Very Un-Goma Like

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G & I

G & I

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I have an amps of 139. Tested twice - Got a 132 and a 139. I know this is a no shoot situation but cannot believe this has happened today after all these high numbers. I had already placed a bowl of food in front of her which she devoured. Already shot time and I have syringe filled. Stall and wait now but the food is going to certainly have an effect. Did not expect this at all.

Any further advice/suggestions?

Edit - Just tested a third time = 131
 
Amazing! She's already eaten so the stall with no food won't work. What I did occasionally with Teasel when he was on ProZinc and he did something like this was feed, wait 30-45 minutes, retest and give a lower dose. How much lower is always hard to determine but you don't want her to lose momentum. Why not try this technique, post her BG after the retest and a dose decision can be made then. If she's well on her way to high numbers the dose can be higher than if she's gone up only a modest amount.
 
Kris & Teasel said:
Amazing! She's already eaten so the stall with no food won't work. What I did occasionally with Teasel when he was on ProZinc and he did something like this was feed, wait 30-45 minutes, retest and give a lower dose. How much lower is always hard to determine but you don't want her to lose momentum. Why not try this technique, post her BG after the retest and a dose decision can be made then. If she's well on her way to high numbers the dose can be higher than if she's gone up only a modest amount.
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Thanks for this quick assist. This came totally out of nowhere. Based on her history, my routine was to prepare the food, test and at the same time place the food in front of her. Had I known the result would come back as quick as it did, I most certainly would not have placed the food in front of her in the first place. Another lesson learned. Okay, for this go around - it will be approximately another 10 minutes for a retest. I will post again shortly thereafter - Have been up all night with Dude at the emergency vet that is about an hour away - Lots going on now....
Thank you again so much -
 
Greg and Goma & Friends said:
Thanks for this quick assist. This came totally out of nowhere. Based on her history, my routine was to prepare the food, test and at the same time place the food in front of her. Had I known the result would come back as quick as it did, I most certainly would not have placed the food in front of her in the first place. Another lesson learned. Okay, for this go around - it will be approximately another 10 minutes for a retest. I will post again shortly thereafter - Have been up all night with Dude at the emergency vet that is about an hour away - Lots going on now....
Thank you again so much -
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Okay - Moving upward - Now 197
 
So - Can I just push out excess insulin (not back in vial) to the dose we want to use? It has been sitting in the syringe for nearly an hour.
 
Kris & Teasel said:
Not a gigantic increase so I suggest a 50% dose - 2 u is close enough. Test at +2. Yes, you can let insulin out of the prepared syringe and use the 2 u remaining.
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Okay - 2u given at 12:17 pm JST will test at 1415 JST.
I will enter the 197 in the amps column.

Thank you for the much needed advice...
 
Greg and Goma & Friends said:
Okay - 2u given at 12:17 pm JST will test at 1415 JST.
I will enter the 197 in the amps column.

Thank you for the much needed advice...
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As I kind of expected she has bounced to 446 at amps +2.5.

Uncertain what the dosage parameters are now for the evening. Do I start increasing again by 0.25, 0.50 or remain at 2u? Realize this is very early on however with Dude still in ICU I really don’t know what is going to come up. Waiting for call from emergency Vet Clinic for results of all the tests I authorized.

Still climbing at am +6 to numbers we have not seen often recently.
 
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Greg and Goma & Friends said:
As I kind of expected she has bounced to 446 at amps +2.5.

Uncertain what the dosage parameters are now for the evening. Do I start increasing again by 0.25, 0.50 or remain at 2u? Realize this is very early on however with Dude still in ICU I really don’t know what is going to come up. Waiting for call from emergency Vet Clinic for results of all the tests I authorized.

Still climbing at am +6 to numbers we have not seen often recently.
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I’d go back to 3.75 u next dose. That reduction to 2 u was a one time thing because of the low pre shot BG. You’ll need to deal with situations like this as she bobbles up and down near a good dose range. Tricky and frustrating I know ...

If, however, the tests today show her starting to drop again that dose decision will be revised. I’ll check in and try to keep on top of the time difference between us. It’s just after 7 AM for me.
 
Kris & Teasel said:
I’d go back to 3.75 u next dose. That reduction to 2 u was a one time thing because of the low pre shot BG. You’ll need to deal with situations like this as she bobbles up and down near a good dose range. Tricky and frustrating I know ...

If, however, the tests today show her starting to drop again that dose decision will be revised. I’ll check in and try to keep on top of the time difference between us. It’s just after 7 AM for me.
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I was not sure I could increase that much in one dose. It is now 9:15pm my time and I am waiting until 11:45 pm for pm shot which is 11 1/2 hours after am as I am trying to get back part of the hour late shot this morning. So there are multiple factors going on that I am not familiar with.
 
Greg and Goma & Friends said:
I was not sure I could increase that much in one dose. It is now 9:15pm my time and I am waiting until 11:45 pm for pm shot which is 11 1/2 hours after am as I am trying to get back part of the hour late shot this morning.
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Yes, you can do that. It’s no different than accidentally giving a fur shot and then resuming the usual dose next cycle. So, if I understand you correctly, the next shot is 2.5 hours from now. I’ll be around the check then.
 
Kris & Teasel said:
I hope you get good news about Dude.
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Kris & Teasel said:
Yes, you can do that. It’s no different than accidentally giving a fur shot and then resuming the usual dose next cycle. So, if I understand you correctly, the next shot is 2.5 hours from now. I’ll be around the check then.
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See - I didn’t think about that since I’ve been lucky to have not given a fur shot yet as she had lost so much hair before that it is hard to miss. Thank you for bringing me back to reality. Been a looong day.
 
The dose reduction to 2 u was in the interest of safety because it was new territory for you. If you get a low PS again, especially if it's closer to 200 you can try a larger % of the usual dose. It's a lot of trial and error that teaches us what to do in a variety of situations.
 
Kris & Teasel said:
The dose reduction to 2 u was in the interest of safety because it was new territory for you. If you get a low PS again, especially if it's closer to 200 you can try a larger % of the usual dose. It's a lot of trial and error that teaches us what to do in a variety of situations.
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I completely understand that and greatly appreciate the help. I am still in worrier mode that I will do something to cause her more distress than she already has.

Is it safe to say that her dose range will probably lie between 2 and 3.75 u? Or am I misinterpreting the data.
 
Greg and Goma & Friends said:
I completely understand that and greatly appreciate the help. I am still in worrier mode that I will do something to cause her more distress than she already has.

Is it safe to say that her dose range will probably lie between 2 and 3.75 u? Or am I misinterpreting the data.
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You do enough testing that you'll catch a dive and you know what to do with food, etc. if it happens. You're well prepared, Greg, so that should alleviate some worry.

I think her good dose range at this point in time will be closer to 3.5 - 4 u based on the lows that have been popping up. The 2 u was a safety dose. There can be a lot of bobbing up and down at/near the good dose range. The more recent appearance of greens in the night cycles suggest that she's responding better to the insulin in that dose range. Sometimes they flatten out more when they get to a good dose but it's harder to figure out with bouncy cats. They don't have calm responses to insulin.

ProZinc is an in and out insulin (mostly) and that action will almost inevitably lead to more high/low on your SS when your cat is bouncy. The depot insulins like Lantus and Levemir can calm it down somewhat but maybe not 100%. My cat is very bouncy and unpredictable. He lived up on a trampoline while on ProZinc. He's been dancing back and forth between roughly 1.5 u and 2 u in the 4+ months he's been on Levemir. It wasn't much different when he was on Lantus for a longer time before that. I switched him because he didn't feel well on Lantus. I had to learn to accept his volatility and just do the best I can in controlling his BG numbers.
 
This recent excitement has shown you that 3.75 u keeps a better lid on her BG than 2 u does. Good info to have. Later on you might want to try what we'd call a "skinny" 4 u by measuring out your version of 4 u and then twisting out a drop more. It's a technique that's helpful when one of two close doses seems too low and the other too high.
 
Kris & Teasel said:
This recent excitement has shown you that 3.75 u keeps a better lid on her BG than 2 u does. Good info to have. Later on you might want to try what we'd call a "skinny" 4 u by measuring out your version of 4 u and then twisting out a drop more. It's a technique that's helpful when one of two close doses seems too low and the other too high.
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I'll give the s4u a try a bit later on as you suggest. She dropped back to blue this morning. However, she is having hairballs more frequently as she appears to be cleaning herself more often then in the past although I give her a good brushing several times a day. Her hair is also finally showing signs of some luster coming back. Diarrhea this morning for the first time. Also continue to note the majority of low figures are in the evening dose cycle carrying on to am. The "fasting" period when the food bowl is empty and I feed her is about 7 hours or so. Once I begin feeding her the numbers climb dramatically during the day. Will be trying various feeding schedules and amounts to see what real effect this is having on her. Perhaps the food is not what I thought it may be.

In addition - I will be going to pick up Dude this morning and bringing him home so this brings another monitoring factor into the equation. Xray, echo, extensive blood work reveal no other abnormalities in Dude and he did not seize while in their care since 1:30 a.m. Monday morning past. Vet says I will need to be monitoring him closely for awhile. Will get more info hopefully when I get there.

Thanks for keeping me in mind and providing me great advice and information - I will always be grateful to you for this.
 
Another dosing technique: once you have ample evidence that her BGs are generally lower at night - and you do - you can try giving a higher dose in the day and a lower dose at night. For example, you could give 4 u in the AM and 3.5 u in the evening.
 
Kris & Teasel said:
Another dosing technique: once you have ample evidence that her BGs are generally lower at night - and you do - you can try giving a higher dose in the day and a lower dose at night. For example, you could give 4 u in the AM and 3.5 u in the evening.
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I may try that in the near future should her numbers hold but Goma will do what Goma wants to right?

Once again you have given me great advice and options. Thank you.
 
Greg- I love your notes in your spreadsheet! It looks like Goma is having hairballs, diarrhea, and constipation? I wonder if you can get Slippery Elm Bark there? It's an herbal supplement that is sold on Amazon or at health food stores here in the states. It can help with all three of those. I give Atticus a half of a capsule daily to help with his similar digestive issues and it works well. I open the capsule, pour out about 1/2 on a little plate and mix it in with a little food for him. Sam will eat it only if he's very sick, but Atticus doesn't mind the taste at all.
 
Djamila said:
Greg- I love your notes in your spreadsheet! It looks like Goma is having hairballs, diarrhea, and constipation? I wonder if you can get Slippery Elm Bark there? It's an herbal supplement that is sold on Amazon or at health food stores here in the states. It can help with all three of those. I give Atticus a half of a capsule daily to help with his similar digestive issues and it works well. I open the capsule, pour out about 1/2 on a little plate and mix it in with a little food for him. Sam will eat it only if he's very sick, but Atticus doesn't mind the taste at all.
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Hey - I really appreciate you taking the time to read the notes. I'll check around for the Slippery Elm Bark. I'm wondering if this is another of her body adjustments to probiotics (MitoMaxSuper) which I recently started. Had been purchasing from the Vet locally, but now ordering through Amazon at a $20.00 savings plus 30 additional capsules. While it should be the same thing - we just never know for sure. If other signs appear, I may be taking her in for bloodwork to ensure nothing else is going on. Conversely if she is improving perhaps she can be taken off some of the medications she has been taking for so long which would be a real plus.
 
ah-ha! Actually, starting on a probiotic can sometimes mess them up for a little while as their insides adjust to the new flora (fauna?). They can end up with either diarrhea, constipation, or both for a few weeks. Although you said she was taking this one for awhile through the vet? Was it the same brand and CFU amount?
 
Djamila said:
ah-ha! Actually, starting on a probiotic can sometimes mess them up for a little while as their insides adjust to the new flora (fauna?). They can end up with either diarrhea, constipation, or both for a few weeks. Although you said she was taking this one for awhile through the vet? Was it the same brand and CFU amount?
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Vet gave to me for another cat. I actually wanted to try it on her because of all the antibiotics she has been on. And it supposedly does the same thing as the slippery elm. What I bought is the same product just came from USA and not the import package. Do you think I should cease?
 
If she hasn't been on it very long, I'd say give her some time to adjust to it. S. boulardii can give some cats the runs when they are starting it. If you're concerned or she seems uncomfortable (or it keeps happening), lower the dose until it stops, then once she's stabilized on a lower dose, you can start to slowly increase again. It looks from your note like things might be...umm...solidifying? o_O...on their own now anyway. :smuggrin:
 
Djamila said:
If she hasn't been on it very long, I'd say give her some time to adjust to it. S. boulardii can give some cats the runs when they are starting it. If you're concerned or she seems uncomfortable (or it keeps happening), lower the dose until it stops, then once she's stabilized on a lower dose, you can start to slowly increase again. It looks from your note like things might be...umm...solidifying? o_O...on their own now anyway. :smuggrin:
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Yes - it has become an on again off again type thing. She has only been taking it since 2/6.

Thank you for the info - I truly appreciate it..
 
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