Need comments on Shaikha's SS

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wombat88

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Shaikha is driving me nuts again trying to figure out dosing. She's still on AB's for the infection she had but we finished off one of them a few days ago. Once we did, her PS numbers started rising. It could be a coincidence, but she's had times in the past when she was in the 300's PS as well. I've had a harder time getting mid-cycle numbers now that I'm off break and back at work. I tried increasing her dose a little and did get her to reach some greens today, but am not sure if the higher PS numbers mean a slight bounce or that she needs a higher dose. She won't be getting midcycle tests while I'm gone, so I likely will have my friend rely on 0.9U doses unless she starts trending up very high. My schedule has been a bit off which may be playing havoc here too. Sometimes I've been late on the PM dose and a little early on the AM, and sometimes the mid-day dose is later than planned due to my work schedule. I've not been unhappy with her AM numbers but the 300s lately are worrying me.

I'd love it if you could look at her SS and give me your thoughts. She is so hard to judge sometimes given all her medical issues. I think we've got the infections under control, but with her liver in the mix now who knows.
 
Hmmm, I see what you mean. Today is tough to know since you don't know what happened mid-cycle - great PS, so maybe the dose was too high, but it's just guessing. The drop on the midday cycle does seem a little steep. I like the greens but I think I might stick with 0.9 rather than the 1u.

Just curious do you give the Pred all at once, SID? Have you noticed any correlation in the numbers? I wonder if dividing it in 1/2 and going BID might be worth trying?

I can't totally get my brain around her numbers. Hopefully some others will be by later. I think both Kelly & Nancy have TID experience as well as ketone experience, so maybe they will have some thoughts. You are doing really great though!
 
I divide the dose because otherwise it is too much all at once. It isn't precisely 12 hours apart now though since we are doing TID now and I don't like giving prednisolone on an empty stomach due to the risk of GI bleeds. She gets it with her AM and PM meals, so doses are 8 hours apart. She can be a steep dropper not to mention zoomer though. She nadirs early usually, but sometimes she'll stretch it out and nadir late. I don't know if sometimes her pancreas decides to help out or what. It is so hard to know what is going on in that poor little inflamed body cavity of hers. :?
 
Wish I had some advice to offer. Sorry.
Looking at her SS, I have to say, you are doing great by her.
She's lucky to have such a great bean!
 
I'd stay right there around 0.9 or 1u TID. Stinks that most of the time she gets such a short duration on the dose though. Have you thought about switching to one of the L's in an effort to get a little longer duration? If she is only getting 6-8 hours on Prozinc, you might be able to get close to 12 hours on one of the L's. It just looks like Shaikha processes insulin a little quicker than most cats.
 
Kelly & Oscar said:
I'd stay right there around 0.9 or 1u TID. Stinks that most of the time she gets such a short duration on the dose though. Have you thought about switching to one of the L's in an effort to get a little longer duration? If she is only getting 6-8 hours on Prozinc, you might be able to get close to 12 hours on one of the L's. It just looks like Shaikha processes insulin a little quicker than most cats.

She sure does process insulin faster. On the one hand I'm not giving huge doses like some cats seem to need, but what she does get she chews through quickly! I've thought about trying one of the L's. We were hoping that we might be able to get PZI to work though. Sometimes she does get good duration, but most times, sadly not.
 
She still has an infection? at least you got out of the 500's and 600's and very few 400's .... the problem is she takes so little insulin but uses it like jet fuel and when you try to counter with dose, she dives. Do you put pepcid in with the pred.? I have gelatin caps that I put both in. (1/4 of a 10 mg. REG. pepcid)

You could go to one of the L's but 12 hr. duration? don't know and you can't shoot the L's t.i.d. I like the flexibility of pzi. We don't know once the infection is cleared ..... she is really hard to dose, give me a Payne and Kitty ..... who could take insulin through a straw :)

I have a houseful of people, later I'll look again but you know that pred. plays havoc with the BG #'s, I have the same problem .....
 
Nancy and Payne said:
She still has an infection? at least you got out of the 500's and 600's and very few 400's .... the problem is she takes so little insulin but uses it like jet fuel and when you try to counter with dose, she dives. Do you put pepcid in with the pred.? I have gelatin caps that I put both in. (1/4 of a 10 mg. REG. pepcid)

You could go to one of the L's but 12 hr. duration? don't know and you can't shoot the L's t.i.d. I like the flexibility of pzi. We don't know once the infection is cleared ..... she is really hard to dose, give me a Payne and Kitty ..... who could take insulin through a straw :)

I have a houseful of people, later I'll look again but you know that pred. plays havoc with the BG #'s, I have the same problem .....

We were giving two antibiotics to work on the bile duct issue plus a UTI. She was getting a longer course than usual since she's had one infection after another since early this year. I like your analogy, though -- she does use insulin like jet fuel! She doesn't take Pepcid -- it made her feel yucky (happens with some cats) so she gets zantac instead. It goes in the same gelcap as her pred and ondansetron.

We'll keep working on the PZI, because as you say it is flexible. She did at least have a better number tonight, so maybe the slight increase in dose helped. We'll see how she is in the AM.
 
Well, true to form, her pancreas decided to help out last night I guess. At +8 this AM she was only at 107. I retested a few times but she was still only at 120 when we had to get on the road an hour later. So no insulin this AM. Hope she isn't outrageously high when my friend comes to test, feed, and give insulin this afternoon. I've told her to give 0.9U but to call me if she's still low or is unsure about dose. This is the same friend who dealt with the unregulated highs she had while I was overseas. :o Am hoping Miss Shaikha's pancreas behaves! The only change I made last night was giving subQ fluid. She had seemed better so I had skipped two days to see how it went. I thiught she needed them again so maybe that played a role. I know the pancreas does need good perfusion though she seems hydrated sufficiently. My friend will continue to give fluid this weekend so we'll see.
 
Well Wendy Shaikha is sure a pip!! if you look at her #'s since you went t.i.d. .... they look so much better!! the pred. messes with the numbers! I have just taken Payne's down 1/2 way and already the #'s are dropping,
but will she be able to do well at 2.5 mg a day?? I wouldn't worry, stay at the lower dose and let her ride the infection/meds out, by then you'll be back?? Happy July!! my favorite time!!
 
Technically you can't do TID dosing on the L's but there have been a few kitties that didn't do well on 12/12 schedules and their beans experimented with split dosing. That is where you give say 0.5u every 12 hours, but 3 or 4 hours into the cycle you may give another 0.5u, for example. I believe Venita did that with Enis and he is close, if not OTJ right now. It isn't a kosher protocol that many in the L groups like to support - but they are very much "my way or the highway". If anyone does ever decide to switch to one of the L's, always start with the set protocol to see if that works first, then you can deviate from it.
 
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