Doesn't look like a bounce but reading staying high

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NancyJac

NancyJac

Member Since 2013
I'm upped Hairy's dosage slightly. I wasn't going to for at least another week but that was when his midcycle readings were in the blue. The last 3 tests were in the red including a midcycle one. I thought one shot might have been a fur shot when the nest PS reading was high, but now I don't think so because they have stayed high. I did 1.25 last night and this mornings preshot was still in the red but a little lower than the day before. The blue midcycle reading 3 days ago doesn't seem low enough to have triggered a bounce and he has not had a change in diet so not sure what to make of this.

Just as a reminder, don't tell me I need to test more frequently cause that ain't happening and the testing is what it is and isn't going to lower his BG per se.
 
I don't know how you expect people to help you without the testing..... without those numbers, there is no way to really see what is going on..... if it were me, I would reduce the dose, not raise it based on the small amount of data you have and the fact that testing is a problem. Find one of BJM's posts and there are some links in her sig that will help you monitor kitty's health without the testing... something is better than nothing
 
Quite honestly, I'm getting pretty tired of the obsession people have on this board about testing. I have explained and defended my rationale for not testing more repeatedly and I'm not going to do it again. If the only way I can get support from this board is to do more testing, then it is completely useless to me.

I am testing once/day either at AMPS or midcycle. My assumption is that this are the apex and nadir of each cycle. That assumption could certainly be wrong, but it could still be wrong even if I tested him more often. I am looked at lots of different spread sheets on this site and have yet to find one where additional daily testing has told more of a story than PS and MC readings. I am not saying there aren't any, just that it appears that the majority of advice is given based on PS and MC readings even when there are others in between. I also monitor him closely for symptoms which I have include in the comments section of his SS.

The impression I am getting from several people that have responded to my posts is that they either tell you exactly what to do as if it were an absolute certainty or, at the other extreme, if they aren't certain, it is my fault because I am not testing enough. Thank you for those that take the middle ground and offer info, suggestions, or possibilities without telling me what I must do or that I am at fault. So times it seems that this board is more about high horses than diabetic cats.
 
Nancy,

I have read every one of your posts and quite honestly, I do not understand what you expect from this group.

You have clearly told us that we are not medical professionals and have no business doling out medical advice, especially when it comes to dosing, yet here you are (again) asking for our opinions on your dose. You told us that you will only accept dosing advice from your vet and will only do what your vet tells you. So, what is it you are asking from us?

We have told you that the only way anybody will even feel comfortable providing our non-medical opinions regarding dosing is from the data that BG testing offers. Yes, we understand that you cannot get tests and nobody is telling you to do so or asking you to explain the reasons yet again. There are alternative ways to testing that doesn't require getting blood from the cat. But again, you don't seem to acknowledge these alternative testing methods and instead focus on our asking you to test more.

We are in a quandary of wanting to help you help Hairy, yet every suggestion or idea is ignored or negated by you. And let's not forget how you have clearly told us that we are not medical professionals and have no business giving this kind of advice....yes it bears repeating.

So, while I know you are sitting there taking offense to what I am writing and preparing to lambast me, may I suggest that before you get defensive and do this, that you please tell us what you want and expect from this group of non-medical professionals.

In simple words - do you want us to help you? How do you want us to help you? What are the acceptable answers you are looking for from us?

I really don't know what information or suggestions to offer and you have received a lot from several members here who are excellent at helping new members get past the fear of diagnosis and help them to understand the next steps and how to help their cats.

We can talk about food, types of insulin available, dosing protocol for that insulin - in general terms, the importance of home testing, even the weather.....

We are happy and willing to help you, but non of us non-medical professionals feel comfortable discussing specific dosing for Hairy without the needed data to help us, help you, help Hairy. For anyone to give specific dosing information, it would be inappropriate and negligent on our part.

We get that you can't take blood, but you must understand that we are limited in exactly how to help you.

Now feel free to blast me if you must.
 
Amen...

And I would add that while everyone was so busy trying to support you there were other folks that were neglected, including one with a critically ill cat.

Let us help those who will listen.
 
Hillary & Maui said:
You have clearly told us that we are not medical professionals and have no business doling out medical advice, especially when it comes to dosing, yet here you are (again) asking for our opinions on your dose. You told us that you will only accept dosing advice from your vet and will only do what your vet tells you. So, what is it you are asking from us?
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First of all, no where in my OP did I ask for advice or opinions. I simply stated that I had changed his dose even though I was not sure what cause his higher readings. However, personal experience and opinions are welcome and usually helpful.

Hillary & Maui said:
We have told you that the only way anybody will even feel comfortable providing our non-medical opinions regarding dosing is from the data that BG testing offers.
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Really? Then why was I told to change the dose after his very first insulin dose and 1 BG test? And that OP didn't ask for dosing advice either. See posting.php?mode=quote&f=28&p=1099699

Hillary & Maui said:
We are in a quandary of wanting to help you help Hairy, yet every suggestion or idea is ignored or negated by you.
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You think? The fact is I have read every link that has been provided, printing several of them for future reference, have gotten many useful tips from people here that I have implemented to get blood from Hairy's ear, diet suggestions, and what other results (5Ps, etc.) to look for and what symptoms to look for and actions to take in a hypo event (which fortunately I have not had.), just to mention a few.

I just don't know what additional words I can use to convey what I am trying to get across. I am not saying I am right, but it seems to me that over time, this board has become very entrenched in the "numbers" and sometimes just can't seem to see anything past that. I wholeheartedly agree that more testing provides more data but if you can't help me or anybody else unless I have more numbers, and you assume that every post is a request for dosing advice, then, yes, you are correct, you cannot help me.
 
If you are not looking for dosing advice and this post appeared that you are, then please tell us what you are looking for.

And people - my intent was not to start a war of words with Nancy, so please do your best to keep your comments constructive and not hurtful.

But seriously Nancy, please tell us what it is you want from us, so that we can answer your questions and not get into nastiness.
 
nancy, i won't tell you you have to test more.

if you're trying to figure out what's going on... what i can say with certainty is this... and I'll be very candid:

there's no way to know if hairy needed a dose increase OR a dose reduction based on the data you've collected so far.

not enough insulin can result in high numbers.

too much insulin can result in high numbers.

has hairy been bouncing from missed lows?


hairy dropped into green and then bounced after his very first shot of 1 unit. was the drop simply an initial reaction to receiving exogenous insulin (which we have seen before) or is 1u bid too high of a dose for him given the cumulative nature of lantus?

understand the problem? without more data, i don't know what to suggest that will help you and i couldn't tell you how many lantus and levemir spreadsheets i've studied over the years.

"we" want to help, but you have to give us something to work with because as much as many of us want to help... i don't know of anyone here who will intentionally make suggestions or comment if their comments/suggestions could put your cat or anyone else's cat's life in jeopardy. "we" just won't take that risk. safety is our number one priority.

i can appreciate your efforts to test a fractious kitty. i hear the frustration in your voice. get the blood tests when you can. in the meantime, for your own peace of mind, please utilize BJM's list of Secondary Monitoring Tools.

lastly, i'm truly sorry you feel the board is more about high horses than diabetic cats. that's not what this board is about. this board is about many, many caring and dedicated volunteers who freely give of their time to help caregivers of diabetic kitties...





Edited to Add: echoing hilary's comment... please, let's keep this constructive folks.
 
Hillary & Maui said:
But seriously Nancy, please tell us what it is you want from us, so that we can answer your questions and not get into nastiness.
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Ok, I'll try again. Perhaps I made a bad assumption that this board was not just for asking questions but also for sharing experiences. I am not a subtle person. When I have a question, it will usually be a sentence that start with a word that begins with a "W" and ends with a question mark. I'm really not trying to be flippant here, but I don't know of another way to say this more clearly. I can see that many people on this board have been dealing with feline diabetes for a long time and as such their knowledge and opinions based on their experience is unique and invaluable. I always appreciate those that share their experiences, whether they apply directly to me or not, and opinions, whether I agree with them or not.

But, if I have misunderstood the purpose of this board, and it is intended to be limited to 911 situations and dosing advice, then I apologize for wasting everyone's time and/or taking attention away from those that do have 911 situations and are wanting dosing advice. Again, it is not, and has never been, my intent to be rude or unappreciative. I have benefited from the information, opinions, and experiences that I have found here. My only complaint is that to get that and to participate on this board, I have to take repeated beating from folks because I don't test enough to suit them.

So, please, if I am wrong, and this board is intended to be only about dosing advice, BG numbers, and 911 situations, just tell me so and we won't waste each other's time any more.
 
Nancy,

There are many forms of support that you can get from this board. Knowledge on day to day management of diabetes, How-to's, vet research,emotional, physical, financial to name a few. We are trying very hard to provide the information you need to help your cat and make him feel better.

I know you consider our suggestion to test your cat at least 4 times a day to be something you can not do. The reasons we already know. More than one test a day is all you will be doing. We understand that and accept that, at least I do.

You must also understand, that as our primary goal is to keep your cat safe, we are conservative in our suggestions on dosing changes. With only a single test a day, I know of no one posting here, not even the most experienced with more than 8+ years of experience and 33,000 posts that would be willing to make any suggestions on the dose for your cat or tell you if this is a bounce or if the bounce has cleared.

With only a single number per day, there is nothing to compare it to. There is no frame of reference. No context to put that number into.

The people that suggest more testing are often those that have personally experienced a severe hypoglycemic event with their kitty, seizures or coma, and had to rush their cat to the vet for lifesaving treatment. I personally know of at least one member who's cat died, hypoglycemia induced coma. Most cats show absolutely no symptoms until they have a seizure or fall into a coma. There is a member right now, doing rehabilitary treatment for her cat, to get the cat back to being able to walk and eat properly. It will be a long extended process and financially very expensive to do that. We prefer to prevent those hypoglycemic events in the first place.

So what you call an obsession with testing, is our concern to know our cats numbers are not dropping too low and headed to a hypoglycemic level, that the insulin dose given is effective, when to adjust it as needed to get the best chance of control and possibility of remission and most of all, to keep our kitties safe.

Use of the secondary monitoring tools, weekly visits to your vet to have them do a curve, not monitoring at all and making dose changes based on your vet's best guess are the only 3 options I can think of as alternatives to daily testing.

I'm sorry you feel that we push the testing, but we do feel it's very important.

We can still make suggestions on other aspects of the diabetes care, give you money saving ideas, provide emotional support, cheer you on, and answer any other questions you may have in regards to the feline diabetes. It's only the insulin dosing changes and related aspects that we do not feel we can adequately give good answers for without more testing.

Please, let us know how else we may help you, outside the testing arena. If you do not think we are able to help you with any aspect of care for your diabetic cat, I urge you to work closely with your vet and get as much clarification from them as possible.

ETA: Jill and Alex is one of those extremely experienced users I mentioned. She may not post much any more, but she is one of the top experienced people we have here on the FDMB.
 
Squeaky and KT said:
Nancy,
Guess I'm going to get on my 'High Horse' because HOW DARE YOU come here and act like you're acting while people are trying their absolute best to help you at the expense of others. If you want to kill your cat, I give up...go ahead...you're NOT going to blame it on us./quote]

Where the heck is that coming from? What have I EVER said to make you think I would blame you or that I am wanting o kill my cat?
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My cat Ozy, who has been on insulin for about two months is still all over the place. In the past week or so he has been as high as 400 and also went critically low to 31. If I weren't testing, I wouldn't know that.

I hate getting up in the night to test him. I hate when he realizes I am about to test and tries to hide. But I sure prefer testing to a diabetic coma.
 
ok, folks... donning my moderator hat.

emotions are running high. how about taking a step back for the moment and while you're at it how about cleaning up posts which are derogatory before a moderator has to do it?

going forward... let's keep comments constructive, please.

thanks.

~ jill
 
Jill and Deb,

Thank you for understanding. I agree with you completely. I do understand that testing is important. And because Hairy's tests are very limited is why I have not asked anybody for dosing advice. But I do have a follow on question to that. I know that multiple tests/day proportionally increases the likelihood of capturing the actual nadir, but it still doesn't guarantee it right? In other words, if testing is done at +4, +6, and +8 for every cycle, that certainly dramatically increases the odds of capturing the nadir, but it could have been at +5 or +7 for any given cycle, right? So, given than I am only testing once/day are my odds at catching the nadir best at +6? And if the +6 reading is in the red consistently, would it be likely that the surrounding readings (i.e. +4, +8) would be hypo level green?
 
So, given than I am only testing once/day are my odds at catching the nadir best at +6? And if the +6 reading is in the red consistently, would it be likely that the surrounding readings (i.e. +4, +8) would be hypo level green?
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Yes on the first question. Odds are it happens around +6, but no way anyone knows for sure.

And no on the 2nd question. There aren't necessarily greens that close to the red at +6. They could be happening earlier or later, by hours, in the cycle.

I shouldn't probably be posting while driving but wanted to hop in...
 
nancy, i have guests here and i'm trying to serve them lunch.
i'll have to get back to you after they leave. ok?


a gentle request for everyone...
please, play nice while i'm gone. :mrgreen:
 
I'm very sorry if you took my post as anything other than what it was... MY OPINION.. I even stated 'if it were me' and I stated the reason/s I would have made that decision. I didn't take your post as a request for dosing advice, I wouldn't have even posted at all if I had thought that was what you were after. I was just as confused on this as everyone else seems to be, not sure what you want I guess. I'll keep my nose out of your business from now on, but really, I'm very sorry if I offended you.
 
Thanks Carl, that was my assumption too.

Of course Jill, I have to get to work too.

It wasn't personal, Barb. Not an excuse, but it just seems that every topic I start, somebody has to comment about my lack of testing, whether it is relevant to the topic or not, and I've become rather sensitive about being beat up about that.
 
Everyone, I did not intend to start a war of words here or anything of the sort. I just got frustrated after reading the posts and seeing this today and I apologize for starting something, rightly or wrongly.

Nancy, the issue about Nadir and what time does it happen is, that there really isn't a one size fits all answer for that.

For example, I took care of a cat named Blue, who was newly diagnosed, given Prozinc. He wasn't my cat, but was in my home and I was caring for him for an entire month. It was challenging to get him to calm down and be able to test him. I somehow managed and it was good that I did, because within 1-3 hours (it varied each cycle) he dropped and reached his nadir.

I was able to manage this by adjusting the carb level of food I gave him and when I gave him back to his person, it only took another two months before he went into remission. She followed the food process I came up with, which was very simple - I served him foods that ranged from 0-8% carbs and labeled each can with the percentage, and depending on how quickly and how many points his BG dropped depended on what carb % or mix I gave him to snack on.

So you can see that is why we can't say for certain that 6 hours or 8 hours after shot is nadir and by getting tests in at those times, will give you the nadir.

There are people here who do test very frequently (I sometimes think a bit too much), but they are getting the needed information and they know their cat and well, I think you can understand how the numbers are important.

While you may not have written your statement in the form of a question, using a question mark and starting with a W, I read it as you were asking a question. If I was wrong, my apologies.

As Deb and Jill pointed out, this is a forum where we share information, ask questions, get help. so, if I misunderstood the intent of this post, again I apologize, but it did sound to me like you were asking a question or at a minimum, looking for information.

And if you took what I wrote about beating you up over not testing, I certainly WAS NOT doing that. I read your posts and your reasons for not testing.

Some things you can do for the future to avoid having to explain it yet again or feel beat up -

1) add a line to your signature that states you are testing as often as you can and that you have a fractious cat

2) add the same line to your SS - this way it's clearly stated and you don't have to repeat or explain it over and over

Would that be something you are willing/able to do?
 
I'm going to offer a radical suggestion...

Nancy, if all you are able to manage at this time is one test per day, and if that test is going to be around nadir, then what do people think about switching insulin?

As you've realized, Lantus is less predictable, in terms of PS and nadir logic. There is a "typical" curve we can show you, and you have probably seen it already. It says that the PS numbers should be the highest, and that the low point should take place about six hours later. But you've also received lots of words of caution that "typical" might not be what you see on any given day. And that prohibits just about anyone with a lot of experience to feel safe or good about dispensing dose advice based on just one test per day.

You should also realize that when it comes to dose advice, we will always err to the low side if there's any doubt. Which is why people have suggested a lower dose based on only one number. That's just common sense safety stuff.

Nobody knows for sure, even if they've done this for a decade, when nadir is going to happen. They have a boatload of data that shows when things should happen with their cat and others. But there isn't anyone here, with 200 posts, 2000 posts, or 20,000 posts who doesn't get a "surprise" out of their meter on any given day.

I'm thinking that in your case, Prozinc might be a better choice given your circumstances. Is the nadir always going to be at +6? No. But the way prozinc is designed to work, it should be close. And it should happen on a more regular basis. Some days, your +6 test might reflect a bounce. Some days, they'll be bounce-free. And some days you'll see a scary low number. But for the most part, you won't be considering a "depot". Prozinc doesn't work that way.

But no matter what kind of insulin you use, there are going to be times when you will absolutely have to test more than once. If you see a 45 at +6 on prozinc, you're going to have to feed HC food and test again in 30 minutes. Again, that's just common sense safety stuff. And most of the advice you would get if and when that happens is going to be that you reduce the next shot, and try to test before giving it.

I'm just thinking that switching might be a good idea?

Carl
 
One test a day. She has already told us the maximum number of tests she will do is one a day. We need to respect her choice.
 
NancyJac said:
I know that multiple tests/day proportionally increases the likelihood of capturing the actual nadir, but it still doesn't guarantee it right? In other words, if testing is done at +4, +6, and +8 for every cycle, that certainly dramatically increases the odds of capturing the nadir, but it could have been at +5 or +7 for any given cycle, right?
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correct.

NancyJac said:
So, given than I am only testing once/day are my odds at catching the nadir best at +6?
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the odds are hit or miss at best.

NancyJac said:
And if the +6 reading is in the red consistently, would it be likely that the surrounding readings (i.e. +4, +8) would be hypo level green?
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not likely with a kitty who has read the manual and is on board with the program, but very possible if you have a late nadir kitty (nadirs between +8 and +12).

at the risk of sounding redundant...
i/we simply can't conclude much from the data collected so far. hairy may be over dose. hairy may be under dose. hairy may be dropping low at night and then bouncing. hairy may have a late nadir and then bounce. hairy's nadir may be at different times. i don't know.

my immediate concern is hairy could be dropping lower than we know and then bouncing. is he dropping to 100s, 200s, or somewhere close to the hypo range? again, i don't know.

was it a good idea to raise the dose or should the dose have been reduced? i don't know.

another concern i have is lantus kitties are known for dropping more at night than during the day. is hairy? i don't know.

i'm pretty good at reading what i call "the invisible numbers" on a spreadsheet (figuring out approximate numbers in-between scarce tests based on patterns), but there's just not enough data for me to even attempt it at this time with only one test a day. i WISH i could offer more insight...

the next best thing to testing hairy's blood is to use the secondary monitoring tools linked in BJM's signature. hairy is not the first nor will he be the last kitty we see who will not cooperate with blood glucose testing. all you can do is do the best you can with the available tools. vet curves plus the use of secondary monitoring tools may be very, very helpful to you.



just voicing some of my/our concerns and thoughts...
i'll be back later tonight in case you have any questions or concerns of your own.
 
That was the premise for my suggestion, Deb. But if you see a hypo, you have no choice in the matter but to test again. So it would be an exception to "normal" and not a new normal.
 
re: switching insulins

carl, you have a better grasp of what it takes to use the P insulins effectively than i do.
i defer to your judgment.
 
Carl & Bob said:
That was the premise for my suggestion, Deb. But if you see a hypo, you have no choice in the matter but to test again. So it would be an exception to "normal" and not a new normal.
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Yes, I agree there are exceptions, such as the case of a hypo where you need to test more. Another possibility in the case of a hypo is of course to take your cat to the emergency vet.

With one test a day, Prozinc may be a better choice for Nancy and her sugardude Hairy. Like Carl said, no depot to contend with.

There are always pros and cons to whatever way you decide to treat Hairy and what insulin you use.
 
Hillary & Maui said:
Some things you can do for the future to avoid having to explain it yet again or feel beat up -

1) add a line to your signature that states you are testing as often as you can and that you have a fractious cat

2) add the same line to your SS - this way it's clearly stated and you don't have to repeat or explain it over and over

Would that be something you are willing/able to do?
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Of course I am willing and able to do that. I thought I had with the comments I had put in Hairy's SS. It isn't that I can't test more than once a day, it is that I won't. I have to compare the advantage of doing 2-3 more test every day against Hairy being injured by struggling or having him spend the rest of his life in constant fear. So if I were to add something like "Hairy is only tested once/day do to other medical/behavioral concerns.", do you think that would stave off having to constantly explain and defend my decision?

Carl & Bob said:
I'm thinking that in your case, Prozinc might be a better choice given your circumstances. Is the nadir always going to be at +6? No. But the way prozinc is designed to work, it should be close. And it should happen on a more regular basis. Some days, your +6 test might reflect a bounce. Some days, they'll be bounce-free. And some days you'll see a scary low number. But for the most part, you won't be considering a "depot". Prozinc doesn't work that way.

But no matter what kind of insulin you use, there are going to be times when you will absolutely have to test more than once. If you see a 45 at +6 on prozinc, you're going to have to feed HC food and test again in 30 minutes. Again, that's just common sense safety stuff. And most of the advice you would get if and when that happens is going to be that you reduce the next shot, and try to test before giving it.
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I think the reason my vet wanted Hairy on Lantus is because it is long acting (i.e. "depot") so that theoretically I could use lower and less frequent doses. I would definitely test him more frequently if he had a hypo event. In that situation, a life threatening event would certainly trump the risk of injury and behavioral concerns.

Your suggestion is worth considering though and I will discuss it with my vet next week when I see him.

Jill & Alex said:
not likely with a kitty who has read the manual and is on board with the program, but very possible if you have a late nadir kitty (nadirs between +8 and +12).
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So given that I am testing once/day, do you think it would be more useful to vary the time of the tests? In other words, instead of testing at +6 or +7 all of the time, test at +3 or +9 sometimes?
 
Just wondering if Hairy objects to the testing? Does he struggle?
Instead of doing one test a day, how about two tests one day and none the next at least until you determine a good dose? To really find out what is going on you really need a BG before insulin and and one at about +6.
After I find a good dose I only test before each shot and only in between when I get strange readings.
 
To say that Hairy objects and struggles would be an understatement.

Interesting idea about testing twice one day and not at all the next. I have been alternating somewhat between testing PS some days and midcycle other days. I'm a little concerned about going a whole day without testing at all, although when I test AMPS one day and then midcycle the next day, it is more than 24 hours between tests. Will ask my vet about this option too when I see him next week. I also have to consider schedules. I am usually at work at +6 3 days/week so with your suggestion that would mean those would have to be don't test at all days.
 
I do not think test twice one day and skipping a day is any more dangerous than not testing before each shot, which you have to do if you only test once a day.
 
I would definitely test him more frequently if he had a hypo event. In that situation, a life threatening event would certainly trump the risk of injury and behavioral concerns.
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You could save yourself that. When I first joined here, I didn't test very often, and I quit because of the "testing nazis" who were nagging me. I felt belittled. Then my cat got ketones in his urine. It cost me $5,000, and it nearly cost him his life.

Now my cat is starting to be regulated. The old guy who I love so much is coming back.
 
You're getting a nice variety of suggestions here. We're "thinking outside the box" or ECID, Every Cat is Different, Every Caregiver is Different.
 
This is somewhat OT and really more of probable user error. I have received some of the same posts that are here also in my PM inbox. I don't know if the duplication was intentional or it was a glitch, but since I first saw those comments as a PM rather than a post here, I replied to the PM. Which leads my other possible user error. When I submit a reply to a PM I get a message that it was submitted but it shows as still being in my outbox rather than my sent mail. So if you don't get my reply, it isn't because I didn't reply, but because I'm not sure if I am doing it correctly.
 
FYI: A PM message will sit in the Outbox until at least one of the recipients has opened the PM. Then, it gets moved to the Sent messages box. Mailboxes do get full, so you need to delete the messages, or at least some of them periodically.
 
My apologies, I didn't look for the info in your SS - but I was already aware of your testing situation..

Regarding changing insulins - the main difference between Lantus and Prozinc is that Lantus can stay in the system longer, due to the "shed" build up. Which is why giving a shot late or early and frequently changing doses can become problematic - others can explain this better than me.

With Prozinc and the reason why Carl suggested it, is because it doesn't build up that shed and while it is supposed to last 12 hours (give or take), it is more forgiving if you shoot late or early or frequently change the dose (even tweaking by a couple drops give or take).
 
HI Nancy...No dose advice, suggestions or anything from me tonight..I think I've given you all the tricks I had already anyway...but I noticed you'd added a picture of Hairy!! It may have been there for awhile and I just hadn't noticed though

What a pretty kitty he is!!! His tail looks like he'd have a bit of trouble in a room full of rocking chairs though!

You're a classy looking dude, Hairy!
 
Hi Chris,

I just added his photo this morning. He's not exactly the best photography model so I had a hard time finding a photo of him that would still look good when cut down to the small thumbnail size. I decided to go with one that showed off his pretty tail and coat rather than an extreme close up of his handsome face. confused_cat
 
NancyJac said:
So given that I am testing once/day, do you think it would be more useful to vary the time of the tests? In other words, instead of testing at +6 or +7 all of the time, test at +3 or +9 sometimes?
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i don't think it would hurt to vary the times you test. however, i honestly don't think testing only once a day will yield much, if any, useful information. let me rephrase that. you might just get lucky by happening on a low.

NancyJac said:
It isn't that I can't test more than once a day, it is that I won't. I have to compare the advantage of doing 2-3 more test every day against Hairy being injured by struggling or having him spend the rest of his life in constant fear.
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you do know there's a real possibility hairy will become accustomed to testing over time? we've seen it happen over and over again. most sugar kitties and their caregivers eventually develop a bond greater than they've ever had prior to diabetes.

when i teach local caregivers to test their kitty i always bring along a heavy sweatshirt, heavy gloves with the fingertips cut off, and a Cat Restraint Bag (rarely needed)... in case i feel like i could be bitten or scratched. i don't rush the cat, i encourage everyone to remain calm and speak in soft voices. we sit on the floor until the cat comes to us. of course, i bring various kinds of treats & toys to lure them in if necessary. :mrgreen: i also ask the caregiver to supply food/treats they know their cat likes. i've never used force nor do i struggle with the cat so there's not a chance the cat could become injured. this method has worked and worked well so far. yes, it takes time... there's no rushing involved. occasionally, i've had to go back a second or third time, but it's worth it. most caregivers feel empowered after mastering the art of hometesting when their cat does not associate hometesting as a bad and/or stressful experience.

just sharing...
 
I work mostly with feral and abused cats. That is a whole different ball game from working with house cats, even ones that are shy or skittish. I have handled many abused and feral cats to medicate them, to sedate them, and to assist in surgery on them. I have been working with Hairy for 3 years. During those 3 years I had the luxury of not forcing him or struggling with him. During those 3 years, he has gone from being terrified of people, dogs, other cats, and even inanimate objects to being to being calm and even sociable as long as people and other animals keep a reasonable distance. He has on occasion even played with and groomed one of my other cats and will occasionally come up and sit beside us for a few minutes. But he still does not like to be picked up or held and will move away from you immediately if you initiate any contact with him even without picking him up. Hairy is currently at least 15 years old. Even without diabetes, he may not have 3 more years. So my option are:
1. Don't treat him at all and when uncontrolled diabetes outweighs his quality of life, euthanize him. And based on his recent weight loss and muscle wasting he was already not far from that point.

2. Follow the ideal protocols for diabetic treatment and maybe get to a point of tight management or remission with Hairy reverting to his previous mindset of constant fear.

3. Treat his diabetes but in a minimally invasive way in hopes of maintaining an acceptable quality of life (physical and behavioral) for his remaining years.

I have chosen option number 3.

And, yes, it is possible, though not likely, that Hairy will at some point almost magically decide that being touched, let alone poked, multiple times a day is tolerable, let alone enjoyable, but I can't make the hard decisions based on what is not likely. Believe me if Hairy were to turn into a typical house cat at any point in time, I would adjust accordingly. But for now, this is my cat world and I do what I feel is best for any of the cats in my care. It has nothing to do with my limitations or abilities and everything to do with Hairy's total well being which consists of a lot more than just being diabetic. I truly do appreciate all of you on this board, but I ask that you respect my decision even if you can't identify with care for special needs cats (and I don't mean because they have diabetes). I know you all have the best of intentions, but stop with the testing more often and how to handle a cat stuff. I've been there, done that. If you can't interact with me on this board without bringing up more frequent BG testing or cat handling techniques, then I respectfully request that you just don't respond. There is more to caring for a cat, even a diabetic one, than BG testing.
 
Nancy,
Thank you for explaining more in depth. Especially by listing your three options.
I was very lucky with Bob, and never had to face the choices you faced.
Given those three choices, I can completely understand you picking #3.

Of course, my hope is that if Hairy eventually is able to deal with one test per day without major problems, that he'll do what other cats have done, and be able to deal with more. If that never happens, then that's your "reality", and you'll do what you can.

I'd also like to say thank you for what is that you do for ferals and abused kitties. You have to deal with the ugly side of "humanity" on a daily basis, and it takes someone special to do that.

I'll do whatever I can to try to help, but all I can offer right now is to always err on the side of caution. If the data isn't conclusive regarding dose, and the question becomes "more or less?", then try "less" first.
 
gosh, if it were only house cats who became diabetic and not the barn cats, ferals, rescues, and abused we see so often on this site...

nancy, i'm fresh out of experience and ideas to share, but there are a lot of other members. i'm hoping someone else has some experience or ideas to share... something that will strike a positive chord with you.

i sincerely wish you and hairy all the best with his diabetic journey.
good luck!

~ jill
 
To answer your original question, a reason why you might have seen a higher number after increasing the dose is due to New Dose Wonkiness. Again, it's hard to say for certain because of the lack of testing data. It could also be that he had an earlier or later nadir (Michelangelo has been pulling this one with me lately and having super late nadirs where his +6 is in the 200s or 300s and then he's in the 100s by pre-shot).

As to testing, you've only been at it for a little over a week and you're still managing to get at least one test a day in. :thumbup I perhaps know better than most how difficult certain kitties can be when it comes to testing. Michelangelo was only 6 months old when he was diagnosed and he was also a feral rescue kitten. When I first started testing him after he was diagnosed, I spent the first week just trying to test him and I wasn't even able to get in one successful test during that first week, so you've already got me beat on that point. ;-) I don't even count that first week as anything but getting us both accustomed to the testing process. And during that week, I also saw him "reverting" back into some of his feral tendencies that I had spent the previous 5 months of breaking him from. I was frustrated, discouraged, felt hopeless, and caught in a state of fear that I'd irreversibly turn him feral again vs. keeping him safe and healthy through testing.

The second week, I was finally able to get in some successful tests and that's when I first started posting here. The third week, it got even better. By then end of the first month, Mikey and I reached a point of understanding: he might not like what I was doing, but he'd put up with it as long as I accommodated his mood. I learned to give myself about an hour to test him so I could be flexible if my first attempt to get him situated resulted in a battle. When that happened, I'd either let him wander off for a bit and try again later or I'd play with him for about 15 minutes and then try again, or I'd even feed him a little bit first to get him satiated from food. Or all of the above (hence the reason it could take me up to an hour sometimes to get a test in).

After about three months, we reached the point where I'm at now. Testing takes about 3 seconds and 75% of the time, he's easy to corral and sits "patiently" for those three seconds it takes for me to test him. The other 25% of the time, I either have to skip the test entirely because he's not cooperative or wait and try again in a bit.

As you know with feral kitties, it takes a lot of intuition and reading of body signs to gauge their mood. But most importantly, it takes a lot of time and patience!

From where I started with Michelangelo, you've already accomplished more than me in a shorter time frame, so that's something worth acknowledging right there. Keep giving both of you the time you need and everything will eventually fall into place. Yes, it would be nice if you could get more tests in right now to see what's going on, but at what expense? You'll eventually get there and it's better that you're testing at least a little bit than not at all.
 
Wendy&Tiggy said:
I know its been mentioned before but perhaps she can do one blood test a day but supplement with the secondary monitoring tools since they arent invasive. ie urine testing and monitoring general behaviours. https://docs.google.com/document/pub?id=1r6ktdF7AMJCYHgPkVQWFUFy5Ag6OnbmfNfQqL3zX_88
Wendy
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Hi Wendy, I have definitely been monitoring his general behavior and symptoms very closely and they have pretty much been very good. I do have some info on the urine testing but haven't done that yet, only because I've been focusing on other stuff first, but plan to get into that next.
 
Thank you KPassa for sharing your early experience with Mikey. They are indeed similar to the situation with Hairy. Hairy is much older of course and rarely motivated by play, but being left alone motivates him positively and I'm hoping that over time he will be tolerant of testing and shooting in exchange for being left alone the rest of the time. I have been approaching him in his favorite hiding spots frequently, just to say "hi" without picking him up or poking him so that at least he won't make a 100% association with hiding/me/poking.
 
Thank you for that link Wendy. I had seen this before but somewhere in the wealth of info I lost track of it. I have it bookmarked now.

The ketone strips are something you can get at any drugstore right?
 
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