Heffernan 1/3/15 AMPS 313 PMPS

Status
Not open for further replies.
Re: Heffernan 12/4 AMPS 374 +3 300

Here is a suggestion for you to try because looking at his spreadsheet just now this might be your stumbling block with Heff.

First you have very little mid-cycle testing, which is fine if you also fill in the bigger picture with a weekly or a bi-monthly curve. Without those data points being filled in, you don't know where his onset is, where his nadir is, or how much over-lap he has from dose to dose. For the most part you have been changing doses based only on preshot values, which isn't how Lantus works.

So my suggestion is, trying to get either a full curve of testing every two hours or an 16-18 hour mini curve testing every 3 hours, so that it runs over into the early part of his pm cycle. Once you have that data then we can go over it, and try to help you see where his onset happens, and when he is mostly like to hit nadir. Sometimes those curve numbers will surprise you, because they will show you where he maybe making a late/early dip that could be setting off a bounce without you even realizing that is what he's been doing. If I based dosing decisions for Autumn on just her preshots values she'd be on a huge dose by now if not dead from a hypo. Because she is very prone to diving late in her cycle. A good example is her run yesterday, flat yellow for most of the cycle and then wham 56 at +12.

Mel and The Fur Gang
 
Re: Heffernan 12/4 AMPS 374 +3 300

Hi Laura
yeah it's really possible that he's going low somewhere in the cycle and then bouncing back up and for that reason, too much insulin looks the same as too little as far as blood glucose numbers go. good luck getting those curves. i know how difficult it is to get them. just hang in there. it took me 4 months before i saw any change in Tibbs. it was very frustrating so i know what you are going through.
 
Re: Heffernan 12/4 AMPS 374 +3 300

I need a clone then because I'm never home an entire day. Short of a curve at the vets, that's my only shot. I'm trying to get tests in when I can. I got a +10 shot in today since I was gone 11-5 on my day off. I need to get sick so I can stay home.
 
Re: Heffernan 12/4 AMPS 374 +3 300

i know Laura . we can only do the best that we can. that's all we can do. it's great that you are testing every day. just wondering when you started over at 1 unit...... you increased the dose after only 2 days. i just wonder if maybe it would help to hold that dose longer if u can't get any curves in to see what's going on. is it possible that maybe you went by his ideal dose? i am not experienced enough but i would ask Mel about that.
 
Re: Heffernan 12/16 AMPS 279 +4 275 +9 295 PMPS 342

How old is your insulin? If it's fairly old then I would try a new pen first. If it's fairly fresh then the only thing to do is go up in dose until he comes down.

Mel and The Fur Gang
 
Re: Heffernan 12/16 AMPS 279 +4 275 +9 295 PMPS 342

Then as flat as he is you only have one real choice and that is to go up in dose. Now what might happen is that you keep going up until you hit a breakthrough dose and then he'll start dropping like a rock and you will be able to starting reducing it again. I've seen it happen many times, they build up a resistance to the insulin then you hit a dose that break that and the dose comes back down again.

Mel and The Fur Gang
 
Re: Heffernan 12/16 AMPS 279 +4 275 +9 295 PMPS 342

Ok, I've been trying to hold the dose for 3 days but I'm just so frustrated that nothing I do is helping.
 
Re: Heffernan 12/17 AMPS 305

The other consideration would be a switch in insulin. But as flat as he is I really don't suspect the insulin choice as much as I do the dose. Sometimes they just take as much as they take. Even though we say MOST cats only take a couple of units per day, doesn't mean that they ALL will. ECID Some days I actually wish one of mine would have been a high dose kitty instead of a microdosed one...because at least it would be easier on my eyes...lol

Mel and The Fur Gang
 
Re: Heffernan 12/17 AMPS 305

I really thought hard about switching to Lev, but my sister talked me out of it.

Upped him to 2 units this AM. He vomiting a bit of breakfast, but I think he cleaned off too many plates too fast. He kept the chicken treats down that he gets with his shot.
 
Re: Heffernan 12/18 AMPS 333

That is just kind of the nature of Lantus in that it doesn't really effect their numbers a bunch until you get close to the ideal dose.

Mel and The Fur Gang
 
Re: Heffernan 12/19 AMPS 262

Even small victories are to be celebrated!!! So.........YAY!!!! HEFF!! :RAHCAT

Mel and The Fur Gang
 
Re: Heffernan 12/19 AMPS 262

We have a new civie...foster failed again. Heff doesn't even know Moseley is in the house yet. He's a flame point himalayan longhair exotic shorthair (if that makes sense!). Breeders should have 60-80 cats when they are in their 80's. :( Poor dude is so neglected.
 
So his #9 was 196 and PMPS was 168. Can he have a super late nadir? He ate around 6:45 and I only gave 1.5 units instead of 2.25 since I'm a chicken.
 
It can be safe to shoot your normal dose as low as 150 mg/dL. It is recommended that you be able to monitor the first few times you do so, just to confirm that the nadirs remain safe.

When you can, do a curve and get tests every 2 hours from pre-shot to pre-shot. Alternatively, if your schedule isn't a good fit for doing that, pick times you don't normally test to snag them and get a different time on different days, until you've covered many different time periods. Some folks even set an alarm to get up at night to get a test around the nadir; if you do that, it helps to make any sleep time a multiple of 45 minutes, which is roughly 1 sleep cycle. It is easier to wake up at the end of a sleep cycle! Basically, any test data you can get helps you understand how he responds to the insulin.
 
They are keeping him overnight. It's either pneumonia or heart disease. He's in an Oxygen chamber & his color is much better after the 2 hours we were there.
 
(((Laura))) how scary. Sending healing thoughts to sweet Heff. Let us know when you hear an update.

I read the thread above and just wanted to suggest that you take a peek at the thread on how people handle following the TR protocol when they work full-time. It has lots of ideas that might be helpful to you: http://felinediabetes.com/FDMB/threads/sticky-can-i-do-tr-with-a-full-time-job-yes.129378/

In the meantime, i'm thinking of you and Heff and hoping he continues to perk up.
 
Checked in with the ER clinic and he's been off oxygen since 5:30 am. Will check in again around 9:30-10 am. Thanks for the support everyone. It sure was weird having my alarm go off at 6:15 am to test, feed & shoot and he wasn't here.
 
I don't know a lot about heart disease in cats, but my dad had heart disease and what can be done with medicine is absolutely amazing. I wouldn't go to the worst case scenario yet, Laura, it may not be as awful as it sounds. More information can often help.

Can I suggest that you put "help w/heart disease?" in your subject line so it is seen from the main page? Or start a new thread for today with that in the subject line. In the New to the Group sticky it asks people to start a new thread daily to keep the length of the threads manageable.

Having the Q in your subject line will bring the people with experience with it to help guide you. Often when you are starting into a new area you don't even know what questions to ask and experienced people can help give you things to ask about.
 
Julie's right. There are a number of kitties here with cardiac problems. Can you try to find out exactly what the problem is? I noted on your FB thread people were making suggestions re. giving liquids (not sub-q fluids). There are some conditions (e.g., congestive heart failure) where you don't want to supplement the cat's diet with excessive liquid. Medications can do wonders to keep things very stable for long time.
 
I'm not doing anything until we see our regular vet & the specialist. I'm on a cancellation call for the specialist and my vet will get us in tomorrow. I had a cat with HCM that lived 4 years after diagnosis. The good news was in the midst of this crisis his BG wasn't over 320 without insulin-they were testing him at the clinic and prepared to give him short acting insulin.
 
Methylcobalamin (methyl B-12) is what is recommended for diabetic neuropathy. Zobaline is formulated specifically for diabetic cats (i.e., no sugar or starch) and is available on Amazon and several other sites. You mix it into Heff's food. It does take a while to work. You'll also see neuropathy resolve as numbers become better regulated.
 
I know you've been struggling with Heff's bounciness since the get-go (he's always reminded me of Mikey when Mikey was on Lantus). Do you think it might have anything to do with his heart or are you thinking that might be a new/separate issue?
 
We think it's a newer issue. The specialist is awesome. His heart was pretty normal at first, but as the exam went on he got more agitated & then the heart showed the problem. I'm sure the numbers could be related. We also have a new cat, that really doesn't appear to bother him, but I think it's influencing him as well.
 
Laura:

Maybe I'm being slow on the uptake here but I'm really confused. This thread was started on the old board (12/4). The date in your subject line is 12/21 and I think some of the comments reflect more recent test data. I don't know what Heff's current numbers are. Help!! You may simply want to start a new thread for Heff.

In addition, when you have a chance, can you update his spreadsheet? I suspect some of the numbers you weren't liking very much were due to lowering the dose due to the addition of his cardiac meds (what's he taking, BTW) and some of the variable dosing. Lantus does much better with consistent dosing.
 
I can't find a way to edit the original post. He just started the heart meds yesterday, 12/31, the cardiac episode happened 12/27. His SS was updated--I have a love hate relationship with google docs. I've been doing consistent dosing-except for since Saturday when all hell broke loose & he was at the ER clinic.
 
In the top right corner of the thread (NOT the first post), there's a link to "Thread Tools." Click on that and it should give you an option to "Edit Title."
 
Better AM number. Heff doesn't like the low carb pill pockets, so we are using the smallest fraction of one for his meds. The pill kept falling out of chicken & he can't have cheese.
 
we used the dog Duck & Pea because the cat ones got discontinued, but they were SO stinky! ugh.

A small amount of the regular ones might raise his BGs, but if it's enough to matter, you can always increase the dose to compensate if you have to. good luck with it!
 
We bought the Duck ones--they are horribly stinky!! He hasn't met too many foods or treats he doesn't like & he turned his nose up at them. I bet the shelter dogs won't care!
 
yeah, i wondered why the cat Duck & Pea were fine, but the dog ones were horrid. Punkin wasn't too selective about his food, though (hahaha about the only good thing about acro) and he still ate them. When they discontinued the cat ones I bought about 6 bags of the dog ones, thinking they might be discontinued too. Punkin had meds all the time, and i just wrapped a teeny bit of pill pocket around them and threw them on the floor. He'd gobble them up. I wanted to make sure I had pill pockets available and wouldn't ever have to go back to poking them down his throat. There are still at least a couple of bags in the freezer - not sure what to do with them at this point.

I have thought maybe i should train my new civvies to eat the pill pockets if i can. Anya, who was punkin's "wife," will eat little balls of the pill pockets if i throw them on the floor, but the 2 kittens that we got after punkin died aren't trained yet. I've thought it would be good in case i ever have to give them pills too.
 
I don't know if the pill pockets are spiking his BG or not, doesn't seem much different. Going to up his dose again to see if we can get out of these 300s.
 
Status
Not open for further replies.
Back
Top