Melville 1/10 353 AMPS, movin' on up...

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ericbakes

ericbakes

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Melville has been trending a bit high lately. He's on his fourth cycle of 1.5 units (up from 1.25):

-6 230
-2 211 (fed 20g)
+0 353 (fed 20g, 1.5 units)
+4 345
+5 350

I know we didn't have a fur shot today, but Melville did a fair bit of flinching this morning. I wonder if we may have gotten into the muscle (my understanding is that the insulin is much less effective if injected into the muscle). (Edit: this may be misinformation. I cannot find the source of this claim.)

I'm not really comfortable with these higher numbers. His litterbox output has increased slightly (nowhere near the "four scoops" a couple weeks ago, but it's on the border of tipping over to 2.5 scoops). Other than that, he seems to be doing well. I am thinking about two options:

  1. increasing dose to the original 2.0 prescribed by my vet, or
  2. progressively shooting earlier, starting at +11.5 tonight

What do you guys think?

(P.S., Melville has an appointment Saturday morning, so I want him to be in tip-top condition! With all the fiddling around I've done, the vet would be right to fuss at me for not keeping him in the loop -- which I rightfully deserve. Poor communication always comes back to bite me in the end...)
 
To increase or decrease. This is the hardest thing about ProZinc. His cycles at 1.25 were just as good or better than the 1.5 but weren't as low as we would like.

If there is a chance the shot today wasn't good, I would stay with the 1.5 a few more cycles and see if you get an inverse curve ( meaning possible decrease) or if he settles into it and gives you some better nadirs.

Regardless you have time to be at 2 units by Saturday if you want - and the numbers suggest it. The vet should not fault you for getting there slowly and carefully. 2 units definitely looked like too much with an unshootable pmps with the first shot. It would not have been safe to continue with 2 units. We could have just gone down .5 units at that point, but with a brand new diabetic, it is safest to start over with a low dose and slowly increase.
 
Or maybe the .25u increase was too much. You've lost the good numbers and nice curve.

It's your call but I would not increase by another .5u, smaller increases seem to let them adjust better.

There is only one way to see if it is not enough or too much and that is to pick one and try it (increase or decrease) and test through the cycle.
 
Thanks, Sue and Rob.

I decided to bump it up to 1.5 after seeing increasing AMPS and nadirs with 1.25. We were on that for seven cycles, and that 406 spooked me a bit. Even then, I had planned on increasing on 1/8 anyway, so I wanted to stick with that.

We'll give it one more round at 1.5 and see where he is tomorrow morning.

Any thoughts on moving the shot earlier?

Regarding the vet... I agree that we were justified in reducing the dose. However, I am lamenting not being a good customer/partner by keeping him informed. That was my bad. :\
 
And, yes, I missed your recommendation to do 1.3 or 1.4. Need to get some U100s this weekend. I tried at the pharmacy, and they gave me the "You don't *look* like a meth addict" look and told me to bring in the insulin to prove that I'm legit. :-D
 
Nope. I'll text my wife at home and see if she can do that.

It's actually pretty consistent with his pattern: really high until +6 or so, low around +8. I should stop being surprised by this cat. He *always* drops around 7 and 8. :)

I've been researching variance and meter accuracy, and it seems that meters are somehow less accurate at higher numbers. This kind of matches the pattern, too. Maybe 353, 345, and 350, +/- 20% is more like 423, 345, and 280. 155 could be 124-186. That makes sense.
 
FWIW the Vet is in your employ, not the other way around. You are paying him for his expert advise. We on the other paw are just giving you our 2 cents :lol: .

I guess my point is that while we want to be working partners with our vets, the ultimate decisions in his care are made by you and you alone. That goes for here too, we give you our 2 cents worth but you hold the syringe. You are the one who lives with and loves Melville and is his advocate and the only one qualified to make the best decisions on his behalf.

Your vet might be miffed that you didn't follow his advise to the letter but you went out and did the research, started learning how to care for an extra sweet boy and I would hope that the Vet would be pleased that you were so proactive and want to fight for Melville's good health. I doubt that he will be though.

Climbing down off my soapbox now.
 
She retested at +9. 161. So the previous number does seem about right.

And now I get to ride by the pharmacy to buy more test strips! :/
 
I know we didn't have a fur shot today, but Melville did a fair bit of flinching this morning. I wonder if we may have gotten into the muscle (my understanding is that the insulin is much less effective if injected into the muscle).
Click to expand...

Eric,
Just curious.... did you see that about insulin into muscle someplace other than on this board?

Carl
 
Carl, it was early on and now I can't find it. I thought it was on the ProZinc website, but now I can't find it. That's how rumors get started, I guess.
 
Eric,
The reason I asked....
My cat was given IM insulin shots for 10 weeks (PZI). I have no idea if it was more or less effective. I just know it worked for him, and he went OTJ after 10 weeks. I would never tell someone to shoot that way. I did it because my vet told me to, and that was before I joined FDMB. Bob was a unique case. Someone told me, when I first joined and mentioned I was shooting IM instead of sub-q, that "insulin is never supposed to be shot that way!", but I googled the hell out of it, and nobody could point me to definite "never shoot IM" information. Just lots of "insulin is shot sub-q" references. Nothing that specifically said "NO! DON'T DO IT!!!!", so I just kept doing it because it was working. Once the dance was over for me and Bob, my vet told me that she had never told anyone to shoot IM before (and as far as I know, hasn't done so since). She just felt it was the only chance he had at surviving (he was all f'd up), so it was (in her opinion) an option worth the risk of trying. Perhaps Bob is just a pioneer of sorts....
Carl
 
carlinsc said:
Eric,
The reason I asked....
My cat was given IM insulin shots for 10 weeks (PZI). I have no idea if it was more or less effective. I just know it worked for him, and he went OTJ after 10 weeks. I would never tell someone to shoot that way. I did it because my vet told me to, and that was before I joined FDMB. Bob was a unique case. Someone told me, when I first joined and mentioned I was shooting IM instead of sub-q, that "insulin is never supposed to be shot that way!", but I googled the hell out of it, and nobody could point me to definite "never shoot IM" information. Just lots of "insulin is shot sub-q" references. Nothing that specifically said "NO! DON'T DO IT!!!!", so I just kept doing it because it was working. Once the dance was over for me and Bob, my vet told me that she had never told anyone to shoot IM before (and as far as I know, hasn't done so since). She just felt it was the only chance he had at surviving (he was all f'd up), so it was (in her opinion) an option worth the risk of trying. Perhaps Bob is just a pioneer of sorts....
Carl
Click to expand...

A great example of "Every cat is different". :smile: Glad it worked for your kitty, Carl.
 
lol, Bob defines "ECID"! I checked him last night for the first time this year. He just looked "off" to me for some reason. It took me four pokes to get blood! I'm out of practice, I guess. As he was munching his post-poke treat (shrimp), he looked at me like "What is WRONG with you?"
The meter read "50".

Oh well, he enjoyed the heck out of the shrimp, and now my mind is more at ease!
 
Very nice day he had today. Almost a 60% drop which is perfect.

Early on with Prozinc (PZ) their nadirs tend to be early, around +4 or +5 but when they start getting used to the insulin their nadir seems to move back to +6 or +8.
 
Again, FWIW if you have a chance go over and look at Sev's ss. Although your ss's look nothing alike, his vet was pushing him to shoot 2 units, today he is going into day 5 of OTJ and has never shot 2 units.

Just food for thought.
 
I was also told to shoot Poopy with 2u, and NOT to home test...haven't reached 2u yet and doesn't look like I will. ECID so I suggest going with their BG #s and not a blind protocol. :smile:

If I am disobeying the vet...so be it. Would rather have my kitty with me. :smile:

It was suggested to me, if the vet asked why I didn't follow his directions, to say something along the lines of being scared to shoot double, and I was moving up to 2u when Poopy's numbers hit nadir so I quit upping the dose, and hand him the SS. :-D It would be true, too!
 
hi Eric :smile:

when callie and I started this dance in june her nadirs would be from +3 to +5 they would move around now they are at +6 to +8 callie gets good mid cycle numbers but her ps suck :cry: I went tid for about a month because when the insulin wore off callie would sky rocket cat_pet_icon I had to go back to bid ( work scheg) I was shooting in the skruff because callie wouldn't let me shoot her anywere else , now she lets me shoot in shoulders cat_pet_icon I switch off left to right and her numbers are much better :smile:
 
Shakes nadirs are +8...
If I were you I think I would stick with the 1.5 for a nother day or 2 to settle in
a little bit more,
but he is lookin good! :mrgreen:
 
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