Samson does not seem to be responding to PZI

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I agree with Kris. You're getting the occasional nice blue nadir. To me, the numbers on both 1.75 and 2 look really similar. I know it looks bad because of the pinks, but you were getting high yellows and now you're getting low pinks...with the variance, those are really the same numbers.
 
Samson is at 453 at +3 after his morning shot :( :( I'm getting so frustrated with this process. It doesn't seem to me that this could be "bouncing" because his morning number was not low. Can anyone help explain this @Kris & Teasel @Rachel @Djamila @Yong ?

ETA: I was so frustrated by this I took his BG again 5 minutes later and got 368 - what's up with that? I am not happy at all with these numbers. So upset.
 
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Hi samsonsmum, sorry I'm not incredibly active right now. I herniated a disc in my back again and can't sit at computer very well. The 453 and 368 are within meter variance and unfortunately every meter is allowed a variation.
I can't look at his SS right now but I think his blues still had wiggle room. Would you want to try a fat 2.0U next time you can monitor? Let's see what the others think too.
 
Hi @Yong, thanks and I'm so sorry to hear about your back, wishing you a speedy recovery! He's been at 2.u for 6 days now and his numbers have been worse than when he was at 1.75u. When you say a "fat 2u" do you mean like 2.25? I am tempted to drop him back to 1.75u - blues at nadir are better than all these pinks :(
 
You could try him back on 1..75 u for a few days to see if his numbers improve OR you could increase to 2.25 u. Either choice is fine and might give good decision-making data. The way forward isn't always crystal clear. Sometimes you have to try a couple of things to see what works best.
 
Thanks guys. Sorry for writing on here so much. It kinda seems like the higher Sam has gone on his dose, the worse he does - he didn't do well on 2.5 u and isn't doing great on 2u either- so I think I'm more comfortable trying 1.75 again. Thanks and I'll keep you all updated (obviously, haha)!
 
Better numbers last night and this morning on 1.75u! I could tell immediately when I woke that Samson was feeling better because he was running around playing with his toys instead of just lying there :)

Edited to add: back in the blues at +3 :cool:
 
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I'm loving these curves I'm getting from Samson - classic curves! His numbers at AMPS and PMPS are still sometimes in the pink, but I've been doing a lot of reading online about BG expectations for diabetic cats and the consensus seems to be that as long as the cat is between 100 and 300 for MOST of the day, it's fine. So I'm happy with these results for now.
 
SamsonsMom said:
I'm loving these curves I'm getting from Samson - classic curves! His numbers at AMPS and PMPS are still sometimes in the pink, but I've been doing a lot of reading online about BG expectations for diabetic cats and the consensus seems to be that as long as the cat is between 100 and 300 for MOST of the day, it's fine. So I'm happy with these results for now.
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Yes! Very acceptable curves! :) Time to reword your thread title or start a new thread. ;)
 
Hey all! Long time no talk - it's because Samson was doing a lot better on PZI and had regulated to some nice curves daily. Well, no longer! TO make a LONG story short, I currently live out of the country. Samson's care is in the hands of a very dedicated caretaker, and she checks his BG levels at AMPS, +6 and PMPS twice a week, when she has days off. He was doing fine. Last week, he had to go to the emergency vet after an episode of diarrhea that left him lethargic, refusing to eat or walk. They checked him out thoroughly and said nothing was wrong with him and discharged him after one night of observation.

In the hospital (he was there on Friday morning through Saturday morning) his insulin schedule was kind of wonky. On Fri morning, the caretaker didn't give him insulin because he refused to eat and it was not safe to give him his shot. In the hospital, when he checked in, his BG was low due to not eating so he didn't get his Friday am shot. In the evening on Friday, they gave him the shot but only 1.5 units instead of his usual 1.75. On Saturday morning they still only gave him 1.5 units. On Sat evening they told his caretaker to only give him 1 unit, and to try reducing his dose to 1.5 units. We only did this once as his BG immediately started to climb too high.

Sunday PM he was returned to his usual dose of 1.75 units but his BG has been too high since then. 436 Monday PM and 426 today AM. He was regulated at 1.75 before, so the whole point of this post is to ask - is this bouncing around normal after hospitalization and messing with his dose? Can anyone weigh in with advice I can pass on to his caretaker? THANK YOU!
 
It's not unheard of for numbers to stay elevated for a few days after a vet visit. Although it's also possible that it's bouncing from an undetected low number. Probably the safest thing to do is wait until the CG can get a mid-cycle number (any chance she would try to grab a couple of them?) to see if there is a drop happening, and then if not, and if Samson has had a couple of days to relax after the vet, then consider a small increase.
 
Thanks @Djamila ! He did have a weird low number - 125 in the AM on the Saturday morning of his vet visit, even tho he hadn't had much insulin during his stay. Maybe it's from that? CG is grabbing a mid-cycle on her day off tomorrow.
 
Possibly Samson didn't eat much at the vet, giving him that low number on Sat. I agree with Djamila, give him a few days to chill out, grab a mid cycle when possible, and let's go from there. And just be sure she's checking for ketones. :)
 
Hello, I'm new here. Our cat Taco was diagnosed with diabetes 2 months ago, he's 12 yo. His BG at the vet was 425, they started him on DM . I went all out and immediately got my own meter and did a curve a couple days into the food.Cut him off cold turkey from his free dry and 1 can little friskies chicken and gravy. Nothing changed. Took him back and in addition to the DM Pate he was put on 1U twice a day. Curve again, and he's all over the place, no rhyme, no reason, but NEVER under 300. Into that a few weeks and he is now on 2U twice a day since 4 days. Again all over the place on his curve and stick. Last night before he ate , 12 hours after his first meal he was at 275. This morning 12 hours after last night he was at 400. I'm completely stumped. Any suggestions? Please Forgot to say that Taco is on Prozinc, and can someone show me where I can find all the abbreviation you all use here, I'm lost :(
 
Hi all! Samson finally regulated after his vet visit and my most recent post, getting into dark greens at his nadir consistently! Here's a new one, though: his AMPS number today was also dark green: 54. Obviously, his caretaker didn't give him any insulin. How do these situations work, though? I told her to grab his +6 number, then his PMPS, and depending on the PMPS possibly adjust his evening insulin dose. Is that right? Thanks! @Djamila @Yong @Kris & Teasel
 
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Wow, those nadirs are great! Here's the thing: if Samson is spending more time in greens, that opens up the possibility that his pancreas could start to heal, which means his insulin needs could start changing, and his numbers might start being a bit unpredictable. Time will tell on all of that. For now, yes, skipping the dose on low numbers is the right thing to do. Another thing you might recommend is that when she gets a number that's wildly different like that to repeat the test and make sure it isn't a wonky test strip. They do occasionally read wrong.

If that 54 is correct, it might mean that he went awfully low during the night, which is a bit concerning. Does he have access to food during the night so he can eat if he needs to? I hate to lower the dose if this is just an anomaly though, since those greens are so good for him. If she could get an overnight test, that would be ideal, and then keep an eye out if there are any more strange numbers like this that might indicate that he's ready for a reduction.

Let's see what others say, and if they think he should get a reduction now. I tend to lean more toward the aggressive side in dosing.
 
Thanks @Djamila ! I think it was a fluke test strip - she tested him again and he was at 354. Oh well. I'll file this info away anyway in case something like it does happen later on!
 
THIS IS AN EMERGENCY - Samson has stopped responding to PZI. Please look at his chart for details. Over the last few days, his AM and PM numbers have been almost 500. I bought a new bottle of insulin last night thinking the other one (only 6 weeks old) had expired. He got his usual 1.75 units and 3 hours later (at night) was back down to 270. Emergency averted, I thought. Nope. This morning his AMPS was back to 494. Nothing in his environment or diet has changed. I live abroad and someone else takes care of him. I am freaking out. Can someone please help? What should I do? Why could this be so? I will have a +4 and +6 number to add later today. @Djamila @Yong @Rachel @Kris & Teasel

ETA: If his numbers later today show he's still responding to PZI at all, should I push his dosage up to like 2 or 2.5 to get him back into normal AM and PM numbers?
 
Deep breaths...sending you a cross-ocean hug!

A couple of possibilities: one is that he needs a reduction. The nadirs were getting lower, so maybe they are getting too low and he’s bouncing in response. The other option is that there is a health issue propping up the numbers and he has a UTI, dental issue, pancreatitis, etc. Check with the caretaker if he’s seemed off at all: not eating, meowing around the litter box, peeing outside the box, lethargic, sitting like a meatloaf with paws tucked under himself, etc. And if she can look at his teeth/gums and see if they look red or irritated.

Then let’s see what the updated numbers show and see if she can get some extra tests in for a few days. If he’s bouncing, a single cycle might be high while another cycle might show a dive.

Hang in there. I’m sure this must be hard to be so far away!
 
@Djamila : thank you so much for your quick response. Today is the caretaker's day off. she'll get +3, +6 and +9 numbers that I will share. cAN You address this question?

"If his numbers later today show he's still responding to PZI at all, should I push his dosage up to like 2 or 2.5 to get him back into normal AM and PM numbers?" Or should we sit tight with his normal dose of 1.75 or 2? THANK YOU!

eta: No other health issues. she says he's been normal or even much better. She said this: "Like I said, everything else is normal. He's even had fewer hairballs and less shedding."
 
Is the caretaker willing to grab some other mid-cycles? The problem is that a bounce (when the cat stays high after going too low) can last several cycles. So the only way to know if that's what's happening is to get mid-cycles on a few days (or evenings) close together and try to catch a low number. The flip side is that if she does that and only finds more high numbers, then that means that there is a hidden health issue. The most common one is dental problems. They can sometimes be spotted by looking at the gums and seeing if they are inflamed, though a vet would be able to tell that best, especially if her gums are naturally a darker color. They don't come with any obvious symptoms other than suddenly high numbers. I'm sorry there aren't any easy ways to solve this mystery. More tests or a vet visit are really the only ways to figure this out.
 
Hard to say. Will you be home to monitor soon? If so, I'd leave the dose alone if it's only a few more days. You need more testing to know if it's bouncing, as Djamila said.
 
Kris & Teasel said:
Hard to say. Will you be home to monitor soon? If so, I'd leave the dose alone if it's only a few more days. You need more testing to know if it's bouncing, as Djamila said.
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If I remember right, she's living overseas for a year, and just left a few months ago.
 
I won't be home soon - living abroad for one year. Caretaker has a full time job so can only grab mid cycles on her days off (weds and sun). Should we keep his dose the same for now? Thanks!

ETA or drop to 1.5 if the theory is bouncing? She said his gums look fine. With a bounce, are the mid cycles also high (like sam's numbers today)?
 
I would keep it the same at this point because if these numbers really are high (not just from bouncing), you don't want to be giving him less insulin. Could she grab some before bed tests? How many hours between the shot time and her bedtime?
 
It depends on the cat, but typically they will go low for one cycle, and then will have anywhere from one to five cycles after that where they will be "stuck" up in high numbers. It's how their body tries to protect itself from the "too low" numbers. The liver dumps a bunch of glucose into the blood stream to bring them back into safer ranges, but then it takes anywhere from a few hours to a few days to get back to normal.
 
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