Just returned from vet - newly diagnosed and confused

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Korynn said:
(What is a "fur shot?")
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A fur-shot means that the insulin didn't get into your cat.
Can be either because you didn't actually get the needle into the skin (rather, it just ended up wetting the fur with the insulin) or that the needle went all the way through the skin and out the other side and you end up shooting the insulin into thin air! (I've done that more than once!:banghead:) Sometimes kitty just flinches at the wrong moment ... the important thing is that if you think you did a fur-shot - or even a partial fur-shot, you just let it go and do NOT try to shoot any more insulin into your cat, as this makes you run the risk of an overdose. So is far better, in the event of a fur-shot, to just chalk it up to "s**t happens" --- as you can always correct it next dosing time. (And as we like to say about blood glucose: "Better too high for a day than too low for a moment!");)
 
Korynn said:
Looks like we'd have to eyeball .3 and it's so tiny.
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I hear you on that! I'm down to a dose of 0.10U with Bat-Bat on Lantus, and it makes me feel like I'm going to go blind:p trying to get the little black plunger positioned to just before that very last marking on the barrel ... sheesh!

Super-strong reading glasses can help enormously with this, even if you're lucky enough to not need them otherwise. (Ha, I wish!:rolleyes:)
 
Korynn, those u100s can be a lifesaver! Just make sure you are using the conversion chart. I highly recommend printing it out and putting it with the syringes. That way, you don't waste time looking for it when you need to shoot!
 
Korynn, it might help if you can get a test at night, maybe before bed. Even if you haven't given insulin it will tell us how long the AM dose is lasting. If you do give a shot, then it's even more important.
 
Hi Korynn - I see you got a high pink this am - what did you give him 0.4? It's quite frustrating to be in this situation where you have to skip a dose because the preshot level is too low, and then it goes high for the next shot. It's a matter of balancing it out - I agree going with the lower am dose should give you a shootable pm level. The other thing to try is to use a 13/11 shot schedule - so that your am shot is the same time, but you move your pm shot back an hour. That would give more time for the pm sugar to be shootable, and less time for him to be high during the night You are doing so great!!
 
Korynn said:
Boy, that would be so wonderful!
I have always loved cats, but Desi is extra special because he was my mom's and I "inherited" him 7 years ago after my mom unexpectedly and suddenly died. I think he reminds all of us (Mark and our sons) of my mom because she loved him so. He's a good boy.
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@Korynn. I know how you feel. I inherited (catknapped) Smokey from my parents. My farther couldn't deal with the diabetes. As it was for months after 3 yrs into diagnosis he didn't receive insulin or enough food. How he stayed alive is beyond me. He is the last "live" link to my parents. He is 18 yrs old. I've had him 2 yrs in May.
 
Hi everyone: Sorry this is so late - but we got a shootable 200 tonight! I was so excited!
We gave him 0.4. I will try to test him before we go to bed.
Thanks for all the encouragement!
 
Hi Korynn, great in the shoot able number, but please do get that before bed test. If he's going low, you may need to check on him at +7 or 8 too. This is the lowest number you've shot, so we want to be certain Desi's safe!
 
Sharon14 said:
Hi Korynn, great in the shoot able number, but please do get that before bed test. If he's going low, you may need to check on him at +7 or 8 too. This is the lowest number you've shot, so we want to be certain Desi's safe!
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OK, will do. We actually were a bit late in the PMPS testing and the shot - like +13-ish. (Does that make sense?) Just fyi.
 
Rachel said:
It does make sense. That's great news!!! A good before bed test would be great as Sharon said. :)
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Yes, I will do that for sure. I'm not sure I'm up to testing him at +7 or +8 because that would be like 3a or 4a in the morning...unless he seems very low before we go to bed.
 
I did check him (but not test him) around 5a and he seemed fine (I think he wanted me to feed him, which I didn't) and then we did the AMPS a bit ago and it's <200. So we are going into some other sort of cycle for now.
 
Wasn't last nights shot was an hour late? This AM did you test 12 hrs from the shot, or at the regular time. Also insulin may be lasting 13 hrs or so. He's an interesting one that's for sure!
 
Sharon14 said:
Wasn't last nights shot was an hour late? This AM did you test 12 hrs from the shot, or at the regular time. Also insulin may be lasting 13 hrs or so. He's an interesting one that's for sure!
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A neighbor dropped by unexpectedly last night and Mark couldn't get her to leave to be timely with the testing (and I was at happy hour with friends - ha!) so the testing was about an hour late. Maybe more like 40 minutes late. Didn't give the shot until after I had arrived home, about half an hour after that. Anyway, this morning's testing was 12 hours from that time. Just tested at +3 and it's up 18 pts. Whatever that means! We will keep testing periodically since it's the weekend and we can. Overall, in the past week he's been drinking less, and seeming perkier (more alert times, more playful). He's not dropping any weight. But we are not weighing him so that's hard to tell.
 
Sharon14 said:
Sounds like he's feeling good and that's the most important thing, so keep doing what you're doing, it's working!
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I guess....I just wish we could discern a pattern of some sort. It was just a week ago that the vet advised 2 units/2x day and that still boggles me, as commonplace as it unfortunately seems to be. I wish there were some advocacy group for these kitties - but maybe we are it!
 
You've only been at this for a short time- a pattern will emerge. It's good you're testing him lots today, the more data the better. You may need less insulin, or a different shot schedule. That's something Sue, Robin and Rachel can help with!
 
You're doing great! Remember, your cat is more than just a number. How is Desi acting? If he's acting okay, and he seems to be, please don't worry too much. We'll figure out a pattern over time. It may even be that Desi's pancreas are sputtering here and there...and helping out. That's good!

Just remember, you're not alone in this. We're all here for you!
 
Rachel said:
How is Desi acting? If he's acting okay, and he seems to be, please don't worry too much. We'll figure out a pattern over time. Just remember, you're not alone in this. We're all here for you!
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This is great advice! Especially the "please don't worry too much" part. (Easier said than done, I know ... I just had to give myself a "talkin' to" about fretting too much over Bat-Bat.:rolleyes:)
I think Desi's doing really well!:)
Korynn said:
I wish there were some advocacy group for these kitties - but maybe we are it!
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Ha, you just said a mouthful, Korynn!:D
 
Yikes, 408! That's the highest we'd had! I'd re-test but he's acting OK and the PMPS is 3 hours away, so we will no doubt give him insulin then (he seems fine...again/still). I am not sure what amount to give, as usual. 0.4? Again? Ugh. But if the numbers are so much higher, then 0.4 should bring it down to the shootable range for tomorrow morning, right? What a dance!
 
Wow! That's odd. I'm not sure that was a true number. Let's see where he is at PMPS and that will probably tell us if this was likely just a bad test or not. I think if it was me, I'd give 0.4 if he is in high numbers just to see. It might be too little, but if it brought him gently down and he was still in shootable ranges tomorrow, that would be good. :)
 
That 408 seems unusual to me, too! I agree with Rachel - that could just have been a wonky test! Unless ... is there any chance at all that Desi sneaked into a little contraband when nobody was looking? As for what to shoot tonight, just wait & see what you get for a PMPS - Desi's BG could drop again by then.

An additional thought: You want to be able to get a shootable BG # at both AM & PM dosing times; given that you had to skip this morning* (and depending on what you see from tonight's preshot test) you may actually want to scroll that next dose downward just a wee bit.;)
*(Again, that need to skip is a good sign - just look at where you started on the 9th vs. where you are now!:D
 
Robin&BB said:
That 408 seems unusual to me, too! I agree with Rachel - that could just have been a wonky test! Unless ... is there any chance at all that Desi sneaked into a little contraband when nobody was looking? As for what to shoot tonight, just wait & see what you get for a PMPS - Desi's BG could drop again by then.

An additional thought: You want to be able to get a shootable BG # at both AM & PM dosing times; given that you had to skip this morning* (and depending on what you see from tonight's preshot test) you may actually want to scroll that next dose downward just a wee bit.;)
*(Again, that need to skip is a good sign - just look at where you started on the 9th vs. where you are now!:D
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No, we don't have any contraband any more. There is the dog's food but Desi has never expressed the slighted interest in that stuff (wish I could say the same about Ryan - the dog - and the cats' food!). Nor our food!
I thought skipping was not good in that the ideal is two shootable numbers vs one high shootable number and one too low to be shootable. Am I missing something? It's good to skip and one have only one shootable number, no matter how high?
I did think of doing another stick after that high number but we've been sticking him so frequently today that I just couldn't bring myself to do it. So maybe it was a bad stick. I hope so! Stayed tuned!
Thanks again for all the support!
 
Korynn said:
It's good to skip and one have only one shootable number, no matter how high?
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No, that's not what I meant. (Maybe I wrote it in a confusing way...:oops:) Of course, we'd rather not have to skip a dose, but sometimes you just need to so that you keep your cat in safe BG#s on ProZinc. (That's why, when you're new at this, we don't recommend you shoot at less than 200.)

And in Desi's case, he's already shown you that he doesn't need a whole lot of ProZinc! So when I said that his skipped dose this morning was "a good sign," I only meant that this is yet another clear indicator that he's probably heading for yet another reduction in dose soon. So don't let that one wonky 408 you got out of him at +9 today factor into your dosing decision at PMPS tonight. Instead, look at the pre-shot # you get tonight and look back at last night's PMPS # along with this morning's AMPS #, and you'll see what I mean: He's actually doing really well, Korynn!:) What you don't want to do is dose him so much tonight that he either gives you an unshootable # in the morning or starts into bouncing.

From the ProZinc "Protocol" at the top of the forum:

If one preshot is above 200 and shootable, and one preshot is too low to shoot, it probably means the dose is a little too high and lasting more than the usual 12 hours. Try reducing by at least .25* to see if you get two shootable preshot numbers (ideal) rather than one that is too high and one that is too low to shoot (not ideal)

*Note that the above was written assuming use of U40 syringes. You already know you can do finer dosing adjustments with those U100s marked on the half-unit that you're using now with the conversion table.

Hope this clarifies it for you. (Again, sorry if I confused you any.):bighug:
 
Robin&BB said:
No, that's not what I meant. (Maybe I wrote it in a confusing way...:oops:) Of course, we'd rather not have to skip a dose, but sometimes you just need to so that you keep your cat in safe BG#s on ProZinc. (That's why, when you're new at this, we don't recommend you shoot at less than 200.)

And in Desi's case, he's already shown you that he doesn't need a whole lot of ProZinc! So when I said that his skipped dose this morning was "a good sign," I only meant that this is yet another clear indicator that he's probably heading for yet another reduction in dose soon. So don't let that one wonky 408 you got out of him at +9 today factor into your dosing decision at PMPS tonight. Instead, look at the pre-shot # you get tonight and look back at last night's PMPS # along with this morning's AMPS #, and you'll see what I mean: He's actually doing really well, Korynn!:) What you don't want to do is dose him so much tonight that he either gives you an unshootable # in the morning or starts into bouncing.

From the ProZinc "Protocol" at the top of the forum:

If one preshot is above 200 and shootable, and one preshot is too low to shoot, it probably means the dose is a little too high and lasting more than the usual 12 hours. Try reducing by at least .25* to see if you get two shootable preshot numbers (ideal) rather than one that is too high and one that is too low to shoot (not ideal)

*Note that the above was written assuming use of U40 syringes. You already know you can do finer dosing adjustments with those U100s marked on the half-unit that you're using now with the conversion table.

Hope this clarifies it for you. (Again, sorry if I confused you any.):bighug:
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Hi everyone: I didn't know how to write a "fat" .3 or "skinny" .4 so wrote 0.35 in the SS. I debated about just giving him a .3 (although that is kinda hard to gauge, even with the U100's). I should have probably tested him last night after the PMPS dose but he has scabs on both ears and I just didn't have it in me! Robin, or whoever wrote it above in the thread is right; he doesn't seem to need a whole of insulin (which may explain why he seems so much healthier than a lot of cats I read about on this site - and I'm very thankful for that) at this point. I keep thinking that he'd be dead if we gave him the prescribed amount! We just need to figure out the small amounts he does need. Even a little is still very important!
 
Korynn said:
Even a little is still very important!
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That's right, Korynn! And that's what so great about collecting, recording & considering the data that we all see in our SSs - this really does provide us with a basis for making dosage adjustments.

Great job on that little redux this morning:D ... and please do monitor his cycle today: You might even want to check him at +2 - just to get an idea of where he's heading (You don't really have any +2s in your SS yet; sometimes it's good for you to have a few of those, if only to see how much his food amount spikes his BG#. For me, this has been very helpful in determining Bat-Bat's food-to-insulin "balancing act" - as she tends to jump off a cliff, so to speak, by about +3 with a too-steep drop in blood glucose.)

I know how you feel, seeing those scabby ears, btw ... but the good thing is that kitties have very little in the way of nerve endings in the edges of their ears, so it's more like a little mosquito bite to them when you poke an ear with a lancet. (Unlike how it feels when you accidentally prick your fingertip :eek:with the darned thing ... ouch!)
 
Robin&BB said:
That's right, Korynn! And that's what so great about collecting, recording & considering the data that we all see in our SSs - this really does provide us with a basis for making dosage adjustments.

Great job on that little redux this morning:D ... and please do monitor his cycle today: You might even want to check him at +2 - just to get an idea of where he's heading (You don't really have any +2s in your SS yet; sometimes it's good for you to have a few of those, if only to see how much his food amount spikes his BG#. For me, this has been very helpful in determining Bat-Bat's food-to-insulin "balancing act" - as she tends to jump off a cliff, so to speak, by about +3 with a too-steep drop in blood glucose.)

We feed Desi several small meals (more like bites) throughout the day, not twice a day as some folks do (just because we can...one of us is usually around and because we read that is easier on the pancreas). That being said, he mostly eats in the morning and evening, not during the day much and not during the night. (And we make sure he does not eat 2+ hours before the AMPS and PMPS.)

I will test at +2 this morning. I'm not sure we can manage that throughout the day given our (other) life, but we will try!


I know how you feel, seeing those scabby ears, btw ... but the good thing is that kitties have very little in the way of nerve endings in the edges of their ears, so it's more like a little mosquito bite to them when you poke an ear with a lancet. (Unlike how it feels when you accidentally prick your fingertip :eek:with the darned thing ... ouch!)
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Great job, Korynn! Looks like last night was NOT a bad test after all. What an interesting and unprecedented jump.

I like you reduction today. If you want, you can try adding F or S to the dose when you fatten or skinny it up. :) 0.35 works too, so whatever works for you.

Yeah, getting the occasional +2 is good to give you that info like Robin said. Looks like your food spike was roughly 100 points. Not bad at all.

Here's hoping Desi has a gentle curve today and is at a shootable (but not red!) number tonight!
 
Well, Desi's PMPS was 199 so we decided to go ahead and give him a tiny dose of 0.2. It was pretty difficult to eyeball. I don't think it will send him into hypoglycemia although he may still be on his way down from this morning's 0.35. He's acting fine (although it was hot in Portland today - and supposed to be 88 tomorrow! Neither cat is acting extra perky).
 
He'll probably be just fine with that 0.2, Korynn. Please do get at least one test in before bedtime, though - just in case he was still on his way down from the morning dose. If he's dropping more sharply (around +3 to +5 time frame) than you're comfortable with, you can always give him a little snack to bump him up a bit.
Korynn said:
It was pretty difficult to eyeball.
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Yeah, I know ... Bat-Bat is helping keep my eye doctor in business!:rolleyes:
 
Robin&BB said:
He'll probably be just fine with that 0.2, Korynn. Please do get at least one test in before bedtime, though - just in case he was still on his way down from the morning dose. If he's dropping more sharply (around +3 to +5 time frame) than you're comfortable with, you can always give him a little snack to bump him up a bit. Yeah, I know ... Bat-Bat is helping keep my eye doctor in business!:rolleyes:
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OK, will do.
I actually need cataract surgery on my L eye (I'm 52 but I had a retinal detachment with accelerated the thing) so the eyeballing is somewhat challenging! Hope to get a new lens in June, though!
 
Korynn said:
OK, will do.
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Cool!:cool:
Korynn said:
I actually need cataract surgery on my L eye (I'm 52 but I had a retinal detachment with accelerated the thing) so the eyeballing is somewhat challenging! Hope to get a new lens in June, though!
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Oh wow! When did it happen? Did you have to do that whole gas-bubble surgical thing for the retinal repair? (My ex-business partner had first one, then the other retina detach. She was down for a while; but it all turned out fine in the end.)
 
Well, the late night testing didn't happen. This morning, we had a bit of a problem because the test strip wasn't pushed in completely - and, long story short, we went through three strips and two different sites to get the sample. All to say that I believe Desi's level was probably elevated in the process somewhat, but I don't have time to re-test and it's quite high, even considering this, so we are thinking 0.3. Whew!
 
Sorry to hear that you had trouble with test-strip malfunctions this morning, Korynn ... but you know the old saying, " **it happens!"
And you're probably right about that BG spiking during that process; wouldn't surprise me one bit. Good job on the small dose & soldiering through all that, btw!:)
 
Well, no shootable # tonight. What the heck? He only had 0.3 this morning! How much lower can we go? This whole thing is puzzling me!
 
One of two things could be happenin' here, Korynn:
1) He's hanging onto the dose longer than 12 hours ... (which means it's working) and that also means he probably needs even less.;)
2) He's lining up to soon be off the juice.:D

In either case, it's very encouraging. Even though it's puzzling to you.;) Go, Desi!!!:cat: Rah-cat!
 
Korynn, next time you get a shootable PMPS, could you also try to get a mid cycle that night? I feel that might tell us something.

As Robin said, it's good news either way!

Here's what I see. The morning numbers are almost ALWAYS higher than nighttime numbers. I wonder if an 11/13 schedule would work better for you. Shoot at +11 in the AM (obviously test first) and then at +13 in the evening. That might help flatten things out. Is that something you would be able to do? Not saying you have to, but it's something some folks try when they get something like this. What do you think?
 
Rachel said:
Korynn, next time you get a shootable PMPS, could you also try to get a mid cycle that night? I feel that might tell us something.

As Robin said, it's good news either way!

Here's what I see. The morning numbers are almost ALWAYS higher than nighttime numbers. I wonder if an 11/13 schedule would work better for you. Shoot at +11 in the AM (obviously test first) and then at +13 in the evening. That might help flatten things out. Is that something you would be able to do? Not saying you have to, but it's something some folks try when they get something like this. What do you think?
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Hi Rachel:

Yes, the 11/13 makes sense to me, too. So today we will try that. How does that work with the spreadsheet, though?
 
Hi again:
We gave him the shot at +11.5 to start to transition to the 11/13 schedule. I wasn't sure how to indicate that on the SS but you can see how I did it for now.
 
Hmmmm...I think you're fine to just put the numbers in AMPS and PMPS category still...and just notate that you are doing 11/13? Like make a line on the SS and Put that you are doing 11/13 and then continue on? Unless anyone has any other ideas. :)

Remember, you are still following the same rules...no shot under 200, still want to get mid cycle numbers, etc. Just dosing at different times in an attempt to be able to flatten those cycles out! I look forward to seeing how this works!
 
OK, I added a +12 column (but didn't take away the +11...but it's not even visible on the page, so who cares, I hope). I couldn't figure out a better way. I tried to make it obvious on the SS but...who knows?
 
I think the 11/13 will really help you - I did that for awhile
one thing you can do is put the times you shoot in the comments section - in the very last column - take a look at Murphy's SS to see what I do
 
This morning's was good, too! We are assuming we will stay with 0.3 dose for now. It's difficult to see much lower than that to dose, anyway, at least for me and using a very good light source. He's been nowhere near <50 since the initial dose given by the vet (!). In fact, most of his numbers seem to be either pink (beginning of day) 0r blue (end of day) (until recently). With mostly yellow in the interim.
 
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