? Help! I;m confused! Coco's numbers have been in the 100's on some AM & PMPS

[Anna123]

I have been away for about 8 days & had someone testing/feeding/dosing Coco. Her numbers got pretty strange while I was gone..she seemed to bounce & hit 100's at preshot times, and I told the cat sitter not to dose when that happened. When I got home I reduced her dose to 8.5 & I still see it happening...I gave her a dose at 199 & she had a close hypo episode, where she was around 47 at Nadir (I gave her karo). I don't want this happening again,,,her amps is 165...do I dose her?? I need help with these 100's at preshot times!!

 

[Bobbie And Bubba]

It's hard to know what is happening as there hasn't been any night time testing since 3/14. Are you able to be home today and monitor her?

 

[Bobbie And Bubba]

Do you have plenty of test strips and higher carb food on hand?

 

[Anna123]

It's hard to know what is happening as there hasn't been any night time testing since 3/14. Are you able to be home today and monitor her?

There HAS been home testing...it never stopped..please look at SS. She was able to get AMPS & PMPS numbers..

 

[Bobbie And Bubba]

I see your numbers during the AM cycle, what I was referring to was the PM cycles where there are no numbers since 3/14

 

[Anna123]

There HAS been home testing...it never stopped..please look at SS

There HAS been home testing...it never stopped..please look at SS. She was able to get AMPS & PMPS numbers..

Coco never had preshot numbers in the 100's before

 

[Bobbie And Bubba]

She could be coming down the dosing ladder and requiring a smaller dose now. Are you able to monitor her today ?

 

[Anna123]

She could be coming down the dosing ladder and requiring a smaller dose now. Are you able to monitor her today ?

yes, but I'm past my normal shot time now by one hour...I haven't dosed her...should I give the 8.5 late?

 

[Anna123]

An hour and a half later after first testing her she's at 164..she only rose 2 points (no insulin)

 

[Bobbie And Bubba]

If you can monitor her today, you can shoot late and make up the time by 15 minutes earlier each cycle or 30 minutes earlier in a 24 hour cycle. Sometimes when they haven't eaten, they will not come up or can even continue to drop lower.

 

[Anna123]

she actually ate at her normal time(1 hr 45 minutes ago), so I'm all messed up on dosing now. I can do a curve tomorrow, but I just feel uneasy giving her the 8.5 units in the 100's...it's like I'm asking for a hypo

 

[Bobbie And Bubba]

she actually ate at her normal time(1 hr 45 minutes ago), so I'm all messed up on dosing now. I can do a curve tomorrow, but I just feel uneasy giving her the 8.5 units in the 100's...it's like I'm asking for a hypo

Wow! She ate and she still had not come up in 1 .75 hours. That's interesting. We say "shoot low to stay low" . But, you have to be comfortable with shooting a lower number the first time. A curve is a good idea .

 

[Anna123]

Wow! She ate and she still had not come up in 1 .75 hours. That's interesting. We say "shoot low to stay low" . But, you have to be comfortable with shooting a lower number the first time. A curve is a good idea .

I think I wouldn't mind shooting as much if her insulin amount wasn't so high...it's hard shooting 8.5 units at a low glucose number for Coco :/

 

[Anna123]

She's at 166 at +4 after eating & without morning insulin & . Weird. This is why I'm scared to give her 8.5 units!

 

[Gill & George]

Hmmmm, she got up to quite a high dose, remind me did you ever have her tested for IAA or Acro?

Just wondering if she did have IAA, whether what we are seeing is the resistance breaking, hmmmm

 

[Anna123]

Hmmmm, she got up to quite a high dose, remind me did you ever have her tested for IAA or Acro?

Just wondering if she did have IAA, whether what we are seeing is the resistance breaking, hmmmm

I took her to a specialist a couple of weeks ago~ one of her 3 specialties is diabetes in felines. She did a battery of tests on Coco (over $1,000 worth!) I asked her if we should also test for those & she felt sure that Coco doesn't have those..she has treated many that do have those. She said that I could, but didn't think it was necessary..and paying over $1,000 & had to agree at this point.. What do you mean by the resistance breaking?

 

[Anna123]

I took her to a specialist a couple of weeks ago~ one of her 3 specialties is diabetes in felines. She did a battery of tests on Coco (over $1,000 worth!) I asked her if we should also test for those & she felt sure that Coco doesn't have those..she has treated many that do have those. She said that I could, but didn't think it was necessary..and paying over $1,000 & had to agree at this point.. What do you mean by the resistance breaking?

on a side note, I know that everyone feels that vets don't know anything about diabetes, but she is extremely knowlegable & experienced.. although I can't afford to get Coco tested like that all the time, I felt it was incredibly thorough testing...she looked for possible tumors, checked urine, ultrasound in abdomen..it was a lot. and she LOVED that I do spreadsheets & asked me to send it once a week to her and she or her tech respond the next day

 

[Gill & George]

What do you mean by the resistance breaking?

From what I understand with IAA the condition is essentially self limiting and eventually, usually about a year down the line, when the resistance to insulin breaks, the kitty can start coming down the dosing scale, and this can happen very fast. I've sent a message to some members who have first hand experience in dealing with this and asked them to take a look at Coco's ss, hopefully they'll be around soon. I'm not sure if that's what's happening here.

I believe that the experience on the board with high dose kitties like Coco, that there is usually a reason for the high dose (assuming there is no HC in the picture) and often it can usually be attributed one of those two conditions. Some kitties have even been known to have both.

What did your vet attribute the High dose that Coco had got to?? Just wondering if she/he had an explanation or feeling as to why Coco had got up to 9u.

 

[Anna123]

From what I understand with IAA the condition is essentially self limiting and eventually, usually about a year down the line, when the resistance to insulin breaks, the kitty can start coming down the dosing scale, and this can happen very fast. I've sent a message to some members who have first hand experience in dealing with this and asked them to take a look at Coco's ss, hopefully they'll be around soon. I'm not sure if that's what's happening here.

I believe that the experience on the board with high dose kitties like Coco, that there is usually a reason for the high dose (assuming there is no HC in the picture) and often it can usually be attributed one of those two conditions. Some kitties have even been known to have both.

What did your vet attribute the High dose that Coco had got to?? Just wondering if she/he had an explanation or feeling as to why Coco had got up to 9u.

After doing all the testing~ including thyroid, which was negative..she just said that we are treating a high dose condition, with no outside factors . I believe she said that even if she was to have one of those conditions, she would be treated the same way.. honestly, she wasn't against doing the testing, but didn't feel it was necessary...

 

[Anna123]

After doing all the testing~ including thyroid, which was negative..she just said that we are treating a high dose condition, with no outside factors . I believe she said that even if she was to have one of those conditions, she would be treated the same way.. honestly, she wasn't against doing the testing, but didn't feel it was necessary...

I also see that although I have withdrawn the insulin a bit in the last week (when she's in the 100's), she does seem to bounce to higher numbers later...so it's not consistently low...do I cut her dose more dramatically, or do I follow the slow progression of lowering it in small increments..so confusing.

 

[Wendy&Neko]

Hi Anna, missed you and have been thinking of you and Coco. How's your girl doing? Did you ever get any further on the idea of switching to Levemir? I'm asking because you'll see lots more lower preshots on Lev because the nadir is later. For context here is your last post here.

Coco never had preshot numbers in the 100's before

I need help with these 100's at preshot times!!

It's great to see Coco finally giving you some blue preshots. That's a good sign, maybe she's learning not to bounce as much. The best way to learn how to shoot blue preshots is to shoot them when you are home and can monitor, have plenty of high carb food (HC gravy in the 40's is a good start unless she's allergic), and plenty of test strips. Once you've shot blue a few times when you can monitor, you'll gather some good data and get an idea of what to expect. Last time you gave karo she zoomed up pretty fast. You have the tools to keep her safe.

One thing you'll notice is that the larger depot helps carry you along for a while and they don't always notice a skip as much. She's really zoomed up when you've had to skip two shots in a row cause that really drains the depot.

I just feel uneasy giving her the 8.5 units in the 100's...it's like I'm asking for a hypo

A cat needs however much insulin they need and the size of the dose doesn't impact shooting low. Today's Wes's Jack, who is on 30 units of insulin, got dosed at 75 today. Wes did give a smaller dose cause Jack has some funky things going on with his IAA. I've seen high dose caregivers shoot green on even larger doses But, and this is the big one, only after having gathered the data to do so and being able to monitor closely.

Did you ever make any progress on getting Coco tested for acromegaly or IAA? If we knew the results of those tests, it'd give us an idea of what we are dealing with and when you need to be more cautious in dosing. As is, it's hard to say what's happening with Coco, but maybe you should go back to 8.0 units for the moment so you don't have to skip as much.

 

[Anna123]

Hi Anna, missed you and have been thinking of you and Coco. How's your girl doing? Did you ever get any further on the idea of switching to Levemir? I'm asking because you'll see lots more lower preshots on Lev because the nadir is later. For context here is your last post here.


It's great to see Coco finally giving you some blue preshots. That's a good sign, maybe she's learning not to bounce as much. The best way to learn how to shoot blue preshots is to shoot them when you are home and can monitor, have plenty of high carb food (HC gravy in the 40's is a good start unless she's allergic), and plenty of test strips. Once you've shot blue a few times when you can monitor, you'll gather some good data and get an idea of what to expect. Last time you gave karo she zoomed up pretty fast. You have the tools to keep her safe.

One thing you'll notice is that the larger depot helps carry you along for a while and they don't always notice a skip as much. She's really zoomed up when you've had to skip two shots in a row cause that really drains the depot.

A cat needs however much insulin they need and the size of the dose doesn't impact shooting low. Today's Wes's Jack, who is on 30 units of insulin, got dosed at 75 today. Wes did give a smaller dose cause Jack has some funky things going on with his IAA. I've seen high dose caregivers shoot green on even larger doses But, and this is the big one, only after having gathered the data to do so and being able to monitor closely.

Did you ever make any progress on getting Coco tested for acromegaly or IAA? If we knew the results of those tests, it'd give us an idea of what we are dealing with and when you need to be more cautious in dosing. As is, it's hard to say what's happening with Coco, but maybe you should go back to 8.0 units for the moment so you don't have to skip as much.

Hi Anna, missed you and have been thinking of you and Coco. How's your girl doing? Did you ever get any further on the idea of switching to Levemir? I'm asking because you'll see lots more lower preshots on Lev because the nadir is later. For context here is your last post here.


It's great to see Coco finally giving you some blue preshots. That's a good sign, maybe she's learning not to bounce as much. The best way to learn how to shoot blue preshots is to shoot them when you are home and can monitor, have plenty of high carb food (HC gravy in the 40's is a good start unless she's allergic), and plenty of test strips. Once you've shot blue a few times when you can monitor, you'll gather some good data and get an idea of what to expect. Last time you gave karo she zoomed up pretty fast. You have the tools to keep her safe.

One thing you'll notice is that the larger depot helps carry you along for a while and they don't always notice a skip as much. She's really zoomed up when you've had to skip two shots in a row cause that really drains the depot.

A cat needs however much insulin they need and the size of the dose doesn't impact shooting low. Today's Wes's Jack, who is on 30 units of insulin, got dosed at 75 today. Wes did give a smaller dose cause Jack has some funky things going on with his IAA. I've seen high dose caregivers shoot green on even larger doses But, and this is the big one, only after having gathered the data to do so and being able to monitor closely.

Did you ever make any progress on getting Coco tested for acromegaly or IAA? If we knew the results of those tests, it'd give us an idea of what we are dealing with and when you need to be more cautious in dosing. As is, it's hard to say what's happening with Coco, but maybe you should go back to 8.0 units for the moment so you don't have to skip as much.

 

[Anna123]

Hi Wendy! Thanks for thinking of Coco I was on vacation for 8 days (Florida) & I felt that it was best not to start the Lev until after the trip a bit...her numbers seemed to get a little strange while I was gone..I was very lucky that I found a cat sitter who was willing to learn how to test glucose...she did great, but Coco started showing more numbers in the 100's while I was gone, so I told the lady not to dose her, for safety. She wasn't tested for Acro/IAA, but literally everything else including thyroid, tumors, ultrasound of abdomen, examing teeth/throat, etc.....please look at my response to Gill & George on this page about that. I am still planning on switching to Lev, but I have to figure out these low numbers first. I really have been afraid to dose when she's in the 100's..ESPECIALLY at night. Should I skip the 8,5 dose & cut her to 8 units...she was at 10 not that long ago. I'm just unsure as to how long to keep her on a dose, when her numbers look like they have. Thanks for your help

 

[Wendy&Neko]

Knowing what we are dealing with for high doses impacts our dosing strategy. IAA can break and acromegaly means you should look for other, potentially serious conditions, that can otherwise go untreated because they are not obvious, but are treatable. I am mostly thinking about heart issues.

As for dose, I suggested above going down to 8.0 units so reduce skipping.