Wynk- returned to a 171!

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Cara and Wynken (GA)

Cara and Wynken (GA)

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Oh... that cat, that cat!! When I got to the house just now after being gone since Tuesday at noon, one of the very first things I did was check his blood sugar, of course. He was sleeping, which he does a lot of, when he is high... I had been thinking that part of the reason he sleeping is because his blood sugar has been so high and when that happens I think they don't get as much energy in their cells, and so they feel tired. At least that's the way one of my human diabetic friends explained it to me.

I had left instructions with the sitter to give 2.2 units, for a couple of reasons. One was because he had been so consistently high for so many weeks, at increasing doses. But the second reason was that I had run out of one of the low-carb components of his meals on Monday (Weruva chicken fricazee) and the only thing I had to substitute was wellness at 4% carbs.... So my thinking was that since he was going to be eating a higher carb load for the next three days I would just leave him at the slightly higher dose. Looking back, I'm not sure I was thinking correctly… But that's because I just measured him at 171. He hasn't been that low in forever!

Jeez:nailbiting:
 
Is there any chance he has not been eating as much as usual while you were gone? That can really lower levels. Maybe check with sitter re schedule and food etc to see what if and differences from regular routine?
 
Sue and Oliver (GA) said:
Is there any chance he has not been eating as much as usual while you were gone? That can really lower levels. Maybe check with sitter re schedule and food etc to see what if and differences from regular routine?
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. Sue- thanks for the very quick response! I'm not exactly freaking out… Because I kind of know what to do. It's just that I'm mystified.
You're asking a great question… But, He ate all of his meal, each time (so thankful now for Robin's suggestion about feeding him separately from his sister… Which we do 100% of the time now ). He didn't have that great of an appetite when we got back from Ohio state last Monday Nite. But he was a totally hungry boy on Tuesday morning and the cat sitter texts me at least once a day to let me know about him as well as my other kitties that have serious issues. She said he ate everything, each meal. She goes back in and takes up the empty plates when she lets his sister out of the enclosure that she eats in, after each meal. So I know his appetite has been normal.
I'm going to back his dose down just a little tonight but not by much. I will easily be able to check him this evening and even in the middle of the night if I have to... but he's never gone low when I shoot normal with a slightly low pre-shot. I do wonder what his blood sugar has been patterning like over the last three days! It will just be interesting to see what he does tonight.
 
Hmmm...that is interesting! Yeah, I think the best thing is to just keep an eye on things for the next few days. Let's see if this was a one time thing or if this is the start of something good!
 
Well, my iPad was completely without electrons last night and so I wasn't able to record anything until this morning, but basically he was still dropping right before the shot so I went a little bit on the conservative side and gave only 1.6 units. He was almost 500 in the middle of the night!:blackeye: That's my boy!
 
There it is, that late nadir. Check with @Bobbie And Bubba My understanding is that was what Lantus helped her with (Levemir should act the same way). With the depot insulins, because they are flatter and take longer to act, it is safer to give insulin into a low number coming late in the cycle. With ProZinc, it is safer to reduce the dose rather than shoot the usual dose into a low number @+12
 
Bobbie And Bubba said:
Yeah, I am still thinking he is a late nadir cat like Bubba and like Sue said, you will be able to shoot more consistently at those lower number. Are you going to make the switch?
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. Yes, I intend to switch soon. Dr. Gilor is supposed to call with the acro results early this week. We had decided to hold off on switching until after we got the results. So at that point I will ask for a prescription for Levemir. Need to think about where to get it. Will spend time in that forum today...
He's high again today....

I am thinking about leaving his diet a little bit higher in carbs (keeping wellness grain free in each meal...) in case that contributed to the insulin actually working better yesterday... Which is sort of counterintuitive... but I don't know what else to think. Maybe I have tried to force him too close to zero carb? and that is actually been part of the problem?
 
Cara and Wynken said:
. Yes, I intend to switch soon. Dr. Gilor is supposed to call with the acro results early this week. We had decided to hold off on switching until after we got the results. So at that point I will ask for a prescription for Levemir. Need to think about where to get it. Will spend time in that forum today...
He's high again today....

I am thinking about leaving his diet a little bit higher in carbs (keeping wellness grain free in each meal...) in case that contributed to the insulin actually working better yesterday... Which is sort of counterintuitive... but I don't know what else to think. Maybe I have tried to force him too close to zero carb? and that is actually been part of the problem?
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Sounds like you are like me, trying to figure it all out, and sometimes it is just "because" LOL. Good luck with the results. Check out Mark's Marine Pharmacy in Canada, their Lantus prices are really low compared to the US.
Marks Marine Pharmacy
 
Cara - I think I will switch to Levemir as well in a few weeks - I just checked with that link Bobbie left at Mark's Marine here are their prices:
Levemir flextouch $169.99 Levemir Penfill $164.99 So does anyone know what a flex touch and penfill is? Also, maybe I am reading Wynk's SS wrong, but I don't see that late nadir all the time many times amps and pmps are pink and red and more or less equal -
 
Carol & Murphy said:
Cara - I think I will switch to Levemir as well in a few weeks - I just checked with that link Bobbie left at Mark's Marine here are their prices:
Levemir flextouch $169.99 Levemir Penfill $164.99 So does anyone know what a flex touch and penfill is? Also, maybe I am reading Wynk's SS wrong, but I don't see that late nadir all the time many times amps and pmps are pink and red and more or less equal -
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I don't know the difference in the pens, but there is tons of info over on L&L that I am still ploughing through... I think it's hard to see what's going on with Wynken... In my mind, basically one of two things happens with him. He is usually high on amps and pmps and he OFTEN either GOES UP for awhile after the shot, or stays flat with no discernible nadir. LESS often (unfortunately) the insulin actually seems to DO something, and he has a nadir... But when he does, it is usually happening right before the PM shot. I think that's what @Sue and Oliver (GA) meant. This morning he was low (yellow!!) and that hasn't happened for a month. I did give his shot almost an hour and a half (!) early yesterday eve because I had a concert to go to.... Hmm.
 
My concern with Wynken is that he is so unpredictable. He doesn't seem to have any patterns, cycle to cycle. The advantage of the depot insulin in a cat like him is that you can continue to give insulin - even with low preshots and late nadirs - because it has a longer, flatter cycle. Levemir seems a good choice because it can last even longer than Lantus.
 
Sue and Oliver (GA) said:
My concern with Wynken is that he is so unpredictable. He doesn't seem to have any patterns, cycle to cycle. The advantage of the depot insulin in a cat like him is that you can continue to give insulin - even with low preshots and late nadirs - because it has a longer, flatter cycle. Levemir seems a good choice because it can last even longer than Lantus.
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You are so right, Sue... He is unpredictable. Even when left on a dose pretty steadily for a week or even two at a time he has markedly different results at a given dose. And that was removing a lot of variables including feeding him the exact same (weighed!) meal for weeks and weeks.

Having read about the insulin depot I think it will really help. And Dr. Gilor seemed to think that Levemir would produce a more predictable response but only after several weeks of shooting the same dose. I don't think I mentioned this in my other OSU post, but he's certainly advocating for "start low go slow". He even warned me that Wynken could be running in the 400-500 for the first couple weeks (yike). I would prefer that we move immediately toward some sort of tight regulation, but I have decided that with his level of expertise and his individual attention on Wynken, I will follow his instructions, at least to start. Since coming back from that appointment and educating myself I am also equally convinced that when it comes time to measure doses in between one unit, I will figure out how to do that !;)
 
Cara and Wynken said:
You are so right, Sue... He is unpredictable. Even when left on a dose pretty steadily for a week or even two at a time he has markedly different results at a given dose. And that was removing a lot of variables including feeding him the exact same (weighed!) meal for weeks and weeks.

Having read about the insulin depot I think it will really help. And Dr. Gilor seemed to think that Levemir would produce a more predictable response but only after several weeks of shooting the same dose. I don't think I mentioned this in my other OSU post, but he's certainly advocating for "start low go slow". He even warned me that Wynken could be running in the 400-500 for the first couple weeks (yike). I would prefer that we move immediately toward some sort of tight regulation, but I have decided that with his level of expertise and his individual attention on Wynken, I will follow his instructions, at least to start. Since coming back from that appointment and educating myself I am also equally convinced that when it comes time to measure doses in between one unit, I will figure out how to do that !;)
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well, we can go through it together, Cara. But the 400-500 sugars in the first weeks is a little concerning - it that because 1) it takes a while to build up the depot and 2) the starting dose will be, almost by definition, too low? I do know what you mean about unpredictable response - take a look at Murphy's SS lately and it's sort of the same thing
 
Yep, check out @Bobbie And Bubba spreadsheet. Bubba is a late nadir cat, so he has those super lower preshots...and she shoots them! I'm not saying that is the deal with Wynk, but if you check out the last few months, you'll see how over time, this has helped and Bubba is finally headed into good numbers!
 
Cara and Wynken said:
Thanks for looking out for that! I see they have been posted for awhile, and Sharon may have laid claim to them...
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Yes I've already spoken with Miriam about the Lev. I started Lev by finding a pharmacy that would sell a single pen (not all will, so call around) I bought it that way for a bit, to see if Colin and I liked it, now I will start ordering from Canada. Cara and Carol, I hope you both have good luck with the Levemir. Love the new avatar, Cara!
 
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