Trouble regulating Lucky after fructosamine came back off the charts/unregulated!

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nvand1993

nvand1993

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Hi All,
I had trouble following this site when I first started. Everything was so confusing for me. Plus the added stress of having a sick cat.
I am a 911 dispatcher and work 12 hour days, so I am gone 13 hours. Lucky doses average at 6:15am and 7:15 pm.
I am trying to get him regulated. The week before Christmas or so I cut both cats off the Diabetic management dry food. I have noticed this causes him to bounce all over with high numbers.
My Vet doubled his insulin dose to 4 units BID on December 30th, and when I started testing I noticed his lethargy... one test at 27, 36 once at 43 or so. You can see my chart. I try to test more when I am off, but my time is limited with other sick family members when I am off (daughter just out of the hospital, brother having surgery soon after infection heals).
I am now seeing improvements in Lucky's behavior. He is now chasing his brother again, and trying to jump all over the place. His energy level has skyrocketed. Now I just have to figure out what the proper dose needs to be. I ordered $169 worth of low carb food (4 and under), from fancy feast to purina speciality, merrick and Hills W/D glucose management food. I kept every buy at .23 cents an ounce or lower (was very cost conscious!). I have received all the food and give him 1/2 diabetic food and 1/2 low carb food, all wet food. His brother is on the same diet now, as its impossible to feed them different food.
His treats during testing and shooting consist of freeze dried chicken, turkey or salmon (which his brother wouldn't touch at first, but now loves it too!).
So, my dilemma... how often do I change his dose. As you can see I am not very good at this.
Should my does be different for the 13 hr spread, versus the 11 hour spread.
Any help would be appreciated!
Please help if you can, with my limited numbers on my chart.
Thanks!
 
Hi Nicole,

Yes, Lucky is all over the place. Several things I notice with his numbers. You are shooting high doses on low numbers. On 1/4, you shot 3.5 into a 130. We suggest, even with diabetics with lots of data not to shoot under 150 or so, and then to shoot a tiny dose. Afterward nadir of 36, he bounced up to 440. (When their body perceives a number much lower than it is used to, it releases extra glucose, causing a bounce up to higher levels.). That 36 definitely earned him a dose reduction.

If he were mine, I go back to 1.5. Only shoot if near 200 (until you have more data) and then, only after you are sure the number is rising, not falling. You want to be the previous shot is done before you add more insulin. So, wait 20 minutes without feeding and retest, to be sure the preshot number is going up, not down, before you shoot.

Give that dose 3 cycles or so, getting a nadir whenever you can. Some people who work odd schedules try to catch an evening test before bed. If he gets shot at 7pm, a test at 11pm would give you some info. Some people who are up at night anyway(people my age anyway) and catch a test then. If he is staying in higher levels, then increase by .25 and hold that dose 3 cycles.

I would ditch the dry food. It is higher in carbs and has poor ingredients and expensive. He is much better off with all wet low carb. (As is his brother). Have we given this site by a vet: www.catinfo.org. She explains the perils of dry food.

For reference, we consider a cat regulated if they are in the mid 200s at preshot and in double digits at nadir, but not under 50, which is approaching hypo territory. Cats in remission range from 40-120, off insulin.

Have you seen the protocol we put together for ProZinc. It could be a guide for your dosing.

http://www.felinediabetes.com/FDMB/threads/protocol-for-prozinc-pzi.109077/
 
Thanks Sue for your input. I am studying the references for PRoZinc and will adjust and track as closely as I can from now on. I guess I will start evening tests before going to sleep to get some idea how he is doing. he is obviously getting his BITING attitude back... Grrrrrr
I have printed the references and will use those as a guide.
What do you recommend for a medium carb food to have for my hypo kit? I had the karo syrup on hand, but only had the diabetic dry food to give at the time and that caused all kinds of rebounding. I would like the perfect kit for my little guy.
Thanks to all who help. This site is incredible.
Nicole
 
Lots of people buy the gravy Fancy Feast types. ( Mark them so you don't feed them by mistake.) Then, if he goes too low, give him a teaspoon of the gravy and test again in 20 minutes. The gravy brings him up but doesn't fill him up. If he stays low a long time, you want him to continue to eat for you.

Is he getting testy when you poke him? Can you keep him distracted with a favorite treat?
 
He is getting very testy when I poke him now... I try to distract him with his freeze dried treats, but he eats them so fast and I have to throw some on the ground fro his brother, that I can't keep up. I use a rice filled sock on his ear... and use his left ear most of the time. My coordination for the right ear is not perfected yet.
I know the numbers are all over the place at the end of the year and beginning of the year... but for the last few days I am trying to be consistent. His attitude and his behavior is completely changed in the last 4 or 5 days and he is getting back to his old testy self.. even his brother is running for his life now!
I am so nervous and new and this and also have so little time that I need all the help I can get. My kitty was almost 12 lbs last time we weighed him.

I will pick up the gravy FF and put them in a separate location.

Thank you Sue for all the input!
Nicole
 
What size lancet are you using? If he is bleeding well, and you are using the thicker gauge, you might try a thinner one, like 30-31. It might hurt less, who knows?
 
Hmmmmm, I am not sure of the size. It is the blue lancet recommend with the Reli On Comfort Meter. I thought it was pretty small. I have just improved and the place for the prick. Should I go completely through the ear?
 
I use rice in a sock after heating it for 20 seconds. It works well. Just have to find something to occupy his paws and biting!
 
We wrapped Oliver in a kitty burrito until he got used to being poked. We'd wrap him up in a towel with only his head showing. We put him on the couch next to the arm so we could gently keep him contained. Other people put the cat between their legs while sitting down. That might help with the paws - not sure about the teeth unless you can keep him eating....
 
Hahaha:) Thanks for making me chuckle. Yes, the teeth are an issues. i have been wedging him between the pillow and my body, but I will try putting him between my legs (provided they are well protected), or I will try wrapping him if he gets out of hand. Surely he knows I am only trying to help him by NOW.
Thank you for your insight and thoughtfulness Sue.
I will work harder on getting my numbers all lined up and testing at night. I have printed the reference material that I will use frequently while trying to regulate.
Thank you every so much!
Nicole
 
Hi Nicole! I was at work all day, so I didn't get a chance to jump in until now. Sue's got it pretty well covered, so I just wanted to say that I agree with all she said! :D

Kitty burrito worked well for me. Gypsy loved being wrapped in a towel oddly, so she got used to the pokes.

It's scary when you get this diagnosis! However, we've all been scared and nervous at the beginning. We made it through to the point where caring for the diabetes was normal! You'll get there too!
 
I don't know if I'll ever get used to this. I can never stop anywhere on my way home because I have to take care of the kitty and I have already been gone almost 13 hours. So I rush home every night to make sure I stay as close as I can. One night I had a meeting and my brother was able to go over to feed and give him a shot. but I haven't taught him how to BG test yet. Besides, he is dealing with his own issues now. I also can never sleep in anymore, even if I am sick, although last saturday I went back to bed and slept until 11:45am. I had been fighting a bad cold and it helped me turn the corner.

I appreciate all your input... and I will work on getting all of you better numbers by the weekend. I will do a curve on my day off again. Probably will start doing the kitty burrito wrap to help me get past the claws... hope I can get past the teeth :smuggrin:
 
Maybe trim the claws before the next round.
For the head, you might wrap part of a towel over the head to provide a buffer between your arm and his teeth.
 
Ok, I used the kitty burrito suggestion for the last 2 injections. Did much better with burrito position and treats. No biting occurred, only a little struggle this morning.
Thanks for all the input.
Nicole
 
"Should I go completely through the ear?"

No

You may need to adjust your pricker(not sure what it's called).

It should just prick the top of the ear.

Are you rubbing his ear before you prick? That was Hanks favorite time, the rubbing. He just purrs and purrs. :)

Kimmie
 
I am getting better on the pricker and haven't used the burrito hold in 2 days. Thanks for all your help. Had to use help with his shots today.
 
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