? Can I get a check up?

Discussion in 'Caninsulin / Vetsulin and N / NPH' started by AlphaCat, May 17, 2017.

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  1. AlphaCat

    AlphaCat Member

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    May 9, 2017
    We were diagnosed 10 days ago. She's been at home in my care for the last 7 days.
    I'm wondering if some of you with great experience can offer up some advice or insight on the numbers we're getting? I know a week isn't a lot of data, but I would hate to keep doing what I'm doing if I could be doing better/differently. The spreadsheet is updated.

    So I don't expect much from my Fabby so soon, but is where we're at normal?
    What should my expectations be for week 2 as we move forward?

    Details not in the spreadsheet:
    Doc said no ketones in urine so at home testing not needed, though I do have the strips on stand by.
    She's slowed down hovering over the water bowl last week. She's still drinking more than normal, just not excessively like the week before.
    Her diet is 1 and a half cans of Friskies low carb wet food. We are trying to increase the amount she eats. She likes the food fine, she eats about a quarter of a can, then just stops. I spend the next half hour chasing her around piling up the other quarter to make it appealing to eat. I can usually get almost ½ can in her at each meal.
    She eats 8am at +5 then again at 8pm and final meal at +5. (The non insulin meals may fluctuate due to scheduling by roughly an hour.)
    Insulin at 8am & 8pm - 1 unit of Vetsulin each time.
    Still having large amount of urine, but all has been in the box. (Urine not excessive for amout of water she's consuming.) Feces is on schedule and normal/soft consistency.
    She hasn't begun grooming again yet. Still having dandruff. Eyes still always dilated.
    Did I miss anything?

    Thank you all for being here and sharing your knowledge and experience!
     
  2. babyBoo

    babyBoo Member

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    May 15, 2016
    Since you have the ketone strips, I'd suggest testing anyday she's getting a pink or higher test number at least for awhile.

    I'm not too familiar with vetsulin but those blue numbers are good and if you just switched to low carb in the last few weeks I would think about holding the dose at least for another week if ketones are not present. Getting out of those pink and red numbers soon though would help curb the thirst and considerably reduce the risk of ketones.
     
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  3. AlphaCat

    AlphaCat Member

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    May 9, 2017
    Thanks for responding!
    Before insulin she was tested at 450 pretty steady (her days at the vet). So I was happy to get pretty regular testing drop down into the 300 range. We've only gotten 2 tests in the 100-200 range, but we'd love to be there more consistently, lol!
    I think that's what the insulin and diet are working on? At least I hope! I'm not quite sure how long this process takes, or if where we're at is normal for vetsulin. (I know you mentioned you're not familiar with that one.)
    We do seem to be trending lower (except for the 24hours we messed up on the shots) so I'm hoping this is normal and were making appropriate week one headway...
    Thanks again for the input!
     
  4. Yong

    Yong Well-Known Member

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    I'm thinking keep doing what you are doing a little longer, including the current extra tests :bookworm:. I think I'm noticing something but need more data before saying anything :bookworm::smuggrin:. And if you have the ketone test strips, use them like babyBoo suggested. Always good to stay on top of whatever we can :cat:

    Might've said this before but if you think you did a Fur Shot (FS), Never re-shoot. :) You can also put FS in the U column when that happens since there's no way of knowing how much or how little she got.
     
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  5. AlphaCat

    AlphaCat Member

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    May 9, 2017
    First, thank you so much for taking a look!
    I'm confused by extra tests.
    Do you mean the 2 that are with food but without insulin or do you mean the ones over Sunday/Monday that were every 2 hours?
    I said to myself, "what's a fur shot? Oh no not another thing to do..." I got a little whiney in my head there for a moment... Then I went "duh" that's when you missed... I will go update with FS now. That makes so much sense!
    And we did not give another shot when we missed (furshot).

    I will keep collecting data, and hopefully whatever you're thinking is good news!

    Thanks again!
     
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  6. Yong

    Yong Well-Known Member

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    Mandatory tests are AMPS and PMPS, extra tests are those mid cycles you've been able to get :)
     
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  7. JanetNJ

    JanetNJ Well-Known Member

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    You're doing a great job of testing. Is like to see more blues. Consider raising the dose to 1.25 and if that doesn't get you down after 2-3 days go to 1.5.
     
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  8. AlphaCat

    AlphaCat Member

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    Thank you! I'd love to see more blue! ;)
    I think I may need to get different needles for that. Mine only have marks at the one unit mark.
    Can I just walk into the pharmacy and ask for a couple bags of needles? (We got the original box from our vet.)
    Today we woke up to our highest numbers since we have been testing. I'm getting a bit discouraged.
    Tomorrow I was going to try for another curve day...
    Will increasing the dose help the numbers at AMPS and PMPS?
    or just lower my +5 or +6 numbers to hit blue more often?
     
  9. Yong

    Yong Well-Known Member

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    As you get better nadir numbers, the preshots should gradually come down too. Hang in there, some of us didn't see improvements in numbers til over a month.
     
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  10. JanetNJ

    JanetNJ Well-Known Member

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    You are using u40's right? They probably won't have those in a store. I get mine with half unit markings from Adwdiabetes.com
     
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  11. Yong

    Yong Well-Known Member

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    I use these: https://www.adwdiabetes.com/product/16363/carepoint-vet-u-40-syringe-29g-half-unit
    I started off with the ones without half unit markings too so what I did for those 0.25 increases is measured 0.5 first, mentally marked it (you can probably put your fingernail to hold spot too) then did half way between whole unit and marked place. You could also do a batch of 10 at a time and mark off some half units, with a super fine sharpie, like from 1-3 unit lines. Just rambling ideas :smuggrin:
     
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  12. AlphaCat

    AlphaCat Member

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    May 9, 2017
    Thank you both!
    In my past life I was a photographer, so I'm really good at eyeballing details and estimating. My spouse however is an accountant and works only in absolutes, lol. I've been trying to make sure any procedure I put in place can be carried out by either of us. I am the normal care taker for the animals, but I'm also chronically ill, so I have to plan in advance a back up plan.

    I hate wasting money, so I will likely do as Yong suggests, (But with extra precision for my spouse's comfort level, I'll use a ruler, lol) and mark off the current u40's that I have. B/c If she keeps increasing, I'll be up to whole numbers again and be back to being these.

    But I appreciate the links. If we get stuck on increments for too long and need to purchase more I'll know where to get them! Thank you both!
     
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  13. AlphaCat

    AlphaCat Member

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    So... we are about to complete day 3 on 1.25 units, but I'm not confident we should move up because the numbers I've gotten are wonky. In these last 3 days I've gotten really high and 'our' really low end of the spectrum. Is this what's referred to as a bounce? Does that mean I should hold steady at 1.25 until we get consistent numbers, or should we go ahead and move up because our lowest number still hasn't reached ideal yet?

    I had an emotional overload breakdown yesterday, then her mid day numbers looked so good I was able to crawl mostly out of that exhausted funk... only to wake up to black numbers this morning. Ugh... so defeating. I'd like to get off this glucose roller coaster please.
    She did start grooming her belly today. So even though we started extra high, I'll take any improvements I can get. Yay grooming!
     
  14. JanetNJ

    JanetNJ Well-Known Member

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    I'm glad to hear Fabulous was grooming! That is a good sign of feeling better. Are you home today and tomorrow?

    If you want to hold the dose another day and see if the numbers settle a bit then do that. If you still are in the yellows mid cycle I'd push it to 1.5 on Saturday.
     
    Last edited: May 26, 2017
  15. AlphaCat

    AlphaCat Member

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    I am.
     
  16. JanetNJ

    JanetNJ Well-Known Member

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    Ok well if you want to hold another day you can... But tomorrow id bump it up.
     
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  17. Yong

    Yong Well-Known Member

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    Jan 11, 2017
    If you get a much higher or lower number than you are expecting, you can retest immediately. There are such things as wonky test strips. Just something else to make us crazy :rolleyes:
     
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  18. AlphaCat

    AlphaCat Member

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    May 9, 2017
    Unfortunately, it's not numbers out of range for us, just... I expected better with upping the insulin. But when she had a really low nadir for her, (blue), it makes sense that her next reading was really high.

    It's just the frustration getting to me. Two weeks in and we don't seem to be making much headway. I know from reading these boards patience is necessary, but it's harder to put into practice.

    I just keep reminding myself of the positives:
    We know what's wrong and it's treatable.
    She's back to using the box exclusively when urinating.
    There are times when her eyes aren't constantly dialated.
    She looks like she's stopped losing weight.
    She began grooming a little yesterday.
    She's not as food aggressive at all times anymore, which means she isn't starving.

    Change is hard, and the pressure and desire to get her stable is overwhelming at times.
    The regulars here that are experienced in all this and just stick around to help others... you people are on a quest for sainthood! Thank you, I just can't say that enough.
     
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  19. JanetNJ

    JanetNJ Well-Known Member

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    Would you be willing to up the dose to 1.5? I'd like to get it down a bit more.

    Is only been a few weeks. I didn't even see a blue number until 2 months in. Lol
     
  20. AlphaCat

    AlphaCat Member

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    May 9, 2017
    I stuck with 1.25 for this morning as we had a vomit issue yesterday, that appears to be resolved, but I don't know what it was from. I got two blues at her afternoon Nadirs on the 1.25, which looks like progress, but the crazy black numbers in the AMPS are scaring me a bit. So, I'm fearful of upping the dose to get better Nadirs, but worse (goodness, how much worse can the get) numbers at AMPS.

    I remember having to wake my grandmother from a diabetic coma-like state a couple of mornings with high sugar. If Fabby passes out between her overnight nadir and morning, I may not notice until it's too late because that's when I actually catch a couple hours sleep.

    So I'm not opposed to a 1.5 increase, but I'm not comfortable either... lol - but none of this is comfortable.
    Can you explain to me in novice terms the benefits of increasing before she develops a pattern on the 1.25? (Perhaps it will quiet my fears?)
     
  21. AlphaCat

    AlphaCat Member

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    May 9, 2017
    So, Fabalous update:
    We seen to have gotten past the throwing up, and it appears to be due to a Neosporin reaction.
    Yesterday, we had our first no throw up day. So today we are working on getting or shot times back to normal. (Should take 3 days total with moving back 30 minutes each time.)
    We got out lowest AMPS this morning of 212. She's almost to low for her insulin!

    Does an AMPS of 212 need to be watched more closely?

    Our (pre-throw up issue) normal insulin do would be 300-400 down. Obviously when she's pulling numbers in the 500's that's good, but when she's 212, she can't handle that big of drop. Will her body handle the insulin and just do it's thing to normalize so there's not as big of a dip?
     
  22. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    I think Fabby has been bouncing a bit from those mid cycle blues. That is to be expected but it seems to be calming down at this point in time. I would be a little more vigilant today and test her at +2 or +3 to see where she is heading. If she is going at a quick pace or by more than 100 points or so at that reading, you can steer her with a snack to try to flatten out the curve and keep her from going too low. I would definitely start steering her if she gets to 90. All in all, I think she's looking pretty good for early days.
     
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  23. AlphaCat

    AlphaCat Member

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    I just saw this and then tested her, it's already at +5. She's at 131, and I gave her her regular afternoon meal (one can of fancy feast). I'll check her again in a couple hours to make sure she's not still going down. Thanks for the vote of confidence in progress,
     
  24. JanetNJ

    JanetNJ Well-Known Member

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    131 is a great number.
     
  25. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    That 131 is indeed a nice number! :joyful:
     
  26. AlphaCat

    AlphaCat Member

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    May 9, 2017
    I'm happy with anything in Blue! But this one is indeed our lowest test number ever.
    Go Fabby! About to test again to double check...
     
  27. AlphaCat

    AlphaCat Member

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    169 at +7 so we should be safe and not going to drop lower (right?).

    So today we had our lowest number, and two blues in a row!
    We're over here breaking records!!!
    Thank all of you for all your help and support, it means the world!
     
  28. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    This cycle is looking wonderful. I wouldn't expect a drop again now but she might surf in the same range for a bit longer. Given that 131 earlier is Fabby's lowest numbers yet, don't be discouraged if the PMPS is up a bit. Perfectly normal as Fabby gets reacquainted with lower numbers. You are making great progress!
     
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  29. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Lovely cycle today! And hurray for no barfing! :D
     
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  30. AlphaCat

    AlphaCat Member

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    May 9, 2017
    So I was totally expecting black numbers tonight!
    330
    That's her PMPS.
    That is usually her mid to low range numbers... definitely low for a PMPS.

    So new question...
    The last 3 days she was doing the throwing up in the morning, which threw her shot schedule off by a couple hours.
    That caused me not to get a nadir reading overnight because the timeframe moved too far I had to sleep. Because she didn't get tested, she didn't get fed either overnight.
    I think today's good numbers are part she's feeling better and part the insulin doing it's job... but I question if the change in feeding schedule is also part of the equation? She went from 4 meals a day before Neosporin issue, to 3 meals a day during the issue.
    I should be okay to get a +5 reading tonight and feed the 4th time. (She needs the food to maintain weight and I can't get her to eat enough in one sitting.) But do you think that plays into the good numbers she had today?

    Also, I am expecting the black numbers to come back sometime... with this diabetes ride, it's been one step forward two steps back...
     
  31. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    I was not suggesting the PMPS was going to be all the way to black :eek:but rather that it might be a little higher than the AMPS and that is what Fabby did.:cat:
    The difference in food intake may have had some impact on those numbers but with Fabby not feeling good that too might have elevated her numbers the previous day so it's hard to say how much is attributable to less food vs. feeling yucky. Yesterday's cycle was great so I'd stay the course for the time being but get her back onto her regular amount of food and then if need be, the dose can be adjusted once you know what she is doing at 1.25u on her optimal food intake.

    Nadirs don't occur at exactly the same time every day so if shot times get pushed ahead, take a reading at +2 or +3, whatever your sleep times allow. While it may be before nadir, it should give you a clue as to where Fabby is headed. You can then offer more food at that time to slow any big drops down. Generally feeding in the first half of the cycle and before nadir will help to smooth out the curve of action.

    Positive thoughts now! While no one can guarantee no more blacks, and yes you may end up doing the two step shuffle occasionally, you are on the right track. :)
     
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  32. Yong

    Yong Well-Known Member

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    Learning the steps to the sugar dance! Only Fabby hears the musique :smuggrin:
     
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  33. AlphaCat

    AlphaCat Member

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    May 9, 2017
    :)
    Thank you for the advice!
    Expecting the blacks wasn't out of fear, it's just been what's regular for us at both AMPS and PMPS since we began testing. I'm mostly a realist. I choose to hope for the best, but be prepared for the worst. That overthinking habit comes in handy in realist mode...
    I'd be thrilled if the 300's range became our new normal at AMPS and PMPS for a while, with black only being an outlier. I like to think I'd be happy with progress, I just don't quite know what progress looks like yet, lol.
    But with each new day a new opportunity to do better/be better arises! Both me and Fabby will work on it!

    Tonight's PMPS puts us back on regular schedule, but if it comes up again, I'll just go as you suggested with an earlier test and feed. Sounds like maybe that should be my regular plan anyway...

    I appreciate all of you being here and following along to nudge our journey!
     
  34. Kris & Teasel

    Kris & Teasel Well-Known Member

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    The perspective you have on all this will save your sanity! Many people drive themselves nuts wanting to get it done and dusted ASAP or wanting to will the FD into submission. Not good for you ... :)
     
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