Napoleon - 410 at +4 PMPS - sugar rising after shot

Napoleon is at 410 + 4 PMPS.
Adjusted his dose to 2.75 units BID and spoke to the vet and we are starting with 3U tomorrow. Is this rebound? He has been high all day, his SS is updated. Will adjusting to a higher dose cause temporary higher readings? What is going on?? :shock:

 

I wouldn't go up to 3u just yet. His liver could be fighting the 2.75u for the first few cycles and then you could have break through greens in a day or so. It usually takes around 3-4 days for a dose to settle in. We are going through the same thing, but I am waiting to see if we have a break through here in a few days. Hang in there!

 

Thanks Kelly ;-)

Good luck to you! Hopefully this will work out for our kitties and they will be at the right dose!

 

With the exception of some missed PSs you are doing an incredible job testing. You might want to put a 0 in for the skipped dose if that's what you actually did on 5-1.

Also another note, that if you have the option to change the dosing schedule you should try not to change it more than 1 hour per cycle and optimally not more than 1/2 hr per cycle. Sometimes if I know I have a function coming up, I will start moving H's schedule up in 1/2 increments per cycle a couple days in advance. But there have been the rare occasions that H did not get his dose until several hours late and it was not the end of the world since PZI is so flexible and I shoot using variable dosing. But while you are just trying to figure this out, optimally you would like minimize timing anomalies. But I fully understand life is rarely optimal :smile: .

I know keytones have been an issue for you in the past and you might think about getting/learning the Sub-Q liquids/LRS routine if you have not already. I've read they can help with the keytones. It would be something you would bring out when you were worried about them or knew they were going on. If you want more info on this please ask.

It seemed like 2.5 was getting you somewhere perhaps - you even skipped a dose at 2.5. I think upping to 2.75 as an experiment is OK. But *I* would give it a cycle or two more. And in the mean time if I were worried about ketones I would be breaking out the LRS [and home testing the urine for keytones with ketostix or keto-diastix]. Do you know at what dose of the BCP the keytones disappear? I remember correctly you have been in a chronic rebound situation before, so you understand that that is something you would optimally like to avoid.

Maybe your vet is more accustomed to making larger changes in dosing?

No other anomalies in Napoleon's routine that could speak for the rises?

 

Dont forget that human glucometers are NOT precision instruments, in other words sometimes you are going to get a reading that doesn't always make sense, and sometimes the cause is the meter, and sometimes its the dog barking next door or the full moon, or the bread crust secretly stolen off the plate on the coffee table ohmygod_smile
Dont worry about a weird cycle here and there. You are doing great, I encourage you to go at it slow and steady until you really have a feel for his normal variations.

 

Thank you for the encouraging words Gator and Nancy. Napoleon got into turkey burger drippings from the forman grill last night so that may account for the spike, not sure. I have been testing for ketones. I do not know how to administor Sub-Q fluids, but this is something I will learn because it sounds like it would be good to know how to do this. Napoleon was at his best when he was at 5 units SID with the compound PZI. He just had his numbers go up of course during the night. This is why I am inclined to think that the 3 units might be what he needs, I think for peace of mind sake I am going to try this for a few days. I just have a gut feeling. Hopefully this does the trick. There has to be an answer out there for him.

 

Nancy and I both do LRS. I don't think I would have gotten this far with H [he has a lots going on] if I did not have the LRS up my sleeve.

The feline CRF folks seem to be the locus of info on the LRS. Here is a site about admin:
http://www.felinecrf.org/fluid_therapy.htm
http://www.felinecrf.com/managh.htm

My first word is to make sure you warm up the fluids. When you get your lesson from your vet tech they will in all probability not teach you about warming up the fluids. I warm them up with a heating pad to 101F. If you have a little extra $ then an IR thermometer from Radio Shack [or other] can really help with this.

My other tips are about procuring supplies. I like the Terumo 21g x 1" needles. You can order a box of these needles and say a dozen 10-20 drop/ml admin sets [admin sets should be discarded once a month] at my new fav place for this here:
http://www.shopmedvet.com - no prescription required in most states!
[You may also like a little extra hose they have 72" ones for $1]

I get a case of LRS [prescription required] from a local Costco for less than $30. Request from your pharm a "prescription request" faxed to your vet for 12,000 ml. 12,000ml is 12 x 1,000ml bags. Shipping on LRS is way too expensive - so hopefully you can find locally.

Here are more supplies info:
http://members.verizon.net/~vze2r6qt/su ... ompare.htm

 

Thank you so much Gator for all of this information! Better to be prepared, just in case.