Newbie - 3 weeks in - advice?

Discussion in 'Caninsulin / Vetsulin and N / NPH' started by Jena4277, Aug 8, 2017.

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  1. Yong & Maury GA

    Yong & Maury GA Well-Known Member

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    Well done, Jena! Glad I got to check in once more. I agree with Mary Ann, to try and get another test in an hour. *paws crossed* just wet food will make her diet controlled :)
     
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  2. Jena4277

    Jena4277 Member

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    Ohhh neat forum lingo :D
     
  3. Tuxedo Mom

    Tuxedo Mom Well-Known Member

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    Not only is it a whole new world here there is a whole new language to go with it. LOL I sometimes have to catch myself when I talk to my vet since she doesn't know all the FDMB lingo. ;)
     
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  4. Jena4277

    Jena4277 Member

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    I see that! Learning fast!
    Will retest around 2pm. She is resting now.
     
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  5. Jena4277

    Jena4277 Member

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    She tested 336 as expected (due to syrup and dry) She is still licking syrup off her face :oops:
    Thank you for all your help again.
     
  6. Tuxedo Mom

    Tuxedo Mom Well-Known Member

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    Not really a surprise, Between the syrup and dry food combined with the expected bounce after that low number this all looks perfectly normal. With having gone so low earlier this causes a "bounce" which means stored glucogen (glucose) in the body is released as the body tries to deal with the low glucose levels. This can cause higher numbers for a few days, so don't be concerned about high numbers at this point. You can keep doing some testing and see how Abby is doing without any insulin
     
  7. Jena4277

    Jena4277 Member

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    Thanks. Not to open up a different can of worms, but she isn't pooping regularly. On the dry, her poops were firm at least 1-2 times a day (yikes). I always put mineral oil in her food twice a day bc of her arthritis pain She hasn't pooped since the night before last. I have seen her go in litter and not produce anything and then come out. I also read freeze dried treats absorb water from the system which can cause constipation. I have been giving her a lot of those...I will decrease that. She pees normally. No signs of distress there. I will keep an eye out. I read pumpkin is good. Will look into that too. I doubt she will eat it! Lol
     
  8. Tuxedo Mom

    Tuxedo Mom Well-Known Member

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    I used pure pumpkin...not the pie pumpkin. My one kitty would eat it just as it was...he thought it was a treat. The other kitty was not too keen but if I put a bit of tuna juice on it she would eat it.
     
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  9. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Try adding extra water to all her wet food meals. Hydration can help constipation and many cats don''t drink much out of a water bowl. Plain canned pumpkin works for some, as does Miralax for others. There's a product called Natural Moves people buy online that has helped many kitties too.
     
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  10. Jena4277

    Jena4277 Member

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    She went #2 but it was very soft, not quite liquid, but runny. I'm going to hold off on any measures and see if her body regulates.

    I just tested 533- you told me not to worry about high numbers right :(

    ETA hoping its from the dry she ate before...god I'm so worried every minute.
     
  11. Tuxedo Mom

    Tuxedo Mom Well-Known Member

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    After the low and all the syrup/HC she had it may take a day or so for the glucose readings to level out. I remember one time I slurged on licorice...major sugar content...my sugar levels were through the roof for about 12 hours...and I am NOT diabetic...let's see how she is in the morning.
     
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  12. Yong & Maury GA

    Yong & Maury GA Well-Known Member

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    Could also be the lack of pooping influencing that test too. Try not to get too upset about a couple high numbers :bighug:. You did very well today, Jena!
     
  13. Jena4277

    Jena4277 Member

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    I tested for the first time today a little late to give her body time to process things. It's 354. Hopefully tomorrow or day after tomorrow will be lower number...trying to give her time...
     
  14. Tuxedo Mom

    Tuxedo Mom Well-Known Member

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    I would do another test today tonight and see how the numbers are. She has come down from the 553 to 354 with no insulin so that is positive. In order to know whether stopping insulin is the correct approach let's see how Abby does through the day. If her system is working on its own she should be able to regulate back to normal numbers within a short period of time.

    Fingers crossed that she can regulate her numbers on her own.
     
  15. Jena4277

    Jena4277 Member

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    Yes I will. What times do you suggest?
     
  16. Tuxedo Mom

    Tuxedo Mom Well-Known Member

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    I would do one around the time that the usual PM test was done. You can leave about 2 hours without food before you do it so that the number is not too food influenced. Then another test about 3 hours after that test and feeding (of course no dry or HC food). If her body is functioning correctly the numbers should be continuing to come down.

    There is always a possibility that she may need a very small bit of insulin for a short period of time, but let's see how the numbers today work out.

    [​IMG]
     
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  17. Jena4277

    Jena4277 Member

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    It went up to 402. I'm going to see what tomorrow is like too before I jump to conclusions. I want to keep testing her in the morning to see what her numbers are off insulin. That will maybe give me a better idea of how much she can handle.
     
    Last edited: Aug 17, 2017
  18. Jena4277

    Jena4277 Member

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    Just tested 3 hours after her PM test. It is 320.
     
  19. Jena4277

    Jena4277 Member

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    @Tuxedo Mom @Yong
    Hello! So off insulin she is holding steady in the 300s, hitting 4 at some points. This is what I'm thinking: I don't want to have her be this way for a prolonged period of time, so what if I start to admin a micro dose of .25 2x a day doing what I can with the syringe and colored water to make dosing consistent and see how she responds?
     
  20. Yong & Maury GA

    Yong & Maury GA Well-Known Member

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    I think that sounds good :), I think I suggested before you may need to try that 0.25U dose since 0.5 pushed her too low. Definitely don't want her staying in those 300's for much longer. If the 0.25U still puts her lower, she may do better on a longer, gentler insulin. Let's see how this works though :cat:.
     
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  21. Jena4277

    Jena4277 Member

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    @Yong @Kris & Teasel
    Can you look at my spreadsheet? Ive been shooting her .25 since Saturday. She is holding steady testing AM and PM in the 300s. Today I couldn't test throughout the day bc I was at work. I'm thinking to increase to .5 tomorrow. Ideally I would like her in the 100s, nothing lower at her nadir. It gives me peace of mind. OR should I wait until Friday to decide to get better numbers? I will be home tomorrow to get some numbers throughout the morning for whichever dose I give. I'm really nervous about the increase but I think it's the right call. Can I have your opinions? I ordered 1/2 mark syringes to make dosing easier.
     
  22. Kris & Teasel

    Kris & Teasel Well-Known Member

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    You could try the 0.5 u experiment because you'll be home to monitor. Make sure you have high carb food on hand or else honey or karo syrup in case you need to boost her BG. You should also have a good supply of test strips. These experiments are the way we pin down the good dose range - stressful but necessary.
     
  23. Jena4277

    Jena4277 Member

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    Fully stocked.
    Do you really think she will plummet that much based on her nadir in the 200s the past two days? Will one day be enough for an "experiment?" Just asking advice/thoughts from experience. Thanks!
     
  24. Jena4277

    Jena4277 Member

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    Also - some diabetic kitties will never be in that perfect 60-120 range. What is a good range to reach for? Less than 200? Less than 300? What is a "decent" range for diabetic kitties who are touchy responding to insulin?
     
  25. Kris & Teasel

    Kris & Teasel Well-Known Member

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    It's really hard to say. The 0.5 u gave you a lime green a week ago but it might not do that now. I use the word experiment to mean a dose decision for which you have limited data on response. When you're in the early days of building up your SS reference data base every dose change is an experiment. Once you have a ton of data and have learned your kitty's patterns from it you can be a little more confident in your ability to predict the most likely response. However, cats make it their mission to surprise us. Some kitties are easier to predict than others.

    The decent numbers range you're aiming for is PSs in the low 200s and nadirs in the low 100s or high double digits. Vetsulin is known to cause steeper dives so we recommend dosing that leaves a bit of a cushion at nadir, so maybe low 100s is a better goal.
     
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  26. Yong & Maury GA

    Yong & Maury GA Well-Known Member

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    I agree with what Kris has said, including the nadir not go much lower than 90 with Vetsulin, so low 100's does sound better for peace of mind and she'll still be in a healing number :). How long after her PM shot do you go to bed? Most members it's between +2 and +4, so sneaking a before bed test can let you know where she's headed overnight too. I can't go to bed without testing my boy. Although I have passed out a couple times on the couch trying to stay awake for his before bed test lol. He is usually right near me and if he needs me, he will paw at me to wake up ;).

    Big reason for the before bed test is that most kitties run lower over night for an idiopathic reason :cat:.

    Here's an excerpt from a document on the forum for what numbers you're looking for, in general terms:
    Q6.1. What is regulation?

    A6.1. There are different definitions of regulation. As hometesting becomes more common, we've been getting a better understanding of what cats and their humans might be capable of. Janet & Fitzgerald propose the following "regulation continuum":
    • Not treated [blood glucose typically above 300 mg/dl (16.7 mmol/L), poor clinical signs]
    • Treated but not regulated [often above 300 (16.7) and rarely near 100 (5.6), poor clinical signs]
    • Regulated [generally below 300 (16.7) with glucose nadir near 100 (5.6), good clinical signs, no hypoglycemia]
    • Well regulated [generally below 200-250 (11.1-13.9) and often near 100 (5.6), no hypoglycemia]
    • Tightly regulated [generally below 150 (8.3) and usually in the 60-120 (3.3-6.7) range, no hypoglycemia, still receiving insulin]
    • Normalized [60-120 (3.3-6.7) except perhaps directly after meals -- usually not receiving insulin]
    There may also be an extra category of "mostly above 300 (16.7) but with good clinical signs" which occurs with some cats who are getting insulin. We don't know why it happens, but such a cat probably should not be considered to be regulated. On the other end of the spectrum, it is possible for a cat who is not getting insulin to have blood glucose as low as 40 mg/dl (2.2 mmol/L) on a home glucometer. If you have a non-diabetic cat, try testing her with the same meter to get a safe comparison figure.
     
  27. Jena4277

    Jena4277 Member

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    @Tuxedo Mom @Yong
    Hi again- she isn't breaking 200s with .5, so I'm going to try .75. Her AM and PM tests are still in the 300s which I don't like. I swear it's like she has built an immunity to insulin LOL
    I haven't been home to test as often as I would like bc work is starting up again soon, but the numbers are still in the mid 200s around nadir.
     
  28. Tuxedo Mom

    Tuxedo Mom Well-Known Member

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    The problem is without getting some mid cycle tests at night you don't know where the numbers went during those cycles. If possible try to get a +3 or +4 test in the evening. If Abby is dropping lower at night this can cause bouncing into higher numbers for a day or two later. She may very well need an increase but an evening mid cycle would be helpful. You want the numbers to drop into lower ranges, but you also want to make sure they don't drop too low. Especially with a faster acting insulin like Vetsulin you want to know where the numbers are especially before each shot and during the cycle.
     
  29. Jena4277

    Jena4277 Member

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    Ok - will do tonight.
     
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  30. Yong & Maury GA

    Yong & Maury GA Well-Known Member

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    I agree with Mary Ann. I think many of us are big advocates of before bed evening tests to see where kitty is going. Most tend to run lower overnight for an idiopathic reason. Also, just checking, you are not rubbing the injection site after giving the shot, correct? It is very possible she'll need another increase but we want her to stay safe too. Helps you stay sane :smuggrin:
     
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  31. Jena4277

    Jena4277 Member

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    I do check it to make sure I didn't miss. I guess it's a soft rub? Why, is this bad?
     
  32. Jena4277

    Jena4277 Member

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    She just tested 290 at +3.5. Should i bump her up to .75 starting tomorrow?
     
  33. Tuxedo Mom

    Tuxedo Mom Well-Known Member

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    As long as you will be able to do a few tests during the cycle tomorrow it looks like an increase may be in order for the morning. However if possible a +5 or +6 test tonight might be in order just to be sure. Abby seems to like having a later nadir than the "usual" for Vetsulin. She has shown some lower numbers at +5 or +6 in the past.
     
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  34. Jena4277

    Jena4277 Member

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    @Tuxedo Mom @Yong She dropped 100 pts at +5.5 to 192. I think .75 might be ideal for her. I will check at +4 and +6 tomorrow as well as at night.
     
  35. Yong & Maury GA

    Yong & Maury GA Well-Known Member

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    Rubbing/massaging, any noteable pressure on the injection site can effect how fast the insulin is absorbed. Actually makes it absorb faster, which is not ideal for an already somewhat fast acting insulin like Vetsulin.

    As for increasing her to 0.75U, what was she this morning? You won't want to increase on a bounce number :)
     
  36. Jena4277

    Jena4277 Member

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    @Tuxedo Mom @Yong just tested her. She tested 420 - the highest she's been in 5 or so days, so I decided not to increase today thinking it was an odd bounce. I don't understand why that may have happened, it is quite defeating seeing red on my spreadsheet.
     
  37. Tuxedo Mom

    Tuxedo Mom Well-Known Member

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    Although (Jennie) should have said Abby :banghead: went down into blues last night it was not an overly large drop. The drop was just over 50% which is what can be expected with Vetsulin. Huge drops are more likely to cause a bounce into high numbers. Because Jennie has a history of DKA if her numbers stay on the higher ranges it may be time to increase. If possible try to do a few extra tests during this cycle....+2 +4 +6 would show how well the dose is bringing down the glucose levels.

    Is she still only eating the DM wet food? If so make sure she is not eating the DM Savoury Slects as it is a bit higher in carbs. With Jennie's numbers in the higher ranges it would be prudent to be testing the urine for ketones. If you don't already have Ketodiastix test strips they can be purchased at most pharmacies.
     
    Last edited: Aug 26, 2017
  38. Jena4277

    Jena4277 Member

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    Was this meant for me? Just making sure.
     
  39. Tuxedo Mom

    Tuxedo Mom Well-Known Member

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    Sorry I called Abby Jennie by mistake :banghead: That's what happens when I post before I finish my :coffee::coffee:
     
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  40. Jena4277

    Jena4277 Member

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    Ok just making sure.
    Yes she eats pate only.
    It is difficult for me to get readings so frequently. Today I will just grab a +6 because I overslept. It is pretty exhausting and it does take its toll on me more often than not.
    I can do more frequent testing tomorrow if u think it's necessary or should I just go with an increase? I don't have many days left where I can stay home all day so it's really getting down to it here and I have to make a decision...
    I'll test for ketones too. I have the strips.
     
  41. Tuxedo Mom

    Tuxedo Mom Well-Known Member

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    If you are not able to test much today then wait until tomorrow to do the increase and get some extra tests in then. That way if this is a bounce today it should have settled down and you will be able to monitor how an increase works. Depending on how the readings go in the next few days it might be worth considering a longer acting gentler insulin such as Lantus or Levemir. They tend to have a longer duration and gentler drops, "usually" with less variance during the cycle. They are more expensive than Vetsulin, but there are reputable places you can buy them much cheaper. Some kitties do well on Vetsulin and some don't. Something to keep in mind.
     
  42. Jena4277

    Jena4277 Member

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    Sounds good thanks.
     
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  43. Jena4277

    Jena4277 Member

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    @Yong @Tuxedo Mom
    In a cat with FD, is it "normal" to have glucose in the urine on a test strip? Abby is not regulated yet, and I know there are factors like when she's last ate etc...trying not to freak out. I forget to use the test strips I bought bc I am so focused on blood testing. I'm going to test ketones and glucose again the next time she pees, but this last glucose strip was very high. I assume unregulated diabetic cats who have >300 like she does for prolonged period of time will have high spillage of glucose...can I assume this correct? (Didn't test ketones yet - I grabbed wrong stick!)
    Her bg at PM +3.5 was 225. Really hoping to remain optimistic but this dark stormy rain cloud isn't breaking anytime soon...:(
     
  44. Tuxedo Mom

    Tuxedo Mom Well-Known Member

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    On the urine test strips you will see glucose showing when the glucose levels are higher. With the numbers that Abby has been showing it would be totally normal to see a higher glucose reading on the urine strips since her glucose readings are in the higher end.. What shows on the ketone panel of the strip is of greater concern than the glucose strip. Ideally you don't want to see any more than a trace..especially with a kitty that has been through DKA before.

    Looking at Abby's numbers today a dose increase to 0.75 units would be in order for the morning...unless for some strange reason she shows a low preshot number. Trying to find a good dose can be very frustrating sometimes. :bighug::bighug:
     
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  45. Jena4277

    Jena4277 Member

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    Definitely increasing tomorrow. Thank you so much. I don't know what it was like for you when you were just starting but I am so overwhelmed and you both really help keep me sane. I am imagining the worst all the time - why is she itching, is her breathing too fast? Is she eating Enough? Is she peeing or drinking normally? - I am driving myself super crazy and the worst is I am alone in this and I feel so helpless sometimes...my entire summer I have felt like a prisoner in my house unable to travel, go out anywhere... Is that awful? I love my cat so much- I can't even describe the agony I feel when she is in pain or distress...the amount of tears I have shed for her...but I have lost a part of me in this process and I'm just so discouraged and constantly afraid of what the next day holds. I live in constant unwaiverif fear that I am going to screw up and lose her or that I won't know what it looks like if she ever needs help and it will be my fault...
    I am taking one day at a time but each day is getting harder than the last. I don't know how you guys got through it. I pray to God that there is a light at the end of this unending tunnel...
    Sorry to rant...it's one of those days. Thanks for reading ... :(
     
  46. Tuxedo Mom

    Tuxedo Mom Well-Known Member

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    Please take a minute to step back and BREATHE!! Dealing with feline diabetes is definitely a hard road to walk and the ups and downs can be very very frustrating. When I first started I don't think I slept more than 3 hours each night so I added sleep deprivation to my already frazzled out state of mind. We all love our furbabies...that is why we are all here...to try to do the very best we can for them. What you are feeling is so normal for FD petparents..but we need to keep our sanity and health while we are dealing with our furbabies. I swear the first 2 weeks after my first one was diagnosed I had more notes on EVERYTHING...I would regularly count the respiration rates while following him around to catch every pee and poop he did. Everyone I knew was sure I had gone off the deep end...totally normal :smuggrin:

    The more you learn...the more you test and watch for patterns..the more you learn and understand and the more empowered you become. Treating FD is not a linear process..there are many many ups and downs and all we can do is document and do the best we can. The whole point that you are doing what you are doing and learning everything you can shows your commitment and how much you care. Some people never get to the point of learning more and just give up on their kitties..sad to say, but it happens.

    I have had so many mental breakdowns over the time I have been dealing with FD, but with the help of people on FDMB and learning as much as possible it has helped me keep (some of) my sanity:rolleyes: Taking it one day at a time is sometimes the best way to approach it because it CAN be so overwhelming sometimes. Sometimes we need to be kind to ourselves...a nice glass of wine and/or some fine chocolate can sometimes boost up our sagging spirits.

    [​IMG]

    Hang in there...you are doing a fantastic job!! :bighug::bighug::bighug:
     
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  47. Jena4277

    Jena4277 Member

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    Thank you :cat:
     
  48. Kris & Teasel

    Kris & Teasel Well-Known Member

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    We all understand how you feel. :bighug::bighug::bighug:
     
  49. Yong & Maury GA

    Yong & Maury GA Well-Known Member

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    Well said, Mary Ann! I was definitely in "hawk mode" with Maury his first couple months. Crying when I kept getting black and red numbers. I still take his respiratory rate once in a while because of his heart. Still trying the pulse but its not super easy to find on him lol. Lots of fur :D

    I was dosing blindly too due to a back injury, which I currently have done again. But I have decent data on him so I'm saving my strength for his PS tests. Those few minutes of sitting are very painful but I won't blindly dose him again.

    Don't worry about the glucose strips, it will spill over if her bg is over like 250. Just focus on ketone strips. You want negative and no more than trace. Adding extra water to her meals and getting her slow increases of insulin should help keep them at bay. Definitely try to go do something for yourself between the 12 hours. :)
     
  50. Jena4277

    Jena4277 Member

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    @Tuxedo Mom @Yong The PM reading is 282. I usually shoot above 300. Should I reduce to .5 or not shoot? Keeping in mind .5 didn't lower her that much, but that overnight kitties go lower like you said....needing some advice.
     
  51. Jena4277

    Jena4277 Member

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  52. Tuxedo Mom

    Tuxedo Mom Well-Known Member

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    Sorry I wasn't on line to help earlier. The 0.75 gave a nice cycle!! I think shooting the 0.50 was a good choice. That is one nice thing about Vetsulin that you can adjust the doses if need be. A few tests tonight would be a good plan. Will check in later and see how you are doing. :bighug:
     
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  53. Jena4277

    Jena4277 Member

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    Idk what happened with the PM shot. Her numbers are increasing so I'm going to assume I didn't get her. She was sitting in a different position and I injected her the opposite way than I usually do so something must have happened. I didn't feel any liquid though on her fur . Try again tomorrow...
     
  54. Kris & Teasel

    Kris & Teasel Well-Known Member

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    She might be bouncing after having those blues today. Try not to worry about it - it's part of the FD dance.
     
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  55. Jena4277

    Jena4277 Member

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    Ok. It's not too bad of a bounce to be concerning I can sleep well tonight. :smuggrin:
     
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  56. Yong & Maury GA

    Yong & Maury GA Well-Known Member

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    Can't look at SS right now but she was probably getting on the trampoline like Kris said if she had blues ;)
    Sorry I couldn't check earlier. Herniated a disc in my back again. Having lots of quality floor time :p
     
  57. Jena4277

    Jena4277 Member

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    @Yong @Tuxedo Mom hello again! Hope all is well with you both.
    I have been consistently giving Abby .75 and she tests in the 300s with dips into upper 100s at nadir. I only had one strip left that I just used so I didn't get a test in last night, but she tested 500 just now for her AM. I left a lot of food out overnight because she wakes me up to eat at various hours, so I assume she just has eaten it because she was not waking me up for food at the usual time! She was content and sleepy lol. So my question is - how much can food affect a bg score? Can it go up 150 points like that? She must have JUST eaten. She was not very hungry when I fed and shot. I have to run out for strips later this morning so I will test and repost later. I am back to work so weekends are my only days to get in extra tests. Thanks so much!
     
  58. Tuxedo Mom

    Tuxedo Mom Well-Known Member

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    Good morning. :coffee:

    Are you out of strips right now? How long until you will have more?

    The high AMPS number could be from either a larger drop last night or having eaten recently or a combination of both. Some kitties can go up a fair amount with eating before the insulin kicks in.

    It would be a good idea to get some extra tests in today since you are not able to do them during the week. Hopefully you will have your strips shortly (not sure what time it is for you there) so if you can do a +2, +3 and +4 that will give some good data on what is happening earlier in the cycle/
     
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  59. Jena4277

    Jena4277 Member

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    I just woke up so I will only get a +5 or +6 in depending on when I can go to the store for strips. Tomorrow morning i will run extra tests.
     
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  60. Yong & Maury GA

    Yong & Maury GA Well-Known Member

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    Now I'm out of town lol but I like Mary Ann's plan =).
     
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  61. Jena4277

    Jena4277 Member

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    Aug 8, 2017
    @Tuxedo Mom
    At the grocery store looking at cheaper options than dm. I am spending too much money on the food. I can get any flavor of FF classics without too much worry about ingredients? I.e. Any Fish and chicken flavors are both ok to give? As long as it's classic pate, correct?
     
  62. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    Yes, any of the pates are fine. Fish is best fed only once a week max. Friskies pates are fine too.
     
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  63. Jena4277

    Jena4277 Member

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    Aug 8, 2017
    Thank you @Kris & Teasel !! :bighug:
     
  64. Tuxedo Mom

    Tuxedo Mom Well-Known Member

    Joined:
    Dec 2, 2014
    Sorry I wasn't on earlier. As Kris said any of the pates are fine...EXCEPT the Friskies Indoor Cat pate variety..that one is HC
     
  65. Yong & Maury GA

    Yong & Maury GA Well-Known Member

    Joined:
    Jan 11, 2017
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  66. Jena4277

    Jena4277 Member

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    Aug 8, 2017
    Thank you! Looking for this! :rolleyes:
     
  67. Jena4277

    Jena4277 Member

    Joined:
    Aug 8, 2017
    @Tuxedo Mom @Yong @Kris & Teasel
    So Abby had been doing awesome with her diabetes...except today.
    Woke up to her peeing small quarter size amounts around the room with tint of blood every so often. At one point she collapsed perhaps from pain and was panting. It is still going on. I didn't give her insulin this AM bc I didn't know what was going on at first, I figured a DKA event. Sugar was high but not that high. Researched online and possibility is UTI. She is having a harder time walking and when she is laying down she lifts her leg to pee a tiny amount usually tinted pink. Sent urine sample to vet and will find out tomorrow. I gave her lower dose of insulin this PM bc did not test her as she is in pain to the touch. She does have an appetite and is drinking water.
    Either of you have experience with this?
    If it is UTI they say antibiotics can mess with blood sugar. What an ordeal.
     
    Last edited: Oct 2, 2017
  68. Yong & Maury GA

    Yong & Maury GA Well-Known Member

    Joined:
    Jan 11, 2017
    Hi Jena,
    Sorry to hear Abby isn't feeling well :bighug:. If you can't test for ketones and you suspect a DKA event, you should really get her to a Vet ASAP. Have you done any additional ketone tests since 3 Sep? With her staying in pink PS's mostly, you should try weekly tests. Especially since Abby has been DKA before, that makes her more susceptible to developing ketones. There isn't much mid cycle data to know how the dose is doing but early on she was still having nadirs of high 100s so there is room for her to get an increase. However, blood in her urine and pain from straining to urinate could be a UTI and will keep her numbers higher.

    If you have to go down to her to get the PS test, so you only have to touch her ears, then do that so she can get her insulin.
    Remember the recipe for DKA is not eating + not enough insulin + an infection. It's good she has an appy right now but she's got 2 out of 3 and we don't want her going DKA again.

    I don't have personal experience with antibiotics but if they start helping clear the infection, you'll need to get more mid cycle tests. As she starts feeling better, her numbers could start going lower. Keep us updated as you can and I hope Abby starts feeling better and stays safe :bighug::cat:
     
  69. Tuxedo Mom

    Tuxedo Mom Well-Known Member

    Joined:
    Dec 2, 2014
    I agree with Yong. You need to be doing regular urine testing for DKA with a history of DKA in the past. Blood in the urine and straining to pee could very well be a UTI or possibly crystals developing and needs to be checked ASAP. An infection will cause glucose levels to rise as will any sort of pain. My other kitty was prone to UTIs and I used antibiotics a number of times, with no increases in glucose levels.

    If at all possible try to get some tests in at mid cycle ( +3-+5 would be a good time) in order to see how low the dose is taking Abby. Without knowing how low she is going it is very hard to say whether the dose is adequate or if you need an increase. Because Vetsulin can drop the numbers sometimes very quickly earlier in the cycle it is important to see if she is dropping quickly or too low or whether the numbers are staying high through the cycle. However as Yong pointed out it is also important to do extra testing if she has a UTI and antibiotics are prescribed, as clearing up the infection can also cause numbers to drop as the infection clears up.

    Do get Abby in to the vet and get things checked out.
     
  70. JanetNJ

    JanetNJ Well-Known Member

    Joined:
    Jun 8, 2016
    Sounds like UTI to me. I'm surprised they didn't give you clovamax in the meantime. UTI'S are painful. Hope she feels better soon.
     
  71. Jena4277

    Jena4277 Member

    Joined:
    Aug 8, 2017
    @JanetNJ @Tuxedo Mom @Yong
    Hi! It’s been a long time! A few updates and advice needed:
    1. Abby did have a UTI. All cleared up with antibiotics.
    2. I stopped doing curves and testing daily as my sanity was wearing thin. It is not something i can commit to anymore so my spreadsheet is not up to date.
    3. I have been giving Abby 1u of Vetsultin 2x a day. in the last month between vet visits she has lost too much weight and is a little above 6lbs. She is tiny normally but her bones are showing and she is basically starving it seems. My vet did every expensive test in the book and said nothing is alarming, and at most, her thyroid is only “slightly” elevated. I think Vetsulin isnt the insulin for her anymore and i want to switch to ProZinc so that she is lower for longer and she isn’t peeing out her calories/not getting nutrients she needs. My godmother happens to be a diabetes LPRN so she was talking to me about it too. Advantages and disadvantages of switching to ProZinc? I don’t think Vetsulin is giving her the longer lasting effects she needs. I increaed her to 1.25 just this week and her sugar is all over the place. From the beginning it did usually leave her system around 1pm. I am waiting for the vet to call back. Her diabetes is clearly not as regulated as I thought even though her clinical signs improved. The vet suggested switching her to Rx Hills food but it’s just too expensive.
    What are your thoughts on A ProZinc switch?
     
  72. Callie & Patches

    Callie & Patches Well-Known Member

    Joined:
    Jun 18, 2016
    Prozinc has been great for Callie. I asked our vet about it, but she didn't know anything about it. When I explained that it was the only insulin made just for cats, she faxed a Rx to the pet pharmacy. I like that it doesn't hurt Callie if I am late getting home. It is a slow acting very gentle insulin. I was using Vetsulin before the switch. Prozinc costs more for a vial, but it lasts longer and ends up costing much less per month.
     
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  73. JanetNJ

    JanetNJ Well-Known Member

    Joined:
    Jun 8, 2016
    I can't coment on the effectiveness of your dose without any tests... Can you do a curve this weekend? Many like ProZinc, so it's fine to switch.
     
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  74. Jena4277

    Jena4277 Member

    Joined:
    Aug 8, 2017
    Yes I will. Thanks
     
  75. Jena4277

    Jena4277 Member

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    Aug 8, 2017
    I have to curve tomorrow bc something happened today with shot and her numbers are super high and unchanged. You would think after 6 months I could do this...after PM shot I will recheck her to make sure the insulin got in. I couldn’t tell you what happened...I just feel bad for her that her sugars are so high. I’ll write tomorrow.
     
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  76. JanetNJ

    JanetNJ Well-Known Member

    Joined:
    Jun 8, 2016
    Any chance you could get a+4 or 5 today or tonight?
     
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  77. Jena4277

    Jena4277 Member

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    Aug 8, 2017
    I have today’s numbers but somethings not right as I said. I can def get some in tonight after her PM shot.
     
  78. JanetNJ

    JanetNJ Well-Known Member

    Joined:
    Jun 8, 2016
    Ok so let's talk about the weight because that's the main concern right now. How many ounces a day of ff classic is she eating? How often do you feed? Does she look for food or seem hungry or do you have to coax her to eat?
     
  79. Jena4277

    Jena4277 Member

    Joined:
    Aug 8, 2017
    She eats two small fancy feast cans a day. She goes looking for food around noon and then eats a lot over night so I always put in extra. She does not finish whole can at shot time, prob half at most. But in an hour, she will revisit the bowl to eat and continue this habit throughout the day. If it is empty she will go find us but she likes smaller meals throughout the day.
    My Vet did a thyroid test and said it is only slightly elevated, but perhaps for her it is a bigger issue. I think though over time her insulin needs changed and I didn’t pick up on it. With her it’s never an easy answer.
     
  80. Jena4277

    Jena4277 Member

    Joined:
    Aug 8, 2017
    Sorry to clarify she gets her can at 5am and 5pm with her shots.
     
  81. JanetNJ

    JanetNJ Well-Known Member

    Joined:
    Jun 8, 2016
    She may eat more mid day if it's fresh. Can you try a full can in the morning. A half of a new can in the afternoon. Another full can in the evening and another fresh half can just before bed. Kitten food is sometimes higher in calorie so you can try that.
     
  82. Jena4277

    Jena4277 Member

    Joined:
    Aug 8, 2017
    Ok. I am a teacher so the midday feeding is iffy but yes that makes sense to entice her. I considered auto feeders but she is very arthritic and there’s not a lot of space in the main room she hangs out in for an additional bulky feeder and going up and down stairs a lot is painful for her. But there’s still the issue that if her diabetes isn’t under control her body won’t process the food anyway correctly. If it is somewhat under control which i will get a glimpse of tomorrow, then i am looking at a whole different issue. I’ll get some numbers on a Monday too my last day off bc I think tomorrow might be a bit skewed with the missed shot this morning.
     
  83. Jena4277

    Jena4277 Member

    Joined:
    Aug 8, 2017
    I also was looking at kitten food but a lot had extra milky ingredients which won’t be good for her. Do u know any reputable brands?
     
  84. JanetNJ

    JanetNJ Well-Known Member

    Joined:
    Jun 8, 2016
    Well until she's more regulated she may need more calories. You could try freezing the half can portion and then by noon it should be fresh and defrosted to eat. I a teacher too.... It's been nice having the week to tweak numbers.

    Really if you can get the preshots and at least one other test during the evening it would help so much. That's what I do. Two preshots and a +3 or 4 before bed. On weekends I try to get at least one more mid day.
     
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  85. JanetNJ

    JanetNJ Well-Known Member

    Joined:
    Jun 8, 2016
    Ff kitten is only 3 carbs. Look on the food list for any others you wanna try.
     
  86. Jena4277

    Jena4277 Member

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    Aug 8, 2017
    If she is on a food with higher calories, will that increase her bg? I know high carb food does....
     
  87. JanetNJ

    JanetNJ Well-Known Member

    Joined:
    Jun 8, 2016
    No. Carbs is what raises the bg.
     
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  88. Jena4277

    Jena4277 Member

    Joined:
    Aug 8, 2017
    This was the result from this PM:
    4:15 380 1.25u
    7:28pm. 183
    9:15 248. Ate at 8:50 but I’m going to bed and couldn’t wait so I will get a AM shot tomorrow and do a curve and post it.
     
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  89. Jena4277

    Jena4277 Member

    Joined:
    Aug 8, 2017
    I did a curve today. This is what it looks like.

    4:45 377 1.25u
    6:30 358
    8:00. 257
    9:30. 190
    11:00. 188
    Vomit after eating a lot
    Ate more around noon
    12:33. 316
    2:30. 392

    Basically the Vetsulin only lasts tilabout noon then is gone. Here is my plan

    1. Go with 1.5 tomorrow since I am off of work and take some numbers
    2. I bought blue wildnerness after reading food chart- it is high in calories. I did see the tiki but didn’t see it on the chart. I will start slowing feeding her that until I can get hills from Vet.
    3. As you said regardless of the food her sugar is not right so it won’t help. I asked my Vet about ProZinc after reading about it and she was hesitant to switch as she’s said it’s a human insulin when everything online says it was made just for cats..... I am calling them Tuesday and demanding that I switch bc she isn’t doing well on Vetsulin and needs a lower bg for longer. She has too steep a dive. Hopefully I can get that, and combined with high cal food and the insulin in a few weeks she will gain weight. I will pull some numbers for her tomorrow but it has been a pattern that by 12/1pm the Insulin is out of her system.

    The vet also wants to draw urine to makesure there is no lingering infection afterher UTI.
     
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