Salem #2

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I think he meant because the duration is up to 14 hours maybe? Either way he’s getting his shot late Saturday night lol. I can back him up during the week so I’m not too worried. I also ordered an automatic feeder so I can leave food out while I’m gone all day.

And yeah I’m going to look into bumping him up I just want to get through the weekend first. I don’t want to give a higher dose when I’m going to be gone Saturday and can’t monitor.
 
Just tested Salem for his PM shot and he's at 106...I really don't want to shoot on that low. I was gone all day so I didn't get any readings for how low he could have gone. I also have to be gone all day tomorrow.
 
Possibly or if he dipped down that might be a bounce starting. Sometimes they can zoom up really quickly. I take you hadn't fed Salem yet?
 
No, I just fed him right now. Normally the pates don't cause him to go up that much though.
 
So if he was up to 135 before food, then you could consider giving him a reduced dose...maybe 0.25u or you can skip. Your call. You've shot 138 before so half a dose shouldn't be a problem.
 
Honestly I might just skip for tonight, just because I really need to go to bed early tonight since I'm driving all day tomorrow and if he goes low for some reason I'd have to stay up. Also it'll make me feel better about giving him a dose in the morning and then leaving all day. I feel bad skipping, but I know he'll be okay for just one night. I'm driving back tomorrow night to give him his PM shot tomorrow so he'll definitely be getting one then.
 
Out of curiously I tested Salem at 3 hours post food to see how much he went up and he’s at 129. :confused: I guess I’ll see where he is in the morning?
 
Actually that is great news. Given that BG is basically unchanged, it tells you that while Salem's pancreas may not be working as well as it should, it is working. In a non-diabetic cat or a cat in remission, the BG +3 hours after eating would be lower than pre food BG due to the insulin that would be pumped into the system to utilize the food eaten.
 
PS today after no insulin last night is 146. Which is lower than I thought it would be. I’m hoping he’s okay to get the .5 today bc I won’t be home until late tonight. I’m going to leave extra food out though.
 
So I left some MC food out and gave slightly less than .5 just to be safe. He’ll probably go up a bit but I’m going to be gone for 14 hours so I’d rather be safe.
 
Salem doesn't like to make things easy...after getting more food than usual today, some of it MC food, and a barely reduced dose +14 hours he's at 132. I guess I'll go ahead and give the .5? I skipped last night so I feel like I shouldn't again. It's also later than usual too.
 
Assuming you might like some sleep tonight, you could do a reduced dose of 0.25u and see what Salem does with it. The last time you shot 0.5u on a 138 he dropped quite low. I'd be sure to monitor a bit with that PMPS knowing how he reacted the last time and through today. Interesting that more food, some MC and he still gave you a low pre-shot. Salem rocks!
 
Yeah on second thought I'll do either that or skip. My problem is I don't trust myself to stay awake tonight bc I'm exhausted after driving all day. I mean he might go up a bit tomorrow morning if I skip but judging by last night it won't be by that much? I really want to start getting him into the double digits I just need to make it to Monday so I can call the vet and figure out a plan.
 
It's fine if you choose to skip tonight too. Salem will get back on track pretty quickly.

Going forward, you can increase the dose to 0.75u to see if you can prompt him into some double digits but you'll need to do it when you can monitor him. He doesn't need a lot more dose wise by the look of his numbers. They've improved immensely over the past week.
 
Yeah it's like his pancreas is working a little, just not as much as it needs to. I just want to get him into lower numbers so he can heal a bit more. I think it's probably safest for me to skip tonight since I won't be able to monitor him all night. Even if he goes up, I can get him back down pretty easily. It's just frustrating that he's not low enough to be off of insulin, but he's also not really that high.

Also I’m going to try to do most of a curve tomorrow just to make sure he’s not going low on the .5. I haven’t really tested him much in the past few days so I don’t actually know if he is or isn’t.
 
After another night of no insulin he’s at 142. I’m going to go ahead and give the .5 and then test him today and see what happens.
 
I love how Salem is solid blue! While my cat seems to be in remission (day 13 of 0 insulin!), it has taken her a long time to "feel better". It's not clear how long she was diabetic, but I think probably a couple of months. In the last week, she is more "active" (she's never been very active). She comes up onto the bed asking for pets, purring, and kneading. She also is using the scratching posts. Yesterday she had a brief "psycho kitty" play time where she ran around the bed room a few times and jumped up onto the kitty tower. That's the most activity I've seen in ages!

I hope Salem starts feeling better and his system adjusts to the new normal and he continues to show improvement.

The people here are truly amazing!
 
So I'm faced with another conundrum of what to do....just tested him and he's at 101 on the AT2 and I double checked with the ReliOn and he's at 64 on that. Last time I checked him was +6 and he was 103 so he either went down and came back up or he's just been sitting at that number all night. I really don't want to skip AGAIN but he's in normal range?? I'm seriously going to have to call the vet in the morning.
 
I know sometimes they dose cats with insulin only once a day, I'm wondering if that might work better for him? Since he's fine to shoot in the morning but at night he's still really low. I'm going to not shoot on that number I guess and check him before I go to bed and see how much he's gone up?

Behavior wise, he's acting like his old self again. He still sleeps a lot but he's a cat. He's sleeping with me at night again which I love and he's playing more and just generally acting more alert.
 
Amy, technically Salem has been in normal range all day. Yes AM numbers are a bit higher than you want but otherwise he is looking extremely good.
Once a day shots don't usually work. They create a roller coaster effect that doesn't get them to the finish line and can make them feel off.

How about trying a dose of 0.25u tomorrow if Salem's AMPS is high enough to shoot. I agree that if he is only 64 on the Relion and 101 on the AT2 tonight it's definitely a skip, but it looks like Salem's numbers have been progressively coming down despite missed shots and reducing again now might just take him to that ultimate goal of you know what (don't want to jinx this progress!). ;)
 
Yeah, I'll try that tomorrow morning then. I'm going to test in a few hours and see how much he goes up from the food and no insulin. I'm also going to call the vet in the morning but I doubt he'll be of much help.
 
So I guess my question is what should I be looking out for to potentially get him OTJ? I know I should be probably looking to see if he's coming back down without the help of insulin, but I don't necessarily know how to gauge that.
 
You can check to see that Salem's pancreas is working by testing him as usual at shot time. Then feed him as usual and retest again about 3 hours later without any more food being given in between. If BG is lower than pre-shot, then his pancreas is working.
You want the pancreas to heal as much as possible and right now, while Salem is spending a considerable amount of time in normal range, it would be ideal to get him spending some of his time in the dark green range. So I suggest trying to find a dose you can shoot twice daily to keep BG in good range and as level as possible for 24 hours a day.

See if 0.25u allows you to shoot twice daily. If you are still having to skip, then you can lower it further.
 
Okay so when I checked him last night at +3 he was at 127. Today his PS is 116. I'm going to go ahead and give the .25 and hopefully it won't drop him too much but I won't be here for about 2 hours. I guess I'll leave enough food out? The .5 isn't dropping him dramatically so I'd assume a lower dose won't either.
 
My other question is I know the protocols on here are done using human meters so should I start dual testing him just to have a comparison? The 116 was 73 on the ReliOn.
 
Ok I'm going to suggest you drop back even further at that preshot with that pre-shot. How about trying a dose of 0.10u? Draw the insulin up to the zero line on the syringe.
 
There really aren't any OTJ instructions specifically for ProZinc but the premise of getting into some green readings still applies. You can dual test if you want but from my experience with the pet meter, ideally you want some green in the 70 to 99 range and may get the odd blue up to about 120 or so on the pet meter in a cat approaching remission.
 
Okay is it around here? These syringes are so tiny it’s hard to figure out small doses.
 

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No, just my phone camera. I'll go pick one up today. So I basically just got the smallest amount possible in there? It's right at the black line with maybe a tiny sliver of space in between.
 
That's fine. You want consistency. That's more important than exact accuracy.

There is a smaller dose yet called a drop dose. It involves holding the plunger in as tightly as you can, inserting the needle in the vial, and then letting go to use the suction created to suck up just enough insulin to get a drop in the needle itself. You actually can't see the dose at all. These fine doses are a bit of a PIA but so worth it if you can get over that final hump.
 
Okay I just gave it. I think I can replicate that amount tonight. I know I need to call the vet, but there's no telling what he'll say. He might recommend getting Salem off of insulin but I'd like to get him a little bit lower first. It seems like his pancreas is working though considering he dropped some from last night.
 
It does seem Salem is on a mission and he is spending most of his time in normal range but some of them are in the higher normal range. The problem with this is that we don't have a baseline to know what our cat's normal BG range was before diabetes. Some non-diabetic cats can sit in the 40s on a human meter but we'd never strive to get our diabetics that low. I'm sure some non-diabetic cats routinely stay in the mid to high range of normal BG too. We try to get our diabetics as low we can safely in order to ensure a strong remission but if the higher range is their normal, that might not be possible without crossing a safety line.
 
Yeah I once tested my other cat out of curiosity and he was at 95 on the AT2. Honestly I'd just prefer him not go much over 120 and generally act like he's feeling better, which he has been at least. I just don't want to take away the insulin just yet because I don't know how he'll do without it.
 
When you get to an OTJ trial, we recommend testing pre-shot as you have been without feeding for 2 hour prior. If BG is within range (depends on insulin and meter) then you test again at night. If BG is higher than ideal, you do the 3 hour post meal test to see if BG has dropped. If kitty can stay in range for a period of 14 consecutive days, you can consider them in remission. Then you continue to test weekly for a while and can if you choose, gradually back off to monthly , although I personally still test weekly so if my girl starts to lose her remission, I will be able to catch it and deal with it as early as possible.
 
So in range would probably be 80-120? And yeah I'd probably test weekly or at least every 2 weeks so I can catch it early if he goes up again. That and making sure I get his teeth checked regularly since I'm suspecting that was a huge part of what threw him into this in the first place.
 
Range wise, once off insulin, even a bit lower than 80 is fine. My girl on her AT2 meter has been as low as 47 since she went into remission. While on insulin, definitely don't want them going too low.
 
So in other news, I checked Salem today at +6 and he was down to 89. His PS tonight was 125 so I'm going to go ahead with the .1 again.
 
PS this morning is 117. I tested him last night at +3 and he was at 84. I guess I’ll keep with the .1?
 
Well he moved when I was giving it so I don’t think all of it went in but oh well. I don’t want to risk giving any more and I’ll just see how he does. :)
 
Well Salem really is on a mission it seems, tonight's PS is a solid 80 so it's a no-shoot for me. This is after I don't think he got all of it this morning?
 
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