Lewie running high... giving 0.5 "fat" with u100 syringe

Kathy4Lewie

Kathy4Lewie

Member Since 2018
I've started the 3rd cycle of a "Fat" 0.5u and I'm hoping Lewie will start to budge today. He's been running high lately and not feeling that great because of it. (A full 0.6u was too much and I had to stall.)
This is a picture of what I'm calling a "Fat" dose of 0.5u using the u100 syringe. It's a smidge more that the 0.5u.
0.5 Fat - using u100 syringe.jpg
 
Are you having trouble with air bubbles? If so, you can pull the plunger back a little and flick the syringe to try to get the air bubbles to congregate at the top (needle end), then push the bubbles and excess insulin back out.

If he's at a high PMPS tonight, I'm inclined to go back to 0.6u. We need to get him out of theses higher numbers, especially since he's not feeling well in that range. Hopefully others will chime in with their opinions. @Kris & Teasel @Djamila @Rachel opinions??

BTW, Your pic looks like a fat 0.4 to me but we all see things a bit differently. As long as you're consistent in how you're doing it, that's what really matters. If that's your fat 0.5, then measure your 0.6u accordingly (should be the 1.5 mark on the u-100 syringe).
 
Regarding the air bubbles, I always seem to have 1 big one so I depress the plunger several times until it's a small bubble. I can't seem to thump it out but I will try again tonight to see if my luck has changed. The picture is a little bit more than my standard 0.5u, but I guess it's not enough to make a difference.
 
I agree. I think it's time to go back up and try to get some lower number. It's possible that the low number you got on 0.6 last time was a fluke...it just seems that even at a fat 0.5 he's stuck in those higher numbers and that's worrisome.
 
Yes, you could try 0.6 u because he's been high for the last 4 days. If he pops a dark green at one PS and stalling up to one hour doesn't get him high enough you can skip or try the "barely a drop" technique: push the plunger in firmly, insert the needle into the insulin vial, relax your pressure on the plunger and withdraw the needle. Believe it or not, that can draw a "drop" of insulin into the needle. You then inject normally, taking care to maintain firm pressure on the plunger once the needle is under his skin AND as you draw it out. The drop should be deposited under his skin. That's the smallest possible microdose. You could also try 0.1 u on a dark green PS that's in the high 90s.
 
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Kathy4Lewie said:
Regarding the air bubbles, I always seem to have 1 big one so I depress the plunger several times until it's a small bubble. I can't seem to thump .
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I used to always get one big air bubble! I was taught to draw slowly to avoid that, but one day in frustration, I pulled the plunger quickly instead ... and no air bubble! I don’t understand it, but I think it has something to do with the viscosity of the insulin? Maybe that will work for you as well.
 
Thank you everyone for your ideas and techniques! :bighug: I'm anxious to get Lewie back on track. I thought he would eventually come down, but his body said no.
I'll give him more insulin tonight... pulling quickly to avoid air bubbles!
As a backup plan, I'm so glad to hear about the 1 drop method or the 0.1u instead of skipping! That will be a relief.
Thanks! Stay tuned. :-)
 
Today's cycle was looking really good and I GOOFED... again! I fed him dinner AND I gave him his pills (in pill pocket) at +9. Drats. :( I did this same goof just a few days ago. Old habits die hard I guess (+9 was his dinnertime for 15 years). My plan now for +9 is just a small snack and then dinner and pills at +12. And today was looking so good. I'm sorry Lewie. :blackeye:
 
Question: It's 3 more hours until Lewie's shot. Is it ok to give him a snack now with his BG is so high?
Or is it better NOT to feed him and wait?
 
Kathy4Lewie said:
Question: It's 3 more hours until Lewie's shot. Is it ok to give him a snack now with his BG is so high?
Or is it better NOT to feed him and wait?
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It can depend on how carb and food sensitive he is. Some people find that giving food in the second half of the cycle (ie., after +6) can shorten the duration of the insulin in that cycle. It's like almost all things FD - you need to experiment to see how he reacts.
 
Kris & Teasel said:
It can depend on how carb and food sensitive he is. Some people find that giving food in the second half of the cycle (ie., after +6) can shorten the duration of the insulin in that cycle. It's like almost all things FD - you need to experiment to see how he reacts.
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I think he's very carb sensitive so I'd better make him wait. I've been leaving food out all night because earlier in his journey it seemed having food out helped him stay more level, but I don't know if he eats during the night now... I have other cats so it's difficult to tell.
I won't purposely feed when he is high AND we are in the second half of the cycle.
Thank you.
 
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Lewie's had 4 cycles at 0.6u and he's not really budging much so I'm wondering if it's time for a dose increase to a "fat" 0.6u?
He had 1 good cycle and I messed it up by feeding him a full meal in the 2nd half of a cycle. There's a chance he's still messed up from that perhaps.
Thoughts?
:bookworm:
 
That was the night he hit the black right? I don't tend to think that would mess him up for so long, but ECID really. If you're worried about that why not wait one more day and then change to the fat 0.6? I do think he needs an increase...I'm hesitant to suggest it since he's dropped before, but I'm really starting to think that was a fluke!
 
Rachel said:
That was the night he hit the black right? I don't tend to think that would mess him up for so long, but ECID really. If you're worried about that why not wait one more day and then change to the fat 0.6? I do think he needs an increase...I'm hesitant to suggest it since he's dropped before, but I'm really starting to think that was a fluke!
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Hi Rachel, I have a couple of questions so that I don't misinterpret your message. What does ECID mean? Also, when you said you're "really starting to think that was a fluke" do you mean the drop to 0.5u?
:cat:
 
Kathy4Lewie said:
Hi Rachel, I have a couple of questions so that I don't misinterpret your message. What does ECID mean? Also, when you said you're "really starting to think that was a fluke" do you mean the drop to 0.5u?
:cat:
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ECID = "every cat is different". Rachel was referring to the drop to dark green at PMPS several days ago. You haven't seen that since, hence possibly that was a fluke.
 
I need some help.
Lewie's body isn't responding to the fat 0.6u. His +8.5 BG = 500. So, obviously something's going on and it must not be good. It's 3 hours until shot time so that means he's going to go super high.
I feel like I need to shoot earlier.... should I shoot at +10? +11? or wait until +12 and give a higher dose?
Please help me think outside the box and come up with an idea to get Lewie out of the blacks.
Thank you in advance.
:(
 
Kathy4Lewie said:
I need some help.
Lewie's body isn't responding to the fat 0.6u. His +8.5 BG = 500. So, obviously something's going on and it must not be good. It's 3 hours until shot time so that means he's going to go super high.
I feel like I need to shoot earlier.... should I shoot at +10? +11? or wait until +12 and give a higher dose?
Please help me think outside the box and come up with an idea to get Lewie out of the blacks.
Thank you in advance.
:(
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Deep breaths! Try not to worry too much about one number. If you look over his SS the past 2+ weeks, he's running high on the 0.5 u to 0.6 u dose. That dark green PS doesn't fit the overall pattern. He probably needs to go up to 0.8 u before he gets too deep into glucose toxicity from being high for too long. I'd bump him up from the fat 0.6 u to 0.8 u in one jump. Get a +2 after that increase. Your goal right now is to shift his nadir down to the high dark greens or very low blues. Don't worry about the PSs if they're high. Ask for help here if he starts giving you yellow PSs.

Lewie has a variety of health concerns that might be affecting his response to insulin. He's also a little dramatic in his response so that can frighten you. You might have to bite the bullet once in a while and give a full dose on a yellow PS instead of reducing the dose. I'd avoid changing dose times because that will drive you crazy. Also - try not to adjust the dose even by a fat or skinny unless absolutely necessary. That can increase the erratic numbers in volatile kitties. Steady as she goes for these guys ...
 
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It's going to be okay! Kris has given you excellent advice above that I agree 100% with.

I know it's hard to watch our kitties be in higher numbers, but remember that this is a marathon, not a sprint. Lewie didn't become diabetic overnight so it's going to take some time to get him back down, but I believe it can and will be done. We've seen this so much. Kitties get in higher numbers, then they get stuck there due to some glucose toxicity. By the way, that is NOT as scary as it sounds...it basically means Lewie has been in high numbers for a bit and he kind of got used to them so his body is just staying there. It sounds scary because of the toxicity thing, but it's not nearly as bad as it sounds. Kitties going through this usually need fairly fast increases and then one day BAM...they suddenly head down the dosing scale...quickly usually! No one ever believes me when I tell them this (so it won't hurt my feelings if you don't!) but I can promise you it's true. I'm going to start keeping a log of these guys so I can refer you to their SS for some encouragement. :)

Don't give up Kathy! We'll get Lewie there. You're doing a FABULOUS job and we're here to help, advise, be venting soundboards, or whatever you need! :bighug::bighug:
 
Thank you both Kris and Rachel. Yeah, it sure is scary. It it is comforting to know that you both have seen this a lot with other kitties and that there is hope. It's also scary to jump 0.2 units in 1 swoop but he certainly needs help! Maybe it's like a loving slap to wake up his body. lol
One thing I've been thinking about is that at the beginning I gave his shot at 8am/8pm. Then with all the skips and low numbers, we got into the midnight shots. Now I'm at 9am/9pm because that would be a good vet appointment time, but I think I need to work my way back to 8am/8pm. He wakes up at 5am but I don't. :eek:
 
Kathy4Lewie said:
Thank you both Kris and Rachel. Yeah, it sure is scary. It it is comforting to know that you both have seen this a lot with other kitties and that there is hope. It's also scary to jump 0.2 units in 1 swoop but he certainly needs help! Maybe it's like a loving slap to wake up his body. lol
One thing I've been thinking about is that at the beginning I gave his shot at 8am/8pm. Then with all the skips and low numbers, we got into the midnight shots. Now I'm at 9am/9pm because that would be a good vet appointment time, but I think I need to work my way back to 8am/8pm. He wakes up at 5am but I don't. :eek:
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Whatever schedule works best for you most of the time! :)
 
Kris & Teasel said:
Whatever schedule works best for you most of the time! :)
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I'll be glad when I get there and can determine my own shot schedule! :joyful:

Here's an article I'm interested in, but I don't understand it! What do you make of this sentence and how it relates to our kitties? It has been well established that the natural diurnal pattern of glucose tolerance is as follows: highest tolerance in the morning, with a gradual decrease into the evening, and lowest tolerance during mid-sleep.
from: https://ndnr.com/mindbody/glucose-insulin-dynamics-the-powerful-influence-circadian-rhythms/
Since all my kitties wake up at 5am and mill about until I feed them 3 to 4 hours later, I'm wondering when the optimal shot time would be.
:cat:
 
I agree with Kris and Rachel on the increase.

I also have this vague sense that the higher numbers started at around the same time you switched to U-100 syringes. I wonder if perhaps you were giving a little more than you thought with the u-40s and are shooting a little "light" on the dose with the u-100s. As sensitive as Lewie can be, maybe that delta, albeit small, might have made a difference. And now that he's used to higher numbers, as others said, he might be sticking there. Dunno, it's just a random thought I wanted to toss out.

Also, is Lewie showing any signs of an infection? Dental and urinary tract infections (UTIs) are notorious for causing higher BG values. Diabetic cats are prone to urinary tract infections so it wouldn't hurt to tune in to his litterbox habits or run a sample in to the vet.
 
Lewie is at 254 this morning so he responded quickly to the 0.8 dose. I hope 0.8 isn't too much this morning.
Thoughts?
:bookworm:
 
Kris, I remembered you said
You might have to bite the bullet once in a while and give a full dose on a yellow PS instead of reducing the dose.
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so I bit the bullet and gave 0.8u. I'll check at +2 and more this afternoon.
:cat:
 
JL and Chip said:
I agree with Kris and Rachel on the increase.

I also have this vague sense that the higher numbers started at around the same time you switched to U-100 syringes. I wonder if perhaps you were giving a little more than you thought with the u-40s and are shooting a little "light" on the dose with the u-100s. As sensitive as Lewie can be, maybe that delta, albeit small, might have made a difference. And now that he's used to higher numbers, as others said, he might be sticking there. Dunno, it's just a random thought I wanted to toss out.
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This is a very interesting thought. It looks like I started the U-100 syringed on 10/06. I also think I went too low giving 0.5u and stayed at that dose too long.

Also, is Lewie showing any signs of an infection? Dental and urinary tract infections (UTIs) are notorious for causing higher BG values. Diabetic cats are prone to urinary tract infections so it wouldn't hurt to tune in to his litterbox habits or run a sample in to the vet.
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I've been worried about UTI because with Lewie's back and leg issues, he sometimes sits a little in his pee and I get a paper towel and dry him off when I see that he's done that. My vet says taking an external sample won't be accurate because of the external bacteria, but doing a cystocentesis is extremely stressful for Lewie because of his back and heartworm issue. He can't be laid on his back... he starts coughing. I haven't seen him going to the little box a million times nor have I seen any blood in his pee so I think we're ok.
 
I'm excited to see where Lewie goes today! What a fast response to the increase. Be sure to keep an eye on things today so you can intervene if needed and also so you can see what happens!

I don't know that sitting in the pee would cause a UTI (but poor Lewie! And poor you...I bet neither of you enjoys the cleaning that happens after that). A cystocentesis is the absolute best way to get the urine sample, yes. Though my kitties are laid on their side for that, not their back (they did it right in the room with me once which was nice...I could see that it really didn't affect her at all). However, that being said...I'm not sure I agree that a free catch sample would be bad. I had one of mine tested with free catch both in AND out of house. The in house sample saw no bacteria at all, and the out of house portion saw SOME bacteria but not much. And the vet and I agreed that probably was just from whatever external bacteria it may have picked up. So we were able to determine she didn't have a UTI using that sample. Yes, cysto is best and if you were pretty certain he had a UTI, I'd recommend it whole heartedly since you can get the best sample from that and then you can do a culture and sensitivity for the best treatment. But I'm not sure it's 100% necessary if you just want to check.
 
Rachel said:
Though my kitties are laid on their side for that, not their back
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Oh, I wish they would do it on his side. My vet has a padded "frame" (for lack of a better term) that keeps the kitty on their back... he then uses ultrasound to guide the needle.

Question: Has anybody ever used a liquid water free shampoo for pets? When we were at the emergency vet in January, they used a spray bottle with a liquid that has Lanolin. I've been thinking I should use this to clean up Lewie from time-to-time. Looking for recommendations if you have used such a product. Thanks!
:cat:
 
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Today was out of the blacks THANKGOODNESS, but that's about it. We ended up at a red at PMPS= 419. I'm thankful it wasn't black, but I was hoping for a high yellow. Maybe his body will catch up tomorrow. He's feeling ok. My brother came over today and installed a cat door for me and Lewie was his right-hand man. :cat: (If only my brother liked cats!)
 
Stay with 0.8 u for today and we can reassess tomorrow AM.

Re cat shampoo: I can't help you there but I know you can buy "kitty wet wipes" at pet stores. They're safe to use as a quick cleanup.
 
Yep, I've used the pet wipes! I'm not saying my cats were thrilled, but it made life MUCH easier for me...and since Lewie is more used to it, he'll probably handle it better.
 
Rachel said:
Yep, I've used the pet wipes! I'm not saying my cats were thrilled, but it made life MUCH easier for me...and since Lewie is more used to it, he'll probably handle it better.
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Glad to hear the wipes really work. Lucky for me, Lewie is very tolerant of everything I do so I think getting wipes will be a good thing. Sometimes when I pick him up to carry him, I have a paper towel in my hand and "just happen" to apply it so that I dry up any dampness. lol
 
Lewie's AMPS=502 so I guess it's time for a dose increase. Last night I shot 25 minutes early because I'm adjusting his schedule so I can shoot earlier. I didn't take any readings last night, but my guess is he didn't go too low... I don't think his 502 was a bounce for shooting early... If you think otherwise, please let me know. Why I don't think it was a bounce is because it seems like he's needing more insulin these days. I shot 20 minutes early this morning, too, because I have to leave the house tomorrow at 8am so I'm bumping his schedule up.
Please let me know your thoughts? Thanks.
:bookworm:
 
Kathy4Lewie said:
Lewie's AMPS=502 so I guess it's time for a dose increase. Last night I shot 25 minutes early because I'm adjusting his schedule so I can shoot earlier. I didn't take any readings last night, but my guess is he didn't go too low... I don't think his 502 was a bounce for shooting early... If you think otherwise, please let me know. Why I don't think it was a bounce is because it seems like he's needing more insulin these days. I shot 20 minutes early this morning, too, because I have to leave the house tomorrow at 8am so I'm bumping his schedule up.
Please let me know your thoughts? Thanks.
:bookworm:
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He's tricky but it seems he needs more insulin. I suggest 0.8 u again tonight and then a bump to 1.0 u tomorrow AM. Continue your small schedule changes until you get where you want to be and feed him normally. Try not to focus on a complex interplay of BG, dose timing, meal timing because it'll drive you nuts, especially with a kitty who's volatile all on his own. :)
 
Kris & Teasel said:
He's tricky but it seems he needs more insulin. I suggest 0.8 u again tonight and then a bump to 1.0 u tomorrow AM. Continue your small schedule changes until you get where you want to be and feed him normally. Try not to focus on a complex interplay of BG, dose timing, meal timing because it'll drive you nuts, especially with a kitty who's volatile all on his own. :)
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Tricky boy, huh? So dosing isn't always this difficult? Oh, well, That's Lewie's body. :cat:
As a learning moment for me, are we waiting to do a dose increase because his numbers are all over the place at 0.8, or is it because I'm pushing his schedule forward? Thanks.
:bookworm:
 
Kathy4Lewie said:
Tricky boy, huh? So dosing isn't always this difficult? Oh, well, That's Lewie's body. :cat:
As a learning moment for me, are we waiting to do a dose increase because his numbers are all over the place at 0.8, or is it because I'm pushing his schedule forward? Thanks.
:bookworm:
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His numbers are high enough to warrant an increase. He's tricky because he's prone to a lot of ups and downs even in higher numbers - red, pink, black, yellow, rinse and repeat. It takes more effort to see through these variations to asses the effect of a dose.
 
Kris & Teasel said:
His numbers are high enough to warrant an increase. He's tricky because he's prone to a lot of ups and downs even in higher numbers - red, pink, black, yellow, rinse and repeat. It takes more effort to see through these variations to asses the effect of a dose.
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I had hoped for a better day.... Black - Red - Black today. I'm really surprised we didn't do better.
:(
 
Today is a tad better... Red... Pink... Red.
Tonight is his 4th cycle at 1u. If he is red or black in the morning, do you think it's time for an increase?
:bookworm:
 
I think you could do a increase to 1.2. Looks like your increase brought him down some, so hopefully another one will bring him down a tad more into some nice yellows!
 
Thank you everyone for the positive thoughts and encouragement! :bighug:
Lewie's AMPS=HIGH :( With our meter that's above 600.
I guess we need to go to the vet. His appointment isn't until mid November, but maybe the bottle of insulin has gone bad... or Lewie isn't doing well.
 
p.s. I did give the 1.2u this morning so thank you so much for your early morning posts... it was great to wake up to direction of what to do from all of you. Lewie has a team rooting for him. :cat:
 
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