Going nowhere fast- what to do

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Sheri & Spyder (GA)

Sheri & Spyder (GA)

Member Since 2009
This is getting worse instead of better. I'm about to give up.

SS is up to date.....we're going the wrong way fast. Back down, or time for "R"
 
Unfortunately, I don't know anything about Levemir. Have you considered trying Lantus to see if it'll help? All I can tell you at this point is that it'll take time for Dante to get used to the insulin, and to build up a shed under his skin. I hope that an expert can come along and help you with your question. Hang in there, ok? Don't give up. I know it's frustrating, and we've all been there several times. You're doing a great job, and you're helping Dante a lot. :YMHUG:
 
I wouldn't give up. One thing to keep in mind is that Lantus and Lev are described as less "potent" types of insulin but what you lose in potency you gain in duration. (By "less potent" they mean that it doesn't grab on and slam numbers down. They are more gentle in their action.) If you opt to use R, I'd urge you to go back and read Libby's note in your previous condo -- you will need to test considerably more. At this point, you're not yet prepared to use R. You MUST know when Dante's nadir is. With R, you will need to do curves for the 4-hour period where R is active. Given that R is a highly potent insulin, you must know they way it effects your cat if you are going to use it safely.
 
Hi Sheri,

Perhaps you should give Dante more time to settle into a dose. Lately you have been raising the dose sooner than every 6 cycles (the protocol recommends every 6 cycles). BUT, sometimes it takes more than 6 cycles for a dose to begin to kick in. Lev. dosing is based primarily on the nadirs, and often when the preshots are high (like Dante's are), it is an indication that a steep dive has occurred somewhere in the cycle and has been followed by a bounce. Would it be possible for you to get more readings during a cycle (maybe on a weekend, or in some nighttime cycles)? A better picture might begin to emerge and people here would be able to make recommendations based on better data. (You don't have to do a curve every time: just get a reading when you can at different hours and gradually a picture should begin to emerge.)

I know how frustrating this is for you. Lev. is a very different insulin from PZI and does best on a 12-12 schedule (there isn't much leeway with regard to shot time, as there is with PZI). Are you confident that your vial or pen of Lev. is OK? The manufacturer states its efficacy date as 42 days. But most of us find we can use it much longer than that if it is kept refrigerated and not shaken up or treated "roughly". Be careful not to allow it to freeze!

I hope that Dante's ear infection is clearing up. His high numbers could be influenced by the infection itself, or the antibiotics.

Hang in there. Lev. can be tricky because of the late onset and late nadir it typically produces. With my previous FD kitty, Stu (GA), I had experience with both PZI Vet (now discontinued) and Lantus. ECID, of course, but once I got used to Levemir, I would not switch back to the Prozinc PZI, and I like the typical Lev. curve very much, compared with the Lantus curve. (If you look at Rusty's SS, bear in mind that we have had a lot of disruptions during the last few months that have impeded his progress--his bout with pancreatitis last spring; switching from inaccurate Monoject syringes and trying to replicate what I thought was his dose on the Terumo syringes; car trips, etc.)

Don't give up!

Ella & Rusty
 
Absolutely don't give up after only a month. This is a very typical pattern while finding the right dose to stabilize and bring down those numbers. It take a lot of patience, I know, and is best done by following the protocol. I remember feeling the exact same way with Salem, but patience paid off.

R is not a good insulin for cats except in very rare cases. It brings bg down quickly and doesn't last anywhere near 12 hours, putting the cat on a bg rollercoaster, if not done correctly.
 
Dont give up Sheri! Hang in there, we've been in the same frustrating situation. Trying our best & yet feel helpless. It really eats our heart out to see kitty in those red & black but be patient. Follow the protocol, post for advice when in doubt , do as much bg testing as you find possible. I am sure our effort will bring improvemnet to the overall health of our sugar babies. They did not get to this stage in a week, or month. Dante need the time & so do you. :YMHUG:
 
Check out Tip's condo from yesterday and her spreadsheet. Cindy has been increasing the dose steadily and all of a sudden is getting good numbers. The thing is, you don't know what dose will bring Dante down to good numbers. You don't want to overdose him, that is even worse. So you have to go up slowly but surely. Keep the same dose for 6 cycles but don't hesitate to increase according to the protocol. We all know how frustrating that is but that's the best method. Hang in there. You have lots of support here when you are feeling discouraged.
Liz
 
Hi guys ... Don't give up .. it is frustrating, especially when switching over to a totally different insulin, but you guys will get there .. it just takes time .. Remember, we've all been there at one time or another and we all understand, so vent away here! What you are doing for Dante is wonderful .. you just haven't quite seen the payoff yet with lower numbers ... but you will!
 
Ella made a very good point that I forgot about. I believe you mentioned that Dante's ear meds are steroids. I suspect they are effecting his numbers. I would temper your frustration against the effect of the meds. You'll be in a better position to evaluate the effectiveness of the Lev once Dante's ear infection clears up and he's off meds.
 
Hi there:

I know it's easy for someone to say 'don't give up'.. but seriously, you haven't been at this very long and trust me it DOES get easier AND, frankly..... your numbers are not that horrific (take at look at Rupert's spreadsheet if you want to see insanely frustrating!). You are in the early stages of this dance and right now, if you are anything like I was, you are freaked out, and wanting results NOW! You are also concerned for your kitty and imagining all sorts of horrible things going on inside. But, try to breathe, and be patient... I'd be really happy with the numbers you are getting right now because they are showing shallow and consistent dips.. this is GOOD, it means that by SLOWLY increasing your dose, till you find the right amount, your kitty will start to regulate nicely. My Rupert is a bouncer and a diver, he gives whopping huge numbers. followed by monumentally spectacular dives, and then bounces up again. I would be DELIGHTED if he gave shallow curves like you are getting at the moment.

it takes time, it IS overwhelming and like most of us, you want to FIX your kitty immediately. As long as your cat is looking even slightly BETTER than prior to diagnosis, then you are on the right track, and I bet that is the case. Just look at the coat, the attitude etc.. It took Rupert about two months before he really started to show that he really was feeling a LOT better, and ultimately, that is the goal. If you cat is alive, and happy...then you are on the right track.

All the testing, and worrying and stressing really does get to you, I know it did with me. It took a long time before I mellowed and realized that the numbers are just numbers and that things don't happen instantly..... stick to the protocol and follow it through... seriously, your kitties numbers really look like they are on the right track. Hang in there!
 
Sheri,

Sit back and take a deep breath. Now, take another deep breath. :)

How much longer is Dante on the steroid drops for his ears?

Dante's numbers started going up on 9/30. His ear infections were diagnosed on 10/9. Infections can cause the numbers to go up until the infections are gone. And, as others have stated, steroids can also raise his numbers. If that is what is happening with Dante, I wouldn't keep raising his dose because, once the infection clears up and you stop using the steroid drops, his numbers could go dangerously low. I hope others will chime in about this, and whether they agree with me or not.

Also, as Ella & Rusty stated, you are raising Dante's doses too quickly, and not giving Dante a chance to settle in to that dose. I know the typical response to high numbers is to want to increase the dose and get the numbers down, but by increasing the dose too quickly, and not being patient and letting Dante settle into each dose, especially when he is fighting an infection and is on steroid drops, you could have already gone past his ideal dose.

Also, re-read about how Levemir and Lantus work. There are links at the top of the Lantus boards which give valuable info about the shed/depot for Levemir and Lantus, and why the protocols call for staying on a dose for 3-7 days.

If Dante were my cat, I would probably drop him back down to 1.75U, and wait for the ear infections to clear before changing the dose again. Again, I hope others chime in here with whether they agree with this or not. I'm no expert, I'm just saying that I would be more afraid that I was dosing too high when the high numbers could be caused not by the diabetes but by the ear infections and steroid ear drops. Too little insulin does damage over time, but too much insulin can kill quickly. And, once you put that insulin in, you can't take it out.

Trust me, I know how frustrating this all is. As does everyone else here. But patience is the key. Don't worry about the high numbers until Dante's infections are gone and he's off the meds. (((HUGS)))

Suze
 
All I wanna do is sit here and cry :cry: :cry: :cry:

maybe MY house is not the best place for him. He's always confined to 2 rooms because he and my civvie refuse to get along- he's hurt her once already (that was an unexpected vet bill) and he's 3x her size, including his teeth. I've already invested in Feliway diffusers, Rescue Remedy & calming treats. He's always trying to bust through the gates and get out- then I have to close him in one room only. At night, he wakes us up meowing because he wants out. Perhaps it is time for that kitty prozac (if I don't take some first)
He really is a sweet boy, and just wants some luvins sometimes. I try and give him attention when it's not testing time, but all I do is test or clean & treat his ears. :roll:

If anything serious happens to him, I won't have the funds to pay for it- my cc is maxed out already, due to 3 medical emergencies this month.

I did manage to pick up 300 test strips for $50 on ebay

oh- this Lev pen was new and got it right before he came to me. It's kept in the fridge
 
I'm not sure if you saw my post on 10/13, but here it is again:

Libby and Lucy said:
Hi Sheri and Dante! Welcome to LL! I don't post here as often as I used to, but I try to stop in occasionally if I think I have something to add.

My suggestion before you make any more changes is to spend the next couple of days getting as much data as you can. Then you will be able to make informed decisions. Slowing down for a few days won't hurt anything and it will give you a much better idea of how to proceed. The tresaderm probably isn't helping his numbers, but if he needs it he needs it. Just expect that he might need to come down in dose once he goes off it, and you might need to adjust quickly. Follow the numbers.

I've been studying your spreadsheet and I have a few thoughts.

One, I actually don't think it's bad that you reduced the dose last week. The increases from 1.75 to 2.0 to 2.25 to 2.5 were all done pretty quickly and without enough data to support the increases, so you're right, he *might* have been over dose then. I probably would have only reduced back to the 1.75 (because you did have data to support that dose), but that's ok. By going down to a lower dose and working up, at least when/if he gets back to 2.5u you will know that it is a good dose.

But..... you really, really, really have to get spot checks before doing any more dose increases. You need to get some PM spot checks too. I don't mean you have to test around the clock, but at least one spot check every night (most of us get a before bed test) and then whenever you are home during the day is needed. There will be times when you'll need to test more than that (especially when he starts changing), but plan on that to start. Dante's spreadsheet shows that he actually CAN drop from this dose - he came down from 400s to 200s on 1.5u on 10/10. Might he be coming down farther than that sometimes and bouncing? He might, and you don't want to increase the dose any more until you're sure. The TR protocol is based on making changes because you KNOW the current dose isn't working. Trying to guess makes it unsafe.

About using R, most of the time we find that Lev kitties using TR do not need R, but it is another tool in the tool box and it's doable if Dante needs it, with some caveats. ;-) Again, the first step is to get data. First you need to understand his Lev cycle (onset, nadir, duration, what makes him bounce and how long do his bounces last, how quickly does he come down from his bounces, how carb sensitive is he so you'll know how to control the cycles if you need to, things like that). Then you figure out the same things about his R cycle. Then you lay the R cycle on top of the Lev cycle to figure out the best times and circumstances to use R. Adding R to Lev will require more testing, but it's doable. Also know that if you add R now, you will probably find that everything you learn will change once he gets off the Tresaderm and the infection is gone. It is likely that those things are causing some insulin resistance right now.

I hope that helps!
Click to expand...
I feel strongly that you need to slow down and get data before making changes. Without mid-cycle tests, we can't tell if Dante is staying high/flat (possibly because of the Tresaderm) or if he is dropping low and bouncing. For sure I would not add R without some data - if Dante can drop 200 points without R, he might drop uncontrollably if you give R before his nadir.
 
Well, I know he's gonna be on the Tresaderm for at least another week. So.....do I drop his dose back anyways?? Leave him where he is?? It's really hard to get anything past a +4 or 5 on him at night. As far as during the day, I can't get anything earlier than a +6 or 8 on him.

**todays +6 = 298**

He was in such bad shape when I got him, that he has "soupy" food available at all times. Sometimes he eats during the night, sometimes he doesn't.
 
I would go back to the 2.5u and hold that until you can get some data. Then you will KNOW what to do instead of having to guess. Most likely he is staying high from the med, but there are indications on his spreadsheet that he could be dropping, so you need to find out.

+4 or +5 at night is fine, just try to do it every single night. Then grab an in-the-door test when you get home in the daytime cycles, and try to vary those times when you can. +6 sometimes, +8 sometimes, +7 sometimes, etc. Whatever you can do, but do it every day. That's all most working people can do and it works out fine. Yes, there will be times when you have to test more, but on a regular basis I just tried to do in-the-door, out-the-door, before bed, whenever I was about to leave the house to run errands on the weekend, etc. Each test fills in a piece of the puzzle.
 
((((Sheri)))) you're doing a good job and it sounds like you have a tough set of circumstances. Hopefully Dante will settle down at some point. Jazzy had to live in her own room for a little while when she came here. She was mean to the other cats! Lucky for me, it turned out that she was just being aggressive with the other cats because she was afraid of them. Eventually she decided that it was more important to integrate herself into the home so she could have more attention. Then she did ok as long as the other cats didn't try to make eye contact. It was hard to manage her diabetes when she was upstairs by herself and I was glad when she decided to adjust.
 
Sheri,
I won't comment on dosing, because as you know, Missy and I are also new to Lev. But, as far as introducing kitties, do you ever lock your civvie up and give Dante time to wander the house? That way they will mingle their scents and maybe it will make the face to face stuff less stressful for them. Just a thought, you might already be doing that.
I understand your frustration and wanting to give up. Take a deep breath, do something nice for yourself, even just take a walk to get away from it a while. I have had days where I felt like you do and that walk really helped my sanity. Maybe a little music while you are walking to keep your mind off Dante for a bit. Missy and I have had a long hard struggle and she is still not regulated, but we are at least looking better on Lev.
And, I do think it is important not to expect too much until he is off his meds and his ears are all cleared up.
Wishing you all well!
 
(((Sheri)))
Could you describe how you've introduced Dante and your civvie? Mares may be on to something. Introducing a new cat to an established territory can be challegning. I really like a cat behaviorist by the name of Pat Johnson-Bennett. She has some great information on introducing a new cat into the household. She has several books out, as well, that you may want to take a look at. There's information about her books on the website that I linked.
 
Sheri, if you switch meters to the Relion Prime, the test strips are only $9 for 50, and are available right at WalMart so you don't have to pay for shipping costs. This has been a lifesaver for me!

Suze
 
Sheri,
I got that thought by reading the book Cat vs Cat. It might give you some ideas on introducing them.

Cat vs. Cat: Keeping Peace When You Have More Than One Cat
by Pam Johnson-Bennett

My two have issues and they are littermates :o . Phoenix has always been too rough for Missy's taste, but somewhere over the years they have had a falling out. Now, when Phoenix is frustrated or jealous he will attack Missy with no provocation. And meanly. :cry:
I use praise with Phoenix when I see him want to go for her and he doesn't, but when he is persistent or actually attacks, I use a squirt bottle. Now, all I have to do is show the bottle to him and he leaves her alone.
Good luck!
 
Sienne and Gabby said:
(((Sheri)))
Could you describe how you've introduced Dante and your civvie? Mares may be on to something. Introducing a new cat to an established territory can be challegning. I really like a cat behaviorist by the name of Pat Johnson-Bennett. She has some great information on introducing a new cat into the household. She has several books out, as well, that you may want to take a look at. There's information about her books on the website that I linked.
Click to expand...

They have been separated by 2 stacked baby type gates. The one on the bottom has openings that they can even sniff each other and also put their paws through. The top one is mesh. When I have "traded places" they have both been in each others part of the house AND even used each others litter boxes. When I am not home, Dante is closed in my daughter's room (used to be in my son's room, but he likes the bathroom floors to lay on) He always manages to bust down the gates, so behind a closed door he stays.
I tried again tonight, to have them in the same area. He tries to go after her, although not as aggressively as in the past. SHe was on the back of the couch; he was sleeping on the floor by me. He got up and started to walk to the couch. I stood in front of him so he couldn't jump on the couch, and he wrapped his front paws around my thigh and bit me then ran off. I picked him up and put him back on "his side" and told him that was really bad.
She still hisses and growls at him. He tries to corner her.
He already got her badly once. NOT letting that happen again.

But he wants to play with the dog......can't figure that one out.
 
(((Sheri))

Just wanted to offer some moral support. To tell you the truth, I've seen SS's that look ALOT worse than his does! And it hasn't been that long. It's ok to lean on us for support...it's what we are here for.

One thing I noticed on his SS was your comment this morning when he was "HI". You stated something about going up to 3u. As difficult as it is, remember that we don't dose on the PS (unless it's their nadir) and, when you start seeing bouncy numbers, we don't dose on the bounces...we let them clear and then decide on the dose.

I understand how stressful it can be when cats aren't getting along. One of our members used an animal behaviorist with great success.
 
Please accept my apologies for my "meltdown" today. :oops:

I also want to thank you all, for your support and encouraging words.

I will now smack my hand, ohmygod_smile 'cause I know not to dose on preshots w/Levemir and to let it settle some.
Just not used to what seems like going in the wrong direction.
 
You absolutely do NOT need to apologize to us. I would say just about everyone experiences a meltdown at some point and we all know the feeling. So do not worry....besides being a place to get assistance with managing the diabetes, we are also here to support each other emotionally during this dance.

Hope you are just smacking your hand with wet noodles and nothing else more serious than that :lol: :lol: :lol:
 
Sheri --

I think the introduction may have been too fast. Try to think about it this way. Cats are territorial. Dante was dropped in to your civvie's territory. He's needing to assert himself in a house that has been marked by another cat. He's the interloper and wants to stake his claim. He's doing that by being aggressive. I would read over the info I linked to get a sense of how to gradually re-introduce Dante to your civvie. In addition, if you're not already doing so, you will want to feed them at the same time. Set the bowls apart. You may want to use something (e.g., a big piece of cardboard) to prevent the two cats from seeing each other while they eat. You gradually remove the barrier then gradually move the bowls closer together.

I'd also get a toy that Dante will play with and tire him out. It's important that he not treat your civvie like prey. It sounds like that's what's happening. If he starts to bug her, distract him with play.
 
Sheri, no need to apologize for a "meltdown". Compared to my meltdowns, yours was mild! :lol:

We all have been through similar stress that you are going through. Well, I wasn't introducing a new FD cat into my household, but others have. And, even though Pumbaa and Larry had been together for nearly eight years, they really got into a huge, scary fight one day after Pumbaa had been on Lantus for a month or so. That was a first, in all those years, but I think it was caused because Larry wanted to play and Pumbaa just didn't feel good. So you are dealing a whole lot of issues right now, including financial stress, which is probably the worst! (((HUGS)))

Have a meltdown, when you need to. I'm a firm believer in venting regularly, like a dryer. It keeps me from imploding. :)

I'm glad you now understand why you need to let Dante settle into his dose, and that what you shoot may not affect him for 6 or more cycles.

Patience will be your best friend taking care of Dante and his FD.

I think the most important lesson I have learned about insulin and FD is what I also stated above: Too little insulin can kill over time, but too much insulin can kill quickly.

I'd rather give too little insulin and see high numbers when there are other factors contributing to those high numbers, than give too much insulin and potentially cause a life-threatening hypo.

Relax. Take a deep breath. You're very dedicated to helping Dante, and that is admirable. Now you just need to find some "patience pants" and wear them, constantly. :)

Suze
 
I just want to say no apologies are needed here .. It sounds like you are dealing with a lot right now, trying to get your cat's used to each other, dealing with ear infections, high BG's .. take a deep breath .. Things will get better ...
 
Sheri: if this helps at all, I did a quick search on these boards (health and the various insulin boards) for Tresaderm, and many people reported BG spikes in their cats due the drops.

You might want to call your vet, tell him about the high numbers, and see if there are any other drops/treatment you can use for Dante's ears that wouldn't cause these high numbers. Or, do the same search I did, and see what others recommended using in lieu of the Tresaderm (I didn't go that far). (((HUGS)))

Suze
 
Hi Sheri
I do not post very often as my Max crossed the bridge this past June, not diabetes related but when I saw your
heading I had to stop in.
Max was a diet controlled diabetic from April 2010 - June 2012 when he died.
Please have a look at his ss to lift your spirits up and to see that this can be done.
I fully understand how you feel and I had many crying episodes myself. Max finally went up to 6u, bid of Lantus
until he broke and went OTJ.

You are in an amazing place for help, both for you and Dante.
Don't be so hard on yourself. You are doing an amazing job.
Dante does not know how much insulin you are shooting. A number is a number. If he needs more, then he needs more.
Many wise ones here have said that to me.
I hope Max's ss will make you feel a bit better.
Sending you lots of hugs.
 
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