Melville 1/10 465

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ericbakes

ericbakes

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Well, Melville has had a rough couple of days. He spent much of yesterday morning/afternoon in pink and yellow, but his readings after the PM shot were disastrous. Solid red through +10. Once again, I checked thoroughly for a fur shot... I can't imagine any other cause. So this morning I upped to 2.0, which was the vet's original prescription. Poor little guy spent the first couple of hours in red, and now he's at 328. I'm going to check him one more time before going back to work. If he's not under 300, I'm going to call the vet and see if he can give me any advice before our Saturday appointment.

For a while there, Melville was doing well. I could tell he was getting some meat on his bones again, he stopped drinking so much water, and his litterbox was at a normal level. These last few days have reversed that. I don't know if I'm imagining things, but he seems very skinny again, and I know that his litterbox use has increased (not as much as it was before treatment, but definitely moving in that direction -- 2 full scoops per day instead of 2 smaller scoops).

My plan for tonight will be the same -- try to shoot him close to dinner time (I'm up to 7:00 this morning, and I'll try for 6:30 tonight), and I'll keep him on 2.0. Not sure what to do at this point, other than call the vet. I'm afraid to try going back to 1.25, because even though his numbers were lower then, they were trending upwards. Hope he's going to be OK.

One last thought -- he's really hungry, which I know is a symptom. Should I feed his hunger, or try to keep his BG low?
 
Yes, you should feed him.

i am still thinking a lower dose but understand your concerns. Definitely wet lo carb,right? Any chance the insulin is bad - any floaties in it?
 
Yes, Eric, let him eat. The other thing, if there's a way that you can make it work.... if you're going to up his dose, try to get a reading around +6 so you can see what it is doing at nadir. If it's really low, then bouncing might explain the really high preshots. If it isn't really low on 2.0, then we'll have to figure out what's up with that. But give it a few cycles.
Oh, and try not to let him eat during the two hours prior to AMPS or PMPS, even if he's acting hungry, so the food doesn't boost the preshot number even higher.

Carl
 
lol. I realize now how silly that question seems -- "Should I feed his hunger?" Of course! ohmygod_smile I get so wrapped up in the numbers that I forget that I have a hungry kitty here. Of course, I don't want to overdo it, but perhaps now is not the time to crack down on his diet. And, yes, it's wet, low-carb Purina DM.

His latest numbers show a nice drop to 214 at +9. My wife fed him 20g, so I expect a little rise again by PMPS -- probably to 350 (even with the 2 hour fasting buffer). I'll shoot another 2 units tonight. The last few cycles, his nadir has been quite high in my opinion, so I'm not worried too much about a bounce. That's a good point, though, Carl -- I'll keep an eye on it tonight.

Oh, and I spoke with my vet. He recommended 3 units in the morning and 2 at night, starting tomorrow morning, until his appointment on Saturday. I'll see where Melville is tomorrow... three seems like a lot.

Thanks for your continued support! :)
 
Eric,
I'd just think hard about uneven doses this early in the game. Did the vet explain the logic?
There's two ways of looking at it, from what I have seen and experienced with my cat Bob.
Some people look at a PS number, and dose looking backwards - I'm going to shoot X into the number I just got because it is what it is.
Others look forward - I'm going to shoot X in order to achieve "this number" at the next preshot.
My vet looked backwards, based a dose on the most recent test, and then advised shooting a specific dose in order to achieve a nadir she wanted to see, and hopefully that would result in a lower number for the next shot.

I used a sliding scale of sorts, but very loose, like if the BG was 200-300, I'd shoot X, and if 300-400 shoot Y and >400 shoot Z. So once I started doing that, Bob's AM and PM doses were frequently not equal amounts.

In general though, the AM and PM doses should be equal, unless one or the other is always higher than the other. With your SS, I see sometimes the AMPS is higher, and sometimes the PMPS is higher, but not "all the time". So I am wondering why the 1u difference in shot amounts. It would make more sense to adjust each up by .5 than to increase one and not the other. I'm thinking the vet has a "plan" in mind, just hoping he shared that with you?
 
Carl, he didn't really share a bigger plan, and I neglected to ask him. Like you, I'm wary of three, and probably won't shoot it... *especially* since Melville is now too low to shoot 2 units: 184 at +11. Should have listened to you folks! :\

I'm thinking 1 unit at +12. I have records of him doing fine when shooting both 2 units and 1.5 units at +11.
 
believe me, we all understand how you feel
but remeber this is a marathon not a sprint,
which is a shame cause I suck at marathons!
 
Last nights curve looks a bit inverse to me suggesting that the dose is too high.

I think that increasing by 1 unit at a time is a bit drastic. If you are going to increase I would do it in smaller increments.
 
Depending on the +12 I would go with 1 or 1.5
If you are going to raise again, maybe try .25 instead
 
Unbelievable. 155 at +12. He's falling, even after eating at +9. I went ahead and fed him again, which means I can't test and shoot until at least +14. Is there a ::headdesk:: smilie?

Can someone remind me the rule about shooting late? You lower the dose, especially if you're going to push back the shot the next day, right?

Well, at least I have two data points now showing that 2 units may not be the answer. I'll talk to my vet about trying to target somewhere between 1.25 and 1.75, perhaps using a sliding scale as Carl suggested.

Sorry for not responding specifically to earlier posts. I was at work trying to get information out quickly.

And, really, thank you for your help, everyone. I don't know what I would do without this group.
 
OK, Eric, the next time you have this happen. you have to convince him it isn't time to eat if you are not comfortable with the number and you know it is falling. Test again in 20 minutes or so and see if it has risen any, because you need to make sure the number is coming up on its own without food. Once you are sure it is rising, then you can feed and shoot without worries.

A late shot acts as a dose reduction, I think is the rule. The way I always look at it is like this - If tonite's shot is going to be late, and you want to get back on schedule in the morning, then you shoot less tonight to compensate. Otherwise, you have two "normal" doses in like a 10 hour time period, which means more insulin on board (unless the first shot is totally used up and "gone", which is hard to tell).

So tonight, you look at the number, and shoot a little less than you normally would. In the morning, you dose as usual based on whatever number you get.

If you are planning on pushing the morning shot to "later than normal" so that tonight's shot and the morning shot are 12 hours apart, then I would just shoot "normal amounts" both times. If it is only half an hour either way, then no big deal, in my opinon. But when you are talking about a 2 hour difference, that matters more.

Again, my opinon, but I think that with PZI or Prozinc, there's a 30 minute window at least either way (late or early) where it really doesn't make any difference. Most people don't get 12 hours or more out of a dose. But always remember, ECID. That's where data collection specific to your cat really helps you out when questions like this come up. You'll know how YOUR cat acts or reacts to doses and timing. It'll be different than it was for my cat or anyone else's.
 
Thanks, Carl. Excellent advice.

Unfortunately, the cats gave me the big middle paw last night and foiled my plans. Somehow, they managed to open the pantry, climb to the top shelf, and knock over the entire bag of emergency reserve Purina DM Dry -- there was kibble all over the floor. All three cats were CHOWING DOWN as fast as they could. I have no words to describe the carnage. We don't know how long this had been going on by the time we discovered it, but it could have easily been an hour. They were actually eating kibble out of the dustpan as I was trying to sweep up.

Bad, bad kitties!

So, needless to say, Melville's numbers were quite high this morning. I gave him 1.75 units and a stern talking-to. He responded by licking my finger, curling up in a ball, and promptly taking a nap.
 
Eric,

One thing to consider is to have high carb gravy food as an emergency (even Melville won't be able to open the can) along with Karo. Those work just as good or better than dry.
 
I know you don't like the high numbers, but the mental picture that goes with.your story is hillarious! I can just see my boys doing something like that (thank.goodness they haven't).
 
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