Getting a baseline for Wilbur

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johnt

johnt

Member Since 2016
This is a continuation of this thread if anyone wants context.

Several people have been helping me work with Wilbur to get a good baseline for numbers and we just started altering his dose levels to bring him in line.

This morning he tested AMPS at 274 which i know is a little high, but it's actually pretty stable and much lower than it was a week ago.

If anyone has input on where I should go let me know. @Kris & Teasel and @Nan & Amber have been 'holding my hand' since after 6 years wilbur just now started letting me test. Others have stopped in too. I can't begin to say how thankful I am

Kris I will get a +2 or +3 today and report back. I also raised his dose 0.25u today as suggested

Also, I've reduced the temptations about 90% now. i'll be removing them completely in the next two days.

Boy since I started feeding him small amounts of tuna his coat sure did come in nicely :)

thank you!
 
Good morning, John! I'll defer to Kris (she's more attuned to Vetsulin cycles and the nuances of dose change responses than I am) on the next time to test, but I'm thinking maybe +4?

Glad to hear that the tuna has its benefits (besides of course just being one of the few things that Wilbur will eat at the moment :rolleyes:)
 
Nan & Amber said:
Good morning, John! I'll defer to Kris (she's more attuned to Vetsulin cycles and the nuances of dose change responses than I am) on the next time to test, but I'm thinking maybe +4?

Glad to hear that the tuna has its benefits (besides of course just being one of the few things that Wilbur will eat at the moment :rolleyes:)
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OK i'll do that, however I need to be cautious with him. he's still a bit gun shy and ifd I keep testing him frequently he'll start hiding again. But i'll get him at +4 which is about an hour and a half from now.

While I'm thinking. I need to buy lancets. They're numbered like wire right? the smaller the number the bigger the needle? I'm using 30 gauge now. but I was thinking of getting smaller. i wonder how hard it will be to get blood from smaller ones.

oh finally, i'm going to carve a handle for these stupid lancets, they're so tiny i kee dropping them. I carve small wood plaques so i think I'll make one. unless there's something else out there already? Do you know?
 
johnt said:
OK i'll do that, however I need to be cautious with him. he's still a bit gun shy and ifd I keep testing him frequently he'll start hiding again.
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This is why I was a little hesitant. I look at that +2 and think, we-eell, it's lower, but not too much lower, this might be a quiet day today and require less testing. But I don't have as much experience with Vetsulin, so I always try to err on the side of caution!

That's correct on the lancets. It gets easier to use the smaller ones after a week or two-- the ears grow more capillaries-- and it's definitely easier on them. The tiny ones can be tough to use at first, though.

They have little devices (come with most meters) that humans use to do the poke-- some people use them (without the cap) to hold the lancet. I'm sorry I'm not describing this very well, but if you look on the drugstore shelf with the other diabetic supplies, you'll likely see them.
 
Nan & Amber said:
This is why I was a little hesitant. I look at that +2 and think, we-eell, it's lower, but not too much lower, this might be a quiet day today and require less testing. But I don't have as much experience with Vetsulin, so I always try to err on the side of caution!

That's correct on the lancets. It gets easier to use the smaller ones after a week or two-- the ears grow more capillaries-- and it's definitely easier on them. The tiny ones can be tough to use at first, though.

They have little devices (come with most meters) that humans use to do the poke-- some people use them (without the cap) to hold the lancet. I'm sorry I'm not describing this very well, but if you look on the drugstore shelf with the other diabetic supplies, you'll likely see them.
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yeah i didn't think about that. I could just keep the cap off. good idea!

He's hiding from me. if I can't find him in the next 30 minutes I'm going to have to bag it and wait till i see him. i don't want to chase him
 
Aha, I was just writing a message clarifying that what I was trying to say is that I think that it might be possible to be a little less frequent with the testing today (I just default with conservative suggestions if I'm at all unsure).

If he's hiding, though, that definitely sounds like he needs a break!
 
I'm back home now. Yes, let him have a break from testing. He didn't have a big drop at +2 so you can wait. Use your judgment about his mood re testing. You don't want to break the hard won gains.

Re lancets: You can try thinner gauge if you like. I use 28 gauge with Teasel and have all along but if you think the 30s hurt Wilbur's ears you could try 31 gauge or a little thinner. I don't use the trigger mechanism but I put the lancet in its holder (without the cap of course) to give me something bigger to hold. It's the holder that came with the meter kit. You can try that.

Re his impatience for PMPS testing: you could give him a little bit of tuna right before you do the test. Test while he's eating it if that works. It's low carb and if you feed it right with the test it won't have time to affect his BG.

Would you say that the reds on your SS can be traced to some high carb treats, stolen or otherwise? I ask because if that's the case you can really see the strong effect they have on BG. I'm glad you're continuing to wean him off those. :)
 
Kris & Teasel said:
I'm back home now. Yes, let him have a break from testing. He didn't have a big drop at +2 so you can wait. Use your judgment about his mood re testing. You don't want to break the hard won gains.

Re lancets: You can try thinner gauge if you like. I use 28 gauge with Teasel and have all along but if you think the 30s hurt Wilbur's ears you could try 31 gauge or a little thinner. I don't use the trigger mechanism but I put the lancet in its holder (without the cap of course) to give me something bigger to hold. It's the holder that came with the meter kit. You can try that.

Re his impatience for PMPS testing: you could give him a little bit of tuna right before you do the test. Test while he's eating it if that works. It's low carb and if you feed it right with the test it won't have time to affect his BG.

Would you say that the reds on your SS can be traced to some high carb treats, stolen or otherwise? I ask because if that's the case you can really see the strong effect they have on BG. I'm glad you're continuing to wean him off those. :)
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I could never do it while he's eating. his little ears move around too much. he fights his food :)

I do give him a shot while he's eating though because his giant belly doesn't move.

i might be able to get him here shortly.
 
johnt said:
I could never do it while he's eating. his little ears move around too much. he fights his food :)

I do give him a shot while he's eating though because his giant belly doesn't move.

i might be able to get him here shortly.
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No rush. Maybe a +6 or +7 if you want to try again later.
 
Kris & Teasel said:
You're learning the finer points of insulin dosing now. ;)
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it's interesting. that's why i thought "Well he was on 9 and 10u twice a day. how could .25 matter?

I still can't believe he was getting that much, and honestly i'm not sure how this didn't kill him. it makes me upset to think about it. Thank God it's over now and in control
 
johnt said:
it's interesting. that's why i thought "Well he was on 9 and 10u twice a day. how could .25 matter?

I still can't believe he was getting that much, and honestly i'm not sure how this didn't kill him. it makes me upset to think about it. Thank God it's over now and in control
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What's that saying? "When you know better, you do better". :smuggrin:
 
Kris & Teasel said:
What's that saying? "When you know better, you do better". :smuggrin:
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No kidding.

He was sketchy all day, I'm going to give him the rest of the day off other than his typical PMPS.

tomorrow I'll stick to the 4.75 I assume? Since I got a +2 today should I shoot for a +4 tomorrow?
 
johnt said:
No kidding.

He was sketchy all day, I'm going to give him the rest of the day off other than his typical PMPS.

tomorrow I'll stick to the 4.75 I assume? Since I got a +2 today should I shoot for a +4 tomorrow?
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Yes, just stick to PMPS for today. You'll keep the 4.75 u for a few days to see what it does unless he dives low into lime green. You can try for +4 tomorrow.
 
Sure thing. We're getting a better routine in and I'm feeling better. I am still hoping to get him off the temptations by Friday.

I got those samples today. Wilbur didn't care about the salmon or chicken kibble, neither did Tinker. but i'll spend some time with them.

I also received two cans of the salmon and two of the chicken wet food. if I can move wilbur to those to replace the temptaions that would mean he'd be off hard food completely. Other than when he skirts in to steal the hills.

B ut Pickle, the 3rd kitty, LOVED the salmon. I'm hoping to get tinker on it too but time will tell.

Feeling better all around though, sure am grateful for your help Kris
 
johnt said:
Sure thing. We're getting a better routine in and I'm feeling better. I am still hoping to get him off the temptations by Friday.

I got those samples today. Wilbur didn't care about the salmon or chicken kibble, neither did Tinker. but i'll spend some time with them.

I also received two cans of the salmon and two of the chicken wet food. if I can move wilbur to those to replace the temptaions that would mean he'd be off hard food completely. Other than when he skirts in to steal the hills.

B ut Pickle, the 3rd kitty, LOVED the salmon. I'm hoping to get tinker on it too but time will tell.

Feeling better all around though, sure am grateful for your help Kris
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Glad to help. :) It's so much better to be proactive than reactive, isn't it?
 
Kris & Teasel said:
Glad to help. :) It's so much better to be proactive than reactive, isn't it?
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listen, for 6 years I've been stressed. I tried several times visiting here and getting suggestinos but I just couldn't get him to let me test.

This is the first time sinxce he's been diagnosed that I feel like I can get a good handle on him.

About dosing. you mentioned go up to 4.75. but my problem is seeing those marks on the syringe. it's not a matter of practicing. it's a matter of I can't physically see the mark. My syringes only have marks at at the 1u point. Doing a .5 is easy, but breaking that down gets tough.

here's my point. This is the syringe i'm using. See how tiny this is? it's very difficult for me to determine where the 1/4 marks are between the 1u markers.

do you use a different kind of syringe? maybe I should switch. the yellow arrow point to the very bottom of the syringe marker. to me this dose is just slightly more than 4.5 and not enough to be 4.75 ( i didn't try to be on point, just loaded some up to take a pic)


dose.png
 
Yes, whole unit syringes are hard to use for fractional doses. If you want to keep using these you can eyeball 4.5 u fairly easily. What I would do to get something between that and 5 u is fill the syringe with insulin to the bottom of the 5 u Mark (ie. the side closest to the 10 u line) and then carefully move the top flat surface of the plunger to the top of the 5 u line using a twisting motion on the plunger for better control. Once you see clearly it’s in that position, twist the plunger slowly to release a drop or two until the plunger top is slightly closer to your estimate of where 4.5 u would be.

You can buy U40 syringes with half unit marks from ww.adwdiabetes.com I think. Another thing you can do with a U40 insulin is to dose with U100 syringes that have half unit marks and a conversion chart. That allows more dose fractions like 0.2, 0.4, 0.6 and 0.8 u. Those half unit marks are important.

I use Levemir insulin for my cat. It’s a U100 insulin so I use U100 syringes with half unit marks. I routinely have to eyeball 0.25 or 0.75 u fractions but I also use finer distinctions like “fat” and “skinny” doses - ie., a drop more or a drop less.
 
BTW - that’s a really good curve today: similar range AM/PMPS and near middle of cycle BG about 50% of PS values. Ideally for an insulin like Vetsulin that has a smile-shaped curve, you want PSs in the low 200s and a nadir in the high double digits or low 100s. Today’s numbers are darn close.
 
Kris & Teasel said:
What do you think changed so that Wilbur let you test him?
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It's all me. It's because i was nervous, uptight and unsure of myself before. This time i just went in with confidence and made him comfortable.

he's getting better. i just got him while he was trying to eat. It was time for his shot and i'd been holding him off from food. i came in and he was sneaking kibbl;e so i just grabbed the tester, sat down with him and pet him a bit. He realized I was going to do it and squirmed just a little, but since I can get it without it hurting him now it happens fast, and then i pet him a lot. So he likes that part.

Was a little high today though. 347.

I seriously think he's sneaking kibble.
 
Chris & China said:
These CarePoint U40 come with half unit markings

Also these BD U40 come with half unit markings

They are both available at ADW
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Here's the issue I have and it doesn't make sense.

the unit in the picture above is a u-40 1/2 cc 29g

I have others that are more expensive and have multiple markers. but they're smaller (the markers), they are 40 units.m 1mL

They're also 28 gauge which i thought meant they'd be bigger than the 29. am I wrong? because with the one pictured below (it's called monoject) it's difficult to get the insulin to go in. Whereas the others it goes right up.

Am i backwards on the gauge/size?

mono.png


one last thing. I have a repairman coming at 10:00am (10:30 would be +2) so I might be late on that. if I am should I just do a +4?
 
johnt said:
It's all me. It's because i was nervous, uptight and unsure of myself before. This time i just went in with confidence and made him comfortable.

he's getting better. i just got him while he was trying to eat. It was time for his shot and i'd been holding him off from food. i came in and he was sneaking kibbl;e so i just grabbed the tester, sat down with him and pet him a bit. He realized I was going to do it and squirmed just a little, but since I can get it without it hurting him now it happens fast, and then i pet him a lot. So he likes that part.

Was a little high today though. 347.

I seriously think he's sneaking kibble.
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Unfortunately it's the human who has to control the access to diabetic kitty contraband. o_O

Re syringes: you don't need larger capacity than 0.3 mL (cc). Any more than that and the marks can be too close together. Those syringes with the red caps and no half unit marks are what vets often sell to go with a U40 insulin like Vetsulin or ProZinc. I've had them but stopped using them when my cat was on ProZinc.

For needles, get what you and Wilbur are comfortable with. Many people use 31 or smaller gauge. I use 29 gauge and always have. Some people like shorter 1/4" needles but I've always used 1/2" with no problem. Either of the ones Chris recommended above in her post (#25) would be absolutely fine.

Here's a conversion chart you can use to dose U40 insulin with U100 syringes:
http://www.felinediabetes.com/insulin-conversions.htm
This is what many people use and is what I did when Teasel was on ProZinc. It works really well to allow a multitude of dose fractions. U100 syringes are readily available at a human pharmacy but you need to ask for those with half unit marks. They can also be ordered from the link Chris gave you above.

Try for a +4 or +5 if you're busy with the repair man.
 
I will. the jerk never showed up yesterday so i was tied up waiting. He'll be late today.

Off topic but it really bugs me. I'm leasing this house for my mother for a year before we decide to buy or not. I bought a new kitchen faucet, called and told him and said I wouldn't take it off the lease, I'll just pay. Before I hung up I told him id install it like I do everything else here.

he insisted I let his son do it since he's 'out of work' and is a retired plumber and needs the $. So I paid $250 for a faucet that I have to have some unemployed half wit install. Nice! that's why it wasn't done yesterday, he never showed up. Sposed to be here at 10 today, I know he wont.

about a 10 minute job if I do it. would have been done 2 days ago.

anyway, ok sorry. just makes me mad.

If he's not hear yet I'll get a +2. I know it's my fault on the kibble, but I'm changing a lot on him anyway, and feeding him a lot less now that I'm testing and can manage a weight loss program while not worrying about glucose so much. I don't mind slipping on one thing, but this is twice and it's interrupting the testing, so no more.
 
johnt said:
If he's not hear yet I'll get a +2. I know it's my fault on the kibble, but I'm changing a lot on him anyway, and feeding him a lot less now that I'm testing and can manage a weight loss program while not worrying about glucose so much. I don't mind slipping on one thing, but this is twice and it's interrupting the testing, so no more.
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Do the best you can. You've introduced a lot of changes into Wilbur's life. If you can ever get him on low carb wet food only I'm pretty sure the weight loss will happen on its own. Try to get some freeze dried fish treats next time you're in a pet store. You can also use little bits of Bumble Bee tuna as a treat if that's his favourite.
 
Kris & Teasel said:
Do the best you can. You've introduced a lot of changes into Wilbur's life. If you can ever get him on low carb wet food only I'm pretty sure the weight loss will happen on its own. Try to get some freeze dried fish treats next time you're in a pet store. You can also use little bits of Bumble Bee tuna as a treat if that's his favourite.
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i got him but it was 366 which is pretty awful

I've got to find a way to keep the food from him. Once all the people are out of the house I'm going to pull the 3 bowls and just leave water. when i give him a shot i'll put it back
 
johnt said:
i got him but it was 366 which is pretty awful

I've got to find a way to keep the food from him. Once all the people are out of the house I'm going to pull the 3 bowls and just leave water. when i give him a shot i'll put it back
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If the only food that's left out is either low carb kibble or low carb wet food you don't have to take it away except for those 2 hours before his PS test is due. If he's a grazer by nature try that. It'll be interesting to see if you can sway his taste in food. Kibble is very addictive to some cats and Temptations treats even more so. I keep a bag of them to use if Teasel's BG is too low and he goes absolutely bonkers with excitement when I open the bag. They're dangerous! ;)
 
@Kris & Teasel, lovely. I just noticed something. I only have 26 strips left. I had already ordered 100 more, but it will be 7 days till they're delivered. That means 3 per day. is that going to be enough?
 
Kris & Teasel said:
If the only food that's left out is either low carb kibble or low carb wet food you don't have to take it away except for those 2 hours before his PS test is due. If he's a grazer by nature try that. It'll be interesting to see if you can sway his taste in food. Kibble is very addictive to some cats and Temptations treats even more so. I keep a bag of them to use if Teasel's BG is too low and he goes absolutely bonkers with excitement when I open the bag. They're dangerous! ;)
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All i have at the moment is the hills, which definitely isn't low carb. but i'll find something else. just take a little time

that really bugs me too. I pay a lot for that food at Chewy ($66 for a 20lb bag is expensive to me), and I did so thinking i was getting premium food. I might as well have gotten meow mix from walmart at $20 for the same sized bag.
 
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johnt said:
@Kris & Teasel, lovely. I just noticed something. I only have 26 strips left. I had already ordered 100 more, but it will be 7 days till they're delivered. That means 3 per day. is that going to be enough?
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Are they available in a pharmacy where your type of human meter is sold? Could you buy some there to fill the gap? You might be able to squeak by for a week with those 26 strips but what if he decides to dive and a little more monitoring is in order?

Re food: you probably are getting premium food but unfortunately it's too high in carbs for a diabetic.
 
Kris & Teasel said:
Are they available in a pharmacy where your type of human meter is sold? Could you buy some there to fill the gap? You might be able to squeak by for a week with those 26 strips but what if he decides to dive and a little more monitoring is in order?

Re food: you probably are getting premium food but unfortunately it's too high in carbs for a diabetic.
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Actually I just checked and it looks like Walmart carries these.

I just didn't think, I ordered a new 100 strips that arrive Feb 1. So i just didn't expect to run out so fast. Going to see if I can find them at Walmart, and if so just buy 400 on Amazon. they're really cheap there. about $56 for 400 and that should last a long time.

Jeeze I feel dumb. i guess it just dind''t dawn on me..
 
Oh, you're ahead of the game! Realizing you are running low when you still have 26 left is pretty good for the first time running low! For a lot of folks, the realization hits when they have 3 strips left, it's midnight, and kitty is going low (they always know, somehow! :rolleyes:)

Good plan to stock up. :)
 
Nan & Amber said:
Oh, you're ahead of the game! Realizing you are running low when you still have 26 left is pretty good for the first time running low! For a lot of folks, the realization hits when they have 3 strips left, it's midnight, and kitty is going low (they always know, somehow! :rolleyes:)

Good plan to stock up. :)
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yeah I just had no idea i'd get to the point I'd go through a hundred so bloody fast. The next one's will lat a long time.

Shame the Verio Flex tabs aren't cheaper. I have two of those that are USB and paired to my cell phone. Could use one but the refills are $39.87 for the verio Flex, or $17.00 for the TrueTrack tester. At over 50% cheaper it's a no brainer.

But i'm paranoid like that. i counted what i had left and then looked at the delivery date for the new ones and it dawned on me I don't have enough.

Just got back from Wally World. Saw on the Walmart.com they show $16 for 100 test strips. But when i got there they only carried the more expensive strips. That were easily double the price. But i wasn't going to start over from scratch
 
@Kris & Teasel FYI i just got him PMPS and he's at 265. THought I'd post before dosing, I'm going to stay at 4.75 unless i hear otherwise. I'll give it a few minutes before going ahead

Nan & Amber said:
Oh, you're ahead of the game! Realizing you are running low when you still have 26 left is pretty good for the first time running low! For a lot of folks, the realization hits when they have 3 strips left, it's midnight, and kitty is going low (they always know, somehow! :rolleyes:)

Good plan to stock up. :)
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Also, I ment to say I ordered the others and they got here Feb 1. But because of all the testing I noticed I was getting low, so I counted what I had left to figure out how long they'd last. It lokos like i can use 4 per day right now. I should only need 3 though. I did already place that order for 100 that will get here the 21st. But i also just ordered 400 more so id be set for awhile.
 
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Early night for me so I didn't see your tag. The few hours time difference between here and where you are can mess things up. I'm glad you gave the 4.75 u. Aside from the (possibly) kibble-induced highs you're seeing a pretty good response at this dose. Stick with it for now. If the pinks and reds are from contraband and I look past them, he's got good duration from the Vetsulin and isn't a crazy bouncer. Won't know for sure until you're further into your new feeding regimen but it looks promising.
 
Kris & Teasel said:
Early night for me so I didn't see your tag. The few hours time difference between here and where you are can mess things up. I'm glad you gave the 4.75 u. Aside from the (possibly) kibble-induced highs you're seeing a pretty good response at this dose. Stick with it for now. If the pinks and reds are from contraband and I look past them, he's got good duration from the Vetsulin and isn't a crazy bouncer. Won't know for sure until you're further into your new feeding regimen but it looks promising.
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Sounds good. he's doing well. although this morning the poor little guy kept trying to throw up but couldn't get it. Man, all 3 of my cats throw up, and with fosters I've seen hundreds over the years. but when he does it it's violent and i can tell it hurts because for several minutes afterwards he winces when he swallows. And yes he ate well after he got through the heaves, i'll keep an eye on him

Anyway, 254 AMPS so we're still in line. much easier to keep him clean for 2hrs in the morning. Starting last night though I removed all access for all cats. not like they're going to die in 2 hours and since I don't hand feed the other two at all they probably wouldn't beg,
 
@Nan & Amber Something I noticed looking at Amber's SS. When you changed to young again it instantly dropped into the blues during your testing. Can I ask if the food you were feeding prior was also low carb?

Also, it looks like it really worked when you started using an auto feeder. I don't think i'd have a problem with Wilbur on that because I'm always around him but i might consider this anyway for all 3 since it would force 'no cheats'. I tried to figure out what "OTJ" meant but couldn't. Can you tell me what that means?

Finally, the claim I keep seeing from the YA site is that yes it's expensive but they will eat a lot less of it so it's not really that expensive. I assume that's hyperbole but thought I'd see what you think after using it for a bit.

Now i know Wilbur isn't going to drop like that, he's way too high and it's been too long, but if the Young Again helps that much
 
Hi John!

johnt said:
@Nan & Amber Something I noticed looking at Amber's SS. When you changed to young again it instantly dropped into the blues during your testing. Can I ask if the food you were feeding prior was also low carb?
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Yes, by that time she'd been on low-carb for a while. I'm not sure the addition of YA made a difference in anything other than her grumpiness (she was a hard-core kibble addict and was thrilled to get some crunchies back!), so it was likely just coincidence.

johnt said:

Finally, the claim I keep seeing from the YA site is that yes it's expensive but they will eat a lot less of it so it's not really that expensive. I assume that's hyperbole but thought I'd see what you think after using it for a bit.
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I'd say that's definitely true. The problem I have now with the YA is that, at some point, Amber decided she wasn't all that happy with it after all and she just stopped eating it. So did my civvies, who had been dipping in once in a while (I kept a bowl out for free-feeding, and after a while I realized I hadn't had to re-fill in a while). Hopefully, if your kitties like it, you'll have better luck getting them to stay on it.
 
Kris & Teasel said:
Early night for me so I didn't see your tag. The few hours time difference between here and where you are can mess things up. I'm glad you gave the 4.75 u. Aside from the (possibly) kibble-induced highs you're seeing a pretty good response at this dose. Stick with it for now. If the pinks and reds are from contraband and I look past them, he's got good duration from the Vetsulin and isn't a crazy bouncer. Won't know for sure until you're further into your new feeding regimen but it looks promising.
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I was asleep at +3 but I got a +4 at 178. I'll get his PMPS and see if I can get the +3 tomorrow
 
I have a general question. This morning wilbur tried to throw up but gave up after a few minutes when nothing would come up.

it just happened again 6 hours later. is that OK? normally he gets a little yellow stuff out which i read was normal, but he can't seem to bring anything up. don't know if i should be concerned or just let it go
 
johnt said:
I have a general question. This morning wilbur tried to throw up but gave up after a few minutes when nothing would come up.

it just happened again 6 hours later. is that OK? normally he gets a little yellow stuff out which i read was normal, but he can't seem to bring anything up. don't know if i should be concerned or just let it go
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Is he prone to fur balls? Does he have less access to food than he's used to? Some cats build up stomach acid when the stomach is empty and they'll vomit watery or foamy liquid. Maybe try giving him a very small snack periodically - low carb of course. You said that he ate well after this morning's episode (and kept it down?).
 
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