Maybe Not Moving

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G & I

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I was unable to get any tests performed during yesterday's early cycle. However amps and pmps were virtually the same. Pmps +7.5 was 414 (will update ss later) and I suspect by her actions it will be higher by amps. I think I may start moving to the 2.75u previously suggested but would prefer the fat/skinny route. I do not have syringes with half marks so this is going to be difficult either way. Any suggestions as to markers on the syringes that may be used as reference points?

Also she is really scratching herself again though I've not changed anything. She's also started sneezing and sniffling occasionally. We are going to the Vets in a couple of hours for scheduled subcutaneous injection. Unfortunately they are not"hands-on" types and have been no help with the skin issues other than stating its the diabetes. Any thoughts or suggestions on this part would be very welcome.
 
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I was unable to get any tests performed during yesterday's early cycle. However amps and pmps were virtually the same. Pmps +7.5 was 414 (will update as later) and I suspect by her actions it will be higher by amps. I think I may start moving to the 2.75u previously suggested but would prefer the fat/skinny route. I do not have syringes with half marks so this is going to be difficult either way. Any suggestions as to markers on the syringes that may be used as reference points?
It will be pretty hard with out anything but whole unit markings. You just have to aim for between what you have been giving and the 3 unit mark . (I know, that isn't very helpful. Sorry.) I have seen some people recommend filling a syringe with colored water to the point you want then using that as a guide each time you fill a syringe. That means you still have to 'guess' when you do the colored water one, but maybe it makes it easier after that to have something to compare.
 
It will be pretty hard with out anything but whole unit markings. You just have to aim for between what you have been giving and the 3 unit mark . (I know, that isn't very helpful. Sorry.) I have seen some people recommend filling a syringe with colored water to the point you want then using that as a guide each time you fill a syringe. That means you still have to 'guess' when you do the colored water one, but maybe it makes it easier after that to have something to compare.
Okay- Thank you. These tired old eyes will get a work out.
 
Can you get some of the 1/2 unit ones? I have them and they do make it easier to do partial unit doses. They do have even smaller markings though.. at least mine.
I’m going to check into the 1/2 units with the Vet today but probably won’t get much help from them.
 
I’m going to check into the 1/2 units with the Vet today but probably won’t get much help from them.
Could your daughter send you some?

Re skin issues: I don't think that skin issues are a given with diabetes. Some cats will have poorer coat quality, dandruff, etc. but not necessarily itching. Itching is more often associated with an allergy, either food or environmental.
 
Could your daughter send you some?

Re skin issues: I don't think that skin issues are a given with diabetes. Some cats will have poorer coat quality, dandruff, etc. but not necessarily itching. Itching is more often associated with an allergy, either food or environmental.
I agree with your skin assessment but working with this Vet is hard at best. I have another cat with similar itching problems that they have performed skin tests, blood tests, X-ray with no resolution in almost a year.

I’ll see if my daughter can ship internationally in regards to syringes.

Do you agree with my thoughts on increasing dose now. Still have not done amps. Am at Vet now with Goma and other cat.
 
I agree with your skin assessment but working with this Vet is hard at best. I have another cat with similar itching problems that they have performed skin tests, blood tests, X-ray with no resolution in almost a year.

I’ll see if my daughter can ship internationally in regards to syringes.

Do you agree with my thoughts on increasing dose now. Still have not done amps. Am at Vet now with Goma and other cat.
That green from yesterday is a sign that you should stick with 2.5 u for a few more cycles. That non-bounce cycle showed you what this dose is capable of doing, as it did on 11 Jan as well. The other pinks, reds, etc. are bounce-inflated.
 
That green from yesterday is a sign that you should stick with 2.5 u for a few more cycles. That non-bounce cycle showed you what this dose is capable of doing, as it did on 11 Jan as well. The other pinks, reds, etc. are bounce-inflated.
Thanks so much. Sticking with 2.5u for now. I’ll learn...
 
Can you get u100 syringes where you are? They are the syringes that human diabetics use. We have a conversion chart so you can dose Prozinc using those, and they enable you to make very small changes with greater precision. It takes a little bit to figure out the conversion, but once you have it figured out, it's easy.

ETA: Although I want to add that I agree with Kris that you should hold this dose a bit longer first - so the syringe information is just something to consider going forward.

I also want to add that dosing on Prozinc is tricky. No 2x4's needed :):):)
 
Can you get u100 syringes where you are? They are the syringes that human diabetics use. We have a conversion chart so you can dose Prozinc using those, and they enable you to make very small changes with greater precision. It takes a little bit to figure out the conversion, but once you have it figured out, it's easy.

ETA: Although I want to add that I agree with Kris that you should hold this dose a bit longer first - so the syringe information is just something to consider going forward.

I also want to add that dosing on Prozinc is tricky. No 2x4's needed :):):)
I thank you once again. I had previously printed out the conversion chart just in case and will look into the u100 syringes.
Okay - no 2 x 4's - (at this time).
 
Also, until you do get different syringes, you might want to look into those reading glasses they sell at pharmacies/Walmart...a lot of people find them super helpful to wear when pulling up insulin!
 
Also, until you do get different syringes, you might want to look into those reading glasses they sell at pharmacies/Walmart...a lot of people find them super helpful to wear when pulling up insulin!
Yes, I agree. It's also helpful to get them in a magnification that's higher than what you'd need to read in a regular way.
 
Okay- Thank you. These tired old eyes will get a work out.
Perhaps get a cheap 'n' cheerful jeweller's loupe to see the syringe markings more clearly, e.g. something like this:

http://www.ebay.co.uk/itm/New-30x-6...640339?hash=item2f125e6a13:g:nE0AAOSwx2dYEw1c

she is really scratching herself again though I've not changed anything. She's also started sneezing and sniffling occasionally. We are going to the Vets in a couple of hours for scheduled subcutaneous injection. Unfortunately they are not"hands-on" types and have been no help with the skin issues other than stating its the diabetes. Any thoughts or suggestions on this part would be very welcome.

Provided there are no contraindications (e.g. high blood pressure) the anti-histamine Piriton (chlorphenamine, also called chlorpheniramine) can help with sneezing and mild allergies. See:

Mar Vista Vets Pharmacy Centre - Chlorpheniramine

From the above web page:

Chlorpheniramine maleate is frequently included in antihistamine trials for allergic skin disease. It is not one of the more effective antihistamines in dogs but is one of the most reliably effective antihistamines in the cat (in one study 73% of itchy cats responded). Its availability and inexpensiveness make it worth trying in many cases.

Main side effect is drowsiness but starting at a low dose can ameliorate this.


Mogs
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Perhaps get a cheap 'n' cheerful jeweller's loupe to see the syringe markings more clearly, e.g. something like this:

http://www.ebay.co.uk/itm/New-30x-6...640339?hash=item2f125e6a13:g:nE0AAOSwx2dYEw1c



Provided there are no contraindications (e.g. high blood pressure) the anti-histamine Piriton (chlorphenamine, also called chlorpheniramine) can help with sneezing and mild allergies. See:

Mar Vista Vets Pharmacy Centre - Chlorpheniramine

From the above web page:



Main side effect is drowsiness but starting at a low dose can ameliorate this.


Mogs
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Goma was prescribed with the anti-histamine Polaramine (dexchlorpheniramine) which I guess is the same. Side effect noted is drowsiness. She will be on this twice a day. Hope this works, I believe all these factors are contributing to her discomfort.

Thanks for finding this and posting. At least I now have some verification that we are in the right ballpark. You truly are a gem..
 
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It's morning for you now isn't it? I'm hoping Goma gives you a nice cycle today. She's been taking her sweet time to get back to work after that green! Tell her if she doesn't show another pretty blue or green soon you're going to have to do an increase. Sometimes just the threat is enough to get them back on track. ;):confused::rolleyes::smuggrin:
 
It's morning for you now isn't it? I'm hoping Goma gives you a nice cycle today. She's been taking her sweet time to get back to work after that green! Tell her if she doesn't show another pretty blue or green soon you're going to have to do an increase. Sometimes just the threat is enough to get them back on track. ;):confused::rolleyes::smuggrin:
Still high, holding on to hope she will return to the soothing numbers, but this go around is getting long. How many cycles can I allow this to go on? It is 1:00 pm here. I gave her injection about 2 hours ago. Will do a check in about an hour or two.
 
We usually say six cycles to clear a bounce, and if she's still stuck up high you can increase on the 7th cycle which if I'm counting right, would be tonight. However, occasionally they can come down quickly on that increase, so you'll want to be a bit careful. Since her 7th cycle is at night, you may want to wait until morning - up to you though.
 
We usually say six cycles to clear a bounce, and if she's still stuck up high you can increase on the 7th cycle which if I'm counting right, would be tonight. However, occasionally they can come down quickly on that increase, so you'll want to be a bit careful. Since her 7th cycle is at night, you may want to wait until morning - up to you though.
If I don't see anything by +7.5 will plan on increasing in the morning when I can be sure to monitor her. Have gone out today to clear up everything so I can be home the entire day tomorrow. I do plan on using small increments up to 2.75u rather than jump to the 2.75 immediately. Perhaps that will mitigate a larger drop. I am actually starting to doubt I am giving the injections correctly with so little movement.
 
Can you get some of the 1/2 unit ones? I have them and they do make it easier to do partial unit doses. They do have even smaller markings though.. at least mine.
What brand are your syringes? I am going on line to order with a company that ships international. My daughter checked with the post office and they said she could not send herself but some companies can. Go figure...but I'll make something work.
 
Do you have a Seiyu near you? It looks like they are owned by WalMart, so I wonder if you could get the u100's there?
If I don't see anything by +7.5 will plan on increasing in the morning when I can be sure to monitor her. Have gone out today to clear up everything so I can be home the entire day tomorrow. I do plan on using small increments up to 2.75u rather than jump to the 2.75 immediately. Perhaps that will mitigate a larger drop. I am actually starting to doubt I am giving the injections correctly with so little movement.

I agree - if you're going to do the baby steps, a steep drop is unlikely. That sounds like a good plan. I was really hoping she would show a better response on that last cycle. Okay, up she goes then! Time to get those better numbers back in her cycles!
 
If I don't see anything by +7.5 will plan on increasing in the morning when I can be sure to monitor her. Have gone out today to clear up everything so I can be home the entire day tomorrow. I do plan on using small increments up to 2.75u rather than jump to the 2.75 immediately. Perhaps that will mitigate a larger drop. I am actually starting to doubt I am giving the injections correctly with so little movement.

Do you have a Seiyu near you? It looks like they are owned by WalMart, so I wonder if you could get the u100's there?


I agree - if you're going to do the baby steps, a steep drop is unlikely. That sounds like a good plan. I was really hoping she would show a better response on that last cycle. Okay, up she goes then! Time to get those better numbers back in her cycles!

In looking through the last two cycles, she appears to have leveled off with virtually no difference in the last 18 hours. Could this be a sign that this bounce is over and a drop could now be expected overnight at the same dose which I have already given? Should this occur, I would need to revisit the thought of an increase correct? I wholeheartedly agree she needs to bet better numbers back.
 
That's an interesting question!!! One well-observed pattern is that a flat yellow cycle often precedes a reactive cycle. So I suppose since Goma runs higher than yellows, that in her case perhaps a flat red cycle could be a similar indicator! Hmmm.....we'll have to wait and see, but now I'm quite curious!

And if she does respond tonight, then yes, you'll need to reconsider the increase. Although, I would also factor in how much she responds. If she is still in the mid to high blues, I might go ahead with the small increase anyway as I'd like to try to start pushing those pre-shot numbers down a bit if we can. If she ends up in a low blue or green though, it's probably best to hold a bit longer.
 
That's an interesting question!!! One well-observed pattern is that a flat yellow cycle often precedes a reactive cycle. So I suppose since Goma runs higher than yellows, that in her case perhaps a flat red cycle could be a similar indicator! Hmmm.....we'll have to wait and see, but now I'm quite curious!

And if she does respond tonight, then yes, you'll need to reconsider the increase. Although, I would also factor in how much she responds. If she is still in the mid to high blues, I might go ahead with the small increase anyway as I'd like to try to start pushing those pre-shot numbers down a bit if we can. If she ends up in a low blue or green though, it's probably best to hold a bit longer.
Okay, if I do a test in the next hour (this would be a +2), it might give me an indicator if I remember what I've been told correctly. I will probably be asking for advice in the morning (wait..it is morning)...later in the morning... Thanks for the pointers again.
 
Wait..I'm so confused! It's morning there now? I thought it was nighttime?!?! That silly date line makes everything so complicated!

ETA: Okay, I just googled it and now I understand! :D
 
Wait..I'm so confused! It's morning there now? I thought it was nighttime?!?! That silly date line makes everything so complicated!

ETA: Okay, I just googled it and now I understand! :D
Didn't mean to confuse you. One of us(meaning me)being confused is enough. 12:30 am here now.
 
Okay, if I do a test in the next hour (this would be a +2), it might give me an indicator if I remember what I've been told correctly. I will probably be asking for advice in the morning (wait..it is morning)...later in the morning... Thanks for the pointers again.
It appears that there still is little to no movement through pm +7. Will be giving slight increase so I think I would record in the spreadsheet as 2.5F. On the syringe I will be move the plunger down just below the #2 so there is a bit of space. Currently I have the plunger at just on the bottom of the 2 with no space. Unless, of course, there is some unexpected change at amps.

She did throw up a bit about 1/2 hour ago. Just fluid. She appears okay at this time. Gave her small amount of food and she held it down, so fed her breakfast which she finished quickly. It is now almost pm +7.5 (0630 local time)
 
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@Djamila -

Idiot questions from someone who's never used Prozinc:

  • For those caregivers who are in a position to test sufficiently frequently, have any Prozinc users ever used food manipulation/curve steering in order to enable larger doses of insulin to be given to kitties who are spending a lot of time in higher ranges but then dip a lot lower on occasions (as Goma is doing here)?
  • Can strategic feeding of appropriately carby, well-timed 'snacks' in the early part of the cycle slow down steep drops and help level a kitty out overall?

(Trying to learn here. I have no idea whether or not the above are feasible/safe.)


Mogs
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Just noticed from your spreadsheet that you've recruited another one of your kitties to help Goma. I had to smile because I felt compelled to test my civvie, Lúnasa, to make sure her BG levels were OK (and to get some sort of idea of what BG regulation looked like in a non-diabetic kitty). There's no denying it; I am a dyed-in-the-wool helicopter parent. :oops:


Mogs
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Just noticed from your spreadsheet that you've recruited another one of your kitties to help Goma. I had to smile because I felt compelled to test my civvie, Lúnasa, to make sure her BG levels were OK (and to get some sort of idea of what BG regulation looked like in a non-diabetic kitty). There's no denying it; I am a dyed-in-the-wool helicopter parent. :oops:


Mogs
.
I have become the same. If I hear a cough, sniffle, sneeze or one of the group seems out of sorts I am all over it to the point I probably irritate them.
 
@Djamila -

Idiot questions from someone who's never used Prozinc:

  • For those caregivers who are in a position to test sufficiently frequently, have any Prozinc users ever used food manipulation/curve steering in order to enable larger doses of insulin to be given to kitties who are spending a lot of time in higher ranges but then dip a lot lower on occasions (as Goma is doing here)?
  • Can strategic feeding of appropriately carby, well-timed 'snacks' in the early part of the cycle slow down steep drops and help level a kitty out overall?
(Trying to learn here. I have no idea whether or not the above are feasible/safe.)


Mogs
.
Yes, some people will try this with varying degrees of success. The carb sensitivity of the kitty can factor into how successful it is.
 
Goma appears to be getting stuck in these higher numbers. A small increase to your best estimate of a "fat" 2.5 u at her next dose is worth a try.
 
@Djamila -

Idiot questions from someone who's never used Prozinc:

  • For those caregivers who are in a position to test sufficiently frequently, have any Prozinc users ever used food manipulation/curve steering in order to enable larger doses of insulin to be given to kitties who are spending a lot of time in higher ranges but then dip a lot lower on occasions (as Goma is doing here)?
  • Can strategic feeding of appropriately carby, well-timed 'snacks' in the early part of the cycle slow down steep drops and help level a kitty out overall?
(Trying to learn here. I have no idea whether or not the above are feasible/safe.)


Mogs
.

Yes, it is certainly possible. Honestly, most people on prozinc either go into remission so quickly they don't need to learn that trick, or they make the jump over to L/L so quickly that they learn it over there. I think in this situation though, it may be something to consider. scs_islander is certainly a skilled enough caregiver to learn the technique - so it would just be a matter of being okay with the potential added stress of feeding the lower numbers. Scs (I'm so sorry, I don't think I've learned your name! :oops:), it's basically just like what you did on 1/4 during the PM cycle, only more intentionally. Mogs' description is basically what you do - raising the dose and then through some experimenting, figure out what arrangement of food, timing, and portion size Goma needs in order to stay away from the lime greens, but have more time in numbers that are near that. It's a more vigilant process than the current approach. Many cycles would be just fine, but there would be more cycle when your intervention would be needed. It may be something to consider though if those PS numbers don't start moving soon.
 
I am all over it to the point I probably irritate them.
I've lost count of the number of times I've felt the need to apologise to my little ones for exactly that reason! :oops: That said, if I hadn't perceived myself as being an out 'n' out pest and been less respectful of Saoirse's 'personal space' and a bit more helicoptery she might have been diagnosed sooner. Can't win. :rolleyes:


Mogs
.
 
  • For those caregivers who are in a position to test sufficiently frequently, have any Prozinc users ever used food manipulation/curve steering in order to enable larger doses of insulin to be given to kitties who are spending a lot of time in higher ranges but then dip a lot lower on occasions (as Goma is doing here)?
  • Can strategic feeding of appropriately carby, well-timed 'snacks' in the early part of the cycle slow down steep drops and help level a kitty out overall?
I just bought a selection of Weruva foods with varying carb content for this very purpose. It is starting to dawn on me that this may be the right approach for Mia. I have come to believe that I have to assume a little risk to make progress with her. When we finally started getting good numbers, there was a period where she ended up going low every several cycles. I was nearly certain the dose was not too much, it had been very slowly worked up to and any less was just not enough. When it would happen, I would give her m/d kibbles to steer her up. It seemed that during those times, giving the carbs not only served to raise her up to stay safe during that cycle, but it also seemed to prevent (or very greatly reduce) the bouncing I expected to see. With her tendency to bounce, I really need to hold a dose to the extent possible, adjusting with PS values (unless absolutely necessary) is just not a good idea. So, I think deliberate carb management may be a valuable tool for me to try. That is why I wanted to 'arm' myself with varying degrees of carbs. Mia would not really eat the FF higher carb foods I tried, so I was always stuck with using the m/d kibbles which are really higher carbs than I need sometimes, and I think she may actually be allergic to something in them. I hope she likes the new foods, and I hope I am right about this. I guess I will find out. This is all an ongoing science experiment for the most part anyway! :)
 
Yes, it is certainly possible. Honestly, most people on prozinc either go into remission so quickly they don't need to learn that trick, or they make the jump over to L/L so quickly that they learn it over there. I think in this situation though, it may be something to consider. scs_islander is certainly a skilled enough caregiver to learn the technique - so it would just be a matter of being okay with the potential added stress of feeding the lower numbers. Scs (I'm so sorry, I don't think I've learned your name! :oops:), it's basically just like what you did on 1/4 during the PM cycle, only more intentionally. Mogs' description is basically what you do - raising the dose and then through some experimenting, figure out what arrangement of food, timing, and portion size Goma needs in order to stay away from the lime greens, but have more time in numbers that are near that. It's a more vigilant process than the current approach. Many cycles would be just fine, but there would be more cycle when your intervention would be needed. It may be something to consider though if those PS numbers don't start moving soon.
For today, I have given the 2.5u(F) following the amps of 354 and see where that takes her. I appreciate your undeserved confidence in my skills as a caregiver and will just have to handle the stress. The ends more than justifies the means. Just need to figure out what are higher carb foods and have everything in place prior to beginning the approach being suggested. Totally on board with it, just want to have all of my ducks in a row (or cats as it may be). Been clearing out all the higher carb foods. I do have the FRW from Specific and the Hills M/D and (shudder) some dry diabetic prescription diet from Hills as well. Would all these provide the appropriate level of carbs to turn her around? Thus far, I have been able to use these successfully when the unintentional drop occurred. If I am going to approach this intentionally I want to be sure this is enough.
 
For today, I have given the 2.5u(F) following the amps of 354 and see where that takes her. I appreciate your undeserved confidence in my skills as a caregiver and will just have to handle the stress. The ends more than justifies the means. Just need to figure out what are higher carb foods and have everything in place prior to beginning the approach being suggested. Totally on board with it, just want to have all of my ducks in a row (or cats as it may be). Been clearing out all the higher carb foods. I do have the FRW from Specific and the Hills M/D and (shudder) some dry diabetic prescription diet from Hills as well. Would all these provide the appropriate level of carbs to turn her around? Thus far, I have been able to use these successfully when the unintentional drop occurred. If I am going to approach this intentionally I want to be sure this is enough.

I want to ask general question - I have been giving the injections on one side of Goma due to her skin condition on the other. Previously when I attempted, it was obvious it was painful due to the condition. The condition is clearing somewhat and I have just today given the injection on the opposite side. My question is, I guess, pretty dumb, but if you continue to give injections in the same general area does it become somewhat sensitized to the insulin?
 
Goma appears to be getting stuck in these higher numbers. A small increase to your best estimate of a "fat" 2.5 u at her next dose is worth a try.
Have given a "fat" 2.5u to see if this will get her moving. She has slowly dropped from red to purple and I hope a gentle nudge will move her along. If not, I will be going to a "skinny" 2.75 and then 2.75 firm. In this case scenario, is one cycle enough or should I be allowing two or three?
 
Oh Goma....:rolleyes: She's just messin' with us now! Giving that lower AMPS number right as you do the increase....Last time she did this was on 1/17 and you ended up with a green....keep an eye on her today. :cat:
 
As for the foods, your usual food is probably under 6%, is that correct? M/D is around 13%, and the Hills dry is....I have no idea really....high though, I assume. Do you have any idea the carb level on the FRW? I don't think I've heard of that one.
 
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