? Comet: 4 Weeks In - Progress and Dosing Help?

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Lauren & Comet

Lauren & Comet

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Hello all,

I've been at this since last Monday and since I began testing Thursday, the 1 u is simply not enough to get her where she needs to be (see SS). We are going for a vet consult (took the advice here and will be curving myself tomorrow) on Tuesday. Her next dose is in about 40 minutes. I was thinking of experimenting with 2u tonight and, if all goes well, tomorrow for her curve.

Bad idea? Thoughts?

I just feel like what I'm doing now is not helpful and want to do something sooner rather than later if possible.

TIA!
 
She is definitely high - great job getting all the data. It allows you to see that she is not bouncing from highs to lows but is pretty high and flat.

I think an increase is a good idea, but I'd suggest increasing by 0.5. Hold that dose 3 cycles and then increase again, if you see no movement. Sometimes if you increase by too much too fast, you can bypass a good dose. The other issue is that if she has only been on wet low carb for a little over a week, it might kick in at some point.

No infections? No dry food?
 
Nope. Only freeze dried chicken as a treat when testing. Other than that, just the canned food. The vet had mentioned it would probably be okay to go up to 2u but I was petrified of the idea until I found this board and can test. I'm no longer blind! Haha.
 
Sue and Oliver (GA) said:
She is definitely high - great job getting all the data. It allows you to see that she is not bouncing from highs to lows but is pretty high and flat.

I think an increase is a good idea, but I'd suggest increasing by 0.5. Hold that dose 3 cycles and then increase again, if you see no movement. Sometimes if you increase by too much too fast, you can bypass a good dose. The other issue is that if she has only been on wet low carb for a little over a week, it might kick in at some point.

No infections? No dry food?
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I'll post her test numbers here before I shoot.
 
Lauren, you are doing Great!! @Sue and Oliver (GA) is amazing and you are in the best possible hands with dosing recommendations.

It takes a long time to get them where you want to see them. So don't worry if Comet stays kind of high for awhile... She is so much better off with insulin on board and especially with you checking her. Good job! :joyful:
 
Well all, headed to bed with a +5 @324, essentially where we started this morning. Thanks for all the encouragement. I am a lot less stressed knowing a have a group that I can ask questions.
 
From dry? If so, usually within 3 days all the dry food carbs should be cleared from her system.
 
Not every cat shows a huge drop. It looks like you might just need to increase dose? I would do it on a day where you can test mid-cycle in case it works really well.
 
Yep, the drop happens sometimes...not always. With the way the numbers are staying high throughout a cycle, I think Carl is right. An increase when you can monitor might help.
 
Carl & Polly & Bob (GA) said:
Not every cat shows a huge drop. It looks like you might just need to increase dose? I would do it on a day where you can test mid-cycle in case it works really well.
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Rachel said:
Yep, the drop happens sometimes...not always. With the way the numbers are staying high throughout a cycle, I think Carl is right. An increase when you can monitor might help.
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Thanks to you both. I'm planning to increase to 2u this weekend starting with her Saturday morning dose.
 
Increased to 2u this morning and just completed a 12 hr curve. Dropped out of the red for PMPS so that's something at least. I'm going to attempt to continue for a possible 24hr. As she is always pink for AMPS, I am curious how her numbers do at night...
 
She did drop, which is good. Some numbers overnight would be good. Have you seen the protocol we put together? It is in blue in my signature.
 
An option when you do a curve is to test every three hours if you don't want to do every two hours. At +3, +6. and +9, assuming a "typical Prozinc cycle", you would still catch "onset", "nadir" and the climb that follows after nadir. And get some catnaps between tests. ;)
 
Sue and Oliver (GA) said:
She did drop, which is good. Some numbers overnight would be good. Have you seen the protocol we put together? It is in blue in my signature.
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Thanks for mentioning the protocol. I tried reading it a few weeks back and got very confused. I just read it again and it makes complete sense! It's amazing how much I have been taught and learned since dx!
Carl & Polly & Bob (GA) said:
An option when you do a curve is to test every three hours if you don't want to do every two hours. At +3, +6. and +9, assuming a "typical Prozinc cycle", you would still catch "onset", "nadir" and the climb that follows after nadir. And get some catnaps between tests. ;)
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The 3 hr test will be a life saver tonight! haha. Thanks for the info! :D
 
We woke up in the yellow this morning! 247 AMPS. It made me nervous to shoot her 2u but by looking at the spreadsheet, she never drops more than 100-150 during her cycle. I checked again before I left for work and she was at 320 +1. Maybe we're making progress?! I'll be anxious to see where we are PMPS... Thanks everyone!!
 
A yellow pmps! Fantastic. The +1 is likely a food spike.

Two choices for tonight. You might get a bounce if she drops lower than her body is used to. Or you might get a lower pmps because she surfed all day in nice numbers. Paws crossed for the latter. Regardless, good choice for the dose. Looking back at her previous cycles is the perfect way to determine what to shoot.
 
Comet had a great day today! Going to bed with a 202 +4.

Now my question is: how should I handle the morning? As long as she is over 200, give the usual dose? If she is under 200, feed, wait, test again to ensure it goes above 200 then shoot?

Though it's late, I'm hoping I can have a game plan for when I wake up in the morning. It's exciting to see her in lower numbers but scary too... :nailbiting:
 
Looks like the amps came down a few points this morning, Lauren but still a little high. Can you plan on getting some midcycle numbers this weekend and maybe upping the dose a smidge? You are getting nice safe numbers, but she could definitely come down more for pre shots and probably more for nadir.

You are using a human meter, correct? If so, regulated numbers are generally considered to be in the mid 200s at preshot and in low hundreds or double digits at nadir, but above 50 - which is approaching hypo territory. So that is your first goal: regulated numbers. She is getting there.
 
Hi Lauren - You are doing absolutely wonderfully. I know it's hard but it just takes a while - I've been at this since August and how Murphy handles insulin now is so much different than at the beginning - it seems their bodies take awhile to adjust to it
While I am still having surprises, it does get better and you just have to be patient - hang it there - you and Comet are off to a great start!! Remember- it's a marathon, not a sprint!!
 
Good Saturday everyone! I tried to get in for a consult with her vet this weekend (mainly to keep him in the loop) but he is off this Saturday and never returned my call. I am out and about all day today but plan on upping her dose tomorrow with monitoring every couple of hours. I only have U40 syringes so will go up to 2.5u. With her numbers still high like they are and me to be here to monitor, I feel comfortable doing so. I will eyeball 2.25 if I need to going forward.

Turns out I have a job interview in California next weekend and will have to board her Saturday through Tuesday. I am nervous leaving her with the vet but truly have no other choice this go around. :nailbiting:
 
Congrats on the job interview! You have a week to get some testing in, try the new dose and see how it works?

Re her boarding: I would think she is likely to run high(and therefore be safe) but the wild card is eating. If she doesn't eat and they give insulin, they need to monitor carefully. Often, if you take her favorite food, put a note on her pen with feeding and insulin instructions and put something that smells like you in with her, that helps (an unwashed tee shirt often works)
 
Sue and Oliver (GA) said:
Congrats on the job interview! You have a week to get some testing in, try the new dose and see how it works?

Re her boarding: I would think she is likely to run high(and therefore be safe) but the wild card is eating. If she doesn't eat and they give insulin, they need to monitor carefully. Often, if you take her favorite food, put a note on her pen with feeding and insulin instructions and put something that smells like you in with her, that helps (an unwashed tee shirt often works)
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As for boarding, she is currently scheduled at her vet. They gave me a little bit of a hard time in regards to "approving" her boarding. I am going to call her vet tomorrow and discuss her current state as well as boarding procedures. Part of me is afraid they will adjust according to their ideals vs my instructions. Maybe that's silly....

While I was awaiting the call back for her "approval" I called a nearby boarding facility. When I asked about protocol for diabetics, she was very open doing whatever I requested. They have a couple of vet techs on the staff and care for several special needs pets on a consistent basis. She made me feel very comfortable. Comet boarded with them about a year and a half ago and seemed to enjoy it (purring, loving on everyone, watching the fish in the tank).

It's a $7 difference between vet and boarding ($13 vs $20) but maybe the extra charge is worth it for peace of mind? Especially since they wanted to give me a hard time about boarding one of THEIR patients... Thoughts? Opinions?
 
In the end, she is your baby, and it's your decision. It sounds to me like your vet might not be willing to follow your instructions...sometimes that happens. If they are already giving you a hard time, it might be worth your peace of mind to put her in a place where they are willing to listen to what you want. Plus, you already know she does well there.

If she was mine, I think I'd go for the boarding facility vs the vet. BUT it's your decision...whatever you think is best.
 
It's kind of funny to me because you would think the best place would be at the vet's but then I think that in a boarding facility, that is their focus in trying to make the pets comfortable when the owners are away. I wonder how much time each place would give to Comet. Will he stay in a crate all day? Can he get out and roam, climb a cat pole? Will Comet meet other kitties? Will he get petted and maybe some lap time with someone? Are they available to Comet 24 hours? Can they recognize any illnesses? For me, I always make a little list of things that are important (like the questions that I just asked) to me and try to rate between the two. See what comes up on top and then add the money equation part to it. Good luck.
 
Okay everyone! She just had a 195PMPS. Yay blue!

Now I had upped her to 2.5u last night after speaking with the vet. Should I back it back down tonight after she eats? Maybe to 2u?
 
What a nice blue. First, how about another test to be sure she is rising, not falling. It seems like 2 units would be a good dose - if she is going up, not continuing to drop. It is hard to be sure about what dose to give, and what the dose did, as we don't know what happened during the day today.

If you end up shooting two units, I would plan to get a before bed test and, if it is showing a rapid drop, some monitoring later.
 
Sue and Oliver (GA) said:
Looking at SS. Brb.

Can you monitor tonight if needed?
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Sue and Oliver (GA) said:
What a nice blue. First, how about another test to be sure she is rising, not falling. It seems like 2 units would be a good dose - if she is going up, not continuing to drop. It is hard to be sure about what dose to give, and what the dose did, as we don't know what happened during the day today.

If you end up shooting two units, I would plan to get a before bed test and, if it is showing a rapid drop, some monitoring later.
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I'll for sure test before shooting. Will test again at 7. She did fine with her numbers last night on the 2.5 so I was surprised to see it so "low". I can monitor if need be.

I'll post the 7PM numbers in a min.
 
I'm making out the instructions for Comets "vacation" this weekend. I'm thinking 2.5u for a pretest 300+ and 2u for 200+. Just to be on the safe side. Thoughts? Anything else I need to make sure to include?
 
Just tested Comet before bed and came in with a 41 at +4. She has never been in the green much less this low. I've given her some high carb treats and tested again every ten min (47,43). I'm now terrified to sleep.

She is exhibiting no symptoms. In fact, she was just running around the house like a kitten. Anyone out there that can talk me through this?
 
Well handled on that 41 and on getting her back up. Please do make sure you test again - preferably in 30 minutes rather than an hour. We usually like to see them above 50 and rising for more than one test before going to 1 hour testing just in case they drop back down when the carbs wear off.
 
Glad you got her back up, Lauren. Many time you get no response here, post on Health where there should be more eyes.

Looks to me like you need less insulin at the lower ranges. You can lower it to 1.5 or so when she is nearer 200. But it would be best, before changing dose amounts, if you could get some mid cycle numbers this weekend. Then you'd know exactly what is going well on. Does she dip low in the middle or toward the end of the cycle? Is it low enough to warrant a dose drop? Does she reach her lowest numbers at the end of the cycle?
 
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