Getting more frustrated by the day

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Ginny & Alex

Ginny & Alex

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I understood from all of you and from my vet that this wasn't going to be easy, but I'm soooo frustrated.

I'm at work now and can't update Alex's spreadsheet because of security, but this morning before his shot, he was at 549.

Since I'm talking to my vet every 4 or 5 days, I thought I'd quit posting so often because I can't take everybody's advice, but increasing the insulin dosage seems to be causing increases and not decreases.

What should I do?
 
Hi Ginny
Believe me I understand your frustration
I was crying yestereday trying to figure out what to do with Shakespeares dosage
I have the same problem that the more I increase the higher his numbers go up,
so last night I decreased the dose and his amps and pmps were much better

I dont want to give you advice on this because I have only been on PZI for one month
now, but maybe if you did back off for one dose to see what happens.
If you want, look at my spreadsheet and maybe that could help a little

I am so sorry I could not help more, but please hang in there, it will happen
it just takes awhile

Denise and Shakes
 
I know how you feel also...I've been at the end of my rope more than once since Thumper was diagnosed April 1. Only a month but it seems like an eternity. I have not had her back at the vet since the week after she was diagnosed. My vet encouraged home testing but I thought no way could I do it. I think if I had not I would have overdosed her by now. I think my vet is good but I can't be taking her there all the time and she told me herself the stress of being there makes BG go higher anyway. So whatever she advised from curves there might very well be different at home. No way can I advise you on dosing...I'm still having to get help daily myself but I think you can do it getting advice here & not making so many trips to your vet. I'm sure that's stressing your kitty and I know it's got to be expensive. Hang in there & good luck!

Barbara
 
Looking at your SS, I think the dose increases have been too much at a time. We usually recommend increases of 0.2 or 0.5 units, depending on how far you are from the goal.

When you look at the cycle on 4/23 where your +12 (PMPS) was 105 and lower than the mid-cycle check had been, that pattern on PZI often means the dose is too high. I would go back to something under 2u, maybe 1.2, and start over with a progression (if needed) in smaller dose increments.

When they jump up by a full unit, it's really easy to miss the right dose, I wish vets wouldn't suggest that. The numbers can be confusing b/c both a dose too low and a dose too high can give you high #s, so it can be hard to decipher.
 
And...I have no idea! But, if Kelly and Joanna agree that would be good enough for me to try it. You've got two good experienced people seeing the samething.
 
I'm so sorry you're feeling frustrated. It's completely understandable though. I've been there and done that too. I think particularly in the beginning finding the right dose can sometimes be hard and patience is needed. It can take time for a newly diagnosed kitty's numbers to settle down. I like the others suggestion to lower the dose and increase in smaller increments if needed. I would also recommend holding the dose a couple days to give your kitty time to adjust before deciding if you need a change. For some kitties, it can sometimes take a few cycles (shots) before you see what they are really going to do on a new dose. This, of course, is dependent on the numbers (i.e. you wouldn't hold a dose if you were getting really low or really high #'s). Paws crossed for some nicer #'s soon.
 
Frustration is part of the dance, and we've all been there at one time or another or continually for days. I'm a short timer too, Maisey was only on insulin for a month, but I'm all for following this groups advice. We never got up to the amount the Vet said to use, I'm sure it would have killed Maisey. She was down to 8 pounds when we had to start.
 
Thanks to everyone for your suggestions. We did decrease to 1.5 units beginning yesterday morning based on comments here and then I talked to the vet last night and he also suggested decreasing to same dosage. I didn't tell him we already had decreased the dosage. :o

Anyhow, this morning's number was 348 which was a vast improvment from the last few days. I realize I can't make a dosage change everytime we have a high number, but a couple of those 500's and high 400's scared me!
 
The other thing that will really help us see the whole picture, Ginny, is some mid cycle numbers. Some people who can't be home during the day, get a few numbers in at night. Even a number before you head out in the am and the first thing when you get home in the pm helps fill in the gaps. And a curve on the weekend would be wonderful!

You have probably already heard that this sugar dance is a marathon, not a sprint. Be patient - you are doing a great job for Alex.
 
Sue,
The morning poke/shot is at 6:30 am and we leave the house around 7:00am. Then we get home around 5:00 or 5:30pm. Are you suggesting I poke him around 5:00pm and again at 6:30 pm?

And when you talk about the curve, how many pokes do you suggest? At first, I did +2, +4 and +6 and maybe one more after the PM shot. Are you suggesting more than that?
 
Not much room in the am....The in the door test might give you some info. Worth a try once. Since you shoot fairly early at night, how about a before bed test test? All data is valuable. The curve can be every 2-3 hours during the day on a weekend. Requires lots of treats, neosporin with pain relief and determination. :mrgreen: Seems like it's a good time for another one
 
Don't let the vet's 2 weeks comment phase you - they are thinking in terms of not home testing I would guess, as that was my vets time-frame too. If you aren't home testing, they want to be sure the dose has fully settled in so when they do a curve they will get a clear picture. When I started home testing I asked my vet specifically about that - do we still need 2 weeks btwn dose changes? - and she said no, not at all, that's only if you aren't home testing.

So anyhow, no 2 weeks :-D if the dose isn't right. If you can get a curve like Sue suggested this weekend that would be perfect. If you need to, distribute the tests out over both days - maybe something like +2 +4 +6 one day, and +6 +9 the other day or whatnot. Just in case you actually wanted to leave the house ;-)
 
I will try to get more readings this weekend.
I like your comment about possibly wanting to leave the house during the weekend.
There's a direct relationship between his BG levels and my mood. When his BG levels are on the rise, I feel discouraged. When his BG levels start moving down, I start feeling happier.
 
Oh gosh, I had forgotten about the BG mood roller-coaster! It can be pretty draining. It helps to take a longer-term view and not obsess about each # (though good luck with that w/all of us analyzing it all! LOL). It also helps to focus on how they are doing overall - even though we focus on the #s a lot here, it is really just one angle on it. If they are feeling ok and acting ok, then that is more important than the #s. Of course if they are feeling sick and not acting well, that is tough all around. It takes a lot of time & patience though to get them regulated - some kitties are easy, but more often it takes several weeks or months. Not to be discouraging, sorry, but for some perspective. I think when people think it ought to all fall in place right away, like taking aspirin or something, it can add to the frustration. Knowing that typically it is a somewhat involved process can help not get freaked out over every number or every bad day. The good news is that many cats go OTJ, and I think their peeps would say it was worth the hassles to be able to get to that point. And even when they don't, they can still get nicely regulated, and it gets a lot easier at that point.
 
That's one of the things I have failed to mention. Alex seems to be feeling pretty good since he was diagnosed in late Feb--more urinating, drinking and eating then normal, and maybe a little lazier (but he's an 11-yr old cat and both cats sleep lots). He still plays with his laser mouse and likes to beat up on his sister, Audrey. For these things I am truly thankful.

I did mean to ask earlier, since I'm decreasing the dosage from recommendations on this board, plus my vet, should I go with 1.5 units BID or 1.25 units BID. Seems better to start lower and then increase if needed?

BTW, his AMPS # was 410.
 
I would agree, Ginny. Start at 1.25; you can always increase as needed. As long as you are testing and keeping a close eye on his numbers, you can adjust and keep him safe. Have we talked about ketone testing? At his higher numbers, it is another way to keep him safe: ketones
 
Don't know whether to start a new thread or continue posting on this one.

With the high numbers Alex was getting, Sue and Joanna (and finally the vet), suggested I reduce my dosage--couldn't decide between 1.25 and 1.50 units, but finally decided on 1.25. Sue also suggested that I try to get lots of readings this weekend. Since I typically work from home on Fridays, I decided to go ahead today and get it over with. Alex is already tiring of the ear prick. So, I have # for AMPS, +3, +6 and +9.

And in answer to an earlier question from Sue, no, I haven't tested for ketones yet. Ketostix is on the list for the next shopping trip.

Ladies, I'll be anxiously awaiting your advice.
 
This is hard, Ginny. You are getting pretty high numbers on your curve today. That could mean too little insulin, but you have given higher doses with little success. Your best numbers in the past month were on one unit, back on 4/13.

I would post on a new post, and ask people for input on your curve. We would have hoped to see a reduction in numbers, but he may be a cat who takes a while to settle into a new dose. This is a complicated decision, and I would like you to get lots of input. I know it is frustrating that we don't all speak with one voice, but it is a puzzle and we all approach it differently. You have to listen to the options and go with the one you are most comfortable with.

I think I would give this dose a little more time, BUT I would get the ketostix and start testing for ketones. You don't want him sitting in these high numbers without being sure he is ketone free. And if you can, get some mid cycle numbers this weekend - particularly the +6.
 
Ketones can be very dangerous, so even a trace means a call to the vet, at least. ketones More than a trace means a vet visit. They can cause a condition called DKA - there is info about it in the link I gave you. One thing that can help them from developing is to add water to the food so he stays dehydrated.

It seems some cats are ketone prone and others just aren't. We see cats with decent numbers getting insulin who develop ketones, and cats with high numbers and not enough insulin who don't. Just a good test to have in your kit.
 
Awesome job getting the curve done, yay!

Typically we go with a new thread each day, that seems to work fairly well. No biggie if you don't follow that, but that's kind of the system so to speak.
 
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