Kitty 7/3 amps +4.5 +6 +8 pmps +3 +6.5

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kse

kse

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7/2

Pmps. 418. Shot a REALLY FAT 4.5 (maybe more U40s?)
+3. 236. 45 percent drop
+5. 146 65 percent drop
+6. 120 72 percent drop. Hungry!!!


7/3

Amps 441. Shot 4.2
+4.5. 159. Ate 1/5 can FF
+6. 165. Holding steady w/ a snack
+8. 367. Zoom


Pmps 429. 4.1 units
+2. Fluids
+3. 245 43 percent
+6.5 232. Surfing or rising???




I need to update SS


Good Morning!

We still have the perfect little curve going on with the red preshots! She hit 120 last night at +6. She does have a "pretty" curve if we could just get lower preshots! I backed down to 4.2 this morning to see if it would slow down the bounce. We might not get as much drop, But maybe it will be softer for her. I started to back down to 3.7 to try to walk her down-- but decided against it!

I don't know why I am talking about a bounce.... My vet assured me yesterday.... You cannot have any type of bounce unless they go below 100! confused_cat


Kitty wanted to get in on the recent vomit threads... So she threw up a big hairball before breakfast! Sometimes
hairballs make her feel crappy -- so, glad that is up and out.

No mid cycle testing today-- I am givIng her a break. I know the curve is there-- I am concentrating on lower preshots.

She will get fluids tonight-- I am going to give them in conjunction with the insulin and ride that out!

I really wish we could get the preshots down, because i like her U curve.

Still open to suggestions!

Have a great day!
 
Re: Kitty 7/3 amps

MOrnin Kim,

What nice numbers you and Kitty have!
looking good, and I hear ya about the preshot numbers!
They drive me nuts too!
Sorry about the vomit, but glad she is feelin better :mrgreen:
Hope you both have a great day!

Denise and Shakes
 
Re: Kitty 7/3 amps

~O)
Mornin'
Hairballs are not a nice way to start the day. Glad it's up and out though.
Have a great day! Are you at the beach? Enjoy!
 
Re: Kitty 7/3 amps

Nope--- not at the beach!!! I leave that to the tourist on holidays! TRAFFIC!
 
Re: Kitty 7/3 amps

I HATE the red preshots! But, the curve is nice---gentle U curve.. consistent preshots and nadir at +6!

Her liver hates her curve!!!!
 
Re: Kitty 7/3 amps

The good news is that their livers eventually get used to it.

We get the holiday/summer traffic here too but I can't avoid it. By noon tomorrow there won't be a parking spot for miles. 50,000 people will come to our little park to celebrate the holiday.
 
Re: Kitty 7/3 amps +4.5

Okay , I couldn't stand it---+4.5. 159--- 65 percent. Maybe more drop on less?
 
Re: Kitty 7/3 amps +4.5

Maybe she is trying to provide some red, blue, ---don't know what the white would be :mrgreen: . But I know how lousy those high ps 's feel. (to you, I am not sure about her!)---sorry. Hope you enjoy the holiday anyway.
 
Re: Kitty 7/3 amps +4.5

The good news is that the insulin is working. :dizcat It is possible too that the hairball threw her off yesterday, both in the way she felt and how the numbers looked.

Wonder if we should think about shooting earlier for that preshoot number so we even things out. (I think Kelly and Oscar asked about TID. Altering the 12/12 schedule would be a first step along that route.)
 
Re: Kitty 7/3 amps +4.5

Well, I know the preshots were better on less when i started the last new vial. Maybe this new vial is in reality-- more than 4.5 to her system. The other vial had pooped-- so I am thinking maybe there is a bigger difference in the potency. Am I making any sense? I think maybe a 4.5 on the old vial compared to a 4.5 on this vial-- might be like comparing apples and oranges.

It is hard to tell exactly what you are dosing using the U40s--- but, last night I am certain it was more than 4.5-- maybe 4.6 or 4.7. This morning it was maybe 4.1-- no more than 4.2.

Look at her SS (not updated), but look at some of the crazy low doses I shot last month-- one night she held pretty steady on 2.8.

?????

Maybe I should back off some?

What do you think?
 
Re: Kitty 7/3 amps +4.5

Ha, Judy!!!! The white is my knuckles from cringing!
 
Re: Kitty 7/3 amps +4.5

Let's see if we can get everyone brainstorming on possibilities.

If you are not seeing any ketones, I wonder if you should try one unit for a few cycles. You got your best numbers on 2 units early on with that one dose a day. I wonder what one unit twice daily would have looked like. Did we ever talk about that? I think it is a bit of a scary experiement since she does seem to have multiple issues. It would have to be a day when you would be around and do testing, and be ready to jump right back up.

The other option is to tweak the schedule.

What do other people think?
 
Re: Kitty 7/3 amps +4.5 +6

Okay--- +6. 165-- holding steady and had a snack at +5

I am so tired of sticking her! She really is Super Cool!
 
Re: Kitty 7/3 amps +4.5

Glad you asked Sue.

I have a developing theory about Prozinc being a low dose insulin and I wonder sometimes if we can get the new kitties started on a lower dose if we might not have more success with it. I'm pretty sure that I've read that the L's have lowered their starting doses to .5u bid, maybe we should follow suit.

Harley was always a low dose guy, the highest dose I ever shot was 1.4u, mostly because I was too scared to be more aggressive and it worked out for us.

How many low dose kitties do we have here now? Beachin with both Rocky & Callie Mae, Barbara & Thumper, new member Calliecat (they started at .5u and we should keep an eye on them), the Ginny & Alex experiment is looking ok so far. Are there more I'm not remembering?

Just my 2 cents to add to the brain storming. Thoughts?
 
Re: Kitty 7/3 amps +4.5 +6

She did good on less before the DKA. After the DKA the vet immediately told me to increase from 2 units once a day to 3 units twice a day.

I have tested religiously for ketones since DKA and have never had a trace reading (anti jinx). Probably due to the high insulin dose and the sub Qs. But, she had a terrible UTI that threw her into DKA.

The DKA experience was awful.....but, I am better prepared and I think I would notice the onset. She had symptoms before, but I was not knowledgeable enough to notice them..... BUT -- it was horrifying!

Waiting for the ZOOM!
 
Re: Kitty 7/3 amps +4.5 +6

Thanks, Robin for weighing in. I was really nervous about suggesting it. And KItty is getting nice numbers today. So I am not at all confident. I do think it has had some merit with Ginny and Alex..... And yes, the most successful kitties seem to have been the ones who started with the lowest doses.

I think we skipped right over the one unit because Kitty went into DKA which is usually seen as too little insulin. Maybe Nancy and Payne will weigh in. She has the most experience with DKA issues. The strange thing for me is that ProZinc never seems to reach that threshold where too much insulin would produce a crash. PZI used to do that. If you were giving too much, eventually there was a severe rebound. But we seem to be seeing more liver training type numbers rather than true rebounds.

Hope you don't mind us kidnapping your thread, Kim. I do think we are learning about this insulin as we go along, and I do think it is not as much like PZI as we would like to think.
 
Re: Kitty 7/3 amps +4.5 +6

I will go ahead and throw this out--- Nancy is going to say --- No way do I decrease to 1 unit!
 
Re: Kitty 7/3 amps +4.5 +6

I dont know if I should give my 2 cents or not...
I am NOT good at the dosing advice but I think with the Ketones one unit makes me nervous,
what about 2 units since she did so well in the 2 range?
 
Re: Kitty 7/3 amps +4.5 +6

A super loud and resounding NO NO NO to any dose decrease trial!!!!!!!!!!!!!!!!!!!!! She is FINALLY seeing some better numbers after all the hard work, and Kim turning into Ms. Super Brave Insulin Shooting Meter Toting No Chicken Sh*tting Gal and I would hate to see things go south.

We know from the DKA that she needs more rather than less insulin, and my recollection is that after that it was only after you got over 3u that she started acting like she was feeling better, so to me it is clear-cut she needs the insulin.

I think when we talk about bounce (uh oh, pet peeve alert!) it is important to distinguish between bounce from liver training, and real bounce from the dose too high (which some do distinguish & I appreciate that!!!! :-D ). When the vet says she won't bounce unless she goes low, he probably is thinking of the low number bounce as the only type. I suspect that not all vets realize that steep drops can cause rebound as well. And I have a strong suspicion that very few vets have ever heard of liver training. We see it all the time here, but I really doubt that most are aware of it as a concept. Without the daily data and stuff we see, it could easily slip under your radar screen and just be "cat with high numbers".

The things that I see you can do are:

- Feed early in the cycle to ease the drop and try to prevent any possible rebound from the drop being too steep.

- Shoot early, for a few days, few weeks, whatever you can manage, to head off the higher PSs and use that to keep the curves gentler. It doesn't have to be TID, you can shoot at +10s or +11 or something, but you do want to be sure you can schedule it in a way that doesn't leave her going longer than +12 at the next shot. Some have found even shooting at say +10s over the weekend and then going back to BID during the week can help - the longer they spend in better numbers, the faster their liver gets used to it and any portion of the high numbers that are due to liver training will start to settle down.

- Stick with BID at these doses (as high as you can get the dose w/o the drop getting steeper than it is now - I would experiment with feeding a little more early-mid cycle and raising the dose a hair, and see if that will ease her down into slightly lower numbers for the second half of the cycle, and result in lower PSs by the end) and see if that way you can get the PSs lower and get out of steep drop territory, and get her in more greens and then see if liver training settles down. My suspicion is she will be on a dose reduction path if you can get her in greens, but I think reducing without that is going to leave her high.
 
Re: Kitty 7/3 amps +4.5 +6

Good morning all! this is a weird thread .... I have actually already put in my .02 on this subject but I will add about the DKA. Kitty is not a young Kitty, I would have a heart attack if she went to 1u ....There is something about a cat that has gone the DKA route, that is just a bit different.

In the beginning with Payne and the DKA's I spent weeks in ER at U.C.Davis, specialists coming/going, theories abounded, I learned a lot! What I learned most of all is that the amount of insulin is very important! Had I got this basic notion earlier, she would not have had DKA #2 and #3.

When we tried Lantus, I was told it was a much stronger insulin AND we couldn't start her at the pzi level but we did start at 3u b.i.d. which got me a lot of flack in LL land ..... ohmygod_smile I watched her like a hawk! and changed nothing else, but on the 10th. day she crashed before I could even do any counter actions. That was DKA #4 and I never saw it coming! (I keep very detailed records on her)

The elephant in the room is duration .... you can do all these other things but until you know the answer to this part of the puzzle? you can raise/lower her dose but you still don't know how long it lasts in Kitty, effectively.

Happy July everyone!
Nancy and Payne
 
Re: Kitty 7/3 amps +4.5 +6 +8

And now we know more...... It sure doesn't last more than 8 hours!

200 point increase in 2 hours!

+8. 367

This has to be here liver-- she has not been having this type of zoom until she starting seeing the blues.

So, maybe I should shoot at +10 today-- what do you think. Truly, I could shoot now... But, I'm
Not ready to dive right in........

Thoughts--- and Joanna, could you be clearer this time!!!!!! :mrgreen:
 
Re: Kitty 7/3 amps +4.5 +6

I'll second the part about amount of insulin (well, I'll second everything, including that I'll have a heart attack too!!!!). Ketones come from too little insulin, not high #s per se. So even with crazy high PSs and being in rebound, a cat with a dose of insulin that is closer to meeting their needs is less likely to get ketones than say a cat getting all yellows on a low dose (assuming the cats are equally prone to getting ketones). As I understand it, which is not a huge amount.

Steve & Jock has written some great stuff on the subject, I can't find the post I am thinking of at the moment unfortunately. He has several TT threads though that discuss various aspects of DKA and are worth reading IMO. He has said before that if they have ketones don't even worry about rebound, they need more insulin. I realize Kitty doesn't have ketones (YAY!), but she has gotten them on lower doses so I just would not even consider going there.
 
Re: Kitty 7/3 amps +4.5 +6 +8

It's either liver training or the drop was too steep, hard to say which (or some combo of the two). Liver training you can counter with a higher BID dose or shooting earlier, if the drop was too steep then you don't want to raise the BID dose unless you can soften the drop with feeding. I'd probably try a combo approach and just see how you can tweak it best.

If you shoot early, just think about how the schedule will work for the next few shots, and depending on how early you will want to lower the dose. I am not super comfortable advising on dosing for early shots, but hopefully others can help you out with that! I think the general idea for TID is to take your 24-hour dose and divide it by 3 for a starting point. For a +10 shot, you might shave a small amount off the dose, maybe 0.2, but I don't have my mind around it.

You can also stay with 12/12 if that is what works best for you, and then either play with the feeding early cycle, or consider a different insulin. Lots of choices, all of them stressful!!!!!!! :mrgreen:

OK, I need to get out & get some fresh air - going to visit the ocean today, YAY!!! Hope things go great today!
 
Re: Kitty 7/3 amps +4.5 +6 +8 zoooommm

p.s. sorry about the shouting :oops: I did tone it down and take off the caps lock, LOL :lol: Nothing personal to anyone, I know we all hate seeing the icky high PSs :razz: and are looking for ways to get Kitty in better numbers more smoothly. Brainstorming is good, and even when we disagree, I think sometimes it is good b/c it flushes out discussion & such. Personally I am increaingly puzzled by ProZinc and wondering too if I am misunderstanding it and it is more different than PZI Vet than I first thought, but I'm not sure. And not sure how to approach it except to say if they aren't getting greens, I think the dose is in most cases too low, with a small number of exceptions.
 
Re: Kitty 7/3 amps +4.5 +6 +8 zoooommm

"100 bottles of beer on the wall ...100 bottles of beer... Take one down ....Pass it around..... 99 bottles of beer on the wall.... 99 bottles of beer on the wall... 99 bottles of beer...take one down pass it around 98 bottles of beer on the wall......."

confused_cat confused_cat confused_cat confused_cat

I started to put that OTJ icon up -- For --- On The Juice!!! Shhhheeeezzzz!
 
Re: Kitty 7/3 amps +4.5 +6 +8 zoooommm

:lol: The OTJ icon would be a nice change from the rainbows and candles! :lol:

Lots of great discussion. Have you decided what you're going to do? I'm wondering if the TID shots would work for Kitty...That was also an option that was posted for Klinger (when we were on prozinc), but I couldn't do it with my work schedule.
 
Re: Kitty 7/3 amps +4.5 +6 +8 zoooommm

Long term--- I don't know if tid would work-- short term, maybe. I have this friend I am going to talk to about other options. ;-)
 
Re: Kitty 7/3 amps +4.5 +6 +8 zoooommm

I am happy to be overruled. I knew Nancy and Payne's DKA advice would be invaluable and Joanna, I really respect your opinion.

I like Joanna's idea of shooting at +10 or so (as long as it can be balanced out for the next shot) when it fits your schedule - like on weekends. I do know that some people have done TID for awhile and then been able to go back to BID because the numbers went down. This flexibility is the main thing that ProZinc has going for it.
 
Re: Kitty 7/3 amps +4.5 +6 +8 zoooommm

In regards to the low dose theory - Oscar wouldn't follow suit on that one. He was diagnosed with glucose levels in the mid 200s and low 300s - not that high all considering, so we started ULTRA conservative. We began with 0.5u SID, then to 0.5u BID and up from there. We didn't see a break through until 3.5u BID. Right now he is on 1.5u of Levemir and got up to 4.75u of Lantus. I personally am a firm believer in the break through dose and have seen it work with several cats on both Prozinc and Lantus. But I also tend to be a more aggressive doser because I am around to test.
 
Re: Kitty 7/3 amps +4.5 +6 +8 pmps

I'd go with 4.5 since you had a nice dip yesterday on that dose. What do you think about dosing TID on the days you can do it and BID on the heavy work days? I am wondering if Kitty is maybe just not getting a lot of duration in addition to the liver training that is going on.
 
Re: Kitty 7/3 amps +4.5 +6 +8 pmps

(not trying to create an argument! lol) The pmps is only 12 points lower than the amps. I don't know if I'd call that statistically lower :-D
 
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