No improvement at all

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Melissa and Celle

Melissa and Celle

Member Since 2011
I need an over-500 plan. It looks to me like that's where we're headed (the wrong direction) even though increasing dose more seems to be the only thing left to try.

Seriously, I don't know what to do if 1.5 doesn't start to show some signs that things are improving.
 
Hi Melissa,
Thanks for getting some more mid cycle BGs yesterday.

I want to show you several spreadsheets, but I have to find the right ones and I'm pressed for time right now.

Here is Pamela & Tigger's from when she first started on Levemir for him.

https://spreadsheets.google.com/spr...FxMFVmX25vRWc&hl=en_US&authkey=CLjftOwI#gid=0

Even though she raised the dose fairly quickly, it shows not much progress, so she kept raising it. Some cats need more, but the method of getting to how much more is what's important.

When I get back I'll see if I can find other spreadsheets. I know I've seen some which looked a lot like Celle's in the beginning. Please don't get discouraged, which is so easy to do at this point because it seems like nothing is working. You are doing the right things - testing for ketones and treating her for an infection, so you're doing very well. I'm sorry the BGs aren't showing improvement.
 
Vicky & Gandalf said:
Here is Pamela & Tigger's from when she first started on Levemir for him.
Click to expand...
Really, I'd be thrilled with numbers like Tigger had at the start of Levemir. Celle is nearly 500 again after settling in the 300s at the low doses. The curve spans 200 points, and the nadir seems too early in the cycle. Most of all, the direction of change is not good. Worse than getting no effect, her peaks are going up. I don't think we can keep increasing if it means continuing to get higher peaks until some indeterminate point when it starts to work. She doesn't tolerate those high values well. I really don't know what to do if we get another 500, but I will be desperate for a plan with hope of succeeding.
 
Reds are always hard to handle for the owner looking at the 400 number blaring back at you from the meter. How does she "not tolerate high values well?" I would expect her to be peeing quite a bit, as well as drinking a lot. Is she overly hungry? Those are signs of high numbers and poor regulation. Lethargy is also probable and more of a concern.

How much longer do you have to go on the Baytril?

It sounds like you're thinking of going back down with the dose because you see her overall numbers going up. One thing I noticed is that she had blues almost always after a few days on 1U. And her best cycle recently was probably on June 17th when she had steady 200s and that was after a few days at .85U.

So too many changes may be creating these wacky numbers. It happens sometimes on Lev. It gets ramped up, then we don't think it's ramping fast enough, so we increase the dose. Or we get reds and think we need to increase the dose. It's like dealing with someone constantly changing their mind - the Lev doesn't know which way to go!

She was on .7U for 6 days, then increased to .85U and that's when that good yellow cycle happened. If you think you should try a dose decrease again, don't go any lower than .75U and stay there. She may be one of the cats which needs longer than the 3-5 days recommended dose hold before you see improvement.

If you make a decrease, you understand it involves a greater ketone risk. I have to make that clear. I would like to see you give the 1.5U dose a few more days to see what it can do, but I understand if you are unwilling to do that.

I'm sorry it's so difficult and I know you want her to feel better. I have faith that you will get her there.
 
Vicky & Gandalf said:
How does she "not tolerate high values well?" I would expect her to be peeing quite a bit, as well as drinking a lot. Is she overly hungry? Those are signs of high numbers and poor regulation. Lethargy is also probable and more of a concern.
Click to expand...
When we couldn't get her out of the 500s before she just layed in the bathtub very lethargic. She peed on herself and didn't seem to notice or care. She just seemed really unhappy.

Vicky & Gandalf said:
How much longer do you have to go on the Baytril?
Click to expand...
We're going to do 21 days, which will be next Friday. She's supposed to go in for a sterile urine sample on Saturday to see if there is anything still growing, so I'm just hoping she can hold her bladder for the trip.

Vicky & Gandalf said:
If you think you should try a dose decrease again, don't go any lower than .75U and stay there. She may be one of the cats which needs longer than the 3-5 days recommended dose hold before you see improvement.

If you make a decrease, you understand it involves a greater ketone risk. I have to make that clear. I would like to see you give the 1.5U dose a few more days to see what it can do, but I understand if you are unwilling to do that.
Click to expand...
No, I'm not thinking of a dose decrease. I'd also like to stick with the 1.5 units for a couple of days, but I know if she goes over 500 then I'm going to be ready to give up. There is nothing now that I can think to do that seems like a logical step in the right direction. I feel like I'm violating the "first do no harm" principle, and I'd just like to stop. I'm just not sure what that means yet. I just keep thinking now that if we had stuck with our very first prescription for 2 units of ProZinc and never did a single home BG test, we'd likely be no worse off than we are now. Bottom line is for all of our efforts her sugar is totally out of control and we're unhappy all the time as we get a reminder with each test that this isn't working.
 
I am not sure what to say to that other than to share my point of view, after 6 1/2 years of dealing with a feline diabetic, who probably wouldn't be diabetic now if I had found this board and begun home testing before 3 months had gone by and I had been making him sicker, not better because I blindly gave him more and more insulin.

So no matter what you see now in the numbers, knowing what her BGs are is much better than not knowing. If I had had the information BG testing provides when I was giving Gandalf 6U of PZI insulin and leaving him unattended for up to 11 hours at a time, I would probably be in the same state of mind you are - panicked and stressed and believing I was doing more harm than good. As it was without the testing I was stupidly in the dark and blinding giving him shots at levels that could have killed a cat less tough than he is. Is that really better?

But with the BG testing I would have had information that was warning me something was not right. That's where you're at right now if I can try to give you a different perspective. You believe something is not right and you want to fix it. I read that in your words, not that you truly want to give up. You are getting the benefit of seeing via the BGs that something is not right, so you have the opportunity to fix it, not let it go on for 3 months like I stupidly did.

Feline diabetes treatment takes time and unfortunately sometimes it involves trial and error. We don't say Every Cat Is Different lightly. I decided to not find any more spreadsheets for you to compare Celle to for that reason. It will just make you crazy as to why hers does not look like other's.

I'm glad you've decided to stay with 1.5U. And I hope others will read this thread and offer their take on ECID. Maybe something someone else says can help you see some light in this dark tunnel.

:YMHUG:
 
Hi, Melissa, been reading your posts because I am in the very same situation. My cat Alley was doing very well with all the help from this site, then, an infection has blown it all away. We have hit 500 yesterday AM and am going crazy and feel helpless like you do. I have increased too soon I am sure but the high numbers have made me trigger happy. What a disaster! I believe I will decrease back to .2 probably tomorrow. Can't go much higher on the dosage because I believe in my heart that Alley belongs in the .15 to .20 range. He is on Clavamox until next Friday also, then he needs a dental for a bad tooth. He also has an ear problem with a slight infection, but that medication is all done and he seems better there.
Hang in there, please don't feel it is hopeless, we all get there from time to time.
It has to be the infections our kitties have, along with some discomfort they feel that is stressing them out.
We can both do this, Melissa, the Lev is the best insulin and the people helping here are the best, we will succeed.
Good luck
Pam & Alley
 
Oh my goodness, Pam! I didn't realize Alley was so off track. I'm sorry. It just takes one infection for a set back. If you need help or just support, please post what you're going through. Thanks for posting your support to Melissa. I believe that is another amazing thing about this board - everyone is so supportive, even when they have their own kitty in trouble. :YMHUG: to you too.
 
Thank you Pam and Vicky. I got a 395 for PMPS. Nothing to be happy about, but it's keeping me in the game.

Tonight Celle peed in the kitchen waiting for me to get her food ready. I wonder if maybe her UTI isn't cleared up with the Baytril. At least that would be an explanation for the high numbers that makes some sense. I just hope the vet can get some urine out of her on Saturday morning to culture. They're only open for a couple of hours -- not much time for her to produce more if she empties her bladder on the way.
 
Melissa and Celle said:
Thank you Pam and Vicky. I got a 395 for PMPS. Nothing to be happy about, but it's keeping me in the game.

Tonight Celle peed in the kitchen waiting for me to get her food ready. I wonder if maybe her UTI isn't cleared up with the Baytril. At least that would be an explanation for the high numbers that makes some sense. I just hope the vet can get some urine out of her on Saturday morning to culture. They're only open for a couple of hours -- not much time for her to produce more if she empties her bladder on the way.
Click to expand...

Yea for 395!!

I hope she has a full bladder for them on Saturday. With these numbers she should be making plenty!
 
Hang in there!
We were dealing with infection too.
And I got nervous shooting at a low number, decreased his dose and we are in the 2-300's again. So I screwed him up big time.
I know this sounds crazy but patience is the key in the FD game in which I have come to discover.
We haven't had good numbers in a year.
But the gals on this board are very knowledgeable on the whole thing.
Heck, if Vicky and Sheila didn't make my shot schedule up, I don't know where we would be. I could have never figured it out.
I hope Celle is feeling better soon :smile:
 
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