Wider swings with insulin than not

Discussion in 'Feline Health - (Welcome & Main Forum)' started by KKL, Jun 29, 2013.

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  1. Deb & Wink

    Deb & Wink Well-Known Member

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    Kris, Would you be so kind as to add your name to your signature? Just before Harley's would be great.
     
  2. KKL

    KKL Member

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    Nope, home for morning shot, might be late for evening shot :)

    This AMPS he was 220
     
  3. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    That's fine. If you are late tonite then tomorrow morning it will need to be 12 hours from tonite.. Or 11.5 and move him back gradually 15 mins each time or 30 a day.
     
  4. KKL

    KKL Member

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    Perfect, that is good to know! :)
     
  5. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    any chance of a +4 before you head out for your bbq?
     
  6. KKL

    KKL Member

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    Yep, got a +4 of 282 :(
    Could it still be a bounce? I'll test as soon as I get home...
     
  7. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    I doubt it. The one drop probably isnt enough. But lets give it the 10 cycles and raise it then if we dont see more blues or greens.
     
  8. KKL

    KKL Member

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    Sounds good, 10 cycles is 5 days?
     
  9. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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  10. KKL

    KKL Member

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    His numbers haven't been great, they've been inching upwards. Is it more than a coincidence it started the day I gave him all that dry food?

    I also ran into another batch of syringes that aren't yielding the same amount. Starting last night I gave him a little bigger of a drop, not sure using the push the plunger method to draw was getting or delivering a consistent amount--if any once in the skin. Not even sure that the one small drop was 0.10 unit...so I am drawing a thin line of visible fluid now (regardless of where the line on the barrel is, it's the same amount next to a syringe I have "preset" with colored fluid), I played with it and it gives me maybe 2x the very small drop I was getting before. Still not sure how much it is in regards to a unit.
     
  11. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    ok but we were going to wait 10 cycles werent we? Anyway its only been 2 cycles since this new dose. We need to give it a minimum of 6 cycles before even thinking about an increase. (unless he drops under 50). Reason is that Lantus is a depot insulin which takes a few days to build in the cats system and you see the true impact of the dose. I think the depot was very full from the 0.2 before which is why you got blues and greens for a while even after the dose was decreased to 0.1. We just need to find the right dose.

    thats the problem with microdoses, it can be hard to judge the amount. Still not sure exactly what the 0.2 dose was. We may well end back up there.

    Anyway lets wait the 6 cycles and see. If you start to see blues or greens we will wait 10 cycles.

    Wendy
     
  12. KKL

    KKL Member

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    I panicked :(
    Do you want me to scale it back to the "1 drop"? I only added a little more because sometimes when I do the push the plunger trick to get 1 small drop it doesn't deposit it well when I do the injection so I fear he gets 1/2 drop.

    I have no clue if I was really giving him 0.1 0.2 or 0.25...I thought I was, but all the syringes are horribly misprinted...they are at least 1/4 unit apart from each other...with his dosing that is a lot.

    I will try to post a photo of what I was giving him.
     
  13. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    Why did you panic? He is doing fine. he could be a lot worse I tell you. There is one cat right now that wont seem to come out of reds and blacks.
    Since we are at this higher dose lets give it a try and see how it goes. I think the 1 drop probably wasnt enough anyway.

    you might want to see if you can get some calipers.
     
  14. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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  15. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    Also can you get a ketone test today?
     
  16. KKL

    KKL Member

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    I panicked because he started peeing a lot again, which makes him very upset because he gets dirty feet and he hates being unclean. He had a ketone test at the vet and it was negative, but I am not sure how to do this here. He is a shy potty and with 3 cats I do not know which pee belongs to who :(

    We had an incident today that we missed his scheduled PMPS reading and shot, but I took his BG as soon as I walked in the door (2 hours past his PMPS) and it's at 71....go figure. No shoot anyway.

    I did mess around with some colored water to give you an idea of the difference in what I had been giving him and what I gave him this morning and yesterday evening. If you PM me your email address I can get that to you.
     
  17. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    Hmm. That new dose is just settling in. Going to be interesting to see how it does. I sent you my email address cos I would like to see the difference in dose.. Can you also send what you think the 0.2 was?

    I am also thinking I would like more eyes and advice on Harley since he is a micro dose cat. Asides from calipers some of the others might have suggestions so I am thinking you might want to start posting on the tight regulation board. I post there myself every other day to keep their eyes on my boys. You are welcome to continue to post here, I just think that we might be able to help you more over there. Also it's a great sense of community, we celebrate together when a cat goes OTJ by having a party and offer sympathy too. They have experience in all sorts of cat issues, not just diabetes. http://www.felinediabetes.com/FDMB/viewforum.php?f=9

    Heres how to post
    Every day ( or as often as you want/need/are able) you open a new thread/post. We call them "condos"
    - The subject has the date/cats name and BG readings ie 07/05 Harley AMPS 476 +2 410 + 4 339. Add a ? icon if you have a question. You can update your subject as you get a reading, or whenever is convenient

    - The contents of your post have a quick update on how Harley is feeling as regards the 5Ps ( peeing. pooing, preening, playing and purring) and any questions and a link to your previous post ie : Today Harley was in a good mood, playing and eating well. But he is peeing a lot. I am having issues with micro doses, how do I use calipers?

    For your first post include "newbie" also in your subject so everyone can welcome you!

    Wendy
     
  18. KKL

    KKL Member

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    THANK YOU!!
    I will do so tomorrow and get the photos to you in the morning...under the weather myself today, hoping it's not something I ate LOL :mrgreen:
     
  19. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    Lol!

    No worries, go have a good night sleep. U didnt shoot so you don't need to stay up testing, maybe just one to see that he is on his way up and off to bed!


    Oh and urine testing tips.. https://docs.google.com/document/d/1quta5WLEjdO0Y_t2dAYSwN84h-LNZWxOdtVsJDKZ16A/pub. As long as you test a few pee samples and see no ketones you should be fine. I have three cats and after stalking them for a while I know they all have favourite areas in the LB to pee... But even if you measure the pee and don't know which cat it was, it doesn't matter, you don't want ketones in any!
     
  20. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    He is probably the biggest pee patch.
     
  21. KKL

    KKL Member

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    thank you again for all your help and advice...it's been a very welcome sounding board as we go through our growing pains :)

    Yes, I'll have to get some strips and try testing the patches...our Hyperthyroid kitty does tend to pee a lot also...but it'll rule it out one way or another :)
     
  22. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    Its a good idea to test twice a week or when he is over 360.

    Ketones are an indicator of DKA which is very very serious, involves a long stay at the vet, expensive to treat and not a guarantee the cat will even survive. Always be on lookout for a smell of nail polish remover. The strips are like $7 from walmart but you might need to ask behind the counter. Urine ketone test strips - Relion make them too but there are other brands.

    Wendy
     
  23. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    No problem - I just want your kitty better. 84% of cats go into remission within 6 months with a good low carb diet, and a good insulin like lantus, and home testing to keep them safe. I am hoping Harley will be one of them.. especially as he is practically just sniffing the lantus bottle right now ;)
     
  24. KKL

    KKL Member

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    You and me too! :)

    Here is "one drop" and "two drop" photos. Where the plunger is in the barrel is where I put it to draw up the amount you see on the needle tip....
     

    Attached Files:

  25. KKL

    KKL Member

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    Well, he's still dropping, he's now at 51. I gave him a wet food snack with some of it's gravy on it (usually I let the other cats have the gel gravy residue part). Gonna keep a closer eye on him since he's coming down still...
     
  26. BJM

    BJM Well-Known Member

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    Since its less than 7 hours since any insulin, you need to monitor carefully every 20-30 minutes or so. If he continues to drop, feed 1-2 teaspoons of medium to high carb food every 20-30 minutes, retest, wait, and repeat until he has 2 or more numbers rising. A sprinkle of flour (ex rice, wheat, corn) stirred in would add carbs.


    Misread spreadsheet, never mind.
     
  27. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    Its been over 12 hours since insulin hasnt it? no high carb is needed.. he is looking great!

    How is he this morning...?
     
  28. KKL

    KKL Member

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    Yep, we did skip PM shot, so he was in the greens right up to his AMPS reading, when he went up to 367. I did give him one temptation at 51 and at 65 since It was the wee hours of the morning and I was a zombie trying to get his readings. Now that he is above 300, I am guessing go back to the 1 drop??
     
  29. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    He didn't need high carb because the insulin should have worn off by then plus he wasn't really that low (remember normal cats are 40-130). The only time we worry is when he has insulin in his system and is dropping.

    Any chance of a dose between 1 and 2 drops? I see a little space on the syringe. If not let's try 1 drop but with a firm press and hold on the plunger to see if that works.
     
  30. KKL

    KKL Member

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    ok will try a plus sized one drop.

    for future reference, i had heard between 30-70 is low and need to monitor closely....is this only within a specific + range?
     
  31. BJM

    BJM Well-Known Member

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    When on insulin, we want them above 50 mg/dL at tye lowest.

    When NOT on insulin, 30s may be OK, so long as no other health problem is happening.
     
  32. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    It also depends where he is in the cycle. If you have a preshot of 200, and a +2 of 50, then you have to watch since you have hours to go before lantus hits its peak. If the 50 is at +10 then it's not so much of a big deal as the lantus has passed its peak.. Normally. Although if the cat is clearing a bounce and coming down progressively at +10 you will still want to watch... Confused yet? Lol

    Anyway looks like he is clearing his bounce. Wonder how his PMPS will be. Might be a busy night again.

    Have you startd posting on the other board yet? I have had family all day and not been on much.
     
  33. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    I just realized .. Your syringes don't have half unit markings! You really need them.. Your two drops could easily be anywhere from 0.1iu to 0.75. Can you get syringes with half unit markings ie Relion 3/10cc 30 & 31 gauge short, or BD Ultra fine 3/10cc short, or Terumo Thinpro Insulin Syringe 31G 3/10cc.
     
  34. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    Check out these picture of doses with the half unit marked t syringes.. You can see the half unit markings and the various doses...

    [​IMG]

    [​IMG]

    [​IMG]

    [​IMG]
     
  35. KKL

    KKL Member

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    OK so based on these photos I have been doing "less than some insulin" and now I have started doing "some insulin" :)
    I have updated his SS and the house is in dire need of my attention, once that is addressed I will attempt to learn how to post in the lantus forum...wow does that sound intimidating :)
     
  36. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    You should be able to get the half unit syringes in Walmart...
     
  37. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    Or use links above to American diabetes wholesale.
     
  38. KKL

    KKL Member

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    Do I need a prescription to buy the needles from Walmart? I didn't see them on the shelves...this may sound like a dumb question, but I have never had to buy needles before lol
     
  39. BJM

    BJM Well-Known Member

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    If your state doesn't require a prescription, just ask at the pharmacy counter for them - 3/10 mL 30 gauge, U-100 syringes with half unit markings.
     
  40. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    Hes coming down - did you get a +9?
     
  41. KKL

    KKL Member

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    I am 45 minutes away from my +9
     
  42. KKL

    KKL Member

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    So his +9 he went up a little, but his PMPS he was down again to 87. Too low to shoot I am guessing
     
  43. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    Yep. You really ned those 1/2 unit marking syringes. Also time to start posting on the lantus board.. Don't worry they are all really nice..
     
  44. BJM

    BJM Well-Known Member

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    Without a lot of data, yes, too low to shoot.

    Once you feel comfortable testing, shooting, recording data, and have your spreadsheet up and the diet switched to low carb foods, you are ready, if you wish, to move into one of the Lantus forums.
     
  45. KKL

    KKL Member

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    I'll have to start that tomorrow.

    He's at 76 +14...if he does go above 150 tomorrow morning (which I think he will) should I go back to the 1 drop vs the 1.5-2 drop?

    I'll try to get the 1/2 marked syringes ASAP.

    He is off dry food and high carb food, he eats solely his wellness turkey but if I have to leave the house and he is real low I have given him a couple dry treats or dry food to bring him up in hopes he doesn't crash while I was gone to work.
     
  46. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    lets try the 1 drop again and give it a few days this time. And get those syringes.. they should help a lot of this craziness.

    Wendy
     
  47. KKL

    KKL Member

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    Alright, he was 407 this AMPS and I gave him a good one drop. I will try to get to Walmart today....
     
  48. KKL

    KKL Member

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    Well, this was the first morning in a long time that he wasn't super high. I have been doing a bigger drop than I initially was, but yet not as much as I tried either...somewhere inbetween...I push the plunger hard down then do a slight twist. We shall see where it puts us. I worked a 12hr day yesterday, wasn't able to get to Walmart or post on lantus just yet...
     
  49. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    ok cool and he might even be coming down now too from his bounce.
     
  50. Deb & Wink

    Deb & Wink Well-Known Member

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    Those long 12 + hour days are rough. Take good care of yourself too please.
     
  51. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    Looking good so far today. U think you can give this dose consistently?
     
  52. KKL

    KKL Member

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    Ah another 12+ hour day...and fun with numbers :) He looked great until PMPS he shot up...oye
     
  53. KKL

    KKL Member

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    I think I can consistently give him that dose :) Work has been CRAZY (feast or famine) so I wasn't able to post numbers yet from yesterday. Had higher numbers, BUT twice now I flicked the needle when pulling off the cap and got some insulin on my nose...I think it might have been some or all of the does and thus responsible for the higher numbers. I won't be home for 10 hours today and since he's already at 200 I decided to skip it since I can't monitor and usually when he is that low in the am we go well into the greens...can't be that far from home and worry about him :(
     
  54. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    Hope you are testing for ketones.

    Really gotta get those syringes....
     
  55. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    Don't put the cap back on?
     
  56. KKL

    KKL Member

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    Funds are very very low, which is why I am working my tail off since work picked up at the moment. Since my measurements are under the "0" line, would it still make a difference?. Just got some ketone testing strips...do I just stick them in random clumps of urine? He's had some weird numbers again.

    We did find to our horror a partially devoured mouse tonight "delivered" right in front of the treadmill as a loving gift, I know it was Harley. He must have found it in the basement...thankfully we don't use any poisons or bait.
     
  57. Deb & Wink

    Deb & Wink Well-Known Member

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    The ketone tests need to be from fresh urine, either caught directly while he is going if you can get the strip in the stream. Or else a method to catch some urine. Like these.urine testing tips
     
  58. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    Sorry I haven't been around much, my works been nuts, and home too with 4/5 pets sick.

    Remind me how you are getting the one drop? And what you are feeding in wet? I don't think we are seeing enough greens.

    Also I would like to see you over on the tight regulation board.
     
  59. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    You can use the litter if its not clumping - Debs tips tell you how.

    Hows he doing?

    Wendy
     
  60. KKL

    KKL Member

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    I am here!! Just working around the clock. Just updated his chart. Got the test strips, found a few large fresher wet patches and was able to test (I think) stips showed normal.

    I will try posting to the TR...
     
  61. KKL

    KKL Member

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    I did post some questions to the TR forum...haven't heard back yet....
     
  62. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    Grreat minds! I just posted on there for you...
     
  63. KKL

    KKL Member

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    Agreed!! Thank you so much for encouraging the jump...took long enough for me LOL
     
  64. KKL

    KKL Member

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    He's at 160 AMPS....do I shoot full dose, half dose, wait, skip???
     
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