Restart at 1 unit down from 7!

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Sue and Oliver (GA) said:
Very nice to see the pinks - SO much prettier than black!
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Absolutely! I am not a fan of pink but I'm happy to see it on there. Next goal is YELLOW! Is it possible his peak is +4 now? Tomorrow night I'll be able to take readings past +5 or +6. But from the last few it looks like the insulin peak is at +4. But he didn't continue to climb to crazy numbers (black) last night. Is it typical for a meal to jack up the BG so much or am I feeding him too much? He MUST gain weight but from what I've read it seems like he will not be able to until he's under 300? I am waiting for a call back from the vet about him. The possible new one. I want to get answers about home curves and if they'll do phone consults if I have questions. The other guy does for now- although I haven't called him back since I chewed his ear off. HAha I think he was more willing to do the phone call back to me because he didn't want me to COME there. Hopefully after all that-- he won't screw it up for another animal! Anyway- back on topic. I'm thinking maybe Saturday I'll see what his numbers are and go up a tiny bit to 2.75 (eyeballed) or maybe by then he won't be STARVING and eat less. Which he did the morning after his first 7 unit shot that he miraculously survived. Either way I'm happy not to see the black and very little red in the last 24 hours. My stress level is getting more manageable! Thank you to all of you who have helped and encouraged me! Hope my baby boy continues to go toward our goal!
OH and- Kitty-cow hasn't had dry food in at least 24 hours. He stuck his nose up to it!! But I am still feeding him a little bit about every 2-4 hours if I'm home. Now we can work on getting him to eat more each time so I don't have to feed him 5 billion bites a day. haha
 
What a crazy day. Feel guilty being gone all day and not getting numbers. High AMPS and Higher PMPS. Hubby left the dog food down. I'm sure he probably enjoyed some. I just start to think we might have a little bit of control and boom. Gone. Back to black. Increased to 2.75units. Is anyone else here on a 3 unit or higher dose or is that when they think of using lantus? Could the OD in the beginning change the way he reacts to it?
 
I think he is doing well. Yes, he seems to need more insulin than some other cats. You have been slowly increasing the dose and keeping him safe, and he got into better ranges yesterday. High carb will blow that out of the water for at least a cycle or two. I would find a way to control the food in your house - some way.

But you have only been doing this a week. You have to give him time for his body to adjust to the insulin. We usually suggest staying with an insulin for at least 6 weeks. We don't worry about high dose conditions or insulin resistance until they are in the 6 unit range.

I have something that might be helpful for you to read:

http://www.felinediabetes.com/FDMB/threads/letter-from-your-kitty-to-you-during-this-time.131186/
 
Sue and Oliver (GA) said:
I think he is doing well. Yes, he seems to need more insulin than some other cats. You have been slowly increasing the dose and keeping him safe, and he got into better ranges yesterday. High carb will blow that out of the water for at least a cycle or two. I would find a way to control the food in your house - some way.

But you have only been doing this a week. You have to give him time for his body to adjust to the insulin. We usually suggest staying with an insulin for at least 6 weeks. We don't worry about high dose conditions or insulin resistance until they are in the 6 unit range.

I have something that might be helpful for you to read:

http://www.felinediabetes.com/FDMB/threads/letter-from-your-kitty-to-you-during-this-time.131186/
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:bighug: What a wonderful letter. I do need to chill. It's so hard. I think a lot of it comes from losing my mom. The what if's and if I would have been more vigilant and on top of things... she might still be here. But I found out later her infection was so bad it was too late no matter what I would have done that night. My thoughts are my worst enemy. Guess I have a bit of anxiety because I didn't get any numbers to see the insulin worked today. With the price of this insulin, I'm hoping we use it all up! Thank you for the link to the letter.
 
I echo what Rachel says! De-stress means less distress for you and kitty! (Sorry I can't bring myself to call him that name lol he's too lovely)
It's still early and you are still collecting data but I can see progress on his ss even if it's tiny increments. :) so well done to you both!

Strive for pinks then go for gold! Then brilliant blues and those oh so gorgeous greens! :)
 
TempestsMum said:
I echo what Rachel says! De-stress means less distress for you and kitty! (Sorry I can't bring myself to call him that name lol he's too lovely)
It's still early and you are still collecting data but I can see progress on his ss even if it's tiny increments. :) so well done to you both!

Strive for pinks then go for gold! Then brilliant blues and those oh so gorgeous greens! :)
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Many people can't... you can call him Chuck if you'd like. My hubby calls him Chuck Norris because"he's a bada**" haha is there any way to keep his bg from spiking so high after the +6 ? He will have a great number as +6 and by the next shot he's back to 500+ with no other food available today...
 
I think you need to up the dose, Steph. You've been on 2.75 for four cycles. Either up to 3 or 3.25, depending on what you are comfortable with and when you can monitor.
 
Hubby did it all for me this morning. AMPS and shot. It was nice not having to get up. I've come down with a cold so sleep was definitely needed. I think I will up it to 3.25 units. I'll be home in case he goes too low.
His numbers spiking so high after the nadir, is that a sign of his pancreas not producing any insulin? I've looked at a handful of other spreadsheets but can't tell really if his is odd or if it's normal. I know you can't compare two cats but some showed bigger spikes than others after nadir so I started to wonder if that means Chuck's pancrease isn't producing at all?
 
An early nadir can be too little insulin (so it just isn't lasting long enough and peters out before the next pre shot) or a bounce. I don't see anything that he could bounce from, so I am guessing he just needs a little more.

What a nice morning gift from DH!
 
Ok, I've been doing more research... I'm my own worst enemy. But I found this site. I'm wondering if I should discuss this with his new Vet? It's pretty intense and straight out says clinical hypo incidents are preventable with just food. Some stuff that screams "yeah right!" But then a lot of things seem like great ideas. http://www.yourdiabeticcat.com/protocol.html
Sliding scale with bg testing and injections every 6-8 hours of ProZinc. Based on Chuck's spikes it makes sense to me but that does not mean it's right!!
 
I am not a fan. The protocol was developed years ago by a vet; she no longer is associated with that site. Two things that bother me about their protocol: One, they have a scale that they use for every cat. If the level is this, shoot this. We are sure that Every Cat is Different and one dose doesn't fit all. Two, their idea is that a cat can't hypo on wet low carb food. I have seen that happen too many times. Yes, you can steer a hypo with food. But I think continually taking your cat into low levels and bringing them up with carbs is not good for their body.

After a month or so of dosing 12/12, dosing every 8 hours is an option, IF 12/12 is not working. But I wouldn't start there. It is very time consuming to test that often, and to be sure the level is rising, not falling. We also tailor sliding scales to each individual cat, based on their history. But again, I wouldn't start there. And based on experiences here, some cats do well with a sliding scale; some need a constant dose for several cycles before changing doses. Again that pesky ECID.

Having said that, he's your cat and you decide. But if you are going to use their protocol, you should post on their site.
 
And this is why I asked here. The no hypo thing was a red flag. I figured you all had probably seen this protocol before. I didn't join that forum. I don't have time to try keeping up with two! I read the case examples and only listed one that didn't respond to her protocol immediately. Seemed more like they were trying to sell the protocol idea rather than help any situation.
My mind is stuck obsessing over the spike after +6 so I was looking for better food or ideas on how to keep him lower. Exercise, massage, I don't know. I'm not changing his dosing schedule unless directed by the new Vet. Even then I'll probably end up here seeking more advice!:)
 
I read that one too Steph, but it seemed too odd and unrealistic. So I dismissed it.
 
Yes, that site is rather odd. We don't really follow that here. As you said, the no hypo thing is obviously wrong and, quite frankly, dangerous. Even if bringing them really low and then forcing them back up did work, it wouldn't feel good for the cat. I am more a fan of gentle drops that slowly and safely bring the cat into remission or regulation.
 
I also looked into that site and the protocols they used when I first started the sugar dance almost 2 years ago. The advice I received made no sense, and I am a person who needs to understand the reasoning rather than blindly follow a protocol. At that time I was at 3 units of Lantus twice a day, and was told I needed to stop the insulin for 3 days to detox???? then start again using a sliding scale. First off stopping insulin for 3 days when my kitty (who ended up being a high dose kitty) was in high numbers made no sense, and trying a sliding scale on a depot insulin like Lantus or Levemir made no sense. So luckily I came across this site which made far more sense to me and have stayed here since.
 
:bighug: I feel like I don't say it enough- I appreciate all of you responding with your opinion and experience! I think maybe in the clinical setting when the numbers need to get lowered and stay lowered that might work but too risky to try at home. His +7.5 number today was 370. I didn't make it home in time to get +6. But I'm just glad to see it pink after +6!!!
 
Yay! We have a yellow at +4!! He was very fiesty today. He hissed at my DH as he was trying to get a ear prick. I told him his ears are probably sore and that I would replace the lancet. He doesn't react when I prick his ear so I wonder if DH is just a little too rough when he does it. It's an auto lancet but he uses it on 4 and I use it on 2. Never have a problem getting blood unless his ear is too cold. I'll have to watch him do it in the morning and see if I can help improve his technique.
Even with yellow bg he's begging like a fool. I weighed him and he's put on 3 oz! Hopefully it wasn't from a full bladder! :)
 
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Sue and Oliver (GA) said:
I really think your early nadir is reflective of not enough insulin. As you increase, the nadir should come later.
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Crazy spike in BG from +4 (286) t0 +6 (440) No food available. Could he be "bouncing" from the 286? His body is use to the 400+ so just wondering if I should wait to increase or go up to 3.5 or 3.75 in the morning? We are changing his feeding time to 4am and 4pm. DH can help me out in the mornings that way. Hah- I was excited over the yellow! I was hoping it would be closer to 250 at nadir. Boy was I wrong. Well I'll see how it works out tomorrow. I'll start testing +5, 6, 7 (if it's going down still at 6).
 
Meter read "HI" this morning! Which according to the manual means 600+. Ugh! He must have gotten into something that I don't know about. Gave 3.5 units. I'll be watching him and checking him to see that it goes down. Feeling a bit defeated this morning.
Update: He is 556 at +2. Fingers crossed that it keeps going down with no bounce today. I'm home all day so I'll be able to see where he's possibly getting some carbs. No dog food left down. Put it in cupboard today. He never gets on the stove but I can't say it's impossible for him to have gotten up there for a snack. It's a freestanding range and gas. He has never been up there as far as I know. I'm just happy it's coming down. He's drinking like crazy so looks like I'll be changing the litter box today!
 
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Very odd numbers tonight. No food available after pm shot. Numbers aren't going down like they should. Could be delayed stress related? My dog ate about 2 oz of 90% cocoa bar today, bad dog! Had to force feed peroxide til she vomited. I was a wreck. Anyway- He did good this morning. He's begging like a mad man! Jumped on the table and attacked my plate during dinner. Got a small piece of pork chop and almost a piece of my finger! Note to self- keep fingers out of "starving" Chuck's mouth! He's probably going to eat me in my sleep! Tomorrow he will be locked out of the dining room while we eat. He's so "hungry" he's not listening to anyone.

I'm thinking about trying 4 units tomorrow morning- Because I can't be here Friday until after his pm shot to check him... but maybe I should give 3.5 another go or try 3.75 before 4?

I'm wondering if I should feed him every 6 hours instead of every 12. If so, it would be 2oz every 6 hours to equal his 8oz a day. And would that change the dosage of insulin- or would I not know that until I see the numbers. I can switch feeding on the weekend (friday pm) when I'm here to monitor numbers. I wonder if his insulin will last longer that way too. He's using it all up within 4-6 hours and spiking after that til his next meal then spikes another 20-30 points after meal. I'm wracking my brain trying to figure out the best way to help him. :) Brainstorming with the ocean of helpful people here!
UPDATE: I just checked his +6 and he's down to 340 from 476 so maybe his trend is changing- will check again and chart at +7
 
He does keep you hopping. Yes, you can definitely spread out the food into smaller meals. Also, you might try adding some warm water to the pate so he feels like he is getting more to eat.

You know me - I like holding the dose for 3 cycles and then increasing.
 
Sue and Oliver (GA) said:
He does keep you hopping. Yes, you can definitely spread out the food into smaller meals. Also, you might try adding some warm water to the pate so he feels like he is getting more to eat.

You know me - I like holding the dose for 3 cycles and then increasing.
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I will hold the 3.5 tomorrow morning and see what his numbers look like.
On a side note- my Kitty-cow keeps begging like a fool too- the 19 pounder. Got a bit nervous so I checked his BG and it is 76. Lucky boy. He's almost out of dry food and will be on a low carb/low phos wet food as soon as the friskies pate is gone too. He's my chronic UTI/crystals kitty.
I'm going to shop for a time delayed feeder. Going to search the forum for favorites!
 
I like the PetSafe 5 - you can program it easily (not just on the hour) and it is hard to break into. (Some are easily flipped open, if your cat is resourceful.). You can program it to close 2 hours before the pre shot.
 
Ok so now I'm in awe. He is at 288 now at +8! Strange night for sure! I thought I was going to bed but now I might stay up to see what it is at +9. Lesson learned: test past +6/+7!
Also found out DH thought I said to increase by .5 not increase to 3.5. So this morning and this evening he got 3.75 units. Looks like it's a good amount for him so far. *fingers crossed*
 
OMG! Take a look at those numbers! I'm in a weird state of disbelief. I think 3.75 is looking good on him so far. Hopefully this morning he won't go too low.
 
Back to black for PMPS. He tried eating a frog outside. Ridiculous. Anyway- got another ketone test- negative! yay. I was worried about the 600+ yesterday morning. I'm getting another bg reading now and then going to bed. I've only had 3 hours of sleep every night this week due to this head/chest cold. I'm exhausted. Hubby will check bg again if his nadir is later again tonight.
 
I just came here to see if you thought an increase would be good! You guys are awesome. You think I should go to 4 or 4.25? I can monitor tonight but not tomorrow morning as much. PMPS is 508. @Rachel @Sue and Oliver (GA)
Ok I gave 4.25 units tonight. If it proves to be borderline too much we might go back to 4units in the morning. I'd like to get to an even .5 increase number (4.0, 4.5) but if it works I'll sick with it :)
 
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AMPS 338! Not sure if I should give the 4.25 or go with 4 units since I can't monitor as close. If it drops as many points as it did tonight from pmps to nadir, he'll get down to about 101. I think that's good but worry he'll throw me a curve ball and drop too low and I won't be here.
 
ugghhh I'm so p*ssed! I tried giving him 4 units and the needle bent! 90 degree angle. I'm 90% sure he didn't get any of the shot. It was all over his fur to the side and down the syringe. I gave him 1 unit after that. Hubby will stay up and check him to make sure he's not going hypo- but I highly doubt he will. I could puke. I just got him to an acceptable preshot number and BAM. I screwed it up. Guess we'll try again this afternoon. How the heck does a needle bend like that?! Must have been a defective needle. Grr. Waste of insulin.
 
I know that is frustrating, but he is getting better numbers and he will again. I had fur shots, but not a bent needle.....

Steph, it is definitely looking like we should have suggested halving that 7 units and having you restart around 3 units. We were too cautious. It is just so hard, when advising about someone else's kitty to not be conservative - especially when they had a hypo. But we were wrong in his case. I'm glad you have increased aggressively and gotten back up to a higher dose.
 
I was happy to restart at 1 unit. He's not doing as bad as I thought he would today. Just checked and he's only up to 438, if I'm remembering the number right, so the 1 unit I gave after the fur shot is helping a bit. I still think I'll see 500+ for pmps. But we'll recover! I really do appreciate you all helping me. I'm thankful I found you all!
 
Ok. So PMPS 519. I expected it. I just updated his numbers. I'm thinking I might see numbers like I did last night. My question is... If he's under 400 tomorrow morning like he was this morning do I still give him the 4.25 or go with the 4? I won't be home much this week to get morning readings. I just worry. As I'm sure you all can tell already! haha
 
If you can monitor tomorrow and can't as much next week, I think I might try the higher dose and watch. If he is in safe numbers, you'll feel safer giving it during the week. If he drops lower than you want, then go with a lower dose this week?
 
Sounds good. I just worry he'll drop the same amount when he's 350 as he did at 550. But I will monitor.
 
I didn't make it home for +6 but he was 161 @ +7.5 then 146 @ +8.5! Going to check again at +9.5. Beautiful numbers but late Nadir. Looks around 4-4.25 is his magical dose.
 
Unless you can wait two hours (after feeding him) and shoot then. But that will mess up your schedule for the following shot.

The safest alternative is to skip, but I hate to see you do that - when he is finally getting some decent numbers.
 
Hubby can do the shot at 7 tomorrow morning, then we can do half hour early to get back on schedule. Do I have to wait 2 hours to feed him?! Idk he might eat the dog! Haha never mind I just read the after feeding him.
 
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