1/06 Rupert amps-299,+3-268,+5-120,+7-240,pmps-366,+3-353

http://www.felinediabetes.com/FDMB/...235-3-267-5-236-10-374-pmps-426-4-203.150467/

Decided to stay with 5.5 today, previous two days on this dose were so different, so want to see how today goes.

 

It looks like he started to clear the bounce yesterday and then didn't. I hope Ruper slides down today.

 

You have to wait for the depot to fill to see what the dose will do, so that's 6 cycles. It often takes Neko until the 5th cycle before she shows me what a dose can do.

Work it Rupert - slide on down today.

 

Thanks Ladies! Hope it will be a better day today!

 

Julie posted this info for me the other day, that is why I was considering increasing after only two days. Thanks so much for your concern and help!

The larger dose increase is mentioned on the Tilly's Diabetes site's interpretation of the Tight Reg Protocol.
Phase 2: Increasing the dose
Most cats need to have their dose increased. Do it in 0.25 IU or 0.5 IU steps (0.25 IU if the cat is getting a low dose and/or relatively low BGs, 0.5 IU if the cat is getting a higher dose and/or relatively high BGs). Hold each dose for 5-7 days. However, if the cat is producing continuously high BGs (nadir always >=300 mg/dl), only hold the dose for 2-3 days before increasing it by 0.5 IU. Alternatively, if the cat is continuously producing moderately elevated BGs (nadir always >=200 mg/dl), increase the dose every 2-3 days by 0.25 IU ( if the cat is getting a low dose) or 0.5 IU (if the cat is getting a higher dose). From this point onward test for ketones once per week, or more often if the nadirs are still >=200 mg/dl.

 

In that quote, Julie is talking about the larger dose increase, ie. 0.5 units, which is what we suggest when they get to 5.o units total dose. There is a second part about increasing earlier, but only if your cat is continuously getting nadirs over 300. Rupert got to 101 two days ago. He's just bouncing, we don't react to the bounce.

 

Got it, thanks for clearing that up, Wendy! I was tired when reading that and the message didn't sink in. Good thing I was cautious and decided to wait.

 

Okay, Rupert, get off the tramp because looks like Bubba will need it tomorrow after today's nice cycle, BOINNGGG !!!

 

Feeding problems again..I tried to wait and feed him his midday meat at +5 today, unfortunately he decided to have an earlier nadir than usual and when I tested him at +5 before feeding he was at 120. I knew feeding him would raise his BG's and he wouldn't have that nice surf, but I couldn't wait till pmps, that was way to long for him to go without food. If I feed him before +5, he is howling at me till pmps feeding. It's not pretty. If he would nadir later say, +8 or so, I would have ample time to get that 3 rd feeding in, but he usually nadir's at +6, +7. Maybe I should try a +4 vs +5? This wouldn't be a problem if he was quiet kitty, but I am not exaggerating about how loud he is and how long he can keep it up. I have had people on the phone say "what is that noise?" The neighbors hear him when he is out on the lanai, he is louder than there barking little dogs. lol Thanks for listening (I am as bad as Rupert) I needed to vent a little, been a frustrating 3 days.

 

Wow, Bubba had a terrific day! So happy for you and him! We have had some good numbers, but having trouble with feeding schedule. I want to feed when it will benefit his BG numbers, but he is not cooperating! He is trying to drive him mom crazy and is succeeding! Lynn vs Rupert...round 1, 2, and 3 goes to Rupert!

 

Oh no. What is he doing that isn't cooperating? Not eating when you serve?

 

I think you could do a small snack of zero carb later in the cycle, so he doesn't chew your leg off. I also wouldn't worry about the odd time he has an earlier nadir. Pick a time that's generally before his nadir and stick to it. Don't want to upset the cats and their fine sense of timing!

Nice to see that +5. Unfortunately it was a big drop from the +3, so could be a bounce again.

Still no green, though very close on this dose. If he doesn't see green tonight, I think you could increase again tomorrow. What do you think?

 

Oh, he always eats! lol It's if I feed him early, he whines all day, but if I feed him at nadir or close to it, he goes high at pmps. I keep moving the midday meal around, divide it, etc., haven't hit on the right combo yet. He is not happy when I change his feeding times. Amps and pmps always stay the same of course! He is just so obsessed with food, it's crazy, he has gained back his weight that he lost, so I know I am not starving him! lol

 

I sometimes think he would chew my let off if he could! lol Still no green, he was high again at pmps- 366, not sure why, he seemed more mellow than normal and no meal since +5. A couple of small pieces of white meat chicken for all the pokey tests. I will increase to 6 tomorrow morning, thanks so much for your help, Wendy!

This is something I have wondered about with Rupert....if a cat's BG levels will be high at the vets when stressed, couldn't he be stressing himself out about the food? He seems to be cranky the closer it gets to feeding time, especially pmps, since I think he is hungrier then being more active during the day vs feeding time at amps. His tail is slashing around, he swats at his sibling if he gets too close, etc. I don't know, just a thought and it seems to be worse at pmps time. At amps, he has just got up with me and I usually test and feed him right away, so he doesn't have much time to work himself up. Just bouncing some stuff around in my head (pardon my pun).

 

Some cats go lower at the vets, Neko doesn't show much difference in her BG at all. Blood pressure on the other hand. Civie has gone up over 150 points at the vets. ECID.

I think Rupert just isn't at a dose yet where he can get good duration. When Neko was on Caninsulin, it didn't last nearly long enough. The four hours before dinner were murder on us. I think another reason Rupert is better in the morning is that he seems to be lower then than the evenings. Any chance you can get Rupert involved in play before PMPS, when he starts getting grumpy? Might be enough to take his mind off things and wear off some energy (carbs).

 

You are probably right about him being "nicer" in the mornings due to lower numbers. I will try to engage him more before pmps, he has been a little more social, getting up on my lap, etc. at least. It will help take his mind off his hunger and burn up some carbs too (wouldn't hurt me none either ) ! Thanks for the great tip, Wendy!

 

I would increase to 6.0u in the morning. The 120 today tells us that that's what he can get to on this dose. It's looking like there's a possibility that Rupert has one of the high dose conditions - with the appetite it wouldn't be surprising if he has acromegaly. They have voracious appetites, sometimes even eating non-food things. Once kitties get to 6u we start looking at that and thinking about testing for acro and iaa (insulin auto antibodies.) The latest research indicates that 1 in 4 diabetic cats have acromegaly, so it's not uncommon. Neko has both acro and iaa and Punkin had only acro.

Are you still feeding him some chicken in the latter part of the cycle? That shouldn't raise his BGs too much, if at all. But if it does, maybe trying a different meat and see if it has less of an effect. Like Wendy, I think he's got high pmps because the dose isn't high enough yet, although that doesn't explain the amps being lower.

 

I have wondered about acromegaly, read some about it. He doesn't display many of the signs, but a lot don't as they stated. He does have a "pot belly" and I even asked my vet about it. He pressed a little on the tum area and seemed satisfied. The other kitties get the same amount of food and they don't have the pot belly look. It does go down, after many hours, but looks bloated after eating. He hasn't eaten any non-food item, but he did eat a piece of lettuce that dropped on the floor. He is constantly on my kitchen counters, knocks over the trash, even if he just ate and if I turn my back while making lunch, etc., he will jump up and try to grab food. I never leave the room while preparing food, groceries always immediately put away, pantry door is secured. I know many have the same problems with their sugar kitties, but his just seems to be a bit more fanatic. I was hoping that Rupert wouldn't be a tough case, my funds are very limited, I really can't afford what I am doing now with him. I originally thought that a vial of insulin would last me 6 months, now it is one month and most likely even less in the future with his high doseage. Sorry, it's been a tough morning, tried to give flea medicine to all the kitties, the one threw up the food and medicine all over my computer desk and papers. Of course, he was just walking across my desk, when he hurled. It was on the wall even, it was like something from the Exorcist! I need more .

 

Oh, Lynn! My morning started with scarf and barf too from Forrest but at least it was on the runner in front of the outside door. Yuck!

The money thing is a biggie for a lot of us. Most my $$ a month goes towards his FD. Let's hope he hits the dose and starts coming down.

I agree with Wendy about the feeding schedule. Pick the times in the middle of the cycle and stick to them. Even if it would be right before he would do an early nadir, I am noticing that with the Lantus (not sure how Lev works but think its similar) he doesn't rise a whole lot from the snacks and then goes back down again.

Here's my schedule that has seemed to help. I adopted it from Merlin.

My AM and PM insulin times are 5:30 AM and PM
5:20 AM Breakfast 1 1/2 can of FF
9:00 snack .75 oz of FF (1/4 can)
1:00 snack .75 oz of FF
5:20 Dinner 1 1/2 can of FF
8:30 PM snack .75 oz FF

He still seems always hungry and all I have to do is open the refrigerator and he comes running. Now all the animals come running because they get a token snack too because Momma couldn't give to one and not the others..... they are eating me out of house and home!

 

Thanks for the feeding schedule advice, Bobbie! I need to pick one and stick to it, changing it around is upsetting Rupert, they sure do have a great internal clock! I also have to give treats to the other civvies, I go through the chicken meat quickly! I have to watch all of them now around food, they have turned into beggars and naughty counter jumpers! They never used to, but once they saw Rupert up there, they were game too. Unfortunately there is an all white counter in this house and you can see the kitty prints easily. Busted! So, the bottle of Lysol cleaner is always handy and between never leaving any food out, sweeping the floors for any crumbs of food and the counter cleaning many times a day, my kitchen is the cleanest it has ever been! lol

Good luck to Bubba today, hope he doesn't bounce and surfs in the blues and greens!

 

Oh, yeah, they all follow suit once they see naughtiness....... Ricky does a good job sucking up food debris on the floor. He is like a little brown dust buster. Bubba's new trick is to up on the counters but somehow he likes the glass top range the most. Once or twice he has jumped up there while food is cooking........ disaster waiting to happen. Yelling sharply at him has shown no results. I too have a cleaner kitchen, no more procrastination of putting the leftovers away. Bam! Right after I eat.

 

I have to put everything away before I sit down to eat, no dirty pans or dishes, he will be licking them, nothing in the sink, he will even eat food particles out of the strainer, counters empty and wiped. My food is usually about cold by the time I actually sit down to eat it! I throw the dirty pans in the mic till I can wash them after eating and sometimes I forget till I go to warm up a cup of coffee! lol

 

I do give him some chicken pieces for pokey treats, but just a small piece. He was low again at +5, but I went ahead and fed him, since he only had 3 oz at amps. If I feed him at +3 and then can only give a few treats till pmps feeding, it is too long a stretch, but if I feed him +4 through +7, it spikes his nadir time. I am going to try the +5 feeding again today and see what happens. Thanks again for all your help!

 

I was throwing the left over food in the microwave too or back into the oven so we could eat without him thinking he was at the Golden Corral Buffet. And, what was happening was I was forgetting they were in there and finding them the next day and would have to throw them out. I should have known that I cleaned up the kitchen a little tooooo fast the night before. Guess I better save the cosmo for after the kitchen is cleaned up instead of while I am cooking........

 

Lol, yep, we need clear heads to deal with kitchen duties now! I also put the pots in the oven, forgot and turned the oven on, not good, now I put a dish towel in the door to remind me. Gosh it's tough getting old or maybe it was the wine!

 

It's both, lol

 

Lol, yep.

Shiver me timbers, matey...Bubba is a pirate lad for sure now! Would be nice if he could tell you were his buried treasure is....oh yeah, that would be in the litter box!