Brady Continuing His End of Cycle Low Numbers (cont)

Status
Not open for further replies.
Irish Pat said:
its 830...should I just do 2U...what time do I shoot tomorrow if I do this?
Click to expand...
I haven’t had a chance to give you the info yet which I’m working on but with him going up that fast, I’d give 2.25u. You could shoot at 7:30 in the morning as long as he’s not sitting in lower numbers (199 or below) and is obviously dropping. If you see that scenario, you don’t want to shoot any earlier than 8.
 
Marje and Gracie said:
I haven’t had a chance to give you the info yet which I’m working on but with him going up that fast, I’d give 2.25u. You could shoot at 7:30 in the morning as long as he’s not sitting in lower numbers (199 or below) and is obviously dropping. If you see that scenario, you don’t want to shoot any earlier than 8.
Click to expand...

Ok, just took it again he is 432, im giving him his 1/4 can and shooting.....Will figure the situation out in the morning, he can get a treat or two in the morning
 
Irish Pat said:
Brady will be looking to eat at 530 AM tomorrow so i will be going thru a miserable bear for sure
Click to expand...
If you shoot at 7:30 in the morning, you can feed him some LC at 5:30 as that is two hours before you shoot.

You do not have to shoot now and you can get right on schedule tomorrow but be prepared his BG might go quite high. He has no ketones and is not post DKA, correct?
 
Marje and Gracie said:
If you shoot at 7:30 in the morning, you can feed him some LC at 5:30 as that is two hours before you shoot.

You do not have to shoot now and you can get right on schedule tomorrow but be prepared his BG might go quite high. He has no ketones and is not post DKA, correct?
Click to expand...


Our post crossed because I’m on my phone...I am shooting and will handle it in the morning
 
Marje and Gracie said:
If you shoot at 7:30 in the morning, you can feed him some LC at 5:30 as that is two hours before you shoot.

You do not have to shoot now and you can get right on schedule tomorrow but be prepared his BG might go quite high. He has no ketones and is not post DKA, correct?
Click to expand...


He had small amount of ketones when he was first diagnosed, I check his ketones when I can catch him heading to take a pee but he has had trace amounts, between trace and negative. I will give him a little food at his normal time in the morning then give him his normal meal or so at 730 after I check him of course. Some day, Lord, please help Brady and I get on a good level.
 
This is all a part of the learning process. Getting lower numbers than we expect at PS, being faced with a very hungry kitty, and the option of stalling can be overwhelming. It’s why my goal is often to get new members shooting lower and lower numbers gradually (but never below 50) as soon as we can so everyone is happy.....especially the cat.

The caveat is also that anyone shooting those green numbers above 50 must have the data to do so and also be available and able to test with all the required supplies including a hypo kit.

Discussing the two methods (I believe you have read the Prozinc Dosing Methods in the PZ Insulin Support Group), we generally suggest new members begin with SLGS. SLGS was the method used on this entire board for all insulins for quite some time. Subsequently, Tight Regulation (TR) was developed for Lantus and Levemir although there are still members in that ISG that use SLGS.

Experienced PZ users developed the modified PZ dosing method to offer a little bit more aggressive method to get into good numbers sooner. If a CG using PZ has started with SLGS and is not seeing any progress, they should switch to the modified dosing. Even within that dosing method, one can further modify it. For example, even though Goose was increasing the dose under the modified method, we started with him taking reductions when the BG fell below 90, then 60, now 50 as the method is written. It just allowed him to have a higher comfort level.

SLGS
Pros
  • less aggressive
  • generally less testing
  • less steep learning curve
Cons
  • potentially leaves cats at higher BG for longer
  • progress is slower
Modified Method
Pros
  • dose can be changed after six cycles instead of 14 if the dose isn’t working
  • reduction number is lower so a dose that is working can be held longer
  • higher rate of remission
Cons
  • steeper learning curve
  • more aggressive so requires a bit more testing
SLGS has worked for many members and cats do go into remission but if a CG has the ability to monitor, the modified dosing allows the CG to change the dose more often if it’s not working. My thought is if a CG has the ability to test as you have been doing, why make a kitty sit at higher numbers for a week before doing a curve when we can increase the dose sooner?

But, it really comes down to what works best for you all. Keep in mind that selecting one method doesn’t mean that you can’t switch to the other if it isn’t working for your kitty. It’s best to not mix and match the methods although I had Goose do it in regard to the reduction point just to get him more comfortable with lower numbers.

I’d suggest you and your wife discuss it. Perhaps you want to try the modified method while you are working from home although many members in the Lantus/Levemir forum do TR (which the modified method is somewhat like) and work full time away from home.
 
Pat

I won’t be up until much, much later after your AMPS. I will leave a couple scenarios for you but be sure and post and ask for help if you need to. I’m going to assume you probably want to follow the modified dosing while you are home to test. I’m also going to post info to help you start shooting 120-150, gradually getting you shooting lower until you can shoot 50 and above.

Please be sure you do not feed after 0530 and any food before then should be a small amount of LC.

AMPS at 0730:
BG 200 or more, shoot 2.25u and feed normally

BG 150-199: shoot 2.25u provided you can test and monitor and have foods to control the cycle (MC and HC if you need it).

BG 120-150: do not feed, stall, and post for help immediately but you’ll want to look at the same scenario as tonight.....stall 30 mins, retest, decide whether to shoot and how much to shoot (2 or 2.25u) keeping in mind how he skyrocketed last night. I would also strongly suggest that with this option, you have a member who has dealt with shooting lower preshots help you and stick with you until numbers are fairly flat after onset. If no one is available, I’d look at shooting a half dose as long as the BG is above 120.

Of course, when you read this, if you aren’t comfortable with something, keep safety in mind. Since you did shoot tonight, if you had to skip, it’s not the end of the world but I hope we can start building your confidence to shoot lower.

Keep in mind that if you need help, you need to edit the subject title to get help as in “4/24 Low preshot, need help please”.

Good luck and I’ll check in after I am up and get my cats cared for which will be close to noon your time.
 
Good morning...I took a few notes (advice) into consideration, since Brady dropped below 90 and probably would have continued to drop yesterday afternoon if he wasn't given a little food, which he did rise up to 106 but dropped right away after that to 81, this is the decision I made....Now with some advice on the future, or if you all think something needs adjusted, let me know. Brady was at 416 first thing this morning, he rose a little to 435, so he was fed and shot given at 7 am. Because he dropped yesterday afternoon and by some of the guidelines given, I reduced to 2U's this morning. I am going to give him this dose for several cycles based off the Modified Dosing routine. In that document, I see the below information, which again is a little confusing:

How to handle a low pre-shot number:
  • Sometimes your kitty will surprise you with a lower than normal PS number (but above 50). When that happens you have four choices:
  • Skip the dose: If the number is below 200, and your kitty is newly diagnosed (less than three months), your best option is to skip unless your kitty has ketones or is post-DKA (see below) and you should post here or in the Health Forum for help.
There is a lot of confusing things for a beginner to understand about these dosing methods and when to shoot and not shoot, quite frankly that's the scary part for us. Again, I read and read and read again these dosing methods and it is sometime quite confusing. The hard part is being totally available for your cat and making sure you can test, test, test....That is fine for now because im home. When things get normal, which i do hope we go back to normal, is where the complications will come in. Those daily testing's wont be able to be done on a regular basis so i have no clue what dosing method will work for us or how to keep Brady safe when life does go back to normal. Ultimately the best dosing method will be the one that will keep Brady from going hypo and keeping his sugar from going out the roof because nobody will be here 24/7 to make sure he is ok.....All the methods seem to be directed to being available to test, test, test and shoot doses in the low numbers and test to make sure when shooting those low numbers the kitty doesnt go hypo. The other problem i have is, Brady doesnt let my wife on a regular basis test him, in fact he doesn't like her doing it at all, he gets quite mad at her and it is difficult for her to do this on a daily basis as well. She isnt scared of him but when he gets her its alot different than when he gets me if you know what I mean. I will be going away in early May for several days and she will have to do this herself, she will be working and will do her best, but she is probably going to have to give him a dose based off his PS numbers because of testing, I dont know what to do there or how to guide her on what to do while im away. I dont ever want to give up on our precious buddy Brady, ever....But how do people do this that have busy lives and arent always available to test??? There has to be some right answer......So there is my struggles and concerns...Helping our cat, keeping him safe and doing this while not always being available to test to make sure he is ok, there is no way we are the only ones in this position, I just wish I knew how people do it.....

Hope everyone is safe and lets pray for normal days ahead!!
 
Uhhh Pat? Would your missus be willing to come here for any emergency or advice? I think that may be the best for all of you.

I remember those beginning days. I was a complete wreck. Couple that with not being computer savvy and its a disaster. But LOOK! I made it and so will you.
Marji said it beast when she said, this is a LEARNING process. Every day has been a calamity or a celebration. The important part of all that is DATA. All this will serve you. I know its a roller coaster of emotions and stress but thats what it takes. We have all, been where you are. Some have had it easier, some worse...MUCH worse.
I get it. Its a huge puzzle that keeps setting itself. Thats why this site exist. To guide us. I feel your anxiety. Its not unnoticed. I just wanted to be a clamming voice, in all that noise that IS feline diabetes.
:bighug:
j
 
jt and trouble (GA) said:
Now is the time to throw up your hands and say OH SHUT UP WOMAN! :p;):):coffee:
Click to expand...


LOL....no I would never ever say shut up woman, lol.....and I love your advice....Its not that my wife cant use this site, well, she is ok with computers, hahaha...shhhhhh don't tell her.....But its the availability she will have. Thank God I have her, we are both involved with Brady as best as we BOTH can be, she is the rock the keeps the house going...trust me she does that very well....But the issues will be normalcy whenever that happens and being involved with testing and proper dosage. I know its tough, but hopefully we can manage something for our guy.....In he back of my mind, and my mind is always going, lol....That's the things that worry me the most....What happens when we aren't home because we are at work and back to normal life...what happens to Brady then....trust me that's really been on my mind since he has been diagnosed.

Trust me I see comments and posts from other people, current ones and ones from the past...I know im not the only one that is filled with the anxiety of what this disease does not only to the pet but the CG's as well.....So as far as her coming here for advice while im away, I don't know...We also have an 11 month old grandson that is so precious to us, we do get to see him at least once a week to help out babysitting and we are very cautious with that due to this stupid virus...So all the stress and anxiety and then this diagnosis on Brady at the start of this stupid virus, not going to lie, it is taking a toll on us. Trust me im not saying my situation is worse than anyone else's because I know people are dealing with death and things unimaginable with this virus that makes our situation look like a party. But it is difficult.

And thank you...you made me smile with your above posts!!!
 
LOL GOOD! That is my intent to lift that cloud. I was under it too! About your missus...Please know I am the worst with computers. I was forced to come here and figure it all out. (heck I STILL dont know how to post a picture! If it dont have a link forget it.) She will be in good company! But I understand if shes reluctant . BUT in an EMERGENCY she is MORE than welcome to pick everyones brain here. We welcome her with open:bighug:

The other thing I have been thinking is, that "Normal" of which you speak. Sure it will happen and depending on where you live, it could happen sooner than say in California. ( I am a native Californian). BUT I believe thats going to be longer then we ALL think.
So the point is, this is the window, I and others never got. I worked a VERY demanding job when Trouble was diagnosed. Talk about stress! smh. I worked 40 miles away from home yet my mind HAD to be at work. Suffice to say I was a MESS. BUT? we did it. You have the leisure now, of coming here and devouring all the intricacies any time of day. USE this time now and you WONT be worried when our new normal comes back. ;)

You got this...I just know it. Heck you dont know it yet, but you do. Plus you have all the help you need, to make this diabetes thing your new normal. Its really a win win, even if it doesnt feel like it. :coffee:
 
Morning Pat

Just a few comments.

PZ should typically be given every 12 hours apart as best can but we do have flexibility and much more so than the L insulins.

When we need to shoot early, we aim for no more than an hour with a new member. An experienced member might shoot two hours early as they understand how to deal with the time. Because you shot around 8:30 last night, my recommendation to you was to shoot at 7:30 this morning to keep you in about that one hour range.

I also suggested you shoot 2.25u if the numbers were high because we have a technique called “shooting through the bounce” that allows you to get a little more insulin in the kitty when numbers are high after a bounce starts. My intent was then to see how he did today and discuss whether you wanted to drop the dose to 2u based on which method you wanted to follow.

What I didn’t want to do was overwhelm you more when you got up and were ready to shoot so my goal was to keep it concise with a plan you could easily follow and then we could discuss later. :)

I’m hoping each day brings you all a little more comfort in dealing with FD.
 
Marje and Gracie said:
Morning Pat

Just a few comments.

PZ should typically be given every 12 hours apart as best can but we do have flexibility and much more so than the L insulins.

When we need to shoot early, we aim for no more than an hour with a new member. An experienced member might shoot two hours early as they understand how to deal with the time. Because you shot around 8:30 last night, my recommendation to you was to shoot at 7:30 this morning to keep you in about that one hour range.

I also suggested you shoot 2.25u if the numbers were high because we have a technique called “shooting through the bounce” that allows you to get a little more insulin in the kitty when numbers are high after a bounce starts. My intent was then to see how he did today and discuss whether you wanted to drop the dose to 2u based on which method you wanted to follow.

What I didn’t want to do was overwhelm you more when you got up and were ready to shoot so my goal was to keep it concise with a plan you could easily follow and then we could discuss later. :)

I’m hoping each day brings you all a little more comfort in dealing with FD.
Click to expand...


So do you think im ok going to the 2U??? And see how that goes and make adjusts off of that???
 
Let me ask this, what is the "goal"?

I realize remission is the ultimate goal...However, I do a lot of research, and it seems there are a lot of articles out there indicating the goal of insulin is to get the feline to be in a BG range of 100-300 most of the day. To eliminate the symptoms of diabetes and keep the feline healthy. No excessive water drinking, no over urination....and avoiding constant high BG readings. Is that the goals on this forum or is the goals on this forum to try to reach remission, or both?
 
100-300 Is too wide a range for my liking but yeah. I think the goal is to keep Brady in a range that is between 90 and 200. IF that is healthy for him. If hes reading consistently in the high 100's and throws keytones then thats not good. Right? We had Trouble in remission for a short time before he went off the juice all together. ECID...You just have to find Brady's niche. and with all this testing and doing, you will.
Marje or Deb...
If I'm wrong thinking on this,PLEASE correct me.
j
 
Irish Pat said:
So do you think im ok going to the 2U??? And see how that goes and make adjusts off of that???
Click to expand...

Irish Pat said:
Let me ask this, what is the "goal"?

I realize remission is the ultimate goal...However, I do a lot of research, and it seems there are a lot of articles out there indicating the goal of insulin is to get the feline to be in a BG range of 100-300 most of the day. To eliminate the symptoms of diabetes and keep the feline healthy. No excessive water drinking, no over urination....and avoiding constant high BG readings. Is that the goals on this forum or is the goals on this forum to try to reach remission, or both?
Click to expand...

It depends on your comfort level.

The only time a cat’s pancreas beta cells (important for producing its own insulin) can heal is if the cat is in the range of 50-99 on a human meter. Therefore, the goal is typically to get the cat really well regulated (which we call tightly regulated). There have been tightly regulated cats who do not go into remission and need just a tiny amount of insulin.

Having said that, there are members here who are fine with their cat being below renal threshold. Renal threshold is where the kidneys dump sugar into the urine; being above renal threshold for extended times impacts the kidneys in the long-term. Renal threshold can vary but is generally thought to be around 250 on a pet meter. One can get an idea of their own cat’s renal threshold by buying the urine glucose sticks and testing the urine for sugar and then comparing it to the BG. For my Gracie, she seemed to dump glucose into her urine at about 200 on a human meter. The lowest I’ve seen a member report (and it’s a small group who take the time to do this) have found their cat’s renal threshold was around 150.

Keeping that in mind, your goal might be to keep him in the 100-150 range.

In terms of dosing, if your goal is to get him to normal numbers sooner where you can aim for him to more be tightly regulated, than you’ll want to do the modified dosing method and, in that instance, I’d suggest going back to 2.25u and learning to shoot lower.

If your goal is to just keep him below renal threshold, you might choose to go slower and hold the dose at 2u.
 
Last edited:
Marje and Gracie said:
It depends on your comfort level.

The only time a cat’s pancreas beta cells (important for producing its own insulin) can heal is if the cat is in the range of 50-99 on a human meter. Therefore, the goal is typically to get the cat really well regulated (which we call tightly regulated). There have been tightly regulated cats who do not go into remission and need just a tiny amount of insulin.

Having said that, there are members here who are fine with their cat being below renal threshold. Renal threshold is where the kidneys dump sugar into the urine; being above renal threshold for extended times impacts the kidneys in the long-term. Renal threshold can vary but is generally thought to be around 250 on a pet meter. One can get an idea of their own cat’s renal threshold by buying the urine glucose sticks and testing the urine for sugar and then comparing it to the BG. For my Gracie, she seemed to dump glucose into her urine at about 200 on a human meter. The lowest I’ve seen a member report (and it’s a small group who take the time to do this) have found their cat’s renal threshold was around 150.

Keeping that in mind, your goal might be to keep him in the 100-150 range.

In terms of dosing, if your goal is to get him to normal numbers sooner where you can aim for him to more tightly regulated, than you’ll want to do the modified dosing method and, in that instance, I’d suggest going back to 2.25u and learning to shoot lower.

If your goal is to just keep him below renal threshold, you might choose to go slower and hold the dose at 2u.
Click to expand...


What kind of test strips are used to test the urine? Do you get them in the common store? Do you have brand names?
 
Marje and Gracie said:
It depends on your comfort level.

The only time a cat’s pancreas beta cells (important for producing its own insulin) can heal is if the cat is in the range of 50-99 on a human meter. Therefore, the goal is typically to get the cat really well regulated (which we call tightly regulated). There have been tightly regulated cats who do not go into remission and need just a tiny amount of insulin.

Having said that, there are members here who are fine with their cat being below renal threshold. Renal threshold is where the kidneys dump sugar into the urine; being above renal threshold for extended times impacts the kidneys in the long-term. Renal threshold can vary but is generally thought to be around 250 on a pet meter. One can get an idea of their own cat’s renal threshold by buying the urine glucose sticks and testing the urine for sugar and then comparing it to the BG. For my Gracie, she seemed to dump glucose into her urine at about 200 on a human meter. The lowest I’ve seen a member report (and it’s a small group who take the time to do this) have found their cat’s renal threshold was around 150.

Keeping that in mind, your goal might be to keep him in the 100-150 range.

In terms of dosing, if your goal is to get him to normal numbers sooner where you can aim for him to more be tightly regulated, than you’ll want to do the modified dosing method and, in that instance, I’d suggest going back to 2.25u and learning to shoot lower.

If your goal is to just keep him below renal threshold, you might choose to go slower and hold the dose at 2u.
Click to expand...


Along the lines of the pancreas, Brady was diagnosed with pancreatitis, im sure you saw that on his SS....However, his numbers are in such a gray area...when he was first tested, he was at 5.5 on the spec Fpl, he had two other tests after that...the second he was 4.5 and this last time he was 4.4....Don't know how much knowledge you have on panc?
 
Irish Pat said:
Along the lines of the pancreas, Brady was diagnosed with pancreatitis, im sure you saw that on his SS....However, his numbers are in such a gray area...when he was first tested, he was at 5.5 on the spec Fpl, he had two other tests after that...the second he was 4.5 and this last time he was 4.4....Don't know how much knowledge you have on panc?
Click to expand...
I wrote the Primer on Pancreatitis if you haven’t seen it. It might give you some additional info. I would definitely say he might or might not have had pancreatitis. I know that’s no help but his results don’t convince me one way or the other. Was he symptomatic?

But having pancreatitis is separate from the healing beta cells can do.

Did he have an ultrasound? The reason I ask is because even the specfPL and snapfPl can be affected by inflammation of adjacent organs. For example, my Gracie had an elevated specfPL and had several ultrasounds. Her pancreas was normal in every one of them. However, her liver enzymes were elevated and she had some intestinal inflammation. She was never diagnosed with pancreatitis by the board certified feline internal medicine specialist we saw. He felt her test results were indicative of inflammation of adjacent organs and I’ve seen that with other cats in this forum who have had the tests and the ultrasound. Gracie actually never even had any symptoms indicative of pancreatitis.
 
Last edited:
Marje and Gracie said:
I wrote the Primer on Pancreatitis if you haven’t seen it. It might give you some additional info. I would definitely say he might or might not have had pancreatitis. I know that’s no help but his results don’t convince me one way or the other. Was he symptomatic?

But having pancreatitis is separate from the healing beta cells can do.

Did he have an ultrasound? The reason I ask is because even the specfPL and snapfPl can be affected by inflammation of adjacent organs. For example, my Gracie had an elevated specfPL and had several ultrasounds. Her pancreas was normal in every one of them. However, her liver enzymes were elevated and she had some intestinal inflammation. She was never diagnosed with pancreatitis by the board certified feline internal medicine specialist we saw. He felt her test results were indicative of inflammation of adjacent organs and I’ve seen that with other cats in this forum who have had the tests and the ultrasound. Gracie actually never even had any symptoms indicative of pancreatitis.
Click to expand...


Brady did have symptoms of panc, but obviously the same symptoms for panc are very similar to FD. He had weight loss, he was a little lethargic and dehydration. He really didn't have any vomiting or any thing else. The vet did not give him an ultrasound or any other test, only the blood work. He is currently on cerenia for the pancreatitis.
 
Status
Not open for further replies.
Back
Top