Hermione's Dosing Rollercoaster pt3

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Probably a bounce from the early blue.

But don't forget, Kimi. These are very tiny doses. You aren't shooting 4/5 units and getting these high/low numbers. She just seems terribly sensitive to changes in her blood glucose levels, even at tiny doses.

Tell us how/what you feed again. I wonder if there is a way to get food involved in flattening things out.
 
Thanks for the encouragement, gang! I'm just frustrated that we were making such awesome progress and now we're not. But you're right, these are tiny doses and she's still feeling good so I need to keep focusing on the positives!

My cats are free-fed Young Adult Zero Carb (started 9/1/2016, previously fed Nature's Variety Instinct), I have two elderly former barn cats who refuse to touch wet food - to the point they will walk away from a dish with even a small dollop of wet food with their dry. I don't want to stress them out in their old age. Hermione gets one can of Fancy Feast Classic with each shot, usually beef, chicken, turkey & giblets, beef & liver or chicken & liver. Sometimes she will get salmon or tuna FFC, but not often because I worry about mercury contamination. The only thing I've changed recently is I started adding 1/4 capsule of Florastor to Hermione's wet food because her poop has been varying from soft to pudding-like since I started her on wet food. Hermione has always had a sensitive stomach and often gets soft poop and a week or so of Florastor clears her up. She was checked out by my vet last week, and she found nothing to indicate anything other than Hermione's sensitive GI tract giving us trouble again and said to start the Florastor again. This is the first time since her diagnosis that I've given it to her, you don't think that could be the problem do you?

Oh, I almost forgot to leave her numbers!

423 @ +6 in the AM

501 @ PMPS, .75u given.
 
As long as she doesn't get into the dry, food looks okay. Not sure about today's cycle except we know how she bounces. Last night was very nice - Yellow and blue. I wonder if we need to reduce the .75 to 0.5 and see if she flattens out. Maybe try that tomorrow? As she is so sensitive to dose gradients, I wonder if the difference between 0.25 and 0.5 is too much for her..
 
Hermione has her own small bowl of YA that she nibbles on occasionally, and has the whole time. Her dry food consumption has decreased, however, and since they all eat the same food she doesn't eat the others' food - everyone's dishes are in different rooms and Hermione's is in the living room where she hangs out. When she follows me into the other rooms she'll sniff at the bowls to see if they're getting anything new, then walk away.

I'll go ahead and reduce her dose to .5u and see what happens. Clearly she's as sensitive to insulin as her stomach is to food! This was easier when she was on high doses and we could make small reductions. I guess I can start counting drops...
 
558 for AMPS, .5u given.

I went ahead and left out the Florastor just in case, although I can't really see how it could be messing with her numbers. I'm pretty sure there aren't any carbs in it.
 
545 @ +6
538 for PMPS

Looks like the Florastor is off the hook. I'm hoping that was a fur shot, but it's hard to tell with these tiny doses :p I gave .5u tonight just in case the morning dose WAS a fur shot.
 
Kimi, I talked to an FD friend and she had some ideas. One was wondering if there could be a simmering infection of some kind - - tooth or a UTI or something else. Two, and I had forgotten this, YA does not always prove to be low carb in some cats. Just anecdotal evidence, but some members report higher levels with YA. If she needs to graze, how about putting out wet low carb? Would the other cats be okay with this - or if not, do they need food during the day? Could it just be something she'd eat that they'd ignore.

May make no difference, but might be worth looking at both things?
 
I haven't seen anything unusual that would make me think she's not feeling well, but I can make another appointment with my vet just to make sure. She's been eating the YA since her 2nd week of diagnosis and this isn't a new bag. She had those really great numbers while on it, so I'm reluctant to point a finger there. If I leave the wet food out for her instead, her brother will eat it and she won't get any. I shut him in a different room when she's getting her shots & wet food. My cats graze because my vet recommended it for Hermione's sensitive stomach. She has a habit of gorging then vomiting, so she's best with frequent small meals. Since I work it's difficult for me to manage that, and with multiple cats timed feeders are a bit impractical. If Hermione was more bossy that would be fine, but her brother will push her out of the dishes.

I really REALLY appreciate all the suggestions, my brood makes managing things difficult. I'm just really puzzled because nothing has changed since we had those great numbers (except the Florastor and I stopped feeding it yesterday). I can try taking the dry food away, but I don't want her to go back to her binge/purge ways.

638 @ +8 :(
 
Boy, Kimi, I don't know. Sounds like the YA isn't raising levels and you have worked on the best way to feed, considering your limitations and hers. It could be a bounce, from the pm cycle on 10/11. Her previous bounces usually lasted 3/4 cycles.

I guess I'd be sure to keep on top of ketones, watch for any kind of infection and stick with the 0.5 for a cycle or two, to see if it is a bounce and if she comes down.
 
Thanks Sue! I've been trying to catch her at the litterbox so I can check for ketones, another thing made tough with multiple cats :p

I'll stick with the .5u and hope she's just bouncing. The only other thing I can think of is this is my original bottle of insulin gotten the end of August, but it's always in the fridge, hasn't changed color or consistency and my vet said it won't go bad in a month as long as I take care of it.
 
ShipsCat said:
Thanks Sue! I've been trying to catch her at the litterbox so I can check for ketones, another thing made tough with multiple cats :p

I'll stick with the .5u and hope she's just bouncing. The only other thing I can think of is this is my original bottle of insulin gotten the end of August, but it's always in the fridge, hasn't changed color or consistency and my vet said it won't go bad in a month as long as I take care of it.
Click to expand...
I doubt whether it's the insulin if it looks OK and it's in the fridge between uses. Teasel's vial was begun in mid-August and it's still fine now, two months later. At the price of ProZinc, I want to use it all up!
 
That's what my vet said, Kris! And I agree - I'm spending enough money on test strips, I don't want to be replacing perfectly good insulin.

We're doing a little better today.

351 @ +6
319 for PMPS! I gave a tiny bit less than .5u, basically I let out one drop from the .5u line so the top of the plunger was just below the .5u line. Hopefully a small change instead of cutting her dose in half will do the trick!
 
Yes I can do a curve today. I was planning on it, especially since I slept through my +6 test this morning.

501 for PMPS, .5u given
 
Here's our numbers so far... high & flat.

532 @ +2
551 @ +3
541 @ +4
549 @ +6 (gap for me to make & eat dinner :p )
 
Darn, Kimi. This makes little sense to me. We tried lowering the dose and haven't seen any progress. I guess back up to 0.75 and see if the numbers improve?
 
Yes, I think it's time to go back up again. Hermione can't do anything according to plan :banghead:

She's high & flat still

548 @ +7
523 @ +8
522 @ +9
508 @ +10
 
Kris, you are definitely doing ketone tests, right? (I woke up last night worrying about you and wondered about that). Also, if 0.75 doesn't help in a cycle or two, I'd move right up to one unit. She has been sitting in those high numbers too long.
 
Sue and Oliver (GA) said:
Kris, you are definitely doing ketone tests, right? (I woke up last night worrying about you and wondered about that). Also, if 0.75 doesn't help in a cycle or two, I'd move right up to one unit. She has been sitting in those high numbers too long.
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I think you mean Kimi, Sue. As far as my routine, yes, I do ketone testing on Teasel and so far all are negative. :)
 
It's OK, Sue! You give us all such helpful advice we'll forgive you if you get a name or two mixed up ;) Especially since Kris and I have our super bouncy rubber kitties!

Yes, I've been checking for ketones, I've been worried about that too since she's suddenly decided to hang out in the black again. Her last tests were yesterday PMPS and +6, both negative.

331 @ +6
537 for PMPS, .75u given

At least we got into pink! I'll hold the .75 for a few cycles and see where we get. Also, she's still happy & sassy so that's good.
 
449 @ +6 but her brother was asleep on my laptop
530 for PMPS, .75u given.

Still high, but at least she went down instead of staying in the black the whole cycle...
 
My goodness, she's challenging, isn't she?! Makes Teasel seem easy in comparison. Your patience is exemplary, Kimi. You're tinkering with very low doses so any change you make is a huge % difference. I wonder if there's any merit in trying some intermediate dose - eg., 0.5 u to start - and playing around with the "fat" or "skinny" versions by letting out drops, plunger just over/under the line, etc. Her insulin needs have dropped drastically and her new magic dose is fluctuating somewhere in the vicinity of 0.25 - 0.5 u based on what I see in your SS.

Are you using U100 syringes? These would allow 0.2, 0.4, 0.6 unit doses as well as a huge variety of fats/skinnies. You might consider going that route along with the conversion table of course. http://www.felinediabetes.com/insulin-conversions.htm
 
457 @ +6
489 for PMPS, .75u given

Hermione is definitely making me stock up on patience pants! I'm using u40 syringes with 1/2u markings, but when I need 1/4u measures I check with calipers. I'm also pretty comfortable with counting out drops too. I just got a new box of u4 syringes right when she decided to do this, of course! I'll get u100 syringes soon, though, since she seems to want to be finicky on her dosing :p
 
479 @ +6

I had to take my oldest former barn cat to my vet today. He (hopefully) has idiopathic vestibular disease. If that's not it, then he has a brain tumor or had a stroke but my vet and I didn't want to subject an otherwise healthy 16yo to the anesthesia needed for an mri. So now I get to hand feed and give anti-vertigo meds to my wobbly old man as well as keep track of Hermione's blood sugar :( I'm glad I have vacation saved up from work!

The up side is we also discussed Hermione's latest weird numbers in person. She thinks it might just be Mr. P wandering in and out instead of sticking around and agreed that it's time for extra patience.
 
535 for AMPS, .75u given.

My old boy Nutter Butter is holding his own. His first dose of anti-vertigo med hasn't done much, but he's happily scarfing down a gruel made of blended up YA and water. He staggers around wanting to get up on his favorite cat tower, so I had to confine him to a smaller room so he doesn't fall and hurt himself.
 
Glad Nutter is doing better. Senior citizens of the cat or people variety have a tough road - Golden Years, hah!

What do you think about going up to one unit on a cycle you can monitor. I see no possible bounces.
 
492 @ +6
529 for AMPS, 1u given

I was going to ask if an increase was due since she's still black/red/black and I'm home with my wobbly & bouncy kitties :p I'm learning!

Nutter is starting to compensate for his wobbliness. He's following me around slowly, leaning on the wall for balance. He's such a calm fellow! His head & eyes are shaking less, so hopefully he's getting better. You're right Sue, it's tough getting old!
 
Glad to hear that Nutter is figuring it out! Sounds like a good time for an increase as you run a cat hospital for a few days!!
 
Sorry for no numbers for a while. I got busy taking care of Nutter and just didn't get to the computer. He's doing better, but it's slow going. Hermione is also slow going :arghh: I got a new vial of insulin when I took Nutter in, so I figured I'd see if my old vial is bad. Nope! It's all Hermione being difficult.

535 @ +6 last night
507 for AMPS, .75 given from the new vial, lower in case it WAS my other vial gone bad
396 @ +6
606 for PMPS :banghead:

I went ahead and gave 1u.
 
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