Bouncing numbers....without insulin?!?

Discussion in 'Caninsulin / Vetsulin and N / NPH' started by Amanda and a Loudogg, Aug 2, 2017.

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  1. Amanda and a Loudogg

    Amanda and a Loudogg Well-Known Member

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    Jun 16, 2017
    Evening all!
    My buddy Lou has been taking my husband and I on a bit of a joyride. He decided he wanted to try an OTJ trial on 7.17.17, and his numbers were absolutely beautiful until literally Day 14, when his number jumped to the 120s. I had posted previously in another thread wondering when to call the OTJ trial a fail, but now I'm having other issues that I'm so confused about. I figured it would be easier to start a new thread and see what everyone here thinks.

    So Lou's BG bounced up to the 120s, and we waffled on giving him some insulin assistance to help him get back down, but I also wanted to give him a chance to get to lower numbers himself. Finally, after two days, I decided to give insulin the next morning (Tuesday) if he was higher. He was only at 129, so I decided to wait until the evening after work so I could monitor his progress. To my everlasting shock and surprise, he was at 87 last night. We were on the right track. Unfortunately, this morning his AMPS was 145. I tested him a couple hours later because I worried my meter was off, but he was at 151. My first instinct was to give him insulin this morning, but the sudden drop last night really worried me about how he'd react. I just tested him this evening and he's back down to 93.

    I am soo confused!! :arghh: How can a cat be bouncing so much without insulin?! He seems perfectly fine, but I'm wondering if he's been eating more. We feed FF cans and YAZ to graze, and he's been eating more of the YAZ, but we haven't always been feeding as much of the wet food, so I can't be sure if he's actually eating more or if I'm just being a worrywart. Does anyone have any ideas?! I haven't the foggiest notion where to go from here.... :nailbiting:

    Thanks in advance! (And I'm sorry about the book, haha)
    Amanda
     
    Last edited: Aug 3, 2017
    Reason for edit: Correcting the OTJ date!
  2. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Feb 18, 2015
    There are several plausible theories to explain the upsweep you've seen.I'm going to throw something out there that some may think is totally nuts but given what I have seen with my own cat and what I've heard from others, and our mantra around here that every cat is different, here are my thoughts on what might be going on with Lou.

    Every living organism has a balance or equilibrium it seeks to maintain. With our diabetic cats, we don't have baseline "before diabetes" BG tracking on which to compare what their normal was vs. what their readings are when they are diagnosed with diabetes. There are humans diabetics that feel better if they keep their BG a little higher than what conventional medical advice would suggest is "normal". Normal is relative and in some cases may be a bit lower or a bit higher than the numbers documented and used as gospel. Why should our cats be any different?

    The highest numbers you are seeing right now are not that elevated. Your meter could be reading slightly higher in that "normal" range than the meters that were used to establish feline norms on a human meter and that could mean that your meter reads closer to a pet meter than some others and Lou's numbers are within normal based on pet meter normal range.

    There is certainly the possibility that he ate a bit more thus raising his BG that little extra or maybe he was hearing something you couldn't hear and was stressed or excited when you tested. Have you been withholding food for 2 hours prior to those higher tests since starting the OTJ trial or was Lou allowed to graze right up to your testing time?

    I can well understand your reluctance to give Lou any insulin when he is bouncing between not needing insulin and possibly needing a teensy dose. I understand how stymied this leaves you. If it's any help, you are not the first to experience this conundrum. There was a kitty several months back who got threatened with a change of insulin to get him over that final hump very similar to what Lou is doing. Little rascal waited till his Mom got the new insulin already to start a new chapter in their journey when his numbers leveled out in normal range and he is still in remission now. She never got to try the new insulin.:joyful:

    So IMHO, I'd give him another week of testing to see what he does. If he keeps holding his current numbers and doesn't go any higher, he could just be happier at slightly higher numbers. He's well below renal threshold so there is no harm in seeing if he can maintain those numbers without any insulin support for the moment.
     
  3. Amanda and a Loudogg

    Amanda and a Loudogg Well-Known Member

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    Jun 16, 2017
    Thank you so much for your reply Linda. I think your thoughts seem perfectly sound and totally logical, and they really do seem like they may be the case. I've actually wondered often what his normal was (or what his new normal is), but he doesn't actually stay at any number long enough to establish anything. Besides all that, I think the fluctuations in meters don't really help matters either, so it makes it really hard to pinpoint a new normal.

    Health and personality-wise, Lou seems perfectly like himself. Lovable, crazy, and even downright weird at times (there's a reason we call him our crazy, wacky Loudogg). Regardless, I have found myself really focusing on his food - particularly what he's eating and how much of it. I don't feel I really paid as much attention previously, just as long as he was eating when I needed him to and that his food was low carb. I never officially pulled his food away (he has YAZ available at all times, and we would not feed any wet at least 2 hours prior to preshot BG checks) throughout this ordeal. While on insulin, he wouldn't eat much of the YAZ, being more excited for the wet food. He mostly ate the dry at night, but generally only grazing. I would only give 1/4 cup of the YAZ once every day or two. During the last week or two, I feel like he's been eating a lot more of his dry food, and at times, not finishing his wet. I've had to give 1/4 cup scoop daily, and even twice yesterday. In the last few days, after the fluctuations started, I have tried to pull away food, and possibly withholding food for longer than I should. I am worried something is up, but all I have to show for it is his seemingly increased appetite (or possibly just changed - maybe he's just enjoying the dry more right now), and the changing BGs. So long story short (too late, haha), it's possible I'm stressing him out by stressing myself out, but I'm not entirely sure what to do about that, since his eating habits have changed. I'm not sure whether I should just give him plenty of food and just feed some wet throughout the day as usual, or if I should try to limit things. Who knows, haha. Obviously this is a new path in our FD adventure, so it's hard to figure out what his "new" normal is now that his BGs are regulated (for the most part).

    Additionally, I got my glucometer from work (I'm a lab tech), and the original strips expired October 2017. I haven't had any issues with it or any reason to doubt it, but I've been worried with these seesawing BGs that maybe my meter is on its last legs. I have no real reason to feel that way except the numbers in the last few days. I've debated just getting an Alphatrak (so his numbers will be in line with what the vet expects), or getting a new meter to put my mind at ease. Ultimately, I imagine he's picking up on some of my stress and indecisiveness, but considering I haven't been completely flipping out, I'm not sure how much my whirling thoughts would affect him.

    Ugggghhh. I feel exhausted mentally (it sucks being an overthinker). I really like your idea of gathering some more data since knowledge is power. I think I'll forgo thoughts of dosing insulin unless he goes above 150. Hopefully his numbers will mellow out, and soon. I don't do well with unknowns, haha. Not the best place to be during a FD adventure. :p
     
  4. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Feb 18, 2015
    Oh I can so relate on both counts! And we have our medical careers in common too. I'm a retired R.N.:smuggrin:

    I have a high dose kitty who refused to eat wet food until a few months back. And here in Canada, we don't have access to any dry food under 10% carbs so when her insulin autoantibodies broke, her dose plummeted. Then when she suddenly decided to eat wet food of her own free will, (after a 6 year battle I started when she joined our family) her dose plummeted again and I felt like I was starting at square one. It's a wonder I don't have a bald spot from all the head scratching I have and continue to do with her. Obviously our cats don't read the manual and every one of them makes up their own steps to this sugar dance.

    Maybe if you go back to monitoring food intake and limiting the dry food again, Lou's numbers will come back down. BG is constantly fluctuating in all of us and the level of hydration will effect BG too. It's possible Lou is a bit less hydrated than he was because he's eating more dry than he was before. Just thinking out loud.....

    If you are worried about your meter, change the battery. I found out the hard way that one of my meters will read high when the battery gets close to petering out. I wouldn't bother getting an AlphaTrak. The strips are crazy expensive (more than double the cost of my human meter strips), not readily available locally, and you'll drive yourself crazy because the numbers cannot be converted to the human references here and will be a bit higher. It's like learning a whole new language. I started out with an AT2 meter and did a massive amount of dual testing with both before switching to the human meter and I honestly don't think it's worth bothering to go that route. All meters have variances and will read a bit differently so if I were you, I would stick with the one you have so as not to muddy the waters when it comes to monitoring how Lou is doing at this point in time.

    I'm sending positive vines your way and will be watching to see how Lou is doing. Keep your chin up! Lou will get his act together! ;)
     
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  5. Elizabeth and Bertie

    Elizabeth and Bertie Well-Known Member

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    Sep 6, 2010
    Hi Amanda,

    I know this must be frustrating for you. (((Hugs)))

    The numbers aren't 'bouncing' exactly ('bouncing' is the body's response to when the BG drops too low or too fast). They're just slightly elevated compared to what they were some days earlier. Sometimes it happens like this. Cats' BG numbers can be 'spiky' sometimes and we may never know what causes an unexpected rise. (I'm assuming your kitty is otherwise healthy, and peeing and pooping OK? And not throwing up furballs? (even things like that can affect the numbers.))

    I realise too that we can possibly create an expectation on this forum with regard to OTJ trials: We often say that after 14 days in normal numbers the cat is deemed 'in remission'. But although that very often happens, it doesn't always go that smoothly. Sometimes the numbers rise and then come down again on their own. Sometimes the numbers rise and it becomes necessary to give a little insulin again, and to start the 14 day count over again. That's all OK. Every cat is different.
    It also occasionally happens - although it is quite rare - that a cat might continue to need small amounts of insulin from time to time and won't go fully into remission.

    I agree with Linda's advice above about waiting for a week (unless you see a significant rise and it becomes clear that insulin is needed sooner than that). The numbers may well settle out on their own.
    And if you do see the odd higher number that may not be reason to give insulin immediately. You could try feeding a little low carb snack and then seeing if the number has dropped on its own a few hours later.

    Relax, Amanda. Breathe.... There's a good chance things will settle out just fine. :bighug::bighug::bighug:

    Eliz
     
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  6. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Aug 17, 2016
    Very interesting discussion, folks! :)
     
  7. Amanda and a Loudogg

    Amanda and a Loudogg Well-Known Member

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    Jun 16, 2017
    Good morning everyone!
    So this morning's AMPS was at 157!! I feel like since he hit 150, I should give him insulin, but I've seen him drop from 145 to 93 before without. Should I give insulin this morning or not? I'm not sure at what number should I give insulin in this mini trial we're doing.... An obvious number would be over 200, but I'm just not sure. Also it's Sunday and I can actually monitor him today, while tomorrow I'll be back to work most of the day.

    What do you think? Between yesterday and today, he has definitely trended upward, but of course the day before he was higher, then dropped into normal, so... I just need to know if it would be more important right now to stay the course and continue to monitor or to try and get him down closer to normal.
     
  8. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Feb 18, 2015
    Sorry Amanda. Just seeing this now. I see you decided no shot today and I think I would have made the same call.

    Are you still closely monitoring Lou's food intake or have you been less vigilant about it as the OTJ trial progressed? Are you still withholding food for 2 hours prior to those shot times tests? Not uncommon for folks to ease up on these things and they will make a difference to the numbers. Just a little extra kibble close to test time could be part or all of the problem.

    Lou is not that far over normal and below renal threshold so I'd give him a few days with close food intake monitoring to see if he doesn't come back down. If he stays up in that 150 range, then when you can monitor, I'd try giving him 0.125u or less to see if that doesn't get him over the hump.

    It's tough when they are so close and yet not quite there especially when you are working and can't monitor through the day.
     
  9. Amanda and a Loudogg

    Amanda and a Loudogg Well-Known Member

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    Jun 16, 2017
    Hiya Linda,
    I've never been as vigilant as I could be (I don't pull the food, but I will shoo him away if I see him trying to eat), but I haven't changed my routine as we've gone on. The only thing that's changed on my end is I don't give him insulin. I've been concerned about when he's eating now that he's been eating his dry food more. I've been wondering if that is the issue since he's generally higher in the mornings. The problem I run into is I test him when I wake up in the mornings, so unless I want to be up at 0400, pulling his food is not a great option for me.... Unless I pull it the night before... The only reason we had the YAZ out for grazing was mainly in case he needed something if he went too low on the insulin. I don't know. I'll think on the how's of it more. My husband works late, so I think he could pull the food for me (if he remembers, which would be the biggest issue). If that doesn't work, I think I'll try to pull it before I go to bed. We'll see.
     
  10. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Feb 18, 2015
    While the YA is low carb, it may still be pushing the numbers up more if he's eating more of it and/or doing so right before test time. Timing is everything and those higher numbers could be food spikes. The other option to what you've proposed would be to keep the status quo and try to nab a few mid cycle tests as well as the morning/night, after a nap for example when you know Lou hasn't eaten for a couple of hours to see what those random tests show.

    You'll get there. It's possible Lou may need the odd shot of the juice to take him over the finish line but if he's in the 120 to 150 range, I wouldn't shoot unless you can monitor.
     
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  11. Amanda and a Loudogg

    Amanda and a Loudogg Well-Known Member

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    Jun 16, 2017
    I'm definitely wondering that as well. So I think we're going to pull his food 2-3 hours prior to testing to ensure no cheating, and I'm going to try to get some mid cycle tests to see what's what. We'll give that a couple/few days and hopefully he'll level back out at a lower number. If he stays high, I'll give him some insulin to get him back down again. Then we'll start over. I'm kind of at the point where I feel like something has to change... obviously doing nothing at the moment isn't helping, so we'll see what being more strict with the fasting times does. Hopefully that will spark something. If not, I've got plan B ready and waiting... and a couple of days off this week to hopefully monitor if necessary. :facepalm:
     
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  12. Amanda and a Loudogg

    Amanda and a Loudogg Well-Known Member

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    Jun 16, 2017
    Good morning everyone!
    Unfortunately for us, Lou's numbers have stayed consistently elevated, so we had to go to plan B. My buddy Lou is now back on the juice. :( While I'm sad, I'm glad I'm doing something. After a couple of cycles testing lower doses, I think I've got him at a point where we'll actually see some results. Lou just doesn't seem to do much with micro doses. Hopefully we can dose him back into lower numbers and I've got my fingers and toes crossed that he'll stay that way this time...
     
  13. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Aug 17, 2016
    Regardless, Amanda, Loudogg is doing really well. Good luck! :)
     
  14. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Feb 18, 2015
    Sorry to hear Lou needs the juice again but sometimes it takes a few tries to get to that ultimate goal. Hopefully a little bit more support with insulin will let his pancreas rest and regenerate. Lou is doing great and so are you.

    I would suggest that even though you didn't see much action from the 0.25u on the PM cycle yesterday, that lack of movement could be his defences going into action to keep his numbers up. It appears his pancreas is working to some degree and the exogenous insulin could have set off his defences to keep the status quo. I'd keep a close eye on him today on that 0.5u. I'd be more inclined to keep the dose down to 0.25u or less for a few days to see what he does before raising it.
     
  15. Yong

    Yong Well-Known Member

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    Jan 11, 2017
    I'm inclined to side with Linda on seeing how he does with just a little help with the 0.25U dose. He'll probably be OK today with the 0.5U and hopefully he has a snack for him if you're not home? :cat:
     
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  16. Elizabeth and Bertie

    Elizabeth and Bertie Well-Known Member

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    Sep 6, 2010
    Amanda, I know it must be disappointing that you felt the need to give insulin again. (((Hugs)))
    But it is entirely possible that Lou will still go into remission.
    ...However, if he doesn't (or if he doesn't at this point), then you have still achieved something wonderful: Lou has fab stable BG numbers on a teensy weensy dose of insulin. And that alone is something to be celebrated. :bighug::bighug::bighug:
    .
     
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  17. Amanda and a Loudogg

    Amanda and a Loudogg Well-Known Member

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    Jun 16, 2017
    Hello everyone!
    Oddly enough, I had the complete opposite reaction today to the 0.5 than I thought. I had a dentist appointment and I was gone for an hour. I screwed up my mid cycle testing and tested him at +6, and he was higher than he started the day at. I'm flummoxed. I didn't really think he was bouncing, because he ate more than he would have normally this morning and he had YAZ out to graze on (i.e. I would have thought it would be higher, but not that high). Basically, I am not seeing any results I'm expecting with his BGs, so I'm guessing/hoping that you're right Linda. I'll play it safe and keep it at 0.25u for a bit and see if there's any change. It's so hard to know how he'll react, because it has almost always seemed like he is determined to stay steady, regardless of what dose he's given. Just prior to his failed OTJ trial, he needed a bit more insulin to get down into the green. Obviously I can't say what it was that held him steady in the green for 2 weeks (and what changed now), so it's hard to know exactly how things will from here on out. Needless to say, he's my problem child at the moment, haha. But I certainly know it could be worse. ;)
     
  18. Amanda and a Loudogg

    Amanda and a Loudogg Well-Known Member

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    Jun 16, 2017
    Ugh!! :arghh: It's like I'm in the twilight zone! Lou was at 171 today... 171!!! He hasn't been that high in weeks! I would almost start to wonder if I'm only imagining giving him insulin if I didn't specifically remember giving it to him. I desperately wanted to give him more insulin today than the 0.25, because at this high number, that small a dose won't do much, but I finally decided to stick with the 0.25u per y'all's advice. I know you said to give it a couple few days, but what point would you start giving a higher dose? If he has an inclination to try to stay steady, I really don't want him staying steady at that high a number. :banghead:
     
  19. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Feb 18, 2015
    :bighug::bighug::bighug::bighug: Amanda. Lou is running this show and you can't force anything. I know there's this overwhelming desire to throw more insulin at the problem but that often slows down the progress. Too much insulin often looks like too little. It can take up to 6 cycles for bounces to clear. Some cats clear them faster, some slower. Patience and baby steps are of the utmost importance right now. Lou is not THAT high so you don't need to be concerned about taking this slow. He's so close and recent days without insulin have been pretty flat which suggests to me his pancreas is doing some work and he only needs a small amount of support. I'm wondering what he'd do on 0.125u because even the 0.25u could be a little more than he needs right now.

    Let's see what he does today. :)
     
  20. Amanda and a Loudogg

    Amanda and a Loudogg Well-Known Member

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    Jun 16, 2017
    Thanks for your reply Linda. I'm really hoping the lower dose helps, because I feel like I'm losing my mind at times. As stupid as it sounds, I struggle trying to give anything less than 0.25u on my U-40 syringes. I at least have the ones with the half unit markings, so that makes the quarter doses easier, but I guess it makes me a bit weary to try to give a 0.125u dose. Is there any way to make the microdosing process easier? Or should I bite the bullet and see about buying U-100 syringes?
     
  21. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    I think your best bet would be the U100 syringes. I can certainly sympathize about the smaller doses because trying to eyeball 0.25u increments is a PIA even with half unit markings. Some folks use calipers with their syringes to do their tiny dosing but that can be a bit hit or miss too given that the barrel shapes and markings on different syringes will change the caliper settings. It's far more important to be consistent than bang on dosing wise because there is no way to be absolutely accurate even with full units.
     
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  22. Amanda and a Loudogg

    Amanda and a Loudogg Well-Known Member

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    Jun 16, 2017
    This is not working. Obviously I know it hasn't been that long, but literally every cycle he has gone higher and higher. This morning, he is at 217. Logically I know this isn't really a disaster, but ... whatever I'm doing is NOT working. I need to give him his insulin, and I'm not sure if I can give him some low dose when all it's going to do is push him higher. I absolutely could not give him the 0.125 dose last night when he was at 194, but I compromised and gave 0.25. Again today he's worse, but now he's over 200. Everything we have worked for is gone. What am I supposed to do now??
     
  23. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Feb 18, 2015
    Sorry Amanda. Got tied up with a kitty who is causing excitement (good excitement) over on Lantus!
    Now don't lose hope here. I think there is an explanation.
    I'm not sure I understand your comment re: not being able to give Lou 0.125u last night. Is it the measuring? The 0.25u looks like it may be too much and it's sending his numbers up rather than down so I really think I'd try to do a smaller dose if you can.
     
  24. Elizabeth and Bertie

    Elizabeth and Bertie Well-Known Member

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    Sep 6, 2010
    Amanda, did you manage to get the U100 syringes?
    .
     
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  25. Amanda and a Loudogg

    Amanda and a Loudogg Well-Known Member

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    Jun 16, 2017
    Hiya ladies. I have been able to do the 0.125 doses, but they're barely anything. I've had at least one time where I put the needle in his skin and tried to depress the plunger, but it couldn't/wouldn't depress. I triple check (at the very least) when I'm pulling up the dose to make sure there's something in there and that there's no bubbles, but it's disconcerting when that happens. So last night, it wasn't that I couldn't get the 0.125, I honestly couldn't bring myself to give him that little when his BGs have done nothing but climb despite the 0.125 doses. At least in the beginning, it seemed like he was trying to keep the status quo, but now, it doesn't appear to be the case. Earlier this week I looked into the U100 syringes and reviewed the conversion chart (although the 0.125 dose wasn't on there). I even talked to a pharmacist at Costco. Unfortunately, after looking at the syringes themselves, I am not sure they'll help me out much because it would still be a really small dose on a U100 syringe. I decided not to buy any at this time.

    I'm really confused, and honestly really lost right now. I cannot fathom how Lou can be at such a high number, but be receiving too much insulin at such a low dose. I mean, if that's the case and I just stop giving him insulin, would it go down a bit or continue to rise? I'm rereading what I wrote and I really don't mean to sound so argumentative or accusatory, because it is obviously not anyone's fault. But everything seems so backwards right now. I'm at my wits end and I'm ready to throw in the towel.
     
  26. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Feb 18, 2015
    You are thinking out loud and trying to wrap your head around the beast called Diabetes! You are NOT being argumentative at all! Diabetes can be totally counter intuitive. This is the one subject where what seems like logical thinking sometimes goes right out the window. Too much insulin causes the body defence systems to trigger and that raises the BG. So just because kitty has a higher number the right answer to the problem isn't always more insulin.

    I think that 0.25u pushed Lou's BG down more or faster than he liked and so it shot a pile of hormones out to raise his BG giving you that 217 this morning. You didn't get any tests after that 0.25u dose so he could have gone quite a bit lower than his starting point of 194 before bouncing back up. When you are shooting into lower numbers the problem of too much insulin is a fine line and harder to deal with but I really do think if you stick to the 0.125u instead, it would be enough to just nudge him down instead of making him drop with a thud!

    I know those small doses are a PIA but whether you think you've injected the insulin or not, something went in. The U100 syringes would make it easier to see what you have in the syringe because the barrel is narrower so at the half unit marking on the U100 syringe, you'd only have drawn up 0.2u of U40 insulin.:)
     
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  27. Amanda and a Loudogg

    Amanda and a Loudogg Well-Known Member

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    Jun 16, 2017
    Thanks Linda! When I feel like I'm losing my mind, it's nice to know that you are there to reign me back in, haha. There are a lot of brands of U100 syringes, and I'm wondering if the ones the pharmacist showed me were different (the numbers on the side started at 10 instead of 5, and there were only 5 lines in between). I currently use Carepoint U-40 syringes. What U100 brand have you had success with?
     
  28. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Feb 18, 2015
    Nope those aren't the right ones. Those sound like full unit marked syringes. The ones you want are 3/10 ml (cc) with an 8mm needle and 1/2 unit markings. Gauge will likely be 30 or 31.

    I'm in Canada and you'd think we were a third world country because I have access to this brand only believe it or not! I use these ones.
    IMG_20150705_160318994.jpg

    and have been happy with them for the most part but occasionally have had a box with some syringes where the black stopper on the plunger wasn't sitting straight in the barrel and one box had 3 or 4 syringes that the needle came off of when I tried to remove the orange needle cap. I always check the needle is solidly attached now.

    I think a number of folks here use the Relion syringes from Walmart. They are very reasonably priced and come with 1/2 unit markings although it seems some of the folks working the pharmacy counters don't know they have them. The other alternative to select something here. https://www.adwdiabetes.com/search.aspx?keywords=U100 syringes with half unit markings

    Just double check to make sure they have the half unit markings yourself. It seems there's a spate of pharmacists not being as well versed on diabetic products as you'd expect them to be lately. Someone yesterday got sold a glucometer that she was assured took a tiny sample of blood. It took a drop 2.5 times as large as the small sample glucometers! :rolleyes:
     
  29. Amanda and a Loudogg

    Amanda and a Loudogg Well-Known Member

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    Jun 16, 2017
    Thanks again! I think I'll head to Walmart after work tonight and see if I can get some of those Relion syringes. If not, I'll see what I can see on the ADW website. :)
     
  30. Amanda and a Loudogg

    Amanda and a Loudogg Well-Known Member

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    Jun 16, 2017
    So looking at the conversion chart, it seems the lowest the chart goes is 0.2 units. Do you happen to know what the conversion would be for a 0.125 dose?

    upload_2017-8-12_16-17-24.png
     
  31. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Aug 17, 2016
    If you're using a U100 syringe for your Vetsulin (U40) eyeball half way between zero and 0.5 to get 0.1 u. That's the best you can get. Less than that involves drops.
     
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  32. Waheeda

    Waheeda Member

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    Apr 11, 2017
    I've been using u100 syringes all the while without the half unit markings. The only brand we have here is BD. I was able to eyeball 0.1u so with half markings it should even be easier.
    All the best Amanda.
     
  33. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

    Joined:
    Feb 18, 2015
    @Waheeda Where are you located? In Toronto (Canada) BD is the only brand I've been able to find but they definitely do make syringes with 1/2 unit markings. Picture of the box above in message #28.
     
  34. Waheeda

    Waheeda Member

    Joined:
    Apr 11, 2017
    I'm in Singapore. No 1/2 unit syringes here. And limited food option for my diabetic cdk boy.
     
  35. Amanda and a Loudogg

    Amanda and a Loudogg Well-Known Member

    Joined:
    Jun 16, 2017
    Thanks everyone! :) Of course the Walmart pharmacy was closed before I was done with work, so I think I'm just going to order some online. I feel like they'll probably be here around the same time if not sooner than I can get back to the pharmacy when it's open, haha. Easier for me too! :p
     
  36. Yong

    Yong Well-Known Member

    Joined:
    Jan 11, 2017
    I think 2 Walmarts and 1 Target were compiled of staff with all the lights on upstairs but nobody home sort of deal so I have not successfully purchased syringes form Walmart :smuggrin:. I was given the suggestion to take a picture of the syringe box as they seem to understand that better but for now I've been ordering mine online. So thought I'd add my link for the U-100 syringes I used on Prozinc (also a U-40 insulin): https://www.adwdiabetes.com/product/1289/monoject-ultra-comfort-insulin-syringes
     
  37. Amanda and a Loudogg

    Amanda and a Loudogg Well-Known Member

    Joined:
    Jun 16, 2017
    Thanks Yong! It is crazy how often I've heard of people have issue with Walmart pharmacies. They're supposed to be the experts, right? (You'd think anyway:rolleyes:). Thankfully I ordered some U100 syringes online last night, so they should be here next week. Also, I almost feel thankful I had my freak out yesterday with his first 200 in a month, since he jumped up to 262 this morning. I was able to keep my wits about me this time and give him the micro dose. The number really sucked, but overall it was a much better way to start the day.

    Fun Fact: Lou was diagnosed around this time two months ago on a Thursday. I had to work that weekend, so I was trying to get used to everything and I had to work 10 hour to 13 hour days. It was a stressful time, to say the least. It's interesting because I'm working this weekend (I do a weekend every couple of months or so), and he's having weird numbers. What a weird kind of symmetry. He needs to just stop wanting so much more attention and get his numbers under control, haha. :cat:
     
    Kris & Teasel likes this.
  38. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

    Joined:
    Feb 18, 2015
    I think these little critters have a way of knowing the least convenient time for some off base shenanigans. Mine doesn't throw low numbers often but she usually does it on a day when I planned to go out. I guess they love us and this is their way of showing they need and want us! :woot:
     
  39. Amanda and a Loudogg

    Amanda and a Loudogg Well-Known Member

    Joined:
    Jun 16, 2017
    Hello all, I'm just checking in. Unfortunately, I don't have anything positive to report at this time, as Lou's BG values have not started to decrease. I did some research and found the renal threshold for felines, which Lou hit today. When Lou was in the blues, it definitely seemed like the 0.25 was too much, as his BG would keep jumping up, but now that he's in the high 200s, I'm not seeing any sign that the dose is enough. I was going to do a curve today to be sure, but my U100 syringes haven't arrived yet, so I figured it wouldn't hurt to wait. I planned on doing the curve Saturday or Sunday. After everything we've been through, I don't want to rush and I've been trying to keep my cool as he's been getting higher and higher. I've been rather proud of myself for my seemingly blasé attitude of late. I have no problem continuing the course at this time, but I just wanted to check in because obviously the less time he spends at these higher numbers, the better. I'm not sure if it's just me, but yesterday and today he seemed hungrier. I haven't seen him at the water dish as much, but the water level has decreased, so he could be sneaking it in when I'm not paying attention (even though I add water to his pate). What are your thoughts?
     
  40. Yong

    Yong Well-Known Member

    Joined:
    Jan 11, 2017
    I don't think the behaviour is too odd. He's not like ravenous, right? Past two days my boy has eaten all of his wet food right away and a tiny bit more drinking with his yellow numbers. I'm thinking it's because he's gotten more time in green and blue :)
     
  41. Amanda and a Loudogg

    Amanda and a Loudogg Well-Known Member

    Joined:
    Jun 16, 2017
    I'm not overly concerned about his food/water intake, just thought I'd note it as a change. It's not really surprising with his numbers so high. It's a bit of an increase, but nothing ravenous. He seemed worse yesterday, but I was also trying to limit his dry food yesterday because he's been eating it like it's going out of style. It could have been in response to that, but yeah, not a ridiculous change in appetite.
     
  42. Waheeda

    Waheeda Member

    Joined:
    Apr 11, 2017
    I really think you should increase the dosage since decreasing it is not working. My boy was on vetsulin too. At one point, I decreased his dose and he went higher. So I turned around and increase it and it got better. I'm not an expert in dosing and I had guidance from @Yong @JanetNJ
    Janet has more experience with vetsulin so perhaps she can help.
    My boy grazes on YA even before taking his readings. Didn't seem to affect it much but as you know every cat is different.
     
  43. Yong

    Yong Well-Known Member

    Joined:
    Jan 11, 2017
    Do you test for ketones? Since you got the U-100 syringes you could try 0.2U again. :bighug:
     
  44. JanetNJ

    JanetNJ Well-Known Member

    Joined:
    Jun 8, 2016
    Time to up the dose. I'd do 0.5 when over 180 and Slightly less when 130-180.

    You may need more when over 250 (1 unit? But make sure you can test).
     
  45. Amanda and a Loudogg

    Amanda and a Loudogg Well-Known Member

    Joined:
    Jun 16, 2017
    Hiya Yong! I don't actually test for ketones. It's been on my radar, but I have found I rarely ever see Lou in the litter box. I know he goes, but I've seen him in there only a handful of times in the 7 or so years I've had him, haha. So I'm not sure if it would work for me. I had thought I had seen some "strips" that you can sprinkle in the litter box and they'll turn colors as the urine hits them, but I can't find anything about them, and I don't know how accurate it would be unless you catch it right away. :/
     
  46. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    Try putting a couple of layers of plastic wrap over his favourite pee spots in the litter box and push a few indentations into it to catch a little pee.
     
  47. Yong

    Yong Well-Known Member

    Joined:
    Jan 11, 2017
    I use the long handled spoon method because I worry the plastic wrap in the box will make him think it's ok to pee on any plastic :confused: or lay in there. He likes to lay on plastic bags lol.
     
  48. Amanda and a Loudogg

    Amanda and a Loudogg Well-Known Member

    Joined:
    Jun 16, 2017
    So I was just reviewing my spreadsheet today, and I realize that all the ups and downs we've been experiencing have been happening all in August. I feel like I've been doing this for so much longer than a few weeks. :blackeye:

    Anywhoo. I figured I should check in. It seems no matter what dose I give Lou, he doesn't do much with it. At first it was too much, but then by the time I got my head on straight his numbers were too high. Now his normal PS range is 250-280. Trying small doses at this point didn't do anything (kept him in the 200s), but larger doses only get him in the high 100s, if we're lucky. After today's seemingly complete lack of reaction, we called the vet and got a new Vetsulin vial. To be on the safe side, I went with a 0.5 u dose, but then I think I got at least a partial fur shot ( :oops: ugh). I know I've probably sound like a broken record at this point, but any ideas where to go from here? We had such success prior to his aborted OTJ trial, that this overall lack of response (and lack of greens/blues) is so flummoxing. :(
     
  49. Amanda and a Loudogg

    Amanda and a Loudogg Well-Known Member

    Joined:
    Jun 16, 2017
    Well, considering my earlier bouncing issues, I thought it might not be a bad idea to lower the dose to 0.5 to see if that helps at all. I figured it wouldn't hurt to try to see if this helps stop the bouncing... If it doesn't (possibly even after moving up to 0.75 as needed if 0.5 doesn't look good), I may need to talk to my vet about other possibilities. I don't want to have to get used to another insulin, but something has to give. I'm willing to try almost anything at this point to get him regulated.
     
  50. Yong

    Yong Well-Known Member

    Joined:
    Jan 11, 2017
    You could ask about Prozinc. It's a gentler and longer lasting insulin than Vetsulin but is not a depot insulin. Like Vetsulin, Prozinc is an in-and-out insulin as well :)
     
  51. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

    Joined:
    Feb 18, 2015
    Amanda, just looking at Lou's sheet and wondering what he'd do if you give him 0.25u for a few cycles to see if that brings his numbers down. When I see "Furshot" with a following pre-shot that isn't elevated and what looks like an extended period of insulin action like yesterday with lowest reading at pre-shot, it makes me wonder if the dose is too high and should be lowered. You've really never tried 0.25u on a consistent basis since the OTJ trial. Food for thought. :)
     
  52. Amanda and a Loudogg

    Amanda and a Loudogg Well-Known Member

    Joined:
    Jun 16, 2017
    Hiya Linda. That's not a bad idea. I didn't realize I had skipped right over the 0.25 dose. I think I mashed it with the 0.125 that I had already tried (after he was in the 200s) and went to 0.5 instead :confused:. I was planning on doing another curve tomorrow. Do you think I should dose 0.5 tonight and tomorrow and do the curve off of that (since I've been on that dose a few cycles), or do you think I should switch to the 0.25 tonight? If so, would you recommend me curving tomorrow or should I stick with 0.25 and do the curve this weekend?

    Yong, thanks for the info about Prozinc! It's good to know there would be an insulin relatively comparable if I need to talk to the vet about switching. :)
     
  53. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

    Joined:
    Feb 18, 2015
    I am not the biggest fan of curves mostly since with my rare little furball, they never worked for me. I find the info you get can be misleading if kitty is having a particularly good or bad day and we both know, no two days are ever the same. I find getting more random tests as often as I can with at least one midcycle test each cycle, gives me the best historical data and lets me know how to proceed. That said, if you want to do the curve, I'd change the dose and do it on the weekend. It's up to you whether you change tonight or tomorrow morning. I usually change doses when I know I can monitor. I know reducing seems very benign, but I just went through making a double size reduction with my girl (who is still giving me bald spots at times!) when without careful analysis it looked like she needed an increase (won't get into details) and I am now testing a bit more because her numbers went down. So if my theory with Leo holds any water, you should see lower numbers too.
     
  54. Amanda and a Loudogg

    Amanda and a Loudogg Well-Known Member

    Joined:
    Jun 16, 2017
    Thanks Linda! I did change to 0.25 last night. I always hate the first day or so after a reduction, because the numbers look so much worse than you'd expect. I had already seen some improvement after reducing to 0.5, so hopefully his PS numbers will improve in the next couple few days on the lower dose. Keeping my fingers crossed!
     
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