AMPS -325; +2- 142; +3- 73 (Vestulin)

http://www.felinediabetes.com/FDMB/...-today-appreciate-any-feedback-thanks.169741/

Did BG curve on Ozzy yesterday. You can see results on his SS. Above is a link to the thread I started on this yesterday. Asked a lot of questions at the end. If anyone has some answers or feedback, I could truly use it.

Ozzy has still been running high on only 1 U so while I'm home to monitor him, I tried to up his dose by a small increment to 1.25 U minus a drop. The vet had initially prescribed him 2 unit of vestulin.

His AMPS was 325. I just took his BG again +2 and it's down to 142 and he hasn't hit his +4 nadir yet. He is eating now. Will continue to watch him and test again at +3 and +4.

I cannot even express how FRUSTRATED I am right now. How am I ever going to get this cat out of high numbers if I can't give him more than 1 U of insulin at a time without his numbers crashing? And my damn vet hasn't called me in almost a week to talk about Ozzy's curve last weekend even though I've called and left messages.

The 1.25 minus a drop dose was barely over 1 unit. Right now I hate vestulin. It's driving me crazy with its unpredictability. The only thing I think I can be sure of is Ozzy's number will definitely be high again at the end of this cycle.

Sorry for the rant and vent.

 

Just did a +3. BG=73. He dropped his numbers in half again. He still has an hour or so to go to get to nadir. He is eating again now. Will test again 30 mins and post back.

 

Hi Joana,

You need to keep a close eye on things at the moment. (50's where you don't want to go below - as a precaution have your hypo guide and food/syrup tool kit ready to hand just in case you might need to give Ozzy something carby.)

Good plan to test after 30 minutes. Will check back in a while.

I haven't forgotten about your questions, BTW. Will look at them as soon as I can manage (might not be tonight - I'm exhausted).


Mogs
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No worries Mogs. Thank you.

Will post back in 30 mins. Got the hypo kit in arms reach.

Thanks.

 

Eating a little is a good idea, but I wouldn't panic. On a human meter you aren't too low until you are under 50.

 

+3.5= 71. Drop has slowed. He's eating again now. Will test again in 30 mins. He is almost at nadir.

 

Thanks Janet NJ. Not in panic mode yet, just frustrated that he drops so fast and so quickly. I was hoping to be able to up his dose a little so we could get his numbers down, but his +2 and +4s on Vestulin are always dramatic and then he is high the rest of the time. I'm not always going to be able to be home with him during the day to test him and give him food if he's going down fast.

 

Ranting and venting allowed here. It promotes mental health ... I commented on your other thread.

 

Thanks Kris. He is back up to 114 at +4 hours. So I am probably going to stop poking him the rest of this cycle. His ears look pretty bad after the zillon pokes last few days. A bit raised and just kind of swollen looking. Not sure if I am doing something wrong. I mean I'm getting the blood tests, just not sure if that is normal for them to be a little puffy. Can they get an infection from so many ear pokes?

Headed to the other thread now to check out your response. Really appreciate you and the awesome advice you keep providing! THANK YOU!

 

He was only diagnosed a month ago. I'd say that he's doing pretty good having preshots in the low 300's. Two months in my cat was still getting readings in the 400's. He will get there.

 

I understand your frustration, Joanna, but it's in the nature of the insulin you're using to see BG levels dropping hard and fast at the beginning of the cycle and then heading up again about 2/3 of the way through the cycle (although some cats do get better duration on Vetsulin; ECID).

I think, looking at Ozzy's numbers, for safety it would be advisable to stick to the 1.0IU dose of Vetsulin (unless it, too, starts taking him so low that there's no safety buffer in his BG levels - ideal would be for nadir in low 100s; any lower and there's no wiggle room for protection against a hypo event should something unexpected cause Ozzy to dip lower on any cycle). I think a dose above 1.0IU Vetsulin is too high.

It might help things a little if you were to give Ozzy a little snack at +1.5 to slow the drop. With a less precipitous descent to nadir Ozzy might stick around in a better range for longer mid-cycle. If it does even out the cycle for him there is a possibility that he might either not start to rise so soon in the cycle and/or possibly not get quite so high by time of next preshot.

To help with the patience side of things, now that Ozzy is on a low carb diet and getting support from the insulin treatment there will be less strain on the pancreas and, even though he may be in a moderately high range for part of each cycle, it will not have to work as hard. Even with this amount of respite the beta cells can show improved function over time. Here's a link to Beth's Elmo's spreadsheet:

https://docs.google.com/spreadsheets/d/1ZAoPctvtyhkyKhyx_vJh8ffy8ZTl_Ac1AqiCovCd_70/pubhtml

As you will see from the data Beth held the 1.0 unit dose for quite some time. Granted Elmo's preshot BGs were somewhat lower than Ozzy's are at the moment but you can see from the data that steadily and gradually Elmo's preshot BG levels trended downwards - without a dose increase! His pancreas was slowly healing/his body was becoming more sensitive to insulin again.

As Elmo's treatment progressed you can see how the overall range of his BG levels gradually came down until it was necessary to reduce the Vetsulin dose because he was dipping way too low at nadir. As more time has passed Elmo's pancreas has recovered more beta cell function and his insulin requirements have been steadily decreasing.

I hope the above real-world example helps you to understand a little more of how the gradual process of regulation works.


Mogs
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I am thinking so too. Thank you for your honesty and for making it bold so I don't miss your emphasis. I will stick with the 1 u for now. The vet prescribed 2 u and we have never given him that much yet. Could you imagine if we followed that advice when we came home from the hospital and hadn't gotten the meter yet to home test!

I wanted to try to test a few different doses slowly while monitoring, and I agree with you that the vestulin at the higher dose is just too risky.

 

Mogs- this actually answers some of the questions I had on my other post about Ozzy's glucose curve yesterday. Thank you! Yes, I was curious if he could/would eventually come down over time on the same dose and we just need to wait (be patient). I wasn't sure if you had to increase insulin to get there or if over time he would come down on his own.

Very much appreciate you sharing Beth's SS. Having an example of a kitty on the same insulin as mine and seeing the gradual drops and fluctuations over time definitely gives me a better idea of what happens. (Also answers one of my questions about what the process looks like). Hope Ozzy's SS looks like Elmo's someday!

Thank you!!!

 

Oh wow! Ok, thank you so much for the feedback. This is really helpful.

As you can see, I am still so new to all this. I just don't know what to expect, what's normal, what's not normal, how long it takes...etc. On the OTJ forum, some guy's cat went into remission in like 2 weeks. Another person said their cat immediately started getting better once he was switched to low carb wet food. Maybe that's an exception and not the norm. It doesn't help that my vet is not calling me back to answer my questions. He is a hospital vet and they are always so busy with emergencies. I have really appreciated all the support and advice from everyone on this board. Can't thank everyone enough for their time and care in taking the time to respond!

 

And then there are kitties like Teasel who was diagnosed in January of this year and STILL isn't regulated!! Mind you, he's an outlier and a particularly tricky cat. I just plug away at it and have a wardrobe full of "Patience Pants" as we call them.

 

I hope he gets there,Kris. He deserves it and so do you. Thanks for all your support. Your have been so kind and wonderful to me.

 

You're very welcome!

 

@Ozzy Pawzbourne - First pair's on the house ...

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Mogs
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THOSE PATIENCE PANTS ARE AWESOME! LOVE THEM. Where can I get a pair!? Hah!

 

I have been poking Ozzy's ear in the marginal vein that runs along the ear. Is this not the correct spot?

 

Click on this link to see a really helpful diagram of where to find the 'sweet spot' on the ear. It's just between the edge of the ear and the MEV.

Testing and injecting tips


Mogs
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Keep an eye out for the FDMB 2017 Fall Collection: it features a line with matching Big Girl Pants.




Mogs
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Nice!

 

Thank you for the link. The tips were extremely helpful. I have been stabbing my poor kitty in his vein several times a day for the past 2 weeks, instead of the 'sweet spot'!
No wonder I got blood so easily... I was like, "wow, I don't even have to warm his ear I'm getting so good at this!"

And I didn't even know the sharps had a beveled edge! Wow!

 

I don't think you're the first and I doubt you'll be the last!


Mogs
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