Mini Curve for Alex-What do you think?

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Ginny & Alex

Ginny & Alex

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While I have one more reading to get for the day, I thought I would go ahead and post because at the +12 reading, I need to leave the house for the rest of the evening. I have hand-bell practice tonight.

Alex has been such a good boy with the pokes today. The last two shots have been very difficult, but I prevailed. :twisted:

Anyway, in looking at the numbers, I'm assuming I'm going to need to increase the dosage? And if you look at the spreadsheet, you'll see that I did try a dosage of 1.5 twice, but only for a couple of days. It seems Alex is taking longer to settle in than some kitties?
 
Hey Ginny,

It's a pretty quiet day here!

I am by no means a dosing expert, but it does appear today's curve was pretty flat. I am sure some of the others can give you some advice on the dose later. Normally they say flat curves mean you need more insulin, and inverted curves mean too much insulin. It appears Alex's was flat to me.

You will get better advice than mine-- check back tonight!

Alex has only been at it for about a month according to your ss-- don't get discouraged it takes some kitties much longer than that to get regulated. You are doing great and the reward will come.

In fact, the quickly regulated kitties are the exception-- not the ones like Alex!

Keep it up!

Kim
 
You guys are getting an early drop, and then right back up to a flat curve, which as Kim said, means you need more insulin. 1.5u may be too big of a jump in dose (might be why you saw that big increase on 5/11 from the 200s to 400s). What do you think about trying 1.25u for a few days?
 
I'll just say I'm impressed that you rode out 1 unit for as long as you did.
That was a great lesson on 1unit for you that there is no two ways about it. That dose is NOT doing the trick. So good for you for giving it a good long chance to do it's thing.

I suppose you could reduce dose for some time to absolutely rule THAT out or, perhaps IN, as well.
Let's say you move to .8 for a few cycles and see what happens.

I used to be a 'shoot the numbers' person...but with the chronic ineffective stuff going on around here since pzi went pro zinc i am believeing that there may be a shed with this insulin on the one paw, and on the other paw I am wondering if it has turned into a fast and short acting insulin like vetsulin.
Truth is, since the change I don't think we really know this insulin very well.

So your patience Ginny, is golden for a learning opportunity.

Lori
and Lord Thomas
 
I had the thought that going to 1.25 would make it clear that you are not skipping any steps as you work your way up. But if it were me I would not spend quite so much time at each step--- I would be inclined to only stay at a dose for about 3 days.
 
I don't think it's taking longer than other kitties. It took us m-o-n-t-h-s. I would move faster on the dose increases though, like others said. It looks like too little insulin to me. There's really only that one day on 2u where the dose looked too high, and that may have been a fluke.
 
Well, Lori, no one has ever called me patient :-D

So, that's 3 people that say raise the dose--to maybe 1.25 units (this didn't prove very effective the last time I tried it).
1 suggests lowering the the dose to .8.
1 says I don't know--2 if you can't me.

The vote is as unclear as Alex's spreadsheet results. :o

Anybody else out there want to weigh in?
 
I'll weigh in.

The only blacks that you've gotten were on 1.5u, 2u and 2.5u. Because of that and no ketones I might try something crazy like dropping to .5u. With so many low dose kitties here these days it might be worth a try just to see what happens, if nothing happens then you can raise the dose and shoot the numbers down.
 
So I guess you are challenging us to debate the question! :mrgreen:

I'd actually go right up to 1.5 and not bother with 1.25, but I didn't want to confuse the issue. Since it's already confused though, hey, why not mention it now, LOL?

Lori do you see something in the #s that is pointing you towards the 0.8 idea?
 
I can't get Audrey (the non-diabetic cat) to eat the canned food, so I'm feeding her some EVO dry. If Alex does get any, it's only a few nuggets each day.
 
So, Ginny, you are getting the flavor of things here. When we don't like the BG numbers we either say more insulin,, or we say less insulin! It's all a matter of trial and error. We try something, watch the data that follows, and then make our next best educated guess. It's often as frustrating as hell, but you would be surprised how many cats benefit from all this craziness. You just keep testing and revising and testing and revising and then what do you know, something works and you have regulated cat--- or even better, a cat that goes OTJ.
 
Hmmm, even a few nuggets can send up their BGs - think of it as M&Ms. Any chance you could feed them separately or something so she can't sneak any? ECID, but it could be making a difference in the #s.
 
well the EVO does change the scenery a bit.
the reason i suggested .8 joanne is to rule it out.
I like the long course on one dose now, once and for all ruling out all possibilities.
if we are not in a hurry, I guess I'd rather see something definative.
 
and yes those loose nuggets at her disposal are affecting the ability to choose a dose. it would almost be better to have her on or off evo as a rule.
 
I can try to make sure that Alex (male) doesn't eat any of the dry EVO by taking it away except at mealtime while I can watch, but that also makes me feel guilty about making Audrey miserable. She is a grazer and rarely eats when I put the food out.

If I take away the dry from Alex, do I change the dose?
 
well yes, you likely would change the dose to begin with.
but sad to see your other kitty suffer without the grazing.
can alex jump on counters....is there any place other kitty can get to that alex can't get to>

or could you leave enuf wet food down to keep your other kitty fed> or did you say she won't eat it>
 
Alex can get to all the places that Audrey can get. And she smells the canned food each morning, but she isn't interested.
If I put more canned food out, I think Alex will just eat it all.
 
wow, that is a tough one.
you don't want Audry to become a timed meal eatter...and Alex needs to.
hmmmm, there must be a way to keep both kitties happy.
 
Yeah, she definitely needs to eat, I wouldn't withhold food if that's all she will eat. Maybe someone will have an inspiration on what to do.
 
could audrey be brought around to a wet food diet...with some encouragement. maybe think of it as if SHE were the diabetic. what would you do then?
 
one question I forgot to ask last night.

How long would it take to see a decline in BG numbers after I take the dry food away?

I'm asking b/c when I started all this back in mid-April, the vet had Alex on Hill's DM and when I took that away, it didn't effect any of his numbers.
 
We have two brothers, one of which is diabetic. They ate out of each others dishes for 7 years so when we switched one to wet, the other had to switch too. The dry food grazer was not happy about it, but what helped us was putting some small shreds of real baked chicken and some dried catnip flakes on top of the food bowl. He came around in about a week and a half to eating the wet food with that enticement. FWIW. Hopefully that might help you with your dry food addict :)
 
You should see a difference right away. Some kitties here have dropped 100 points overnight.

I had 1 civie who I began to think that I would never convert to wet, it took me months but she finally came around and is happily eating wet low carb. Now I don't have to worry about Harley being able to get into any kibble, it's much less stressful for me.
 
Audrey has shown no interest in any of the snacks either--either low carbs or higher carbs.

I'm still wondering that if I take away the dry food, should I also increase the dosage? If his #s get better, how can I determine the cause?

And are we saying that just a few days w/o the dry food will tell us whether that will have a positive impact?
 
It's that darn Every Cat is Different thing. With Oliver, we switched from a completely dry diet to completely wet and his numbers went down 100 points overnight. With other cats, it is a slower but continual process. And since he eats mostly wet now, you may not see such a dramatic effect - or you might. :mrgreen:

If you can't get mid cycle numbers till the weekend, I would try the food change and see how that goes. Then by this weekend, you should have some idea about how it might work with your other kitty, and you can consider changing the dose and getting those nadirs?
 
I guess this is the part I don't understand. If he's consistently getting a few nuggets of dry everyday, then experimenting with the insulin dosage should change things, right? You're not saying the insulin won't work with dry food, are you?
 
Both can potentially change things. If he is a real carb sensitive kitty, then taking away all dry can lower bg levels. Increasing the insulin, of course, also has that potential. If you want to be super careful, you can do one first, not both at once.

Insulin seems to, in most kitties, work best with an all wet diet. It is not so much that the insulin won't work with dry food. It is that both are working on the bg levels. If you give insulin and feed dry, the insulin can bring down the bg levels and the dry can bring them up.
 
If you are feeding dry food even if it is only a few kibbles a day you will probably have to compensate for it with more insulin. Like Sue said they go hand in hand.
 
I took away the dry food for 24 hours and Audrey was so pitiful, I caved in. So, after reading these replies multiple times, I went ahead and increased Alex's dose to 1.50. I don't know if he got any of yesterday's AM shot as he bit me when I shot, but hubby shot the last 2 times successfully--so, he's had 2 for-sure shots with 1.50 units. Would the skipped shot cause this rise is #'s or could it be a fluke?
 
Not sure. Let's ride it out a cycle or two and see what happens. If you get consistently high numbers, then we need to look again.

Can you compromise? Give her the dry when you are watching and then offer the wet during the day? She will get food, but maybe will be willing to try the wet also. Have you tried crumbling up the dry and "dressing" the top of the wet? Have we suggested FortiFlora?

Fortiflora per Dr Lisa
Try a product called FortiFlora. Most cats LOVE FortiFlora and this has recently become my favorite trick. This is a probiotic made by Purina but you are not going to use it for its probiotic properties. You are just going to use it as a flavor enhancer. The base ingredient in FortiFlora is animal digest - the very substance that makes dry food so very enticing to cats. The directions say to use 1 package/day - and you can use this much if you want to - but this amount is not usually necessary. You may only need ~1/4 of a package - or less - with part mixed into the food and part sprinkled on top of the food just as you would use.

Sometimes it's magic, sometimes it's not. If you can find a source for a little amount and try some. Sometimes the vets at PetSmart carry it and they might sell you a sample. I know you can buy it online, but I think usually in bulk.
 
Maisey's littler mate Vinney used to sniff wet food - mew and back away as if I were trying to kill him.
I finally got him to taste it by making it very soupy - as much water as food and sprinkling catnip on top.
He still wants his wet food soupy, but doesn't fuss any more. ps I did notice him sneaking some from Pumpkins dish twice now, and I don't dilute her's at all unless I'm going to be away for a long time. pps All but Maisey actually like to eat the frozen pops of food while frozen - that I make in the silicon cup cake molds. 1/3 canned; 1/3 ground baked chicken; 1/3 water. Maisey likes hers to melt.
 
Bix was a long-time hold out, he did not believe canned food was food, would just look back and forth from the dish & me, like "ok, you're going to feed me soon, right?" I tried *everything* and no go. What finally worked was out of sheer frustration I shoved a couple bites of the food in his mouth. Once he tasted it and realized it actually was good, then he was hooked and wouldn't touch dry after that. So I wouldn't necessarily just take up the dry, but I would experiment with getting her interested in the canned. You can try mixing just a miniscule amount with a few pieces of dry (don't leave out all day once they are mixed, the dry will get gross), and see if she will take to it that way. Of course that didn't work with Bixie, but it does for many cats I think. There are also lots of tricks of tasty things to put on top, and I think someone already suggested maybe crumbling a few bits of dry on top of canned, I never tried that, but maybe something like that would get her hooked on canned. You may have already tried all those things :) just trying to brainstorm...
 
Well, I know I don't have a lot of numbers for you to review, but the 1.50 dose seems to be making things worse, unless of course, I haven't given it time to settle in. Also, I have reduced the dry food availability. I also know someone will suggest a curve, but Alex is now fighting both the shots and the pokes.

Not sure what I'm going to do..
 
The same thing that worked for Joanna worked for my Harley and civie hold out. I would sit on the floor with the canned food bowl and would put bits of the canned food in their mouth so they could taste it and realize that it was food. At first they would spit it out and give me that look, but I didn't give up and did it every day until they they finally switched over.

Hang in there.
 
Would you want to post on Health and Community to see if anyone lives near you, Ginny? Maybe they could watch and give you some pointers on the shots/pokes to make it easier for both of you?

The one thing that some people use with difficult cats is the clothespin trick. You could put them on before the poke and the shot and then get them both done at once. It looks silly, but mimics the way a mommy cat holds her kittens by the neck to immobilize them. Clothespin trick
 
I feel sure I'm doing the shots and ear pokes correctly. In looking at the the clothespin trick, he would go ballistic with that--maybe even worse than with the shot. I don't think it's the shot itself, it's actually grabbing him by the scruff. He's always been that way, so I'll just plod along and do that best I can.

If I could just get one thing right, I would feel better. Wrong dose, doesn't want pokes, doesn't want shots.
 
I think periodic spot tests are fine, IMO there is no need for a curve in most cases. It is certainly helpful, and works well for those who can only spot test on weekends, but in general I think if one can get spot tests when you can, ideally varying the times, that is fine.

I would raise the dose to 1.75 and try that for 2 or 3 days, and if you are still seeing U curves with no better numbers, I'd go up to 2u. My suspicion is he is overcoming the doses, which means you need more insulin. I'm thinking my original take, that 2u was too high, is just not the case. It's possible it was too high at one point but I think you will need more insulin to break through. I'd still be tempted to move in 0.25 increments though, as I am hopeful you will see a breakthrough somewhere fairly soon.

If you could get any spot test in I would go for a +9, just to double check - if that is high and then he comes down to a lower +12 that would suggest the dose is too high. I wouldn't expect that though, but then you never know.
 
I'm not sure if I read this right, but are you scruffing him to give the shot and ear pokes? I would experiment with not doing that if possible - I had a hard time with ear pokes for Bix when I would try to restrain him at all. When I discovered that if I played my cards right he would sit still on his own, things went MUCH better. For him, what worked was to give him a distraction (turned out to be the little plastic baggie the 10 starter lancets came in). He just fussed with that and didn't care what I did at that point. I know some give the shots while their cat is eating, so same concept.

If you are using the U40 syringes with the larger needle, you might want to try switching to U100s (REQUIRES using the conversion chart for doses) with a shorter needle - I found those shots are pretty much unnoticeable, you don't need to tent as carefully, and they don't seem to notice the poke at all.
 
Ginny, the shot's generally go in unnoticed by kitty. It should not hurt at all. sooooo, he is conditioned to not like it i think...not that it hurts him at all.
can you try to make it a non event. you do not have to tent unless he is really skinny. you can just kind of jab it in.
try catching him busy...face deep in breffis...just jab and walk away. no sweet talk, nothing. jab, plunge, walk.
that is what i do.
i honestly do not think tom knows he is getting a shot.
 
The routine:
I pick him up (1st strike) and put him on my lap--back legs on my lap, front legs on the table. I scratch around his ears. Sometimes he relaxes and lays down and sometimes not. I then poke his ear (2nd strike) and give him a low-carb treat. He's usually pretty hungry by this time, so he gobbles this down, but doesn't want to maintain the position for the next step, the shot. If he maintains his position, then I scratch behind his ears again (he loves this). As soon as I try to find a place on his neck to tent (3rd strike), he starts getting agitated and then gets squirmy. It's very difficult trying to get the needle in when he's moving, biting and hissing! But as soon as shot is over, we run downstairs to his meal and he's happy about that.

I tried giving the injection while he was eating and that was successful for the first few days of the shots, but he wisened up.

I don't think the needle has anything to do with it, but I did recently switch over to U100s. Also switch to finer guage lancets b/c my hubby had bought some really big ones. Currently, I'm using a Tru-Track meter and that requires 1 microliter of blood, but see where the Relion only requires a third of that, so will be switching to that very soon.
 
hmmmm, i wonder if you'd have more control over the situation if instead of having him in your lap...you had him on the floor and gently kneel over him. In the beginning I used saddle tom between my legs and sit on him (of course with no weight at all) and this way I had full view of ears, equipment and he was under me so not as easy to swipe me (he never tried to swipe but he's good in that regard)
 
So the things that jump out at me are:

- separate the shot from the rest, so once he is getting squirmy after the test, let him run off and do whatever - then do the shot later, so you aren't starting off from an agitated place already. You may find he's less squirmy too if he's eaten already? I'm wondering how much of the resistence is b/c he's hungry? (I know I'm grumpy when I'm hungry, LOL!!!)

- if the U100s you have have the short needle, you don't need to spend the time it takes to do all the tenting bit - I never shot straight in, I know several do that, but I lift up a bit of skin on their side, behind the shoulder blade and a couple inches down from the spine. Might make him less fidgety if it isn't up by his neck (I wouldn't get down towards the tummy though, that's just asking for trouble IMO!). When I have to give a shot I just pull up the skin a little, poke & done, they don't seem to notice it much, or if they get agitated I'm done before they can really react.
 
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