<Le sigh> Nico, the “rollercoaster” cat

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Emily Tuomey

Emily Tuomey

Member Since 2020
Up down, up down, up down. I mean I know bounces are pretty normal in the beginning, but man alive(!) if we could get outta the black for good that’d be lovely. I guess practicing patience isn’t my strong suit...

Dose increased to 3.5u this evening, and we will see where that takes us. Thank you, everyone, for your unending support. We are immensely grateful for all of you.

https://www.felinediabetes.com/FDMB...gnosis-nico-ma-suga-butt.238630/#post-2684332

https://www.felinediabetes.com/FDMB...mbers-all-over-the-place.238707/#post-2684051
 
Emily Tuomey said:
Up down, up down, up down. I mean I know bounces are pretty normal in the beginning, but man alive(!) if we could get outta the black for good that’d be lovely. I guess practicing patience isn’t my strong suit...

Dose increased to 3.5u this evening, and we will see where that takes us. Thank you, everyone, for your unending support. We are immensely grateful for all of you.

https://www.felinediabetes.com/FDMB...gnosis-nico-ma-suga-butt.238630/#post-2684332

https://www.felinediabetes.com/FDMB...mbers-all-over-the-place.238707/#post-2684051
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That 254 last night was nice to see
 
JanetNJ said:
That 254 last night was nice to see
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I agree. Was back to his usual pre-shot of 600+ this morning though. Is this normal? I’ll continue to see how he does for the next few days, I guess. He’s due for an official curve this week — probably Wednesday — though that will be called into his vet for review. Just a heads up, in case there’s anything I/we need to be aware of or prepare for prior, especially with the holiday. Be in touch, pretty please.
 
Emily Tuomey said:
I agree. Was back to his usual pre-shot of 600+ this morning though. Is this normal? I’ll continue to see how he does for the next few days, I guess. He’s due for an official curve this week — probably Wednesday — though that will be called into his vet for review. Just a heads up, in case there’s anything I/we need to be aware of or prepare for prior, especially with the holiday. Be in touch, pretty please.
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When you are due for new insulin you could consider lantus. Not every insulin work with every cat. Maybe it would be a better fit of this doesn't work out.
 
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JanetNJ said:
When you are due for new insulin you could consider lantus. Not every insulin work with every cat. Maybe it would be a better fit of this doesn't work out.
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Okay. I think we are at about 2/3 of the 10mL vial left, so it’ll be a bit. His vet did mention Lantus first, but Prozinc was a little more economical so we opted to try it out first then switch, if needed. He’s 290 at +4. Can I leave him be until PMPS, or would you guys like to see another mid (and if so, which interval would help fill out his spreadsheet for you?)??
 
Sienne and Gabby (GA) said:
I would give Prozinc a few months before switching. It's a good insulin.

Was there a reason you increased the dose by 0.5u? Typical increases are 0.25u.
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Her cat's nadir are above 200.
 

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The problem with Nico seems to be the duration of the Prozinc is so very, very short. Although most cats get 10-14 hours of duration, I don't think that Nico is getting more than about 8 hours duration on his good days. So that gives you the near constant highs at the pre-shot tests. The Prozinc is acting more like an NPH insulin for Nico, with the short duration. NPH insulins often only have a 6-8 hour duration in cats. Kind of what you are seeing with Nico while you are using the Prozinc.

Emily Tuomey said:
Just a heads up, in case there’s anything I/we need to be aware of or prepare for prior, especially with the holiday. Be in touch, pretty please.
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I'll be home for Turkey Day! As long as you keep posting so we know what is going on, I have my alerts set to let me know when there is a new response to a thread where I have commented before. Might not get around to signing on until later in the evenings, but I do read those posts where I have an alert to follow up on.

p.s. Thanks for the new thread. My reply here will cause me to continue getting those alerts, but for this new thread.
 
I swear these PMPS #’s are the bane of my existence :banghead: I cannot get them down for him! I was so hopeful because he was acting quite the opposite right up until testing— even now he’s bounding through the house, getting into shenanigans with his sister, cuddling nonstop. It’s the absolute BEST I’ve seen him in the evening, probably ever, since our diabetes journey began! I know that he’s more than his number, so I guess despite the 600+HI reading I can still be hopeful that maybe tomorrow will bring change to his actual number. We shall see.. For now, I just love having my boy back :bighug: he’s gained a bit more weight back and is handling his injections like a CHAMP.
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He’s keeping his eye on the household tonight; just thought I’d share. Eye on the prize. :cat:
 

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Deb & Wink said:
The problem with Nico seems to be the duration of the Prozinc is so very, very short. Although most cats get 10-14 hours of duration, I don't think that Nico is getting more than about 8 hours duration on his good days. So that gives you the near constant highs at the pre-shot tests. The Prozinc is acting more like an NPH insulin for Nico, with the short duration. NPH insulins often only have a 6-8 hour duration in cats. Kind of what you are seeing with Nico while you are using the Prozinc.


I'll be home for Turkey Day! As long as you keep posting so we know what is going on, I have my alerts set to let me know when there is a new response to a thread where I have commented before. Might not get around to signing on until later in the evenings, but I do read those posts where I have an alert to follow up on.

p.s. Thanks for the new thread. My reply here will cause me to continue getting those alerts, but for this new thread.
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Thank you for all of this! I will be around as well (we here in Washington are under strict lockdown orders, so no Thanksgiving Day gatherings sadly). We will keep doing what we are doing, and I will keep updating. Fingers crossed for some more decent (nonblack) numbers in the coming days.
 
JanetNJ said:
Excellent.
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He just read 439 at +5. Is it normal for a cat’s body to have this type of jump over the past two cycles, since beginning his new dose of 3.5u? Or is it possible I furshotted him this morning without being aware of it? I always feel around afterward for wetness, but there wasn’t any after his am injection (nor last night). I’m totally second-guessing myself and my shot-giving abilities (or disabilities) now..
 
Emily Tuomey said:
He just read 439 at +5. Is it normal for a cat’s body to have this type of jump over the past two cycles, since beginning his new dose of 3.5u? Or is it possible I furshotted him this morning without being aware of it? I always feel around afterward for wetness, but there wasn’t any after his am injection (nor last night). I’m totally second-guessing myself and my shot-giving abilities (or disabilities) now..
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If you didn't feel any wetness then it probably went in fine. You just have a tricky case here.
 
Emily Tuomey said:
even now he’s bounding through the house, getting into shenanigans with his sister, cuddling nonstop. It’s the absolute BEST I’ve seen him in the evening, probably ever, since our diabetes journey began!
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As you said yourself, he's more than just a number. How our cat's are acting is also important! A cat that feels crummy isn't going to play and interact the same as a cat that's feeling good, so despite the lousy numbers, take joy in the fact that he's feeling better overall!

The numbers will eventually come down.
 
Emily, your SS says you are using the SLGS dosing method. But we have been making recommendations based on the MPM (Modifed Prozinc Mthod). I think that is the best dosing method for you to use with Nico.

If you agree, please change your SS at the very top, to say MPM instead of SLGS.

As Chris said, how a cat feels and acts is also a big part of the picture on how they are doing. The 5 P's (purring, preening, playing, peeing, pooping) plus the appetite are a simple visual assessment quick check you can make for Nico.

Him playing sounds fantastic!
 
Chris & China (GA) said:
Those are actually pretty much the exact same numbers. Remember, all meters are allowed a 20% variance so even if you test the exact same drop of blood at the exact same time you could get two different numbers. As long as they are within 20% high or low, they're considered valid.
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I guess I just wouldn’t have expected a (relatively similar) lower number at his PMPS just given his “usual” PMPS of 600+ or HI, that’s all. I just I didn’t really explain that very well...
 
JanetNJ said:
Hooray for something other than black in the pmps!!!!
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Was 600+ this morning, AMPS. Oh well. But, I had a thought: what happens on a ReliOn Prime if there is too much blood on the strip? Does it give an error code, or maybe it just reads as 600+HI?? This morning it seemed like perhaps the strip was overfilled, but did not give an error code so I figured it was okay. But, maybe not! I’ll ask the rest of the group too..
 
Emily Tuomey said:
Was 600+ this morning, AMPS. Oh well. But, I had a thought: what happens on a ReliOn Prime if there is too much blood on the strip? Does it give an error code, or maybe it just reads as 600+HI?? This morning it seemed like perhaps the strip was overfilled, but did not give an error code so I figured it was okay. But, maybe not! I’ll ask the rest of the group too..
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You could always do a second test if you aren't sure of the accuracy.
 
jt and trouble (GA) said:
I havent looked at a meter since 2010. I'm sure the code is no longer the same. Also I has some weird brand monitor. Keep asking someone will know. ;):coffee:
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Thank you. Here’s another, probably ignorant, question. When you get lab results back for glucose (also interested in the answer for Fructosamine) what is the measurement system they are using? Is it similar to what numbers I’m getting at home with the ReliOn Prime? Or is it totally different? Just curious what his lab results actually mean in relation to his numbers now. Does that make sense?
 
I copied and saved this from a past thread, it might help answer part of your question:

"Fructosamine is an average of a couple of weeks. Not affected by stress.

It measures one of the proteins in the blood, measuring mean (average) glucose concentration.

Some resources say the average is about 2 weeks, other sources says the average is 3-4 weeks.

Remember, if you take 30 and 100, the average is 65.

If you take 200 and 100 and 50 the average is 116.

If you take 300 and 100 and 50 and the average is 150.

If you take 500 and 100, the average is 300.

So those averages can make things look better than they really are, which is why blood glucose testing is also key to determining what is going on. BG testing tells you more in real time what is happening with your cat. It helps with catching those daily swings in the BG levels.

Basically, the Fructosamine is equivalent to the A1C test in human diabetes, which averages a humans glycemic control over 2-3 months. Gives an idea of how the diabetes is being controlled over a period of time. But no human diabetic would ever rely on an A1C average to help them know how much daily insulin to give themselves.

Same thing for cats. No way to know how much insulin a cat needs, based on the Fructosamine. Nor does the fructosamine test alone tell a vet a cat is diabetic. Vets need to take other signs and symptoms into consideration, to diagnosis a feline diabetic and to see how well the diabetes is being controlled and regulated.

Personally, I think the fructosamine test is not of much use if someone is home testing. But vets run it because so many of their clients do NOT home test their cat's BG levels and never will.

Think of it as another tool in the toolbox, and use at your discretion."


(ETA: I agree, other than using a fructosamine test as part of the initial diagnosis, it's not much use otherwise if someone is home testing.)
 
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Emily Tuomey said:
Thank you. Here’s another, probably ignorant, question. When you get lab results back for glucose (also interested in the answer for Fructosamine) what is the measurement system they are using? Is it similar to what numbers I’m getting at home with the ReliOn Prime? Or is it totally different? Just curious what his lab results actually mean in relation to his numbers now. Does that make sense?
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They will be using values closer to a pet meter (alphatrak) So don't be surprised if they are higher. Shelly explai ed the fructosamine test. Fructosamine tests are good for diagnosis, but otherwise not really helpful.
 
Emily Tuomey said:
What are the ranges for an Alphatrak? I’m not familiar, because I decided not to purchase one after my vet recommended it, haha.
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The alpha and human meters are similar at lower values (for example a 50 on a human meter might be a 70 on a pet meter) but further apart on higher numbers. So a 300 on a human meter could be a 400 on a pet meter. I use an Alphatrak just because I like having the same readings as my vet.
 
Could not find any information in the Relion Prime user manual about an error code if there is too much blood on the test strip.
The manual only showed a picture of a test strip, with blood smeared all over the area where the black strip is, that sips up the blood.
There is an error code if there is not enough blood on the test strip. E13

To prevent too much blood from smearing that black strip, you have to gently touch the end of the test strip to the drop of blood, but let the test strip itself "sip up" the blood. It does this using capillary action. Think of it as touching the very corner of a paper towel to a drop of water, and that gives you an idea of the "sipping" or capillary action the test strip is doing for you.

If you put more of the paper towel down on the drop of water, it "smears" the water instead of sipping it gently up.
Go ahead and try it for yourself!

If you look closely at the test strip, on the end where the black strip is, you will notice there are actually 2 layers of plastic, with a truly tiny bit of space between. This is where the blood is drawn into, by that capillary action.

Pictures are always worth a thousand words. I haven't used any test strips since Wink's passing, so I can't take pictures for you.

But if you could take a picture of your test strip, and post it here, we could see if there is too much blood on the test strip and let you know. It never hurts to verify something, in my opinion.

Do you think you could do that Emily? Take a picture and post it here?
 
Deb & Wink said:
Do you think you could do that Emily? Take a picture and post it here?
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I can, but I’m pretty sure I’m usually just fine. I think, in all honesty, that I just don’t like that I don’t have anything to explain his numbers— in general not having a “why” for something isn’t a feeling I enjoy, hence my insatiable thirst for knowledge. Patience isn’t my strong suit either, well it is, but only in the short term haha. Tonight Nico was 500 at his PMPS. I plan on leaving him be until his AMPS, as we need to do a curve for his vet either tomorrow or Friday and I don’t wanna overdo it. Although, we don’t have an Alphatrak so I’m not sure how his vet is planning on converting that but I guess we will find out... if anyone has any words of wisdom on that, I’d certainly welcome them!!
 
Emily Tuomey said:
I can, but I’m pretty sure I’m usually just fine. I think, in all honesty, that I just don’t like that I don’t have anything to explain his numbers— in general not having a “why” for something isn’t a feeling I enjoy, hence my insatiable thirst for knowledge. Patience isn’t my strong suit either, well it is, but only in the short term haha. Tonight Nico was 500 at his PMPS. I plan on leaving him be until his AMPS, as we need to do a curve for his vet either tomorrow or Friday and I don’t wanna overdo it. Although, we don’t have an Alphatrak so I’m not sure how his vet is planning on converting that but I guess we will find out... if anyone has any words of wisdom on that, I’d certainly welcome them!!
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When I get a number on the boarder of another color I always take a second reading hoping the second one will be one number lower. Just so it's the other color Lol
 
Not great numbers today (he must know we have to send these over to his vet, or something..).

AMPS: 544
+3: 537
+6: 342
(+9 & PMPS remain, but honestly I’m not holding my breath they’ll be anything but red and/or black :()
 
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Emily Tuomey said:
Personal preference, but I will change it. Sorry.

His +9 was 527.
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I just could not see what the number was at all. Had to look at the SS. No apologies needed. Aging eyes can't see as well.

At least 500's are lower than the HI, which means the BG level is down a bit. Still too high though.

I'd recommend increasing the dose again. You've given the 3.5U dose enough time now. I think you should increase by another 0.5U.

Let's see if @JanetNJ concurs.
 
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