Have question on TID dosing

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Lydia & Sid & Jake(GA)

Lydia & Sid & Jake(GA)

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So I am working on cutting back Sid's R and increasing the Prozinc. Yesterday he only received a 1/2 dose of R at AMPS and PMPS. Last night his BG was high but I did not give him any more R to bring him down. His ketones were negative.
This morning I got up at 4 am to start the TID today. here are the readings so far

4 am Hi - gave 0.8U of Prozinc. Also received his famotidine and ate 1/2-3/4 can of food.
+2 501
+4 281
+5.25 186
+6.5 57 - I gave him 1/4 can of food at this point.

Should I have giving food at 57 or waited to see how low he would go? His next .8 dose is supposed to be in 1 hour. I imagine the food is going to spike him right up because that is what happens. Do these numbers look about right to give him another dose at +8?

yesterdays condo: http://www.felinediabetes.com/FDMB/viewtopic.php?f=24&t=63782
 
Lydia & Sid & Jake(GA) said:
So I am working on cutting back Sid's R and increasing the Prozinc. Yesterday he only received a 1/2 dose of R at AMPS and PMPS. Last night his BG was high but I did not give him any more R to bring him down. His ketones were negative.
This morning I got up at 4 am to start the TID today. here are the readings so far

4 am Hi - gave 0.8U of Prozinc. Also received his famotidine and ate 1/2-3/4 can of food.
+2 501
+4 281
+5.25 186
+6.5 57 - I gave him 1/4 can of food at this point.

Should I have giving food at 57 or waited to see how low he would go? His next .8 dose is supposed to be in 1 hour. I imagine the food is going to spike him right up because that is what happens. Do these numbers look about right to give him another dose at +8?

yesterdays condo: http://www.felinediabetes.com/FDMB/viewtopic.php?f=24&t=63782
Click to expand...

Waiting to 57 to feed is not the way to go.
Instead, for a cat who drops upfront, you need to stop the drop, and you can do that by feeding at +1 +2 +3 and +4.... small tsp of foods. If you don't stop the free fall, upfront, the bouncing will continue.
By feeding early, you would not have that massive drop around +3.... that's where you want to slow it down. If you feed again at +3, the numbers should not drop so quickly, and you would not hit 57.
 
He doesn't always drop like that - that is the problem. You can look at his spreadsheet and see that. At +2 he was 500, why would I feed him a small meal then when I don't know what he's going to do next?
 
Hi Lydia,
Gayle is right. You really need to feed small amounts more often. In a human diabetic, their meal plans are 3 meals (small), plus 3 snacks. That way, the carbs are being introduced into the body in a consistent manner. It is easier on the body and the insulin works better. I get better numbers on Harley if I feed small meals.

Pattie
 
Looking at his ss, there are a fair number of times that he does drop upfront, so that's his style. No cat is the same every cycle; no cat has nadir at the same time, but you get a general idea of the cat's style and way of reacting to insulins.

All the amps look like HI and then after shots, he often jumps right over the 400s and into 300s, so I would think maybe try small bits of food to slow his dropping style. It's worked for other cats, so maybe it's worth a try.

At the very least, I would have given a bite at the +4 mark.
 
I will often feed Harley at 400, because I know that there is going to be a fall. I certainly don't want him to stay in the 400's but the little bit of food seems to stop him from free falling to a really low number.

Pattie
 
Good afternoon Lydia & Sid -

I have absolutely no experience in TID, but if I was seeing a 57 on my guy with only 1.5 hours until the next scheduled shot [in ANY dosing], I'd be putting the brakes on - really fast! Unless his numbers do something really dramatic, I'd be checking him every hour or half hour to see how quickly he climbs. For me, right now, the threshold to shoot is 250 - and then only half a dose of what he's been getting.

Lu-Ann
 
I shoot Prozinc TID and I do not shoot unless the +8 number is rising...and I have a line in the sand for Kitty of 200. I do not shoot less than 200 regardless if it is rising or not-- due to the potential of insulin overlap.

If I remember correctly you were shooting 2.5 units of Prozinc daily---and if you divided that by 3 you would have what most people would consider your tid dose--.8 units. BUT, it is ALWAYS advisable to REDUCE your dose further to prevent any insulin overlap when starting tid. When I started Kitty on tid she was getting 10 units of Prozinc daily--but, I started at 3 units tid to be safe. You need to be careful with the tid dose until you have more data. Most cats need less insulin when dosed tid than they did on bid, due to the consistent supply of insulin in their body. TID with Prozinc can be great for complex Kittys with high BGs, but you need to use caution.

My Kitty, never goes low....so, I am in a different situation than you are with Sid and the possibility of low numbers.

There is no way, I would be shooting insulin in 1 hour into Sid. Even if he zooms up quickly, I would assume it was a bounce off of the 57 and would be scared to shoot.

When you test again post your number. I will check back and offer any assistance that I can. But, I think you are in a wait and see mode and need to reduce your dose.
 
Lydia & Sid & Jake(GA) said:
So I am working on cutting back Sid's R and increasing the Prozinc. Yesterday he only received a 1/2 dose of R at AMPS and PMPS. Last night his BG was high but I did not give him any more R to bring him down. His ketones were negative.
This morning I got up at 4 am to start the TID today. here are the readings so far

4 am Hi - gave 0.8U of Prozinc. Also received his famotidine and ate 1/2-3/4 can of food.
+2 501
+4 281
+5.25 186
+6.5 57 - I gave him 1/4 can of food at this point.

Should I have giving food at 57 or waited to see how low he would go? His next .8 dose is supposed to be in 1 hour. I imagine the food is going to spike him right up because that is what happens. Do these numbers look about right to give him another dose at +8?

yesterdays condo: http://www.felinediabetes.com/FDMB/viewtopic.php?f=24&t=63782
Click to expand...

No you can not shoot Prozinc insulin into a 57 under any circumstances, please don't shoot.
 
Well, I have to take my chances with Sid because it is better for him to risk going low than developing ketones. I will monitor him every 30 minutes and see how he does on this dose. Also give him a bit of food in an hour just in case.


Here is an update:
+6.5 57 fed <1/4 can food
+8 175
+8.75 402 fed 1tbs food and gave .8 PZ
 
Kim - I didn't see you post about reducing the dose until after I had given him .8. I will see how he does on this dose and more than likely give him a bit less for the overnight.

Rob - No I would never shoot a 57 ever. I actually would never shoot below 200. He was at 402 when I gave him the 2nd dose.
 
Wow, he zooms up just like Kitty!

I actually think that PZI tid might work for Sid--here's hoping! My Kitty, got very little duration, just like it appears SID gets--but, once the tid dosing settled in she has adjusted well, hopefully it will provide Sid the same results. I am glad you are trying it and please let me know if I can offer any help.

I will keep a check on your thread throughout the day and weekend to see how it is going.

Good Luck to you and Sid!
 
Thanks Kim! He sure does zoom up very fast. Here's an update:

12:30 pm +8.75 402 gave 1tbs food and 0.8 Prozinc
1:20 pm +.75 HI
2:00 pm +1.25 507
2:50 pm +2.75 323 fed 1tbsp food - hope that wasn't a mistake. I have the feeling it is going to spike him right back up but we shall see. If it does, next time I will not give him food until he is lower.
 
Hi Lydia,

I'm an old ProZinc user, we started out on it when Mr Tinkles was diagnosed, when the insulin was pretty new. We switched to Lantus after 3 months because he had a chronic URI and the big swings he was seeing with PZ were not allowing him to clear the infection. After 15 months on Lantus, he went OTJ. I just wanted to give you a brief background so you know where I'm coming from....feel free to take a look at our SS, the ProZinc data is on the second sheet. Probably nobody who is here in PZI now remembers us from then, but PZI was our first home on FDMB.

When we arrived in PZI, we were fortunate enough to have two members who had recently successfully used ProZinc on a TID schedule....Michelle & Prudence, and Hope and Aria. They both had only used it for about a month, and then they returned to a BID schedule.....they could no longer shoot TID, their kitties were well regulated and their duration was more typical of PZ at that point. I will link their SSs below, I think you will find them very useful...they both kept good notes on the SS to explain their thought process. Both kitties ultimately went OTJ. Unfortunately, Prudence is GA. :cry: I don't think either of them have posted in a long time. I personally have never used a TID dosing schedule, but both Michelle and Hope (among others!) were invaluable to me during the start of our journey. I would suggest doing a search in the PZI forum for some of their posts about TID dosing...the more info you have, the better!

You will notice that they were both pretty aggressive about monitoring and shooting as soon as kitty started to zoom up, but they also were careful about waiting for significant/clear rise when necessary. Their TID schedule was not always every 8 hours because they let the numbers be their guide as to when to shoot...it makes for a crazy schedule, but in their cases, it was relatively short term and it had a big payoff. They also found more success with relatively consistent dosing VS sliding scale....that was also my personal experience with ProZinc. I think you are wise to be pretty aggressive with Sid because of his DKA history, as long as you can do the necessary monitoring. TID is not easy on the bean!

Michelle and Prudence's SS
Hope and Aria's TID SS
Hope and Aria's BID SS

Another thing I would like to mention because I haven't seen anyone address it....you are giving Sid fluids, and it looks like sometimes the timing could be adding momentum to his drops. I don't have direct experience with fluids, but I do know that it can cause numbers to drop. You might want to adjust your schedule to administer fluids after nadir.

I think the feeding schedule is up to you, but in general, smaller more frequent meals help keep numbers more even. I would keep notes about feeding (along with meds, fluids, etc) on the SS, it will help you see how it affects the cycles. ECID, you will need to see what works for you and Sid.

You're a good bean, Lydia, Sid is lucky to have you. :YMHUG: I wish you both the very best of luck with ProZinc TID, I do think it can be a very effective strategy when used properly. Please let me know if there's anything I can do to help.
 
This is our 8th month dosing tid and I hate to admit, that I stopped updating Kitty's SS once I felt like I had the mental data to know what to shoot. I really wish I had kept it up to date, so it would be available to you to look at. There have been very few that have shot tid since I have been here, and even fewer that stuck it out! BUT, it is the ONLY option for Kitty. Kitty does have the occassonial long cycle, where I have to wait an hour or so to shoot--but, she still is a zoomer! Just this week, I was an hour late and she had climbed into the 400s. If I shoot the 8 hour schedule I can keep her preshots mostly in the 200s. In fact, I took Kitty to the vet last Saturday for some blood work and the vet wrote ...Regulated and Stable on her chart!!!!

I use to give fluids sub q to Kitty--in an effort to help support her kidneys, while her numbers were so high-- I don't any longer. I also would suggest that you give them after nadir. They definitely lowered Kitty's BG and at times lasted for an additional cycle.

I also agree that a set dose is better for tid-- it keeps the insulin more consistent in the body. The only time I change Kitty's dose is if she about 200 when I shoot. I will reduce a little if she is right at 200, if I don't she has a tendancy to bounce.

FWIW-- I would have fed the snack also! It is all about gathering data!

I am interested to see this cycle unfold!

I have a good feeling about this for Sid!
 
Thank you for that very valuable information, Laurie. I will definitely take a look at their SS. I know that fluids can lower bg but I haven't found that to be the case with Sid. I often give him fluids when he is HI and they do nothing to bring him down. I've also been told that the pred will make his bg higher. He still has gone low many times on the pred.
I honestly don't think Sid is going to go OTJ or even be regulated. I would be very surprised if that happens. My goal right now is to simply avoid ketones. And that means more insulin, more food, and more fluids. And I will do whatever it takes to achieve that.

It seems to be the food and even just getting a little food spikes him up very much. And that is why I only like to feed him at shot time or when he is getting low. I should have tested him at +6 and given him a little food then. I think what happened just now shows what food does to him:

at 4:00pm +3.5 he is 422 = I don't think I should have fed him that small meal at +2.75.
 
Either way, it is good you fed the meal--now you will know next time!

This will work....Hang in there!

AND, Me nor anyone in this forum thought Kitty had a prayer of being regulated. I was just trying to keep her alive. So, don't give up on regulation!
 
Lydia, have you thought about asking for budsonide for the IBD instead of pred? When Harley was on pred, I had problems with his bg but when he was switched to budsonide (still a steriod) his bg were better. The budsonide is a liquid, chicken flavor, that I mix in Harley's food. He started with 1ml twice a day and he is now on .4ml every other day. He has not had an IBD flair up in over a year.

Pattie
 
Lydia & Sid & Jake(GA) said:
He doesn't always drop like that - that is the problem. You can look at his spreadsheet and see that. At +2 he was 500, why would I feed him a small meal then when I don't know what he's going to do next?
Click to expand...

Lydia,
Gayle's logic is good. It looks like sid drops between +2 and +3 often. If you feed some at +2, the food will hit right aboutwhen the insulin kicks in, and it will make the drop more gradual.carl
 
Lydia & Sid & Jake(GA) said:
Thank you for that very valuable information, Laurie. I will definitely take a look at their SS. I know that fluids can lower bg but I haven't found that to be the case with Sid. I often give him fluids when he is HI and they do nothing to bring him down. I've also been told that the pred will make his bg higher. He still has gone low many times on the pred.
I honestly don't think Sid is going to go OTJ or even be regulated. I would be very surprised if that happens. My goal right now is to simply avoid ketones. And that means more insulin, more food, and more fluids. And I will do whatever it takes to achieve that.

It seems to be the food and even just getting a little food spikes him up very much. And that is why I only like to feed him at shot time or when he is getting low. I should have tested him at +6 and given him a little food then. I think what happened just now shows what food does to him:

at 4:00pm +3.5 he is 422 = I don't think I should have fed him that small meal at +2.75.
Click to expand...

Hi Lydia & Sid, I was looking over your posting about TID. It's been awhile since I've been to the FDMB, but if there's anything I can help with.. I will surely try to help you. My Prudence went OTJ after tight regulation TID. I understand your goal is to keep Sid from ketones which makes me feel that it's even more important to stay right on top of BG levels. Have you thought about starting a new SS? I know it helped me to reorganize the way I posted on Prudence SS when I went TID. Here's a template if you want to use it. https://docs.google.com/spreadsheet/ccc?key=0AjHx5M1mMFP4dGxDX2E4MGVhSmJZaE9ZRkc2SHZabUE#gid=0

I have not looked over on what you are feeding Sid. Do you free feed?
 
Hi Lydia,

It looks like Sid is showing trace ketones, where recently, he was showing none. I'm wondering if you were testing for ketones before Sid's first DKA, or even after his 1st, and 2nd, DKA? If so, how quickly did his ketone levels increase to life threatening levels? Did they turn on a dime? I have no experience with DKA, but it's bugging me that he is now showing "trace". I realize that "trace" is only one step above "none", but I don't know how quickly things go from bad, to worse, especially with a DKA prone kitty like Sid. If you have the time, I’m interested to hear your experience/knowledge regarding how quickly ketones go from none, or trace, to life threatening.

I know you have spent a fortune on Sid's DKA hospital stays...and I don't know what your budget is...but has anyone ever discussed using a blood ketone meter, as opposed to ketone urine strips? It's WAY more expensive than testing the urine, but the ketones show up in the blood 2 to 4 hours before they show in the urine. It may be money well spent (only if the money is there to spend) since I think your main fear is Sid's ketone status. It would certainly put your mind at ease, when ketones aren’t present, or alert you to a problem hours sooner, when they are present.

In case you're interested, here's a link to one of the cheaper meters that measure blood ketone levels. The strips aren't as pricey as the meter & strips I use. My strips are over $60 for a box of 10 (for the Precision Xtra meter). The link to the Nova Max Plus, is showing the strips on sale for $37.80 (10 strips with a free meter). However, even though they're cheaper than the Precision Xtra, they're still going to run you about $53 per week to test only twice per day. I don't know if this helps, or if it's an option, but here's the link:

http://www.americandiabeteswholesal...e-ketone-meter-kit_3400.htm?source=SiteSearch

I was also going to suggest you add a tab to Sid's Google Doc, and start a new TID SS. I’m glad there’s a template you can use. Since Sid is so complex, it might help to see Sid's TID data more clearly, without mucking up your BID data. Just a thought, when/if you find the time.

I hope you and Sid are doing better.

Deb
 
Questions for Carl...if you happen to see this...or anyone else who has the answers:

carlinsc said:
Lydia, Gayle's logic is good. It looks like sid drops between +2 and +3 often. If you feed some at +2, the food will hit right aboutwhen the insulin kicks in, and it will make the drop more gradual.carl
Click to expand...
I don't have the ability to analyze spreadsheets like you guys do, but I think I get why Lydia is questioning the +2 feeding. She's feeding about a 1/2 can of food at shot time which gives Sid a pretty good food spike. I'm just not seeing a drop between +2 & +3, except previously when R was involved. What am I not seeing? Also, I'm only seeing 6 hours between cycle 2 and 3...so I'm just really confused, right about now, as to when Sid drops???

1. If she were to start feeding "mini meals", as they say, wouldn't she have to cut back on his 1/2 can at shot time?

2. Lydia is now dosing TID, but not feeding the same amounts at shot time. So, if she's feeding 1/2 can at the first, and the third, shot time...but only a tablespoon at the middle cycle (which could be because she fed a 1/4 can when Sid dropped to 57 @ +6, during cycle 1)...doesn't Lydia need to adjust the shot time feedings so they are equal amounts at the start of each of the 3 cycles?
 
Hey there Lydia! (and Michelle - my bestie!!)

Michelle and I went through the wringer together with the TID, but for both of us, it was extremely helpful. I'm not on the boards any more as my sweet Ari passed away last year. However, she was a cat who did NOT regulate at all, for a HUGE amount of time (our vet offered euthanization 3 different times) and then ProZinc came along. It takes about 3 months before ProZ settles fully into the system and it was new when we got on it. After the first month, I started seeing more consistent results. I think we found for a majority of us that the dosage lowered dramatically right at the 2 1/2 to 3 month mark. Right at 3 was when Ari weaned off of it.

8 months is a huge accomplishment for TID. It was exhausting but the data I collected was invaluable as you well know. I knew my girl and her BG's better than anyone. I would suggest going back to giving SubQ's as the fluids really do help a huge amount. When Ari was at the point of really weird #"s, we'd get her fluids and she'd stabilize a bit.

If you have any questions or need any support, please email me.
 
Thank you for all of the good advice everyone! I just created a TID SS for Sid - hopefully it is viewable from my signature (if I did it right).

Sid eats only canned food. Right now that is Authority Chicken because he LOVES it and inhales the food. He only weighs 4 pounds so anything I can get him to eat makes my day. He's been averaging 2 cans/day. He also has a feeding tube that I use for his meds.

He does get SQ fluids 1-2 times per day. Particularly because he has trace ketones right now.

Deb, he had moderate ketones the entire time before and after every hospitalization. In fact I brought him home from the 3rd hospitalization with moderate to high ketones and using R helped with that. I did not know about using R at home after the first and second hospitalizations. I don't know if that would have helped had I known... He had been going to stay the day at the vet office every single day while I was at work and they would give him R when he was high. At home I would inject him and he was not responding to insulin at all the majority of the time. That is why my vet taught me how to shoot IM. Sid has no body fat and was not able to utilize the insulin SQ. Shooting IM has helped tremendously. I also saw a marked improvement in his demeanor and appetite after 2 weeks on the pred, 2 weeks on the leukeran, and starting metronidazole. I'm not sure what of all those things helped, but Sid is active and alert and wants to eat on his own. So those are all good things.

Honestly, Sid's numbers before he became ketonic the first time where not all that great but I never thought he was high enough to be throwing ketones. Ive since learned that ketones result from infection, too little food, too little hydration, and not enough insulin. In sid's case, he had all of those things - along with the lymphoma and IBG which were not yet diagnosed. It is possible I may never be able to get rid of the ketones no matter what I do. I've also had several vets tell me I am fighting an uphill battle and there is no hope and that I have done everything I can for him. However we are not giving up yet.
 
Lydia,

When I was using PZ, I would feed at PS and around +3 when the numbers were dropping fast, but that was MY cat and it worked for us. You will need to do just what you are doing, experiment and see what works for you and Sid.

I discovered that different foods (even with the same carb %) had different effects on Mr Tinkles' BG. For example, if I fed him Fancy Feast, he would have a HUGE food spike, but if I fed him Special Kitty, it didn't spike him nearly as much (thank you Michelle for that little nugget of wisdom! :smile: ) I know Sid has multiple health issues, and it may not be possible for you to do it, but you may find that trying different foods may help you reduce his food spikes....but keeping him eating has to be the priority. (Special Kitty is crummy food, so I wouldn't try it with Sid in his condition...it's also lower in calories....but you get the idea!)

The TID SS looks great!

I'm glad that Michelle and Hope stopped by to see if they could help you...thank you both! The more help you can get, the better, IMHO.

I would not hesitate to shoot early if you need to in order to keep his numbers from getting so high. He zooms up so fast that if you shoot when he is already at 400, he's getting up to 500s or HI before the insulin starts working on the BG. I know you're still gathering data, just making an observation...you're doing great!
 
Laurie, I was going to shoot early... but look what he did...
+5.75 257
+6.25 345
+6.75 301
+7.25 432
He shot up 130 points in 30 minutes with no food spike or anything. I'm thinking that tonight I may want to increase the dose from 0.8 to 1U. Is this a good idea or keep him at the 0.8 TID for another day or so?
 
IMHO, you are much better off shooting early than increasing the dose. Here's why....look at the AM cycle yesterday...you shot 0.8u and he hit 57 at +6. He bounced from that green, and the higher numbers you are seeing now are combination of the bounce + the wonkiness of PZ during the first 4-6 weeks + the change in schedule...he's adjusting to a lot of things right now. If you increase to 1.0u, you are likely to be looking at Sid going lower than 57. You have to watch both the highs and the lows...it's a balancing act.

Others may disagree, but that's my opinion FWIW.

Good job shooting early! The idea is to flatten him out, keep him from zooming so high, and support the lows by feeding as necessary. I know it's crazy right now, but I'm hoping that as he settles in you will see his cycles flattening out. I would keep monitoring closely, because sooner or later he's going to go low again.
 
Ok that makes sense. I thought I should probably keep him at 0.8 and I will not wait a solid 8 hours but let the numbers dictate. I just hope he doesn't spike up at +5 or something because that will really mess up the schedule. The TID can only work if I'm able to shoot him during my lunch hour from work. I know that will be bad not to be home to test him when I go back to work, but the alternative of no insulin is probably worse. I just have to try to understand his nadir and offer food if necessary at the appropriate time. I'll do the best I can -that's all I can do.
 
I know it can make the schedule really crazy...but I wouldn't shoot at +5 anyway..his nadir is around +5-+6 usually and you need to make sure he is clearly rising before you shoot. I don't think you should/will be able to shoot much earlier than about +7.

Again, this is MHO and others may have a different opinion. Remember that I'm basing my opinion on other people's experience with TID....you need to listen to what experienced folks have to say.

When do you work...you've been doing so much monitoring, I can't tell!? As far as working.....your ability to monitor definitely has to affect how aggressive you can be and keep him safe. Do you leave food out for him, use an automatic feeder? The good news is that he is carb sensitive, but will he eat reliably if you are not there? Some kitties won't eat when they are low....is he one of them?
 
Hi Lydia,

You are doing great! and Sid is so lucky to have such a loving mommy. I agree about shooting before Sid hits those crazy high numbers. With that said, you have to make sure you're able to be home to do the TID - meaning you may need to shoot before +6, +7 etc. I know every cats is different and you know your Sid better than anyone. I would of shot when I saw the numbers rising @+6 but that's me. I know there are other health issues you're dealing with and again you are doing AWESOME!

Looking at your SS. Are you using a huge monitor :smile: If not, maybe start a new line for every 8 hours, so you can see you're number and compare them right above each other. Just a thought. I may have missed it somewhere, but are you adding water to your wet food? It helped me to add enough water to mine so I could leave it out for a few hours.

Here's an example:
SS.png
 
I typically work 7:30 to 5:30 every day and take the liberty of taking my lunch when it is best for Sid. I also take advantage of off site meetings or other spots here and there to get readings if I can.

I don't add water to the wet food. I give Sid extra water in his tube. Probably about 20 to 40 mks depending in addition to the SQ of 40-80 mls.

I do have timed feeder dishes and I think he would eat if he went low.
 
I'm glad Michelle posted...she knows more than I do about TID!

It's nice that you have some flexibility on your lunchtime, that will help you. You shot an hour later this morning than yesterday, and then an hour early at mid-day, so that puts you about back on schedule, I assume?

I would use the autofeeder and/or leave food out for Sid when you go to work so that he can feed himself if he goes low. Adding water to the food helps to keep it fresh and it is good for him, as long as he will eat it that way.

Any updates on tests? Ketones?
 
Laurie and Mr Tinkles said:
I'm glad Michelle posted...she knows more than I do about TID!

It's nice that you have some flexibility on your lunchtime, that will help you. You shot an hour later this morning than yesterday, and then an hour early at mid-day, so that puts you about back on schedule, I assume?

I would use the autofeeder and/or leave food out for Sid when you go to work so that he can feed himself if he goes low. Adding water to the food helps to keep it fresh and it is good for him, as long as he will eat it that way.

Any updates on tests? Ketones?
Click to expand...

Yes, I agree about adding some water to the canned food to keep it fresh. Plus, I've found that they like to slurp up the food. I hope Sid is like that too :-D
Not sure if you can see the example SS, so I'm adding a closer view:
exampleSS.jpg
 
Yes here are the updates - Sid is not following my plan to lower his bgs to a consistent level. :YMSIGH:


12:30 pm 432 0.8U
+2.5 331
+3.25 410
+4 562

He had negative ketones. When I wrote trace ketones the other day, it may have been negative but it looked like there was a slight pink tinge to it. I will test again but if he is HI, what is the earliest I should shoot?
 
Thank you for the book suggestion. I am going to go read about it now.

I changed Sid's SS to the format you suggested. I just wish he had as many greens and blues as the example. :sad:
 
Lydia & Sid & Jake(GA) said:
Yes here are the updates - Sid is not following my plan to lower his bgs to a consistent level. :YMSIGH:


12:30 pm 432 0.8U
+2.5 331
+3.25 410
+4 562

He had negative ketones. When I wrote trace ketones the other day, it may have been negative but it looked like there was a slight pink tinge to it. I will test again but if he is HI, what is the earliest I should shoot?
Click to expand...

I would shoot now, but only if you are able to watch him throughout the next 8 hours (non stop). I would check BG every hour and watch for him dropping and raising. You have to keep in mine that you're still using 0.8 and once this starts to get into his system... you'll start backing it down because 0.8 will be too much.

Just to give you an idea of what I went through, but again every kiddo is different, so it's just food for thought, ok?

Pru was at 1.0 to start. Not very long after... I realized that being that I was doing TID. It was almost as if I had to split my doses to .3 three times a day = 0.9 etc. I don't know if that has any reason to it or just how it happened, but I hope you get the idea? Sorry if I didn't explain it right.
 
I also wanted to add that I have used acupuncture for my cats in the past - not Sid though because this has been a crisis and did not get to that thought yet if you know what I mean. I have a vet who makes home visits. She is holistic minded and has my 3 FelV+ girls on Chinese herbs. She and I have discussed acupuncture for Sid but not gotten there yet. I have also been in contact with a vet who is moving to my area from Chicago. She is also holistic minded and does acupuncture so now I have 2 choices to help me in that area. Unfortunately, both of these vets will not be available until early March.
 
It may help you to look over Prudence SS on March 13, 2010. Just remember not to back too much down because it kind of makes you start all over again. I won't lie... this is a scary process, so you need to make sure you're able to be there for him. I had my close calls with BG @29 yikes! but those things will happen when you're doing TID.

You're doing awesome Lydia! I will check back in awhile <<<<<<Hugs>>>>>
 
I get your idea - I think. I thought Prozinc was out of the body and did not build a shed?? Are you saying there could be overlap with the MPS dose - if so, yes, I get that.

I can watch him the rest of the night and check every hour. Sometimes I check every 1/2 hour. I am going to go check him again and see where he is at.
 
Hi Lydia, just checking in...sorry he's higher, but I'm glad to see the ketones are negative...yay!

Come on down from there, Sid!

There's no shed, there can be overlap. I'll let Michelle clarify for you...you're in good hands with her. He may need a dose adjustment depending on what happens.

Not to scare you, just making sure you are prepared...you do have HC food and karo around if needed? Plenty of test strips?

How is Sid acting? Whole cat report? Peeing, pooping, eating, playing, grooming, purring?

You're doing great, Lydia...I'm really happy to see no ketones..I bet you are too! :-D
 
I do have lots of test strips and HC food (plus karo syrup if worst case).
I have a bad feeling he will stay Hi though - I hope I am wrong.

He eats ravenously. He literally sits in the kitchen all day waiting for food and most of the time I have to be careful I don't step on him because when he hears me in there, he usually comes right behind me.
He's been peeing a fair amount but not as much today as yesterday or the day before. I believe his poops are solid or at least more solid than a week ago when it was squirty liquid. (He is now on metornidazole for the diarrhea.)
He does not play like he used to. Yesterday I saw him bat at a piece of paper a couple times. and that made me pretty happy.

Like I said, he spends the majority of his day sitting in front of the fridge. When he is HI as he is now, he is sleeping in a little enclosed spot on his cat tree. Compared to last week when he spent almost all of his time sleeping on the couch, I am glad to see him out and about, sitting in the kitchen as he does.
I know he doesn't feel good when he's Hi :sad:
 
What a nice Whole Cat report, Lydia.

I am so excited that some of the "old" ProZinc users who have experience with TID/R are helping you out. Know that the rest of the PZI family is watching and cheering you on from the sidelines. Only a few of us have TID experience/R experience, but we are all here, rooting for you and Sid.
 
Those are all good signs...many times you see improvement in behavior and symptoms before you see improvement in the numbers. I would take that as steps in the right direction!

Did you shoot? Hang in there, you are doing everything you can...he WILL come down.

If you look at the beginning of our journey, I was looking at HI on the meter a lot too. We never had ketones to deal with or the serious issues Sid has, but Tinkles had a chronic URI that took 6 months to get rid of...I know how frustrating it is to seem like you are getting nowhere no matter how hard you try. :YMHUG:
 
Hey Lydia, Just checking in. Was wondering if and what time you shot? I also noticed on your SS that you may want to flip your dates around having the 18th start at the top then work downward. Keep SS updated as much as possible even if you're holding back on shot time. Just make note of it to help us when we check in... this way we know where you're at etc. You're doing great! hugs to you & Mr. Sid :YMHUG: Sending you good numbers!!!
 
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