George 6/18

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High amps, but we can't be sure what is going on without a midcycle number from last night. (Always awful feeling to run out of strips. You are lucky; it usually happens during hypo numbers when it is vital to get levels. :mrgreen: )

Any numbers you can get today will be helpful.
 
+2 AMPS 391

Sue I guess that's what I don't get with the weird numbers - he eats the same amount and gets the same amount of activity (or lack of haha) every day so what happens to them that sometimes they have low numbers and sometimes they're super high?
 
I agree it can be any number of outside factors as Dr. Lisa suggests in the thread. I would also guess he is bouncing around a bit, from lower numbers midcycle to higher numbers at preshot. At some point he should get used to the lower numbers and stop reacting to them. (the theory is that the pancreas releases more glucose when he hits a low number and his numbers climb. It's a defense mechanism. We call it a bounce.). This is the general idea
http://petdiabetes.wikia.com/wiki/Somogyi_rebound

The insulin is certainly working; it brings his levels down nicely. His body just needs to learn how to use it.
 
So basically there's not much we can do so just hold on for the ride and do our best to help out? Yikes!

I think the other thing that confuses me is that his numbers weren't that bad when we switched vets and doses after his seizures - we dropped his dose and the numbers were better and as we give more insulin they get worse...but we have to give the higher insulin dose because something happens to require it. Is there any possibility that, while the 5 units 2x a day was too high, there could have been insulin left over in his system from the overdosing that compensated the lower doses initially and as the old insulin wore off the numbers got worse and now we've had to keep raising? I don't even know if that makes sense but I'm just trying to figure out why his numbers are getting increasingly worse and more varied over time :? Also, when he was on the 5 units 2x a day he was holding weight on much better, now on the lower doses he's skin and bones and crying for food all the time....it almost seems like the longer he's on the lower doses the worse he's getting.
 
They call it a sugar dance. The trick is that not only does George lead, only he can hear the music! :mrgreen:

It does some patience, and data. The more numbers you can get, the clearer the picture becomes and the better you can figure out the dose. I know it is frustrating, but he has had some good numbers in the 2 - 2.5 unit range. You've gotten stalled because his preshot was low and we were too cautious with the dose, or he bounced from a low number to a high one. I think you're close to a good dose that will give you a shootable preshot that isn't in the blacks.

Are you also testing for ketones? It's the other diagnostic tool that keeps him safe. You get the ketone/urine strips that humans use and stick them in his stream while he is urinating. (if that sounds impossible, we do have tricks....)

We got Oliver OTJ in six months and that was considered early. Many people work for several years getting their kitty regulated. George is looking good for just a few weeks into the dance. Patience, Mom.
 
So basically there's not much we can do so just hold on for the ride and do our best to help out? Yikes!
Click to expand...
I've posted that link in quite a few threads, and I always worry that the reaction will be "so no matter what I do, I have no control???".
But the main reason that I like what Dr. Lisa says in it is that I see it as a stress reducer. I think her point is that many times, we get so caught up in trying to have control over the management, that we can drive ourselves crazy, and beat our heads against the wall. What I think is important is that we have to realize that while we can have absolute control over what we put into kittie's body (insulin, meds, food), we have little to no control over what her their body does with it once it's "in".
You can monitor the BG to "correct" if you have a day where the insulin seems more potent, by feeding food for instance (at different times or different portion sizes), so you do have some control over low numbers that just pop up one day. And if you see patterns in the data that indicate "something" you are doing needs to be adjusted, you can adjust accordingly. But insulin isn't a "if this - then that" thing, not to a great degree of accuracy anyway.

So, many times, you just have to sit back and watch what happens, and not panic when something unexpected happens. Every day is a different day, but trying to manage on a cycle by cycle basis, and not looking at the overall big picture is a road to "crazy". That's why people are always telling people to "breathe" around here. :lol:

Carl
 
+4 AMPS 211 - I still have 1/2 of a 5.5oz can of food to feed him so his later numbers may get a little messed up, but he is definitely curving!

Gotcha Carl...still is hard to grasp though ;-) And Sue, I do have the ketone strips but I'll admit to not being great about using them. When George pees he pees A LOT (always has even pre-diabetes) so sometimes if I hear him going I'll run and grab the ketone strip and sometimes I get lucky and there's standing urine in his lake of liquid that I can test from, but if there's not then I'm less likely to test. I'm open to trying out the tricks you mentioned, very interested to hear how you do it!

Just wondering, when a cat is regulated what kind of numbers do they typically have and how much does it bounce up and down? I think part of my problem is I have no idea what to be looking for to see if there's progress.
 
A regulated cat ranges from the 200s at preshot to 100s and below at nadir (midcycle) on insulin.

A cat, off insulin, can range from 40 - 120 with the majority of the time spent in double digits.

Oliver would not pee if we were in the room. So we had to put aquarium gravel in a clean litter box and leave him alone In a room until he went. Other people put a patch of Saran wrap in the litter (a little scooped out place) where the kitty usually goes.
 
I'm thinking saran wrap might be the way for me :smile:

So once George is on the correct dose he will hopefully start each pre-shot in the 200s...does the dosage eventually have to be lowered because I can't imagine him starting in the 200s and then giving him 2.5 units of insulin?
 
+6 AMPS 137 - fed 1/2 of 5.5oz can at 5p, waiting to see numbers impacted

I feel like this has probably already been answered somewhere but I'm still a bit confused - if George started on a low dose and it has to be continuously raised to get him into better numbers, how does he then start doing well enough that the dosage can be lowered back down and the numbers don't go back up? I know the feline pancreas can start working again (sometimes), is that what's happening when the numbers get better, is the higher dosage basically jump starting the pancreas allowing us to then decrease how much insulin they need added into their systems?
 
No this is fantastic! It looks pretty much like the cycle he had the last time you shot 2.5. This time, (we'll see what George does by midnight first), maybe he'll be around 200 again, or he might be a little bit higher than that. Last time you shot .5, which looked like it wasn't enough. So we'll figure out what makes sense when shot time gets closer.
If you do give him a shot at PMPS, will you be able to test between then and his morning dose?

Carl
 
suwannee79 said:
+6 AMPS 137 - fed 1/2 of 5.5oz can at 5p, waiting to see numbers impacted

I feel like this has probably already been answered somewhere but I'm still a bit confused - if George started on a low dose and it has to be continuously raised to get him into better numbers, how does he then start doing well enough that the dosage can be lowered back down and the numbers don't go back up? I know the feline pancreas can start working again (sometimes), is that what's happening when the numbers get better, is the higher dosage basically jump starting the pancreas allowing us to then decrease how much insulin they need added into their systems?
Click to expand...

OK, this is probably an oversimplified explanation, but here's what basically happens.
Diabetes is caused by a couple of things. Either the pancreas isn't producing insulin correctly, or the cells that need glucose for energy are unable to absorb the glucose and turn in into energy. So, the glucose remains in the bloodstream, and eventually shows up on your meter as higher than normal BG values.

So, you get your insulin and your needles and you add insulin to his system so that his body can get the glucose into the cells, and the cells can function more normally. This causes the BG to do down.

When you first start treatment, you start at a low dose, see how it works, and if needed, you increase the dose. What you are trying to do is to lower the BG to numbers closer to normal (say in the 250 or lower range) for most of the day. By doing that, you are giving his pancreas and his other organs the chance to heal, so that they can start to work like they are supposed to. High BGs for a length of time can make the problem worse, because it causes insulin resistance, making it that much harder for the cells to absorb the glucose.

You will get to a point where the body is taking care of at least some of the problem by itself. At that point, you won't need to "shoot" as much insulin into the system, the numbers will stay lower more often, and things will continue to heal. What we are all trying for is to get to the point where everything is "back to normal", and the body self-regulates blood glucose. When that happens, insulin is no longer required from you, and kitty goes "off the juice".

Most cats go through this process. Doses start small, they increase over time, and at some point you'll see blue and greens more often. That's when you start on the way back down the dosing ladder slowly as he continues to heal and improve.

Bob started at 1u twice a day. He went up to 4u twice a day until he got to the point where his numbers began to improve noticeably. He then went down pretty quickly to "zero". In his case, it was around 6 weeks "up in dose" and 4 weeks "down to zero". In this aspect, the "ECID" (every cat is different) thing is really true. Some cats take less time than Bob did. Most cats take longer. Some might never get there, but they can live for years with numbers just above normal, requiring two shots of insulin a day for the rest of their lives. And they can live healthy happy lives for years as diabetics (just like people do). Some cats go off the juice, and then end up needing to go back on for whatever reason. Once a diabetic, always a diabetic. Bob is one bag of dry food away from possible relapse. That's why he'll eat low carb canned forever.

Carl
 
+11 AMPS 170

That is an awesome explanation Carl, thank you so much!!

As for George I'm wondering if he'll even make it to 200 in the next hour but you're right, .5 wasn't enough last time and taking into account he'll be eating about 3/4 of a 5.5oz can of food (plus another 3/4 throughout the night) do you think maybe 1 unit would be ok? I can check him probably up till +4 PMPS but I'm on vacation so I can stay up later if necessary.
 
PMPS 206

Looking at the last time this happened we know the .5 wasn't enough but, looking at how high he came back up last time, I'm concerned if 1 unit will be enough. I went ahead and did the 1 unit because as my husband pointed out this is all still trial and error so this way at least we'll know how 1 unit works the next time he stays low like this. Very interested to see how this plays out!
 
Your husband made a good point, trial and error. And it is much better to give 1u and find out it isn't enough, than to give 1.5 and find out it's too much.

Carl
 
+2 PMPS 339.....and now he decides to go up :roll:

Hopefully this is just because of dinner, but he still has more food to go so I'm a little nervous now; but at least this way we can compare what his morning number will be with 1 unit vs. the .5 last time.
 
A lot; of kitties seem to rise and then the insulin seems to kick in at about +3 or so. All data is good to have. It helps make sense of things later.
carl
 
+4 PMPS 212 - fed rest of food

Looks like what you said could happen Carl, here's hoping he stays in a decent range tonight!
 
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