Request for extra eyes on SS

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RobbiesMom

RobbiesMom

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I'm honestly trying very hard to "blend" my vets advice to be giving 3.00 to 4.00 "whichever seems comfortable to me according to his numbers since I'm self testing" with all the advice here to be giving him 1.0 (and the whole start low go slow approach). Since that was not what was done with Robbie first time around and he did go OTJ in 3 months I'm wondering if I should have just stuck with 4.00 and maybe "kick started" things a bit that way. However, I do feel that the input here is so on track and comes from so much knowledge I wasn't simply going to ignore it and so I've been working very hard to find a place that works both for Robbie's health and that I can sustain with my work schedule and my husbands.
So there have been some time adjustments that probably haven't helped in establishing a good pattern and I'm also questioning one of the FF flavors we were giving him and had to have my husband dig thru the trash for the can as I want to make sure I am checking the right one. But all in all he has mostly been eating his tried and true flavor that is low cal/carb.
ANYONE willing to look at his SS and give me an honest gut reaction is welcome to do so. I'm sort of at a loss here. I hate to see his numbers in the Pink so much as that wasn't the case the first time around. I DO believe he fell back into this situation due to a lapse of restriction from the low cal/carb food. However, I have no way of knowing this to be the case (except that I was feeding him a small amount of FF gravy food to get him to take meds for 3 weeks prior to this happening and I know he'd been getting into the garbage to his sisters left over cans and licking out the gravy).
At +6 and he's still 305 after 3.5 shot this morning I'm really lost. My gut said give him 4.00 but I held back and am now kicking myself. I'll listen to any and all thoughts and while I might feel and sound defensive or upset with some answers I am ALWAYS appreciative of the time and thoughtfulness that has gone into trying to help and I do understand it's all coming from a good place.
thank you
 
Ellen,
I think that part of the problem, and your frustration, is due to lack of consistency on dosing. I know we all said "drop to one and start over", which is contrary to your gut and your vet's advice.
I think it was yesterday's thread where I sort of waffled on that, and said that it looked to me like 4u was too much, and maybe going all the way back to a low dose isn't the right thing to do.
What I am seeing is that he gets decent cycles on 3.0 it seems. He gets a good percentage of drop, his cycles don't see to show too much duration. No, the numbers aren't green, but I think it is too early to expect or want green numbers. The drop to green is too far, and will result in bounces and liver panic.

It seems like when you do 4 units, you end up the next cycle or two with high flat numbers like today that drive you crazy and make it look like the dose isn't high enough.

What I would advise is to stick with 3.0 for at least 3 days, AM and PM. Unless you see numbers in the middle that are too low, in which case you would want to reduce. Let the PS readings be what they are going to be during this time. Unless you see a low yellow or a blue, which would be too low for a 3.0 unit dose. I think that there has to be a constant dose so that you can see what it does over a period of time. Adjusting the dose every shot is hard to do. You will either be reacting to the last cycle, or trying to forecast the upcoming cycle, and the numbers just don't do what you want them to do.

Carl
 
I vote with Carl on the 4u being too much, it doesn't give nice curves when Robbie does drop and it takes him low for over 12 hours too often. 3u looks better, but if Carl is saying you don't want low blues on that high of a dose you have gotten in that range already, 157 the other day at +8ish (can't remember off the top of my head). You're in charge of course, and you do need to hold a dose for a few so you can see what is going on, I'm wondering if a little less would be good so you don't skip over the ideal dose....like going down to 2u and working your way back up? Take my advice like a grain of salt, everyone else knows so much more!

Cathy
 
carl and cathy
Thank you - I'm going to see how he cycles today - my gut is staying stick with 3 and I probably should have stuck with 3 and I'm chasing blue which is stupid of me. I really needed to hear this :
No, the numbers aren't green, but I think it is too early to expect or want green numbers. The drop to green is too far, and will result in bounces and liver panic.
That makes sense - I need to read up more on what it's doing to him to be in the high numbers so I feel more informed and maybe less panicked that he's becoming a very sick cat from all these high BG numbers.

Thank you again.
 
I'm attaching a link to the ss of a gal who came here shooting 6 to 9 units of insulin twice a day advised by her vet.

You can see that in the very beginning even with that much insulin the kitties body was protecting itself and the curves looked pretty normal for a newly dx cat.

After we convinced her to drop her dose to 1 unit it took 3 to 4 days for the rebound hormones to clear the kitties system and she dropped right down into those beautiful blue numbers and eventually went OTJ.

I'm not saying that is what would happen with Robbie but I think this ss will show you that even with too much insulin their numbers can look somewhat normal.


https://spreadsheets.google.com/spreads ... utput=html


I would drop back to 1 unit and start over to make sure that you havn't by-passed the right dose. Because if you have already passed over the right dose you will never figure this out.
 
OK Rob that looks almost like Robbie's first time around - starting out at 8 - that's one of my points - the high dose in the beginning JUMP STARTS the whole process and than you CAN go low and go OTJ - that's exactly what happened with Robbie but I didnt' stick with the 4 this time around and the Vet didn't suggest higher than 4 since I ripped into him the first time around that he'd messed up giving me the 8 number to begin with - but look at her SS - she started out waaaay high like we did first time around and than dropped down and finally off. This is my total frustration. Is it that 1 was the right number ALL along? or is it that 8 up front and than dropping is what really worked?
I hear you and I'm trying to work it out in my mind but seeing this SS makes me feel like I do when I look at Robbie's old one - like I should have started out high for a bit than dropped to 1.00. Can you see my point on that? I don't have the jargon or the info to toss back out as to why this would or could or did work but that's what happened with Robbie first time around and that's what happened with this cat too - or so it appears.
I'm banging my head against the wall and worried sick about doing the right or wrong thing.
 
I don't know if there is anything to starting high or not. But I think you would be playing with fire by trying 8 units.

I was able to get Harley regulated the second time and I never shot more than 1.4u.

I think that most here suggest starting low because you can always go up in dose if the lower dose doesn't work. But you can't take it back out once you shoot it in.
 
I don't think that a high dose jump starts the process, it just makes the liver really really active trying to keep the cat from hypo. I saw the same thing with my cat, she actually was super sensitive to insulin and her starting dose of 1u hypo'd her badly on day two. I didn't know any better so we didn't reduce much and her numbers were way all over the place due to constant rebounding. Turns out that she really did best once the food was corrected on 0.1u to 0.05u. You might be right, your cat might need more than 1 unit, and I understand wanting to make this go quickly. But if you're incorrect and the dose is too high you won't know until you back off, and if you try to work your way down instead of up it is much harder to tell if you've reached the optimal dose since if you're still high the liver will still be active and masking things. And it will take longer that way as well, because while it will take a few days if you drop to 1u for the hormones to clear, if you try dropping down doses gradually from 3-4u it will take a few days EACH time you drop to be sure that you're seeing real BG numbers on the reduced dose and not ones caused by Mr. Liver.
 
More good info. Thank you.
And when he's in the high 300's or 400's and I can't check for ketones how to I stop from wringing my hands and how badly am I hurting his poor body? This is what runs thru my mind as I lie awake at night wondering what number his BG is at ...and will be in the morning.
 
I guess this seems like a difficult or annoying case since I don't tend to get much feed back or maybe I should be posting in the main forum? All the input is so valuable maybe I'm just being greedy.
So the next 2 days are just insane for me - I won't be home much at all and neither will my husband so I'm sticking with the 3 or 3.5 until I can be around more - unless something drastic happens. I'll get a morning test, hopefully an afternoon test and evening - so I'm praying he'll be OK. If there's going to be a time I can go DOWN and be able to monitor him it will be Friday night - I had thought I'd give the 3.5 dose 2 weeks but so far this week it's been pretty depressing except for Monday which ended badly anyway. So at the risk of being a total flake with my baby's life at stake I'm considering trying the opposite of what I had thought would work and going along with the advice I keep being given here. Go to 1 or 1.5 and see - but I'll need some hand holding thru those RED numbers cause I get very freaked out by them. Hoping there will be some input here to help along this path - his numbers are all posted. The timing got a tad screwed up tonight I had a meeting and told my husband to test at 7 and if he was over 350 to give him 3.5 but he thought I was going to call him after he sent me the number and tell him what to do. So the shot didn't get given until 7:45 at which point he was 377. He's acting fine, played with his cat nip toy and is right now screaming at me for more "snack" (he just got his 11pm snack and wants more). Now as I'm falling asleep on the couch wondering if I can stay up for another BG test he's next to me preening and cleaning himself up . He seems really good - it's so odd.
 
Ellen
Like I said a few days back, no matter what you do, you'll get support and help. I myself would rather hold your hand through a few days of high numbers (from reducing the dose to 1 or 1.5 as some people have advised), than hold your hand through a sleepless night when you are dealing with a high-dose related hypo. I've held people's hands through both scenarios on the board in the months I've been here, and the high number hand-holding is much less stressful for everyone involved, believe me.

Don't get too frustrated by lack of speedy response. The PZI forum is busiest at 7-9 am, and later at night like now. And our most prolific poster, Sue, is away from a computer for a couple more weeks, otherwise she'd be posting in your threads regularly. I've had leaves of absence recently due to multiple reasons (moving, loss of internet service, a back injury, blah, blah) so there have been times when I have not posted for a few days in a row. My schedule changes every week, and just when you get used to seeing me on late night, I suddenly switch to early in the day, then back again. Anyway, you can post in Health too, and you can get input from people who may not be "Prozinc" savvy, but they still have lots of other information on things like diet, testing, all sorts of stuff, that will help you out. I used to post a lot more in Health than I do now, mostly because the "traffic" in PZI is probably 4 or 5 times as much now than it was 6 months ago.

He's acting fine, played with his cat nip toy and is right now screaming at me for more "snack" (he just got his 11pm snack and wants more). Now as I'm falling asleep on the couch wondering if I can stay up for another BG test he's next to me preening and cleaning himself up . He seems really good - it's so odd.
Click to expand...

Try to pay more attention to "this", what you just posted. We, as you know, are really big on home testing, and dose numbers. Numbers can consume all of us. But, sometimes your eyes on him can tell you just as much, if not more, than the damn meter can. "He seems really good" tells us a whole helluva lot. He has no clue that he's got diabetes, and he could not care less what his BG is at any given moment. He just knows that sometimes he feels like crap, and most of the time, he's just a little off but okay with it. He knows he getting a lot of attention lately, but no idea why, and if he could talk, he'd probably say "Mom, Dad, chill out okay? I just want to eat, sleep, and play once in while, just like I did "before". "

If you think the reduction trial is what you want to do, go for it! It's something you will have to let go on for a few days. One day of lower doses isn't going to be conclusive. It'll take 3 or 4 days till you see a payoff. But if you're up for trying, we'll be here to help, hold hands, whatever you need.

Carl
 
Thanks Carl - I hope I don't sound bratty - I apologize if I do it's probably due to the fact that my dad, as I mentioned, is in the hospital and not doing great but we don't know why so my intense frustration at that is certainly being heightened by Robbie or vice versa. Thank you for your kind input here. He does feel good it seems - and trust me he's such a spoiled boy he hasn't noticed the "extra" attention- I've just gone from holding him and fussing over him to doing it with a needle and a meter in my hand! But you are right - he doesn't know he's sick - and he clearly feels MUCH better than he did when I took him to the vet so numbers schnumbers he's feeling better. Like I said I'm going to give the 3.5 a the rest of the week till Friday night when I can be here than if there's no improvement in the numbers I'm going to reduce and try and give that a week or so... I did get some good advice in health about putting water in his food - I had tried that a while ago and he wouldn't touch the food but now he's lapping it up just fine so I've been able to reduce his actual food intake a tad (not much but he does he ALOT so I thought this couldn't hurt if done gradually). He's sleeping peacefully now - this morning he climbed up ontop of some furniture where I put his cat food can with half the food in it (cause he hasn't been active enough to get up there) and from the bedroom I heard a crash - came in and he was up there going for the can - so yes, he's feeling pretty spunky.
 
FD is stressful, and you have a lot of other stress right now too! Don't be too hard on yourself. Dosing is hard to figure out without being sleep deprived!

As for the high numbers, most of our cats had FD for god knows how long before we realized it. Looking back I saw symptoms at least 6 months before diagnosis, I just didn't realize it at the time. This means most cats likely have numbers 400+ for months and months, we're just not testing. It's hard seeing those numbers on a meter, but a little more time in the high numbers does a lot less damage than too much insulin can do. As Carl says, your cat doesn't know anything is wrong, and probably thinks "hey, I'm feeling a little better" already. If they look like they're feeling better, that's all you can ask early in. Low numbers do not come immediately, but seeing some yellows during the day rather than being red/black is an improvement. You love your cat, and you want him to get better ASAP, so does everyone here. They will not lead you wrong, and will be here for you.

Cathy
 
Thank you Cathy and I realize you all have lives outside of the support you give here and kitties of your own that you are worried about and dealing with. I'm just obsessing and I know that part of this is I can't control what is going on with my dad and am scared we'll lose him but I do feel some sense of control over Robbie's fate so I'm just over focused on that right now.
thank you for your help.
 
dinner and a couple of hours further along and his numbers popped up from 239 to 386. I want to look into what the lowest carb/calorie FF flavor there is that's not the shrimp, cod fish -
 
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