Having hard time to regulate Kitty

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Peg and Toby

Peg and Toby

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My name is Peg My cats name is Toby. He is nine years . He's a black and white domestic short hair.
About a year ago he was diagnosed with diabetes after a bout with Pancreatitis . He is on 2.5mg of
Prednisolone 2X daily for inflamation of the pancreas. We tried to reduce this but he got real sick and his bg
went way up. He is on 1/8 miralax 2X daily for constipation. His insulin in BCP PZI 4-1/2 units 2X daily every
12 hours. He eats ff classics pate . We make his treats out of chicken breasts that we dehyrate our self. I home
test him with relion prime. I also do my own curves. He just had a CBC all of his organs were alright the only thing
he had high cholesterol. Don't know if i should try a different food or not. When we started out a year ago he was
regulated on 2 units 2X daily. Each Time we reduced the Prednisolone his bg kept going higher and so did his
insulin. He was in the 280's down in the 100's about a month ago. Sometimes he would be to low to give a shot
at the end of 12hrs. I would wait 2 hrs test again and give insulin. He is always higher in the morning. The last month he has been in the high 300's 400's 500's. Don't know if i'm giving too much insulin or not enough. I just
opened a new bottle of insulin hoping this will help . I am at wits end. I don't want to lose my kitty. He is also taking b12 shots. He is not acting sick and is legs are strong. No ketones as of yet. Hope someone can help.
 
This morning he started out a 391 at +4 he was 339 at +9 he was 265 So far better since starting new Bottle
of insulin.
 
I was wondering the same thing. It was warm when they delivered it and the ice pack had melted. I am hoping that is
what it is. Just took is +12 bg was 354 last night it was 395. Hope it better in the morning. I want to thank you so much for
replying to my post. Peg and Toby
 
Peg and Toby said:
... Just took is +12 bg was 354 last night it was 395. Hope it better in the morning. ...
Click to expand...

Mid-cycle tests show you how well the insulin is working.

The pre-shots don't tell you how well the insulin is working, only if it might be safe to shoot, based on how much the cat drops with the insulin (ie pre-shot vs mid-cycle tests).
 
Would you go to 5Units for the night shot. I get up between 12 and 2 to feed him a half can of 3oz ff. I give shot 6am and 6pm. I feed Quarter can at shot time and at 8am I feed him a half can at 12 pm I feed half can then he free feeds most of the day. I Pick up the food three hours before preshot. Then I feed same way for pm. I know it's harder to regulate a cat on steroids but am hoping I can get him back in the 200's. He started out this morning at 401.
 
If he were mine, I wouldn't jump by full units - maybe up by half a unit. And I'd get some more data. He was dropping late in the cycle yesterday. Did he go go down more and then up to 400?
 
Hi Peg & Toby,

Welcome to FDMB! I'm so sorry you're having a difficult time regulating Toby's numbers. You've come to the right place to get help, though. The wonderful people here helped me get Jersey into remission; I couldn't have done it without them.

I'm not familiar with PZI (we used Lantus), but there are lots of others here who use PZI. I have no doubt they'll give you some great advice.

I just wanted to make a suggestion to start a spreadsheet. You'll see in our signatures at the bottom of our posts that we have spreadsheets where we keep track of the bg #'s. It really helps those who are giving dosing advice if they can see the "big picture" with the numbers. If you're interested in using the spreadsheet, let me know. I'll be happy to send you instructions for setting one up.

Hang in there!
Shelly
 
Hi Peg,

Here are the instructions for the spreadsheet:

1. First of all, you’ll need to set up a Google account if you don’t have one already. Here’s the link for it: https://accounts.google.com/SignUp?continue=https://accounts.google.com/ManageAccount

2. Once you set up your account, make sure you are signed in to it. Then click on this link: https://drive.google.com/previewtem...U5BVEdyU1dGZmx5bnRvdG10OWc&mode=public&pli=1#

3. This will bring up the template that you can use. In the upper, left-hand corner of the page, it says “Use this template.” Click on that.

4. Now you have your own copy of the template. At the top, left-hand corner of the page, click on “File” and then choose “Rename.” You can now change the name of your spreadsheet (e.g., “Toby's Chart”).

5. Once you finish entering the date, blood glucose numbers, etc., you will need to publish your spreadsheet. Click on “File” again and then click on “publish to the web.” A little pop-up box will appear. You will want to make sure that the box that says “automatically republish when changes are made” has a check mark next to it. Then click on “start publishing.”

6. Now, you need to make sure other people can see your spreadsheet. Click on the blue “share” button on the upper right-hand corner of the page. A pop-up box will appear. Where it says “private,” change that to “anyone with the link can see” and click save at the bottom of the box.

7. Finally, you have to add the spreadsheet to your FDMB account. First copy the web address that appears in the address bar on your spreadsheet. Come back to FDMB and click on “User Control Panel” at the top left-hand side of the page. Then click on the tab that says “Profile” Next, click on the tab that says “Edit Signature.” There’s a little “url” button at the top of the box where you write. Click on it. This is what will show up in the box:



Click in between the middle brackets and paste the web address for the spreadsheet that you created.

In the end, it will look something like this: https://docs.google.com/spreadsheet...s if we run into technical problems! Shelly
 
Tried setting up spread sheet everything came up entered entered Toby's information. Don't know if it worked or not don't see anything.
 
It isn't where we can see it yet. Did you go the Publish to the web, pick the url that came up, put it in your signature and then choose submit?

If this is frustrating, send me a private message (button in lower left hand corner of this post). I can go in and do it for you.
 
I tried to post Toby's spreadsheet again don't know if it worked. Couldn't figure out how to send private message.
Not to smart at this sorry. Peg and Toby
 
Glad your spreadsheet is up, Peg. The first thing I notice is that we need some midcycle numbers to see what is happening. Is Toby flat throughout the cycle or does he go down low and bounce up? Some of the yellow pre shots may (or may not) have been dropping instead of rising. And then shooting those, if dropping, sets up a real bouncing scenario.

It is hard to get midcycle numbers if you are gone during the day. Some data that will help is to get a In the Door test - one right as you walk in the door at night, before feeding and shooting time. And a before bed test to see how the cycle is going. Some people set the alarm at night occasionally and get a midcycle test before dropping back to sleep.

And then on the first day you have a day off, get a curve - tests every couple of hours during the day to really see how the insulin is working.

I remember he is on a steroid which can really raise the numbers. What is he eating?
 
Toby eats ff classic pates he eats mostly the chicken feast. I'll get some better numbers for you. I went up to 5units
at night to see if that helps any. Peg and Toby
 
Did some pm bg checks last night posted them in my spreadsheet. Welcome any suggestions on them. They were all high.
Don't know if i'm giving too much insulin or not enough. Sometimes he gets a low number and i can't shoot for two hours.
I've been wondering if iI should try another insulin? Peg and Toby
 
Hmmmmm. Sometimes an inverse curve indicates too much insulin. That is, a curve where the midcycle numbers are higher than the preshots like last night. You could test this by getting him less insulin for one cycle (maybe halve it down to 2.5?) and see if the numbers are lower. If you'd do this, you'd want to do it on a day you can monitor and also do a ketone test.

Yes, you definitely could try another insulin. One of the depot insulins may work better. I think I'd post over on the Lantus TR and Relaxed forums (ask about Levemir on the relaxed one) and ask about kitties on steroids receiving their insulin and how they are doing.

I do think the steroid complicates this whole picture, but you did say he was getting better numbers before, even while still on the steroid?
 
Peg just sent me this via pm. I am posting it here and answering on the forum.



Sue, Last night Toby was at 224 and I gave him his 5 units. This morning he was 91 Don't know what he was earlier. At +3 he was 159 at +5 he's 339 and I gave 2 units of insulin. Do you think
that also indicates the dose is to high? Or is this just an odd Thing going on? Peg and Toby
  Sent: Sat Aug 16, 2014 9:20 am

Yes,, I think it means the dose is too high. A long cycle generally means the dose is too high and a amps that low means the dose is too high. I like your 2 units. If you can monitor today, see how he does. There are a couple possibilities.

He may have a very bouncy cycle today as he could have dropped very low overnight and will bounce, especially for the pmps. (you need to wait at least 8 hours before giving him another shot and be sure he is rising. If he were mine, I would try to wait at least 11 hours and if rising, shoot that 2 units again and see if you can get some numbers after.)

He could be okay in 12 hours with a nice number in the 200s and not bounce this cycle but be high and flat the next cycle. I'd still go with a lower dose.

My thinking is that he definitely needs less insulin but it may be hard to see what is really happening for a few cycles if he bounces. It may be that he needs less than 4/5 but more than 2, but the only way to figure that out is give him some time and get some tests in. While you are giving the lower dose, try to get a ketone test .
 
Thanks Sue for your reply will give 2 units tonight and get more numbers. Was hoping it was okay to give 2 units at +5
but didn't want him to get to high with no insulin.
 
Peg and Toby said:
Thanks Sue for your reply will give 2 units tonight and get more numbers. Was hoping it was okay to give 2 units at +5
but didn't want him to get to high with no insulin.
Click to expand...

Just to be clear, you gave 2 units at +17 (5 hours after the skipped shot at +12) Right?
 
Yes, It would be + 17. Tested again at his 6pm shot and he was at 400. Just gave him 2.5 units see how he does with that.
Will test for ketones. If he starts to test for them what do I do go up on his insulin? How long would you go to see if this works. He usually takes a week to tell if he has a change. If he stays high would you go that long on 2.5 units if he doesn't show signs of ketones? Peg and Toby
 
Anytime you can get a number in that 5-7 hour window, it will help us see how the dose is working. BUT with that darn Every Cat is Different thing, we don't know yet whether he is a cat who reacts within a cycle or two to a change in dose, or whether he takes a week. It sort of looks like he takes longer - he was getting 4.5/then 5 for a while before he finally crashed into lower ranges.

If his ketones are okay, and he stays out of blacks and reds, I think I'd keep the 2 or 2.5 (I think either is okay) for at least 3-5 cycles, unless he dops low again.

This is the difficult thing about trying to reduce. It is so much easier to add a little because the testing shows you he is too high, than it is to try to guess how low you should go because the dose was too high.
 
Got some new pm numbers on the new dose of 2.5 units. It looks to me that they aren't any worse than when he was on 4.5 And 5 units. I don't know if it is to early to tell anything yet or not. Peg And Toby
 
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