Newbie Seeking Advice

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I can't believe he survived 5 units either, it's amazing. I have been taking his BG every 2 hours today as you can see on his chart.

The only physical differences that I have noticed are less trips to the water bowl and peeing in the litter box. Since he's been diagnosed though, he walks a little funny as if his back legs are weak.

My main concern now is that even .5U will be too much while I'm away...but then again I don't want his numbers to go way up either.
 
The back leg weakness may be diabetic neuropathy. My boy had it too, as well as in the front paws. The 109 around nadir today is very nice and safe but since it's quite a drop from his AMPS, he may bounce tonight at PMPS. Don't be alarmed and do not increase the dose. If he doesn't bounce before PMPS and you get another PMPS less than 200 tonight, we may consider further reducing the dose to 0.25U. As his numbers get under better control, it should help reverse the damage from neuropathy :).
Also, if he is under 200 for PMPS, if no one is around to help (I can't stay up tonight) you can skip the shot again. Will probably give a higher AMPS like today but try the reduced dose of 0.25U :)
 
I agree with Yong. Try the 0.25u dose to see if that brings the pre-shot AM numbers down. Leo is clearly demonstrating every cat is different. But that's Ok 'cause a lot of us have cats who have not read the manual! What interesting cycles Leo is having!
Some folks us Zobaline for some extra support for the neuropathy.
Do you have syringes with half unit markings? There are two options for dosing small amounts with U40 insulin. You can get U40 syringes with half unit markings or you can use U100 insulin syringes with a conversion chart. The latter lets you finesse doses even more but you may have to take some other measure to ensure a sitter draws up the right dose. Don't worry , it's a bit more work pre-trip (maybe 10 minutes tops) but for safety sake it's worth it.
 
MrWorfMen's Mom said:
Do you have syringes with half unit markings? There are two options for dosing small amounts with U40 insulin. You can get U40 syringes with half unit markings or you can use U100 insulin syringes with a conversion chart. The latter lets you finesse doses even more but you may have to take some other measure to ensure a sitter draws up the right dose. Don't worry , it's a bit more work pre-trip (maybe 10 minutes tops) but for safety sake it's worth it.
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The syringes I have aren't marked for half units. Do you know how I go about getting syringes from a different source? If possible, I would like to avoid going back to the vet where I usually take him. The last time I asked about getting supplies or insulin elsewhere they pretty much told me they would be the best and cheapest place to get everything. I did call Walmart about a week ago and asked about purchasing syringes and they said I need some kind of proof that I need them. I have receipts that say syringes/vetsulin but I'm not sure if that would work? If not how would I go about asking my vet for a prescription?
 
Every state has their own .laws regarding syringes. You are using a U40 insulin whereas most human insulins are U100. A lot of folks in the US get their syringes both U40 and U100 from ADW diabetes online. U100 are available through local pharmacies but U40 are not. If you need a prescription in your state, then I think ADW just has you fax it to them.

As far as dealing with your vet is concerned, they have probably never heard of using U100 syringes for U40 insulin and might give you a hard time. I'd check out ADW and ask the vet if they will price match on the U40 syringes with half unit markings., If they can't, they should give you a prescription for them or the U100 syringes. If you need proof that the U100 syringes can be used, HERE is the conversion chart. I think your biggest issue is going to be dealing with reducing the dose from 5 units down to 0.5 unit or even 0.25 unit. I'd take/send a copy of the Spreadsheet showing the low pre-shots Leo has been getting as proof the 5u was far too much insulin. That may be you biggest hurtle and I wish I had a simple answer for that problem.

It can be challenging dealing with vets especially those who think they know what they are talking about but are really totally out to lunch on feline diabetes. Your vet has been treating Leo as if he were a dog and that just doesn't work.

I'm in Canada so I am not up on all the regulations, laws etc. in the US but you definitely face a few more challenges than we do when it comes to syringes as ours are readily accessible without a prescription.
 
I think Leo may benefit from using U-100 syringes with the conversion chart. It really does help with finer doses and smaller ones. :) I taped the conversion chart to the refrigerator and hid any left over U-40 syringes I had :D. If it makes you too leary since you are still early in the dance, I'll leave you the link for the U-40 syringes with half unit markings that I used. Should you decide you want to try the U-100s, I can link you the one's I used with a U-40 insulin and conversion chart too :)
U-40 syringes with half unit markings: https://www.adwdiabetes.com/product/16363/carepoint-vet-u-40-syringe-29g-half-unit

Also, I like visuals so if you want to try U-100s, I can take pictures of the 0.25U dose on a U-40 syringe AND the 0.2U dose on a U-100 syringe with conversion ;)
 
Thanks for the tips guys! The vet has actually sent me home with U-100 without telling me they are different. It wasn't until I looked it up online weeks later that I realized I needed to convert so I do have a little experience with them. For now I'll do my best to calculate where .25U is on the U-40's I have. His PMPS is 227 so I guess that means we'll try out the .25U again tonight.
 
Crystal & Leo said:
Thanks for the tips guys! The vet has actually sent me home with U-100 without telling me they are different. It wasn't until I looked it up online weeks later that I realized I needed to convert so I do have a little experience with them. For now I'll do my best to calculate where .25U is on the U-40's I have. His PMPS is 227 so I guess that means we'll try out the .25U again tonight.
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Your AM dose isn't showing on your SS. Was it 0.25 u?
 
Leo's AMPS was 382 this morning so I gave him another .25U. His stool was really soft, light in color, and really smelly! Do any of you know of any good low carb sensitive stomach foods? I found something called Instinct by Nature's Variety Limited Ingredient--just not sure of the carb amount in it.
 
Looks like Leo has had some issues with food before. What was the reason he was on the Hill's Sensitive food? History of IBS or IBD? You made the food change to FF relatively recently so that is likely the culprit and a change to something else may be the ticket. I would watch his appetite and if he shows any signs of becoming reluctant to eat, a vet visit might be a good idea. Chronic pancreatitis is more common amongst diabetic cats and smelly, light colour stool could be symptoms of that so while it's probably just the diet change it's better to be forewarned just in case.
 
MrWorfMen's Mom said:
Looks like Leo has had some issues with food before. What was the reason he was on the Hill's Sensitive food? History of IBS or IBD? You made the food change to FF relatively recently so that is likely the culprit and a change to something else may be the ticket. I would watch his appetite and if he shows any signs of becoming reluctant to eat, a vet visit might be a good idea. Chronic pancreatitis is more common amongst diabetic cats and smelly, light colour stool could be symptoms of that so while it's probably just the diet change it's better to be forewarned just in case.
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Pancreatitis was my next thought too.
 
Yong said:
Is he still eating and drinking well? Have you tested for ketones yet? Have you seen the Food Chart many of us use? 3 of the NV Limited are less than 10% carbs. :)
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He definitely has a good appetite and is drinking just a little less. I haven't tested for ketones, can I do that at home? I just checked out the chart, thanks! His +6 check was a bit higher than yesterday but that could just be me not giving the same exact dose since it's harder to do on these syringes. Should I continue with the .25U tonight though?
 
I'm assuming you may have shot already but if I were you, I'd stick with 0.25u tonight and tomorrow. He seems to be flattening out a bit which is good but let's see what he does tomorrow before increasing again. This is the first day he's had what I would consider to be more like the expected curve. Looks like he may need a bit more juice but let's get him comfortable where he is first to keep any more bouncing at bay at much as possible.
 
I agree in sticking with 0.25U tonight and we can see what he has for AMPS before increasing. Yes you can test for ketones at home. Just pick up some strips from a pharmacy or waltmart/target and a long handled spoon. Label it Leo's spoon and you'll just sneak it under him when he's peeing to catch a tiny sample to dip the strip in ;)
 
Nice pre-shot this morning. Gotta wonder how low he went last night but it looks as though he has leveled out and stopped any bouncing now. I'd stick with 0.25u today and see if today's cycle is similar. :D
 
Today is my last day to get a full true "curve." I'm planning on freezing some FF to be put out in-between insulin since nobody will be here during the day. Hope we can come up with a definite dose to give him while I'm away.

Leo is doing well and the BG readings are much less stressful. :)
 
Crystal & Leo said:
I can't believe he survived 5 units either, it's amazing. I have been taking his BG every 2 hours today as you can see on his chart.

The only physical differences that I have noticed are less trips to the water bowl and peeing in the litter box. Since he's been diagnosed though, he walks a little funny as if his back legs are weak.

My main concern now is that even .5U will be too much while I'm away...but then again I don't want his numbers to go way up either.
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Get your cat on vitamin b 12 methylcolbamin for the neuropathy
 
Crystal & Leo said:
Leo's AMPS is 403 this morning. If anyone is awake could I get some dosing suggestions? Maybe try .5U again? @Yong @MrWorfMen's Mom
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You can try 0.5 u again to get the data and IF you're able to monitor. He's had several cycles at 0.25 u and that part of the picture is fairly clear. It's possible that you'll end up doing what we call "fat" and skinny" doses once we see what 0.5 u does.
 
Glad Kris and Janet were around to help out this morning! Leo is definitely keeping his puzzle interesting. Some kitties are very sensitive to small dose changes and it looks like Leo may be one of them.
 
Good morning! Today is the day! I will be leaving in a few hours.

If anyone has a moment to look at my chart and give any dosing advice for when I'm gone it would me much appreciated! If I don't hear back from anyone I will go just go with my best judgement and play it safe with .25U, just while I'm gone.

Thanks everyone!
 
I'm inclined to think it's best to stick with the 0.25u for now especially if your sitter will not be testing. We never know if our fur balls will eat as well when we are away or if they will gobble all their food up early and have nothing left for later in the cycle so letting them run a bit high for a few days is safer.

Are you leaving a sample syringe so sitter knows how to draw up 0.25u or have you shown the sitter how to do so? I'd also leave your sitter instructions for nearest vet and handling hypos just to be safe.

Happy Birthday and enjoy your trip! :D
 
Crystal & Leo said:
Good morning! Today is the day! I will be leaving in a few hours.

If anyone has a moment to look at my chart and give any dosing advice for when I'm gone it would me much appreciated! If I don't hear back from anyone I will go just go with my best judgement and play it safe with .25U, just while I'm gone.

Thanks everyone!
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Have fun! Yes stick to 0.25
 
I think he should be OK as well with 0.25U especially if pet sitter will be keeping his food schedule :). Just hope you left some instructions and she'll be able to let him eat his meal before getting the shot. I'm working on typing instructions for my boy and thinking back to gradeschool "write instructions on how to make a pb&j sandwich" then someone will use them to make one. This is obviously more serious but you get the gist :smuggrin:. Have fun for your ....birthday (did I remember right? lol) trip!
 
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