I want to bang my head against a wall

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Renegaderem+Dainty

Renegaderem+Dainty

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Instead, I'll ask for opinions. The last week or so I dropped Dainty down to 1 unit. She did okay on that for like a day and then we started getting higher numbers again. I started moving her dosage up to match the increase. Today we finally tried two and a half units. She responded by having levels of 352 +4 hours after shot. Her PMPS was 353.... It went down a point. I am utterly confused on how to manage my cats diabetes. I have no clue where to go from here, up/down/sideways? Any input would be appreciated.
confused_cat
 
Hi and Welcome Renegaderem and Dainty.

What a great pic of Dainty, she's beautiful.

Congrats on learning to test, that is the hardest part of this sugar dance. Prozinc has a bit of a settling in period, and even small dose changes can cause some wonky numbers at first.

Looking at your spreadsheet the first thing I see is until now there are no PS tests, it is so important to test before each and every injection to make sure their bg # is high enough to give the insulin safely.

The second thing I see is that you started at a pretty high dose. Our mantra is "start low go slow", when you dropped back to the 1 unit you got some really good numbers but I would guess that since Dainty hadn't seen those pretty blues in a while she bounced up to higher numbers, which is normal at first, and you raised the dose reacting to the higher numbers.

I would suggest that you drop back to the 1 unit twice a day and start over. Let her settle into that dose for several days and then we can re-evaluate the dose. Get a PS test before every injection so you know what her bg is and then you can adjust her dose accordingly.

Breeeaaath, no head banging here. Come back and ask any and all questions you have.

Welcome to our little family,
Robin
 
We have all been there---so my first suggestion is to make it a padded wall :mrgreen:
It's great that you are testing! But could you clarify something, please? Are you not getting preshot numbers or just not posting them as such? The preshot columns are designated AMPS ( morning preshot) and PMPS (evening preshot ). These are very important readings to get, they will help you keep your kitty safe---if you get too low a number (under 200) we strongly advise you not to shoot. The next most helpful number is +6 which is around the time you should be reaching your nadir (nadir is lowest BG level in the cycle from shot to shot). Of course, in between data---every 2 or 3 hours is most helpful in figuring out what is going on. If your kitty's ears seem to be bruising, be sure to put pressure on the ear for 20 seconds or so after you poke.
You mention leg pain in your spread sheet. What is that about? Pain can greatly increase BG levels. Also, does your cat have any access to dry food or treats? What it the dental situation? Dental problems are a frequent culprit in raising BG levels.
One suggestion about your doses--- you might consider smaller changes. We often only increase or decrease in .1 or .2 increments. It is surprising how much difference just the littlest change makes. Also, you might consider holding the dose for a few cycles. It sometimes helpsnto let it settle in.
We often say this is not a sprint, it is a marathon, so relax if you can and tell yourself you arenon the right track. And keep asking questions, we like to help!
 
I'm really new here also & your post caught my eye cause I feel the same way! LOL! The ladies here know their stuff though & will help you through it. I keep asking the same questions over & over, I just don't get most of it, but they keep answering. :smile:
 
First let me give you all sincere thanks from Dainty and myself, without the people on this site, I'm pretty sure I would have been committed by now.
When we first mentioned we wanted to home test, our vet office taught me to do it with this huge needle. Maybe it works for professional vets but when I attempted to do it I really was hurting Dainty so I decided to only test with it once a day. Hence the lack of amps and pmps I figured that this would be the least traumatic for her while still getting results. I then found out about lancet devices and these little tiny needles that would do the same thing without making her bleed out like a quart of blood (I'm exaggerating a little with my estimate). This method has been working far better for us. Dainty still doesn't like the testing but she doesn't run in terror now. I'm working with treating her after each poke to get her accustomed to it. I am trying to increase the frequency with which I test without scaring her. Dainty for the last couple of years has had arthritis....? In her back legs. The vet said is was a very mild form and that there was nothing we could do. She hates having the area touched to the point of hissing with just a gentle nudge of the hand. The pain comes and goes, though I have noticed it is more likely to be present when she has higher numbers. She does get treated with semi-moist pounce treats. They are her favs. I don't give her a ton. Just a couple after each poking session. I've just been reading about treats on the board. Looks like the pounce ones are out. Luckily she loves tuna. As to the dental situation; For the first 6yrs of Dainty's life she was an indoor-outdoor cat. She would get into fights with the other cats in the neighborhood. I guess she was trying to take a bite out of someone and lost half of her left front tooth. She is also missing another on her back right. The transition to wet food has been easy on her mouth. I'll take her down to 1 unit and keep her on it for a couple of days. I will do my best to take amps and pmps. Do I have to the do the +6hrs twice a day? Because I don't get home from school until +8. Would that be better than nothing during the day?

I read to Dainty about her treat changes, for once she paid attention http://i.imgur.com/mFp98.jpg
 
Awwwww. I think that look is "ok, so where are my new treats?!?" :lol:

Sounds like you are getting things on track. Did your vet mention Cosequin for the arthritis? If not, I would ask about that. It's a supplement you can sprinkle on their food - I don't know how it might affect BGs, but from what I understand it can really help with arthritis. Some also use pain meds for it - I'm not sure which ones, but you could post on Health for arthritis suggestions and I'm sure you'll get some good ideas. If she is at the point of hissing then she is surely in some pain. I'm surprised your vet said there is nothing they can do, I think there are quite a number of things. Some may have undesirable side effects so I would be careful in deciding what to do, but still I am pretty sure there are options.

Did your vet start you out at the doses at the beginning of your spreadsheet? Or did you start at a lower dose and move up gradually? In either case I agree you do need to stick with a lower dose for a few days and get some data to be clear if a dose increase is warranted, and then move up in doses if needed, knowing for sure that you are moving in the right direction.

Also I think if you switch up to LC treats, you may see a difference. Hard to know for sure, but even a couple bites of something higher carb can really make their BGs skyrocket.

Finally, are you checking for ketones? Does she have any ketone or DKA history?
 
Just wanted to say hello and welcome. I'm sure you're already figuring out that you've come to the best place for help with your diabetic cat. I knew next to nothing at first and was overwhelmed and stressed. This forum and following the great advice/protocol really helped me turn Max's health around. We've all been there wanting to bang our head against the wall. Just try to take things a step a time.
 
Welcome to you both!
You are in a great place to you can breathe now and everyone here will help,
except for me and dosing...I am still trying to understans that! and I have been doing this for awhile

so anyway, good luck and we are all here for you both

Denise and Shakes
 
Welcome to our little community! I agree with what has been said already - the flat curve in the 300s the day after those blues is probably what we call a 'bounce'. Newly diagnosed diabetics have had their systems essentially reprogrammed to think that 300s and 400s are the new normal. When the numbers lower dramatically, as you saw the first night on the 1u dose, the system panics and thinks that it is heading for hypoglycemia (even though it really isn't) and the liver is triggered to send out glycogen stores to protect the body. You usually have to give it up to 3 subsequent shots (what we call cycles) before the body calms down again and goes out of 'protection mode.'

I would recommend going back down to that 1u dose and hold it there for a week to see how her body will even out. Now with the 2.5u dose you aren't even getting yellows, which tells me that the 1u dose may be more optimal for her in the end.
 
Awww she is paying attention, what a beautiful girl.

Harley has arthritus too, he walked very stiff legged in his hind legs, the vet started him on Adaquan injections a few months ago and he is feeling much better now. He even forgets now that his legs don't bend well and tries to trot down the hall :-D You can ask your Vet for Bupe for the pain also.

If Dainty has a few bad teeth that could be raising her bg's, maybe think about getting her a dental, since Harley's dental he has been flirting with going OTJ but so far just flirting. Every little bit helps.

Whenever you can get a mid cycle test would be great. You want to be able to see how the insulin is working for Dainty, if it's a +8 that will tell us something too.

Robin
 
Sorry about not getting back to this thread earlier today, Easter this year has kept me running. When the vet diagnosed Dainty's arthritis she just said there was nothing that really could be done. The next time I see her I will ask about the ones mentioned on this thread. I'm not quite clear on what a dental is. I'll ask about that one as well. I'm not exactly rolling in the money being a college student but if there is some way I can help her experience less pain I'll gladly look into it.
Finally, are you checking for ketones? Does she have any ketone or DKA history?
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Not currently checking for ketones, I've been warned about them on another post but honestly with trying to manage everything else its kind of fallen to the side. But alas, it seems that it is also an important part of diabetic kitty management. I've just ordered some test strips from Amazon.
your vet start you out at the doses at the beginning of your spreadsheet? Or did you start at a lower dose and move up gradually? In either case I agree you do need to stick with a lower dose for a few days and get some data to be clear if a dose increase is warranted, and then move up in doses if needed, knowing for sure that you are moving in the right direction.
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We started at 2u 2x a day. Then we gradually moved up as her bi-monthly scores at the vet office were still sitting high. I have since read that most likely the stress of the visit boosted the numbers and we just overshot her correct dosage. I will keep Dainty on the 1u dose for a full week even if her numbers go high (as someone posted that they probably will for a short while)and then come back with that information before I increase any.
:YMHUG: Thanks for all the solid advice and welcs everyone!
 
Good morning! Looks like better numbers. What most people do here is start a new thread daily (otherwise it gets too long to scroll down). Typically, you would start the subject line with the date, your cat's name, and your amps. Then you can keep on posting in thAt thread for the whole day. It makes it easier for people to follow and make suggestions. Oh, and I know you are Dainty's mama bean, but did I miss your name? I am Judy. Glad to meet you!
 
You know I think I completely forgot to introduce myself. :lol: My name is Heidi and I am currently a 2nd year college student.
I've actually run into a little speed bump with the daily testing. Dainty's ears are now both really red and irritated. On her left ear, the ear I've been testing with the smaller needle. When I shine a flash light on the underside I can see these huge red patches centering on the red line that circles her ear. The right ear is totally bright red, warm to the touch and is losing hair on the fluffy side. Now that I'm typing it out I'm realizing it sounds like the ear is infected so I'm going to take her in to the vet for that one. I'm not sure what I'm doing wrong with the testing. If its the needle I am now using (28g lancet) or if she just has sensitive ears.. I've done what was recommended (applying light pressure with some tissue for about 20secs after poking, using pain relief neosporin on the area.) But her ears are still really not happy right now. Continuing to test them 4x a day, I'm worried will permanently damage her ears.I figure I'll give them a week or two to patch up a little. I am concerned about not keeping an eye on her PS numbers, on the 1u dose they have been dipping on the low side. Behaviorally she's been responding to the 1u dose really well. She is drinking less and remembering that she has toys. Anyone else run into this problem with ears responding badly to testing?
 
Hi Heidi,

I would absolutely NOT stop testing PS's. She is responding really well to the 1unit, your PMPS was 50 points lower than your AMPS which is exactly what you want. If this trend continues you will need to know what bg you are shooting into.

You can move up or down the ear, aim more for the edge of the ear rather than the vein, maybe apply more pressure for a little longer, some people here have been testing multiple times a day for years and years so you won't permanently damage her ears. Definately have the vet check for infection and treat if necessarily.

You are doing great.

Robin
 
Renegaderem said:
I will keep Dainty on the 1u dose for a full week even if her numbers go high (as someone posted that they probably will for a short while)and then come back with that information before I increase any.
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Actually I wouldn't recommend going quite that far. Usually with PZI you can get a pretty good sense of how they are doing on a dose in 2 or 3 days. No need to wait a full week if they are in high #s, it's much better for them to start moving on the dose. We do recommend starting at 1u as you are, and then moving in no more than 1/2 unit increments. If the #s aren't too high sometimes we suggest moving in 0.2 increments. But if the #s suggest you are no where close to the right dose, then I like 0.5 better for increases.

Some people use Neosporin on their ears. You might also post on Health if you haven't already for more ear suggestions. Are you pressing on the spot for several seconds after each test? I always used a folded up kleenex to hold behind Bix's ear when I poked, and then I used that to stop the bleeding and hold on for a bit after each test. That reduces bruising and minimizes the stuff like the red circles.

Dental is just a teeth cleaning. If they have any bad teeth or infection going on, that can raise their blood sugar.
 
OK I should really start looking at the SSs before I type! ohmygod_smile Her numbers look really good on the 1u YAY!!! If your morning PS is quite a bit lower than tonight's, I would pull the dose back to 0.8 or so until you have a little more data.

Do you know about no-shoots? We usually recommend when people are new to this that you don't give insulin on a PS under 200. Instead, if your schedule permits, retest in maybe 30 minutes, and only give the shot once they are over 200. If your schedule doesn't permit, you can reduce the dose a little (if the PS is over 150 - if it's under 150, NO insulin), or you can skip the shot.
 
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