Cassie 9/18-tid amps 214!
- Thread starter bookw0rm
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Wasn't expecting this! Went ahead & shot reduced .5 & will be checking later. Maybe I should have stuck w/ .6 but honestly this is so much lower than usual I was afraid to.
kse
Very Active Member
Good Job! I would have shot the .5 also.
There are no rules and definitions to any of this, but it does take some time to get them adjusted to dosing patterns. Hopefully, yesterday is an indication that Cassie it taking to TID.
I will share one more thing from my experience---normally when I get a low preshot like you did this morning, the next preshot shoots up some. I am yet to find the "key" to holding on to the low preshot on the next cycle. So, don't be alarmed if the midshot preshot is 300 plus. If so, just stick to your guns and don't panic. You can see this reflected in my SS.
Good Luck!
There are no rules and definitions to any of this, but it does take some time to get them adjusted to dosing patterns. Hopefully, yesterday is an indication that Cassie it taking to TID.
I will share one more thing from my experience---normally when I get a low preshot like you did this morning, the next preshot shoots up some. I am yet to find the "key" to holding on to the low preshot on the next cycle. So, don't be alarmed if the midshot preshot is 300 plus. If so, just stick to your guns and don't panic. You can see this reflected in my SS.
Good Luck!
Ginny & Alex
Very Active Member
Very nice AMPS!!
Rob & Harley (GA)
Very Active Member
Yay, maybe Cassie is getting used to tid.
I would have reduced the dose too and don't agonize over it, it was only 1 drop, besides it is more data gathering.
I hope you both have a great day.
I would have reduced the dose too and don't agonize over it, it was only 1 drop, besides it is more data gathering.
I hope you both have a great day.
kse
Very Active Member
It might be food...but, check out Kitty's SS on low preshots. They go up the whole cycle. Sometimes, I wonder if the low test is just a timing issue--where we catch the bg right before the "big" increase. I don't know, I just know that I have a hard time holding Kitty down on low preshots. The best preshots for us are the 280 range....they don't drop drastically, nor do they increase greatly. Crazy....but, true!
kse
Very Active Member
I ask because hydration can play a big role in insulin absorbtion. I am not suggesting it, just thinking...I give Kitty sub q fluids...when her numbers get wonky or when she appears dehydrated and they help lower her bgs. I think Carl also gave them to Bob. Maybe he will chime in......
C
Carl & Polly & Bob (GA)
Guest
hmmm, that is a pretty good weight gain in 5 days. If he's been a little piggie this week, I suppose it is possible. I tried to put half a pound on Bob recently and it took about 2 weeks, but I was "trying" by giving him extra calories on purpose. I know they can lose that much that quick when they are sick or un-contolled, but putting the weight back on is usually tougher. Now that you have a weight from your scale, you can compare "apples to apples" and not have to worry about the difference in scales thought.
As for the questions on fluids. Kim and I have discussed how they affect Kitty's numbers, and I agree with Kim that in Kitty's case, they lower her BG a half day or so after administering them. IIRC, Kim uses them when Kitty has p-titus flare ups?
I can understand why they would help Kitty. If her p-titus flares up, she's feeling lousy and maybe in some pain. That would raise her BG. And the fluids would remove the symptoms, so her BG would go down because she feels better. Same with dehyrdation. If the fluids remove the condition, the BG should improve as a result.
When it comes down to insulin absorption, it seems counterintuitive that pumping fluids into a cat would help the insulin absorb better, or more quickly, but that is the effect it appears to have with Kitty. And I guess that as long as the fluids and the insulin are being shot into different parts of the body, then one shouldn't intefere with the other. If you shot both into the same place, like the scruff, it would seem that the fluids would "dilute" the insulin, and you'd figure you'd see less of a positive effect on the days you give fluids. If you're giving fluids in the scruff, and insulin say in the flank, then you wouldn't see a dilution. Maybe the fluids enable insulin to absorb better, or maybe more slowly. In the case of more slowly, then if you are a TID schedule like Kitty is, then that 10-12 hour improvement might be caused by insulin overlap? If it takes the AM dose longer to absorb because of the fluids, then it may overlap with the MD shot until the sub-q fluids clear the system.
Does any of that make sense?
Carl
As for the questions on fluids. Kim and I have discussed how they affect Kitty's numbers, and I agree with Kim that in Kitty's case, they lower her BG a half day or so after administering them. IIRC, Kim uses them when Kitty has p-titus flare ups?
I can understand why they would help Kitty. If her p-titus flares up, she's feeling lousy and maybe in some pain. That would raise her BG. And the fluids would remove the symptoms, so her BG would go down because she feels better. Same with dehyrdation. If the fluids remove the condition, the BG should improve as a result.
When it comes down to insulin absorption, it seems counterintuitive that pumping fluids into a cat would help the insulin absorb better, or more quickly, but that is the effect it appears to have with Kitty. And I guess that as long as the fluids and the insulin are being shot into different parts of the body, then one shouldn't intefere with the other. If you shot both into the same place, like the scruff, it would seem that the fluids would "dilute" the insulin, and you'd figure you'd see less of a positive effect on the days you give fluids. If you're giving fluids in the scruff, and insulin say in the flank, then you wouldn't see a dilution. Maybe the fluids enable insulin to absorb better, or maybe more slowly. In the case of more slowly, then if you are a TID schedule like Kitty is, then that 10-12 hour improvement might be caused by insulin overlap? If it takes the AM dose longer to absorb because of the fluids, then it may overlap with the MD shot until the sub-q fluids clear the system.
Does any of that make sense?
Carl
kse
Very Active Member
Every vet I have used (none of whom I am crazy about!) say that the fluids make the kitty more hydrated-- thus making them more "porous" and enhancing absorption. They compare it to a hard dry sponge vs. A moist sponge trying to absorb water. They all say that fluids help lower the bgs.... I can't explain it, but they help Kitty!
I do administer fluids and the insulin in different locations-- and at least 2 hours apart.
Maybe if a cat is fully hydrated on it's own , then this would all be irrelevant!
Makes for good conversation.....!
I do administer fluids and the insulin in different locations-- and at least 2 hours apart.
Maybe if a cat is fully hydrated on it's own , then this would all be irrelevant!
Makes for good conversation.....!
C
Carl & Polly & Bob (GA)
Guest
OK, as far as my experience with Bob and sub-q fluids goes... Bob and I are very familiar with them. I've been through 4 1000ml bags since May 10th or so.
At first, when Bob was just diagnosed DKA, I had to give him 2 100ml treatments a day, to rehydrate him. That was only for a couple days, then we cut back to 100ml a day. A few days later it went to every other day, then 3x a week, then 2x a week.
The original reason was to rehydrate. Once that was accomplished, the vet found that his potassium levels were too low. So, they added potassium to the 2nd bag, and I continued the sub-q fluids, not to rehydrate, but as a means to get the potassium into his system. This continued for a couple of months. It did help, and at one point he got up into the normal potassium range. Today he's a little below normal, which is why I've been looking into other ways to give him potassium. He and I just got tired of doing the "humpty-backed camel" thing when the primary reason for doing it was to give him potassium.
Alright, this is where I address the insulin absorption with fluids thing, and reveal Bob's dirty little secret... The question of "do fluids inhibit or aid the absorption of insulin" never applied to Bob. He was getting sub-q insulin in the scruff before the fluids treatment began. About a week. When my vet told me I was going to flood his scruff with fluids, she never told me to change sub-q locations of the insulin. Instead, she told me, and showed me how, to inject Bob's insulin inter-muscularly (IM shots). Her reasoning was that in doing so, the whole fluid and insulin question would be avoided. So for the final 9 weeks of his dance, he got BID injections of insulin into the big muscle (what we would call our hamstrings) in his back legs. I posted once in a "where do you shoot insulin?" thread that I did this. The 2 responses were "insulin is never shot that way", and "I can't believe a vet would tell you to do that" or words to that effect. At that point, I dropped out of the discussion. I was following vet orders, and I didn't want to argue about it, and it was working, which was the only thing that I cared about. That's the reason that you never saw any posts from me asking for dosing advice, or ever saw me create a SS. I didn't feel it would be worth the hassle to be told I was doing something "wrong", and have all the threads become a pros vs. cons thing. So I winged it.
One day, I'll post "Bob's Tail, A Case for IM Injections" in the Think Tank. All I know is that even if Bob was the only cat in history to get IM shots, it worked! Tomorrow he'll be off the juice for 2 months. I try not to advise others based on Bob. Most of the advise I give is based on what I have seen and read here, and from analyzing people's SS's. I do think I understand how PZI works, and I can examine someone's data and try to figure out what is going on and what will help, so that's what I try to focus on.
This I can tell you. I know that I shot pretty big doses (up to 3 units) into "non-shootable" numbers on a regular basis. And I know that Bob never displayed any hypo symptoms. The lowest I every tested his BG at was a 44, and I didn't flinch. All I did was keep an eye on him for a little while, then stopped worrying about it. I knew "what to do" if I needed to, but I never needed to. I also know that I would never tell someone else to dose that way.
I don't worry if you shoot a reduced dose into a low PS if I can see on your SS that kitty has not dropped severely before on that dose. But the huge difference is that your kitty isn't my kitty, and I realize that nobody worries more than a sugarcat's bean does because it's your cat, and it's right there in the same room as you are, and no matter what decision you make, it's you that has to live with it, not me. So I tend to be pretty conservative when it comes to dosing unless I see data that makes me not worry. In that case, I see my "job" as convincing you not to worry.
Bottom line - I am not qualified to tell you what the combination of sub-q fluids and sub-q insulin does to BG. I think it helps, but I've never done it.
whew. sort of glad to let Bob's secret out actually.
Carl
At first, when Bob was just diagnosed DKA, I had to give him 2 100ml treatments a day, to rehydrate him. That was only for a couple days, then we cut back to 100ml a day. A few days later it went to every other day, then 3x a week, then 2x a week.
The original reason was to rehydrate. Once that was accomplished, the vet found that his potassium levels were too low. So, they added potassium to the 2nd bag, and I continued the sub-q fluids, not to rehydrate, but as a means to get the potassium into his system. This continued for a couple of months. It did help, and at one point he got up into the normal potassium range. Today he's a little below normal, which is why I've been looking into other ways to give him potassium. He and I just got tired of doing the "humpty-backed camel" thing when the primary reason for doing it was to give him potassium.
Alright, this is where I address the insulin absorption with fluids thing, and reveal Bob's dirty little secret... The question of "do fluids inhibit or aid the absorption of insulin" never applied to Bob. He was getting sub-q insulin in the scruff before the fluids treatment began. About a week. When my vet told me I was going to flood his scruff with fluids, she never told me to change sub-q locations of the insulin. Instead, she told me, and showed me how, to inject Bob's insulin inter-muscularly (IM shots). Her reasoning was that in doing so, the whole fluid and insulin question would be avoided. So for the final 9 weeks of his dance, he got BID injections of insulin into the big muscle (what we would call our hamstrings) in his back legs. I posted once in a "where do you shoot insulin?" thread that I did this. The 2 responses were "insulin is never shot that way", and "I can't believe a vet would tell you to do that" or words to that effect. At that point, I dropped out of the discussion. I was following vet orders, and I didn't want to argue about it, and it was working, which was the only thing that I cared about. That's the reason that you never saw any posts from me asking for dosing advice, or ever saw me create a SS. I didn't feel it would be worth the hassle to be told I was doing something "wrong", and have all the threads become a pros vs. cons thing. So I winged it.
One day, I'll post "Bob's Tail, A Case for IM Injections" in the Think Tank. All I know is that even if Bob was the only cat in history to get IM shots, it worked! Tomorrow he'll be off the juice for 2 months. I try not to advise others based on Bob. Most of the advise I give is based on what I have seen and read here, and from analyzing people's SS's. I do think I understand how PZI works, and I can examine someone's data and try to figure out what is going on and what will help, so that's what I try to focus on.
This I can tell you. I know that I shot pretty big doses (up to 3 units) into "non-shootable" numbers on a regular basis. And I know that Bob never displayed any hypo symptoms. The lowest I every tested his BG at was a 44, and I didn't flinch. All I did was keep an eye on him for a little while, then stopped worrying about it. I knew "what to do" if I needed to, but I never needed to. I also know that I would never tell someone else to dose that way.
I don't worry if you shoot a reduced dose into a low PS if I can see on your SS that kitty has not dropped severely before on that dose. But the huge difference is that your kitty isn't my kitty, and I realize that nobody worries more than a sugarcat's bean does because it's your cat, and it's right there in the same room as you are, and no matter what decision you make, it's you that has to live with it, not me. So I tend to be pretty conservative when it comes to dosing unless I see data that makes me not worry. In that case, I see my "job" as convincing you not to worry.
Bottom line - I am not qualified to tell you what the combination of sub-q fluids and sub-q insulin does to BG. I think it helps, but I've never done it.
whew. sort of glad to let Bob's secret out actually.
Carl
bookw0rm
Very Active Member
Carl, thanks for sharing.
Kim, ditto.
I'll take all the advice I can get. I'll probablly ask the vet about sub-q fluids if Cass is still throwing wonky numbers when we go back in a couple weeks. It certainly can't hurt to ask.
Cass has never shown hypo symptoms except when he was dka. When they referred him to the vet hospital his bs was 24 when admitted. We had one scare early when he got down to 45 (on 1u) but no symptoms.
I honestly think if I can get his numbers down to a decent range he'll stay there without too much hassle. He's showing fairly consistent (if high) numbers on a low dose.
I'm wondering if he'll eat kitty kisses made from canned food if that will convince him to try wet. (I think it's Mel's recipe from the dehydrated cat treats thread over in FH.)
Kim, ditto.
I'll take all the advice I can get. I'll probablly ask the vet about sub-q fluids if Cass is still throwing wonky numbers when we go back in a couple weeks. It certainly can't hurt to ask.
Cass has never shown hypo symptoms except when he was dka. When they referred him to the vet hospital his bs was 24 when admitted. We had one scare early when he got down to 45 (on 1u) but no symptoms.
I honestly think if I can get his numbers down to a decent range he'll stay there without too much hassle. He's showing fairly consistent (if high) numbers on a low dose.
I'm wondering if he'll eat kitty kisses made from canned food if that will convince him to try wet. (I think it's Mel's recipe from the dehydrated cat treats thread over in FH.)
C
Carl & Polly & Bob (GA)
Guest
The whole "kitty won't eat canned food" thing is so frustrating for me. In the 30+ years I've been owned by cats, I have never had one that didn't eat canned food. The little ones we always started that way, but the orphans and strays and shelter kitties we've taken in over the years, it's just never been an issue. I guess we always assumed they'd eat it, so from day one, that is what they got. They also got dry put out for grazing, and the only time that has ever changed is since Bob became diabetic. I just ditched it, and two cats who have been eating dry and wet for over a decade just went with the flow. Before I joined this board, I didn't know there was such a thing as a kitty not liking canned food.
I wish I could tell you some sort of magic trick to make it happen with Cass. But try the kisses..... something's got to work!
If cat's had opposable thumbs, they'd rule the world, I think.
Carl
I wish I could tell you some sort of magic trick to make it happen with Cass. But try the kisses..... something's got to work!
If cat's had opposable thumbs, they'd rule the world, I think.
Carl
bookw0rm
Very Active Member
I probably haven't pushed the transition as hard as I should. He went through the not wanting to eat with the dka. He refused to eat more than a bite or so of the wet at the vet & they finally resorted to dry. I didn't want to push him to not eating so I switched slowly to evo. Maybe if he has no other option he'll eat canned but I don't think I'm willing to risk a hunger strike, at least not until he's back to a decent weight.
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