Mauer

[SashaV]

Link to previous thread https://felinediabetes.com/FDMB/threads/mauer-ss.233393/

@Deb & Wink So I made a decision on my own to raise her to 3.25U.
Its 8.1 on the syringe I gaver her 8 straight, just to explain the skinny dose.
I'll watch her closely since this is where we went too low the last time.
I hope you agree with my thoughts

Tuesday we're going to the vet to find out why she's limping on her front leg.

Hope you're well and safe, Deb

 

[Deb & Wink]

Hey, making your own dosing decisions is fine. It's where we want people to be, with enough information to make informed decisions like raising and lowering the dose per the protocols.

Why the reduction to 3F (fat dose) for the PM cycle? Her BG was plenty high to give the full 3.25U dose.

Limping is not good. Hope she only sprained it, jumping too far. Paws crossed for a good vet visit on Tuesday.

p.s. I'm fine. Very busy with yard work. My cat thinks I've abandoned her, and wants to rub herself all over me when I come inside for a late afternoon break.

 

[SashaV]

Whats the difference between a fat 3U and a skinny 3.25U?
I got confused about that and now I can't remember what the syringe said. But if it where a reduction is was a drop a the most.

It isn't a sprain, she's been walking funny for the past year. Some nights limping, next day almost nothing, on soft surfaces like couch and bed the walks normal, when she's on a leash in the garden absolutely nothing. Every time I think it's seriously wrong, she stops. My vet has checked the front legs and found nothing, now I want an x-ray.

Aaaaaw your cat misses you! Is she only indoors?

 

[Deb & Wink]

Whats the difference between a fat 3U and a skinny 3.25U?

None. They are the same. It's simply how you record the dose on the SS.

A fat 3.25U on the other hand, would be more than the fat 3U dose.

Diabetic neuropathy? For the walking funny?
Does the walking funny only happen after you have walked Mauer on the leash? Thinking pinched nerve or something like that.

Aaaaaw your cat misses you! Is she only indoors?

Oh gosh yes! We have coyotes, raccoons, opossums, fishers, mean barking dogs, other cats to pick fights with, people driving way too fast on the road out front. Much safer for her inside. Crazy neighbor that uses my driveway running over baby raccoons. Things like that make me have indoor only kitties. I have a screened porch, but the screens need repair before it would be safe for her to be out there on her own. She can watch the bird feeders, and see the chipmunks and birds come up to my back deck.

She escaped several years ago, when I was coming inside, so she could chase off another cat. Coldest windiest part of December and she was gone for 4 days. Took that long to lure her to the back deck with some treats, and then lure her inside.

She is a formal feral colony cat, so hiding was her natural instinct. I have her trained now, to come to the sound of the ziploc bags being crinkled and crumpled, and the sound of the metal spoon hitting her food dish. It would still be hard to get her to come back and let me get her inside if she escaped again. I slept on the floor, in front of the sliding door, in a down sleeping bag for all those days. With the sliding door open a foot or so, to see if she could come back inside on her own. I could see her after dark, but she would run away from me. She still is difficult to approach, even inside my home, unless it's on her terms. "Sausages? You've got sausages?!? Share please!"

 

[SashaV]

I don't believe its the diabetes, its the front leg and only the one leg not both.
But I find it interesting that the bed and couch doesn't make her limp.
When we humans feel pain, we prefer a plane hard surface..

What is fishers?
Omg she sounds like a real cat, with her own mind!
It wouldn't be safe to let her out, speciallyif she goes wild that fast. I'm afraid too and I don't have coyotes and all the other funny wild animals. In Denmark we actually have a law that says its illegal to have cats running free. Almost everyone does it, but still the law is there..

Mauer is gonna hate me. Like seriously hate me. The first thing she does when she sees the transportbox is....to poop
And pee. But pee is what it is, hut poop...
I always apologize for the smell its so disgusting. And sad that she's so scared of the box.
Sometimes I'm "lucky" she starts to poop before I get her in the box. One time she almost hit my shoes. Fingers crossed that my shoes survive and its not serious with that stupid leg.

Thank God she came home. Wasn't she very hungry? Did she loose interest for the doors after her runaway?

 

[SashaV]

I didn't know neuropathy could be in the front legs. My vet believes that's whats going on.
My vet is calling me tomorrow about some b12. I really believed she'd be high today. She hates being transported. And we got blue. Three in a row! Now I'm afraid she'll drop too much at the pm cycle. Is there ever a time when I can sleep through the night?

 

[Deb & Wink]

I didn't know neuropathy could be in the front legs. My vet believes that's whats going on.
My vet is calling me tomorrow about some b12. I really believed she'd be high today. She hates being transported. And we got blue. Three in a row! Now I'm afraid she'll drop too much at the pm cycle. Is there ever a time when I can sleep through the night?

When you get a better feel for Mauer's patterns, you can sleep through the night.

Mauer's blues are good! But did she eat ok before going to the vet?

Neuropathy can get better. Wink had it really, really bad when I fostered him. It resolved completely. The B12 you want is the methylcobalamin version, not the cyanocobalamin version. Only the Methyl B12 helps with the nerve pain and healing. It will take time to get better if that is what it is.

I helped rescue a diabetic cat once, that peed and pooped in the carrier on the way to my home. One week later, xI drove him to the airport to get him to his new family. He peed and pooped and vomited in that carrier too, but I had learned from the first incident, and transferred him to a different carrier for the flight. People checking us in at the airline cargo facility suggested I take the cat into the rest room and clean him up more. Thank goodness for puppy pee pads and plenty of extra towels and a good supply of paper towels. The cargo area on the flight must have stunk to high heaven.

A Fisher is a mammal in the weasel family, aggressive and sounds like someone screaming in the yard. Had one this summer, under the bird feeders.

No, my civie Dancer has never escaped outside again. But I'm very careful and make sure where she is before I open the sliding door. Or better yet, use my mud-room area, which has an inner door as well as the outer door so she can't escape. Storm doors get closed closed tightly, just in case the outer wooden door pops open with the wind, which can happen when there are windows open and a cross breeze.

 

[SashaV]

She ate just fine before the vet
She didn't know she was going until we were out the door.

I've told my vet about the b12 af the difference, so hopefully she thinks its a great idea!

She didn't poop or pee yesterday! Feliway did the trick.
However there wasn't feliway on the vet's floor... so she pooped
Did you see my other thread? She needs to loose weight. She's now 7.5kg. She was to thin at 5.2 in March. Ideally she's about 5.5kg. Its a massive weight gain on very short time!

Thankfully no one else is in the cargo area on a flight

I'm going to Google that Fisher, looks like something we have in DK too.

Its really a science to keep clever cats indoors when they really wants to go outside. I prefer having a room between doors to the outside, mostly because other people like guests and so forget to close the doors.

I'm going to my girlfriend's house on Saturday, its her first evening and night alone with the twins, so I'll be there during the evening to help her. Its just about shoot time so my sister is learning to take Mauers BG and give insulin.
Yesterday it hit me and my mom, I need to print some things out like the conversion chart, my mom and sister have access to Mauers SS. But God forbids if something happens to me, they need to know what dose shes on and how much insulin to draw up. My mom said she'd drop Mauer at the vet's but my vet has no idea about the syringe and converting the dose, so Mauer would most likely get an overdose of the pzi.

Just a thought. But what about getting a page on the SS with what to do in emergency like if the owner get hospitalized? Its easier to send a link thats always updated than to give half a book on paper. Specially now when everyone is at risk.

 

[Deb & Wink]

There is a spray version of the feliway. So you can spray it in the carrier, and maybe on the vet's floor next vet visit!

Yesterday it hit me and my mom, I need to print some things out like the conversion chart, my mom and sister have access to Mauers SS. But God forbids if something happens to me, they need to know what dose shes on and how much insulin to draw up. My mom said she'd drop Mauer at the vet's but my vet has no idea about the syringe and converting the dose, so Mauer would most likely get an overdose of the pzi.

Just a thought. But what about getting a page on the SS with what to do in emergency like if the owner get hospitalized? Its easier to send a link thats always updated than to give half a book on paper. Specially now when everyone is at risk.

I wrote up a text document (I used Word) or you could add a new tab to the SS, that is a Google text document instead of the spreadsheet version. Whatever works for you. Or create a separate Google document that you give your sister, mom, vet, etc access to.

I have a copy of my very detailed care instructions for my cat emailed to a friend that would take my cat in case of an emergency, a copy posted on my fridge and I'm going to send the document to another friend and to a pet boarding facility near me. The pet boarding facility will have some prior arrangement made with me before my cat is taken there in an emergency. Just in case, I'm trying to have backup plans in place.

 

[SashaV]

It was the spray version. I just don't think we thought of Mauer being on the floor

Good idea to spread it around and a backup to the backup! Just thought it'd be easier with it combined to the SS.

I found out why Mauer is fat. I fed her as if she was 10 kilograms. I made her fat

I talked to a mom and her daughter yesterday. Their cat just got the diagnosis and they worried about quality of life and how difficult it would be. So we talked on video while I tested Mauers BG, fed her and gave her insulin. They were like "is that it?!"
I recommended they came here, and showed of my wonderful SS.
Its seriously the greatest thing ever!!

 

[Deb & Wink]

So Mauer needs to lose some weight again. Slow and steady wins the race, to weight loss. Try just a teaspoon or 2 less food per day.

Let us know if that mom and daughter come and post here on the message board. It's a bit overwhelming at first, but there are a lot of helpful people here. Sometimes, too helpful and we throw too much information at someone new.

 

[SashaV]

So Mauer needs to lose some weight again. Slow and steady wins the race, to weight loss. Try just a teaspoon or 2 less food per day.

Let us know if that mom and daughter come and post here on the message board. It's a bit overwhelming at first, but there are a lot of helpful people here. Sometimes, too helpful and we throw too much information at someone new.

I've started to feed them in separate bowls, so I can see who is eating what. I've adjusted the raw food, since it's what made her fat. They still have canned food available 24/7 since it's mostly water

I know, thats exactly why I'm sticking to you. I don't need advice from every corner of the world it just makes me confused

They are in a unique position to help the cat, the mom has diabetes, and thanks to danish rules, has free access to teststrips
And then I believe the diabetes has been induced by the use of steroids. I definitely hope they join us!

 

[Deb & Wink]

I've started to feed them in separate bowls, so I can see who is eating what. I've adjusted the raw food, since it's what made her fat. They still have canned food available 24/7 since it's mostly water

Calories. How many calories are in the food makes a difference. Wet food has calories too.

Get Mauer to play more, some interactive playtime with a feather teaser or a laser light of a fleece toy on a fishing pole can be very helpful, to bump up the calories burned.

Keep your eye on those food dishes!

They are in a unique position to help the cat, the mom has diabetes, and thanks to danish rules, has free access to teststrips
And then I believe the diabetes has been induced by the use of steroids. I definitely hope they join us!

Steroid induced feline diabetes can often resolve within a couple of months, sometimes even sooner.
Diet change from a high carb food to a low carb food is the key. Since just about all the dry foods are high in carbs, they'll want to switch their cat to wet food or to raw
food.

p.s. I think Mauer is going to be ready for a dose increase this weekend.

 

[SashaV]

10% fat in their rawfood, 5% in their canned food. Mauer just eats Mivers too, so they both got 150g raw - witch is way to much based on their age and activity levels, but Mauer is a very clever cat.... she ate Mivers raw too. Miver doesn't eat up from his raw, I see now since they have their own bowls. So it's been nice and easy for Mauer.

She doesn't like to play, she doesn't move after treats, and she's so spoiled she doesn't move when I feed her...she know ill just bring the food to her.
So, I put her on a leash and we walk in the garden. Even if she don't want to, I pick her up and walk to the back of the garden and put her down this i forced exercise and I love it!

I know, I've told them to switch foods. And prepared them on the fact the cat might not be diabetic for long, and to monitor closely. Unfortunately their vet told them not to test the first three weeks. Like what the f?

I know she's ready...
Today my sister is giving the nightshot, tomorrow ill be tired and napping a lot. Depending on how late the twins go tonight ill raise her first thing tomorrow, or possibly Monday morning. I just didn't want to raise her when the sitter/sister is rather uncomfortable testing, and only doing the pmps test and shot, when a raise requires more testing.

But ill be cuddling twins today!!!!

 

[SashaV]

+2,5 up by 0.2, ill sleep until amps. Haven't been up this late since she got diagnosed.
Will most likely increase Sunday morning. I'm ready to be done with this. Just finding a steady dose and going with the flow. I have 3 weeks left on this vial, could I possibly expect that same as last time? A huge drop? Its a bit stupid I use the amount of time a vial last on getting her back up.

Infant farts is the new nuclear weapons, watch out!

 

[Deb & Wink]

Infant farts is the new nuclear weapons, watch out!

So the twins were a delight to visit were they? Smelly farts and all. The smell probably doesn't beat out the stinky poo that some cats have.

Yeah, kind of silly, crazy, funny to base the dose on the amount of time a vial of insulin lasts you.

Will most likely increase Sunday morning.

Ok, increase on Sunday AM.

So if Miver doesn't finish his food in one sitting, you'll have to pick it up and then try to feed him again later, without Mauer around. Any place in your home where you can put Miver and his food for 30 minutes or so, a couple of times a day?

I know, I've told them to switch foods. And prepared them on the fact the cat might not be diabetic for long, and to monitor closely. Unfortunately their vet told them not to test the first three weeks.

Ok, that's kind of crazy, especially since the mom is diabetic and has the test strips and a glucometer already.
Please send them some information from here, like the Prozinc Dosing Guidelines for a start.
Sticky PROZINC DOSING METHODS

 

[SashaV]

I'd prefer anything that didn't exit thru mouth or nose on humans and specially children, so cat poop is a true delight

So when I start a new vial she bumps down to the neon green, thats not healthy

I've put his food on the cattree on the highest platform where Mauer doest come. Unless I vacuum

I know, and I don't know if the cat is going to be on prozinc. I told them to avoid caninsulin if possible cause that would be a true disaster without testing.
I've already given them the link, so hopefully they'll come in here and get help.

 

[Deb & Wink]

So when I start a new vial she bumps down to the neon green, thats not healthy

I'm not seeing any neon green colors on your SS. Only the pink and yellow colors still. No blues, no tree greens, no low numbers at all.

IF Mauer does drop down to the low BG levels, down to those neon green BG levels, you know how to raise her BG levels back up with food. Easy peasy as we say.

You've got this Sasha.

 

[SashaV]

I don't feel like I've got this.
We've been at this for months now Deb.
And not gotten anywhere..

I was thinking about starting her on B12
But I can't give her pills, she gets nauseous and mad as hell, and I can't find any B12 with 3mg methyl cobalamin, except Zobaline which is ridiculous expensive and a just as high shipping rate...
What about injections from the vet? Dosage? I've read the type doesn't matter when not taken orally.

 

[SashaV]

Did you see the huge bounce she did yesterday?
I'm just making a huge ANTI-JINX here, cause she had a low amps, so hopefully we'll reach those wonderful blues, fingers crossed!!!

Gosh I'm sleeping terribly these days. Waking up all the time thinking "need to test! Slept through my alarm!!" I just never do. Then its too hot, or cold and then I wake up every morning with new mosquito bites
Mauer is lazy in her old days, its usually her job catching those flying things.
I'm literally sleeping from pmps to amps, only getting up to test and pee... and eat, totally bad habit I know

 

[Hercule's mum]

Hi Sasha, just wanted to offer some hugs
I found your thread while trowling through peoples spreadsheet to try to see if I can see patterns and understand what is going on with my kitty, which is also frustrating me to no end.... I feel your pain! But we are doing the best we can!

 

[SashaV]

Hi Sasha, just wanted to offer some hugs
I found your thread while trowling through peoples spreadsheet to try to see if I can see patterns and understand what is going on with my kitty, which is also frustrating me to no end.... I feel your pain! But we are doing the best we can!

Thank you so much!!!
We can only do our best, but its a darn unfair fight when we can't ask the cat whats going on.
But hey, you've got blues and green! And a lot of bouncing! Kinda glad to see Mauer is not the only bounce cat, its really the most frustrating thing about all this, the bouncing up and down for no apparent reason. And just as we think its going the right way, the cats throw themselves into a huge bounce.
A want a smiley that pulls his hair out, that would be a describing smiley!

 

[Hercule's mum]

I know! You rtead all the stuff and describes a perfectly logical cycle, where you feel like you know what the variables are and what needs to be done. Then you look at our SS, and I go.... someone forgot to tell the cat what they are suppose to do!
But other have managed, so will we!

 

[SashaV]

We sure will!
SHE HIT BLUE!!!!!!
And now I left home for my first corona test...

 

[Hercule's mum]

YAY! That is what they always do... Mine usually likes to approach hypos in the middle of the night...

Hope your test is negative!

 

[SashaV]

Mine too. I've never this bad as since she got diagnosed.

I'm not sure I'll get in today, the line is looooong and they're only open for another hour.

 

[SashaV]

@Deb & Wink we've got blue! And a blue pmps. I made a 911 call to my sister and asked if I was silly to not want to shoot the full 3.5U.. "yes, cause you don't know what's going to happen!" Every time I've been a chicken and gave almost nothing. Today is different. Okay, still a chicken, I did a 3.25U no skinny or fat, just the full 3.25.
I dont know if its the right call, but we'll see. I have Sheba canned food with added sugar, honey and crappy dryfood available and close by in case it all goes wrong.

I've set alarms on +4 and +6, if +4 is horrible ill stay up. 3.5 hours from now. Better sleep.

Why do she keeps going down? Nadir isn't +12?!

 

[SashaV]

+3,5 6.9, not critical, I sleep one more hour and test again

 

[Deb & Wink]

Nice blue, that 6.9 (124 mg/dL).

I was thinking about starting her on B12
But I can't give her pills, she gets nauseous and mad as hell, and I can't find any B12 with 3mg methyl cobalamin, except Zobaline which is ridiculous expensive and a just as high shipping rate...
What about injections from the vet? Dosage? I've read the type doesn't matter when not taken orally.

I've never heard of the cyanocobalimin doing anything to help with diabetic neuropathy. All the studies, both human and feline, point to methylcobalamin being the one to help with the nerve damage.

I got liquid methylcobalamin from a compounding pharmacy here in the US for Wink. That was many years ago. Is there a pharmacy/drugstore/chemist near you that compounds medications?

If you don't feel like you have gotten anywhere with the Prozinc, maybe it's time to give Levemir another chance or try Lantus (glargine). Both are really good insulins for cats. Gentler, less steep drops. Of course, Mauer will probably prove the exception, and give you a hard time on what ever insulin she is getting.

 

[SashaV]

Nice blue, that 6.9 (124 mg/dL).

I've never heard of the cyanocobalimin doing anything to help with diabetic neuropathy. All the studies, both human and feline, point to methylcobalamin being the one to help with the nerve damage.

I got liquid methylcobalamin from a compounding pharmacy here in the US for Wink. That was many years ago. Is there a pharmacy/drugstore/chemist near you that compounds medications?

If you don't feel like you have gotten anywhere with the Prozinc, maybe it's time to give Levemir another chance or try Lantus (glargine). Both are really good insulins for cats. Gentler, less steep drops. Of course, Mauer will probably prove the exception, and give you a hard time on what ever insulin she is getting.

I feel we're going somewhere as of today!
On zobalines website they say if injected the type doesn't matter.
I can't find anything in DK, we don't have methylcobalamin over 1000mcg.
But I can get b12 in various types in Germany also for injection. Unless it goes in the muscle and not subcutaneous then i won't do it. But then I don't know what dosage and how often. If I shoot her with one or the other same same

Just made a 6.7

So its not just me who thinks she's difficult?!

I'll be back in an hour

 

[Deb & Wink]

Liquid methyl-B12 can be given IM (intramuscular) or subq (subcutaneously).

It's been 7 years, and I don't remember the dose for the injectable B12. Memory is not THAT good anymore! I think it was only once a week, but don't quote me on that. It was simply too long ago.

p.s. And no, I wasn't savvy enough to note it on Wink's SS.

I did keep a separate spreadsheet, detailing his food and medication intake, but only on my computer. That says he was getting 0.25 ml of the methyl B12. But then, I don't remember the concentration of the liquid. He got the methyl B12 injections once a week, for about 4 months, or until his severe diabetic neuropathy resolved.

I think you'll need to ask your vet about this one Sasha.

 

[SashaV]

6.4

Ask my vet about what?

I'm feeling the lack of sleep now. Feeling rather stupid

What do I shoot amps? Still 3.25, or? Depending on the bg?

In answer the rest tomorrow

 

[Hercule's mum]

Morning Sasha! Looks like we both had PJ partys last night! Well done you!
You did great, with nerves of steel! and I see Mauer seem to have hold steady!

 

[SashaV]

Morning!
She's not usually this steady, so I'm excited to see her number in 10 minutes!
Think ill be napping a lot today
Where are you from? UK?

Gosh a small dose Hercules is on! Wish it was Mauer on that tiny dose

 

[SashaV]

Omg my cat is an idiot

24.8!!!!! Thats just enormously stupid.
Why can't we just stay down there?! Seriously

 

[Hercule's mum]

oh, i guess he bounced

But honestly, even for a newbie like me, I *think* this was to be expected. He hasn't seen much blue, and he did really well last night. I think it is a bounce, and it will pass, you are both moving in the right direction!

 

[SashaV]

So that was an unusual short bounce, or maybe not a bounce after all?

I'm considering levemir again Deb. Can you advise on that too?
First and foremost I'll wait and see what is going to happen since Mauer obviously cleared something...
And my usual vet i out sick, and I'd rather not do anything big without her knowledge.
And then the methylcobalamin, is there anyway to find out a dosage? I've been on Google and found nada..
The other vet in the clinic doesn't know me or Mauer, and she and I has been told anything that involves Mauers diabetes is my usual vets thing. Not to get more people involved, since I practically is running my own show with my vets approval. Therefore I'm not sure the new vet will allow me to inject Mauer with B12 on my own. In reality I don't need her approval or prescription since I can buy it freely in Germany. So either I wait on my own vet and hear her thoughts or.. dig out some research on dosage on my own and try.

I've spent a few hours today figuring out how I can shoot half units on Levemir, if that's the way I go. I found a junior pen that gives half units. Until it hit me to look in the levemir group and found I could just use the syringes I already have, and just use the two pens I have in the fridge.
Here I thought I needed a new vial of levemir, a totally different pen, new needles.. and then it turns out I have everything I need in my fridge and DB-box
Huge win!

If i look at Mauers SS its obvious the levemir had the best effect on her. Lasted longer, she was comfortable in the blues. And then we hit the wall with her not eating, but I'm quite sure it was my anxiety effecting her, and now I have primperan in my own little pharmacy-box. So in case it happens again, and it didn't after I got the things home to threat her with, I'm better prepared.

I don't know. I need some other thoughts on this
What do you honestly think? If she was your kitty?

 

[Deb & Wink]

What do you honestly think? If she was your kitty?

I'd go for one of the longer lasting insulins, like levemir or lantus to smooth out the cycles (hopefully). IF THE PROZINC WASN'T working for my cat and I'd given it a good chance to work. Two to three months at least, maybe more. It depends on your schedule too. Prozinc is a bit more forgiving with time changes (by that I mean late or early or stalled shots) than the L insulins.

I don't think you gave levemir a chance, really. Plus, you did HUGE dose changes, sometimes doubling or halving the dose.

I've never used levemir, but understand some of the basics. Lots more people in the Lantus/Basaglar/Levemir forum use lantus than levemir.
About the only thing I remember, is that levemir has a later nadir usually, around +8 to +10 I think.
I don't help out in the Lantus/Basaglar/Levemir ISG group, mainly because there are too many people asking for help with Prozinc, and too few of us to help with that. There simply isn't enough of me to cover everyone in all the forums that needs help. These days, I rarely even check Feline Health, unless someone has tagged me.

The ask your vet suggestion was in regards to the dose of methyl B12 injectable to give Mauer. It depends on the concentration of the liquid you get. So for example, I think Wink was on the 1000 milligram (could have been microgram) liquid and he got 0.25U of the methyl B12 a week. But I'm not positive on the concentration of the liquid injectable methyl B12 he got. You're asking an old lady to remember something that happened 7+ years ago, and the aging brain cells are simply not that good. Heck, I can't remember what I have for breakfast half the time.

p.s. Yes, that was a bounce to the red BG numbers for the 9/15/20 AM cycle pre-shot. Her body is not used to those lower blues, and that self protective mechanism kicks in and shoots her BG level up high. Back down to the yellows for PM pre-shot, so I think Mauer has cleared the bounce.

 

[SashaV]

I believe I've given it a shot, I've been patient and I don't think I'm seeing the results I'm supposed to see.
My schedule depends totally on Mauer, I start the process at 9:40 am and pm, test eat and shoot. I don't have work or anything else.

No I didn't give levemir a chance. I was expecting short term results on a long-lasting insulin. I only realized when she got back on caninsulin that the first days was a result of the levemir. I didn't respect the longer duration and the time between increasing and decreasing.
With the experience I have now, I'm sure it would be different.

I was afraid of that. I'm really no good at humans, and I've looked in the group and read the sticky notes and I still don't get how it works. This, you and I works like a charm! My brain can't work with different people giving advice
And I need a person who's not afraid to tell me if I'm doing something wrong.

It makes sense that the subq is a much smaller dose than the orally methylcobalamin. And stop, you ain't that old Deb! You're awesome!!!
Its amazing you still help, even when you don't have your own sugarkitty.

It was indeed a shot bounce! They usually last longer. Perhaps she's finally getting down!

 

[Deb & Wink]

There are a few people over in the lantus/levemir forum that understand levemir and could help you.
Maybe post a thread there in that ISG group and ask who has experience? So you know which people to trust when you get recommendations and suggestions on the next steps. I think Wendy&Neko is one of the people, but she is really busy as a moderator and has elderly parents she has to care for too.

The main difference in the lantus/levemir forum is that people use either the TR (tight regulation) or SLGS dosing protocols, regardless of which of the L insulins they are using. TR is closer to MPM that is used here for Prozinc. Faster dose changes, let the BG levels drop lower before doing dose reductions, increasing the dose faster when the BG numbers warrant it. But the L insulins also provide a gentler action, longer duration, less chance of hypoglycemia. There are definitely some benefits to the L insulins.

One thing for sure, you'll need to test about as often as you do with Prozinc. The folks in that ISG group are even more data driven than I am, and I can be a tough one to please on testing. You've been doing fantastic with the testing, both in the AM and PM cycles the last couple of months. When do you ever sleep?

I'm not afraid to tell you that you need to do something different or are doing something wrong. You're pretty "thick skinned" and can take the truth to help Mauer as best you can. My one major fault on this message board is I'm horrible at "sugar coating" what I say and I'm too blunt. I tend to let other people take care of the "touchy feely" part of this, I'll provide the "how to do this" information.

Yes, I am that old. Could have taken social security a couple of years ago, but I'm holding off. My body let's me know that I'm old and creaky. Not as agile and strong as I used to be, but I keep working at it to stay strong. You should see me struggling to put my socks on in the morning, since I wake up so stiff and can't bend my knees or reach down to put the socks on until I've done my stretching exercises. It's pathetic but funny too. At least now the weather is cooler and I can put my warm slippers on until I get stretched out and can move again. Getting old s**ks!

 

[SashaV]

MPM?

I'm attracted by the longer and gentle duration than this SLAM its in. I think that would make the difference to Mauer, that her baseline gets down and not fluctuate as mush as now.

I sleep when I feel its safe. Set alarms. However I look forward to testing less during the PM cycle
Like my sister said "now you're ready to have kids!"
But I'm definitely happy to be retired and not having anything else to worry about! Otherwise I don't think I could do it.

And that's exactly the thing. I have ADHD my brain can't decode the sugarcoating, I don't get the hidden agenda. I need to be told straight forward what I'm supposed to do. I'm also too blunt, but as I get older I'm more aware about it. It's so hard to navigate when people wrap their opinions in, in layers of sugarcoating, instead of just saying what they mean from the start.

Age is not everything. We have a 95 year old on my street, he walks faster than I do!
Maybe you need a heatpad under your sheet so you're warm when you get up
Gardening is hard too, you know! But a great way to keep in shape!

Mauers diabetes keeps me in mental shape too. I've always been a night owl, but with the 12 hour intervals I need to be awake so I prioritize my sleep much more, so I've never had this much structure before. Its really positive, weirdly enough. It's definitely not all bad!

You know you can get a stick to help you with the socks, right?

 

[Deb & Wink]

MPM = Modified Prozinc Method of dosing. Quicker to type out than that longer string of words.

You want Mauer's baseline to be lower? Then you have to take some chances, some risks with the BG levels being down in the blues, greens and low yellow ranges (<220 mg/dL) more. Especially the greens and blues. Most yellow BG numbers are really too high. There has only been that one time, on 8/7/20 where Mauer dipped down into the green BG ranges. You need her to get back to those green BG levels mid-cycle.

MPM has you do more frequent dose changes, only holding the dose for 3 cycles or so. Lower reduction point too, 50 mg/dL instead of 90 with the SLGS method of dosing. More support may be needed with feeding to bring Mauer's BG levels back up. You'd need a medium carb food and a high carb food to give her, not just the raw food. You don't have to start out with that 50 mg/dL reduction point. You can work you way down to it.

You know you can get a stick to help you with the socks, right?

The day I need one of those sticks to help pull on the socks will be when I skip socks all together, and only wear slippers.

p.s. It's going to be colder starting this weekend, in the 50's and 60's Fahrenheit (10-15 C) for the daytime highs. Already have the heat on low in 2 heat zones of my home, although it has not kicked in yet. I already have a heated mattress pad and love the extra warmth in the cooler months. Too hot for me in the summertime. Also, if you just wear clean socks to bed, it's not a struggle to put them on in the AM when you are stiff and not moving so well.

 

[SashaV]

I'd really like having yellow amps and pmps rather than pink. And then I'd like to see her surf the blues and green.
Taking chances is not really my thing

Do you think its worth a try?
If so, I'd like to wait until a fresh vial of pzi. That's what got her down the last time. Maybe it's me who contaminating the pzi?

Did you se her huge bounce last night?! I tested +2 and thought she'd be on her way down, but no. Then I stayed up thinking maybe it was a faulty test, and tested again 45 minutes later. And then i slept through the night

I have high carb in my hypo-kit! Also bought the ketone strips to my meter.
And I have honey. I'd like a paste with longer lasting sugar and fast acting, like cat malt but a bit juicer. Just haven't found anything like that.

Lol Then you'd have constantly cold feet!

Its that cold here too. We had 27 degrees earlier this week. I've already pulled out my heating things, to warm me up at night.
I refuse to turn on the heat until it gets colder. Until then, my Oodie is my best friend! Do you know Oodies? Best thing EVER.
Omg why hadn't I thought of that? Just keep the socks on!
I just planted my drumsticks, and they don't like the cold weather

 

[Deb & Wink]

I'd really like having yellow amps and pmps rather than pink. And then I'd like to see her surf the blues and green.
Taking chances is not really my thing

Do you think its worth a try?
If so, I'd like to wait until a fresh vial of pzi. That's what got her down the last time. Maybe it's me who contaminating the pzi?

Yes, I think the MPM (Modified Prozinc Method) is worth a try for Mauer.
Waiting until you get a new vial of Prozinc is not necessary.
It's worth increasing the dose now, for Mauer, so she gets into better BG numbers and feels better.

How do you think you are contaminating the PZI?

What was up with Mauer's 100+ point rise in BG at +2 last night? Got into some food somewhere? Any people food left out on the counter or somewhere she can get to it?

 

[SashaV]

I really don't know, I was surprised myself. After the pmps I seriously rushed to bed to get some sleep before a new PJ party.
Only canned food left out with meat and no veggies and no added sugar.

Yesterday she didn't have any food other than my sausages and ham on my pizza after the +7, I was surprised to see it drop that late.

By drawing it up, and pushing it back in?
What else could make it much less potent? Last new vial bumped her low.
So I must be doing something wrong..

 

[Deb & Wink]

61???? Are you kidding me? Another Pajama party for you and Mauer?
Did you double check that reading?

The major risk with drawing up the insulin and then squirting the excess back into the vial is the risk of bacterial contamination.
That is the main reason we suggest that people overdraw the insulin a bit, remove the syringe from the vial, and then "twist" the plunger very slowly to get the excess drops of insulin out of the syringe before shooting the insulin.

The other risk with putting the excess insulin directly back into the vial or pen, is that the syringe lubricant can degrade the insulin itself.

Yesterday she didn't have any food other than my sausages and ham on my pizza after the +7, I was surprised to see it drop that late.

So no food for Mauer, after +7, except little bits of sausages and ham!!!! She'll be thrilled, I'm sure. (Just kidding)

What else could make it much less potent?

Age. How long the insulin vial/pen has been opened. Prozinc tends to have a shorter life expectancy when opened, and is why smaller containers like the 3 ml insulin pens are preferred over the larger 10 ml insulin vial, since you can usually use those pens to the last drop. Don't think you have that pen option with Prozinc though.

Storage conditions. Both at your home and at wherever you bought the insulin.
Mixing errors. Not mixing it gently every time, to get the particles re-suspended in the solution. Only needed for the "milky" colored insulins, not the clear ones.

Too many changes with the dose, such as using a sliding scale for every cycle which rarely works. But you are NOT using that technique and I don't recommend it either.

 

[SashaV]

Were going back up!
I'm sleeping a half hour at the time.
I just fed her dryfood. She seems fine, no shaking, ravishing hunger, just relaxing

I had a feeling this would happen...

Just don't know why, no changes in dosage or food.

I went to bed +3 witch means I had 2 hours sleep. I was so tired I went to bed with my clothes on. And my socks!!!!

 

[Deb & Wink]

Mauer earned a dose reduction, back down to 3.25U.

Tired? I was so tired and grumpy this morning, that I "yelled" at my cat Dancer. I told her that breakfast wouldn't come any faster for her meowing at me constantly.
Felt guilty all day, and realized that I need to "chill and get calm again". She didn't hold a grudge against me, and still came seeking food and some attention at my breakfast time, which was hours later than her breakfast.

Socks it is!

Please post in Feline Health if you need help. I need to head off to sleep, so I'm not sleep deprived in the AM again.

 

[SashaV]

I'll start a new thread tomorrow.
I really thought we'd run into a bounce.
I bumped her down to 2U just for the night.
Had 3-4 hours of sleep witch is far from enough, so now I've got a massive migraine and I need to sleep it out.
I'll do her +5 as usual and start tomorrow on the 3.25U as we agreed.

Normally I'd just eat painkillers and be done with it, but with lack of sleep I'd fall asleep hard and probably miss the pmps shot. So for everyone's best interest i shoot low today. Don't know why I'm defending it.. maybe I'll just keep writing so I don't have to stand up and feel stabbed in my head...

But Deb, we got freaking GREEN!!!!!
And almost blue on what should have been a bouncing day!

 

[SashaV]

I believe the difference in her numbers is because she's not fed in am cycle. Only pm so she can get herself back up if needed. Couldn't it be it? The pzi is obviously working as intended all of a sudden

 

[SashaV]

I believe the difference in her numbers is because she's not fed in am cycle. Only pm so she can get herself back up if needed. Couldn't it be it? The pzi is obviously working as intended all of a sudden