Am I doing this right?

First of all, I know that I'm lacking mid-cycle numbers. I have to work all day, so close monitoring isn't going to be an option this time. Last time he was getting insulin, I could keep an eye on him. So given the lack of monitoring, I'm wondering if I'm doing this right?

It doesn't look like much is happening right now, but without mid-cycle numbers, there isn't really any way to tell, right? If you look at his spreadsheet, I gave less when he was closer to 200 and I knew I wouldn't be home to watch. It was more than .75, but not 1.0. Since I'm using U40's, it's hard to be exact, so the .75 is sort of a rough number. Am I being too conservative? I'm just so afraid he's going to go hypo while I'm at work for ten hours.

I'm going to do a curve tomorrow, so hopefully we'll have a better picture after that.

As far as going hypo, both of my cats are grazers, so I give them food in the morning, they take a few bites, and then just nibble on the rest during the day. Which means that there is food out for them even when I'm not here. Last time he had this, he never had a hypo episode (thank goodness!), but I'm wondering if cats are likely to just go eat if they start to drop low, or if it happens too quickly for him to steer himself while I'm gone. Obviously I can't leave out high-carb food, but is just having access to regular low-carb food likely to help keep him safe (or at least safer) while I'm gone? I'm trying to figure out how conservative I need to be given the lack of monitoring this time.

Thanks for any insight on how this is going so far!

 

You, and we, will know a lot more when we see your curve. For now, you are making good, safe choices on pre shot numbers and leaving food out. (Some cats rush to eat when low; some don't). But yes, there is no way to tell how the dose is working or whether he needs more or less without those midcycle numbers.

Since you can't test during the week, you'll have to err on the side of caution then. And plan to get more data on the weekend to help you make a good decision on doses for the next week. It's not the best way, but lots of people do it like that because they have no choice.

One thing you can do is to get an out the door test whenever possible to see whether he is dropping low faster than usual. And an in the door test at night to get an idea of whether he moves up late in the cycle. Also a before bed test to catch a +2/3/4 when you can. All data helps.

 

Thanks so much @Sue and Oliver (GA) ! I stopped at home between meetings just now and grabbed a +5. It's not showing much change. I hate that I can't care for him as well as last time. I appreciate your encouragement to get in a few more when I can. He is drinking and peeing significantly less, so it seems like it's helping a little, even if the numbers aren't really showing that yet (at least not the few numbers we have). Why couldn't he have waited until summer vacation when I'm around more?!?

 

Looks like he could use an increase to get into the blues. I'd try a few days at 1.5.

 

I would not increase by 0.5 when he is in the 200s. If you increase after getting some data tomorrow, I would only increase by 0.25 - if he were mine.

 

It's pretty nerve wracking to have to work when caring for a sugar kitty...but we do it! I had to work full time too, and I found ways to get mid cycles when I could. I always tried to get them on weekends/holidays. I also would go downstairs and grab a test if I woke up during the night. And I would grab a before bed test whenever possible...+2 or +3 was my bedtime, so I'd get one then. You just do what you can.

As for food, I left food out all day too. My cats were grazers so the food was there for them to get some when they wanted it.

 

@Sue and Oliver (GA) I totally agree with you. The protocol is to make adjustments of .25, and says "If the cat is high and flat during the entire cycle, the dose could be raised by 0.5 units, as long as monitoring if possible." At this point we really don't know if he's high and flat since I haven't done a curve, and as I mentioned, monitoring is not possible due to my work schedule. So even if he is high and flat, I still can't keep him safe with large jumps in dose. Besides, it increases the odds of sending him into a bounce, and that really isn't really what I'm aiming for!

You taught me well last time I was on here!

@Rachel - Thanks so much for the encouragement. I'm trying to remind myself that really his numbers aren't all that terrible, and he just had blood work at the vet at the end of December, and at that time he was in good shape. I've continued to check him at home, so I know these numbers have just appeared in the past two weeks. He hasn't had it for long. So hopefully he'll be okay with a conservative approach for now. I'm very curious to see what the curve shows tomorrow!

 

@Sue and Oliver (GA) @Rachel, and anyone else who wants to chime in...

Can y'all take a look at the curve so far? Do you think I got a bad bottle of insulin? It seems weird that he isn't responding at all, doesn't it? I even poked myself to make sure the meter wasn't just stuck on those numbers. .

 

Is this a brand new bottle of ProZinc? The numbers do look strange. If it's fresh insulin try raising the dose to 1.25 u.

 

Yes, it's a brand new bottle and new test strips. I even changed the battery in the meter. When I got it from the vet, it honestly didn't feel cold enough and I even commented to the person who was helping me. Maybe I'll call and see if they would be willing to exchange it. I'm going out tonight, but I can up him to 1.25 in the morning and monitor him during the day. Although at this point, there isn't much to monitor, so maybe I should go ahead and up him tonight and just check him when I get home. It won't be until about +5.5 though. What do you think?

 

Hey there! Sorry I had to run to the pet store to get cat food...darn recall (seriously, though, I'm glad they caught it! And I was lucky my pet store had some Wellness in stock). Yeah he is just surfing along. My thought is with Kris..I think it's time to up the dose. However, if it was me, I'd wait until the morning since you can't monitor tonight. Most likely it won't cause a problem, but JUST in case it does make him drop, I'd wait. You just never know what could happen. He's not in terribly high numbers, which is good.

You could certainly ask the vet if they'd be willing to exchange it. I don't know if they would or not..but never hurts to ask.

 

Conversation I just had with the vet:

Vet: Well, it can't be the insulin. I'm sure that's fine. You just need to up his dose. Let's move him to 2.5 for his next dose.
Me: um...well....I can't be home to monitor him tonight, and that seems like a pretty big increase.
Vet: We always increase by at least 1.0, and he's being unresponsive, so that's why you need to increase by at least 1.25, so his dose should be 2.5 tonight.
Me: (Thinking inside my head - well, if he goes hypo and dies he'll REALLY be unresponsive!) Okay, well last time he was pretty sensitive to the insulin, so maybe I can increase to that slowly instead of jumping there at the next dose?
Vet: Yes, but what happened last time is unheard of. Sam is the only cat I've ever seen that has ever gone into remission like that.

And this is why I love you all so much! Because from being on this forum, I know that there are lots of cats that go into remission. And that there is a well traveled path for getting there. Or at least for keeping them safe while they try to get there. Why, oh why don't vets read these forums every day?!?

So needless to say, I am NOT going to increase him to 2.5 tonight. Geez! I'll up him in the morning, to 1.25, and we'll take it from there. He may well end up at a higher dose this time around, but let's get him there safely!

Did I mention how much I love you all?!?!

 

Good idea to up his dose to 1.25 u in the morning. What the blankety blank are (some) vets thinking??!!

 

Agree. 1.25 sounds good.