 226
 
When the following PS is lower like that, it can be a sign the dose is too high, that's typically the explanation I have seen for that pattern on PZI. The pattern you want for the most part is a U-curve during the 12-hour period following a shot, so something like a 300 PS, 100 nadir at +6, and 300 PS again at +12. (Not that those are really the ideal #s, but just to show the pattern). Since you are seeing a drop all the way to +12, that suggests the dose is too high.

I would probably try shooting 1.5 2x day for a couple days (lowering if the nadir is below 50 or the PSs are below 150) and see where you are. If you get a [CORRECTION: PRESHOT!] below 150, I would wait for 30 minutes or an hour (depending on how much lower it is), and then shoot once he is over 150, rather than skipping the shot. I know you are used to once a day shooting so that is an adjustment. I think you'll be seeing better #s soon if you can get him on a stable BID dose. You are already seeing some blues which is great, just a matter of getting things more evened out so he is shootable every 12 hours.

p.s. thanks Judy!!!! :oops:
 
I agree, Angela, when you get a low pre shot at night, you need to cut back a little on the dose. You want a dose that will let you shoot every 12 hours. It will just take a little tweaking and a little time.
 
Here's Henry's numbers for the day so far:
PMPS: 461, 2U, +4.5 314 +7.5 354.
Called vet she thinks higher numbers in afternoon may be from Cosaquin we have given him the last 2 days for joint pain, but also may be from halfing the insulin dose in AM when he got 4.1 U prior to reducing to try to do BID dosing.
Will check him PMPS and see if BG is high enough tonight to shoot; just never know with him, but he is higher this afternoon for whatever reason, usually he's in low 200's by +4.
He also will start a half Cipro tonight for his UTI
I am going to stick with 2U for another day or two and see if starting antibiotic or discontinuing Cosaquin make any difference.
 
02/23/11
No shoot last night +12 193
AMPS 433, +4 354 +6 350
started antibiotic at 10:00PM last night.
high flat numbers today. Thought it was maybe from Cosaquin but he had none today. Maybe antibiotic or UTI?
I bought some fish varieties FF classics he started last night..thought they were on low-carb list, but will check list again.
 
You can let things ride awhile until the antibiotic kicks in and the infection kicks out.

The FF fish are lo carb, but high in phosphorous and mercury. We suggest limiting to once or twice a week.
 
When they are higher for most of the cycle and then drop down to a much lower # at the end of the cycle, with PZI that is often a sign the dose is too high. You are looking for a U-curve, with lower #s mid-cycle and higher at the ends (PS and +12). If you don't see that pattern, it usually means the dose is wrong (too high if the curve is inverse, drops low at the end, or slopes down the whole cycle; too low if it is just flat or is a shallow U-curve), or something else is going on, like eating high carb food early in the cycle or something oddball like that.

If it were me, I would try shooting a lower dose and see if you can get a more normal U-curve. Not to beat you over the head with it :-D but I would also then shoot the lowered dose in the evening cycle. Even if you feel unsure what to do, you might try some things and gather data on it, then you have something to compare to the results you have so far, and decide at that point where to go with it.

A/Bs and infection of course can also mess with the #s and give you wonky results, but those effects I wouldn't think would follow the same pattern on different cycles, it might be more like #s going up overall, or down overall.
 
02/23 AMPS +398 2U
This is one of the lower BG he has ever had in the morning. Maybe antibiotic is helping.
When he finishes the antibiotic I will see about dropping dose a hair. He was getting good drops into blues at nadir when he was on 4U in AM, yesterdays mid cycle numbers were some of the highest hes had for sometime, I am just afraid to shoot when he is <200 at +11+12 +13. He seems to be feeling really good the last few days and he is still walking better; haven't started the baby aspirin yet because he is getting around better still.
 
With your late nadirs and no shot in the pm, you have really halved the dose but are still dosing once daily. How about playing it conservative, cutting back to one unit twice daily and seeing what he does? You can always raise the dose if he is too high, but I really think twice daily dosing will make a huge difference.
 
How about 1.5? I just don't want him being up in mid 300's in the afternoon.
I will try 1U.
AMPS +398 +4 324 +6 357 PMPS 210 going to try 1U Hope it won't drop too low at nadir.
 
1u sounds good to me. Hope it goes great! Remember if you need any immediate advice and no one is here, post on Health. There is almost always someone there. It will take a little getting used to doing BID shots, but hopefully you will see better nadirs and more typical curve patterns, and you'll get the hang of it! I think you are seeing the high mid-cycle #s b/c the dose has been too high, so hopefully with the lower dose you will see a drop to a nice nadir. I would try 1u BID for a couple days and if the #s are a U-curve but still too high, then go up to 1.5, or maybe 1.25 depending on how the #s look. Anyhow, keep posting! If you want you can start a new thread each day, that helps people follow along.
 
Keep us posted and try for +6 test. Sounds like it's not been easy with Henry feeling under the weather from the UTI and disc problem. Best wishes!
 
+ 6 142 Dose was 2U this morning.
Fed and gave 4 Temptations treats after +4 BG of 137.
Thanks for the support Sue and Holly!
 
Just a hint for next time- numbers in the 100s are safe and even a few Temptations have carbs. Next time try a little bit of wet lo carb or lo carb snacks. (Oliver loved the freeze dried fish - Bonito flakes.). He might have gone further down with no carbs.


Might have been my comment -sorry. I wasn't worried about your number. It just was a big drop and I wanted to make sure you would test again.

You don't really need to intervene with any carbs until you hit the 40s.

I would get a lo carb snack - that could make a difference with your numbers.

viewtopic.php?f=14&t=9172
 
I have some freeze dried "jerky" type chicken vitamin treats.
I fed 1/2 can of FF low carb and the 4 Temptations treats after +4 because of steep drop.
Anxious to see what tonight will bring. update: +12 152 9:30 PM Going to check again in just a few minutes.
Thanks Sue.
 
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