Shots and charts oh my

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Lois and Java said:
I think what happened is that even though he ate, and I watched him eat... because I was making breakfast for guests, I didn't follow him to where he is around plus 1 and plus 2 and make sure he ate some more Fancy Feast.
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Even if he didn't eat enough this AM, that's an awfully big drop. Lack of food might be a factor though.
 
He's getting up and he's grazing on YA on his own, but the FF is from me bringing him to food, or food to him.
I already did a little honey, and he licked the bottom jelly from FF. He's just on his pillow again. Will change photo to right now.
 
Dinner?! Vive le difference! (la?)

I'm waiting for an answer to the vet about the Henry Schein strips, so I'm going to call check on that and ask them what I should expect from the ringer solution and the lab tests results.
 
Lois and Java said:
Dinner?! Vive le difference! (la?)

I'm waiting for an answer to the vet about the Henry Schein strips, so I'm going to call check on that and ask them what I should expect from the ringer solution and the lab tests results.
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La différence. Dinner, supper, all the same. :)
Any more BG numbers?
 
94. He wants to go outside. I let him go out, went out with him. He just kind of wants to stand and stare, it's misty-raining, so I brought him back in. He's thirsty, he ate a little of a fresh batch of watered down FF. And now is off to his pillow again.

I'm reading about the PSL test. http://precisionpsl.com/faq.html

Cornell. http://www.vet.cornell.edu/fhc/Health_Information/pancreatitis_serious.cfm

The progression of feline pancreatitis can take various paths. Says Dr. Goldstein: “Your cat can have a perfectly normal pancreas but then develop—for no apparent reason—a sudden, very acute, and very severe case of the disease. And the cat may die as a result of that single acute attack. Or it may recover and never experience a problem with its pancreas again. But what often happens is that a cat will recover from the initial acute attack and then develop chronic pancreatitis. The animal will tend to have intermittent little bouts of the disease over time. With each occurrence, there will be less inflammation, but there will be gradual scarring of the pancreatic tissue, which could eventually take its toll on the organ’s ability to function.”

Diagnosis and Treatment
The clinical signs associated with feline pancreatitis, says Dr. Goldstein, are quite nonspecific: inappetence and lethargy, for example. The standard diagnostic procedure will involve a medical history of the animal, a thorough physical examination, bloodwork and ultrasound. Radiography tends to be of little value, he notes, since pancreatic abnormalities—indeed, the organ itself—are not readily perceptible on x-rays. They are sometimes useful, however, in ruling out other disorders, such as an intestinal obstruction, which can have symptoms resembling those of pancreatitis. The only way a definitive diagnosis can be made is through a biopsy, he notes, but this involves a surgical or laproscopic procedure that may not be advisable for a seriously ailing, physically debilitated animal.
....
Although no uniformly effective cure for feline pancreatitis has yet been developed, an affected cat will typically be hospitalized for several days while supportive treatment proceeds. This treatment will entail feeding the patient—through a tube leading directly into its stomach, if necessary—to make sure that it is getting adequate nutrition. This must continue until the animal’s spirits pick up and it resumes its normal eating habits.

Edit. The vet's with someone, will call me back. I can do syringes of food in side of mouth.

Java's essentially a hospice patient because of his age. I want to do as much as I can, without being so intrusive, I make him miserable.
 
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Lois and Java said:
94. He wants to go outside. I let him go out, went out with him. He just kind of wants to stand and stare, it's misty-raining, so I brought him back in. He's thirsty, he ate a little of a fresh batch of watered down FF. And now is off to his pillow again.

I'm reading about the PSL test. http://precisionpsl.com/faq.html

Cornell. http://www.vet.cornell.edu/fhc/Health_Information/pancreatitis_serious.cfm

The progression of feline pancreatitis can take various paths. Says Dr. Goldstein: “Your cat can have a perfectly normal pancreas but then develop—for no apparent reason—a sudden, very acute, and very severe case of the disease. And the cat may die as a result of that single acute attack. Or it may recover and never experience a problem with its pancreas again. But what often happens is that a cat will recover from the initial acute attack and then develop chronic pancreatitis. The animal will tend to have intermittent little bouts of the disease over time. With each occurrence, there will be less inflammation, but there will be gradual scarring of the pancreatic tissue, which could eventually take its toll on the organ’s ability to function.”

Diagnosis and Treatment
The clinical signs associated with feline pancreatitis, says Dr. Goldstein, are quite nonspecific: inappetence and lethargy, for example. The standard diagnostic procedure will involve a medical history of the animal, a thorough physical examination, bloodwork and ultrasound. Radiography tends to be of little value, he notes, since pancreatic abnormalities—indeed, the organ itself—are not readily perceptible on x-rays. They are sometimes useful, however, in ruling out other disorders, such as an intestinal obstruction, which can have symptoms resembling those of pancreatitis. The only way a definitive diagnosis can be made is through a biopsy, he notes, but this involves a surgical or laproscopic procedure that may not be advisable for a seriously ailing, physically debilitated animal.
....
Although no uniformly effective cure for feline pancreatitis has yet been developed, an affected cat will typically be hospitalized for several days while supportive treatment proceeds. This treatment will entail feeding the patient—through a tube leading directly into its stomach, if necessary—to make sure that it is getting adequate nutrition. This must continue until the animal’s spirits pick up and it resumes its normal eating habits.

Edit. The vet's with someone, will call me back. I can do syringes of food in side of mouth.

Java's essentially a hospice patient because of his age. I want to do as much as I can, without being so intrusive, I make him miserable.
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His BG seems OK for now.
 
Okay, thanks.
>> Java's essentially a hospice patient because of his age. I want to do as much as I can, without being so intrusive, I make him miserable.
Because he's old and cats sleep all the time anyway, it makes it hard to know what's going on. This photo? Pretty typical. It doesn't look like the meatloaf-pain hunch, right?
 
I'm reading another thread that had the searchable word "pancreatitis" in it.
What do you think about this hyper-hypo combo? meaning, selfishly, am I doing the right things for Java? (I'm sorry about Milo.)

>> Rapid drops leading to hypoglycemia combined with the rebound hyperglycemia can sometimes be very detrimental to the brain. My sweet baby boy, Milo, did not recover from his hypoglycemic episode even though I acted quickly as instructed by my vet. The problem is, the initial signs of a HYPO episode can be overlooked by the untrained eye and hypoglycemia needs to be treated as quickly as it begins for the best outcome. In all my reading and learning about feline diabetes one fact stood out more than anything else I read and that was the fact that not only rapid drops leading to HYPOglycemia, but the rebound HYPERglycemia also can be very damaging to the brain; it's a double edged sword affecting the ability to perform basic bodily functions.
 
Checklist for QOL, factoring in age of cat:
  • eats, pees, poops
  • moves around
  • shows interest in his surroundings
  • no obvious signs of distress.
Yes, he's a very senior cat, Lois. Even younger ones sleep away much of the day. He can sense your anxiety so try to stay calm.
 
I went out to a movie, Oscar time. Came back and Java woke, was looking longingly outside, so I took him out. He's got a bodyguard wherever he goes, but it makes him so happy to be outside drinking rain water. His tail is super thick, the bone is twice as thick as a normal cat's tail. He thrashes it back and forth when he's happy. He was happy!
Thanks for that, qol list.
What the vet said is, it would take a month for the values to change for Java on the PSL test. Stick to twice-a-week Sub-Q, a teaspoon of food here a teaspoon of food there, adds up and is okay.
We compared prices of test strips. He doesn't get any kind of a break apparently on alphatrak. The Henry Schein rep gave him a vial of 25 test strips that he's going to give me for free.
About to setup and then test.
418 - PMPS
He ate some FF from his pillow.
I need to shoot.
 
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Kris & Teasel said:
That's a gigantic drop in 4 hours. Test again at +5 and +6. If he doesn't go too low, give either a regular 1U or a "skinny" 1 u tonight. Put the numbers in your SS as you get them. I'll check periodically.
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Regular 1U.
Will test +3 and +5, if not too low at 5, let run to AM.
Edits
2-3 Tbsp fresh cooked salmon eaten after shot.
+2.5, 251.
Ate another Tbsp fresh salmon around 1.5.
+5, 214. Peed. Wished he could go outside to drink the good water.
 
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It's interesting that the dose reduction to a regular 1 u gave you yellows last night while the fat 1 u resulted in low greens. You asked yesterday whether lack of food around AM shot caused BG to be lower. That could well be the big factor along with the slightly higher dose. I'd try a regular 1 u again today. Data collection ...
 
Hey I'm up, 5 am. Woke up and Java wasn't in his usual spot on pillow. Found him in closet hunched over - he has a folded towel in there that he sometimes sleeps on, lying down.. Am feeding him as much salmon as he'll eat ... A tiny bit. He just went back into the closet. He's just sitting there.
Test blood?
 
https://www.petpremium.com/pet-health-center/diseases-and-allergies/pancreatitis/

He's lying down normally now. It could be pancreatitis. He might have been getting away from Lily, who sometime lies on k top of him. I'm going to test, since I'm up, and see if I can get him to eat any FF slurry, since if it is P., getting food into him is key.
Eta: tried a little water in salmon, not FF. No. Heard a bird. 6 am already. He wants to go outside now. I have to get more sleep. FF up. Leave salmon down?
 
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Someone did this this morning, see photo.
He goes to the uphill property behind me and walks along the odd privacy screen to fencetop, steps over onto shed roof.
Amps, 460. 1U.
118 - +5.5
He's eaten some chicken, salmon, YA.
The higher the dose, the lower the low?
125 ml Ringers subq at +8, ate more food.
 
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PMPS 322. Scant 1 U.
45 mins to find something he'd eat and get some eaten. Scant 1, because his bg lower than other PMPS, 1 not .75 because, stay on the track.

His hind legs are really weak. He splatted jumping from bed to floor directly instead of via step- box. He gets B12 shot on Monday.
He's weaker despite roof of shed in am. I think he is better in morning and worse at night.
3 am +5 221, peed normally, ate. Yay!
Time creep today am and pm. Move up 30 min tomorrow am.
 
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Maybe try the regular 1 u today? Re B12: I think some people here have found the oral version (methylcobalamin?) more effective for neuropathy (@Marje and Gracie ) than the injection.

Many elderly humans are worse at night. Maybe similar with elderly kitties.
 
Something liquid would be better. Since his appetite is diminished and picky, FF with powder B is often rejected.
So much time creep yesterday, I'm going out with him this morning. AM test in about an hour, try to get back to normal schedule.
Thanks for being there Kris.
 
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AMPS, 359, 1 Unit
Could not have been an easier morning!
He went out and drank and drank rainwater, and came right back in.
He lapped down three small bowls of Fancy Feast slurry. (I see thirst)
I'm back on a nearly normal time schedule.
Awesome!
 
Looks like a bit of bouncing yesterday. Maybe try 1 u today to see if he comes down and consider a fat 1 u tomorrow if you can monitor.
 
Yesterday looked like bouncing? And here I thought it looked really good! No black, no red. Yes, magenta, but then a nice couple of yellows, and then another magenta. But that's not a good "run" for a day?
Another Q; I woke up to pee at 5 AM and debated whether to test him or let him sleep, and fell back asleep while pondering. How often should I test him if I'm not on notice to monitor him (like if I do a fat 1.0, then 3, 6, 9 is okay?).
You're testing Teasel a lot lately. Is that because of the red and green values?
 
Lois and Java said:
Yesterday looked like bouncing? And here I thought it looked really good! No black, no red. Yes, magenta, but then a nice couple of yellows, and then another magenta. But that's not a good "run" for a day?
Another Q; I woke up to pee at 5 AM and debated whether to test him or let him sleep, and fell back asleep while pondering. How often should I test him if I'm not on notice to monitor him (like if I do a fat 1.0, then 3, 6, 9 is okay?).
You're testing Teasel a lot lately. Is that because of the red and green values?
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I'm testing Teasel a lot because I just switched insulin 2 weeks ago and I'm monitoring his progress on it.

The reason I said there was bouncing yesterday is that with the same dose (1 u) that produced a blue the day before the BG didn't fall below yellow/pink. Re how often to test: on an uneventful day - AM/PM before feeding and injecting and one other test either mid day or before bed.

I suggest you try a fat 1 u tomorrow. Monitor BG at +2 and +4 to see where he's heading.
 
The high numbers last night are a bounce from the blue yesterday. Try a fat 1 u and get your first test at +2 to see where he's headed.
 
I'm reminded of the book Flowers for Algernon. I feel like Charley in the slide away from intelligence. There is something about bouncing that I fundamentally fail to grasp, and I feel like I would have, another earlier smarter time.
 
Lois and Java said:
I'm reminded of the book Flowers for Algernon. I feel like Charley in the slide away from intelligence. There is something about bouncing that I fundamentally fail to grasp, and I feel like I would have, another earlier smarter time.
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Bouncing recap:

How to identify:
Whenever a dose has given you some lower numbers (eg. blue) mid cycle and then the same dose fails to do so next cycle (only yellow or pink and higher), that's evidence of bouncing. When a good mid cycle low skyrockets to an unexpectedly high number at the end of the cycle, that's evidence of bouncing. Bouncing is caused by a normal physiologic regulatory process aimed at keeping kitty's BG at safe levels but the process goes into overdrive and over compensates. This "computer glitch" is an idiosyncrasy of that particular kitty. Not all kitties do this but it's very common.

What will trigger bouncing in kitties who are prone:
  1. a BG that falls too low
  2. a BG that falls to a lower level than has been the case recently but not necessarily too low
  3. a high rate of BG drop in a cycle - eg. dropping 100 points in the first hour or two.
Does this help?
 
Yes!
Straight 1 U, only slightly jumping ahead 30 mins.
Edit, I'm at the end of AlphaTrak strips, more on the way, and will switch to Henry Schein. Tonight, I tried both at same time. AT read 450, HS read 210! Crazy. My thought is that since it wasn't a really fat juicy drop of blood, that the HS, which was #2, didn't get enough for a good read, even though it got A read. I have enough to compare again on another stick.
 
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I've gotten behind on dosing time. I'd like to dose him at 10 or 11 hours instead of 12 to get back on track. How would adjust the dose; in this case, a regular 1 U instead of a fat 1 U?
 
Lois and Java said:
I've gotten behind on dosing time. I'd like to dose him at 10 or 11 hours instead of 12 to get back on track. How would adjust the dose; in this case, a regular 1 U instead of a fat 1 U?
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No need to adjust the dose. PZI is quite flexible in terms of moving dose times by up to one hour. I think the dose needs to come up a tiny bit.
 
Okay, back to fat 1 U.
This morning, I did a dip with both alphatrak and the Henry Schein meters. It was a big fat juicy drop of blood.
Alphatrak -523
H Schein - 477
At least they're in the same ballpark, but I'm surprised at the difference.
I'll be using the Henry Schein for the next little while. Hmm, which one to enter now?
 
I'm at the library. My printer died a long time ago so I come here to print stuff. I'm cut-copy-pasting all the key info from you into one doc so I can read it in print. Two goals - 1) go over it / see if I missed anything / work more on understanding bouncing, and the SS in general. 2) I'm hoping that I can talk my neighbor (with 6 cats. Humane Assoc. volunteer) to take care of Java so I can go away for two days when a friend from East Coast visits in a few weeks. Right now, I have to be here, there's no one else who can sub for me. She's worried that something bad will happen while I'm away and doesn't want to be part of that. I'm feeling more calm about him in general, and I also want to use some of your words, with your permission, to write up a To Do list for Sarah.
Don't know if you heard about the huge fire in Calif. two years ago, The Valley Fire ... we have too many of those! My friend Mona lost her house in the fire, we want to go up and see it. She moved.
 
Lois and Java said:
I'm at the library. My printer died a long time ago so I come here to print stuff. I'm cut-copy-pasting all the key info from you into one doc so I can read it in print. Two goals - 1) go over it / see if I missed anything / work more on understanding bouncing, and the SS in general. 2) I'm hoping that I can talk my neighbor (with 6 cats. Humane Assoc. volunteer) to take care of Java so I can go away for two days when a friend from East Coast visits in a few weeks. Right now, I have to be here, there's no one else who can sub for me. She's worried that something bad will happen while I'm away and doesn't want to be part of that. I'm feeling more calm about him in general, and I also want to use some of your words, with your permission, to write up a To Do list for Sarah.
Don't know if you heard about the huge fire in Calif. two years ago, The Valley Fire ... we have too many of those! My friend Mona lost her house in the fire, we want to go up and see it. She moved.
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Feel free to use any of my words in the posts I've made on your threads, Lois. Yes, I did hear about that awful fire two years ago. I can't imagine how traumatic it is to lose your house. California has a lot of catastrophic "acts of nature"! One of my brothers has lived there a long time and the first disaster he witnessed while he was at Stanford was the huge earthquake in 1989.
 
Thanks! I wonder what other people do when they want to get away?
I've been resting next to Java for 2.5 hrs, which, aside from running around doing errands, including walking a neighbor's dog for the second time today, is my feeble excuse for not testing him midday. On the Henry Schein meter at + 10, 255.
He's having some YA right now, had a pee. Reassuring things.
Oh yeah I was here for the Loma Prieta. I hope to never go through as big an earthquake as that again. Our office was not far away from the Cyprus Structure, the freeway that pancaked. I accidentally saved my boss's life by delaying him with some questions about a project when he was trying to get home for the baseball game. One of the Cypress slabs came down on cars right in front of him...He was able to drive away.
Stanford's a good school! A friend of mine is getting treatment at the med center down there. I help her with rides to and from when I can. Her arm's been amputated, she needs more surgery again, sarcoma.
I need to find out about that liquid vitamin B. I haven't tried Googling yet let me do that.
 
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+10, 255
PMPS, 333
This is with the Henry Schein meter.
Because it's (reading) lower (than AT meter), I went with a straight 1U instead of a fat 1 (and I'll sleep better if I don't worry it might hg too low).
I'll set it up to check him when I get up to pee in the middle of the night.
(Eta,) 2 am, +5, 175, ate some FF, pee'd.
Not finding liquid b super easy. I should be sleeping....
 
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Kris & Teasel said:
I like those blues from the fat 1 u doses yesterday. I'd try it again and aim for a few +4 to +7 tests.
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Okay! I'm starting to see it, today's start of 440 is lower than yesterday's, we want to see if fat 1s at night will bring it down more.
Hey, so I took the litter box outside to clean it, and Java came out to use it. I grabbed a detergent-rinsed smoked trout tin to collect some pee, and neg for ketones. Tin should have been clean enough, yeah?
 
Lois and Java said:
Okay! I'm starting to see it, today's start of 440 is lower than yesterday's, we want to see if fat 1s at night will bring it down more.
Hey, so I took the litter box outside to clean it, and Java came out to use it. I grabbed a detergent-rinsed smoked trout tin to collect some pee, and neg for ketones. Tin should have been clean enough, yeah?
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Tin should be fine. Hurray for no ketones!
 
Also 117 at 5.75. That's good. So the Q is, is that the nadir, or is the nadir later, or earlier. Right now is 6.75, test now?
I'm asking because I don't wanna. 5 hours solid yard work, including small tree cutting...Tired! Java's asleep on the bed next to me and I might join him in the land of nod. On the other hand, info.
 
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Lois and Java said:
Also 117 at 5.75. That's good. So the Q is, is that the nadir, or is the nadir later, or earlier. Right now is 6.75, test now?
I'm asking because I don't wanna. 5 hours solid yard work, including small tree cutting...Tired! Java's asleep on the bed next to me and I might join him in the land of nod. On the other hand, info.
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I like that 117. Is it the nadir or not? The only way to tell is to do a full curve when you can spare the time. Tomorrow?
 
217 at +7. Wow, that was fast.
So is that a normal increase?

Maybe Sunday. Oscars! I'll be glued to the TV. Or maybe tomorrow. I'm so beat now, more yardwork tomorrow seems doubtful.
 
Lois and Java said:
217 at +7. Wow, that was fast.
So is that a normal increase?

Maybe Sunday. Oscars! I'll be glued to the TV. Or maybe tomorrow. I'm so beat now, more yardwork tomorrow seems doubtful.
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It might be the start of a bounce from the 117. Don't fret. Just keep doing what you're doing and give another fat 1 u tonight.
 
335 at 2:30 am. +5. Why's it so high? Why isn't it around 117 like this am?
I can't do a curve. I have to be sparse with strips. I was assured last Tuesday by a customer relations that strips were on order and being mailed out that day, arriving to me by Monday at latest. Then I got email Friday saying, your order was just mailed today. Sounds like Barbara forgot to put the order through...?! Grrr. I can get AT strips from the vet if I have to. but this weekend, soaring with strips.
 
Lois and Java said:
335 at 2:30 am. +5. Why's it so high? Why isn't it around 117 like this am?
I can't do a curve. I have to be sparse with strips. I was assured last Tuesday by a customer relations that strips were on order and being mailed out that day, arriving to me by Monday at latest. Then I got email Friday saying, your order was just mailed today. Sounds like Barbara forgot to put the order through...?! Grrr. I can get AT strips from the vet if I have to. but this weekend, soaring with strips.
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He could be bouncing from the 117 earlier in the day. He might have dropped lower than 117 but you don't have any data. That's why I'd suggested getting more numbers in the +4 to +7 range. However, if you're short of strips that might not have been possible.

Many people on FDMB use a human meter for day to day testing. They read lower than the pet meters but the strips can be a lot cheaper and much more readily available. What if Java's numbers were too low and you didn't have enough strips to monitor? The Walmart ReliOn types are very popular and there are a couple that use only a tiny drop of blood. I suggest that you think about switching. You'll get used to the shift in number ranges for too high, OK and too low. People who have a pet meter as well save it for full BG curves, especially if they show the curve data to their vet.
 
Could there be something wrong with the meter? 359, 334, and 339 all in a row?
Is that good, not a lot of up-and-down?
Oh, we overlapped! Good morning!
Edit, Marin doesn't have a Walmart, we're anti big box generally, except we do have a Target and Costco. I'm really bummed because I went through this scarcity of test strips before, and thought I had it taken care of. But I definitely see the advantage of having something that's in common use here, and I can run through strips without being so parsimonious.
Oh wow, $18 for 100 test strips?! Okay! I'll bet there's a sticky here somewhere re meters.
 
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Lois and Java said:
Could there be something wrong with the meter? 359, 334, and 339 all in a row?
Is that good, not a lot of up-and-down?
Oh, we overlapped! Good morning!
Edit, Marin doesn't have a Walmart, we're anti big box generally, except we do have a Target and Costco. I'm really bummed because I went through this scarcity of test strips before, and thought I had it taken care of. But I definitely see the advantage of having something that's in common use here, and I can run through strips without being so parsimonious.
Oh wow, $18 for 100 test strips?! Okay! I'll bet there's a sticky here somewhere re meters.
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You could try another human pharmacy to get a human meter that takes a small blood drop and has relatively cheap test strips. Walmart in Canada doesn't sell ReliOn meters so we buy others. My backup (not in use right now) is a Freestyle Lite by Abbott. Its strips are cheaper than AT strips but still $$$.
 
I drove to my yoga class, parked my car, and then got back in it and drove to my vet. I figured it's easier to beg them for 10 to 15 individual accutrak strips than it is to drive to Sonoma to find a Walmart.

And lo and behold they had ordered an extra 50 strip bottle of Henry Schein strips, so now I am set. I am inquiring what happened!? to the ADW people, because they told me in writing that they shipped my order, then didn't until 4 days later.

I think I will also get a human meter. Better to collect information, not so rushed. I just can't get over the price of the Relion test strips, $18 for 100.

The online Walmart menu said that the ReliOn meter is supplied by ADW. Which is interesting.

It surprises me that there isn't a sticky on this site with more information about meters. There is a whole section on meters in the FAQs, but not one word about Relion! So maybe I can help compile info in one place so it can be updated.
 
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