Buddy's SS up and going 2nd part about dosing

I just took Buddy's number at 1 hr. and it is 96. How to proceed.

 

Thanks for the new thread. I said in your other thread to retest in an hour but don't give any food. You need to see if he's holding or on the way up on his own.

 

OK

 

I took another test @ 3:30 he was @94 and wanting to eat. What would you suggest I feed him RC wet, FF classic, FF grilled w/gravy or should I wait to feed him.

 

Just saw the blue 144 on your SS. Was that with no food beforehand? If so, you can let up on the testing until his PS. I think it would be safest to reduce the dose this evening to 0.25 u if his PS allows. You can expect another day of pink and yellow tomorrow but you'll likely have to stay at 0.25 u unless the picture changes a lot. Any of these decisions can be revised at the last minute.

 

OK, now I'm confused about the 144 on your SS. Was that before the 94 just now? If the 94 is the most recent number you need to withhold food so we can see how he manages on his own, even if he's telling you he's hungry. We need that data.

 

I am losing my mind he is @144. Sorry

 

OK. Then for sure don't feed him any more until his supper. You can also give his ears a break until PMPS. I'll watch for it - around 7:30, right? That's when I'm doing my guy's routine too so I might be away from the computer for a bit but can generally check by 8 PM.

 

Do you think it would be safe for me to run out for about an 1 hour

 

Yes, I think he'll be fine.

 

Waiting to see how he's doing at PMPS.

 

He's having some good cycles! Those lows are scary, but the insulin is definitely working!

 

His # is 393. Isn't that crazy. I must have feed him too much the 2nd time. Do you know of anybody else having the same kind of problems we are having with ProZinc. What unit do you think we should do tonight.

 

That's a bounce from the low greens you had today, not from the food. It was very similar on 01/24 at the PM test. The dose for tonight has to be based on what happened this afternoon, not on this high bounce number. If you give 0.5 u again, you'll probably see pink and yellow tomorrow and then the same low greens on Saturday. The safest thing to do is to reduce tonight to 0.25 u. You'll still see bounce numbers tomorrow most likely. The data on Saturday will probably tell the story about the true effect of this low dose.

Every time Buddy goes into low numbers he depletes some of the glucose stored as glycogen in his liver because he mobilizes it into his bloodstream to prop up the low BG. That leaves him extra insulin sensitive in the days following because his reserves are depleted - ie., he'll react more strongly to small doses. He's had several brushes with low numbers the last ten days. You need to test, log data, look for these patterns and lower his dose as needed. All these greens are actually a very good sign.

Are you OK with this plan?

 

Yes, I appreciate all of your help. This is all new to me. Does having the low numbers like Bud's cause any permanent damage to him. I hope you will still be able to help me, since you know so much about what is going on with Buddy. Going to dose Buddy .25

 

No, the low numbers won't hurt him. What can be harmful is a full blown hypo where they lose consciousness, seizure, etc. Buddy has been fine through all of it because you gave him food and kept him from going too low. It was probably harder on you.

I'm pleased to help. I'll be out tomorrow from about +2 to +5 or so. I'm in the rest of the day but will be busy from +8 to + 11. I can check in periodically at my computer. I think tomorrow will be a quieter day.

 

Thank you

 

I gave Buddy .25 @8:00, so far today Buddy is eating FF classic.

 

As I said last night, you can expect pink and maybe yellow today. It'll be less stressful for you. I'm glad he's eating the FF classic.

 

You are doing a great job with Buddy. I love all the blues and greens on his spreadsheet. It is a mixed blessing when your kitty responds well right away to the insulin: the lower numbers are lovely and encouraging but you have to learn a lot fast about dosing and levels.

 

I like that yellow on your SS. I think you mean 0.25 u for your AM dose.

 

I did, just posted new numbers. Will correct the dose. I just got in the mail Young Again 0 carb dry cat food, feel as I should post so I can see what other cat lovers say about this before giving to Buddy. Should have checked before ordering, in a day of desperation I ordered.

 

Many people have a lot of success with it. StephG here on this forum has started
using it. @JanetNJ has really good things to say about it.

I like that string of yellows today!

 

I may need to stay with .25u, is that 3days. I guess we will find out.

 

You'll stay at 0.25 u tonight and probably tomorrow morning. One dose at a time ...

 

As kris said I use it and love it. Doesn't raise my cats numbers at all. I give wet morning and evening and leave Yaz out all the time to eat whenever she wants.

 

I ran test Bud@318, I was expecting it to be lower. I gave Buddy some Young Again Zero carb dry food several hrs. ago, wonder if that could have brought #up.

 

318 is less than the pmps you have been getting. It's the lowest pm number you've seen all week. Considering You gave a really small dose today and he ran yellows all day I'd say it's surprisingly low. I personally would do 0.5 when the preshots are in the 300's.

 

I respectfully disagree with Janet on the size of dose for Buddy tonight. I think you should give 0.25 u once more to see if this is the end of a bounce. You can raise the dose tomorrow if he isn't showing signs of diving.

 

Yeah I'd be inclined to 0.25 myself. Especially since it's a nighttime cycle, and you might want to get some sleep tonight.

 

It would be nice to sleep all night and not get up to do testing.

 

Hope you check in the morning to let me know what you think I should do.

 

Will do.

 

Hi Wolfey. I just wanted to comment that if you add the YA dry food you are changing one of the variables. If Buddy's BG goes up, how will you know whether it is the dose being too low or the change in food. You already had the variables of switching to low carb wet and the Pred wearing off. That has given you some active cycles. Unless Buddy refuses to eat the low carb wet you might want to see where he settles on this dose before making changes.

 

I never thought about that. Thank you.

 

Buddy stayed pretty even yesterday, for the 1st time. I am beginning to wonder if there was any insulin in the syringe because it was such a small amount and he did much better yesterday. Let me know what you think.

 

Pati made a very good point about waiting before you try the YA. I like that the numbers were staying yellow. See how low his AMPS is today compared to yesterday? That's because he's finished bouncing. I'd give 0.25 u again and you'll likely see some blue today. It might feel like there's no insulin in the syringe but it's a very powerful hormone. A little goes a long way.
Would you mind telling me your first name?

 

He is not so anxious to eat today, most of the time he is starved, not today. He took a few bites then walked away. Maybe later. How much will this affect his dose.

 

My name is Teresa Wolfe, sorry I did not do that. For the last month I have been so worried about Buddy, I haven't known whether I was coming or going.

 

Hi, Teresa. It feels friendlier being able to refer to you by name.
I'd give Buddy the 0.25 u regardless of him not wanting to eat too much right now. Is this his usual habit - eating well one day, less so the next?

 

Since Bud has had this diabetes problem most of the time he is starving except for maybe 2 days he seemed to be nauseated. I gave him some meds for that and within an hr. he was eating. He does not seem to be nauseated, just does not want to eat. He would rather look out the window.

 

So long as he doesn't seem nauseated, give him his 0.25 u. Offer a bit of food later. The insulin is important - he's made a lot of progress in a short time.

 

Did you give Buddy the 0.25 u dose? A test later at +3 would be useful to see if this will be an "active" cycle.

 

Yes I gave Buddy the 0.25 dose this morning. He did not want much to eat, only ate about 1/4 can of FF classic. He would not eat any of the wet food when I tried to feed him. Took his # at 3hrs. it was 210. He wanted to eat but would not eat the FF wet, so I gave him some YA. Two hrs, later took reading, his # was 319. I am going to try and hold off on the YA for a while, hope I can stick to it.

 

How much YA did you give him? It's very concentrated so the portion size can be tiny. That pink number sure does look like a food spike.

 

I don't know how much I gave him. I put some in my hand and put it in his dry food bowl. I am hoping tonight he will eat his FF wet food, if he will I am going to hide the YA for a while. He has been crying around wanting to eat, it is so hard to ignore him.

 

Thank you, you are right.

 

I had to learn a lot about everything, 2 weeks ago I was having problems getting blood for testing. That sure does seem like a long time ago.

 

When do you sleep? Lol.

 

We definitely can't say you aren't getting enough data.

 

That yellow at +9 sure convinces me that the pink was a food spike.

 

Yep, I'm with Kris! Looks like you had a food spike..

 

I sleep at night, but I do set the clock and get up and check Bud's levels.

 

Thank you.

 

I think you should finish up today with 0.25 u.

 

You might want to think about getting U100 syringes with half unit marks to use with this conversion chart:
http://www.felinediabetes.com/insulin-conversions.htm
It would allow you to measure 0.2 u, 0.4 u and eyeball 0.1 u, 0.3 u.

 

You can do.25 but I doubt it will get you out of the yellows. I say 0.5 when in the pinks as long as you can test.

 

I saw that on the conversion chart but what would .25 be on the U 100 syringes. I have some, I take injections 1 time a week

 

I will do that. Will be checking in the morning to see what you think.

 

They have to be proper U100 insulin syringes with a capacity of 0.3 mL and have half unit marks. You can't easily measure 0.25 u on them but you could eyeball 0.3 u or measure 0.2 u or 0.4 u. You have to be very sure of what you're doing if you try this.

 

OK.

 

I looked at my syringes last night and I do not think they will work. I did have some reli-on syringes that I think might work. Did not jump right in and start using different syringes because I do not want to make a mistake and hurt my cat.

 

I want to try and go to church today if Buddy's numbers allow. If we use the same dose this morning I might try and go. Buddy '
dosing must come 1st.

 

His numbers seem to be coming back up, he was 312, if you think he needs increase let me know. Whatever is best for him.

 

Yes, He needs a dose increase. You'll have to give 0.5 u. If your U40 syringes have half unit marks, you could measure out 0.5 u and then turn the plunger slowly like a screw to let out a small drop. We'd call that a "skinny" 0.5 u. Then you can feed him a bit of his higher carb wet food before you leave for church. His nadir will probably be in the +5 to +7 range. If you can be home by then to test it should be OK.

 

Just so you know: I'll be leaving at +1 or so and will be back around +6.

 

It's up because the dosing has been too conservative. As long as you are testing you want to get those numbers under 120 on a human meter for part of the day so the pancreas can rest and heal. Low blues and greens over 60. Aim for 85-110. No reason to keep the numbers in pinks and yellows.

180-225 0.25
225-325 0.5
325 -375 0.75
375-425 1
425-450 1.25

 

I think Buddy's mom was frightened by the lows a few days ago. It's matter of learning to tolerate them and eventually "enjoy" them. Thanks, Janet!

 

I get that but still don't want the numbers going back to what they were. The numbers were low a few days ago, but not hypo. If it goes low just steer them up a bit with some food. Can't be afraid of seeing some green. It's what we want to see.

 

Thank you, I will do that

I did not know that, I am always afraid he will do too low. I am always afraid to leave the house.

 

I totally get that... and I say if ever not sure and you won't be around then go cautious, but you have the info you need right there in your spreadsheet. study it and find the patterns and trends. You can leave the house. the more time he spends in the healing range, the more likely you are to have him gradually go into remission, which should be the ultimate goal. Now of course not all cats go into remission, but there is a good chance here. Just look at the progress already! Three weeks ago he was on 3 units... now down to 1 and under! that's a huge improvement! the sooner you work toward it the more likely it is to happen. Lets get him surfing in the blues.

 

It surely IS terrifying at first. Heck, I remember the first time I had a low preshot number...I KNEW not to shoot, yet I had to come straight here and get advice first and I was dizzy and terrified until Sue confirmed that I shouldn't shoot!

I know Kris has already give you dose advice and you surely don't need to hear it again from me! I do think Buddy will be fine. It's important to get out sometimes and get a little time away from worrying! I'd encourage you getting out for a walk or a movie or coffee with a friend...just give yourself a break sometimes. You deserve it!

 

Hurray for other people helping with their advice! Any more BG numbers since the yellow I see on your SS?

 

Buddy was @ 280 @7:30 p.m., I gave him some RC wet food today before I went to church, he had not had RC for several days. He is not eating very much tonight, after he gets his insulin is it alright for me to continue to try and feed him. My u 40 syringes do not have a 1/2 unit mark, only whole numbers.

 

No problem feeding him after insulin. I suggest you give 0.5 u tonight and he might need to go up tomorrow AM.

 

He can eat whenever as long as he doesn't eat two hours before preshot testing.

 

I think I will be home all day tomorrow, on Tuesday I have an afternoon appt. If you think he needs an increase, then I will do it. Would rather start an increase when I will be home all day. I thought you were supposed to go with a new dose for 3 days. Does anyone e-mail their SS to the vet they use, if so I had a couple of question.

 

I did not know that.

 

Most of us feed several small meals rather than just two big meals.

 

Generally we say hold a dose for a minimum of 3 cycles (one cycle is 12 hours, the time between 2 doses) but if it's obvious a change is needed it can be made sooner. Let's see how he is tomorrow AM.

 

I printed my SS out and brought it to my vet...but there's no reason you couldn't email it.

 

The vet Buddy saw for diabetes said he would eat 2 meals a day, also to eat Royal Canin wet and if Buddy wanted dry he could have prescription Purina OM (he was eating OM before diabetes). At mealtime especially in the evenings Buddy will want to sleep, but earlier he will be crying and going to his bowls to look for food.

 

The most important thing is that he gets some food on board with the insulin. It doesn't have to be the entire meal...just as long as there's something there to keep the insulin from dropping him quickly. Considering some of the steep dives you've had, food might actually be helpful during the cycle. My cats grazed during the day...still do. I put wet out in the morning, and most of them go over and eat some...but then I leave it out and they eat during the day. And, as Janet said, most important is no food 2 hours prior to preshot tests so the number you get isn't food influenced.

You do have him off dry food now right? I want to say I remember you saying that...

 

I have him off dry food, bought YA and he seemed to like it. The day that he ate the YA his numbers seemed to spike ,so I took him off of it until we are on a more even basis. He is eating FF classic.

 

I had some questions like would it only e-mail what was on the screen in front of you, or would it go all the way across the screen and get the readings for the whole day. I don't think it will, just wanted to have my eggs all in 1 basket before I did it and messed it up.

 

Hi Teresa,

I saw the blue you had last evening. I think you should try 0.75 u today. If you're home you can keep an eye on him. You asked a few posts back whether any of us email our vet with the SS, etc. No, I don't. She knows what I'm doing generally but all my decisions are my own.

 

I started Buddy on .75 u today, he was not eating this morning he has a problem with nausea. Mid morning I gave him 1/4 pill for nausea and then he started wanting to eat. He would go to his bowl and eat, then leave, then come back. I am not for sure that I had the correct time he quit eating, that is why I did not do much testing in the day time. Tomorrow I will be gone for several hours starting @+5, please don't change Buddy's dose till the next day.

 

You don't have to test a lot every day, Teresa. As for dose, you can give 0.75 u tonight and whatever you feel comfortable with tomorrow. We're here to help but you're not obliged to follow any suggestion we make if it doesn't feel right.

 

I want your help, I don't feel obliged to follow your suggestions. I think it probably would be wise to up the dose for Buddy, but I am such a coward that I don't want to leave him when we start a new dose. When you think his dose needs to be upped, please let me know. I need your help, I was getting no where with out it.

 

As I said before, I'm pleased to help. I truly understand your reluctance to up the dose if you can't be there to monitor. That's just being sensible. As you go along and get more experience with Buddy's responses to insulin you'll find that your confidence will grow and you'll trust yourself more.

As for tonight's dose, if you're home to test this evening, why not try 0.75 u again to see if he'll show you some safe greens. That's the goal after all. A test at +3 is usually a good indicator of where they're heading and if he's low-ish then you can give a small snack to head him off at the pass.

 

Yes, it's not necessary to constantly test. Try to get a +6 when you're home and maybe a +3 at night to check if the night cycle will be active. A lot of people will also do different tests on different days. Like, today they might grab +3 and +9. Tomorrow, +5 and +11. Just to keep an eye on things without giving constant tests.

 

Kris, I want your opinion on this. I think I will give Buddy 1u this morning, @.75 he was pretty close to 1. I will test him before I leave and give some Royal Canin, that would prop him up some for a few hours. I have ordered syringes with 1/2 unit markings so it will be easier next dose change. I appreciate all of your help.

 

Hi Teresa,
Sounds like a plan! I know it's hard but sometimes a little bravery when dosing gets us further ahead. Those two yellows last night after his PM dose show you that his dose should go up.

 

Buddy's little ear is getting sore, so I need to let up some on the testing. Thank you for the help. I don't know what I would have done with out the help I got here. The vet was way off.

 

Without your help I would had to have turned to the vet and you know what happened the last time.

 

That's why this place is so wonderful!!

 

Yes, I think you can: maybe AM/PM before shot, mid day and one more before bed unless he decides to have what we call an "active cycle". Many people here put Neosporin ointment with pain relief of kitty's ears. Maybe try that?

 

I agree with upping it to 1