We had not fed her yet but she ate a full meal right after. We were running out of time so decided to give her a token dose of 1U. We are doing a curve today so we will be here to see how she does on 1U. Our new vet convinced sushi’s dad to stop texting her unless it’s during a curve and I’ve lost his support in him restraining her for me. Vet told us to jump from 2U to 3U do curve in two weeks. She’s coming from 2.75u Vetsulin so even tho I was freaked about doing this I agreed. Now I feel like I have proof that we need to go back to attempting more testing (Sushi is very very spicy) and that going up a whole unit at once is not the right thing to do. What dose would you recommend we scale back to? She was getting low 100s on 2U but the new vet didn’t really look at my spreadsheet. She based the dosage adj on her fructosamine which was 500+ but the whole first week of what that test would have covered was going towards building her Lantus depot. I’m so upset with myself over being bullied into going against my intuition and I’m hoping I can get her dad back on board for at the very least doing random spot checks especially during dosage adjs.
I absolutely agree with everything you just said and I actually said ALL of those things to Sushi’s dad the second I got off the phone with her vet and told him what she wanted us to do. I told him it doesn’t make sense to me to go up a whole unit when she was getting numbers in the 100s on 2 units and that the fructosamine doesn’t take the lows into account. Not to mention the depot was still building for the first week those results covered. We skipped right over 4 potential good doses. Heck I don’t even know if 2U was too much because even tho we were testing way more often than Sushi really even had the tolerance for it still was sporadic and not enough IMO. I think sushi’s dad is now receptive to hearing me. Trying really really hard not to shout a big fat TOLD YA SO at him lol
I'm glad Sushi's dad is more receptive to you, I would be dying to say I told you so too
Have you done anymore tests after the +4?
Thank you! I’m HOPING to get a +10 on her soon and then another one before bed but we are going to comply with the vet’s instructions to withhold insulin tonight and tomorrow morning to see what her numbers are like without insulin… but I am going to fast test then check about an hour or two after she eats. If she’s sky high tomorrow morning after we do this experiment I’m putting her back on insulin tomorrow night. I really don’t like the idea of withholding insulin but also I’m worried that I wont be able to trust her preshot numbers tonight and tomorrow because of bouncing and I know cats can be extra sensitive after a low dose event that their bodies aren’t accustomed to. But if she’s still high by tomorrow she’s going back on insulin tomorrow night and I’ll just have to figure it out based on how her numbers look this evening and tomorrow. I know our data is limited but I think 2U was doing better for her than we realized. Whatever dose we DO go back to I’m making sure we force blood out of her way more often than once every two weeks that’s go for sure. I still am kicking myself over this. Thank goodness she’s got no ketone or DKA history because skipping two doses in a row has me so nervous. We just keep putting her in the bouncy house over and over not really knowing her proper dose! And now that depot will have to build all over again. Ugh sorry for the venting I’m just so frustrated because I want to trust myself and my research but then we get instructions from the vet that completely conflict what I’ve read and what makes sense in my brain and all my confidence goes out the window lol. This new vet is so nice, she comes right to the house and is the first vet to manage a blood draw on Sushi without having to use total anesthesia…her and her tech honestly blew my mind with how not intimidated they were by Sushi and just got what needed to be done, done! Literally blew my mind. she also prescribes glargine as her first choice for diabetics so that was a big relief to learn. I am thinking she’s not used to having clients that are willing to do all these blood checks at home especially on a VERY fractious cat like Sushi lol.
Woops! Done! I’ll get the hang of this forum eventually lol!Nicole can you fix your title your SS says 62 +1 and your title says 63 +1 ,not a big deal I guess but I just wanted to let you know
Thank you!! We just switched from 28guage to 26guage and we use her pads because she is too biter at the lancet on her ears lol. She bleeds immediately on the 26 and if the droplet isn’t big enough I squeeze the pad and it works like a charm. And guess what! We just got a +10 of 120 so now I feel better about going with her vets instructions to withhold insulin tonight. I honestly am besides myself with this low number… I did a happy squeal and scared her. if she were still on Vetsulin she would have been at 600 by now because of bouncing from going low and it not lasting long enough. maybe just MAYBE her pancreas actually is starting to do a lil something. If nothing else, I’m convinced Lantus is doing more for her than Vetsulin was and maybe she just needs to scale back. We’ll get there we just need to get way better about testingAre you using 26 or 28 gauge lancets ?
Always aim for the sweet spot warm the ears up first, you can put rice in a sock and put it in the microwave, test it on the inside of your wrist to be sure it's not to hot, like you would test a babies bottle. You can fill a pill bottle with warm water and roll it on the ears also.Just keep rubbing the ears with your fingers to warm them up
6. As the ears get used to bleeding and grow more capilares, it gets easier to get the amount of blood you need on the first try. If he won’t stand still, you can get the blood onto a clean finger nail and test from there.
When you do get some blood you can try milking the ear.
Get you finger and gently push up toward the blood , more will appear
You will put the cotton round behind his ear in case you poke your finger, after you are done testing you will fold the cotton round over his ear to stop the bleeding , press gently for about 20 seconds until it stops
Get 26 or 28 gauge lancets
A lot of us use the lancets to test freehand
I find it better to see where I'm aiming
You can also put a thin layer of vaseline on the ear ,to help the blood bead up
Yes Sushi is super food motivated when it comes to training her in all things except for the greatest of offense of all which is being TOUCHED in any way lol! She eventually comes around and accepts her dehydrated turkey or dehydrated chicken heart slivers after the fact but nothing is enough to distract in the moment and she still hates being touched just as much after 7 months. But once dad or I get her into that football position she basically just accepts her fate with lots of earth shaking grumbling to let us know how mad she is. But try to touch her without her being held and she does more than vocal complaints that’s for sure. The three of us honestly make a great team I just need to keep my quarterback on board so he can get her into the football position for me lol. Maybe after another 7 months of this she’ll let one of us do what needs to be done without being restrained! It took her 7 years just to let me scratch her chin occasional so hopefully things get better faster than that rate! I never in a million years think we’d be able to pull off what we have with her since her diagnosis
Thank you so much… we just got an AMPS of 454 and we decided to take her back to 2U… after looking at the data we had on her I honestly think we should have stayed at 2U because she was getting some low 100s. Her vet based the dosage adj on her fructosamine results but the whole first week it would cover was going towards building her Lantus depot. Her vet wanted us to withhold insulin last night which we did and also this morning and test her two hours before breakfast and then two hours after breakfast to determine what dose to go back to but that didn’t make sense to me. 2018 AAHA guidelines say to reduce by .5-1U or 10-50% after BG has resumed above 250 after going below 80 so I went with the 1U reduction and am just going to tell her vet we decided to continue the dosing AAHA guidelines that we’ve been following before she took over sushi’s care. I really hope this doesn’t upset her vet but I didn’t feel comfortable withholding insulin just to see how she reacts to food when she’s so high over the renal threshold. Yesterdays token dose and last nights skip have surely drained her depot at this point and I did not want to set her back even further. I do know that reducing by .25 is what the forum follows but as you can tell by our SS we suck at regular testing and I’d rather err on the side of caution. I’m almost convinced she’s been dipping close to or into hypo numbers for weeks with us having no idea! I think she probably was even getting lower numbers than we realized while on 2U and might have done better if we just held the course on it and continued to get data on her. I definitely don’t think we should have used her fructosamine results as a dosing guideline and we should have give up on .25 or .5 increments. All these things I know… I need to work on my confidence and figure out a way to do what I think is right for our baby without making her vet think we are non compliant. I value her intellect and we were on a waiting list for 2 years for this mobile vet so I’ve followed all her instructions… how do I tell her she’s not following proper dosing protocol without making it seem like I don’t appreciate her expertise and recommendations? Sushi’s been blacklisted by our local vets because she’s unmanageable and chooses violence lol. we were on a waiting list for this mobile vet for years and she was amazing with how well she handled Sushi without having to put her in a chamber tank and gas her, so we really like her and hope to not lose her for that reason. In all honesty she seems really nice and I’m probably thinking way too much into it lol
Ok disregard my entire last novel of a response… her vet just emailed me after taking the initiative on her own to check her SS first thing in the morning saying she saw that Sushi had a high reading this morning and we gave her 2U. She said let’s see how she does on this reduced dose over the next few days and run a 12hr curve in about 5days. That’s exactly what I had planned on doing and she doesn’t seem upset that we took the dosing into our own hands. I obviously have been worrying about nothing