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hbs60

hbs60

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Hello, everybody,

I think I have posted here way in the past about my 14 y/o cat Eukanubo, who was diagnosed late 2009 and went into remission around 2010. He recently had a relapse (about a month ago) and I've posted about it in the general forum.

He is currently on ProZinc 1 unit twice a day, however his glucose readings are all over the map, so I'm hesitant to increase his dose even though his numbers are consistently high. He is a free-feeder, and I've been trying to find a new can food that he would like (his remission was on Friskies Mixed Grill but for some reason, he refuses it now. Last year he had some mystery illness, lost lots of weight even though his glucose was normal, but he recovered on Fancy Feast Medley Shredded Chicken Strips Fare, but I suspect that is pushing his glucose high, anyway, I know this is probably part of the problem). Clinically he is all over the map, sometimes very frisky and playful, but sometimes looks very ill and listless. Yesterday for his PM shot, his glucose reading was HI, repeated it was 533, so I decided to give 1.5 instead of 1 unit. He did OK on this, although by +6 he had dropped to 261. This morning it was 449, so I gave the usual 1 unit. I'm not sure if I should be concerned about Somogy. More worrisome, I don't think he's used the little box since yesterday, which is why I'm taking him to the vet, but if anybody could comment on his spreadsheet readings (scroll way down as this is data from 2010 on) that would be great.
Thanks!
 
PS: he just used his box, much to my relief. The vet won't open for another hour, but at least it seems a bit less urgent now.
 
Good morning, HB and Eukanubo! ~O)

I'm glad to hear a vet visit is coming up so everything can be checked out. Poor little guy sounds like he just doesn't feel all that well.

No dose advice. It's a head scratcher for me. :sad:
 
Hi HB ~O)
That’s good news Eukanubo used his box now and you can relax a bit. I think it’s wise you are going to get him checked out at the vet to make sure nothing else is going on. Indeed his spreadsheet is all over the place. Has he showed any other clinical symptoms of the diabetes coming back? You know, the standard stuff of drinking a lot or really hungry and scarfing down food or a muddy litter box?

I hope you get some good answers today from the vet. I think once you find out what’s going on with him you can get down to business finding a good dose and feeding scenario.

Best to you guys today. Keep us posted :-D
 
Update:
No ketones in urine, but glucose ++++
Curve: 8:30 AM: 345
10:30 AM: 338
12:30 PM: 274
3:00 PM: 397
5:00 PM: 481

The vet recommends increasing dose from 1 unit twice a day to 2 units twice a day. I'm inclined to start at 1.5 units twice a day for a few days to make sure he doesn't bottom out, then increase to 2 units twice a day. Thoughts?

Clinically, he looks very good right now, happy to be home!
Thanks!
 
Welcome back! I hope we can help you figure your boy out. Did the vet check for a UTI? I noticed in your notes he peed outside the box recently.

Yes, our suggestion would be to increase by .5 rather than doubling the dose.

Hard to know about his numbers. He seemed to be doing pretty well on one unit, then started throwing pinks and blacks. Nothing else changed - food or end of the vial or?
 
I don't like to give dosing advice; but looking at your ss hes all over the place.
I would not go up from 1.0 to 2.0 units without more data.
I would probably try a 1.25 U and see how he does on that for a few cycles, no more than 1.5 U
1 unit is a big jump, and you might miss the dose he really needs by upping that much at a time.
 
HB,

Welcome back! I'm relatively new here, but it seems like your instincts about 1.5 units are good. I also think you're on the right track looking for a wet food. If you can afford it, I would recommend the canned Purina DM available from your vet. My cat loved it (but he's not a picky eater).

People will get tired of hearing me say this, but I have found that the most important thing for me is consistency in feeding. As soon as I started feeding Melville only twice a day, he immediately improved. I went almost two months feeding him 4-6 times a day, sometimes feeding him 180 grams, sometimes 250 grams total, thinking that smaller meals would be better (and also believing that Melville would stage a mutiny). Now, Melville eats 100 grams in the morning, 100 grams at night, and a small 20 gram "bednight snack." So, he always get 220 grams of food in a 24-hour period (this comes out to be 20 grams per pound per day). That's one variable I no longer have to worry about. I can check that off the list, so to speak.

Of course, you know your cat best, and it sounds like you're on the right track. I hope you find that he doesn't have any other problems (infections, etc., which can cause bouncy BG) and that you can get back onto the road to regulation.

Just curious: how much does your cat weigh? If he's a big boy, 2 units might be just about right (there's some formula out there -- xx number of units per pound -- that is supposed to be a safe starting point. I'm just interested to see how accurate this is).
 
I'm not sure about the UTI issue, as this wasn't actually a vet visit, I dropped him off for the curve but requested the U/A for the ketones, I don't think he has a UTI but it's more about spilling so much glucose in the urine. As far as the 1.5 or 1.25 doses, my syringes only come in 1 unit increments, so I'm eyeballing 1.5, any suggestions on how to be more accurate with the syringes I have?
 
He weighs around 10 pounds, he used to weigh a lot more and currently fluctuates between 9 and 11 pounds. He is very finicky and temperamental when it comes to food, very unpredictable, and I don't know how to convert him from a free feeder to a twice a day feeder. I also have a female, younger cat who eats dry food (she has a chronic vomiting problem so I would rather not feed her wet food) and I have to be on alert to keep him from eating her food, it's quite a juggling act but so far we are working it out. aaarrrggghhhh! :YMSIGH:
 
Many ProZinc users use U100 needles and a conversion chart to give the smaller increment doses. To get .25 on U40s, you can eyeball it and then mark it with a marker or tape and keep that as a sample syringe, to try to get the same amount each time.

I know Melville likes the Purina DM but he is the exception. Usually cats tire of the liver. If you try it, I would only get a few cans to start.
 
Keeping food intake constant can be helpful, but you must know the caloric value per portion first. 100 grams of food A is not the same as 100 grams of food B. You have to make sure they are getting sufficient calories per day.
Insulin doses for cats are independant to weight. A starting dose may sometimes be determined that way by some vets. But a ten pound cat may require more insulin than a 20 lb cat. Other things factor into it.

Carl
 
I had to eyeball my u40 syringes for dosing Poopy. My eyes are old and worn out. I ended up counting ring widths (I counted five ring widths between same spots from 1 unit to 2 units, so I counted them as .2 each, and marked them with a fine Sharpie. I used my marked syringe as my guide filing other syringes. It may not have been perfect but it was consistent. :-D

When I switched to u100 syringes, I didn't see much difference with Poopy's numbers so I must have been pretty darn close. :-D

On the food note: I'm trying the feeding one type of food for Poopy to see if it makes a difference since he likes to move up and down with his numbers. Not as much up and down as Eukanubo though. My civvie kitty was a barfer. At least once a day the dogs would get all excited, waiting to see what she'd bring up. (Ewwwww!) Since switching her to the same canned food I feed Poopy - no more barfing! Woot and Woohoo! Dogs aren't so keen about it but I can sure live with that!

A small note about Eukanubo's curve at the vet's. A lot of cats are stressed at the vet's and show higher numbers. While Eukanubo may very well need more insulin, I'd hesitate before bumping it up too much at once - especially since Eukanubo goes low on occasion with the 1u. If you're able to monitor, that's fantastic! I'd still go slow raising the dose though. Maybe .2-.25 at a time to see how Eukanubo reacts. :smile:
 
Thanks, all. I slept all night as I didn't sleep well the night before, and I wanted to give him a break from all that testing, so I don't know how he did after the evening shot of 1.5 units, but he was very perky and looking better. This morning he is doing great, but saw that his AMPS was 248, so I was hesitant to give the higher dose, so I just gave him 1.0 units, as I have to go to work and don't know if I can be back in 4-6 hours to recheck on him. I notice that his numbers at the vet yesterday were better than expected, probably because he wasn't able to free-feed, giving a curve that made more sense. Problem is that he keeps whining for food, I serve out a little, he eats a little, but leaves some, then he wants more but won't eat until I serve more, but the food accumulates and eventually goes stale. If it wasn't for the insulin I would just ignore him and he would have no choice to either go hungry or eat, but with insulin on board, I'm hesitant to do that especially if I'm not around. I think he is neurotic and needy and I think he needs counseling :lol:
 
Cats on the couch - wonderful! I'd suggest they ALL could use counseling.

If I were you, I would work with the food. Since the latest numbers (which were pretty good) were at the vet probably with less food available, maybe controlled meals will help. We use an automatic feeder which you could set up for a few times during the day with small amounts of food. To work with his pickiness, if there is a treat he likes, maybe sprinkle it on top? The theory (hah!) would be that once he realizes the door will open and food will appear, he will be interested.
 
I stopped home for lunch and his dish was empty and he was whining for food so I served more, checked his glucose and it was 320 (this is around +5, it's difficult to test him before eating as he gets very angry and combative, so I check it while he is eating, he doesnt' even know I'm there). He seems to insist that I stay there while he eats, if I go to a different room, he ignores the food until I go back and sit there. Sometimes he seems to need to be reminded where the food is, I wonder whether he could have some dementia. Still, today he is very perky and looks a lot better than 2 days ago. I expect the PMPS reading to be high, but I'll try to give 1.25 instead of 1.5 and see how that goes, if the AM reading is acceptable tomorrow (meaning not too low but kind of high), I may then try 1.25 for an AM dose, but we'll see how he does today.


Update: PMPS up to 550, so I went ahead and shot 1.5 units. He's had a good day overall, but I take it one day at a time...
 
So far, so good as far as increasing his dose to 1.5 units twice a day, his mid-cycle readings have been around 160-180, but, it's now time for his PM shot, and his PMPS reading is only 263, which is still in need of treatment, but I'm concerned about giving a full 1.5 units, maybe just one unit? He's been sleeping all afternoon but just woke up, looks OK and I'll try to get him to eat and maybe wait a little before his shot, any guidelines as far as dosing at these improved numbers?
Thanks!
 
I think I would do one unit as it is evening and it is harder to monitor overnight. You can always raise it by .25 when you can monitor.
 
I think I would drop it to 1 or 1.25 on that 263. If you want to wait for a higher number, then hold off on feeding since the food will push it up.
Carl
 
I agree with Carl...If it were me I would reduce to 1.25...
and try to get some numbers tonight :mrgreen:
 
Thanks, I've already given 1.0 units, just to be safe as his appetite is not great right now. He is really hard to figure out, he could look like he is about to die but is just sleeping, then at other times he is wide awake, alert and active, so I feel I'm on a rollercoaster chasing his sugars up and down! But I'm not complaining, as long as he looks comfortable and is not suffering I'm fine with all of this. cat_pet_icon
 
Believe me we all understand!
Shakes has some great days...
then other days I just look at him and cry cause he looks bad,
but then the next day he is looking better again!!
It will drive you nuts sometimes...just take it one day at a time :mrgreen:
 
Well, well, the numbers are looking much better even after I cut back on the dose. This morning it was 262, so I gave only 1 unit, now at +6 it is 140. I need to check a +8 as he seems to have his nadir around 7-8, luckily I don't have to go back to work until later in the afternoon. He seems irritable, and this morning he was stealing some of his sister's dry food, so I'm pleased the reading is as good as it is. I'm not sure why he seems so annoyed (probably because of me being a Helicopter Dad) but better that he is mad than lethargic. :lol:
I'm not sure what to aim for in terms of regulation, so I'll see how he does. I have the hope that he may did just like his first time around, by going into remission after only a few weeks of treatment, of course I know that this time that may not happen, but he seems to be doing exactly the same as before, either way I think we'll be fine.
 
~O) Well, how about that? This morning had to skip the shot as his reading was 195, and that was after eating! However, after a day of very good readings, his PMPS was 412, so I went ahead and gave the upper dose of 1.5, but now I'm nervous that maybe it was too much, but he seemed fine when I went to bed last night and he's doing great this morning. Do I dare hope for an OTJ celebration soon? (don't worry, I won't hold my breath but I could see it happening).
 
I think it's important to always be hopeful Mr. P (pancreas) decides to join the party, or possibly get and stay active and well! :-D That's part of the reason I try to test during cycles. If I only tested at pre-shots, I'd miss seeing a better picture of what is happening inside the Poopster. I could also miss any activity Mr. P decided to bring to the party.

I know not every cat can go OTJ, but I'm sure the kitties would go there if able and given a chance. :o That can take a lot of time and effort on our part...and on their poor little ears. :-D

~O) Here's to Mr. P and hoping he joins the parties!
 
Are you going to be around today to test? I think you could give him a token dose to keep your momentum going and support his P while it's healing, that 195 is so close to the 200 no shoot number. I would just hate to see him go all day without insulin and be really high tonight and you have to start over.
 
Darn! It's now noon and he's up to 415. He's doing well otherwise, but I'll wait until his usual evening time for his PM dose, as I don't want to throw his schedule off, unless I should do otherwise. :sad:
 
Yes, I would wait. You can shoot 30 minutes early as long as he is definitely rising.

For next time, if your preshot number is below 200, wait 20 minutes without feeding and retest. If it rises and is 200 or above, shoot a reduced dose. (The reasoning is that he would have had a long cycle to be under 200 at preshot and may have dipped low.) The amount of the reduced dose depends on what data you have. If you know he didn't dip low on the previous dose, you might divide the previous dose in half. If you don't have data, you can might be more conservative. Once you have more data, you can lower that 200 and maybe not reduce the dose as much. But not without the data. You have to know what he might likely do.

If there is any way not to skip a dose, that is best because, as you have seen, the numbers can rise quickly.

It is possible that shooting 1.5 into your pmps (which might have involved a small bounce from the blues) set you up for the low amps this morning. You might consider 1.25 next time or the one unit as it had been working well.

Tonight I would shoot either 1.25 or one unit just to get back on track safely.
 
OK, it's 4:35, and I got a "HI" reading, which makes perfect sense since he was already at 400s at noon. He's been eating ravenously all afternoon, so I'm inclined to give 1.25, maybe even 1.5, any advice? I'm planning to give the shot around 5, so if I don't hear from anybody, I'll go safe and give 1.25. Thanks for all your advice
 
YIKES!!!!!

This morning, his reading was 342, so he got about 1.25 units, but...

+ 6 reading is down to 75!!!!!

Luckily, he looks fine and comfortable, but I gave him some food (and mixed in some dry food just in case). Unfortunately, I must leave in about 1 hour, but this is too close to comfort. He seems to be eating fine, but still...

I'm thinking that he is getting more sensitive to insulin, so maybe I should drop his doses to 0.75 units (I gave him 1.25 this morning thinking that 1.5 might be too much, seems I was more right than I thought!
 
Update: recheck glucose was 81, that was after eating a mix of wet and dry food, after about 1 hour, still not high enough, so I gave some Karo syrup, it's now up to 101, so I think he'll be OK. Unfortunately I have to get going in a few minutes, I think the worst is past and maybe his reading will be 600 tonight, the way it is going. I'll be back as soon as I can...
 
Those numbers are not scary low, but if you have to go out I can see where you would be worried. I don't think you need to give any more high carb now.
 
Also, I would not lower the dose that much maybe only down to 1 unit.

He is going to be higher tonight because of the carbs but that is ok, the carbs will wear off. Don't go with a higher dose tonight because of the higher PS, just know that the higher number is because of the higher carb food and shoot a regular dose, you could stick with the 1.25u or go with the 1 unit.
 
Thanks!
I just got home, it's a little after 5, his reading was 334 and he looks fine. I'm actually surprised that his reading wasn't off the charts, so I'm still debating if I should dose at .75 or his regular 1 unit. I think I'll stick with 1 unit and since i'm home, I can monitor and force-feed if necessary :-D
 
Sounds like a good plan. I think the .75u would be ok too if you are more comfortable with that.

I expected him to be much higher tonight too.
 
hmmm... +3 reading is higher (387) than his PMPS (334). He was very irritable and growling and giving the shot was difficult so I'm not sure he got it. He seemed very hungry and irritable but has since calmed down. If I don't fall asleep I'll check again around midnight but I don't think I have to worry about his glucose dropping too much.
 
Good morning!

This is so difficult to figure out. He did OK after the weekend drop, running typically high readings through the week, been giving him mostly 1 unit, but yesterday I gave him 1.5 units twice a day and he did great, however this morning his AMPS was 244 and I was a little nervous about giving 1.5, but from prior experience, if I gave just 1 unit, he would probably have high readings later on. So, I compromised and gave about 1.25 units (eyeballing, it was probably a bit less), he is doing fine but his +2 reading is already down to 120, which makes me VERY nervous. Luckily I'm off this morning (which factored in my decision to give the dose I gave) so I can monitor him. He seems to have a good appetite, I just fed him some more just in case, but this is really hard because I can't do this every day, if I had to go to work with a morning reading like that, what should I have done?
For now, I'll keep monitoring and feeding as needed, but I have to go to work at 1:00 PM (his dose was around 5:00 AM), so I hope that by then he would have hit his nadir and on the way up. Any feedback after looking at the spreadsheet will be appreciated.
Thanks!
 
+4 is 82, he keeps dropping and it's not even his peak yet. Luckily he looks fine but this is nerve racking...
I have the Karo ready if needed.
 
Good job monitoring. 82 is a safe number. By the time you have to go to work he should be on his way back up.

I'm glad you can be home to stay on top of this.

Post your next number, how often are you testing?
 
Right now I'm testing about every 1 hour, because of the sharp drop. I wouldn't be so worried if the 82 was at +6 or +7, but if he's already at 82 this early, I worry how much more he will drop.
 
You are absolutely right to worry about that. I think I would test every 30 minutes to stay on top of it in case he starts dropping lower.

Feed him a teaspoon of his regular low carb food. You don't want him to get too full in case you need him to eat later.

You don't want to break out the higher carb food or Karo unless he starts going below 50.
 
He just ate maybe a couple of spoonfuls of his regular low carb food, he didn't seem to want the high carb, which normally he craves a lot. He is starting to avoid me because of the constant glucose checks but he is up and about, and I'm watching him like a hawk...
 
In about 1/2 hour. He is up and looks fine, and he is getting very nervous when he sees me approach so I won't want to agitate him more than needed.
 
Darn! it's 68. He just hid under the bed so it will be difficult to make him eat now, luckily he ate a little while ago. aarggh!
 
So it's 68 at +5? You are still ok. If he will eat another little bit of regular low carb food to slow down the drop even more that would be great.

Maybe a little tuna juice to get him out from under the bed, it won't help his bg but might lure him out to eat.

You are doing great.
 
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