Misho from Bulgaria

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Di&Misho said:
Elizabeth, what a coincidence - I was browsing this webs site today :lol: and I actually added as second choice to Animonda ( which I know is premium quality ) Bozita and Grau. The last is quite expensive like the diabetic brand I am buying now. For our standard these foods are really costly :oops: I will try either with Animonda and Bozita because both are grain free and because they are a bit cheaper than Grau .
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Yes, quite a coincidence, Diana!

Grau is expensive unless you can get the really big tins and freeze some of it (much cheaper that way; though you could buy it only to find that your kitty doesn't like it...)
But Bozita is popular here in the UK. It's a good quality food, nicely priced, and cats seem to like it too! ;-) The canned Bozita is a meaty 'pate' style food, and the tetrapacks are more 'chunks in jelly' style (with higher water content). My cats like both... :-D

Eliz
 
though you could buy it only to find that your kitty doesn't like it..
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No way Elizabeth, Misho is not a choosy cat at all, he was stray before and stray animals here eat at garbage containers...Anyway, he will eat anything and will be grateful bcatrun_gif
 
Re: Misho from Bulgaria/Automatic Feeder

Hi Diana,

Kind of like an alarm clock, you set the time you want to feed and the lid pops up, for both wet and dry food. There are MANY on the market, some with more options and some more expensive than others, but as an example only from Amazon who have lots to choose from, here is the product description for the "Catmate" as a guide for you. Hope that helps. Angela.

Product Description
Catmate Automatic Feeder C20 2 Meal Feeder

"The CAT MATE C20 is designed to feed one or two cats, kittens or small dogs when you are away during the day, evening or over the weekend. Food is kept fresh in two easy-clean compartments sealed by closely fitting lids, and cooled by a built-in ice pack. Just set the timer on each lid to open at the required time, up to 48 hours later. The feeder is constructed from high quality tough plastics and carries a three years manufacturers guarantee. Features: - Serves one or two fresh meals at your pet's normal meal times. - Suitable for cats, kittens or small dogs. - Easy clean, removable dish-washer proof lids and bowls. - Easy to use 48 hour timer gives 12 months battery life. - Over 1 year's continuous use from 1 x AA/LR6 battery (not supplied) - Ice pack and close fitting lid help keep food fresh. - Two food bowls each hold 450g (1lb) wet food. - For dogs, feeder may be easily attached to a wooden board. - 3 Years manufacturers guarantee"
 
I hope someone will be online to give me advice. I am accessing Internet from office PC now and I can't add today's numbers in the SS BG at +9- 266 BG at +10 - 257 In case it continues to drop or holds the level around these numbers do I shoot normal dose ? Anyone online please help . Thank you !
 
Hi Diana,

I want to make sure I'm understanding everything correctly as I read through your thread.

You're testing with a human meter and you're currently giving 1unit of Levemir twice a day?

If all of that is correct, I would say you should stick to the 1unit for your next shot.

Levemir has a later onset than other insulins. Lantus, for example, kicks in around +3. We switched Cobb to Levemir a few weeks ago and his onset is around +6, +7 now. It looks, to me, like Misho's may be an hour or two earlier. The one nervewracking thing I've found about Lev is that you do sometimes have to shoot lower numbers than you are used to because of that later onset. The insulin is still working when Misho is due for the next shot. It can take a little while to get used to that.

I think, given what I'm seeing on Misho's spreadsheet, it's safe to shoot with him around where he is right now. The 275, 266, and 257 are all basically the same number. He's surfing rather than dropping, which is fine!

I would stick with the 1 unit for the next shot, but since it is lower than you've shot recently, grab a +1 or +2 test if possible to see if it is going to be an active cycle.

~Suzanne
 
Hi Di,

Yep you're good to shoot, he's nowhere close to a dangerous range. :-D But does look like you're starting to make progress with his dose. A lot of Levemir kitties hit their lowest point at or very near their next preshot time.

Mel and The Fur Gang
 
PMPS was 293 , slight rise. I shot the usual but was not sure if I am making the right decision so I gave Misho a little bit more food. Will get back to the board later as I am on my way home now typing on cell :lol: THANK YOU !!!
 
Here I am again. First of all thank you to all of you who tried to help me with answer of my question. I think we have a very big time difference, I am 10 hours ahead if I am not wrong :smile:

To begin with - Angela thank you for the info regarding the automatic feeder. As I thought it is something that here we refer as luxury and is not available on the market. It seems very useful indeed and I love the idea to have it even for my own pets at home but it's quite expensive am afraid. I guess this will sound a bit silly but standards of our countries differ quite a lot :oops: So we will stick on our feeding schedule - twice daily and I believe it will not be a problem. May be I will add some sugar free treats to Misho's daily menu and I am sure he will be happy :razz:
I want to make sure I'm understanding everything correctly as I read through your thread.
You're testing with a human meter and you're currently giving 1unit of Levemir twice a day?
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Absolutely correct Suzanne.
The onset with Misho is I think at +3 / +4 it depends. Though I am not sure I know what active cycle is I followed yr advice to check BG earlier but managed for +3 and to my surprise it was a bit higher than I expected. May be it is due to the extra food I gave to Misho being afraid shooting 1 unit at lower PMPS might cause quick drop. Let's hope it is the only reason for this reading. We will see what happens next...

Elizabeth, Mel , Squeaky and KT :YMHUG:
 
Di&Misho said:
...I didn't quite get that. I should not shoot if the pre shot is 150, right? But the second part I can't understand ...
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While you are posting in the Health forum, if he is under 150 mg/dL, stall for 30 min and re-test to see if his glucose is rising. If yes, shoot. Otherwise, it can be safer to skip the shot.

If you find you have to skip a shot half of the time because he is too low, you might need to reduce a bit (skinny the dose) so you can shoot twice a day. But ... if you decide to follow the Tight Regulation protocol, they reduce the no-shot number below 150 mg/dL so long as the test data shows it is safe to do that.

An active cycle is one in which the glucose drops faster than anticipated. Sometimes the food batch changes, or the cat may be feeling unwell, or the reason is unknown. When you see signs of a faster than usual drop at +2, it can be a clue you need to be ready to intervene if the numbers head dangerously low.
 
Thank you BJM !!! I think I got it at last,what a dummy I am :-D When we reach such numbers I will surely remember it but most likely will again panic and ask advice :oops:
Of what you have explained it is clear to me that yesterday it was NOT an active cycle,right? I don't know if the reading last night and the pre shot this morning were subsequent upon the extra food I gave to Misho at PMPS , actually it was something like +2 spoonfuls.I hoped to see yellow color again ...
I guess that now I will have to keep this dose for a longer than 3 days and let's hope Misho will make some progress with numbers.
Have a happy day all of you :thumbup
 
This stuff can take a while to learn, so be patient with yourself.

Some cats go up at +2 due to feeding. Thus, when it is going down instead, it is unusual, too.
 
Hi everyone! Here I am with my next question.
After 3 days (6 consecutive cycles)... if nadirs are greater than 200, but less than 300 increase the dose by 0.25 unit.
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Does this mean that tomorrow morning I have to shoot 1,25 ? And if so shall I test earlier as 1,25 I have only shot with very high BG levels so far, I mean above 500 only.
And another question- I guess that the BG will drop more with the increase to 1,25 . What are the BG numbers I have to watch for? I mean under what level BG will not be safe for Misho having in mind his latest readings. I am sorry for asking too much but I want to know how to proceed in case there is no one of you online due to our time difference.
Thank you cat_pet_icon
 
You don't want to shoot if he's below 150 at preshot and you don't want him dropping below 50.

Mel and The Fur Gang
 
Unsubstantiated information about pet-specific meter reference numbers has been removed by Moderator.


* * * * * * * * * * * * * * *​
Examples of using the chart:

Ex. You are a new insulin user and you test your cat before giving insulin. The test is 300. It probably is safe to give insulin.

Ex. You are an established user of Lantus, following the Tight Regulation protocol. You've tested around +5 to +7 to spot the nadir. It is 200 mg/dL. You probably need to increase the dose, following the instructions for the protocol.

Ex. Your cat is acting funny. The eyes are a bit dilated. You are concerned and test the glucose. The number is 35 mg/dL. ACK! The cat may be in a hypoglycemic state. You quickly follow the HYPO protocol linked in the glucose reference values chart. (which we really, really, suggest you print out and post on your refrigerator.)
 
Mel and BJM thank you for your directions I will have all of this info in mind !
Today ( it's 6 a.m. here Saturday) dose increased by 0,25 but I am a bit confused by Misho's numbers :oops: Do you think his liver "paniced" as you say ? That was what bothered me lately that when the BG begins to drop the liver will act like this. Or may be there is another explanation for the high readings... I don't know if with the increased dose to 1,25 the BG will drop more than yesterday morning but if so does it mean there will be this bounce that happens ? I was so happy to seeNIsho's nice yellow color in the ss. I though I will see it much often but now I am in a maze again :sad: Tell me,please if I am doing something wrong !
 
I am using my phone and it doesn't always let me see the spreadsheets. My internet modem isn't working, or i'd use my computer.

If the pre-shots are higher than usual, that could be bouncing. It takes about 3 days to clear. Because you are using Levemir, it could take a dat or so longer.

Also, there is a phenomenom we call "New Dose Wonkiness". Sometines, when you give a new dose, the results are opposite of what you expect. You may need to give it several days to settle down and stabilize. As long as the lowest number in the cycle stays above 50 mg/dL, Misho should be OK.
 
So glad you are online, it was not the new dose. He was still on 1 U yesterday at AMPS 369 he was 202 at +5 and the PMPS 400 . I measured 2 times last night and it was pink and red color.Todays AMPS - 436 :oops He is now on 1,25 and I am afraid the BG will drop more so what do I do with his Liver ,obviously cannot explain him @-) as he will probably be as confused as I am :roll:
 
The best you can do is be prepared. Have Karo syrup or honey or other sugar avaiable, plus high carb food with gravy. Also have enough test strips in reserve so that if you ever think he might go too low, you can test to check that.

When the numbers are in the 50s and there are hours to go before the Levemir starts wearing off, you steer the numbers. That means you use medium or high carb food (or regular food plus some syrup or honey) to keep the numbers from going lower.
The pattern is:
Test (re-test if you want to confirm it)
- its low, so feed 1-2 teaspoons of medium or high carb food
- wait 20-30 min and repeat until you have 3 rising numbers and are past the probable nadir.
 
Thank you BJM, your info is as always helpful but what I meant was not hypo , I have seen low numbers and I don't panic as usually I have spotted the hypo in the very beginning and actually my lowest number (just once thanks God) was 1,8 the others were all around 50 No signs of hypo or any change of Misho's behavior but what happens with Misho is different from what I read here. When I see such number I usually give him 1-2 spoons of his normal food and within an hour his BG reaches numbers from the pink zone which is obviously due to Mr.Liver's hard work and not the food.
By low I meant numbers like 200 as dropping to these numbers from pre-shot BG like 360 for the liver of Misho looks like danger. For me this is what happened yesterday. I know the pre-shot readings are not important but he continues to have high pre-shot BG and with the increase of insulin his BG is supposed to drop lower. And then comes the problem with Mr. Liver who finds this abnormal. I don't know if I explain correctly what my worries are. This is why yesterday at BG 202 I gave Misho some extra food as I didn't want it to go lower but the liver has found even 202 for dangerous . I guess it is fun to read me when I explain in English :lol: I just think that lower pre-shot numbers are much better when our goal is the yellow and blue zone of BG because the drop will not be that sharp. We will see what happens next I hope the liver will get used and will not panic.
 
As his body becomes more accustomed to lower numbers, he sould have less wide swings in numbers.

You're doing great.

If you want to do some more reading, the Merck Veterinary Manual has lots of stuff you can search and read. Depending on your budget, you might want to get a copy for yourself.
 
Something went wrong but I don't know what... Can any of you tell me what is going on and why I see this red color so often? Definitely I want to keep the current dose for more than 3 days before increasing .
BJM said:
If you want to do some more reading, the Merck Veterinary Manual has lots of stuff you can search and read.
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I'd love to and I am going to write my letter to Santa Claus earlier this year :lol:
 
There are a couple of reasons you might be seeing those higher numbers. This thread on New Dose Wonkiness explains why you can get higher numbers when you first increase. That same post also describes bouncing. Cats can bounce either from fast drops or getting to lower numbers than they are used to. Misha's body may not be used to those yellow numbers he got.

As for dose, as long as the lowest number you are seeing is yellow, I think you are fine to increase by .25U after 6 cycles at this dose. When you start to see blue numbers, then you can slow down the increases. More insulin will also help reduce the reds.
 
Hi there! I am on cell phone and cannot access Misho's ss.I came to measure his BG at +6 and it's 172! Shall I give him some food because I am afraid BG will drop lower and Misho will bounce again? Hope someone is online to help with advice!
 
172 is safe and great to see! You only need to worry about giving him high carb food if he's less than 50 (2.8). If he gets below 100 (5.6) you can give him a teaspoon of low carb food, but this late in the cycle he should be fine.
 
Wendy&Neko said:
172 is safe and great to see! You only need to worry about giving him high carb food if he's less than 50 (2.8). If he gets below 100 (5.6) you can give him a teaspoon of low carb food, but this late in the cycle he should be fine.
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Won't he bounce Wendy ? His pre-shot was 358.I am so much afraid his Liver will panic just like me :sad:
 
He may bounce, but there's not much you can do to stop it. As his body spends more time in lower numbers he will become used to them and bounce less.
 
Thank you Wendy :YMHUG: I came home to take some stuff and will go back and stay with Misho just to be on the safe side and test him again. Hope all will be well till his AMPS . Have a good night !
 
Good morning. I decided to hold Misho's dose for some more days before increasing to 1,5. The reason why is because I think his liver is not yet used to low numbers and bounces . May be he needs more time and I decided to shoot 1,25 for at least 5 days which I read is according protocol. I hope this was the right decision. If you think my logics is wrong tell me please as I want to do the best I have to and may be it is not what I do. Thank you !
 
Its OK to slow down so long as ketones are not an issue. Some cats may do better aiming for nadirs below 200, then shifting to nadirs below 100. ECID = each cat is different. You have to find what works for you and Misho.
 
Good morning everyone! I thought that keeping this dose will help the liver to get used to lower numbers but it seems to me it doesn't work :sad: I think to increase by 0,25 for tomorrow's morning shot and hope to see at least small progress. I don't understand why MIsho's pre-shot continue to be high and how increasing the dose will lead to reducing the reds :roll: Tell me please are his numbers normal according to what I shoot and the time we've been working following the protocol.Thank you !
 
If you are following the Tight Regulation Protocol, this is what it says:
Increasing the dose:

Hold the dose for 3 - 5 days (6 - 10 consecutive cycles) if nadirs are less than 200 before increasing the dose by 0.25 unit.
if your cat is new to numbers under 200, it is recommended to hold the dose for at least 8-10 cycles before increasing.
when your cat starts to see nadirs under 100, hold the dose for at least 10 cycles before increasing.

After 3 days (6 consecutive cycles)... if nadirs are greater than 200, but less than 300 increase the dose by 0.25 unit.

After 3 days (6 consecutive cycles)... if nadirs are greater than 300 increase the dose by 0.5 unit.
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You will have held the dose for 10 days if you increase by .25U tomorrow morning, so that is the right thing to do. More insulin will improve all the numbers, including the preshot numbers. His numbers look normal for what I've seen in new diabetics following the protocol. You just have to keep increasing as you have until you find the right dose.
 
Thank you Wendy ! I Tomorrow I will shoot 1,5 . I feel better when you say his numbers are normal. The other thing that bothers me is that when you shoot doses like 0,25 or 0,75 or whatever but not exactly an unit you never know if you draw the right dose. I do it using magnifying glass but still I am not sure it is one and the same everytime :oops: My syringes are BD Micro fine+Demi 1/2 unit . I have also seen a tiny drop left after the shot I don't know why it happens but I think that even a small amount can affect the BG :oops:
 
I too am using the BD syringes with 1/2 unit syringes. Several of us here use digital calipers to measure. Here is a post on dosing with calipers. My calipers came from a metal working tool shop. Between the calipers and a magnifying glass, I think I'm getting consistent doses. The BD syringes don't always have the zero line in the same place. I've seen differences of at least .25U between syringes. The other trick some people have done is create a scale on a piece of cardboard, and compare against that. It helps to be consistent from dose to dose.
 
:shock: Wendy this looks way too complicated for me.. I read it several times but I doubt I can manage with finding this type of caliper here or finding out how many mm is the dose I draw. I am shocked to read every syringe is different, is that normal ? I doubt that in hospitals anyone uses such techniques to dose insulin. My gosh I am all mixed-up. It is so nice though to read such themes and watch videos people have recorded to help all of us .That is :RAHCAT
 
The reason for in inaccurate dosing of small amounts is that the location of the lines on the insulin vary from syringe to syringe (zero line is not in the same location). I would expect more variation of syringes from different lots (manufactured at different times and maybe different machines) but there can be large variations between syringes in the same box.
However, the inside diameter of the syringes are well controlled so that if you push the plunger fully in and then pull it out a specified distance the does will be essentially the same. That is what the caliper method uses.
You push the plunger fully in and measure the distance and then pull the plunger out the same distance for the same dose.
 
You can use a ruler with fine tick marks and line it up with the syringe barrel to get consistent dosing.

If you always line it up the same way, even if the tick marks doesn't give you an exact volume, they do give you a reference point.
 
Larry and BJM thank you so much for your explanations. Definitely the caliper is not an option for me .In the meantime I read about a kind of printed pattern some people use but I couldn't find any.
BJM said:
You can use a ruler with fine tick marks and line it up with the syringe barrel to get consistent dosing.
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I am sorry to ask silly question again but is it a normal ruler I can buy or it is the kind of printed pattern I have read about? I will continue to search info myself but honestly this issue is quite oppresive for me as things are difficult and complicated enough under the circustances I take care of Misho . I mean the thought that may be I don't draw consistent doses due to my lack of knowledge :sad:
Today I increased Misho's dose by 0,25 and shot 1,5. I hoped to see more blue color if I keep the 1,25 longer but it didn't work like this I wonder what will happen now.
Thank you again for your help !
 
A normal ruler, perhaps millimeter markings. You want something with fine enough tick marks that it makes sense to use it as a reference.
 
Good morning everyone ! Yesterday something strange happened when I least expected. After the PM shot the BG didn't drop at all I tested twice and there was slight raise to end up at red AM pre-shot. It definitely wasn't fur shot I always smell the spot. In the morning it was all OK and I saw very nice numbers so I thought it will be the same in the evening. Can you please tell me what can be the reason ? Thank you !
 
Sometimes, there is no identifiable explanation.

Might be slight bouncing - he got down near 100 mg/dL.
 
Thank you BJM ! That was exactly what I thought. But yes it was a slight one and for me this means things are getting better . I so much believe that someday we will have these green numbers and no shot marking on our ss cat_pet_icon
 
Nice to see those low blues on the SS. Misho is making progress. :-D

There is another option for rulers, if you are using the BD Micro-Fine1 Demi 0.3-mL U-100 syringes. If you look at the Tight Regulation Sticky, 5 paragraphs down, there is a document you can download called Management of Diabetic Cats. Starting on the 5th page of that document, there is a technique for measuring smaller doses, plus a link to a document you can print with rulers for the BD syringes.
 
Thank you Wendy .
.. plus a link to a document you can print with rulers for the BD syringes
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That was what I have once read about but couldn't remember where I have seen it. I will print this out and use it as I understand that not exactly the dose to the very last tiny drop is so important but the consistence of dosing or at least this is what I think. Yesterday it was the same situaton with Misho- nice blue numbers after AMPS and then again more high after PMPS and red AM this morning. I took a test earlier last night as I thought it might be a possible earlier drop off but nothing like this happened.
I have read about how Lantus and Levemir are prolonged insulins but with Misho we always see a rise after +8. In very rare cases I have seen a drop to the +10 or +11.
Anyway I think that BG levels are much more steady than they used to be before and no matter I don't see this nice green color I am dreaming of :smile: I am much more convinced we are on the right path.I will keep the current dose for today . Do you think I have to increase the doses more quickly once I see the nadirs ? I don't know why I prefer to keep every dose for more than 3 days,it 's just a feeling.
 
With Levemir's longer sustained effect (compared to Lantus), it makes sense to me to stick with a dose longer.

The Start Low, Go Slow protocol holds a dose for a week before considering an increase.
 
If you are following the TR protocol, you slow down once you see blue nadirs, so your instinct is right. From the protocol:
Increasing the dose:

Hold the dose for 3 - 5 days (6 - 10 consecutive cycles) if nadirs are less than 200 before increasing the dose by 0.25 unit.
if your cat is new to numbers under 200, it is recommended to hold the dose for at least 8-10 cycles before increasing.
when your cat starts to see nadirs under 100, hold the dose for at least 10 cycles before increasing.
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I'd stay 8 to 10 cycles on this dose before increasing. You are seeing more and lower blues, so Misho is seeing progress. :-D The TR protocol makes no difference whether you are using Lantus or Levemir, we hold them the same length of time regardless of which of those insulins you are using.

You may find as Misho gets closer to the dose where he sees those greens, you'll get longer duration. Neko has a variable nadir, but it's generally later on Levemir when she's seeing more green, and has been as late as +12 to +15 (into the next cycle).
 
Thank you to you both BJM and Wendy. I think I carefully read and I hope I understand :smile: all your directions but sometimes it is really a feeling that I have to do something. May be it is not always the right decision to make but I follow it. When I decided to hold this dose my thoughts were the same as yours Wendy but now I see than on some unknown reason the BG level is raising and though we didn't have any low blue nadirs last night, today our AM pre-shot is red :roll: And here is where I am confused- to hold the dose or increase by 0,25 tomorrow :oops: . If in the first days a slight rise I accepted as bounce now I don't see any reason for this high pre-shot number or the yellow nadirs instead of blue ones. And if I don't see them today and the nadirs are > 200 I would prefer to increase to 1,75 tomorrow morning. Will this be OK? Today I am going to print that ruler and start using it when dosing, I am very much curious to see if this will make any difference. I do apologize for being a nuisance all the time but your opinion is always my starting point. Have a happy day everyone !
P.S. A very important question to ask ! As I have mentioned before Misho is a rescued stray cat and he is not vaccinated yet . I had his FelV /FIV test negative in the very beginning, i.e. he is not ill .. The vaccination protocol in my country requires rabies +Feline calici virus infection, rhinotracheitis, and panleukopaenia vaccine. My idea is to find a forever home for Misho in Austria or Germany one day and thus he will have to travel internationally but movement of pets within Europe is not allowed w/o vaccination. My question is do you think it will be medically contraindicated to vaccinate Misho ? I don't know if the immune system of diabetic cats is generally compromised :oops:
 
There are numerous factors which go into the blood glucose level - activity, food batches, food timing, stress, insulin age, illness, and more. Sometimes, you just have to wait it out, monitor for things you can control, and aim for the overall averages of several days to be within preferred levels.

You might go ahead and vaccinate him now or wait until he is more stable and you have his optimal dose determined,. If he has never been vaccinated before, maybe start with rabies, then add in the others a bit spread out over time. Some cats can have adverse reactions to vaccines, so by spreading them out, you can determine if any provoke that. I did have a cat have a reaction within about 30 minutes of getting a vaccine, so waiting a bit at the vet before leaving can be helpful if it is a far distance from your home.
 
If he has never been vaccinated before, maybe start with rabies, then add in the others a bit spread out over time.
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The core vaccine is 3 in 1 they always administer the core vaccine and the rabies in one and the same day it is for dogs and cats as well I don't know what the protocol is in your country. But I can ask my vet to administer the core vaccine separately from rabies I have done this before . Thank you for your answer BJM!
As regards BG level - Misho's schedule is as constant as possible. Insulin is always administered every 12 hours +/- 5-10 min. Meal immediately after shot always one and the same portion, one and the same food. Misho lives in a quite roomy place with no other pets and nothing to cause him any inconvenience. He is not an active cat ,shows no interest in any toys and prefers to sleep or just look out of the window and "speak" to the birds :smile:
Today I saw no blue color again but the PM pre-shot was yellow . I will check the BG later and will decide whether to increase or not for tomorrow's morning shot. Let's hope for the good !
 
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