? Curve day for Jester! - Weird numbers. Opinions?

My second curve since he was dx. His numbers have been a bit high and I was considering increasing his current dosage but decided to see what's happening throughout the day on this one.

Just curious - how strict are most folks about the two hours?

 

Not strict at all. There isn't anything magical about two hours - you just want a smattering of tests throughout the cycle to try to pin down the nadir.

EDIT: Sorry, that makes it sound like the nadir is static. It does and will change on different days, but most cats tend to have a 'typical' nadir.

 

I've been worried about Jester's numbers. But I think he may have had a low grade fever. He's prone to URIs and his nose and eyes have been a bit runny this week.

Most times he gets over them on his own - although that was before the diabetes. Currently it's been a waiting game to see if things go back to Jester's version of normal, including his BG.

I've been planning this curve for a little while and didn't want to increase his dosage haphazardly or in a panic.

AMPS was down a bit and I'm hoping that's a good sign.

 

@Djamila - if you saw numbers like Jester's, would you think there might be an infection involved?

He didn't get lower than the mid-200s all day and we're at +8 now. Two of the tests were fasting.

 

I just changed the title to reflect the flat numbers all day long.
AMPS - 296
+2 - 303
+4 - 260
+6 - 255
+8 - 279
+10 - 363
UPDATE W/+10 #

Might this be indicative of an infection? Jester is prone to URIs and I think he might have been working with a mild one this week as his PS have pretty much been in the 300 - 400s with mid-cycles in the 200s for the last few days.

Thoughts?

I'm planning to reach out to his vet to see what he thinks too.

FTR - he's been eating very well today (Just ate almost an entire can of cat food after his +8 and nearly 2 cans all day long so far) and has been behaving pretty normally all day.

 

Hard to say what's going on. It's possible he has something infectious raising his BG. If he's prone to URIs and felt feverish to you that might be it. Maybe keep the dose another day or two?

 

A lot of times, he doesn't feel feverish for a while. URIs for Jester usually first manifest with a drippy nose and crusty eyes. When the runny nose gets snotty, that's when he's really sick.

While that hasn't happened yet, his BG just jumped up high enough that I increased his dosage this morning to 1.5U. Over 400 last night and nearly 400 this morning. Even his pre-bed test was still in the mid-300s.

Sort of sucks - I feel like I wasted a curve yesterday and put Jester through all those ear pokes by being too cautious with changing his dose. And now I'm doing extra pokes today to monitor the increase.

:-<

 

Shoot! I wrote this early this morning, and then apparently forgot to post it!!! I'm so sorry. Anyway, better late than never...:

It looks like you increased to 1.5u this morning. I think that was a good decision given the number you're seeing. Even if it's an infection, sometimes you have to raise the insulin dose until it's resolved. I have to do that when my kitty gets a pancreatitis flare - increase the dose while he's stick and then be prepared to lower it quickly when he's better. Has Jester been to the vet for the URI? Does he need meds? Or is it the kind where you just have to wait it out and it resolves on its own? Sending healing vines your way - hopefully he'll feel better soon.

 

That's interesting. When Jester had a UTI, the vet told me to keep him at the same dose. Hmmm....

Not been to the vet - I can't afford it except when the retired owner of the practice comes in on Monday evenings.
And, yeah, I usually wait and see if it gets to the point where he has milky discharge.
He hasn't been sneezing as much and his nose seems to not be running today so it may be all over now.

Thank you - what's a vine? Is that like a vibe?
I'm just hoping his BG goes down and stays there. I'm disappointed that the 1.25u dosage didn't last.

 

Healing vines are healing vibes...it's one of our FDMB sayings. Years and years ago someone had a typo and said vines instead of vibes and it just kind of stuck! Now we all send vines instead of vibes.

 

Tomorrow's going to be a bit rough for monitoring Jester.

I have an eye appointment with a retina specialist for a problem that cropped up last week. The office recommended that I don't drive myself because they don't know what they might have to do on the spot. (The optometrist literally told me I needed to be seen sooner rather than later for this.) And since I don't have anyone to drive me, I have to take the bus. Which means I may not be home until mid-afternoon and almost certainly will be dilated.

I'm going to have to leave about an hour and a half after Jester gets his insulin. And taking a mid-cycle when I get home may be next to impossible.....

 

Good luck with the doctor tomorrow I hope everything goes well!!

 

Ack! Let us know how the eye doc goes.

 

Still dilated . That was actually painful. They had to poke at my eyeball to check the pressure.

I have a fairly big floater in my left eye and it needed to be checked. Going back in about two months to follow-up. According to the doctor, it should start to float down and out of my general field of vision eventually.

On the Jester front, his BG isn't going down as quickly as I'd like. Trying to be patient for a few more days. I got home early enough to test with my dilated eyes.
It was a bit of a surprise that his +4 was so high considering it was fasting.

 

I can understand feeling impatient with that PMPS. I wouldn't hold at this dose for long if he doesn't respond better. See how he does tomorrow, and if he isn't getting better numbers, I would suggest going up to 1.75 on Wednesday (if you'll be around to monitor).

And yuck on those eye pressure tests. They are awful. Hopefully the floater will clear soon!

 

This is weird - the vet just told me my alternatives are to increase to 2u per day or 1.25u three times a day?.....

How on earth can anyone give three doses a day when you can't dose less than eight hours apart?!

 

Vets can’t seem to wrap their heads around 0.25 u dose changes. I’d try 1.75 u. Dosing three times a day is far too burdensome for most people - I wouldn’t do that.

 

Most vets only recommend whole unit dose changes because Prozinc is marketed with the u40 needle kits that only have whole unit marks. It isn't what's best for cats, it's what's best for profit. And to be fair, since the syringes don't have any marks to guide a 0.25u dose change, they can't be confident in our ability to draw a smaller change accurately.

Three times/day dosing is possible on prozinc, but it requires that the caregiver rarely leave the house for more than a few hours in order to sufficiently monitor. You have to know that the BG is rising before you give the next dose, so you have to have at least one mid-cycle every cycle, and preferably two every cycle. And with three cycles each day, that is a lot of testing and very little freedom. Eventually you can get away with skipping mid-cycles occasionally (assuming the cat stabilizes), but it's just way more of a burden than most of us can take on. The benefit is that it can produce a flatter curve than dosing twice/day, but the requirements make it hard to maintain.

If you dig back through the old threads here, there are people who have done it, but it's been awhile.

 

As Djamila said some here have done 3x a day dosing...but we rarely recommend it. It was generally suggested when insulin wasn’t lasting long enough and in that case I’d suggest Lantus or Levemir instead honestly. Only if the bean couldn’t get that would I suggest more frequent dosing.

You’re not in that boat I’d say. I agree with Kris...I’d go 1.75 2x a day.

 

I wonder if "floater" means the same thing as my eyes. I can turn my eyes side to side quickly but a second later what looks like a hair on a lens swings by, totally weird. I've only known one other person that has this and doctors just look at me funny so I stopped telling them 20 years ago.

 

Talk to an optometrist or ophthalmologist.
Floaters can be a symptom of something very bad or something fairly simple.

 

I'll try again when I get new glasses. But you know that feeling right? The doctor looks at you like you're nuts.
The last time I was put under was for dental surgery and I gave a printed page of reasons why general anesthetic was not a good idea. They looked at me, I caught one guy looking at his watch and away we went.

 

I wouldn't wait too long if you've had it for a while.
Depending upon the reason for the floaters, it could mean the difference between blindness and sightedness.

And I'm very sorry you have doctors who don't listen to you. Frankly, I think you need to find another doctor. Generally speaking, my doctors listen to me when I tell them about my health issues.

 

Canadian healthcare is "free" so every time you get a boo-boo it's off to the doctor. A double boo-boo means emergency, pay for parking only. That is why doctors here don't listen and I can't blame them either. They can't distinguish between urgency and hypochondria any more.
My mother in law needs a simple operation to save her vision in one eye but the drops she has to take first have been giving her headaches so she just decided to stop taking them. She would not be in that position if Cynthia's stupid sister had not taken Mom to an organic witch doctor first. I'm all for natural remedies which in this case include a good slap to the head.