Confused with numbers...

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Annemarie/Tigger(GA)

Annemarie/Tigger(GA)

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Hi everyone, last time I posted It was suggested to me to get some mid cycle numbers on Frazzle to find his nadir. Well I have yet to be awake or home to take a reading at +6 to find out. My concern is that his numbers are all higher than they were a week ago from when I started his SS. is this typical of newly diagnosed diabetics, I figured because he's on insulin his numbers wouldn't be getting this high? He has been on ProZinc for one month, but I just recently started tracking his numbers. The only thing that has changed in the last week was a dose increase from 1unit to 1.2units. Could it be that he is reacting badly to the increase and I need to go back down to 1unit?

I'm super frustrated...Frazzle on the other hand is doing great!

Any suggestions??

Thanks so much everyone

Annemarie
 
Hi Annemarie. :smile:

Without more history of mid-cycle numbers it's really tough to know what is going on. With the numbers you do have, I'd lean more towards 1.2u is too much (due to the higher numbers mid-cycle than at PSs). But, again, it's really tough to know without more numbers.

Are you feeding a low carb food? Is Frazzle eating only at PSs or throughout the day? Could some of the mid-cycle numbers have food on board? These are other variables that play a part.

Understanding how the insulin is working in Frazzle is the key to knowing what to shoot. I know it can be tough getting those numbers. Just get them when you can (like days off and such). :smile:
 
He eats either friskies or fancy feast pate, nothing over 7% carbs. I feed him in the morning before his shot, at 12 or 1 when my boyfriend is home he gets one fancy feast can and I feed him again before the evening shot. I also put down a fancy feast can when I go to bed. He's a really good eater, and usually eats everything when it's put down.

If I were to drop his insulin, could I just go ahead and do it or do I have to wean him down?

Annemarie
 
Going slow, raising or lowering, is best. You raised by .2u, you could easily go down .2u. :smile: (The exception is when testing low.)

I notice sometimes you aren't getting PS BG numbers. I hope that gets better. :smile: The PS numbers are important, too. Sometimes our sugar babies surprise us and test low at PSs, sometimes causing no shots or less insulin. Without getting those numbers, it's shooting blind. That's risky, and I'm sure you don't want that. :smile:

Today, Frazzle had a 540 at +6. Was this after eating mid-day or before?

If Frazzle were my kitty, and I was trying to get a handle on testing and everything, I'd stick with the 1u and get as many numbers as I could when I could (like days off) and all the PSs. Without the numbers, we're guessing on what to do. Make sense?
 
Hi Annemarie,

It's hard to be sure, but to me it looks like the dose could be higher rather than lower. It doesn't look like his numbers are dropping much on the tests that you do have in the middle of the shots.
I also think that black number in the middle of yesterdays' cycle was a meter glitch or a bad strip. The increase from 354 to 540 in just one hour is "illogical" seeing that it was only 405 a few hours later. I'm just guessing, but I think the AM test was probably somewhere in the range of upper 300's or low 400's?

Like I said, this is just me guessing when trying to fill in the blanks. I don't think the increase has caused worse numbers.

However, if you wanted to reduce, are you talking about just going back to 1u? Or were you thinking less than that?

The only decent drop I see is when he went from 402 to 243 on the PM cycle on the 16th.

The food you are giving him is fine, all "low carb" stuff.
I agree with what Teresa said about shooting without testing. It is possible that for some odd reason he would have a lower BG than you might think, at which point the dose might be too much. I know sometimes they don't cooperate when you need to test, and some times it's just impossible to do so. If for some reason you can't test at shot time, make sure and try your best to get a test 2 or 3 hours later, just in case his numbers are dropping.


Carl
 
Here's an early morning thought...is there any way at all of getting your boyfriend to learn to test? Him coming home around noon and feeding Frazzle may be the perfect time to get a BG. :smile:

(If he's like my DH, it's taken me 8 months just to get him to give a shot and still no luck on the testing! :lol: )
 
Are you off today and could you get a couple midcycle numbers today? That would help you see whether yesterday 500 was a bad test or whether he is truly going up midcycle instead of down.

If he goes up again midcycle, I think we would call it a pretty clear inverse curve and suggest you reduce. Maybe back to one unit or .5 if you can figure out a way to get midcycle and ketone tests. (when reducing the insulin, we want to be certain he is safe)

If yesterday's midcycle was a bad test or a fluke and he is going down at midcycle but not very much, I'd suggest increasing by .25
 
I am trying to convince him to test for me, but that's a work in progress :-D I got some mid cycle numbers today and he did go down. Now I'm wondering if I should stay at 1.2 units? I gave him 1 unit this AM.

Thanks for all your help guys!

Annemarie
 
I know you are trying hard! It is still an incomplete picture for us. Your 1.2 gave you a yellow preshot, which was great, although one unit did too a couple cycles ago. This is hard for us, Annmarie, but our primary focus is to keep Frazzle safe. If you were around to monitor and test, I think I'd suggest trying the 1.2 awhile. But since you aren't, I am nervous about that advice. The safest is one unit but it may not keep him below the renal threshold (generally considered 250 and below)


If there is any way you can get midcycle numbers, you can be more agressive. But if you can't, playing it safe is probably better. It may not be the path to remission, but truefuly, it would be hard to get there without more tests. And again, truefuly, it is possible for some cats and not for others, no matter what the bean does.
 
How does everyone get BG numbers throughout the day? I work and can't get home to test him, and the only reason my boyfriend is home now is because he lost his job. Even if I taught him to test he will be going back to work soon and I would be back to the same problem. I feel horrible that I can't get his numbers down because I'm not home enough. How does everyone manage this???
 
Most people who work wake up at night a few times a week and get a midcycle test. I know it's hard, but lots of people do it. Then, on the weekends, they do a curve. It does give you some information if you get a test as you walk out the door and in the door and before bed, but it's that midcycle number that really tells you how well the dose is working.
 
Ok well, I don't know what I'm going to do. I'm feeling very defeated, and sad for Frazzle because I will never be able to get him regulated. Thanks for your suggestions.
 
I never want to make you feel bad, Annmarie. I'm sorry if I did. I just try to give you the information. You can safely give him one unit during the week, testing before each shot. Maybe on the weekend, when you can monitor, try the 1.2 and see what it does over two days.
 
Annemarie,
You manage as best as you can, and that's all any of us can do. I tested Bob before every single shot. Other than that, I tested when I could. If I happened to be working a shift where I could stop by the house (I work on an island and I am never more than 3 miles from home) to test him during the day, I did. Or I'd test him once in the evening before I went to bed. He was on insulin for 10 weeks. I tested him more than 3 times a day perhaps once every two weeks. It was all I could do, and it sufficed.

There isn't a direct correlation between how many times you test per day, and how likely regulation or remission is. Testing provides data, and it provides safety and reassurance that the dose is not too high or too low. It doesn't guarantee success or results.

I believe that your dose could be increased. I am probably the most aggressive person who posts here regularly as far as "dose" goes. That doesn't mean I'm right or anybody else is right. What makes me hesitate to give advice is that your kitty is not my kitty. So what I will tell you is that if you choose to increase the dose, it should be on a day when you can be around to test in between shots. Like a weekend, or on a night where you don't have to worry about getting up the next day early. If you increase, you would want to be able to test at +4, +6 and +8 so that you can catch the "low point" as see what it is. You have to be able to know how to deal with lower numbers than you are expecting to see, just in case they do drop into the 40-50 range. That can be scary the first time or two that you see that big "50" on the meter display, especially if it happens before the normal nadir time.

I personally feel that you could up the dose to 1.5 without any problem, but I won't advise you to do that unless you can test during the cycle and be able to bring up his BG if you need to intervene.

What it really comes down to is that you hold the needle, and it is always "your call" no matter what anyone advises. The best thing to do is to read a lot, ask a lot of questions, and be prepared no matter what you decide.

Carl
 
Annemarie,

We do the best we can with what we have. I am one of those who cannot test at night. Sure, I can set my alarm and if I hear it I can get up and test, but then I'd never get back to sleep and it can cause my health issues to flair...so I don't even try it very often. I work close enough I can sometimes come home during the day at lunch to test (and I can test when I'm at home ill) but other than that, my mid-cycle testing is done on weekends.

Don't feel bad if you can't do mid-cycle tests when you have to work. Just do them when you're off. :smile:

The PS testing does get easier. Poopy now comes to me before testing time is due, wanting to be tested so he can eat. :-D They learn the routine. :smile:

As far as getting Frazzle regulated, being able to test does not insure regulation. True, it makes it easier to know what to shoot for insulin doses because we have better knowledge of how it's working. The better knowledge does not insure success. :smile: ECID (Each Cat Is Different) is a saying often heard for a reason. What works for one cat may not work for another, and often we can't repeat the same thing in the same cat! ohmygod_smile

Just do the best you can with what you can. Help is still in your reach. We just question ourselves over giving advice because there isn't much to go on.

It will get better. :YMHUG:
 
Thanks for everyones encouragement, it means a lot. I was feeling overwhelmed and frustrated, I'm better now :-D all I want is the best for Frazzle, I want him to be off insulin and live a long healthy life! He deserves it after the condition he was in when he was brought to the shelter, no animal should have to live the way he was living. I'm going to go back up to 1.2 units and get some numbers this weekend. If I go up anymore I want to be home to test every 2 hours right? Will I see a change that quickly or does the insulin have to build up in his system first?


Thanks everyone :-D

Annemarie
 
Depends; (ECID again) sometimes there's an immediate result for an increase, sometimes you have to wait to see. With Cassie I have to hold for at least 4 days (more like a week) for him to really settle into a dose.
 
Glad to see you back, Annmarie. I was afraid I had completely scared you away.

I agree with Lisa; you won't know how he will react until you try a new dose. If you can make the most of the weekend, try the 1.2 on Friday night and get a late night number. I don't think you need a full curve right away - maybe a number around +4 to +6 and then a +9 number on Saturday to see how long it is lasting. Then on Sunday maybe +3, +7 or +10 so you can see some different numbers. (Or some variation of that) Hopefully by Sunday night, we will have some idea of what the new dose is doing and at least know whether it looks safe for you to use it during the next week.

If you get any wonky numbers in the high or low range, retest.
 
Yes I'm back! I just tested his BG now, for a mid cycle test (his cycle was off a little) so he had his shot at 11:30 this AM. and it was 58, I tested it twice and it's real. So I'm feeding him how and I should retest every 15 minutes right?? He's never had a mid cycle number this low yet, what gives???
 
Awesome number for a +6!
Yes, you can test in 15-20 minutes. That food should bring it up a little, but it will take a few minutes to do so.
Carl
 
Lovely number! We don't start to worry until they are in the 40s. Hope you can test again to be sure he is headed up, not down.

This validates our nagging! If we had raised the dose based on the preshot, he might have gone way too low at nadir.
 
I live in Colorado, so don't know when 11:30 will be, your time. :mrgreen: Was the 98 at + 7 or later? How many hours until the shot tonight?
 
Then it's possible he might be up to 200 by shot time. Post with your number. Carl or I should be around.

I am thinking I wouldn't reduce much. So far, it is really a beautiful cycle with a lovely nadir. This dose is giving him a great cycle. The only complication would be if he had an early nadir and it was down in the 40s, before it got up to the 50s. Then we would want to reduce.
 
I hate to see you skip just when you are getting somewhere. Let's see if he is anywhere close. Maybe you can give a CSD (chicken $&#+ dose)
 
I'll be around too. I get off work at 10 eastern.
Carl
 
So did he come down this low because he's getting regulated or is this a fluke? I'm so shocked he was that low because I've never seen him go that low. All I see is high high numbers! Can I start to get excited??!! :smile:
 
I think a little excitement is in order. That was a nice number midcycle which shows the insulin is working, at a nice low dose.

Regulated kitties range between 200s at preshot and double digits at nadir for most cycles. This cycle was skirting regulation.

Don't be surprised if he bounces for pmps. We don't know if this was his first green or if he has had them before.

But I'd say it is positive news!
 
What you are seeing at +7 might be partially "bounce" and partially the boost he got from eating in the past 2 hours. Still a good number. :smile:

Carl
 
What great double news to see! Annemarie back on the board and sharing Frazzle's beautiful nadir number! Woohoo!

Often when new to diabetes kitties have a beautiful nadir number like Frazzle's, the PSs can tend to be high. Their poor little bodies haven't been used to seeing the low numbers, their bodies dump glucose in their system to "save them", and you get the high PSs. Carl explains it all so much better than I. :-D

Congratulations for getting the +6...as you can see, it really makes a huge difference on knowing what to shoot than just going by the PSs. :-D

Way to go Annemarie and Frazzle! :RAHCAT
 
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