Hi from me and Molly, any advice please

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Sue Hammond said:
The syringes I have been sent are 0.5 which is the same doses as the pens, I thought they had 0.25 doses...Are there any with that dose
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Nope, the smallest increment marked on the syringe is .5 of a unit. But it is quite easy to 'eyeball' a .25 of a unit, or even smaller increments. ...There is a photo of small doses somewhere, I'll try to find that for you.

Another advantage of syringes is that you can make a dose 'fatter' or 'skinnier'. Using syringes means you can shave a bit of a unit if necessary, or make a unit 'fatter'. There is very much more flexibility than there is with the Vetpen.

If a kitty needs small doses it's also worth considering using syringes made for U100 insulin (rather than those made for U40 insulin); but these have to be used in conjunction with our 'conversion chart' so that you know how much to draw up into the syringe to get the dose that you want.
U100 syringes can make it a lot easier to measure very small doses. But you would need to be comfortable using the conversion chart.
 
Elizabeth and Bertie said:
Nope, the smallest increment marked on the syringe is .5 of a unit. But it is quite easy to 'eyeball' a .25 of a unit, or even smaller increments. ...There is a photo of small doses somewhere, I'll try to find that for you.

Another advantage of syringes is that you can make a dose 'fatter' or 'skinnier'. Using syringes means you can shave a bit of a unit if necessary, or make a unit 'fatter'. There is very much more flexibility than there is with the Vetpen.

If a kitty needs small doses it's also worth considering using syringes made for U100 insulin (rather than those made for U40 insulin); but these have to be used in conjunction with our 'conversion chart' so that you know how much to draw up into the syringe to get the dose that you want.
U100 syringes can make it a lot easier to measure very small doses. But you would need to be comfortable using the conversion chart.
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Here's the photo of some small doses using syringes with .5 unit markings. 0.25 and 0.75 doses are shown here.
Note: These are shown in U100 not U40 syringes, but the method is exactly the same.
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025unit-1.jpg

5e86c3d4.jpg

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Sue Hammond said:
I can't see well enough to draw up .25, so I guess I'll have to stick with the pen
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I typically measure 0.1 of a unit these days, and my close vision is pretty poor. But if I hold the syringe against a light source I can see it sufficiently well. And some folks use a magnifying glass to see the syringe (but it's still better with a light source behind it.)
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Elizabeth and Bertie said:
I typically measure 0.1 of a unit these days, and my close vision is pretty poor. But if I hold the syringe against a light source I can see if sufficiently well. And some folks use a magnifying glass to see the syringe (but it's still better with a light source behind it.)
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I'd get some high-strength reading glasses from supermarkets etc - you don't then have to hold a magnifying glass (and they are handy for plenty of other things too!)
 
Diana&Tom said:
I'd get some high-strength reading glasses from supermarkets etc - you don't then have to hold a magnifying glass (and they are handy for plenty of other things too!)
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I have prescription reading glasses already, I don't feel comfortable using the syringes really..
 
Sue Hammond said:
I have prescription reading glasses already, I don't feel comfortable using the syringes really..
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Sue, do whatever you feel most comfortable with. :bighug:
Some people do prefer to stick with the Vetpen.
If, in the future, it looks like Molly might need doses of insulin lower than .5 of a unit you can always reconsider the syringes.
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@Sue Hammond

Sue, is it possible you can get some tests after the evening insulin shot?
Molly has had lower morning pre-shots the last couple of days, and that was a big jump up this morning at +3.... ....I'm wondering if she's dropping lower at night, and then bouncing....
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Elizabeth and Bertie said:
@Sue Hammond

Sue, is it possible you can get some tests after the evening insulin shot?
Molly has had lower morning pre-shots the last couple of days, and that was a big jump up this morning at +3.... ....I'm wondering if she's dropping lower at night, and then bouncing....
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Only if I stay up until gone midnight, I usually go to bed around 10.30
 
11.7 bg was the lowest recorded test she's had overnight, she's not low every morning sometimes it's really high
 
Sue Hammond said:
11.7 bg was the lowest recorded test she's had overnight, she's not low every morning sometimes it's really high
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Because of that 24.1 jump at +3 I'm wondering if she could have dropped low during the night at some point and be bouncing from that.
It may not be the case, but it is a possiblity. Some cats do drop lower at night.
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Sue, I think you just have to accept that Molly's ups and downs are not unusual or abnormal, if you look at other people's threads you will see very similar stories. It's not easy, we all know that, but it's a matter of doing the best you can... sometimes dosing is pure guesswork, trial and error, until you hit on a dose that seems to "suit" her... but even then, her insulin requirements may vary from day to day over a period of time. Not all FD cats get regulated by any means - that's why this board exists! Try to stay positive and just carry on as you are... you may have heard us say here that FD is a marathon not a sprint, ie unless you are very lucky it could take a while to get Molly into better, more stable numbers. You are actually quite early on in your FD journey so don't despair - you may just have to be prepared for it to take longer than you'd like. Unfortunately there is no quick fix and FD is often for life, but with dedication, patience and love a kitty can live out a normal lifespan. Have you seen Elizabeth's post about her Bertie? A heartwarming story if ever there was one!
 
Diana&Tom said:
Sue, I think you just have to accept that Molly's ups and downs are not unusual or abnormal, if you look at other people's threads you will see very similar stories. It's not easy, we all know that, but it's a matter of doing the best you can... sometimes dosing is pure guesswork, trial and error, until you hit on a dose that seems to "suit" her... but even then, her insulin requirements may vary from day to day over a period of time. Not all FD cats get regulated by any means - that's why this board exists! Try to stay positive and just carry on as you are... you may have heard us say here that FD is a marathon not a sprint, ie unless you are very lucky it could take a while to get Molly into better, more stable numbers. You are actually quite early on in your FD journey so don't despair - you may just have to be prepared for it to take longer than you'd like. Unfortunately there is no quick fix and FD is often for life, but with dedication, patience and love a kitty can live out a normal lifespan. Have you seen Elizabeth's post about her Bertie? A heartwarming story if ever there was one!
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I haven't Diana, but I'll try and find it....The vet told me it can take up to 6 months to stabilise FD....it's just I've still no idea how much I should really give Molly, I'm so scared if giving too much, especially at night when I can't watch her
 
Sue Hammond said:
I haven't Diana, but I'll try and find it....The vet told me it can take up to 6 months to stabilise FD....it's just I've still no idea how much I should really give Molly, I'm so scared if giving too much, especially at night when I can't watch her
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I know... just err on the side of caution, especially at night. The important thing is that Molly is getting insulin, which she had been without before she was dx, so in that respect she is better off already. Softly softly catchee monkey and all that...
 
Diana&Tom said:
I know... just err on the side of caution, especially at night. The important thing is that Molly is getting insulin, which she had been without before she was dx, so in that respect she is better off already. Softly softly catchee monkey and all that...
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Should I carry on with 1u, or reduce to 0.5
 
I've given her 1u at night for the last 8 nights, but her amps has ranged between 5.4 at the lowest, to 24.9 the highest, so I don't know what to give for the best to keep her well...
 
Same dose last last night, yet her bg this morning is 21.4, same low carb Mac's diet, same routine, yet such a difference in morning results...I'm sorry to keep bugging you with all this, but something isn't right here surely,
 
I do sympathise Sue, you certainly have a real rainbow of colours on your spreadsheet and it is hard to work out what's going on. It could be a mixture of some pancreatic activity and bouncing - either on its own would confuse the picture but the two together (IF that's the case, a pure guess) is making it very difficult to suggest a single regular dose. I would be inclined to show the spreadsheet to your vet and see if they have anything to say... I know a lot of vets aren't very clued up but it might be worth asking. Otherwise, you might just have to plod on and hope that things start to even out soon... remember, the vet said it could take months to achieve regulation. It's nothing you're doing wrong, but FD is a complex disease with lots of variables so you just have to hang in there really. I know it's a shock to the system as it is to everyone who comes here, but eventually we realise that there's no quick fix and sort of build our lives around kitty's routine.

Maybe someone else will comment on dosing.
 
I showed him, and he said carry on with 2u or 1 if she hasn't eaten, so I don't tend not to take his advice on that one...even the nurse said if her number is low provided she's had a meal, still give her 2u, no way that in my opinion, is dangerous
 
Sue Hammond said:
I showed him, and he said carry on with 2u or 1 if she hasn't eaten, so I don't tend not to take his advice on that one...even the nurse said if her number is low provided she's had a meal, still give her 2u, no way that in my opinion, is dangerous
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What do they say though about the extreme fluctuating numbers?
 
Sue Hammond said:
He won't prescribe it Janet, he said to carrying with Caninsulin
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I know he didn't want to perscribe ProZinc, but I wonder why not lantus? Add long as the client is willing to for the cost it's industry known as an effective insulin. Frustrating.

Well I see it as you can keep doing what you're doing with 1 unit, or up it to 1.5 and just be consistent about testing for when she dips every few days as she tends to do so you can steer it up. 2 I think it's too much. For days you might not be able to test go more conservative. Your third option, but certainly not covienient, is to do three smaller doses (.5-1) 8 hours apart.
 
JanetNJ said:
I know he didn't want to perscribe ProZinc, but I wonder why not lantus? Add long as the client is willing to for the cost it's industry known as an effective insulin. Frustrating.

Well I see it as you can keep doing what you're doing with 1 unit, or up it to 1.5 and just be consistent about testing for when she dips every few days as she tends to do so you can steer it up. 2 I think it's too much. For days you might not be able to test go more conservative. Your third option, but certainly not covienient, is to do three smaller doses (.5-1) 8 hours apart.
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Thanks for your advice, I'll carry on with 1u for now then, I can't really do every 8 hours x
 
@Sue Hammond

Sue, is there any chance of your giving the shots an hour or so earlier so that you have time to get a test after the evening shot?
I do think there is a possibility that Molly could be dropping lower during the night on occasion, and it would be useful to be able to rule that out. (Quite a few folks give the shot earlier in the evening and then grab a 'before bed' test last thing. That test can often provide some really useful info...)
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JanetNJ said:
I know he didn't want to perscribe ProZinc, but I wonder why not lantus? Add long as the client is willing to for the cost it's industry known as an effective insulin. Frustrating.
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Janet, vets in the UK vary enormously in their willingness (or otherwise) to prescribe alternative insulins. It seems to be something of a lottery depending on the individual vet. Even within the same practice the vets can have different views about prescribing... :confused:
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Elizabeth and Bertie said:
@Sue Hammond

Sue, is there any chance of your giving the shots an hour or so earlier so that you have time to get a test after the evening shot?
I do think there is a possibility that Molly could be dropping lower during the night on occasion, and it would be useful to be able to rule that out. (Quite a few folks give the shot earlier in the evening and then grab a 'before bed' test last thing. That test can often provide some really useful info...)
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I did get after pm shot tests, but just lately I've been going to bed early, around 10.30,also I thought the shots had to be 12 hours apart
 
Sue Hammond said:
I did get after pm shot tests, but just lately I've been going to bed early, around 10.30,also I thought the shots had to be 12 hours apart
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I can d
Elizabeth and Bertie said:
Janet, vets in the UK vary enormously in their willingness (or otherwise) to prescribe alternative insulins. It seems to be something of a lottery depending on the individual vet. Even within the same practice the vets can have different views about prescribing... :confused:
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Most of her night tests were significantly lower, one time I was up until about 4am testing.
 
Elizabeth and Bertie said:
Janet, vets in the UK vary enormously in their willingness (or otherwise) to prescribe alternative insulins. It seems to be something of a lottery depending on the individual vet. Even within the same practice the vets can have different views about prescribing... :confused:
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I gathered that was the case. Just seems to me that if one type wasn’t ideally working they would consider an alternative. This vet seems pretty rigid in his opinion.
 
Sorry to bother you all again, Molly's bg test last night was 20.9 and +2 was 19.8... this morning amps is 10.7, only gave .5 u, and now +2 its risen to 20.2....This is stressing me out so so much,
 
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Elizabeth and Bertie said:
Janet, vets in the UK vary enormously in their willingness (or otherwise) to prescribe alternative insulins. It seems to be something of a lottery depending on the individual vet. Even within the same practice the vets can have different views about prescribing... :confused:
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How true that is. Frankie was diabetic for over a year before my vet relented and referred me to the RVC where they eventually prescribed Lantus, (although the dosing they told me was all wrong!) This was before ProZinc was licensed in the UK. I kept bugging my vet to put Rom on Lantus but she said no, then one time said as ProZinc was now licensed to try that. I used one vial and as my cats need a check up each time insulin is prescribed I took him in and saw a different vet, who immediately said that he had no problem prescribing Lantus which he did there and then as he could see from my spreadsheet how well Frankie was doing on it and how much I knew about treating FD. Rom was recently only on one drop of insulin and then unfortunately got an abcess in his cheek and had to be admitted. I showed my vet how to dose one drop, and she admitted that the whole practice is now aware of how well they are doing on Lantus and my spreadsheet and everyone is really impressed with how I am treating them. I only got to this point due to the people on this forum so all credit should go to them.. They really do know their stuff. It does take a while though, so be patient. Have a look at Frankie and Rom's spreadsheets going back to 2014 and 2015 and see how far they have come, bearing in mind they both only started being regulated last year.
 
Sue Hammond said:
Sorry to bother you all again, Molly's bg test last night was 20.9 and +2 was 19.8... this morning amps is 10.7, only gave .5 u, and now +2 its risen to 20.2....This is stressing me out so so much,
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Ok so next time you have a preshot like that and you are home to test try 1 unit. But test again at +4 today and see what you get.
 
Well I've had a phone conversation with my vet, and he isn't going to prescribe prozinc yet..but he hasn't ruled it out.He's also suggested trying a different bg monitor, one that means a very small needle under the skin, and a monitor that just scans over where the needle is...He seems to think she's getting so stressed with all the poking of needles it's raising her bg results significantly., And she is a very stressful cat.as soon as she sees me with the ear pricker she runs and hides..Here's the link to that particular monitor
https://www.freestylelibre.co.uk/libre/products.html
 
@Sue Hammond

Sue, a couple of observations...

You're getting a few low preshot numbers. That can happen happen for a number of reasons. But with Caninsulin common reasons are:
1. Insulin dose too high (causing longer cycles; or causing fluctuating numbers due to bouncing).
2. Longer than average duration with Caninsulin (so the number is still dropping late on in the cycle).
3. The pancreas is doing some work and is able to put out some insulin sometimes to reduce the blood glucose.

As it is, we don't know the reason. But as you gather more data things should hopefully become clearer.

Sue Hammond said:
He seems to think she's getting so stressed with all the poking of needles it's raising her bg results significantly
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I can't see any evidence on your SS to show that is happening. If the test was stressing her enough to raise her BG you'd expect to see a rise after each preshot test. But - to my eyes at least - that doesn't seem to be evident in the data you've collected so far....

Since you are finding this whole thing stressful yourself though it could well be that Molly is picking up on your stress, and that may be making testing a bit harder for you both. The more relaxed and casual we are about testing the more relaxed our kitties are likely to be. So, maybe take some deep breaths and get nicely settled before doing a test. (We have one member here who sings to her cat during testing!)

And be sure to do some things that make you feel good. (Chocolate, bubble baths, and wine are traditional favourites on FDMB.... ;)).
And do remind yourself that you are doing really well. You've learned to hometest, and you've set up Molly's SS and are collecting data. That's great!
Things will get easier in time. But it does take patience....

Regarding the freestylelibre system, there aren't yet many kitties using it, but you may find that this thread (from 2016) has some useful info to think about.
New glucose meter that does not require the blood drop

Eliz
 
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Thanks @Elizabeth and Bertie , I've had a read, and that one doesn't seem to be that accurate either...Why is her bg going from 10.7 to 20.1 in two hours, and still rising to 20.3 at +4, shouldn't it surely be coming down instead of rising so steeply so quickly, it must be making Molly feel pretty rough wouldn't it...I'm so sorry to be such a pain, but this is all doing my head in, it really is x
 
Sue Hammond said:
I don't want to get to excited, I know how quick things can change, but today has been a very good day, have a look at Molly's spreadsheet, the first night with no Insulin xx
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Great. I would test though and if it’s going up give a small dose or the morning is going to be very high again. ESP with a human meter an 8.9 is low but still above normal.
 
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