Thumper 7/14

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Barbara, I don't see any DKA in your SS, why do you test for ketones so much?

One thing I've also found about ketones, meters and cats that throw off ketones is they seem to cycle, and when you test in that cycle is where you think the cat is .... but that isn't necessarily so. Think if your not testing? are there still ketones at times??? I have found with the meter she can test high in the AM, med. at mid day and no ketones at night. So on that day if I had tested in the AM I would assume she had bad ketones, and if I tested at night, none.
 
+4 - 248

I bet that was a sight, glad it's dark cause I was in the grass checking her BG! :smile:

So I'm at a total loss as to what to do in the morning. I might get a +6 but I doubt anyone will be up & I'm not positive I will make it. If it was too much insulin would she come down this much???
 
Ok, with all of the pink numbers I'm now convinced that your dose is too high.

Go to bed, there is no use in getting a +6 we have the info we needed.

I would drop back to a .6u for now.
 
Nancy and Payne said:
Barbara, I don't see any DKA in your SS, why do you test for ketones so much?

One thing I've also found about ketones, meters and cats that throw off ketones is they seem to cycle, and when you test in that cycle is where you think the cat is .... but that isn't necessarily so. Think if your not testing? are there still ketones at times??? I have found with the meter she can test high in the AM, med. at mid day and no ketones at night. So on that day if I had tested in the AM I would assume she had bad ketones, and if I tested at night, none.

Oh, I think I forgot to answer that one. I was randomly checking with pee stips a couple of months ago & started getting a trace reading. My vet ignored me about the whole situation & said it wasn't possible and ever said they didn't know if they could even test ketones by a blood test. I got the Precision meter free so I started using that, then found out there was some confusion with it. The night she went to the ER with the 600 BG & not able to stand the initial diagnosis they gave me was DKA, but by the time the next day rolled around they changed their story cause after they gave her R insulin she went from over 600 to 100 something, and they had also given her fluids. Then they started talking somogyi then said her problems all stemmed from uncontrolled diabetes. There are several things that came into play...she had not been feeling good, very lethargic. She spent that day at the vets getting xrays, blood work, ekg. When I picked her up they started talking maybe something was wrong with her heart & decided to give her a shot of lasix cause they thought she might have fluid build up. I took her home & she seemed fine, 45 mins later her BG was 600 & she wouldn't get up to eat. I picked her up & carried her to the food but she fell into her food dish & couldn't get up. I picked her up, cleaned her off & laid her back on the rug, after a minute or so she stumbled across the room, peed in the cat bed then managed to get to the couch & jumped back up there. That's when I took her in.
 
Rob & Harley said:
Ok, with all of the pink numbers I'm now convinced that your dose is too high.

Go to bed, there is no use in getting a +6 we have the info we needed.

I would drop back to a .6u for now.

Even with the drop she has, from 385 to 248? I'm just confused since today seemed flat then I increased & got a drop??? I don't have a problem dropping I just don't get it.
 
Nancy, also I hadn't been testing much at all lately but figured I better since her #'s started going high again.

Ok, I'm gonna lower the dose tomorrow. She's chillin on the patio! :roll:

She will be 15 Aug 1st
 
It really is as simple as what Robin is saying .... she goes low and her body isn't used to that low number so her number shoots up high and you raise the dose on that high # .... but the high # actually came from the low one but you are shooting the high # with a higher dose, and so on, and so on ......

She is an old girl, Payne is only four .... you need to go slow and take baby steps and don't worry so much!
 
I'm fine with trying the lower dose :mrgreen: but I just want to keep things as clear as we can.

Are people saying she got an unseen low somewhere in there and that's where rebound has come in?

She has spent tons of time now in nice blues & greens and does not zoom after them, so she doesn't look to me to be in liver training at this point.

So that would mean she actually hit a hypo number, or had a steep drop, and that's what triggered Somogyi rebound? I just don't see it in the data.

I'm not saying that she might not be fighting the higher doses and a lower dose is what she needs, but I don't see where actual rebound comes into the picture, not when you look at the history of the numbers she has been getting, I don't see where the slight dose increase could have her hitting hypo numbers?

Just trying to clarify.
 
I'm gonna go back to .6 but I think my blonde is showing here. I don't get it...on the 10th I raised to .6 to see if I could get even better #'s for her, she went down to 56 so that night I lowered just a hair. We were good on the 11th & I held somewhere around a fat .5 or just .5 I'm never really sure of those odd doses. We got the pink AM on the 12th & it was even higher PM so that's when I raised to .6, after that I did panic & raised the 13 & 14th. So are you saying I went wrong on the PM shot on the 12th? What I don't get is where did the pinks come from? Just raising that hair on the 10th?

Geez, I just went back & read through Joanna's post. What she says makes sense to me. I just don't see how I will ever get this right. Until yesterday I didn't think I had made that many changes. I just makes my head spin.
 
Joanna & Bix (GA) said:
I'm fine with trying the lower dose :mrgreen: but I just want to keep things as clear as we can.

Good luck with that!

As for the rest of it I obviously don't get it. The only low she's had was that 56 when I tried .6 & I can't get my head around the fact that that would cause a bounce. After the 56 I just lowered slightly, like I said it's so little I couldn't swear to the fact that it's really any difference. Did that slight difference cause the pink?
 
I definitely agree with Nancy's advice that you should worry less! :-D I don't think anyone knows for sure, we are all just doing our best to look at the data, the symptoms (or lack of), and the overall picture and give you our best ideas what is going on. I don't know for sure, but I agree with you, I don't see how the raise from a .5 to a fat .5 and a low PS to a high PS could be triggering rebound.

I do think there is a mystery we are seeing with ProZinc where it seems like they fight the dose a lot, and I'm not sure what to make of that. It seems like there are a lot of cats right now where dose raises simply aren't working, and if you lower the dose you see some better numbers, but then they don't stick. I don't know if it's that with ProZinc you have to raise the dose past the resistance point to get to better numbers, or if there's some incredible level of finessing that it needs, or what it is, but I for one am finding it really frustrating! I can't speak for anyone else, but I would guess other people are experiencing the same frustration - just day after day with cats not getting good numbers, and whatever their peeps try it doesn't seem to come together. I don't know if it's the insulin, if the doses aren't right, or other factors in play, or maybe some combo of all of those, or ECID and it just looks like a global problem when it isn't.

When I see her #s go all high and icky all of a sudden and she was doing well and there are dose increases, my first reaction is "oh yeah, the dose is too high and she's fighting it". But then I think about how Bix at times needed dose increases, and I knew from experience with him that reducing the dose didn't help, he just flat out needed more insulin at times. And I think about how it has evolved day to day with Thumper, that her numbers went higher on a dose that had been working for days, so you raised a hair and then as you have gone along since then it has had every appearance to me that the numbers were going higher ahead of your dose raises, not the other way around.

So that's where I come around to feeling like it's probably a good idea to do a quick check on the dose to make sure it's not the case that she is SO sensitive she only wants .5 or something like that, and she is freaking out now at the increases. And a good idea then to raise back up quickly if she doesn't respond to that. IMO none of us know 100% what is going on, so you try things in the safest way you can, and gather data, and find out for sure. Ultimately with Bix when I had him in good numbers it was because I tried things and got data until I knew what worked and what didn't, not because I was able to look at his numbers and really know what was going on for sure (until the patterns repeated enough that it was predictable).

There are people with more experience than I have who may be able to look at the SS and know for sure what is going on, but for various reasons they all left the forum a long time ago. At the risk of offending everyone :mrgreen: we have kind of been the blind leading the blind here for a couple years now, and though a number of us have some good experience, mine at least pales in comparison to the people who taught me when I got here, for instance. So I think it's more of a support system and ideas forum here, than anyone really being able to tell you for sure what is going on and here's what you need to do (if even the super-experts can do that, I don't know).
 
I agree with Joanna here. Something has happened the past few days that is increasing numbers and it looks like you need more insulin as a result. How did Thumper do on the 1U dose? Did she get any lower than what you reported? The numbers did look better on that dose for sure. I'd wonder whether an infection is on board given the sudden change. Can you get her to the vet for a urinalysis at least?
 
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