Hypurin PZI dosage correct?

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Dr Schrodinger

Dr Schrodinger

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Morning Lovelies.

Milo has been on on a dosing regime of 1.5U in the morning & 1U in the evening, and over the last 6 days has been looking like he's settling in to it. The injections are going much more smoothly & I am much calmer about them.

Please will a clever person have a look at his spreadsheet & see if we have got things correct? Have we achieved the correct dose, do you think? Should I keep him on this level & see how he fares? His AMPS are still in the high-ish in comparison to the PMPS numbers. Is this OK?

He seems like a much more contented cat. He's obviously stronger, has started playing properly again & is generally being a right nosey pain in the butt. Which I love. cat_pet_icon

Thank you!

Juliet
 
Morning, Juliet,

I'm not a clever person so I don't do specific dosing advice. Although I do think a small increase could be in order now. But as to the specifics I'll leave that to the cleverer people! :lol:

I'm so pleased and relieved that you're finding the insulin shots easier. Was worrying about you there for a while. nailbite_smile

And it's nice to see those long gentle Hypurin curves. Milo must feel so much better with the numbers being more stable.

Eliz x
 
You are very much a clever person, Eliz! Don't do yourself a disservice!

Yes, the shots are much easier, now something's clicked in my brain that's made me far calmer & relaxed about it all. Poor Milo! I've really put him through the wringer, recently. Couldn't have turned it around without you, Eliz. Thank you.

I was thinking a slight increase in his PM dose. Maybe up to 1.25U or even back to 1.5U? Thing is, I don't know what his nadir's like during the night....umm....
 
Dr Schrodinger said:
Thing is, I don't know what his nadir's like during the night....umm....
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You can always set an alarm and find out...annoying, I know, but it works.
 
bookw0rm said:
You can always set an alarm and find out...annoying, I know, but it works.
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Aaargh! I'd have to do a full curve. His nadir's have been anywhere from 5 to 12 hours. I think I would end up a single lady very quickly! :cry:

It might be the best way, in the end, though (doing a full curve, I mean, not ending up a single lady) I'd have to book a special night on the weekend. Just me, Milo & Lola in the spare room. How romantic!

To return to the original Q - is it worth increasing dose? If so, by how much?
 
Juliet, I'm not giving you dosing advice but...

In the absence of any other suggestions (and you may well get those later...) and given your anxiety about low numbers during the night, how about increasing by .25 of a unit if Milo's PMPS is above a certain number, and sticking with the 1 unit if below a certain number. For example, giving the 1 unit if he is say, below 16; and 1.25 if above 16 (and 1.5 if he is really high...?) But here I am straying into 'sliding scale' territory and I don't know if that's where you want to go...

What I will say is that I think you are developing a good instinct for dosages.
 
Great minds think not too dissimilarly, or something!
His PMPS was over 20 (360+) this evening, so I gave him 1.5U.
I talked it over with Andy, first. He's good at logic, that man, & he suggested 1.5U before I'd even said it.
I'll test him before bo-bos time & see what happens tomorrow morning.
I think your idea of 1.25 if above 16 is good, too. Looks like it could be sliding-scale country for us!

Thanks Eliz!

J
 
Weeeell, Milo bounced from his 1.5U last night. Not sure what to do this evening. 1.25U? Or stick with the 1.5U try & get him used to his BG getting a bit more bluey-green? :?
 
Yep, looks like he's probably dipped into the blues last night....

I know it is a dilemma. Milo seems very comfortable in yellow numbers. And he must feel good to be in numbers that are more stable rather than experiencing highs and (relative) lows. Ideally, it would good to see those numbers come down a bit though. But that would involve getting Milo into blue numbers more often. Currently that is a little out of Milo's comfort zone, and he bounces.

So, the 'cost' of trying to get Milo into better numbers may be that, initially at least, his numbers may be more unstable.

Milo has got used to his blood sugar levels being high. And his body needs to re-learn what normal blood sugar levels are. As to how long that will take, well, that varies from cat to cat. Milo might get used to lower numbers really quickly. Or it may take longer.

What we hope will happen is that Milo gets used to blue numbers and reacts to them less and less: And then even gets to like them. And then perhaps starts to develop a taste for green numbers too...

But getting from 'here' to 'there' involves a journey. And we don't know how easy or difficult that journey would be.

The benefits of being in lower numbers ongoingly are huge. The cat feels better. The body is under less stress from the high glucose levels. And the pancreas may begin to heal itself.

Currently though, even with the situation as it is, and with what you've already achieved (and you're doing really well :smile: ), Milo seems to be a happy chap.

As to what happens next, well, I think that has to be your call...
 
How did you manage with Bertie, Eliz? He's nicely in the blues & greens, isn't he?

I think I should just plough on with the same dose for a while & see if Milo acclimatises. Now he's heftier & stronger, he's in a far better position to deal with a bit of instability. Before he gained weight, the goal was simply to stabilise & pile on the pounds...now we have a more sturdy animal, who is eating well, and responding well to insulin, it would be heartless not to try & bring him to the next level, wouldn't it?

Commence Phase Two of Operation 'Sugar-Pussy'.....The Quest for Tighter Regulation (or 'less slack' regulation....probably more appropriate!).

cat_pet_icon (<--- my fave smiliemoticon)
 
Dr Schrodinger said:
How did you manage with Bertie, Eliz? He's nicely in the blues & greens, isn't he?
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Hi Juliet,

Bert is now mostly a 'blue boy' with occasional dips and forays into green numbers and the occasional spike into low yellows where he can get stuck for a couple of days. He spends most of his time between 7 (126) and 8 (144) at the moment. It's hard to get him to hang in numbers any lower than that. (I really must set up a new spreadsheet for him, but every time I look at the instructions I get the sudden urge to go off and get a 'nice cup of tea'... :roll: ) I'm currently experimenting with shooting him at lower numbers to see if that helps (last 3 preshot numbers were between 9.3 (167) and 9.8 (176)).

But these decent numbers are a fairly recent phenomenon for us. This has only happened since switching to Hypurin. Bert's previous numbers were all over the place, and often just really high. During the past 6 years I've clocked up 3 different insulins and quite a range of different shooting strategies in order to try to help him into better numbers. I've tried fixed dosage and sliding scale; shooting twice a day, three times a day, and shooting TR (Tight Regulation) as soon as the BG was past peak and rising. And all complicated by the fact that Bert had a 'sputtering pancreas' that flicked on and off like a light switch (Bert has had 3 hypos...) nailbite_smile

Bert's numbers are now the most stable they've ever been. That's partly due to Hypurin's long duration, I think, and partly due to the fact that his pancreas is either producing a little insulin more consistently or has died completely! Either way, that's one factor less to deal with! :lol:

Just like Milo, Bert didn't like lower numbers at first. But then suddenly he got used to them and things settled down.

Milo is doing way better than Bert was at this stage of the game! Those long gentle yellow curves Milo is starting to get are lovely. But it would be great if we could keep the long gentle curves but ease the numbers down into the blues...<She drums fingers on desk and dreams, wistfully...>

Dr Schrodinger said:
I think I should just plough on with the same dose for a while & see if Milo acclimatises. Now he's heftier & stronger, he's in a far better position to deal with a bit of instability. Before he gained weight, the goal was simply to stabilise & pile on the pounds...now we have a more sturdy animal, who is eating well, and responding well to insulin, it would be heartless not to try & bring him to the next level, wouldn't it?
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I think you're right that initially the important thing was to get Milo feeling stronger. And you've done that really well! So, perhaps this is the time to try to move things on, and maybe see how Milo deals with dipping into those blue numbers on a more regular basis...? You know him well, so if you see that he's not happy doing that then you can always pull back from that strategy...? But maybe he'll surprise you! ;-)
 
Cripes! You two have had quite a ride over the years! I am so glad he's settled out. I don't think it had quite sunk in that it had taken him so long to find a happy & stable low BG plateau. :oops: You certainly have patience and a massive heart, Eliz.

Elizabeth and Bertie said:
Bert's numbers are now the most stable they've ever been. That's partly due to Hypurin's long duration, I think, and partly due to the fact that his pancreas is either producing a little insulin more consistently or has died completely! Either way, that's one factor less to deal with! :lol:
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I hope it's the former rather than the latter!

Elizabeth and Bertie said:
Just like Milo, Bert didn't like lower numbers at first. But then suddenly he got used to them and things settled down.

Milo is doing way better than Bert was at this stage of the game! Those long gentle yellow curves Milo is starting to get are lovely. But it would be great if we could keep the long gentle curves but ease the numbers down into the blues...<She drums fingers on desk and dreams, wistfully...>
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One can but hope. We haven't had a blue for a good few days. May have missed one last night, though.

Elizabeth and Bertie said:
Just like Milo, Bert didn't like lower numbers at first. But then suddenly he got used to them and things settled down.

So, perhaps this is the time to try to move things on, and maybe see how Milo deals with dipping into those blue numbers on a more regular basis...? You know him well, so if you see that he's not happy doing that then you can always pull back from that strategy...? But maybe he'll surprise you! ;-)
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This has given me more resolve, Eliz. I will keep him at his current (new) dose for a few days at least & see how he responds. Here's hopin'... cat_pet_icon
 
Aw, bless you for your kindness, Juliet...

I don't usually tell people (who are fairly new to dealing with FD) about Bert in case it puts them off: I worry about them thinking or feeling that they may be dealing with a similar situation! But Bert seriously is a 'one off'. :lol: (The little wotsit just gave me a PMPS of 7.4... So, either I skip tonight's shot or wait until he's shootable (9pm? 10pm? Later..? Much later...?) Hmmm, I'll have a glass of wine and then decide, I think....) :-|

Edited to add (because I was just focussing on myself there and should really have been focussing on you (Duh!)):

I've got a good feeling about Milo, and think he will do just fine. Especially since he's got you looking after him. Fingers and paws crossed here that he falls in love with those blue numbers soon.... Maybe you could start 'singing the blues' to him to get him in the right frame of mind... :lol:
 
Elizabeth and Bertie said:
But Bert seriously is a 'one off'. :lol: (The little wotsit just gave me a PMPS of 7.4... So, either I skip tonight's shot or wait until he's shootable (9pm? 10pm? Later..? Much later...?) Hmmm, I'll have a glass of wine and then decide, I think....) :-|
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What did you do in the end?

I managed to test Milo at +7 last night/this am. He wasn't that low, really, and crept up to 12.1 (218) at AMPS. I've given him his full dose. nailbite_smile

Will work from home for a few hours, test him again & then head in to work.
 
Dr Schrodinger said:
I managed to test Milo at +7 last night/this am. He wasn't that low, really, and crept up to 12.1 (218) at AMPS. I've given him his full dose. nailbite_smile

Will work from home for a few hours, test him again & then head in to work.
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Oooh, a blue number at +2. That's a first for Milo, I think?
Juliet, if he drops too fast over the next hour or so you should be able to slow that down somewhat with ordinary low carb snacks.
 
No he didn't!
He's been about 12 constant hours under 13 (234) & I'm trying not to get excited. He's sitting on my lap as I type this, purring away, waiting for his next 'weird cuddle' (blood test) & liver treat.....
 
Hi Juliet,

I'll admit now that I was nervous when I saw that you'd given 1.5 units this morning... nailbite_smile
But that is a lovely result: Normal numbers! :-D

Did Milo have anything to eat at around +4?
 
He's been munching throughout the morning as usual & gets his liver treats with each blood test.

I'm at work now, wishing I had stayed at home with him & Lola! (Nothing new there, though..... :roll: ).

I was nervous giving him the full whack this morning too. But, his AMPS was higher that his previous test, and as Andy put it: "He's 10 points higher than a normal cat. He's mobile, he's got plenty of food, he'll be fine on his usual dose". nailbite_smile
 
Yaaaaaaaaaaaaaay!! \M/

Go Gremlin Catface!! (Actually he's looking a little less gremlin-like now)

I'm hoping we've found his dose, and I'm hoping he will drop into the greens of his own accord . I'm a bit scared about increasing it slightly from here & being able to deliver repeatable doses if I end up upping it by a tiny wee fraction. nailbite_smile
 
Dr Schrodinger said:
I'm hoping we've found his dose...
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Hi Juliet,

There may not actually be a "his dose", because over time things will change. They've changed a great deal already! You may need to be prepared to reduce the dose if Milo's numbers get lower. And it may even be that Milo ceases to need insulin at all at some point...

Are you going to be home to monitor this morning...?
 
Elizabeth and Bertie said:
There may not actually be a "his dose", because over time things will change. They've changed a great deal already!
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They have indeed. I guess I am hoping that we've found the right dose for now. However long 'now' may be... Oh I dunno what I'm saying!

Elizabeth and Bertie said:
You may need to be prepared to reduce the dose if Milo's numbers get lower. And it may even be that Milo ceases to need insulin at all at some point...
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I don't want to get my hopes up yet!

Elizabeth and Bertie said:
Are you going to be home to monitor this morning...?
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No, unfortunately not. You think 1.5U this morning was unwise? I was thinking that 3 days on the same dose was standard if a good response was being observed? ECID, though I s'pose.

He's not dropped into greenery yet, so I was thinking it may be safe. Now I'm worried. He has loads of food, though. nailbite_smile nailbite_smile
 
I expect Milo will be fine, Juliet.

As you say, he's not dropped into greens yet. And he's shown that if he hits a number he's not comfortable with he can respond to that pretty well and raise his own BG.
 
This morning:
+12/AMPS = 5.1 (92)
+12.5 = 4.2 (76)

Needless to say, he ain't getting insulin this morning! dancing_cat

He had a bit of breakfast in between the tests, and had clearly eaten quite a bit overnight.
He seems very happy.
So am I!

cat_pet_icon
 
Oh, forgot to say...

The fact that Milo's BG dropped (after the snack) at that point in the cycle would seem to indicate that his pancreas is working. That is extremely promising... :smile:
 
Elizabeth and Bertie said:
Oh, forgot to say...

The fact that Milo's BG dropped (after the snack) at that point in the cycle would seem to indicate that his pancreas is working. That is extremely promising... :smile:
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WHOHOOO!! :RAHCAT

I am trying not to get too excited about this. I promise I am.....but WEEEEEEEEEEEEEEEEEEEEEEE!!!! Go Professor Milosevitch Von Katz!!! :mrgreen: :mrgreen:
 
Milo's numbers are looking amazing, Juliet. Things are just getting better and better for him (well, apart from that furball!)

Has his neuropathy resolved now?
 
Hey you!

Yes, life seems to be much rosier in the Miloverse.
I think his neuropathy has resolved, but I ain't sure. In comparison to Lola, I reckon he's not quite so tippity-toesie, but 99% there. He'll have his Zobaline for a while longer.
He can take corners properly now. You should have seen him exit the kitchen when he caught sight of the cage I just brought up from the cellar! :lol: He knows it's Vet Day! :mrgreen:

J
xx
 
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