Hey, Wally How about an update?

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Sue and Oliver (GA)

Sue and Oliver (GA)

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Hope when you are on next, you will give us an update. I think your week trial at 1.5 should be over. What kind of numbers did you see and what are you thinking about the dose?
 
Hi Sue and everyone- Sorry, I've been busy helping out a friend with his boat the past few days. I moved his dose, yesterday, the 8th day, up to 1.75 u, as his readings went up slightly to the low 400's, ( but still pretty steady), from the 369 amps a several days ago. I was going to keep it on that for one week, but decided to up it, again, to 2 u today, for the next week, as his amps was slightly higher than yesterday's amps and pmps. I left the darn chart at home, again. I'm also still trying to determine if it's food allergies or the diabetes thats causing the facial lesion. Thank you- Wally
 
Good to "see" you, Wally.

Well, you know we like to keep the dose for 2-3 days, unless we see movement downward. Hope the 2 units make a difference. One of my concerns is that he is staying above the renal threshold for several weeks, making it much harder on his pancreas. http://petdiabetes.wikia.com/wiki/Blood ... guidelines Have you gotten any nadirs to see whether he is high and flat or dipping down?

Not heard of diabetes affecting the face. Have heard of allergies doing it.
 
Spoke to Wally for a good bit of time tonight. Will post more tomorrow, but basically, I encouraged him to stick with the 2u dose for at least 4-5 days.

The big point I tried to emphasize was this: When he is considering a dose increase, or decrease, he needs to test at nadir BEFORE changing the dose. It is the only way to be sure that a dose adjustment makes sense and is safe. I also told him all about Bob's dance, and how he was dosed (not correctly) and that I wasn't a member of the board for most of the time Bob was on insulin.

I reiterated that we were all willing to advise as a group, and hope that he will post updates here when possible.
Oh, he also located the box that dcin sent, so he's good with meters, strips, lancets and ketosticks for quite some time.
He also said he has about 1/2 the insulin he started with, enough for another month or month and a half.
Costello is still in the pinks/reds and current dose is 2u BID. I think he's still only testing preshots, no mid-cycles. Eating okay.
Carl
 
Thanks Sue and Carl for the advice. I hope the 2 u will drive the levels down. My sister, an RN. said that diabetes patients often get sores. That's what made me think it might be that. I'm going to get a different, less costly computer service started on Nov.3rd. Yay! See you-
 
Ok. The computer should start up late afternoon on the 3rd. Friday's amps was 439, 2u... pmps 469, 2u...+6 249. Saturday amps 354, 2u...+6 287. Looking better! I'll be in touch. -Wally
 
Thank you, Kim, for the Wal Mart gift card I got yesterday. That's great. I can really use it. I've been unable to get to a computer the past few days. I raised his dose to 2.5u at day 4, Mon. pmps, after 4 days at 2u, because his readings jumped up to 505! After 365 Mon. amps. May have been the milk I gave him for a day or so before that for his digestion. What a dumb mistake. It worked well, but drove up his bg's. After the 505, the bg's have been 498, 400, 393, 283, (pmps- tues). I hope 2.5 wasn't too much. I'll keep an eye on his numbers, and see how low they go, then see the bonce back up, and how much. Later- Wally
 
Thanks for the update Wally!
Sue, can you plug those numbers into the SS so we can take a look at it?
Wally, with the gradually dropping PS numbers, make sure to check nadirs if possible.

Carl
 
HI! My new service is up and running. How is everything? The +6 on Wednesday was 368, and PMPS 395. Thurs AMPS was 392, and that's the last reading. I feel like I need to take it easy on his ears for a few days to let them heal. They are beat-up. The readings have been slowly coming back down and leveling, since the milk. I'm glad I'm back on, ohmygod_smile
 
Great to see you back Wally!
Don't let his ears have too much of a break. You still need to check at least before every shot. Is he doing well? Eating okay, no litter box problems? Glad to hear his numbers are creeping down!

Sue, can Wally add the SS to his sig so he can update it going forward? That'll be one less bowling pin you need to juggle. :smile:

Carl
 
Wally,
Now that you are back and can post regularly, let's start a new thread for Costello tomorrow!

Carl
 
I apologize, again, but I think it's best if I continue to stick with the vet's recommendations, as for the methods. I don't mean any disrespect and I am grateful for the outpouring of support from fd.com. But I believe I am going to switch back to my vet's care on this one. It just fits with what my gut is telling me. Don't worry about Costello, and I'll check in from time to time.
 
Wally,
If your vet is teliing you no tests are required prior to shots, well, he's just flat out wrong. We had a kitty die last week because of that. We'll worry about Costello no matter what. We worry about all the kitties. Stay in touch when you can, and we wish you and him the best.
Carl
 
I agree with Carl. It is like playing Russian Roulette with a syringe. He's your cat but it is dangerous. Also dangerous in my opinion to see these high flat numbers above the renal threshold.
 
But don't forget his numbers swung back from low range to high range, then back lower, then high range, again, under the more frequent doseages. We just couldn't get the right dose. Since the doses flattened out, his readings have slowly declined. I'm just hoping the increased dose to 2 1/2u will be enough to keep a downward pressure. Thanks
 
To be fair, Wally, we gave you a scale very early on because you couldn't be on the internet to post numbers and get dosing advice consistently. During that period, he was also coming off the crazy TID doses and wild swings.

We agree with your holding a dose for a few cycles. We don't agree with shooting without testing and we hate to see a dose held for a whole week if he is consistently in high numbers.
 
I agree, shooting without testing is very dangerous nailbite_smile Lucky gets stuck 6x a day as of right now for testing until I feel he's regulated well enough. As long as I alternate ears and sites and use a new lancet, he doesn't mind! He bleeds easier now and it's a very small and quick stick. He jumps up to his "spot" and purrs while I test him!

And you can't increase dose based on PS's alone either. You have to consider how low he went during the cycle and whether or not he's bouncing or rebounding. If you increase on a rebound or bounce and he's getting too much insulin, you will start seeing chronic rebound and will not get decent nadirs no matter how much you increase and it could actually make matters worse. http://petdiabetes.wikia.com/wiki/Somogyi_rebound Once you rule out rebound, increase dose. But there is always the threat of DKA if he's not getting enough insulin. It can be very complicated!

I NEVER would have gotten this information from my well meaning Vet. I learned all this from this message board and the helpful people here (Carl, Sue, Kim, and Joanna, etc). My Vet didn't want me to test so much either but you can't get an accurate view of the situation without numbers! My vet said that Lucky would be okay with nadirs in the mid 200's. That is above the renal threshold and dangerous and she tried to argue with me. I know you want to go with your gut but please do some research on your own as well and form an educated opinion. The helpful people here deal with feline diabetes every single day and have day to day first hand knowledge, the Vet doesn't. They get occasional diabetes patients and hand out generic information that may or may not be outdated. (not all Vets are like this!) Of course it's your cat and you make those decisions, just do your own research first ;-)

Good luck with your kitty!
 
I get what you are both saying. That makes sense, but I'm thinking that, in theory anyway, the readings will hopefully ease down more each day with the same dose, as his own pancreas picks up the slack, and by the end of the week if still falling on a declining slope, then keeping the same dose would take it further downward the following week. Upping the dose, then may drive it too fast downward, and rebound. As long as he is eating the same food and amounts, and other factors remain constant, as well as the dose, I would think that his levels would not fluctuate much. And his ears have red splotches-bruises, (whatever they are), all up and down both edges of both ears.
Yes, it was hard to get the swings under control at first, with the scale. But when we started to, it was holding relatively steady at 1.5, then 2, then 2.5, even if not for entire weeks. I guess you have to decide between waiting longer for results, or risking bounces.
 
Wally,
That kitty had been getting insulin for 3 years. She could almost do it in her sleep. That morning, she didn't test. He'd never shown any sort of problems before. For whatever reason, that day, the insulin was too much. You can never know if or when that day will come unless you test him. Two pokes a day, Wally. Would you rather Costello have sore and blotchy ears, or a hypo?
You are looking at this whole treatment regimen too logically, I think. It isn't logical. Yes, it's all about numbers and ratios and formulas. But it isn't predictable, at least not as you appear to think it will be. There's chaos in there too. Randomness. If it was just as simple as "if this, then that", then every cat would go OTJ, and this board wouldn't exist. There wouldn't be hundreds or thousands of people with FD cats posting here. Vets would NEVER be wrong, all they'd have to do is plug numbers into a computer, and "voila, here's the perfect dose plan for you kitty". There are just way too many variables, most of which you can't "see" taking place, no matter how closely you watch. Vets don't seem to believe, or won't admit, that ECID.

Carl
 
I didn't mention this, but I had been planning to test the nadirs, at-least every other day, even with the splotchy ears. Maybe I can try the open areas between the edges. Less blood there, though. I sure wish there was another way to test. And vets also test nadirs before changing the dose after end of week, in fact they do a glucose curve, although that's a lot of testing for one day. I read the string you mentioned. I feel so badly for Marie. What a tragedy! I lost my elderly female cat a few years ago, after having her for about 8 years. She was rescued after her previous owner passed on. But she was 18 y.o., and died peacefully as we watched. That tore my heart out, but nothing like this poor woman! I cried as I read that. The commenters were very articulate and comforting, as well as insightful. I guess I've been scared straight... Thanks for the post. -Wally
 
Wally, if Costello's ears are so sore and bruised, I'm wondering how you are testing? My vet absolutely horrified me with the way she tested Lucky at her office. She literally stuck the lancet in his ear sideways and dug around with it. It wasn't a quick sideways poke. He bled and bled. He had a huge red spot on his ear for days. I stayed away from that area at home to let it heal and vowed to never let her check him in her office again.

I found that if you do a quick sideways poke into the edge of the ear, it works so much better. Make sure to use a tissue, paper towel or cotton ball to put pressure on the ear for a few seconds to prevent bruising. You could also use a little bit of Neosporin + pain relief until he gets used to the pokes. I do my pokes free hand with just the lancet, I've never used the lancet device. I think that would hurt him worse.

And Carl is absolutely right about unpredictability. When I got up this morning (late of course, need to work getting up on time on weekends!), Lucky had that look he usually has when his BG is high (400's). I tested him and he was 325. Not terribly low, but definitely not what I was thinking based on observations. I would have shot a higher dose if I went off my observations. I fed Lucky at the same times every single day with the same dose and his BG was all over the place. Constants don't mean that his BG will be constant! And yes, ECID! I wish it wasn't that way because then this whole thing would be soooooo much easier. At this point, I don't know if Lucky's pancreas will ever kick in. We may be dependent on this insulin stuff for the rest of his life :sad: I don't count on anything at this point. In the beginning I thought I could "fix" him or control things. Boy, I found out pretty quickly that that is soooo not the case. I still don't understand why he won't respond to higher doses and why I'm having a hard time with regulation. It could be so many things, including being on the wrong insulin.

But anyways, my point is, it is very important to keep an eye on what his BG is doing. Poke before insulin and at nadir when possible, at minimum, to be safe. His ears will be fine if you look at how you are doing it and maybe change a few things if needed ;-) I'm still considered a newbie and I've been at this for 5 months, feels like forever though. There's a lot to learn!!
 
Allformymarine-
Thanks for the help! Sounds like you're having a similar situation to mine. I'm going to go to WalMart with the gift card Kim sent, and get some ReliOn strips. It seemed like I had a little easier time getting the blood onto those strips, adequately. I've been holding the lancet device up and down, perpindicular to the back surface of his ear, at the shallowest setting. Usually it's enough to get a sufficient blood draw. I don't trust myself to give it free- hand. I would do it too hard, or not enough. And I massage the area before, or apply heat. After, I squeeze the tissue around it for a few moments, to stop bleeding. Then I apply neosporin or aloe to help heal. It's just that I had been testing him regularly for over a month, three or more times every day. They healed quicker the first few weeks. Now the bruises are just lingering. Since I wrongly gave him the milk a week ago, I've had a tough time getting the numbers down again. I increased to 3u this morning, amps at 569. AMPS yesterday was 445. And yesterdays +6 was 403.
 
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