Dosing help needed

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Case, I think decreasing the dose slightly would be good if what you get is a light green number as you are in the hypo territory. If the nadir is dark green sticking with the same dose is probably going to be ok but bear in mind that kitty will bounce if the nadir is 50% lower than the preshot number. What we need to understand is that we don't want bounces if we can help it, we want to slowly get kitty in better numbers so if your preshot is 300 you want your nadir to be above 150 and you need to give your cat time to adjust to lower numbers. The main thing here is to really act reasonably (meaning we have to lower the dose) if we suspect Somogyi so if you have a nadir in hypo range and then you have a high number pretty quickly and it is higher than preshot number at the beginning of the cycle.
Regarding decreasing the dose, yes, you need to wait few days and observe.
 
Case said:
I just worry so much about making a mistake and hurting her, it's scary to me to have the responsibility of her life in my hands. I know its not an exact science and I appreciate you taking the time to explain this to me.
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I know, this worry is terrible, I went through this and actually I still am at loss what to do and question myself all the time despite the fact that I have been doing this for 3 years now! Try to keep your Sookie safe by testing her as much as you can, observe how she eats, what she's like in herself etc. Any problems - report to the vet and here as well. Be prepared for hypo - don't panic, just feed and test in a calm manner. Post here for help.
Sometimes it is very difficult to figure out what's happening with kitty's BG as various things can interfere with glucose levels and you can do everything right and still get weird and unpredictable numbers. I'm in a situation like that at the moment. Although Rocky is still in blue numbers area but he gives me lots of higher numbers which are unusual for him and I'm so worried but without giving me more clear symptoms (he doesn't feel very well but nothing jumps out) and without further testing at the vets (he had tests done not so long ago) I really can not tell what bothers him. That makes me so upset and frustrated!
Case, it is quite a challenge but please remember that you are doing best you can to help your kitty have healthier longer life and once you start seeing results of your dedication you will feel so much better. I do know very well how you feel and so many members went through the same. I went through few almost nervous breakdowns. These little furry creatures mean so much to us.
 
Marlena said:
If the nadir is dark green sticking with the same dose is probably going to be ok but bear in mind that kitty will bounce if the nadir is 50% lower than the preshot number. What we need to understand is that we don't want bounces if we can help it, we want to slowly get kitty in better numbers so if your preshot is 300 you want your nadir to be above 150 and you need to give your cat time to adjust to lower numbers.
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Ok this really clears it up for me, thank you! I definitely don't want her to bounce around and while I was glad to see a dark green number, I had a feeling it went down too fast/too much. I feel much better about what to do moving forward. We can take it slow and allow her body to adjust to the lower numbers as you said, hopefully without going too low or setting off a bounce.

Marlena said:
I know, this worry is terrible, I went through this and actually I still am at loss what to do and question myself all the time despite the fact that I have been doing this for 3 years now! Try to keep your Sookie safe by testing her as much as you can, observe how she eats, what she's like in herself etc. Any problems - report to the vet and here as well. Be prepared for hypo - don't panic, just feed and test in a calm manner. Post here for help.
Sometimes it is very difficult to figure out what's happening with kitty's BG as various things can interfere with glucose levels and you can do everything right and still get weird and unpredictable numbers. I'm in a situation like that at the moment. Although Rocky is still in blue numbers area but he gives me lots of higher numbers which are unusual for him and I'm so worried but without giving me more clear symptoms (he doesn't feel very well but nothing jumps out) and without further testing at the vets (he had tests done not so long ago) I really can not tell what bothers him. That makes me so upset and frustrated!
Case, it is quite a challenge but please remember that you are doing best you can to help your kitty have healthier longer life and once you start seeing results of your dedication you will feel so much better. I do know very well how you feel and so many members went through the same. I went through few almost nervous breakdowns. These little furry creatures mean so much to us.
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It's reassuring to hear I'm not the only one! It's so true isn't it? I mean we're all here because we love our cats so much! I will do my best to take care of her however I can and I honestly feel this dedication to our kitties makes us all better people. I look up to the people on this board who help so many others with knowledge and understanding that we're not alone in this because it is so devastating at first. I think the worry is something we all deal with (and I will probably always have) because like you said, they mean so much to us! I'm sorry about your situation with Rocky, sometimes the worst thing is not knowing what's going on and I can absolutely understand the frustration! I hope its nothing too serious and I really hope he starts feeling better soon!! Hugs to you both :bighug:
 
Case, thank you.
Rest assured that we all are in the same boat - we deeply care about our furry children. It is very stressful but so rewarding when you start seeing results.
I'm so happy that I can help you and your kitty. I have received so much help from others when I joint the group, now I can pay it back!
I'm myself in a bit of a state now as Rocky is not quite right and I don't know what to do. It is so difficult now when he is mostly in the right range of BG but he is higher than he should be and I haven't got a clue why. It would probably be easier to see a pattern when you first start using insulin and you get all these colours but when kitty is on a low dose and in blues I don't know if higher numbers are bounces or he, for some reason needs more insulin. I have tried a few times to ask other members to give me their opinion on this but unfortunately there was no opinion so I'm guessing nobody really knows. The vet keep saying that this might be an "over swing" by which I think she means Somogyi but I have no evidence of that. In the meantime Rocky is giving me hell (meowing constantly) and I'm loosing the will to live!
Sorry about my rant but I really am struggling.
I'm happy to help you making decisions as it helps to take my mind of things at home.
 
Aww poor Rocky! I'm so sorry you're having such a hard time, Marlena. :( I'm sure he just wants you to know he's not well in some way. Its so difficult when they don't feel well and you just want to help them but you don't know how because they can't simply tell us what's wrong. And cats are usually so good at hiding it. So frustrating that the vet can't help you more. :arghh: The numbers are such a mystery to me and I don't think too many vets understand it either. Especially since he is so far along his journey and doesn't need a lot of insulin. We all need to rant once in awhile, no need to apologize for it! I wish I had answers or advice for you but the best I can say is don't give up! Sometimes all it takes is time and the answer will come to you. I know its easy for me to say, but I really do feel for you! Don't be too hard on yourself, you obviously take great care of him and what an accomplishment to come so far with his diabetes. Just the fact that you know something's up with him when the vet and tests may say otherwise, speaks volumes of your relationship together, and that's something to be grateful for! Sending you both lots of love!!
 
Case, apologies for hijacking your thread for a moment. Marlena, I'm so sorry things are hard right now! I wonder if you might be able to load your recent blood panel information (along with any previous labs) in the Labs tab of your spreadsheet so some of the lab experts could take a look and see if they notice anything. If you're interested in having someone take a look at the labs, and need help getting the Labs tab added into your spreadsheet, just ask and we can tag someone for you to get that fixed.

Also, I know it seems crazy, but I think my kitty does show some signs of neuropathy even just in the 9-11 range (higher 100's). I saw the note on your spreadsheet about that, so hopefully if that's the case for Rocky, then the B12 will help a bit. As for the crying, has he been checked for thyroid issues and blood pressure? Both can sometimes cause excessive vocalizing and may impact BG.

Regardless of the cause of the rise, it does look like a little bump up in dose might help. Just a few thoughts. I know there is nothing definitive, but I think that's the nature of it when numbers start changing mysteriously. Until the root is found, we just have to manage the symptoms the best we can. Hugs to you in the meantime! :bighug:
 
Thank you Case for your warm words.
I have decided to take Rocky for testing early next week as I'm pretty sure he has an infection or something like that. It is not normal for well regulated cat to get BGs like that.
See what the testing will give us.
 
Marlena said:
Thank you Case for your warm words.
I have decided to take Rocky for testing early next week as I'm pretty sure he has an infection or something like that. It is not normal for well regulated cat to get BGs like that.
See what the testing will give us.
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Best of luck to you both!
 
Djamila said:
Case, apologies for hijacking your thread for a moment. Marlena, I'm so sorry things are hard right now! I wonder if you might be able to load your recent blood panel information (along with any previous labs) in the Labs tab of your spreadsheet so some of the lab experts could take a look and see if they notice anything. If you're interested in having someone take a look at the labs, and need help getting the Labs tab added into your spreadsheet, just ask and we can tag someone for you to get that fixed.

Also, I know it seems crazy, but I think my kitty does show some signs of neuropathy even just in the 9-11 range (higher 100's). I saw the note on your spreadsheet about that, so hopefully if that's the case for Rocky, then the B12 will help a bit. As for the crying, has he been checked for thyroid issues and blood pressure? Both can sometimes cause excessive vocalizing and may impact BG.

Regardless of the cause of the rise, it does look like a little bump up in dose might help. Just a few thoughts. I know there is nothing definitive, but I think that's the nature of it when numbers start changing mysteriously. Until the root is found, we just have to manage the symptoms the best we can. Hugs to you in the meantime! :bighug:
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Thank you so much Djamila, your advice is much appreciated (as I'm close to bursting in tears I'm so frustrated with this)!
As I have decided that I'm taking Rocky for testing on Monday or Tuesday I will be looking into the results of brand new tests, they might tell us more.
I'm quite capable of interpreting test results as I don't rely on the vet's opinion I had to learn a lot and I question everything vets tell me. Last tests Rocky had (bloods in May, urine in June, July) were unremarkable. The only thing which is off is Spec gravity, everything else was good according to my vet. Potassium was low in my opinion (although within the range and the vet was happy with that) so I decided to give Rocky potassium supplement as per instructions on Tanya's site so testing again after supplementation is a very good idea. We are going to do SDMA (early detection of kidney failure) as well as the vet insists that Rocky should be on Metacam for his arthritis but I hate this medication and refuse. We have just finished a course of Cartrophen injections (similar to Adequan in US) and I can't see any improvement in Rocky's arthritis. Vet says that if Rocky is not diagnosed with CKD than he should be on Metacam. Rocky had BP checked many times as well but it was all good - I think below 150 but I need to double check that.
Now I need to wait and hopefully we will get to the bottom of this.
Sending love and hugs too:bighug:
 
Case, I apologise for hijacking your thread.
I will create my own tomorrow so we can continue concentrating on Sookie.
 
Thank you Marlena! I think she's doing well with this dose so far, I'm looking forward to see how it continues :smuggrin:
 
Sookie has been bouncing around quite a bit lately. Today I stayed home from work and I'm glad I did because she dropped really quickly today. She went from an amps of 310 to 78 at +4. I gave her about 2 tbsp of FF then and that seemed to even her out a bit. I'm not sure if I should back off the dose to 2 units, what do you all think? I'm just concerned she's possibly dropping into low numbers when I'm not around. At the same time I also don't want to get stuck on the yellows and pinks again, I feel like we're only beginning to make some real progress. This is so confusing.

I was also wondering about the high preshot numbers. At what point do they start to come down? I know the prozinc curve should look like a smile but shouldn't the whole number range eventually start coming down? It seems like her body has gotten so used to high numbers that when she's in normal range she doesn't feel good. Like today she was so lethargic and was screaming at me when I gave her the extra food at her +4. I'm still trying to understand how this works, any help or insights would be so appreciated!
 
Case,
your PS this morning was a bit lower than normal but still pink and last night was lower pink as well.
So maybe the dose you gave worked better today because she is generally dropping a bit or she did not eat enough.
Luckily you were at home. She might be bouncing to red tonight or tomorrow morning. If she isn't in higher numbers at preshot but she is in lowish pinks and you are at home you can stay with the recent dose but if you can't test because you are not there it might be safer to give her 2 units.
To me it looks rather good that after many days of pinks and yellows she finally drops to blue but the drop is too sharp and she can bounce back to higher pinks and reds.
This is all I manage to say right now as I'm tired and need to go to sleep!
I'll check in tomorrow in about 9 hours.
Good luck
 
Thank you Marlena. I was expecting a higher pmps and it was close to 400 so I gave her a fat 2, just a smidge less than 2.25. I may try this for awhile to see how it works because I want to try to be consistent with the dose.
Marlena said:
To me it looks rather good that after many days of pinks and yellows she finally drops to blue but the drop is too sharp and she can bounce back to higher pinks and reds.
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I totally agree with this and she does seem to consistently bounce after a few lower numbers. I hope her body adjusts soon. For so long she wasn't hitting any blues and now I'm glad she is but it seems so unpredictable how low she'll go especially when the insulin kicks in so quickly. I appreciate the help, have a goodnight!
 
Case darling, so far Sookie did not bounce too high, still in pink numbers rather than red.
See what happens tomorrow.
You are doing so great.
I'm so tired from dealing with this sugar dance, they seem to be doing their own thing, it is so frustrating.
One thing which comes to mind right now is that you can do the right thing, the same thing consistently and you would have a different, unexpected result. Just prepare yourself for ups and downs but it will be all right in the end,
Good luck.:)
 
That's very true. The numbers are always changing and I realize I shouldn't expect it to be predictable. Thank you for your support and insights, it's been so helpful. I think I'll just take it one day at a time and hope for the best.

I understand what you mean about it being frustrating, it really is. I've only been at this for such a short time but it already feels like it's been so long, I can't even imagine how it must feel for you. I saw your post about Rocky's seizure and I'm so sorry about that, it must have been terrifying. :( I really hope its nothing too serious and that the vet can figure something out for you. Good luck to you both as well!
 
Case said:
That's very true. The numbers are always changing and I realize I shouldn't expect it to be predictable.
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Yes as soon as you think they're predictable, kitty throws a toy in the works :rolleyes:. To help with frustration, just take things one cycle at a time. You're doing very well with Sookie, Case :)
 
Good advice from Yong - one cycle at a time. Try hard to put aside any notion of getting this done quickly and remember that you're following, not leading, this dance. Sounds trite but there really is peace of mind in acceptance.

I saw your SS note about her feeling lethargic in low numbers. That's a common observation and they usually tolerate them better with frequent exposure to them. Having said that, kitties differ in their natural/preferred BG "set point". Some are more comfortable in higher "good range" numbers while some are OK running lower.
 
Thanks Yong, I will do my best to not rush the process and take it one cycle at a time as you said. Its getting a little hard to keep up my patience but I will do my best.

You're right Kris, I think I do need to accept that I'm not in control of it. It's a tough lesson for me but I think what you're saying is important to consider. I guess I was sort of hoping it would have been easier to get her regulated. I'm not even sure how long she was diabetic so I don't know why I am trying to rush it. Remission might not even happen, and logically I know that but I'm just kind of emotional about it. I guess I'm really looking for reassurance that I'm doing the right thing with her dosing and treatment. I can't thank you all enough for the support, I worry so much about it sometimes. I'm glad her reaction to lower numbers is not unusual, I have a feeling she'll like being on the higher end of normal.
 
Dear Case, you are doing a fantastic job!
You seemed to be very collected and organised about it but I can sense now that you, like the rest of us are very emotional and stressed by it and I really understand how you feel, it is not easy.
But you are in very early stages of this dance and you still have plenty of time to get Sookie in remission, it really is very probable!
Really interesting that you noticed she is not very good when she is in lower numbers, Rocky is exactly opposite - I see a difference in him when he is not higher than 110. But saying that now I don't know if he is not feeling very well today because BG control is not very good after few days in good numbers or he has higher BG because of some health issue! Go figure!
Hang on in there, she doesn't really give you many red numbers which is fantastic, think about positives.
If you feel stressed or frustrated just vent it out here, that will help but at the moment things with Sookie look very promising.
Rocky and I are sending hugs:bighug:
 
Marlena said:
Dear Case, you are doing a fantastic job!
You seemed to be very collected and organised about it but I can sense now that you, like the rest of us are very emotional and stressed by it and I really understand how you feel, it is not easy.
But you are in very early stages of this dance and you still have plenty of time to get Sookie in remission, it really is very probable!
Really interesting that you noticed she is not very good when she is in lower numbers, Rocky is exactly opposite - I see a difference in him when he is not higher than 110. But saying that now I don't know if he is not feeling very well today because BG control is not very good after few days in good numbers or he has higher BG because of some health issue! Go figure!
Hang on in there, she doesn't really give you many red numbers which is fantastic, think about positives.
If you feel stressed or frustrated just vent it out here, that will help but at the moment things with Sookie look very promising.
Rocky and I are sending hugs:bighug:
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Yup sometimes I try to be calm and collected about it but other days are harder. You're right though, it could be much worse she really isn't doing too bad. And I know she's generally pretty happy so that's a big positive. Thank you for the kind words, it's encouraging! It's so funny how different they all are, they like to keep us on our toes don't they?;)
 
Case!
I really like Sookie's curve last couple of days.
Brilliant numbers, going down gently into blue at nadir.
Fantastic job, this is the way to go.
I wouldn't be surprised at all if Sookie goes into remission soon.
Sending kisses and hugs,
Rocky and Marlena:):):)
 
Marlena said:
Case!
I really like Sookie's curve last couple of days.
Brilliant numbers, going down gently into blue at nadir.
Fantastic job, this is the way to go.
I wouldn't be surprised at all if Sookie goes into remission soon.
Sending kisses and hugs,
Rocky and Marlena:):):)
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Thanks! She's been doing really well, I'm relieved to see some nicer numbers without a bounce! :D

Of course now that we're making progress I'm a little scared to be going on vacation next week. I have someone that is willing to test and give shots, just have to hope she doesn't have a breakthrough and dip too low while I'm gone.
 
Case said:
Thanks! She's been doing really well, I'm relieved to see some nicer numbers without a bounce! :D

Of course now that we're making progress I'm a little scared to be going on vacation next week. I have someone that is willing to test and give shots, just have to hope she doesn't have a breakthrough and dip too low while I'm gone.
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Yes, that's a major worry.
You can decide on a lower dose like 1.5 during that time (better higher numbers for few days than going too low, you can always go back to higher dose on your return).
Do you really need to go on vacation? Just kidding darling!:p
You must go and enjoy yourself, everything is going to be just fine.:)
 
Haha I know right! We had it planned before she was diagnosed but it just happens to be coming up now that we're finally getting somewhere. Ah these cats and their timing! :facepalm: I'm thinking about going to 2 units while I'm away and have the sitter leave out extra food just in case. Haven't decided yet for sure. It's hard because I don't want to lose our progress but I still want her to be safe. I'll be nervous no matter what. I can really use the time off! :cool:
 
Case said:
Haha I know right! We had it planned before she was diagnosed but it just happens to be coming up now that we're finally getting somewhere. Ah these cats and their timing! :facepalm: I'm thinking about going to 2 units while I'm away and have the sitter leave out extra food just in case. Haven't decided yet for sure. It's hard because I don't want to lose our progress but I still want her to be safe. I'll be nervous no matter what. I can really use the time off! :cool:
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It is so difficult, I know!
Sending hugs:bighug:
 
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