Linus today 2/11 +am 2/12 update

[Dragonfly229]

I took the advice and backed Linus off to 1 unit. His numbers today were high, but not extreme, and stable. I didn't do a full curve, just a check midday to see where he was. In the past, he has stayed high until +10 and then dropped, so I may have missed a drop if there was one.

2/10, pps 439 (gave 2 units as I was starting to lower dosage)
2/11, pas 376 (1 unit)
2/11, +7.5 363
2/11, pps (+13) 378 (1 unit)

So is this what I'm looking for? Higher but more stable numbers, and then bringing them down across the board a little at a time? I'm watching his urine output and general attitude, I don't have any ketone test strips yet. Do I need to be concerned at these numbers?

*update from this morning, at 0630 (+9) he was 431. I fed him 1/2 can of Cowboy Cookout and rechecked pre test at 0830, he had dropped to 379. So I'm thinking a couple of things could have happened, he does sleep all night, so lack of activity could be driving the high morning numbers, or I'm still getting the insulin finally working at +10 or so. I'll check today to see if/when it drops.

 

[Lisa & Jax]

Re: Linus today 2/11

Hi Sue,

It looks like you did accomplish a few things on the lower dose...Linus's numbers were not erratic and he did not have a long duration which would indicate a dose too high.
Perhaps 1u is too low but the mantra at FDMB is start low and go slow so you don't miss what could be the right dose for him. :smile: I'm sure others will come along and advise you as I am fairly new around these parts but I'm glad to see that he had a nice cycle without going red.

 

[Teresa and Poopy]

Re: Linus today 2/11

A great step in the right direction! You'll be amazed at how much .1u or .2u change in dosing can make in numbers as you start to increase to lower his numbers. Usually, we start on a low dose, get numbers, then slowly increase (staying with the increase for at least a few cycles, if not more than a few, and getting numbers). Some cats "settle" into a dose quickly, and some can take a while. Getting numbers as you go helps build the picture of how Linus reacts with the different doses. Will he settle quickly or slowly? Only Linus can answer that. :smile:

I'm still very much learning this sugar dance, and there are others much more experienced. What I am seeing in Poopy, it takes him a bit to settle. I tend to want to sprint (to hurry things along) and he's much more laid back (takes his time). I've also found sticking with one food has helped (takes away one more variable - one more dance move) in Poopy's case. ECID though.

Ideally, we'd love to see our kitties have a nice yellow PS (my goal is 200-250), with a nice gentle curve down into the lower 100s/higher double digits at nadir, and a nice slow increase back up to the lower 200s at PS again. Picture a nice smile for the curve. The closer we can get to keeping the numbers safe (above hypo) but under 280 the better.

Finding that perfect smile dose isn't going to happen overnight. Just like the diabetes, it creeps up on you - so you have to watch the numbers to know when you're close. You don't have to test all the time, but I would do a minimum of three times a day (both PSs and one around what you think may be nadir or when you can), with the occasional curve (testing every 2-3 hours, like on a day off every week.

Ketones testing. After reading of so many folks dealing with DKA, I find it helpful for my sanity to test Poopy when I can. (He doesn't like an audience when he pees so I have to be in the right place at the right time to get a sample.) I keep the bottle of strips near the litter box. If I happen to be close when he starts to pee, I can quickly grab a test stick, dip it into the pee puddle before it's all absorbed into the litter, and can do the test. Many buy the ketone test only strips - and that's fine. I bought the type that tests both ketones and glucose in urine. One dip for me gives me both readings. There is no requirement to test the urine for glucose as doing BGs is in real time (urine glucose is an after the fact thing and not useful for dosing). I test Poopy since he does hit higher than 280 numbers and therefor still has glucose in his urine. I'd rather be safe than ignorant if he decides to start throwing ketones. Is it likely? No. But it does give me piece of mind of one less thing to worry about. To paraphrase Lauren Becall, "Because he's worth it!"

 

[Sue and Oliver (GA)]

Re: Linus today 2/11

I'd say it is a positive step toward what you want. The pmps is not red - that's good. (we are assuming he went down and bounced back up on the previous curves with the high pmps) As Teresa said, eventually, we want a smile curve, dipping down at nadir. Yours is flat, but it's early in the dance.

As Teresa said, some cats need to settle into a dose. We need to be cautious with Linus as you have reduced your dose. If you can get a nadir today, we can see if he is moving lower during the cycle. If he is staying flat, we might raise it a little tonight, to be on the safe side.

And yes, work to get a ketone test. We were only successful when we put Oliver in a room with a clean litter box filled with aquarium gravel. (he was shy)