5/12 Aria

Still doing well at the low doses and although we're still shooting as needed, I think we're getting closer to being back on BID. I'm thinking I may lower my no shoot # with a lower dose. Right now I'm shooting .2 at anything over 145 (.1 was working but we stopped seeing greens), but she seems to like to hover in the mid 120's to low 130's for a few cycles before going into the shootable #'s. I'm thinking that maybe a .1 dose for a few cycles if she's hitting the mid to high 120's and up instead of just skipping the dose might get us back to the days/weeks without shots again (yep, I'm nostalgic already.) Also I want to make sure the protocol is set and working well before handing off to the kitty sitter in two weeks.

So my plan:
125-145 .1 unit
145+ .2 unit

Anyone who shoots as lower #'s... chime in if there's any advice you could share.

 

Just stopping by to say I am glad Aria is doing well. :smile: I know what you mean about nostalgia, although I can barely remember that month when Buzz was OTJ anymore. You guys will get there; it sounds like you are doing really well with dosing decisions.

As far as shooting on a low #, the only advice I can give is to just study your data and know how Aria reacts. If you've gotten some +1s and +2s and you know that from +11 to +2, she is generally on the rise, then that will help determine whether or not you should shoot on a lower PS. If, however, she usually drops starting at +1, then of course that will change things. It's all about your personal comfort level, how often you will be around to test that cycle, and how Aria reacts to insulin.

At the end of Buzz's time on PZI (Idexx), I had lowered my no-shoot to around 120 but I never really had to make that call, as her PS #s were almost always pretty close to 150 (or higher). I do shoot on very low #s now, but Buzz is on a different insulin, so that doesn't really help you. ;-) I am sure someone with more expertise than I have will be around soon to give you better help. Keep up the good work! :mrgreen:

 

hope you know i was told 3 years ago the 2 scariest times of shooting is when you just start and then when your nearing the falls. you just never know when the pancrease is going to go back to work doing her full time job. but in those days i swear i never heard phrases like .1 or .2u's so I think you can't do too much damage shooting 120 with that. i cannot imagine a cat having a hypo over .1u,
i sure miss the 2 1/2 years tom was otj and to think, i used to complain then that i always had to rush home to feed him every 8 hours! now that we're back on the juice i am nostalgic as well.

 

Thanks guys! That does make me feel better. She gave me a 111 tonight, so no shot.. lol! It's the craziness that is us!

Previously (back when the wonkiness was weird spiking) I knew that if she went down at +1 and even +2 that it was too much insulin. Now even at .1 or .2 units, she goes down at +1 and +2. Which is good. Means there's some activity there, I think. I'm thinking maybe her pancreas just isn't well enough to handle long term stuff. So then she'll hold in the 120-130 range for days and then we'll have a few days that we have to shoot 2x or 1x. No real pattern yet, but it does all look like improvement (especially if you consider we were shooting 2 units TID not that long ago)

Lori - thanks for the encouragement. It's still daunting for me to shoot at low #'s, but I'm trying here and there. Usually when she gets stuck and I don't see greens for a few days.

 

I am so happy Aria is doing so well. Prudence and Aria seem to be on the same page. I wonder if their age plays a roll in any of this? It's funny how you'll get a few days of greens then all of a sudden there's the low blues back down to greens again. At least that''s what Pru is doing. DH keeps telling me to just leave her be. He thinks all the attention plus when I am frustrated trying to figure out why certain things are happening... he thinks she's picking up on my energy. :roll: I dunno, maybe he's right to a certain point, haha Kind of makes you wonder if humans are always in the greens. :lol: You're doing an AWESOME job Hope! Big hugs to both of you. BTW - Isn't it nice to finally be able to get some sleep ;-)

IMO - I'd stay at 0.1U, but that's just me. I found that if I gave too much (0.2) it takes a few days to work through Pru's system. That's just Pru though? Anyway, Just wanted to mention that, ok? :YMHUG:

I've also been using the Mid-point deal from time to time. I figured Aria's mid-point from 5/11 930am to 5/12 930am Her highest was 145 and lowest was 75 giving a mid-point of 110

http://www.felinediabetes.com/bg-curves.htm

To determine the dose of insulin or if dysregulation is a problem, evaluate the nadir and range midpoint.

If the nadir is < 100 mg/dl, decrease the insulin dose.

The ideal range midpoint is 200 mg/dI, and 150-250 mg/dl is acceptable. If the range midpoint is:
The ideal midpoint of the range is 200 mg/deciliter. However, the midpoint is satisfactory if it is from 150 to 250 mg/deciliter. If the midpoint is less than 150 mg/dI, the dose of insulin is too high and should be reduced.
1.150 mg/dl: reduce the dose of Insulin.
2.150-250 mg/dl: don't change the dose.
3.250 mg/dI: several possibilities exist:

The cat may have been stressed when the blood glucose curve was performed.

The Insulin dose may be too low.

There may be an insulin problem (inactive insulin, insulin not mixed property, poor injection technique, poor absorption).

Insulin resistance may be occurring due to concurrent disease (systemic Illness, hyperthyroidism, hyperadrenocorticism, acromegaly) or insulin antibodies

 

Michelle - how's my favorite late night, coffee drinkin', sleep deprived buddy!!

Here's my current thoughts and tell me what you think. We got all the way down to .1 unit BID then .1 unit as needed, then we went from 3 days no shot, to 4 days, to 7 days. Then she started getting stuck and getting higher #'s. I'm thinking that her pancreas just got plain tired. That's a whole lot of work to do for 2 weeks and only having .2 units given total for the 14 days. Now this may be wrong thinking, and please someone tell me if it is, but she had so much help for almost a full year (and was on some pretty high doses for so long) that her pancreas just hasn't gotten used to spitting out insulin on an everyday basis. Could that be possible? I went to the .2 just in the last few days because the .1 wasn't hitting any greens (and I remember the post about if you never see a green, your dose is too low.) With the last 3 12 hr cycle and .2 at each, slowly her PS's came back down. Tonight we hit another no shoot. Maybe the .2 building up and giving her pancreas a chance to catch it's figurative breath will be enough for it to kick back in gear for another few days before it needs help again.

Then again I could just be anthropomorphizing a pancreas :roll:

 

Hey you! You could very well be right? Again, I WISH we had a rule book!!!! haha It's so wack not knowing what's right for our babies. I noticed when Steve & Blue went a little aggressive with going from 0.2 to 0.3 even 0.5 back and forth a few times... it seem to do the trick for Blue. (Those doses weren't exactly in that order... I'm just sayn') Pru hit me up with BG160 this morning, but I am going to wait it out awhile. What are you feeding Aria these days? Pru wouldn't really eat the past few days, so I am back to whatever gets her to eat. Now, I am noticing that when she has the Friskies Counrty Style Dinner... it seems to keep her higher in her numbers. ohmygod_smile I may start a post about what OTJ beans fed their kitties?

I'll check back with you guys later in the day.

 

We are back to feeding FF Chicken Feast. I need to pick up some more Sophisticat. She doesn't mind that mixed in, but will not eat it by itself. The Friskies was a bust, belly problems all around. Got some EVO 95% Turkey and that was a bust. They wouldn't even touch it mixed in. She is really partial to the FF Chicken feast. Just wish it wasn't so high in phosphorous. Supposed to go next week for another IStat. I'm hoping the improvement in her diabetes will transfer to overall better #'s even with her Creatinine and BUN.

 

That's great she is doing so well!!! Bix had a while when he was going several days between shots too - #s were good, but he started showing more signs of a problem, like weak back legs, and maybe not feeling great (I didn't notice at the time, but now that I am shooting more often he is more playful). I find I am more inclined to shoot on a lower # as the hours/days pass. If it's +24 and he's at say 125 he may still bring the # back down on his own, but as time goes on if he's not in the DDs I'm thinking he is probably needing insulin, otherwise he might hover for a long time in diabetic #s that are decent, but still taxing his pancreas. Back in those days of uber-duration/OTJ wannabee though I *didn't* shoot til the #s rose, which - learning experience, big sigh - was not the way to go for him it turns out.

Not sure if that helps, but regardless, it sounds like she is doing awesome, which is great to see!!!

 

Thanks Joanna - that does help. The 120's holding steady after a week without shots made me think a shot would be appropriate, but I had never shot that low. When I waited for it to come up to my shoot level, we ended up shooting a higher dose for more cycles, so it seems similar to what you saw. I think for the sitter I'm just going to have her shoot at my no shoot level, but I'll shoot if she's gone a while without a dose in the lower range.

 

Come on Aria! Show your mama some green!!! ;-) Hey, When are you going on vacation? Just thought about this, but did you tell your sitter about this site? Not sure how long you'll be gone, but maybe if she needs to talk to us or ask questions... she could jump on here? just a thought :idea:

Well, Pru had that 160 this morning, but gave me 70 at +2 PM, haha crazy cat confused_cat I'll check on you in the morning.

 

Good to see Aria is doing so well! So close to... you know. :smile:

I was tempted to shoot with Blusethlerion around those numbers, but he does not seem to do much with under .4U doses. Also, he did zip up to 130 and even 160 a few times recently (which is over his shoot threshold), but I held off hoping his panc would do it on it's own. Thankfully it did.

If she gets into green numbers on her own and then back to blue and then green again I'd be very patient. If she hovers in blue range then I also think dosing would be your best bet as Joanna mentioned.

Let's go Aria... stop teasing and just get it done! :mrgreen:

 

there seems to be this epidemic of kitties coming down on their own after their breakfast at next testing time. and a rash of very low but not entirely normal #'s.
I must say I don't remember this back 3 years ago when there were a whole lot more folks here with a whole lot more experience. it's really very unique. but back then i don't recall anyone even saying things like .1 or .2 u's.
It's a whole new ball game this time around.
Know what we used to consider lowering our dose from 1u? what we'd call 'a skinny u' :lol:

 

Lori, this made me laugh because the "fat" and "skinny" doses are driving me crazy currently. It's such an inexact science, I have no idea if I am giving the same dose from one cycle to the next. I guess it all depends on how sensitive your kitty is to small dose changes and how many units he/she is on. Obviously even one drop of insulin is going to make a larger difference on 0.5u than on 2u.