Dweezil AMPS (144), +6 (65)...vet still thinks 2 units is ok

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monty_dweezil (GA)

monty_dweezil (GA)

Member Since 2014
Dweezy was at the vet again this morning and had a successful and calm blood test, unlike last week! (he has one particular vet he's always seen and who he always seems to be comfortable with) His reading was 144.

This is great, but now I'm worried he's going to go hypo if he has his regular 2 units as normal. The vet says he wants him to stay on that dose for now. He has been on 2 units twice a day for almost a month now.

I'm also a bit confused as his urine glucose is still constantly the second highest reading, every single time without fail. How can it be that high if he's 14 hours past his morning dose of insulin on that relatively low number???
 
Dweezy just got back home from the second vet visit to test his nadir and it was 65.

Is this a good thing?? He seems to have really stabilised on 2 units twice a day. But up until yesterday his urine was still high in terms of the glucose. I still don't know how that can be.
 
Has Dweezil been getting one or two shots a day? The spreadsheet looks like one shot a day as the units column in the PM is empty. Do you have any data besides the blood tests at the vets? I don't see much data for the last month. Are you doing home testing? If you aren't doing home testing, 65 is a little low for a nadir.

A blood test captures the sugar in the blood stream at the time the test is taken. That sugar in the blood stream takes a while before it ends up in the urine stream, so what you see in a urine test is what the blood sugar was a number of hours previously. It could be that Dweezil is bouncing and there are times when he has high blood sugar from the bounce.
 
OH! I didn't realise I was supposed to be putting the shots in both columns! Yes, he does get 2 shots a day.

I have managed ONE successful home test. *sigh* It is exceedingly hard as after that first one, he now doesn't let me go anywhere near his ear, ever. Also, he is so sensitive, if it's ever raining or storming I can't even try as he's scared and already hiding from the thunder. If he and Monty seem a bit funny and tense together, I also can't try, as he is extra "touchy". I always seem to be waiting for a time when he's calm and MIGHT let me near his ear.

Is it possible that Dweezil would be bouncing on this dose of 2 units twice a day after almost a month of being on that dose? Doesn't the bouncing settle down after a few days?

If he is bouncing, shouldn't his highest number be higher than 144? He was 14 hours post his normal shot at the vet this morning and only 144.
 
monty_dweezil said:
Is it possible that Dweezil would be bouncing on this dose of 2 units twice a day after almost a month of being on that dose? Doesn't the bouncing settle down after a few days?
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I wish it were true. Neko's been on insulin a little over three years, she's finally starting to not bounce as much. :rolleyes: We can't control how long it takes, cat's do it in their own time. Cats can have nice cycles, followed by bounces for several cycles, then nice cycles again.

Have you ever tried paw testing on Dweezil? We've had a few members who had to do that because the ears were a no-go zone.
 
monty_dweezil said:
I have managed ONE successful home test. *sigh* It is exceedingly hard as after that first one, he now doesn't let me go anywhere near his ear, ever.
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Are you offering treats with any attempted tests, whether you get blood or not, offer treats, praise Monty- in fact, it might help to just throughout the day- give him a treat for no reason. Soon kitty learns to beg to be tested!
 
if you are gentle but firm and persistent with him, and always give a treat after testing, he will learn to accept the testing. I think one key is for you to be convinced that he must be tested for his own safety.

I've got 3 kids and lots of practice making them do things for their own good. This is the same thing. Monty doesn't know he needs this. When I had to start testing punkin, he hid under furniture and I pull him out by his arms, hoping I didn't dislocated anything. Then I burrito-wrapped him in a beach towel so he couldn't move. There are youtube videos on how to do it. I pinned his front legs down tight against his chest. When he was immobilized then I could test. Then I let him down and gave him his treat.

It took 2 weeks of that before he gave up and stopped fighting me.

newly diagnosed cats can have their pancreas heal. If that happens, the pancreas begins to put out insulin and then the amount being injected needs to be reduced. A dose that was fine before can become too much.

I'm not trying to scare you, but these are the reasons that it's so critical to hometest. Cats are not like dogs, which can get a dose figured out by the vet and stay with that dose for the next year. Cats have a fast metabolism with insulin and the dose has to be changed regularly.

It's really hard to help you with dose without the data. We aren't vets and data is what we rely on to make dosing decisions. We all have a ton of testing tricks that have worked for our own cats. I can't encourage you enough to work on the testing. You'll feel so much more confident about Monty when you KNOW what's going on in his body. Cats do accept the testing. Their ears aren't that delicate and they totally get used to it. Punkin loved the piece of chicken he got after every poke.

Hang in there! It gets easier and so much less stressful when you master it.

One more thought, you might want to close him in the bathroom with you for testing. No furniture to hide under.

Hugs, julie
 
Thank you! Monty is actually a civvie and Dweezy's brother. Lol Dweezil is the Diabetic patient.

Now his numbers are much lower, my resolve to test is much stronger. Before, i kind of took a bit of comfort in the fact his numbers and urine glucose were not low.

What also puts me off is that many people seem to test SO often. I can't imagine being able to do that.

Dweezy does not like being restrained. He becomes very stressed and if not released quickly, freaks out and starts yowling and won't let anyone near him for a while.

We actually often give both boys treats. Dweezil is less treat motivated than Monty. If he doesn't want to do something, no treat will change that.
 
I'm one of those "often" testers. There's a reason. Gabby's numbers are capable of diving early in the cycle. You'll notice on our SS that my tests are typically bunched in the first 5 hours of the cycle. She has an early nadir. In part, getting those tests early on educated me to when her nadir fell so I know when to get tests. Since I work, knowing when to get those tests is crucial.
 
I also would be concerned about not-testing, given how well Dweezil is responding to insulin. Since you did manage to get one successful test, you can get another!! We've had some pretty tough kitties here adjust to testing - some definitely take longer than others, but it can be done. Since Dweezil gets upset with being restrained, he may take longer. You can start by doing some "dry runs"....go through the motions of testing, without actually testing. Give him treats every single time, whether or not you are successful in getting a drop of blood. Go slow, and hopefully he'll become more compliant. Right now he's probably a little confused by all the changes, but they really seem to eventually put 2 and 2 together and realize we are helping them.

I remember when Trix was first diagnosed, someone here told me that now their kitty comes running when he hears her shake the test strip bottle. I thought "No way!!!" Well, yep, they were right....before I knew it, Trix would come to her testing spot when she heard me getting supplies together.

A lot of us do test often, and part of that is for safety; part of that is to be able to track response. At the very very least, you really should try to get a test before Dweezil eats and gets his insulin; this way, you'll know if it's most likely safe to shoot (and I say "most likely" because sometimes a kitty can drop dramatically even if they have a high starting/preshot/PS number.). Ideally, one other test during each cycle will help fill in the gaps of the puzzle. Most of the time, these 4 tests (two pre-shot tests and two mid-cycle tests) are all you'll need, but there may be times (like if Dweezil is running too low) that you need to get a few more tests in.

It DOES get easier...and you'll get a lot of encouragement, tips, and tricks here at FDMB!
 
monty_dweezil said:
What also puts me off is that many people seem to test SO often. I can't imagine being able to do that.
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It took me awhile to get on the home testing bandwagon. As many at my vet clinic could attest to, I was traumatized enough with giving him shots, and when it was suggested here I try to home test, I almost threw up. Even the vet tech who taught me how to home test later admitted he didn't think I would be able to do it. That could have something to do with my hands shaking horribly the first time he showed me. Skooter was not a super huge fan of it at first, but he has learned to be ok with it. Yes, there are those kitties who will come running at test time, Skooter DEFINITELY isn't one of those kitties, but he doesn't really fight me on it anymore either.

Dweezil will eventually take his cues about testing from you. If you show any sign of stress or hesitation, then Dweezil will sense that and be stressed or hesitate. I cannot tell you how empowering it is to know what is going on with his numbers and feeling some sense of control in a disease where you don't get to have much control. I thought I would not be a huge tester and while I have not tested as much as I would like so far in 2015, if you look at Skooter's 2014 spreadsheet, I am a big tester. I love to get the data so I can tell what his numbers will TYPICALLY do. By doing all the home testing, I have learned Skoots like to nadir early and more importantly, when he gets a fur shot or a skipped shot, he barely even blinks. I am very lucky in that respect as there are times I won't be able to be home at shot time or need to be out right after and knowing his cycles somewhat (even though there are others here who know his cycles better than me) has really helped me feel in control.

The other thing I did with Skooter when we first started testing was go and pick him up and just cuddle with him. I noticed it was getting to the point where a lot of our interaction was during testing time, so I wanted him to know that wasn't the only time I was gonna give him attention.

At this stage of the game and with a good chance of going OTJ, home testing is going to be the only way to do that. AT first, you don't have to home test tons, though I think once both of you get the hang of it, you will do it more often. I would say definitely before each shot and then 1-2 tests spread out through the rest of his cycle as you can.

Another piece of advice, use the three strikes rule. If you don't get a test within three attempts, give Dweezil his treat and let him go for a few minutes, get yourself untense and calm and then give it another go.
 
LOL! Sorry about that!!!!! (how DO I update the subject line? I tried to do that once before and it wouldn't let me)

Last night I was worried Dweezy would go hypo so I only shot 1.5 units instead of 2, and he also got three dinners. He was fine, thank GOD.
 
If you look at the top right side of your post, there is a spot labeled "thread tools." Click there and you'll see "Edit title." We encourage people to keep the title updated with anything recent because there are quite a few folks who scan the board, looking at the subject lines to see if anyone needs help. Sometimes new members need help and don't even realize it, but an experienced person looking at the subject line can tell by the test data.

I did want to give you this Testing & Shooting Tips post - full of lots of helpful hints. If your goal is remission, you definitely want to master testing! Just fyi, you can never assume that just because a cat's blood sugar is high at one point that it doesn't mean it can't go low in the next few hours. Sienne, who posted above, has Gabby who can go from 400 to 40 in three or so hours, and be back at 400 for the next shot time.
 
If you go to your first post on the top right hand side there's a link that says thread tools (at least I think that's what it says off the top of my head but at any rate there's only one link there) click on that and a drop down option to edit the title will appear, click on that and voila you're in the subject line.

A lot of cats don't like having their ears messed with to start off with. I found it beneficial to prepare Vyktor for testing by regularly rubbing his ears and praising him and giving him treats for letting me. Then I added clicking a pen near his ear to simulate the sound of the lancet, next thing you know I turned into a testing maniac!

Don't be put off by the amount of testing that some of us do, as others have mentioned you can get away with not doing anywhere near as many, it's just that some of us find it addictive once kitty is okay with it. When you know what's going on in there you can make better decisions and you won't be so scared. I would be absolutely terrified to shoot blind :nailbiting:
 
Do you clip Dweezil's nails at home? When I thought I couldn't get the hang of home testing with Noodle's ears, I thought of how I clipped Noodle's nails--which she HATES--and tried that strategy for getting a BG test.

I sit down with a towel on my lap, give her a treat, then pick her up and sit her upright in my lap. I wrap her up like a burrito with her bottom paws sticking out and give her another treat. Sometimes, I have to pull the towel down my lap a little so she's more laying on her back than sitting on her bottom so she can't wiggle out as well. I grab a back paw, rub a little vaseline/aquaphor on the pad, then use the lancet pen at the highest setting to poke her paw pad. Usually that gets enough blood, but sometimes I have to squeeze a little out, I'll have another treat handy to distract her in that case. I get my monitor and grab the test as soon as there's enough blood, give her another treat, and set her free. If she's calm, I'll rub a little antibacterial/pain relief ointment before letting her go. If not, I just let her out. I've never been successful with ear testing, but paw testing works just fine for us.

The key is having all her supplies handy and ready to go by my right hand (right handed). I have a little box with her monitor, strips, lancet pen, extra lancets, a tub of Aquaphor, and ointment. I open everything and put the testing strip either all the way in or partway in so I can pop it all the way in as soon as I need it. Then, I break up a few pieces of freeze dried chicken and set them next to me so they're easy to grab, too. By the time I sit down, she's circling for treats, but you could do this in the bathroom or another small space to get to Dweezil easily, like @julie & punkin (ga) suggested. It helps to talk to her in a calm, happy voice the whole time, sometimes praising her, sometimes just telling her about my day or talking about the TV show we are watching, it keeps me calmer to do that, too. :smuggrin:
 
Mmm, yes. Dweezy is ok (sometimes) with having his nails clipped. We do that, sort of. My partner does anyway. When he's a bit sleepy he doesn't pull his arm back as quickly as he does when he's more alert. :)

Dweez HATES, HATES, HATES being restrained in any way at all. Blanket, arms, he HATES it! The one time I was able to get blood from his ear, it went everywhere all over me, him, the dining table, the floor, his spreadsheet, and he shook his head and ran off before I could hold his ear to stem the bleeding.

Thanks for the tips about the subject title!
 
Well. I was a bit confused (and still am I think...maybe) as right up until the day before the vet day with the good normal BG numbers, Dweezy's urine glucose reading was consistently (3 times a day) the second highest on the colour chart. Soooo...that was somewhat confusing. (never any ketones thankfully)

The urine glucose readings the day of and the two days after the good BG numbers vet day appeared to be NOTHING. This worried me a bit. I was constantly worried he'd go too low and to have NO glucose in the urine would be a bad sign. But then I read that it won't pick up any glucose if the level is under the renal threshold, which obviously at those normal BG numbers, he was.

However, today, his urine glucose is back up to the third highest reading. What?!!?!? Nothing has changed with his diet, frequency of pee or water consumption at all!
 
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