Bella’s FD journey part 2

Discussion in 'Feline Health - (The Main Forum)' started by Bellasmom, Mar 3, 2018.

  1. Bellasmom

    Bellasmom Well-Known Member

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    Bella seems to be doing better today with his UTI
     
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  2. Bellasmom

    Bellasmom Well-Known Member

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    Bella’s sugar so high it won’t register
     
  3. krazy4kritters

    krazy4kritters Member

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    Last edited: Mar 3, 2018
    Reason for edit: Added tag
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  4. Bellasmom

    Bellasmom Well-Known Member

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    re tested 45 min later 569, so it’s going down, he is just sleeping is that normal
     
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  5. Nan & Amber

    Nan & Amber Well-Known Member

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    Hi--

    I'm sorry, I'm currently out of town so I haven't had a chance to do more than quick checks of the boards over the last several days. Give me a minute to review Bella's recent history.

    Question: when was the last time you checked for ketones? When running high with a UTI in the picture, you want to be extra-diligent about that.
     
  6. Bellasmom

    Bellasmom Well-Known Member

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    I just checked and it was neg
     
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  7. Nan & Amber

    Nan & Amber Well-Known Member

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    I don't see the "HI" or 569 on your spreadsheet for today-- are you in the PM cycle now? When?

    I"m guessing this is another bounce from some low-ish numbers this afternoon. As long as he seems otherwise OK (eating/drinking, and, when you get a chance, clear of ketones), there's really nothing you can do other than wait it out :(.

    Hope he continues to improve re the UTI (and your other kitty, too!).
     
  8. Bellasmom

    Bellasmom Well-Known Member

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    I fixed it sorry
     
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  9. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Just seeing this now. I've been away from home. Looks like bouncing but the UTI might also be having an effect - or possibly the meds. I'm glad you got a ketone test. How is he acting?
     
  10. Bellasmom

    Bellasmom Well-Known Member

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    +2 296
     
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  11. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Nice drop. Try for a +4 if you can.
     
  12. Bellasmom

    Bellasmom Well-Known Member

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    Sleeping, he has slept quite a bit today
     
  13. Becky & Baby Girl Kitty

    Becky & Baby Girl Kitty Well-Known Member

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    Baby’s UTI caused some high numbers, an infection can cause everything to be out of whack. Just so you keep testing for ketones in the next couple of days would be a good idea. When you can. Sleeping is probably healing or could be just wore out, high numbers, or even the meds. As long as you’re checking the bg & ketones you will be ok. You know what to do. Baby is sleeping a hunch today but it seems she goes for days & then has a crash day. You got this!
     
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  14. Kris & Teasel

    Kris & Teasel Well-Known Member

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    I think you can go to 1.75 u tomorrow AM.
     
  15. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Those darn blacks! However, you have an almost 100 point drop between PS and +1 on this increased dose. If it's at all possible another test or two in the +4 to +6 range would be very useful info. You're nearing the dose that dropped him to lime green a while ago so some extra vigilance is in order. Is he feeling better with all the meds? Eating well? Peeing appropriately?
     
  16. Bellasmom

    Bellasmom Well-Known Member

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    I can’t test him again till 230 when my husband gets home, I had to work today i will be gone till 7pm, do u think he will be alright I left food down OMG
     
  17. Bellasmom

    Bellasmom Well-Known Member

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    He didn’t eat a whole lot but someone said if there BG is high they don’t eat a lot, he is peeing, do u think the meds are affecting his bg, he just acts like he doesn’t feel very good
     
  18. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Antibiotics can cause tummy upset so that could be what's making him feel "off". Try not to worry about his BG while you're away. That 2:30 PM test will be fine and you've left food. I'm sorry if I alarmed you - I don't think he'll dive into lime green.
     
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  19. Bellasmom

    Bellasmom Well-Known Member

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    What do you think of Young again cat food
     
  20. Kris & Teasel

    Kris & Teasel Well-Known Member

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    I've never used it. I know that people with die hard kibble addicts feed some of it in addition to low carb wet food because it's low carb kibble. I know that in general wet food is better from the point of view of proper hydration, kidney function, etc. Dr. Elsey's Clean Protein also comes in canned and kibble form - also low carb. If Bella likes what you're currently feeding him (when he's feeling good, that is) you probably don't need it. Your choice, though ...
     
  21. Bellasmom

    Bellasmom Well-Known Member

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    Ok just making sure I’m giving him what’s best for him, you would be proud of what I did with all my anxious energy yesterday, are we allowed to post pictures on our threads??
     
  22. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Yes, absolutely! We like pictures. Some people choose to show their face, some choose not too. Kitty faces always welcome! :smuggrin:
     
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  23. Bellasmom

    Bellasmom Well-Known Member

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    0E0AE974-277A-43F5-B861-BE12BDD90358.jpeg
    I moved shelves around, got out some carpet had in the shed and made a cat wall for the cats to lay or sit on, I had a shelf behind the love seat, that’s the one bella is sitting on in his profile pic so I thought why it a whole wall
     
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  24. Kris & Teasel

    Kris & Teasel Well-Known Member

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    This is fantastic!! My kitties would love something like this! :D:D:D I see that shelf full of cat toys near the floor. :smuggrin: Mine have a basket full near their cat furniture. I have a tower and two story condo in front of my living room window. They spend a lot of time there. Love your kitty themed wall decorations too.
     
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  25. Becky & Baby Girl Kitty

    Becky & Baby Girl Kitty Well-Known Member

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    @Bellasmom - your cat wall is amazing! Love it! Baby has her own box with tissue paper, long basket on legs with her blankets. But nothing high anymore... great idea! I ordered the YA chicken treats & she loved them for after testing treats. But not today! I don’t know what happened but she’s still sitting by her old temptations drawer looking up. I don’t know what to try next short if cooking her a chicken! I’m not even sure she’d take that over her old beloved treats?!? The freeze dried chicken has no smell or not enough to even make her stop & search for it! Don’t know what to do!
    Baby’s number are not going down much at the end of her cycle. Nadir is good but I feel like you - afraid to leap up that she’ll go too low! Help! Sorry to chime in on your thread! Take a pic of cats in the wall when they get there! I’d love to see that!
     
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  26. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Maybe try some stinkier freeze dried fish treats, Becky? Some people buy bonito flakes (tuna) from Asian grocery stores and you can find freeze dried shrimp and salmon in some pet stores. All very stinky.
     
  27. Becky & Baby Girl Kitty

    Becky & Baby Girl Kitty Well-Known Member

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    Lol ok she’s normally a land lover type but it’s worth a try. I wonder if Walmart has them? If not therers a little health market near by & I bet they would carry them! She loves stinky cheese... stinkier the better! Thanks Kris!
     
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  28. Bellasmom

    Bellasmom Well-Known Member

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  29. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Good drop! Unless anything changes, give 1.75 u tonight and tomorrow. Try for a +2 or +3 this evening. Next step up will be 2 u but we have to keep meds and UTI in mind.
     
  30. Bellasmom

    Bellasmom Well-Known Member

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    I have worried all day about it being so high and I was so glad when he text me that number
     
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  31. Kris & Teasel

    Kris & Teasel Well-Known Member

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    The highs can look scary but the good drop he had is more important in judging the dose. :)
     
  32. Bellasmom

    Bellasmom Well-Known Member

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    When is BG dangerously high and what happens
     
  33. Kris & Teasel

    Kris & Teasel Well-Known Member

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    If it's only a few very high numbers very little happens. If it's very high for many days or longer it increases the risk of ketones developing and the kitty will feel ill. That can lead to lack of appetite and that, too, increases ketone risk.
     
  34. Bellasmom

    Bellasmom Well-Known Member

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    490 +12, here we go again, 1.75 now after he eats or wait an hr
     
  35. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Let him eat then wait at least 30 minutes. Novolin hits hard so he needs food in his system.
     
    Last edited: Mar 4, 2018
  36. Bellasmom

    Bellasmom Well-Known Member

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    +2 278, we have a yellow as well
     
  37. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Nice drop. Stick with 1.75 u tomorrow AM and PM.
     
  38. Bellasmom

    Bellasmom Well-Known Member

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    We were lower this am at 411, gave 1.75 and he seems to be feeling better this am, he ate better, can’t retest till 230
     
  39. Kris & Teasel

    Kris & Teasel Well-Known Member

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    I'm glad he's feeling better. The 2:30 test will be fine. :)
     
  40. Bellasmom

    Bellasmom Well-Known Member

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    Higher now than it was this am +9 431
     
  41. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Don't worry. He might have been lower a bit earlier and this is a rebound or "bounce". I suggest 1.75 u again tonight and then up to 2.0 u tomorrow AM.
     
  42. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Here's something for you to think about - no rush needed: it's possible that Novolin is causing the reds and blacks on your spreadsheet because of the way it works. It hits fast, drops BG quickly and can drop it quite low if the dose is the slightest bit too high. In other words, it's aggressive in its action. That can be the reason why Bella's curve is deep - eg., red to green to red or red to blue to red.

    Has Bella been on Novolin right from diagnosis? What was your vet's explanation for prescribing that particular insulin? I know it's economical to use and that can certainly be an important factor. He obviously responds to it because you have blues and greens on your spreadsheet. It's the reds and blacks at PS I'm looking at more. It's possible that a slower acting, gentler insulin might help you get those PSs down and flatten out his curve.

    If you're interested, I can tell you what I know about ProZinc, Lantus and Levemir. I've used all three for Teasel. :)
     
  43. Bellasmom

    Bellasmom Well-Known Member

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    He has been on it since beginning, am I able to get it without script like I can the Novolin and are the other ones expensive
     
  44. Bellasmom

    Bellasmom Well-Known Member

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    I looked and this is what I can get OTC B4428D59-43D3-472B-B57A-ABBF76AD1E07.jpeg
     
  45. Kris & Teasel

    Kris & Teasel Well-Known Member

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    ProZinc is a veterinary insulin for cats so it has to be bought through your vet or from an online pet pharmacy. It's very expensive (about $100+ for a 10 mL vial) and is less concentrated than Novolin (U40) so you'd go through it faster. It's action is similar to Novolin but slower and gentler. A 10 mL vial contains 400 units so the cost per unit is about $100/400 = $0.25 (25¢) per unit. If you use 4 u per day on average (2 u AM and 2 u PM) a vial should last 400/4 = 100 days max. Breaks down to about $30 a month at about 4 u per day.

    Lantus is a prescription human insulin that works very well in many cats, is very slow and gentle in its action and can flatten out BG numbers well. It's extremely expensive in the US ($300+ per 10 mL vial) but is as concentrated as Novolin (U100). Many US people on FDMB get their vet to fax a script to a reputable Canadian online pharmacy, Marks Marine Pharmacy, in Vancouver. They ship to many US users. The cost for a 5 pack of 3 mL cartridges, a total of 15 mL of insulin, including shipping, is around $180 US - a little over half the price. However the cost per unit isn't too bad when you work it out. That 15 mL of Lantus gives you a total of 1500 units and that means a cost of $180/1500 = $0.12 (12¢) per unit. If you use an average of 4 u per day that 1500 units should last 1500/4 = 375 days or about a year. You won't waste any because each cartridge is small enough to be used to the last drop and the rest of the pack is good in the fridge until expiry, about 2 years down the line usually. So the cost breaks down to about $15 a month if you use about 4 u per day on average.

    By contrast, Novolin N is OTC and is about $25 per 10 mL vial, right? That's 1000 units at a cost of $25/1000 = $0.025 (2.5¢) per unit. Using about 4 u per day it'll last 1000/4 = 250 days or over 8 months. However, it probably should be discarded well before that because it'll lose its potency.

    There's no doubt that Novolin N is the most economical and it might be what your vet prefers. Levemir is similar to Lantus in cost and works in a similar way. If you decide down the line you want to try something else you could ask your vet about Lantus.
     
  46. Kris & Teasel

    Kris & Teasel Well-Known Member

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    I see that low yellow - nice! Go with 2 u tomorrow AM.
     
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  47. Bellasmom

    Bellasmom Well-Known Member

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    I called vet about new insulin and he said I would have to bring him in and let him stay there a cpl days he won’t just give me a script, I can’t financially do it right now, just had a vet bill and trying to get that one pd first
     
  48. Kris & Teasel

    Kris & Teasel Well-Known Member

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    You have to do what works for you financially. I'm not sure why your vet wants Bella there for a few days though ... o_O When Teasel was diagnosed, I was sent home with some Lantus and told to do a curve at home after a week and email the data to my vet. Every vet is different.
     
  49. Bellasmom

    Bellasmom Well-Known Member

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    I have a thought, can his insulin be given in smaller doses 3x a day wonder
     
  50. Bellasmom

    Bellasmom Well-Known Member

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    When he was diagnosed they kept him for several days
     
  51. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Yes, it can but it's extremely hard on the owner because you have to test a lot to track what one dose is doing before you give the next. If one dose lasts a bit longer than usual it'll overlap the next dose and maybe drop the BG too much, etc. It's not something I'd want to do myself.

    I'm guessing that your vet's thinking is: change insulin --> keep cat several days to track first dose level and see how cat tolerates insulin --> do a curve to assess dose --> change dose based on curve done in clinic --> send cat home. This often ends up with a kitty being overdosed because of stress elevated BG at the clinic. He might want to do this to be very cautious in making any change. If Bella was new to insulin and you a new care giver it might make sense but he isn't and you aren't. However, I don't want to get in the way of your relationship with your vet. If you really like him, you don't want to create a problem.

    Just keep this idea of another insulin in the back of your mind for now. You might be able to do something different down the line. :)
     
  52. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Well then! If you have a notion to change vet sometime down the road you could call around to see how much experience they have treating diabetic kitties and/or take Bella in for a "meet and greet" where you go armed with a good list of questions. There's a good list here on FDMB somewhere. This is expensive so you want to get your dollar ducks in a row. :) A couple of visits to "test out" a vet or two should give you a feel for their manner, level of FD knowledge and most important of all their willingness to work collaboratively with you on treating Bella's diabetes.

    Please don't think I'm twisting your arm - I'm not. I truly understand the financial constraints involved in treating FD. It just seems that you might have an opportunity here to rethink this. A vet that works with you and knows you can monitor at home, know how to adjust doses, etc. can save you money because that vet won't require expensive stays at the clinic for curves, etc. Food for thought ... :)
     
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  53. Bellasmom

    Bellasmom Well-Known Member

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    Great idea
     
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  54. Bellasmom

    Bellasmom Well-Known Member

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    +8 231
     
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  55. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Not bad. :)
     
  56. Bellasmom

    Bellasmom Well-Known Member

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    When you get time will you look at Bella’s spreadsheet, and hubby forgot to take before insulin, I’m sorry and I did tell him how important it was to do it
     
  57. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Don't worry - mistakes happen. It looks like this cycle is similar to others recently. Is there a reason why the dose was dropped a bit to 1.75 u? Was it because of no PMPS? Not a problem - just go back to 2 u tomorrow AM, numbers permitting.
     
  58. Bellasmom

    Bellasmom Well-Known Member

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    Is that what I put, omg, I’m wrong, it was 2, sorry, just tired
     
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  59. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Any chance of a test before +8 today or a little later this evening? We need some data from those areas to see what the dose is doing. You can't tell with only the PSs - eg. on Feb 24 you would not have known how low he went if you only had PS numbers.

    You're getting close to 2.25 u where he had some green action a while ago. He might not this time but I suggest you keep 2 u until your next day off and do a full curve so we see how he's responding to it. Are you off this weekend?
     
  60. Bellasmom

    Bellasmom Well-Known Member

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    Yes my husband can do a test this am around +3 and yes off all weekend
     
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  61. Bellasmom

    Bellasmom Well-Known Member

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    He only has to go in for a meeting from 11 to 3 today so I’m having him do 1 at +3
     
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  62. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Good - we have a plan. :)
     
  63. Bellasmom

    Bellasmom Well-Known Member

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    I’m also going today and get a human meter and strips after I get off work, will have to change my spreadsheet, is there a certain way I need to do that
     
  64. Kris & Teasel

    Kris & Teasel Well-Known Member

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    I'm not sure. We usually refer these techie things to @Marje and Gracie to fix. Maybe @Chris & China can help. She sets up SSs for people. Really, all that changes is the automatic colour coding cutoff for lime green. It'll be lime green for anything below 50 on the human meter version whereas it's below 68 on your pet meter version. I'm not sure if it would hold onto the colour if you manually changed any number between 50 and 68 to dark green on the SS you're using now.

    Are you going to buy a Walmart ReliOn meter? Very popular and strips are fairly cheap for the models that take only a tiny blood drop (Micro or Confirm). We have Walmart here in Canada but they don't carry those meters - don't know why. I use a Freestyle Lite but its strips are pricey in the US. All meter strips are expensive here - it's the human insulin like Lantus that's a lot cheaper - and I can buy it OTC.
     
  65. Bellasmom

    Bellasmom Well-Known Member

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    Yes Walmart and I will check with Chris and China if I need help thanks so much
     
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  66. Bellasmom

    Bellasmom Well-Known Member

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    One more thing how much are they off from one another, or somewhere close
     
  67. Kris & Teasel

    Kris & Teasel Well-Known Member

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    You'll have to get used to seeing a different range of numbers. Human meters read lower than pet meters but the difference is much bigger at high numbers and less at low numbers. The array of colours on your SS will change - reds will be pinks, pinks will be yellows, etc. There's no easy conversion between pet meter numbers and human meter numbers so it's best to just shift your focus to human meter numbers and forget the pet meter all together. Too high is too high on either meter. The important number is the "take action" number where you want to give a little snack to prop up the BG. It's 50 on a human meter whereas it's 68 on a pet meter. Almost everyone here understands human meter numbers if you ever need help quickly.
     
  68. Bellasmom

    Bellasmom Well-Known Member

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    Omg omg omg we have a BLUE number:):):):):):)
     
  69. Kris & Teasel

    Kris & Teasel Well-Known Member

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    :D:D:D:D:D I'm so glad you caught those tests today!! Good info to have to assess this dose.
     
  70. Bellasmom

    Bellasmom Well-Known Member

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    He has appointment next sat with another vet, there are multiple vets and 2 are real good with diabetic cats, office visit is cheaper and they are open 7 days a week
     
  71. Kris & Teasel

    Kris & Teasel Well-Known Member

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    My goodness! you certainly didn't let the grass grow under your feet! ;) I hope one of the new vets is someone who'll work with you and understand that you're perfectly capable of being hands on with Bella's treatment.
     
  72. Bellasmom

    Bellasmom Well-Known Member

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    I explained what I wanted and the vet tech I talked to, I didn’t want to talk to receptionist lol he said they do work with you in his treatment so we shall see
     
  73. Bellasmom

    Bellasmom Well-Known Member

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    Yes I will do anything bella needs
     
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  74. Bellasmom

    Bellasmom Well-Known Member

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    Oops I forgot I have a question,so Bella’s number was good this afternoon, so if I go home and take it and it’s back to over 400, what makes it jump like that it can’t be food
     
  75. Kris & Teasel

    Kris & Teasel Well-Known Member

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  76. Kris & Teasel

    Kris & Teasel Well-Known Member

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    It can jump up for a few reasons:
    • Novolin isn't lasting a full 12 hours so the AM dose peters out well before the PM dose time
    • he's rebounding from the much lower blue number - the drop from 439 in the AM to 132 at +8 is a big one
    • the way Novolin works: it starts to work quickly, can drop BG fairly low and can poop out before the 12 hour mark. Those are the characteristics of this insulin in cats. That's why I brought up the subject yesterday.
    The faster acting in-and-out insulins (meaning they go in, get used up and nothing is carried over into the next cycle) like Humulin N, Novolin N (human insulins) and Vetsulin, a veterinary insulin (originally for dogs) all have this type of action. It's in their nature to give a deep BG curve after a dose and they tend to have less than 12 hour duration.

    ProZinc is a veterinary insulin that is mostly in-and-out in its action but there can be some carry over of a dose into the next cycle, so good duration. It's slower in onset and gentler in action so it can produce a shallower BG curve after a dose. Some cats till react fairly dramatically to it though.

    The two depot insulins, Lantus and Levemir, are the slowest in onset, gentlest in action and tend to have longer duration. They still have to be given every 12 hours. What the "depot" means is that a little of every dose you inject is stored under the kitty's skin and is released slowly somewhat like a time-release medication. That means there's always a little bit of insulin doing some work and one dose blends into the next quite smoothly. That can reduce ups and downs in BG and result in a much flatter BG curve in a cycle. This effect will be more pronounced in some cats than in others. Really bouncy cats (like mine!) will still bounce.
     
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  77. Bellasmom

    Bellasmom Well-Known Member

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    +12. 172, no insulin???
     
  78. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Whoa! That's amazing! No shot for sure because you have no data on giving insulin at a low PS like this. I see the yellow at +2. Did you feed him before that?

    He'll probably be high tomorrow AM but I suggest dropping the dose back to 1.75 u.
     
    Last edited: Mar 7, 2018
  79. Bellasmom

    Bellasmom Well-Known Member

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    Yes I feed at 5 insulin 1 hr later
     
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  80. Kris & Teasel

    Kris & Teasel Well-Known Member

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    His number might be lower because his UTI is clearing up.
     
  81. Bellasmom

    Bellasmom Well-Known Member

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    Do you think it’s gonna be crazy high in the am
     
  82. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    It probably will be because of the skipped dose tonight. It's no worse than having an accidental fur shot. Just resume in the AM at 1.75 u.
     
  83. Bellasmom

    Bellasmom Well-Known Member

    Joined:
    Feb 12, 2018
    Good, so no worries, I can sleep tonight, thanks so much
     
    Kris & Teasel likes this.

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