DOSE ADVİCE PLEASE HELP ME WITH TIFIL'S CRAZY NUMBERS :(

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ISIL&TIFIL

ISIL&TIFIL

Member Since 2011
Hello,
For a long time Tıfıl's numbers are out of control. First I blamed the UTI and thought it was all about the pain that she is going through. But now I understand that I am the one who is messing with something and I really need your help.

First of all, I am not sure if the dose is right. I mean is it too much and are there rebounds or is it not enough and she is always floating up high all the time?

Secondly, what about this Humulin R? Is it making everthing worse?

And last question, should I change the insulin, I mean maybe it is not going good on her anymore?


I must say that I have stopped giving her fancy feast for along time due to my doubts about it causing the UTI. I am feeding her with Dr.Lisa's raw recipe. I am using chicken, Turkey and chicken hearts as meat. But I am suspicious about chicken, I think that it is rising the BG levels.


Thank you for helping....Pleeeeeaaassseeeeee show me a way out, I am about to go crazy with a bouncy cat and a broken legged housband @-) @-) @-) @-) @-) @-)
 
Re: PLEASE HELP ME WITH TIFIL'S CRAZY NUMBERS :(

oh isil, that is a bit of a crazy numbers spreadsheet! no wonder you're frustrated.

one question occurs to me - how old is your lantus?
 
Re: PLEASE HELP ME WITH TIFIL'S CRAZY NUMBERS :(

Hello,
I was suspicious of that also, so I bought a new pen and I am using it for about three weeks. But no change in the numbers..:(
 
Re: PLEASE HELP ME WITH TIFIL'S CRAZY NUMBERS :(

hmmm, ok. you might want to start noting new bottles in our spreadsheet, because sometimes it can make a difference.

i'm not sure what to suggest - i think sandy or libby would be the best at interpreting this because they have the most experience with using a second insulin. i am going to guess that they'll see your very descriptive subject line (nicely done and it will get eyes!) and stop by before long. hang in there in the meantime!
 
Re: PLEASE HELP ME WITH TIFIL'S CRAZY NUMBERS :(

Thank you very much Julie for your support. I will start to note the new lantus on my spreadsheet
Big hug and kisses...
 
Re: PLEASE HELP ME WITH TIFIL'S CRAZY NUMBERS :(

:YMHUG:

you are so sweet! if i ever get to turkey i want to meet you and Joy! my husband's parents came home today from a trip to Palestine, Israel & Jordan. I love to travel and have been to Europe several times, but no further south/east than italy. I would like to go more into the Middle East sometime.
 
Re: PLEASE HELP ME WITH TIFIL'S CRAZY NUMBERS :(

You are always welcome to stay in my house when ever you like. I would love to host you. Please know that you have an adress here in Turkey and I am sure you will love our country. I must say that you must come on summer for the beautiful beachs....
 
Re: PLEASE HELP ME WITH TIFIL'S CRAZY NUMBERS :(

You can knock on my door when ever you wish :) Tıfıl and I will be so so happy...:)
 
Re: PLEASE HELP ME WITH TIFIL'S CRAZY NUMBERS :(

Goodness, Isil! no wonder you are feeling frustration!

I can't help with the numbers, but I know one of the sages will come by to offer input.
Dyana (and JD) is another member well acquainted with using 2 insulins.

Sending healing thoughts for your husband's leg...hopes for Tifil's numbers to even out...
and a calming & supportive tiger hug from Binks and me!

celi & binks

tigers.jpg
 
Re: PLEASE HELP ME WITH TIFIL'S CRAZY NUMBERS :(

Thank you very much, I love the pic...I'm licking binks and kissing you with a big hug. thank you for coming by and supporting ...
 
Re: PLEASE HELP ME WITH TIFIL'S CRAZY NUMBERS :(

Hello Isil,

It looks like Tifil was getting a good response to 3.25u Lantus on 11/04-11/06.
Why did you reduce to 3.0u on 11/6/PM?

Humulin R can be tricky and if used incorrectly can make things worse, however I don't think this is the case with Tifil.
What is the dosing scale you use for the R? Also, at what + hours do you use R?

How are Tifils teeth and gums?

I don't have experience with the raw diet - hopefully someone who does can comment on that.
 
Re: PLEASE HELP ME WITH TIFIL'S CRAZY NUMBERS :(

I'm not a big expert on R, but I have used it for awhile.
On 10/29 Tifil went from 102 at +9 to 501 at +10!!!! cat_pet_icon :sad: That's a big rise.
Uhmm, I have found that R will sometime cause a bounce to happen. You are sometimes giving 1.5 units of H?
I don't know if H is the same as R, but I know it is somewhat simular, and used as a bolus.
I have found that 0.1 of R is enough to get J.D.'s BGs down (almost always). And I will often give less than that (0.05), but ECID. I just know that sometimes giving the bolus can create a viscous circle, and sometimes it's better to try to lesson the R (or N) to get "things" back under control.
She was doing so well on just a touch of insulin. I just feel or have a feeling that maybe, you increased too much, too quickly, and have passed the "correct" dose.
Has Tifil ever had any ketones issues? Her UTI is gone?

These are just my random thoughts. But, maybe, you should try to give less H (a lot less), and see how she does.
I know how hard it is to see a high number, and how easy it is to have the tool (the R) to bring it down quickly.
But, sometimes just being patient and waiting it out, seems to help me with my cat.

I hope Libby and Sandy will be along shortly, to give their opinions as well.

You are adding the recommended suppliments to the raw food, correct? I know for one thing, cat's need taurine added.
I have not tried to make my own raw food, yet.

ETA: I see Sandy has posted. She knows more than me. I would follow her guidelines.
 
Re: PLEASE HELP ME WITH TIFIL'S CRAZY NUMBERS :(

Sandy and Black Kitty said:
Hello Isil,

It looks like Tifil was getting a good response to 3.25u Lantus on 11/04-11/06.
Why did you reduce to 3.0u on 11/6/PM?

I suddenly got the feeling that all of those were something like a rebound. I thought maybe if ı can take the dose down ı can come back to normal numbers, but ı was wrong :(

Humulin R can be tricky and if used incorrectly can make things worse, however I don't think this is the case with Tifil.
What is the dosing scale you use for the R? Also, at what + hours do you use R?
I was thinking of giving at +2 and +10 but today ı diceded to give at preshots.

How are Tifils teeth and gums?
Tıfıl has a red gum on one back tooth, on monday I will take her to the vet.

I don't have experience with the raw diet - hopefully someone who does can comment on that.
Click to expand...
 
Re: PLEASE HELP ME WITH TIFIL'S CRAZY NUMBERS :(

Dyana said:
I'm not a big expert on R, but I have used it for awhile.
On 10/29 Tifil went from 102 at +9 to 501 at +10!!!! cat_pet_icon :sad: That's a big rise.
Uhmm, I have found that R will sometime cause a bounce to happen. You are sometimes giving 1.5 units of H?
Yes I have used 1.5 units of Humulin R.
I don't know if H is the same as R, but I know it is somewhat simular, and used as a bolus.
I wrote H for humulin r, but now I am thinking it was not a good idea, I think I should write R on the spreadsheet.
I have found that 0.1 of R is enough to get J.D.'s BGs down (almost always). And I will often give less than that (0.05), but ECID. I just know that sometimes giving the bolus can create a viscous circle, and sometimes it's better to try to lesson the R (or N) to get "things" back under control.
She was doing so well on just a touch of insulin. I just feel or have a feeling that maybe, you increased too much, too quickly, and have passed the "correct" dose.
Has Tifil ever had any ketones issues? Her UTI is gone?
Yes she did whe she was dka. but now I am checking..there are no kettons in the urine.

These are just my random thoughts. But, maybe, you should try to give less H (a lot less), and see how she does.
I know how hard it is to see a high number, and how easy it is to have the tool (the R) to bring it down quickly.
But, sometimes just being patient and waiting it out, seems to help me with my cat.
You are right, I feel terrible to see those numbers :(

I hope Libby and Sandy will be along shortly, to give their opinions as well.

You are adding the recommended suppliments to the raw food, correct? I know for one thing, cat's need taurine added.
I have not tried to make my own raw food, yet.

ETA: I see Sandy has posted. She knows more than me. I would follow her guidelines.
Click to expand...




Thank you very much....
 
Re: PLEASE HELP ME WITH TIFIL'S CRAZY NUMBERS :(

A pattern of highs followed by an abrupt low may indicate you are using too much insulin. Now that the infection has been treated, your insulin dose could be too high.

If you go to the top of your spreadsheet, you were getting greens and blues on very low doses ... and there was a bladder infection present at that time too.

You might consider reducing the dose and be testing for ketones in the urine, just to be careful. I also discovered there are some multi-test urine testing strips which look for bacterial infection too. Those could be helpful if you can get them - maybe through your vet, or online?

It is really, really important to be slow and steady in Lantus dose changes - holding doses for enough cycles and changing them by small amounts when you are dosing in low numbers.

You'll get there!
 
Re: PLEASE HELP ME WITH TIFIL'S CRAZY NUMBERS :(

PS - be very careful with the R - 0.25-ish units may drop him 100 points so rapidly that the liver reacts and produces more glucose and R only lasts about 4 hours.

It is better to stabilize the long acting insulin first and save the R for when there are ketones, a condition such as acromegaly or insulin autoantibodies exists, or you get up into the 500s or higher (been there, done that - fed A/D to my cat because he's very thin and wound up spending a day checking him every 2 hours and giving tiny R doses to get him down to the 400s ranges - NOT a recommended practice!!!)
 
Re: PLEASE HELP ME WITH TIFIL'S CRAZY NUMBERS :(

I have a couple of thoughts...

First, make sure the cranberry powder you are giving has no form of sugar in it (nothing ending in and "ose" -- like sucrose, fructose, dextrose, etc.) Often cranberry is sweetened.

When you stopped the antibiotic for the UTI, was an additional sterile urine draw (cytocentesis) along with a culture and sensitivity (C & S) done? Sometimes, another round of antibiotics are needed to completely clear a UTI. If a cytocentesis and C & S wasn't done initially, the wrong antibiotic may have been prescribed.

If Tifil has a bad tooth, that could also be causing high numbers.

I do think it would be helpful to know what kind of scale you are using for dosing the R. It sounds like you are using a large dose of R and it may be adding to the confusion.
 
Re: PLEASE HELP ME WITH TIFIL'S CRAZY NUMBERS :(

BJM said:
A pattern of highs followed by an abrupt low may indicate you are using too much insulin. Now that the infection has been treated, your insulin dose could be too high.

If you go to the top of your spreadsheet, you were getting greens and blues on very low doses ... and there was a bladder infection present at that time too.

You might consider reducing the dose and be testing for ketones in the urine, just to be careful. I also discovered there are some multi-test urine testing strips which look for bacterial infection too. Those could be helpful if you can get them - maybe through your vet, or online?

It is really, really important to be slow and steady in Lantus dose changes - holding doses for enough cycles and changing them by small amounts when you are dosing in low numbers.

You'll get there!
Click to expand...


I am also suspicious for the high numbers of insulin dosage.
I have the multi testing strips for human now I am trying to find the one for anımals.
Thank you for helping, kisses
 
Re: PLEASE HELP ME WITH TIFIL'S CRAZY NUMBERS :(

Sienne and Gabby said:
I have a couple of thoughts...

First, make sure the cranberry powder you are giving has no form of sugar in it (nothing ending in and "ose" -- like sucrose, fructose, dextrose, etc.) Often cranberry is sweetened.

When you stopped the antibiotic for the UTI, was an additional sterile urine draw (cytocentesis) along with a culture and sensitivity (C & S) done? Sometimes, another round of antibiotics are needed to completely clear a UTI. If a cytocentesis and C & S wasn't done initially, the wrong antibiotic may have been prescribed.

If Tifil has a bad tooth, that could also be causing high numbers.

I do think it would be helpful to know what kind of scale you are using for dosing the R. It sounds like you are using a large dose of R and it may be adding to the confusion.
Click to expand...

Hello,
Before buying the cranberry powder I really searched alot and found this brand with no sugar in it. After I bought it I tasted it, it is really sour.
A cytocentesis hasn't been done, your are certainly right. But on monday we are going to the vet and I am going to ask for it.

By the way, I forgot to say that Tıfıl is fealing great. The rise in the numbers didn't seem to effect her. She is more playful then ever! Catching mice in the house (plastic bags which she thinks are mice) and bringing them to my bed every single night to serve me a good tasty meal :)
 
Re: PLEASE HELP ME WITH TIFIL'S CRAZY NUMBERS :(

Today the numbers are high again. what is the problem I don't understand. Is it the dose? I am going to go crazy :(
 
Re: PLEASE HELP ME WITH TIFIL'S CRAZY NUMBERS :(

It is possible the multistrips for humans might work for cats, if you already have them.
 
Re: PLEASE HELP ME WITH TIFIL'S CRAZY NUMBERS :(

I have heard that these strips give wrong numbers for leukocyte. I have tested and had a high degree of leukocte. So I am not sure if these test really work for the leukocyte.
 
Re: PLEASE HELP ME WITH TIFIL'S CRAZY NUMBERS :(

Hi Isil,
I'm sorry not to be able to help you (I don't know anything about these issues), but I just wanted to say that I hope Tifil's numbers will start to come down soon and that you will find the "magic" dose for her. Feline Diabetes is a mysterious condition and sometimes things just get "out of whack" for a while. As soon as other possible problems (the tooth, the UTI that might need more attention, the food) are taken care of and the insulin is working well and at the proper dose, I'm sure that you will see a return to good bg numbers.
Hang in there!! And good luck taking care of your DH !! (mine was terrible to live with when he broke his ankle, years ago!)

Ella & Rusty
 
Re: PLEASE HELP ME WITH TIFIL'S CRAZY NUMBERS :(

Ella & Rusty & Stu(GA) said:
Hi Isil,
I'm sorry not to be able to help you (I don't know anything about these issues), but I just wanted to say that I hope Tifil's numbers will start to come down soon and that you will find the "magic" dose for her. Feline Diabetes is a mysterious condition and sometimes things just get "out of whack" for a while. As soon as other possible problems (the tooth, the UTI that might need more attention, the food) are taken care of and the insulin is working well and at the proper dose, I'm sure that you will see a return to good bg numbers.
Hang in there!! And good luck taking care of your DH !! (mine was terrible to live with when he broke his ankle, years ago!)

Ella & Rusty
Click to expand...

:) Thank you very much Ella, with your beautiful words I hope my cat is going to come down again..
By the way, I agree with the terrible husband issue..:)
 
Hi Isil! Mainly just keeping you bumped up, but when Tifil got the UTI you did raise the dose very quickly. Her good dose could have been missed. Tess had a UTI last year and it is very important to to get he urine tested after the ABs are finished. Our vet was great and did the cystocentesis, but when the initial test found no trace of bacteria, told us that the C&S was then unnecessary. Save us a lot of money. The C&S is needed to determine which bacteria is present for the proper AB. Tess has been fine ever since.

Dr. Lisa often points out that UTI is not necessarily infection, often just an irritation so ABs are often not needed. One thing that was very helpful for Tess was that the vet recommended Cosequin (glucosamine/chondritin). It is usually for joint problems, but it also has been found to help the bladder.
 
Ann & Tess said:
Hi Isil! Mainly just keeping you bumped up, but when Tifil got the UTI you did raise the dose very quickly. Her good dose could have been missed. Tess had a UTI last year and it is very important to to get he urine tested after the ABs are finished. Our vet was great and did the cystocentesis, but when the initial test found no trace of bacteria, told us that the C&S was then unnecessary. Save us a lot of money. The C&S is needed to determine which bacteria is present for the proper AB. Tess has been fine ever since.

Dr. Lisa often points out that UTI is not necessarily infection, often just an irritation so ABs are often not needed. One thing that was very helpful for Tess was that the vet recommended Cosequin (glucosamine/chondritin). It is usually for joint problems, but it also has been found to help the bladder.
Click to expand...

Hello,
I bought cosequin but it made the bg levels rise. I have it still, I will start again when I find the right dose for insulin.
I feel terrible.. Now it is time to shoot and her bg is 374. It was a strange cicle again :(
 
Hello, Isil...

i feel badly that i don't have any wisdom to add...
but I want you to know that we are holding you & your gorgeous Tifil in our hearts and thoughts.


Celi & Binks
 
Hi Isil,

I am a relative newbie, so I don't give advice. I watch your messages, but usually don't respond because I don't want to clutter your condo when you need advice. I just want you to know you and Tifil are in my heart. I'm sure someone with more experience will be along soon to help you.
 
Hi Isil,

Do you have a scale you use for R dosing?
If you look at my Black Kittys ss, on the 2nd page I have some of his R scales, which I used as a guide during the period of time I used R.
Do you have something similar that you use?
 
Sandy and Black Kitty said:
Hi Isil,

Do you have a scale you use for R dosing?
If you look at my Black Kittys ss, on the 2nd page I have some of his R scales, which I used as a guide during the period of time I used R.
Do you have something similar that you use?
Click to expand...

Hello,
No I don't have a scale, bu I will follow yours now. I think I must increase the R dose aswell? what do you think?
 
Do NOT follow BKs R scale!!
He had a condition that required very high doses of insulin. That much insulin would kill Tifil.

A dosing scale is different for each kitty and you create and develop it very carefully and gradually.

I ran home at lunch and took a quick look at Tifils ss - I see you increased the Lantus, I think that was good.
Hold the Lantus dosoe for at least 6 cycles.

You *may* be giving Tifil too much R . The only way to find out is to stop the R for a few days and then re-evaluate.
What do you think?
 
This is just my opinion, and I may be wrong, so I welcome other opinions.
I see that Tifil was at 453 at +1 and you gave 1 unit of R which brough her down to 304 by +3. I think coming down 150 points (75 points per hour) is too fast, and sets up the next bounce. This is just my personal opinion, mind you, but I think you should try to halve the R dose (when you are thinking of 1 unit, give 0.5 units, when you are thinking of giving 0.5 units, give her 0.25, etc). When I give R, I want it to bring my cat down 150 points in total, in 4 to 5 hours of total time. And, if at all possible, I want it to bring him down as slowly as possible to not set up the next bounce.
Again, this is just what I am thinking, and I defer to the opinions of others more experience than I.
 
Thank you very much everybody...
Dear Dyana,
You may be right, I am not experianced about R so I am open to every openion...


Dear Sandy,
Thank you, I am waiting for your advice ...
 
i don't want to add too many variables, but i also wonder about the cosequin. has anyone else had the experience that it raised their cat's BG? because perhaps it was a coincidence that it increased it. i was reading about the cosequin because i have punkin on it now, and it said that it helps bladder conditions also. i have not seen an increase in punkin's BG with it.

do you have any idea what dates on tifil's ss you were giving the cosequin?

i'm not suggesting starting it right now, isil, i'm just asking the question. if no one else has had that problem, perhaps trying the cosequin again.

in the meantime, let's wait for sandy to suggest something after she gets home from work.
 
I am certainly no dose expert, but I remember Sienne telling us that sometimes the pancreas takes a break and numbers go high when it seems like there are no other contributing factors. I hope all is sorted soon and Tifil is giving you beautiful colors.
 
FWIW
I see a 453 at +1, and a 190 at +4. That's a drop of 263 points in 3 hours, or almost 90 points an hour, if divided evenly.
But, sense we do not know.. between +1 and +2 could have been a 50 point drop and between +2 and +3 may have been a 140 point drop, and between +3 and +4 could have been the remaining 73 point drop.. I just think the liver will panic when the drops are too fast like that. I know J.D.'s does. I think J.D. will bounce if the drop is more than 50 points an hour.
 
Hello again,

I see that Tifil is down to 190 at +4. I agree with Dyana, that is too far too fast. It will cause a bounce. It is clear that 1u R is too much for Tifil.

How do you feel about trying the following R scale:
-Only shoot R at shot time
--PS >400 - .5u
--PS 350-400 - .25u
--under 350 - no R

This is a suggestion - it may turn out to be too much, it may turn out to be too little, you have to try it and monitor closely to see.

Try and get some PM late cycle spot checks - it's common for kitties to run lower during the PM cycle. Set your alarm clock if need be.
Continue Lantus per the protocol
Monitor closely and post in a fresh condo daily. This way you have many eyes on tifils progress and if something is not going well it can be addressed quickly. Also, it's easier for us if there is a separate thread each day.
Have the vet check tifils teeth and gums.

What do you have as HC food, in case you need to bring numbers up?
 
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