Heading up again out of desperation

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RobbiesMom

RobbiesMom

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I need some help if anyone is up to it - I'm toying with the idea of going back to the vet for some input and testing, a find idea generally - except for me the current unpaid vet bill is making me feel sick about doing that, it's up there higher than ever, - the poor dog needs her heartworm and rabies shots and is waiting patiently until money figures out that HER need warrants the financial impact the same way the cats issues with huge cysts (Roxie) and diabetes/asthma/arthritis (Robbie) have already.
I simply do not understand the numbers I'm getting from Robbie- I generally consider myself fairly smart but this whole trip is making me seriously reconsider that. Bounces? What is behind that and am I seeing them? Less insulin helping lower numbers - didn't work for us but now higher doses aren't either. I'm truly struggling here and I'm pretty sure the Vet will say "why didn't you shoot 4.0 all along like we discussed? Esp. since it's the only time you saw some blue numbers" I know he'll work with me and he'll look at the SS and consider all I say but I just am really struggling with the financial end of things and hate to go in both owing money AND explaining why I didn't follow his advice - I currently owe him for a surgery and Robbie's entire re-visit to diabetes - we aren't in dire financial circumstances or anything but it's a delicate balance as I'm sure it is for all. One reason I love this vet is he knows that my mantra is I will never ignore a pets health needs because of money and so he works with us via payment plans etc. - it's just been a bit of more building up than chipping down recently.
I'll go thru the weekend at 4.0 and see where it goes but PLEASE someone maybe just point me in the direction of where I can read up on how to figure out what these numbers might mean. Also what all the food impact is doing and how maybe I can work thru that. I keep reading everything I can find here but feel it's not sticking in my head.
KETONES - OK I have started following Robbie into the litterbox every time he goes - I have now managed to get it so I can stand next to the box and he will still pee or poop - So I will pick up the strips and now see if I can bend down and grab a test from him without him going bonkers. I'm actually frightened what I might see - and how that needs to be handled. Thoughts, encouragement, discouragement - all accepted gladly.
Robbie is trying to snuggle with the dog now - usually a sign he's feeling ok but he's also watching me with one eye to see if he'll get a second breakfast...
 
I am sure others will scream at me but have you thought of trying a longer lasting insulin?
I would have said just keep increasing the dose but when I see you are giving a .5u shot mid cycle to bring down the numbers and they are not moving, I have to think what you are using is not working.

I do not know about your insulin, but wonder if maybe using R at the start of cycles is ever done by P users?

If you have ruled out any infections, and dental is not due, plus you are feeding low carb wet food, I would think you need to change something with the insulin.

At the present, I hope you get some better numbers with the increase to 4u
 
Ellen -

I know you're frustrated, but when I look at your spreadsheet and see the dose changes from 1.5 to 3.5 and 4.0 within one or two cycles, I'm concerned. I don't know what your "ideal" dose is, and if you keep going like this, you'll never know either.

If you look at other's spreadsheets, (not necessarily mine - we raced up because of ketones; do as I say, not as I do), you'll find that most of us do a dose increase of .2 or .25 Maybe a .5u. Then hold. You can't go all over the board and expect him to settle in. And this early in the dance, I wouldn't be trying to use a sliding scale... especially at such high doses (>2u).

I'm in the process of a reboot, as we probably missed his dose in the race to avoid ketones. I looked back last night at how I stairstepped up... in some cases it was 4, 5 or 8 cycles; in others it was 1. That wasn't enough. This week, I've gone from the EXTREME 6u; skipped a dose completely (no different than a fur shot), followed by a 3u dose. I was advised, by THREE different vets, to hold this dose for at least five days. Then we'll gradually do an adjustment.

I know you want his numbers to be good and consistent. But keep in mind that it usually takes about 45 days to settle into insulin. Yellows aren't bad at this stage - neither are pinks w/ occasional red preshots. Sue (who's off doing grand-ma things) always says, it's a marathon - not a sprint. You can't get on top of this if you don't stay put long enough to see if something is working. And, as I've heard told many times, you don't want to shoot the bounce - so when you see a red preshot, you shouldn't jack up the dose.

Perhaps if you called the vet for a phone consult, he could advise w/o running up your bill. Or fax/drop off a copy of his spreadsheet and ask him to call to discuss.

Kudos to you for following him around w/ the ketostix. The first time you see something you don't like, you'll be glad you went through all of this!

Good luck - breathe - and hold a dose - whatever dose, for at least 5 cycles before jumping ship.
 
I forgot to add one thing about catching the urine for testing. If you have a cat like one of mine who sticks his head out the LB opening and has his back end in the corner where I could not reach, some have said that you can lay the strip in the urine in the LB right after your cat gets out of the box. It may not be ideal, but it's better than nothing.
 
Thank you Gayle and Lu - I did have a phone consult with our VEt about a week ago - he was oncerned about ketones - said "bring him in and we'll get some urine out of him" for test but I didn't do that - I also managed to "gloss over" the fact that I wasn't consistently shooting 4u right now - I had told him previously that I was going down to 1.5 for a week to "test it out" he wasn't excited about that but was fairly supportive due to all the input he knows I get here. When I mentioned the reds he did voice concern about ketones and strongly suggested I watch him carefully if I couldn't test him so as not to have an issue - so I've been trying to avoid being in the red too for fear of ketons but only by watching how he acts - when he's high like that (Reds, high pinks) he is CRAZY for food constantly - that concerns me. If I can keep him in yellows and low/mid pinks he sleeps and plays with the dog and his cat nip toys which is more his normal self. So I've been going by gut on some of this too. I guess I'll hold the 4.0 as long as it remains safe and see what that does. At least that way when I do go back to the vet he will see the results of his prescription as well as my own jumping around technique. I am also starting to wonder if what I was seeing as more advanced arthritis might have been some onset of nuropathy?? It's not as bad as it was before he got on the insulin - or at least I don't think it is - his back legs were really not working as well and since I KNOW he has significant arthritis beginning back there I just jumped to that conclusion. Now I wonder.
thank you for the input - so far I'm not following him around with the ketone sticks just following him around - I figure if he's used to me standing there while he uses the LB than how bad can it be if I reach down and zap the stick in? He generally lets me do anything in the world to him and is a big momma's boy mush bear - but when I clean the LB he will stand there looking at me like "hurry up I need in there" and than while i'm working on LB number 2 he'll get in the other box and just stare at me and paw the litter a bit and will NOT squat until I walk away. However, now I've got him so I'm standing there minding my own Biz and he'll squat and produce so the stick will be next.
 
I remember the first time I lifted the lid off of Sneakers while she was in the LB- she looked at me like I was a pervert and stalked away (just like she doesn't watch me shower, go to the bathroom, brush my teeth every time it happens :lol: ) now she's an old hand at it and it doesn't bother her anymore.
 
Ellen -

In some of my posts, probably about 4 days ago or so and previously, I've mentioned that Grayson is "ripping off my arm to beat me with it, cuz I can't open the can fast enough." When he was getting 6u/day, he could have eaten a can an hour. Sometimes 2 (that IS on my SS). At 3u, he's eating w/ the shot... it's now +6, and he'd LIKE to eat (and will), but right now he's sitting in the chair next to me grooming himself. That NEVER happened with the higher dose! NEVER! It was him screaming GIVE ME FOOD! before I even got a bathroom visit in the morning, or got in the door from work! Imagine if you took a large quantity of hormones, which is what the insulin is. Your body counters that hormone trying to adjust to this new "thing" that's been introduced. I don't have any documentation to prove this theory, but seeing the difference in Grayson is proof enough for me. He's much calmer, and more normal at half the dose he was getting. And ironically, his numbers are running about the same... or better! Yesterday I had 3 yellows in a row, and the previous and post-yellow numbers were within 10 points - so virtually the same! That's the first time I'd had 3 yellows in about a month!... let alone 5-ish! Today's +6 is also yellow. I'll take them! Again, not so much the number, but the percentage drop... from 383 to 280 is about 26%. That's as good as or better than I was getting previously.

I think you're trying to rush things. I know it's hard to stand still when the dance is in full swing... but I think you've got to give the insulin a chance to do it's thing. Your vet may or may not appreciate the fact that you have all this input from strangers that didn't attend vet school. I'm thrilled to have the support network, but there are times when I may have to go against the popular recommendation and give the vet's theory a chance. Likewise, if there's something they recommend and you're NOT comfortable with it, it's important for you to discuss, share your concerns, and understand the reasoning behind their advice. As much as I was the one that initially thought about re-booting, when they recommended it, I was scared to death. But not as scared as when I jumped from 4.5 to 5.0... or two days later when I jumped to 6.0! Those were extremely difficult doses to administer.

Not too long ago, there was someone on this board who gave her cat 5u (starting dose) per the vet's advice. It was horrible, and the cat did not survive. I would HATE for anyone else to have to go through that - which I'm sure is partly why everyone initially advised you to reduce. And why I've suggested you look at the spreadsheets of those here and see what kinds of doses they're doing - MOST of the cats are between .5 and 2.0u. Why would your cat, or mine, be any different? My friend told me repeatedly - cuz i'm thick-headed - the likelihood that my cat is anything but normal is slim. She also told me I'm being one of those neurotic pet moms... which I know I have been, and she's right. So, I'm trying to be more balanced, and work with my boy to find what works for him... patiently. Not squirming over reds; revelling in every yellow or near-yellow. Little victories. You might want to do that as well. Remember, Rome wasn't built in a day. Patience will get you where you want to go sooner.
 
Have they checked for agro yet? I was just at the vet's this am for a check and they talked about agro with me just because he is a maine coon. He is not agro because he is responding to insulin, but she said to watch out for it because MC cats are more prone to it. Just a thought.

Hang in there! You really are doing a good job!

lori
 
I believe that ketones are not necessarily at high numbers, and once had ketones, I get the feeling they could happen again.. some cats just seem prone. Don't rely on visual or hunger as indicators for ketones; see if you can get a test a day.
 
I agree with Lu, your numbers now are no better than they were when you were on 1.5 u. In fact you saw blue at the lower dose. Continued overdose can lead to insulin resistance. I really think you need to come back down and give it time.you don't even know if the 1.5 dose was too high,I think you need a reboot and hold that dose for a while, at least 5 days. I know you are desperate for quick results, but most of the time getting a dose figurd out takes some time. A dose of prozinc for a non insulin resistant cat should be no more than should be no more than .5 to 1 u per kg, so you are really at the top end of the maximum you would ever give, which isn't normal.
 
I agree with the advice above. I struggle with this as well, and although I would love to do something, anything, to get better numbers, I bite the bullet and take the baby steps. Linus has had a rough few days lately, but this morning at +8 he was 212 :-D . I am seeing better numbers by holding the dose longer before I make the next decision. I wait for all of the numbers to drop, pre-shot and nadir, and then hold to see if they remain consistent. If they are still too high, I make a tiny increase (.2u). Then I wait for the consistency again. It takes a while with each increase to find out where he will end up, and, while there have been some days that are higher or lower, we have not had the extremes that happened with the larger increases.

We started at 1u and quickly ended up at 3u on my vet's advice based on the numbers I initially had. After reading this board and getting help from all the friendly people here, I backed down to 1u and started up again s l o w l y. We are now at 2u and things are looking much better than they did at 3u. I think the consistency in BG is better for Linus than the occasional really low numbers followed by really high ones. It is definitely not an overnight thing, and all I can tell you is what I tell myself, just be patient.
 
OK deep breath - he was just 398 at +10 and before dinner. We had most of our blues initially when we started out at 4u's which is why I keep creeping back to that. This is a cat that got thru a few weeks at 8u's when he was previously diagnosed - and after two near hypo's (pretty low greens) he ended up at 1.00 and less for a few weeks and than went OTJ. I don't think he's resistant at all - or at lest wasn't originally.
I just don't know - I'd like to stick to 4.0 and at least give that the same try I gave 1.5 (a week) it took me a week at 2.50/3.50 to climb up here and except for the reds at AMPS +10 and +11 the last couple of days looked pretty OK.
I hear it all gang and I'm going to mull it over and try and figure it out . I don't want to drop him to 1.5 or 1U now... I'm afraid he'd go into the black... I'm going to seriously try the ketone test this weekend - if I can get that going so I'll KNOW if he's suffering with this issue than I'll feel safer about going lower (if that makes any sense) - I can't say how much I appreciate this outpouring of information even if it all just makes me want to cry right now... it's all valuable and helpful.
OK and what on earth is AGRO? I just googled it and can't find a thing that makes sense.
ALso - I spend hours pouring over other cats SS - seriously - it's an obsession. Many of them don't make any sense to me. How do you shoot under .50U? Are you all using different hypo needles than the standard?

Cycles + ??? I feel it's AMPS and PMPS = one cycle?
 
More sorry - did anyone see my post in this other section - it's about his food intake- thought it might have some relevance.
Re: Feed my cat twice a day, or small meals during the day?

Postby RobbiesMom » Thu Apr 12, 2012 7:00 pm
This is a very useful thread. I'm convinced that my cats eating habits and how I'm dealing with them are interfering with his BG levels - when he was OTJ for 18 months he ate 5-6 meals a day - 2 larger ones (7:30am/6pm) and 3-4 smaller ones - noon, 8pm, midnight or thereabouts before I go to sleep and 5am when he'd often wake me screaming. It was perfect he seemed happy and all was right with the world (except for my interrupted sleep schedule). Now - back from the honeymoon with his numbers running in the 300's most of the time and me bouncing around with insulin levels (for a variety of reasons some good some just probably my stupidity) he's looking for the same food schedule but I can't really regulate it with when I test and shoot. I try NOT to feed him at 5 or 6am even though he often asks for it - if he continues to be fussy and pulling him into bed doesn't calm him down I give him some watery FF Cod, shrimp mixture about 1/4 to a 1/2 a can and he hoovers it right down. I test him before I give him this so I have a PRE-food number to consider at 7am/7:30 when I give him his shot and he gets his "real" breakfast (about 3/4 of a can FF low cal/carb with metimucil in it) this he eats pretty quickly too - I test again and shoot but I compare the 5am # and the 7:30# since he's had food at 5am (which is technically about PMPS +10) and try to base my decision on what makes sense with the PMPS+10 number and the AMPS number. Than before I leave for work around 8:30am (AMPS+1) he gets the small amount of his breakfast with water added to it. I have a auto feeder that we can't get to work - it's about a year old and if I can't figure it out this weekend when I have time to fiddle with it I'm buying a new one - I think if he had smaller amounts in the morning when I'm home and than something mid - day he'd be better off - neither of us can always get home at noon or so - than I also think he if got some food at say 9pm and than again at maybe 3am he'd be happier and I would have a clearer idea of his morning number at shot time without food interference.
Didn't mean to hijack someone else's thread - but any input on this would be much appreciated.
 
RobbiesMom said:
OK deep breath - he was just 398 at +10 and before dinner. We had most of our blues initially when we started out at 4u's which is why I keep creeping back to that. This is a cat that got thru a few weeks at 8u's when he was previously diagnosed - and after two near hypo's (pretty low greens) he ended up at 1.00 and less for a few weeks and than went OTJ. I don't think he's resistant at all - or at lest wasn't originally.
I just don't know - I'd like to stick to 4.0 and at least give that the same try I gave 1.5 (a week) it took me a week at 2.50/3.50 to climb up here and except for the reds at AMPS +10 and +11 the last couple of days looked pretty OK.
I hear it all gang and I'm going to mull it over and try and figure it out . I don't want to drop him to 1.5 or 1U now... I'm afraid he'd go into the black... I'm going to seriously try the ketone test this weekend - if I can get that going so I'll KNOW if he's suffering with this issue than I'll feel safer about going lower (if that makes any sense) - I can't say how much I appreciate this outpouring of information even if it all just makes me want to cry right now... it's all valuable and helpful.
OK and what on earth is AGRO? I just googled it and can't find a thing that makes sense.
ALso - I spend hours pouring over other cats SS - seriously - it's an obsession. Many of them don't make any sense to me. How do you shoot under .50U? Are you all using different hypo needles than the standard?

Cycles + ??? I feel it's AMPS and PMPS = one cycle?
Click to expand...
I think i can answer a few of your questions.
a cycle is from one shot to the next. If you are shooting TID/ every 8hours, then one cycle would be 8hrs.

AGRO is incorrect; I think the poster meant acro, short for acromegaly.

the needles that people are using, are the U100 syringes for Lantus and Levemir, R and N. The vet insulins, like th P insulins and caninsulun use the U40 syringes, but I think many are using the U100 syringes also for the P insulins for smaller dosing.

Yes, it is possible to give a smaller dose than .5u but it ain't easy! You can practice the drop method.
Just take a used U100 syringe and fill with water to that .5u mark on the syringe.
Holding the needle end upward, then twist the plunger until one drop forms on the end of the needle tip, flick off that drop.
Repeat the plunger twist, drop form, and flick, until the syringe is empty.
With a little practice, you should be able to get 4 drops out of that .5u amount of water.
Personally, I have no clue how people can claim to get a .1u dose but whatever... you can get a .125u without too much trouble.

This is a cat that got thru a few weeks at 8u's when he was previously diagnosed - and after two near hypo's (pretty low greens) he ended up at 1.00 and less for a few weeks and than went OTJ. I don't think he's resistant at all - or at lest wasn't originally.
Click to expand...
Cats with insulin resistance conditions have functional pancreas, so if there is a stop to the hormone output, the cat will not need insulin. Think of a faucet .... turn it on and you need to react. Turn it off, and you don't need to do a thing.
My cat Oliver was at 37u BID in Oct/2011, down to 21u BID by Christmas, and OTJ by Jan4th/2012. He tested positive for both acromegaly and IAA in June2010. He is still acromegalic but the growth hormone secretion has stopped. He now does not need insulin. he will need to be still tested like any other OTJ cat, and he may well go back on insulin again when the tumor's output starts again.

There was another cat with acromegaly who went OTJ 4 times in his life.

We can do only our best in caring for our cats and if down the road the testing is needed for your cat, then get the acro and IAA tests done and whatever the results, just remember that your cat doesn't know numbers; all Robbie knows is that you love him and take good care of him.
 
Ellen, I just want to clarify that I wasn't saying drop back to 1u, I was trying to say to just hold where you are for a while, like a week or even 2, get a really good picture of where Robbie is at, and give him a chance to get used to the dose, and then decide where to go from there.

As long as he's eating and healthy, hopefully ketones won't be an issue, and it's better for him to be a little high than a lot low, especially if you're not around to catch it.

I think a little differently than some folks here about food - I try to feed at least 4-5 times a day, and actually don't see much of a spike in Linus' numbers from feeding before testing. Sometimes I see a decrease. I think with low carb food it's not as much of an issue as it would be for a human diabetic eating a candy bar. I think we're treating the whole cat here, and the cat needs to eat. I'm not going to starve him just to get a "clean" BG number. When we get down to the nitty gritty (like he's 150 pre-shot and how much am I going to give him?) it may become more of an issue, but right now my theory is, if the cat is hungry, feed him.
 
thank you thank you all - I'll look into the acro situation. I've said this before - I love all my animals deeply - but Robbie is somehow special - he "replaced" a wonderful boy cat I had that died of cardiomyopathy (PTS when I knew I could do no more and was just keeping him going so he wouldn't leave me) - he walked right into the house like he owned it and into my heart the same way. He was by my side as I saw my mom die a very difficult death 6 years ago and he never left my side while I was despondent over that, he was sleeping by my side thru my own illness and cheered me up constantly thru both of those difficult times. I only want to do right by him and that is what makes this so hard - he's never done anything but the right thing by me. Breaks my heart to think I'm messing him up or not doing what will help him the most.
I shot 4 tonight - I'm going to stay here for a bit - at least enough cycles to see whats happening. Please keep your thoughts and encouragement coming and I hope all your sugarkids are doing well and thriving under your loving care.
 
At this point I would incourage you to have him tested for Acro and IAA as soon as you can. If either are positive then at least you will know what you are dealing with and can procede with confidence. The tests might clear up alot of the questions.
 
Wow Robin really? Even considering he responded so well to the insulin last time around? So far tonight I've read just about everything I could find on Acro and other than not responding very well this time around to the insulin Robbie doesn't meet any of the symptoms/signs. I'm going thru the next 6 days at 4.00 if it doesn't cause issues and than next week he's going to the vet and I'll talk to him about it. I'm continuing to read about both these conditions and and see what more I can learn. Thank you.
 
RobbiesMom said:
Wow Robin really? Even considering he responded so well to the insulin last time around? So far tonight I've read just about everything I could find on Acro and other than not responding very well this time around to the insulin Robbie doesn't meet any of the symptoms/signs. I'm going thru the next 6 days at 4.00 if it doesn't cause issues and than next week he's going to the vet and I'll talk to him about it. I'm continuing to read about both these conditions and and see what more I can learn. Thank you.
Click to expand...

Ellen,
what signs are you finding listed that your cat does not have.

I have to say that I had a small and dainty female who met none of the 'signs and symptoms' other than a dose that kept rising, but Shadoe tested positive, despite my vet saying 'don't bother as she does not look acro or have any signs'. She had a fine face/head, tiny paws, did not snore or have any breathing issues, and she was female. She did not fit the picture but she was positive.

There is also IAA which can be temporary and does not have the signs like acro.

Sure, my Oliver looks like an acro poster boy, but Shadoe was a surprise to everyone except me and the other acro owners.
 
Gayle
I could probably convince myself he's got anything but here's where I go when I'm trying not to project something worse is going on
7) Have you noticed changes in the way your cat breathes? Any changes in their eye sight?
Robbie has had asthma probably since he was a kitten- as his purr always sounded quite loud and odd from day one he was DX when he was about 1.5 years old - diagnosed via chest x-rays (but this could be considered a breathing issue although not a change really). His eye sight seems fine - no issues there.

8) Have you noticed any behavioral changes in your cat? For example, appearing to be in pain, avoiding bright light.
No - he's seemed stiff in his back legs a bit more recently but x-rays have shown arthritis there as well as a chip out of his hip bone probably from a fall he took off the cat tree once. No issues with bright lights - in fact he loves to rip at the lamp shades to get my attention.

9) Have you noticed any physical changes in your cat's appearance?
None
10) Has your cat had a tendency to gain weight despite no increases in amount of food you are feeding?
No actually he's been totally static and held his weight for almost 2 years.

So that would make me think there aren't any signs at this point although he DOES snore and started that when we took him off the occasional prednisone for his asthma 18 months ago - so clearly I'm going to speak to the vet about this.
 
Gayle Shadoe & Oliver said:
the needles that people are using, are the U100 syringes for Lantus and Levemir, R and N. The vet insulins, like th P insulins and caninsulun use the U40 syringes, but I think many are using the U100 syringes also for the P insulins for smaller dosing.

Yes, it is possible to give a smaller dose than .5u but it ain't easy! You can practice the drop method.... Personally, I have no clue how people can claim to get a .1u dose
Click to expand...

Okay... here's the difference. When you're not shooting prozinc, you use the U100 needles. One unit is one unit of a U100 insulin. ProZinc is a U40 insulin and uses the U40 needles. Many of us have used the U100s WITH THE CONVERSION CHART, to do smaller doses. Mini-dosing (.1u, .2u, .4u, etc.), not micro- (the drops). In order to do this you MUST use the conversion chart, as there's a difference of 2.5X. On the U100s, each half unit mark = .2 units. So if you did 1/4 unit on the syringe, that would equal .1u. Likewise, 1 unit on the syringe = .4 units of ProZinc. I don't have the conversion chart bookmarked, but do a search on "Conversion Chart" and I'm sure you'll find it. Print it out and keep it either on your fridge, or in w/ your supplies.

The Acro and IAA tests aren't that expensive. I think one was $15 and the other about $50 - probably plus a little more for your vet to take the blood, freeze, prep, ship, etc.

Lastly, regarding the food. Grayson was always ravenous at the higher doses. Since I've cut him back, he's not nearly as famished. he still is "carb-starved" - would sell the dog for a bowl of Kitt-N-Kaboodle! Anyways, I logged onto the spreadsheet what and how much Grayson was fed throughout the cycle. I was also trying to see if his "IHOP days", (cycles flat as pancakes) were food induced. I typically see about a 30 point spike from a can of FF Chicken or Turkey/Giblets. Sometimes it clears in 2 hours, usually a little longer.

Hope that helps w/ some of your questions.

Lu
 
Yes, Lu as with everyone else's input that was extremely helpful - when we get the ketone strips tomorrow I'll look and see if there are those syringes so I'll know where to get them if I need them.
thank you again.
 
Ellen,
You are one sign up on what I had with Shadoe... she never had snoring or loud breathing, and was fine featured.
Eventually, over time, she got the acro pot belly and started looking like a pregnant cat, a soccer ball on little legs.
Her paws eventually looked a shade bigger and her head became broader, but otherwise, she had no signs or symptoms other than her dose increasing.
While she got up to 14u BID, after her dental, her dose dropped to 2.75u BID.
 
Sorry about the typo of "ACRO" in earlier post. Was in a hurry and typed it wrong. Glad you could find some info on it. Just keep it in mind.

Also, the U-100 syringes need to say: 3/10cc, U-100 with 1/2 unit markings. I use the 30guage and shorter needle 5/16". He seems to really like the shorter one better. But everyone has their preference. I get mine at Walgreen's (Walgreen's brand version). Very cheap. Not sure what state you are in, but some states require a perscription for syringes. Our's does not so easier to get. Just check on it.

Good luck with the 4u and hope the ketones stay away!

lori
 
hi ellen! after your pm i wanted to come and find out more about what's going on with robbie. sounds like you've had a heck of a time.

one thing i wondered about - are you giving Robbie anything for the arthritis? cosequin can make a big difference in their mobility - you can buy it at a store like Petco or you can order it online. tastes like chicken (hehe not that I'M trying it!) - we open the capsules and mix into punkin's food. most cats over the age of 7 have some arthritis. pain can increase BGs - so that might explain some of what you're seeing. i started seeing a benefit in punkin in maybe 2-3 weeks. if the cosequin doesn't do enough, there are 2 stronger related drugs - adequan and dausequin.

do you know that steroids can increase BGs, including bringing a cat out of remission and back into active diabetes? you mentioned prednisone for the asthma, that could explain why he has gone in and out of active diabetes.

there are 2 schools of thought about the food. you may need to experiment to see what works best for robbie. when cats are near to going OTJ, it's good to feed them many small meals throughout the day. that is easier on their pancreas, which is healing. when they are dependent on insulin, it's good to get most of the food in during the time that the insulin is strongest. you don't want a lot of food when there is no insulin available to deal with the carbs.

when you're trying to figure things out, it helps to keep all of the variables constant while you just tinker with one. for most cats, that means figuring out a food plan (volume, timing & carb content), sticking with it, then tinkering with the insulin dose. if you want to change the food plan, don't do it at the same time as you're changing the insulin dose. if you change more than one factor at a time you won't know what caused/helped what.

another factor that's a biggie on cats that you can't get regulated - has Robbie had his teeth cleaned? i keep seeing cats go OTJ on the Lantus TR forum after getting their teeth cleaned, all the bad teeth out, the infection and pain cleared up - and then BOOM - the cats get regulated and pretty soon are off of insulin. most of the time the vets can't tell for certain how bad the teeth are until they have the cat under anesthesia. I would put that on the top of "spend money here" list because i've seen so many times how incredible the response is. personally, i would certainly do that before i spent money on testing for a high dose condition in the situation you're describing with robbie. 4 units is not a high dose - i wouldn't even consider high dose until you were giving 6-7units per shot consistently and not seeing good numbers over the course of at least a couple of weeks. it's not especially unusual for a cat to need 4 units.

may 2011 when i had punkin tested, it was $11 for the blood draw, $61.25 for the acro test, $18.75 for the iaa and $75 to ship the blood overnight cold from Oregon to Michigan State University via Fed Ex (MSU's choice) - so a total of $166 at that time. it's probably more now.

re the ketones - i took a box lid and slipped it inside a plastic garbage bag and filled it with a few cups of lentils. after punkin had eaten, i put him and the box into the laundry room. he obliged by peeing in the box, hopped out, and i dipped the ketone strip in. easy. you can use anything non-absorbent. some people use aquarium gravel too.

re his dose - someone wise told me that the important number is not the size of the dose, it's the number of punkin's BG. i had mental blocks at every dose that ended in a 5 or a 0, but staying focused on the BG number is the only way to go. I don't see bouncing on Robbie's ss - i didn't super study it, but just looking, i'd say 4 units is probably what he needs, and if it's not enough after a week, go up rather than down. keep reminding yourself that a non-diabetic cat range is 50-120 (human glucometer) and that's what his body wants.

anyway, fwiw, there's my 2 cents worth. i hope it helps. :-D heehee and he DOES look just like punkin's brother! wahoo - FAMILY! we share another thing besides matching cats - my mom died 6 years ago too. :YMHUG:
 
So much to respond to and I will but work calls early today. Daddy is home testing Robbie who was 292 at PMPS+11 and ate breakfast than was 338 at AMPS - one thing I will say - I have been screwing with both the dose and food at the same time - stupid but I do think I know something from it - I have to get the auto feeder working - I think and have thought for a while if he could eat at 3:30ish instead of waking me screaming at 5:30ish he'd do better. So his "daddy" has orders today to get the darn timed feeding thing working or Im buying a new one.

thank you again and more soon so as I'd love some feed back on other things this all brings about.
You are all truly kind and caring people.
 
Just got home from a long work day - still no time to go over all the recent input but I think I got a decent curve from Robbie today although he's gonna end it on a high note :sad: at his PMPS I'm guessing - he was 398 before we gave him dinner at amps +11 but we'll see - have to go out tonight so kind of concerned that we won't be here to test him much but am going to make sure we get home asap.
 
I am sure others will scream at me but have you thought of trying a longer lasting insulin?
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Not screaming, but I'd think a really long time before making a switch. I mean, he's already gone OTJ on a P insulin, right? I know Prozinc isn't exactly the same as PZI Vet, but still, it worked once.

cosequin can make a big difference in their mobility
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Agree, cosequin has helped with Bob. I used the capsules and sprinkled it over his food to hide it and he didn't seem to mind (or he eats so fast he didn't taste it).

I believe that ketones are not necessarily at high numbers, and once had ketones, I get the feeling they could happen again.. some cats just seem prone. Don't rely on visual or hunger as indicators for ketones; see if you can get a test a day.
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One of the factors in the appearance of ketones is "not enough insulin" which is why most people associate it with high BGs. But high numbers are not required for ketones to show up, so Gayle is right. Bob was DKA, but after that time, he never showed higher than "trace" levels. But from what I've read on the board, kitties seem more prone to ketones once they have shown them once. Bob's luck may have something to do with the amount of sub-q fluids he got for most of the time he was on insulin (pretty much the whole time - he was given fluids to deliver potassium supplements easily along with to keep him hydrated).

Carl
 
julie & punkin said:
one thing i wondered about - are you giving Robbie anything for the arthritis? cosequin can make a big difference in their mobility - you can buy it at a store like Petco or you can order it online. tastes like chicken (hehe not that I'M trying it!)
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Part of what I think pushed him back into the diabetes was he won't eat his food with the cosequin in it - he hates it but if I put a pill in a tablespoon or so of the gravey salom FF food that he used to get and LOVES he'll eat it. So since he was OTJ and doing so well I spend about a month or so giving him that every morning than started seeing the changes and tested and his BG was back way up. I'll try it again and see if he'll go for it without the high carb food.

julie & punkin said:
do you know that steroids can increase BGs, including bringing a cat out of remission and back into active diabetes? you mentioned prednisone for the asthma, that could explain why he has gone in and out of active diabetes.
Click to expand...
Yes, we know that. He was pulled off all steroid treatment when he was originally diagnosed.

julie & punkin said:
when you're trying to figure things out, it helps to keep all of the variables constant while you just tinker with one. for most cats, that means figuring out a food plan (volume, timing & carb content), sticking with it, then tinkering with the insulin dose. if you want to change the food plan, don't do it at the same time as you're changing the insulin dose. if you change more than one factor at a time you won't know what caused/helped what.
Click to expand...

I've been pretty stupid about this - I've changed his food around too much - I do see some pattern that I think would indicate that if I can get him fed at about 3am instead of him being starving for food at 5/6am he does better. So we have to get the darn autofeeder working.

julie & punkin said:
has Robbie had his teeth cleaned? i keep seeing cats go OTJ on the Lantus TR forum after getting their teeth cleaned, all the bad teeth out, the infection and pain cleared up - and then BOOM - the cats get regulated and pretty soon are off of insulin. most of the time the vets can't tell for certain how bad the teeth are until they have the cat under anesthesia. I would put that on the top of "spend money here" list
Click to expand...

No he has not - I noticed a slight amount of tar and our vet checked him out and felt his teeth were still in good shape. Our girl kitty has the cleanest teeth our vet has ever seen on a 12 year old - when I compare her teeth to Robbies - his look yellower. I'm going to talk to the vet about this for sure.

julie & punkin said:
he ketones - i took a box lid and slipped it inside a plastic garbage bag and filled it with a few cups of lentils. after punkin had eaten, i put him and the box into the laundry room. he obliged by peeing in the box, hopped out, and i dipped the ketone strip in. easy. you can use anything non-absorbent. some people use aquarium gravel too.
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He will NOT cooperate with this. He's a brat about the LB - I'm working on this.

owlgal said:
Sorry about the typo of "ACRO" in earlier post. Was in a hurry and typed it wrong.
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NO problem - thanks for getting the topic going with that.

Thanks for the conversion chart Gayle

He really seemed to be less food crazed last night - I think the food when his insulin is at it's strongest should be a goal. Working on all of this gang and thanks for ALL the input.
 
Carl & Bob in SC said:
Not screaming, but I'd think a really long time before making a switch. I mean, he's already gone OTJ on a P insulin, right? I know Prozinc isn't exactly the same as PZI Vet, but still, it worked once.
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OK confusion here - he went OTJ 18 months ago on what I thought was the SAME insulin? Am I just tired here? same box, same everything - have I made some major error in info here?
 
Ellen,
Most likely my error. I didn't go back and read your first posts, so I thought it was PZI or PZI Vet the first time. There are so many new "P" cats lately, I can't keep 'em all straight!
If it was Prozinc the first time as well, then disregard what I said. That actually makes my point though. If he went OTJ the first time on Prozinc, then there would be no logical reason to switch insulin now. What worked once should work again.

Carl
 
thanks Carl - I wouldn't change this early on anyway but was hoping I hadn't missed something and been putting out the wrong inf to people here.
Just to make sure I went and double checked the insulin he's on ProZinc for sure.
 

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Just checking in, nice blue nadir today! He bounced from it, to be expected, that quick rise to 300ish in 2 hours. You're in a bounce cycle now and it might keep going for another cycle so if he stays high you know why.
 
thanks for checking in - figured that was a bounce there - now I'm dealing with more human error this morning since we woke up to a nice 283 at his AMPS (first yellow since his second day) and I wasn't sure what to shoot since I won't be around to keep an eye on him - I shot 3.00 and than when I was posting about all this here he managed to push open the bedroom door and get to his sisters food - which since she's a picky eater has remained the high carb, gravey FF food they both used to get . I have NO idea how much he got - might have been a couple of licks, might have been full on bites - the plate was licked clean when after about 4 minutes I realized what he'd done and when charging in there - in that 4 minutes he also used the LB and had to climb the cat tree to get to her food which takes him about a minute - than typically there's a stand off between them - so he might have gotten nothing but I'm guessing he got a bite or so.
 
perhaps you already know, but i've heard a number of people say (ie, i don't know firsthand, but through stories) that when a cat has come out of remission, it takes getting to a larger dose of insulin to get them there the next time.

celi's binks came out of remission because the petsitter was unknowingly giving him high carb foods. have you had any luck with giving him pills in pill pockets? the duck and pea ones are low carb and ok for diabetics - the others are not. i throw little balls of them on the floor without pills in them to get them used to it, then load the pill in. punkin's such a hoover than he never even notices - sucks it all up without even tasting.

i haven't used the adequan or dausequin, but i think they *might* both be available as as injection, similar to the insulin shot. you might ask the vet about it. or try the cosequin again in the pill pockets if you haven't tried it yet.

sounds like the teeth might be worth a closer look then. punkin seems prone to tartar build-up. i can't remember, but i kinda think serryn's vyktor didn't look like he needed a dental until they actually got him under. I posted ss in Grayson's thread last friday or saturday of 2 cats, vyktor and mikey, who were nicely dramatic in going off of insulin following a dental. wish we could have that experience! :lol:
 
Robbie is kind of odd about his pigginess... he likes what he likes and wants lots of it but he can be picky. He's never liked cat treats - the cosquine caps we had were pretty big - I don't think he's chomp them down but it's worth a shot. I've got a nice long list of questions for our next vet visit - I'll add the one about adequan etc. to that list.
thanks again
 
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