Micrometer

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Ruthe and Smokey (GA)

Ruthe and Smokey (GA)

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Had one heck of a weekend with Rugs. I went and bought 1/2 " syringes at Wally World because I was convinced that the short needles weren't getting all the way in. God forbid I die and someone comes in to see almost 300 syringes - different brands and sizes all lined up on the ol kitchen counter! Since such small amounts can take her too low for my happiness, I need to find another method of measuring - I can't do the drop thing...between my eyes and my sore hands...that just isn't going to work. I saw a picture of a micrometer but can't imagine how to use that for insulin measuring.

Thanks!!
Ruthe and Rugs
 
Hi Ruthe, I don't understand. You are giving her .5 unit....why is that so hard to measure? I think I am missing something here, sorry! Vicky uses a Micrometer so she can explain it when she comes by.

We use the longer needles for Tigger too. I tried the shorts some time ago and wasn't happy with them. ECID

Is she still on the antibiotic?

You said you had one heck of a weekend...maybe you could update your spreadsheet so we could get up-to-date? A nag I am, but you already knew that. ;)

P.S. Been wondering how you have been doing....don't be such a stranger! We worry!
 
Hi Ruthe,
I'm sorry I don't have the capability to photoshop a picture of the micrometer "in use" and label things etc.

I can try to do it via Photobucket, but my camera battery needs charged.

This is the micrometer I use: http://cgi.ebay.com/6-inch-LCD-Digital- ... 5d263a85dd

I measure the markings first to determine what 1U is but I decided the easiest thing to do is consider 1mm = 1U. It depends on whether you're going from the top of the lines or the bottom of the lines, etc, but 1mm=1U works very close. The important thing is to remain consistent. The digital readout really helps with adjustments to doses!

The picture makes it look intimidating, but it's not very big. You use the ends that are holding the big washer in that picture - they come to nice points and make it so much easier to see. I have trouble with my eyes too, I have to hold it up to natural light or I found out the TV works well too. Overhead lights make too much glare for me, especially those CFL bulbs, which I bought because I'd heard they were brighter and that's what I thought I needed.

You hold it alongside the syringe after you've drawn the insulin to measure, but you have to squeeze off small droplets to get the plunger where you want it. So this may not work for you if you have trouble holding things. You can't hold the micrometer and squeeze off the drops at the same time, you have to put the mm down, but that's why you have to do it drop by drop so you don't squeeze out too much. I keep measuring till I get it where I want it. You measure the space in the barrel which holds the insulin to the top of the plunger.

Sorry you're having a rough time. What about a magnifying glass? That might help you better.
 
I wonder how well a micrometer actually works for doses below .5u? I ask becasue if you have to measure, set it down, twist off a drop, measure, repeat until you are there... and also see clearly enough to SEE that you are there, it seems more trouble than it is worth.

I have to take off my glasses to see the damn plunger top and lines etc. and so far I can see them well enough that way, but at one point I was putting readers over my glasses (which are progressive lenses, btw). You might try super strong readers like 2.5 or 3.0 or stronger. If it were me, I'd snip off the needle on a used syringe and take it with me to the drug store to test various reader strengths.

Sorry you had a rough weekend, Ruthe.
 
Sheila & Beau & Jeddie said:
I wonder how well a micrometer actually works for doses below .5u? I ask becasue if you have to measure, set it down, twist off a drop, measure, repeat until you are there... and also see clearly enough to SEE that you are there, it seems more trouble than it is worth.

I have to take off my glasses to see the damn plunger top and lines etc. and so far I can see them well enough that way, but at one point I was putting readers over my glasses (which are progressive lenses, btw). You might try super strong readers like 2.5 or 3.0 or stronger. If it were me, I'd snip off the needle on a used syringe and take it with me to the drug store to test various reader strengths.

Sorry you had a rough weekend, Ruthe.
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It's worth the trouble because I don't think I could be accurate with the plunger every single time. The GNP syringes have too much variance in their markings to be reliable, which is why I went to the micrometer. And then when you need to adjust dose, it is so much easier to determine if it's .8U or .6U My recent splits were based on 1.3U, so that is .65U split!!

The point is the micrometer takes the guess work out of it. Yeah it's some trouble, but otherwise I'd be aiming at the broad side of a barn.
 
I use 2.5 readers and a magnifying glass and a good light...and still have problems. The reason I am interested in the micrometer is to be as consistent as possible. With Smokey and 12 units, a little bit up or down didn't make a big difference most of the time...but with this small of an amount of insulin having such an effect, I want to know what I am giving - for certain. I bought a box of 1/2" BD syringes over the weekend because I didn't feel like the short needles were getting thru her fat layer. The only ones I could find locally (had to have them right then ya know!)were BD and they didn't have 1/2 unit markings. I like the 31 gauge and am going to stick with these. So I feel the micrometer will be a double check that I am giving consistent amounts of insulin. Also, for those times when I want to shoot less than 1/2, the micrometer will be a better gauge then these old eyes.

Yes Pam, I know ya love me and that's why you're bugging me...today..I promise... :twisted:

Edited to add: spreadsheet is updated!
 
Yay, an updated spreadsheet!

Ruthe, we need to get her down from those highs. What about going up to one unit now? She did well on that the other day. What do you think? I know it is hard for you not being able to test during the day and feeling comfortable. And I know you are still getting used to this return trip to Levemir.

Good job on getting the before bed checks!

Any plans for getting her teeth looked at? How bad do you think they are?

Soooo, all done with the ab's?
 
I am more inclined to think she is rebounding. She is swinging from high 500s and 600s to 75-140 and back. Those are big swings. Also, she dropped to 38 on her first shot, which was 1u. Levemir is supposed to build up in their system over several cycles, not come on like gang busters the very first shot.

Ruthe, you were not posting at the time that I started Beau on Lev (switched from vetsulin), but he also dropped to low numbers on the first shot and then to 38 on the 3rd shot - which was .5u. And I got his first 400+ in months and months after about a week of lev. It took me a couple of months to figure it out because it looked like he was doing well on .5u (after I worked him back up to that), but all the 300s are rebound numbers. Take a look at his SS.

I just wonder if a lower dose would work better. I brought Beau down in .1u amounts and then in .05u amounts, so if it was me I would try .4u, but maybe a skinny .5u? Bring the top of the plugger just above the .5u line (with needle facing up).
 
I really looked at her numbers after Pamela suggested she may need more insulin. That hadn't been my first thought, but thought I should consider the possibility. I went thru my notes that I keep with her shot and food detail and I think some contributors to the high numbers were the short needles, food too late in the cycle, but for the most part when none of those come into play, I believe she is rebounding and not needing more insulin. My gut was to not give more, but less based on her drops on 1/2 unit.

I am ordering the micrometer to help me measure consistent doses as I do see differences in the syringes/plungers. She was in the 380s this morning and high 500s last night. For a cat that is not touchy feely, she really is being a great cat. Of course the treats do help too!

To help me with my fur shot / not sure if I'm getting thru her fat layer phobia, a friend of mine suggested that I find one place comfortable for both of us, with good lighting to shoot her. The place for his dog is on top of his washer/dryer. That same place in my house is working great. It is the perfect height, I put a nice comfy blanket on there, a few treats and while she does protest, I feel like I am getting the insulin in and not doubting that part any more. The 1/2" syringes seem to be better for both of us, so that is what I'll use going forward.

She will be on Zeniquin for another week or so. I believe it's 30 days total before her re-check. If I don't speak with him before, when I take her back in, I will talk to Dr E about her teeth being a factor in all this. Dang, maybe he can do mine and hers at the same time!! nailbite_smile

Maybe it is too early in her treatment, and maybe I don't remember the details of those dark days when starting Smokey on insulin, but I just have this nagging feeling there is something else going on with her. Not sure what, but I know you guys understand that feeling. I should sit with her quietly and let her know i'm worried and see what she might be able to tell me.

xoxo
Ruthe and Rugs
 
Ruthe and Smokey (GA) said:
I really looked at her numbers after Pamela suggested she may need more insulin. That hadn't been my first thought, but thought I should consider the possibility. I went thru my notes that I keep with her shot and food detail and I think some contributors to the high numbers were the short needles, food too late in the cycle, but for the most part when none of those come into play, I believe she is rebounding and not needing more insulin. My gut was to not give more, but less based on her drops on 1/2 unit.
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I am concerned about giving less insulin right now instead of more because of the possibility there is an infection lurking somewhere, her teeth, or whatever. More insulin would be needed to keep those ketones at bay imho....those numbers are so high. At least she dropped down somewhat last night - not a huge drop - but then back to the 500's this AM. :( So I am still thinking more insulin is needed here at least for now.

I am ordering the micrometer to help me measure consistent doses as I do see differences in the syringes/plungers. She was in the 380s this morning and high 500s last night. For a cat that is not touchy feely, she really is being a great cat. Of course the treats do help too!
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Well, that would be two people on FDMB that use the micrometer then. It will be interesting to see how you like it. Vicky sure does find it useful for dosing Gandalf.

To help me with my fur shot / not sure if I'm getting thru her fat layer phobia, a friend of mine suggested that I find one place comfortable for both of us, with good lighting to shoot her. The place for his dog is on top of his washer/dryer. That same place in my house is working great. It is the perfect height, I put a nice comfy blanket on there, a few treats and while she does protest, I feel like I am getting the insulin in and not doubting that part any more. The 1/2" syringes seem to be better for both of us, so that is what I'll use going forward.
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Do you ever shoot her while she is eating? Or is it just easier to have her up higher when you do it?

She will be on Zeniquin for another week or so. I believe it's 30 days total before her re-check. If I don't speak with him before, when I take her back in, I will talk to Dr E about her teeth being a factor in all this. Dang, maybe he can do mine and hers at the same time!!
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LOL! Wouldn't that be nice...a two for one deal maybe! :) Okay, glad you answered about the Zeniquin.

Maybe it is too early in her treatment, and maybe I don't remember the details of those dark days when starting Smokey on insulin, but I just have this nagging feeling there is something else going on with her. Not sure what, but I know you guys understand that feeling. I should sit with her quietly and let her know i'm worried and see what she might be able to tell me.
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I understand the feeling Ruthe, you know her best after all. But hopefully maybe all she needs is a good teeth cleaning.
 
pamela and tigger said:
I am concerned about giving less insulin right now instead of more because of the possibility there is an infection lurking somewhere, her teeth, or whatever. More insulin would be needed to keep those ketones at bay imho....those numbers are so high. At least she dropped down somewhat last night - not a huge drop - but then back to the 500's this AM. :( So I am still thinking more insulin is needed here at least for now.
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Okay- so I am CORNfused!

...If it IS rebound and less insulin is needed, but she continues to give more and continues the rebound, won't the numbers also continue to be high, thus the opportunity for ketones, still? ( scratches head and squints left eye)

why not try the less theory for a day or three and test for ketones? ( scrathes head and squints right eye) :?:
 
Melissa&Paul-Kyle said:
pamela and tigger said:
I am concerned about giving less insulin right now instead of more because of the possibility there is an infection lurking somewhere, her teeth, or whatever. More insulin would be needed to keep those ketones at bay imho....those numbers are so high. At least she dropped down somewhat last night - not a huge drop - but then back to the 500's this AM. :( So I am still thinking more insulin is needed here at least for now.
Click to expand...

Okay- so I am CORNfused!

...If it IS rebound and less insulin is needed, but she continues to give more and continues the rebound, won't the numbers also continue to be high, thus the opportunity for ketones, still? ( scratches head and squints left eye)

why not try the less theory for a day or three and test for ketones? ( scrathes head and squints right eye) :?:
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I guess for me I am just leary of her taking a chance on a rebound check right now. Miss Rugs is presently being treated for a UTI and/or an infection which maybe occurring somewhere else. Her vet put her on Zenequin which I believe is a broad spectrum antibiotic and he put her on it for a whole month so I would think he thinks something is wrong somewhere(?)

Or again, maybe it is just her teeth, but still there could be an infection there too.

Miss Rugs has been on a canned diet for a number of years now. Why is she all of a sudden diabetic and with these high numbers? (scratching MY head)

I am hoping this is transient and that all possible reasons for her becoming diabetic will be cleared up and then at some point she could start backing down on the dose (which is still pretty small right now at .5 units).

There are just too many unanswered questions here (not from you Ruthe). She is going to be talking to her vet soon and updating him when she is done with the Zenequin.

It is good to get all these various opinions though. It always helps to have everyone's input and it helps that Ruthe is no stranger to this disease and can weigh all her options.

P.S. checking for ketones is a challenge too since Ruthe works all day. But try to when you can Ruthe.
 
Thank you Vicky!!

Question...just saw that Rugs has a red and slightly swollen area on her butt. I believe it might be an anal gland. Any way this might be impacting her #s? Will call the vet today to get her in and have that taken care of. She did have a problem a few years ago with one rupturing, so I am thinking that might be brewing.
 
Ruthe and Smokey (GA) said:
Thank you Vicky!!

Question...just saw that Rugs has a red and slightly swollen area on her butt. I believe it might be an anal gland. Any way this might be impacting her #s? Will call the vet today to get her in and have that taken care of. She did have a problem a few years ago with one rupturing, so I am thinking that might be brewing.
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You're welcome :-D

Hmm, that's a good question. It's most likely brewing some type of infection, so possibly. All I have to say otherwise is Ewwwwwwwwwww! LOL
 
Vicky, that is the first time I have seen those pictures! Did you just do these? They are too cool! Now it makes more sense exactly how this thing works!

Ruthe, good that you are taking her in then he can check that out and answer all your questions about the other stuff too. Let us know how it goes!
 
pamela and tigger said:
Vicky, that is the first time I have seen those pictures! Did you just do these? They are too cool! Now it makes more sense exactly how this thing works!

Ruthe, good that you are taking her in then he can check that out and answer all your questions about the other stuff too. Let us know how it goes!
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Yep, did them this AM. Glad it makes sense. Thanks for looking. Feel free to bookmark and forward or link to them any time for anyone.
 
First off, i must say - you have a fabulous sense of humor Ruthe. I find it's often important when dealing with a feline diabetic and the 'omg, what the hell is the correct dose' game. Look how easily i speak from experience :-D . I just keep asking Molly (said diabetic cat) what dose she needs and yet she never answers. Coy is not cute and she likes to keep my guessing.

I'm certain that once the infection is gone, things will be a lot easier. You know this dance, just the tempo has changed. You're doing great. I'm curious to hear what the vet says.

Vicky - thank you so much for the great photos. They are clear, concise and easy to understand. I've always been curious about that thing-a-ma-jiggy so thanks for sharing.
 
Trip to the vet was uneventful....the "outie" part of the anal gland issue drained and now there is something inside that isn't draining. The vet tried to get it to drain but obviously her anal gland had other plans! I am to apply warm compresses to help it along. He doesn't feel at this point it is so serious that it would need to be surgically removed. Obviously, if she is in distress or uncomfortable, we will do what we have to do. Other than high numbers, the cat is perfectly fine...eating, walking around, sleeping, eating. walking around,sleeping, and did I mention eating and sleeping?

He doesn't believe her teeth are so bad as to be a contributor to the high numbers. He said that this anal gland thing could be involved since there was a little bit of pus that was on the outside of the disappearing red bump on her butt. He told me to go with my gut on the insulin dose. I should be home for most of tomorrow and will try to do 3/4s and see if that helps. Once my fancy smancy micrometer comes, this will be soooooooooooooo much easier. My vet was impressed and knew exactly what it was. He had on an "optivisor" to inspect her buttisimo and I am thinking i'm going to git me one of those to help too! Damn I never thought 50 was going to be so hard!!

Michelle, thank you for your comments on my humor. I have to tell you that I would be in a padded room without it!

xoxo
Ruthe and Rugs
 
Well, I certainly wouldn't inspect a buttisimo without an optivisor, that's for sure. :lol:

Ruthe you ARE funny. And 50 isn't so bad....but you won't get younger, that's for sure. Every day I grit my teeth over some other part of me that isn't working the way it used to (I'm 51).

Well, here's to hoping that the rear-end work helps to bring down her numbers.
 
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