Caninsulin dosage advice needed please

Discussion in 'Feline Health - (The Main Forum)' started by Monica Lewis, Jun 10, 2017.

  1. JanetNJ

    JanetNJ Well-Known Member

    Joined:
    Jun 8, 2016
    It generally peeks 4-6, so any readings then.

    5 is halfway.
     
    Monica Lewis likes this.
  2. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    I'd go for the +4 if you can get only one. :)
     
    Monica Lewis likes this.
  3. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

    Joined:
    Feb 18, 2015
    Monica, I agree that testing between +4 and +6 will generally catch the lowest reading but there are some kitties that drop a lot even earlier. Rather than testing at +4 every day, I would shuffle test times it a bit and randomly test from +2 through to +6 . I am curious about those red pre-shots. Not what I expected to happen and it makes me wonder if she is dropping before +4 and what you are seeing is actually a rise rather than the lowest reading of the cycle. Of course it could also be that Josie does need more insulin. Hold the dose for the moment and we'll see what she does. :)
     
  4. Diana&Tom

    Diana&Tom Well-Known Member

    Joined:
    Dec 29, 2009
    Hi Monica, it wasn't me actually who sent you the link, it was probably @Elizabeth and Bertie so by tagging her here she will hopefully see it and let you know...
     
    Last edited: Jun 22, 2017
    Reason for edit: Correction
    Monica Lewis likes this.
  5. Elizabeth and Bertie

    Elizabeth and Bertie Well-Known Member

    Joined:
    Sep 6, 2010
    Monica Lewis likes this.
  6. Yong

    Yong Well-Known Member

    Joined:
    Jan 11, 2017
    Before I realized the thread went onto page two I was typing, if you have to pick one go for +4 :smuggrin:
     
    Monica Lewis likes this.
  7. Monica Lewis

    Monica Lewis Member

    Joined:
    Apr 16, 2017
    That's great, thanks very much Eliz!
     
  8. Monica Lewis

    Monica Lewis Member

    Joined:
    Apr 16, 2017
    Interesting point about shuffling times of read, will try to do that thank you!
     
  9. Monica Lewis

    Monica Lewis Member

    Joined:
    Apr 16, 2017
    Hello nice ladies,
    I'm well pleased and relieved to see lower PS numbers and out of the reds! I'm hoping we are on the right track here but as Diana suggested will keep an open mind and prepared for anything..

    Josie's been eating very well and a happy kitty, even up for playing which is a big thing for her lazy butt! :)

    Will try to get random readings to include everyone's suggestions and if things are getting consistent we'll regroup in a few days time to review the action plan.

    Ps. Vet couldn't open the link for spreadsheet so Im going to print out and hand it in to her, she specialises in diabetic cats so Im curious to see what she'll say..

    As always thank you everyone for being there for me and Josephine, hope you all have a lovely weekend! :cat:
     
  10. JanetNJ

    JanetNJ Well-Known Member

    Joined:
    Jun 8, 2016
    She may have to download Google Sheets to see it.
     
    Monica Lewis likes this.
  11. Monica Lewis

    Monica Lewis Member

    Joined:
    Apr 16, 2017
    Ladies I need help please!

    Josie's been eating well past few days and PS numbers bit high but consistent..
    This morning she ate ok and even played a bit, seemed happy. I managed to do 3 readings before we went out around 1pm. It's been pretty warm today, we just got back around 5pm, Josie didn't want to eat,snack or drink water, she wasn't even interested in her favourite treats whilst testing her which has not happened since we got these freeze dried chicken treats as she goes nuts for them....

    Her readings were surprisingly high at 5pm - 21.9 / just under 400. She hasn't eaten since just laying there sad and no insulin given but 2 and half hours later her PMPS numbers gone down a bit to 19.8 / 350 ?!

    How's that possible and what shall I do now?
    As she's not eating Im holding off the insulin at the mo. Or as it's a small amount 0.25 shall we give her? Her ears and paws feel warm so might have a temperature ( or just hot in this weather..?)

    The only thing she was willing to lick off my palm was a little blob of coconut oil which she always eats no matter how unwell she is... ( I adore coconut oil, use it and eat it, it's supposed to be good for cat's digestion and aid their wellbeing as well - although now certain websites say it's not good for diabetic cats so now I'm reluctant to give her the tiny odd treats.. any opinion on this subject would be appreciated too...)

    Anyways, any suggestions what to do now?
    Just when I thought we were actually finally getting somewhere..!:banghead:
     
  12. Diana&Tom

    Diana&Tom Well-Known Member

    Joined:
    Dec 29, 2009
    Hi Monica, sorry to hear you sounding worried, these kitties do like to keep us on our toes and honestly, they can throw you an unexpected number out of the blue at any time with no rhyme or reason. But for now I think I'd try to tempt her to eat with the usual tricks - tuna, Parmesan cheese, anything strong-smelling? See if you can persuade her to eat even a little. It may be that she just feels a bit off because of her fluctuating BGs, and that plus the heat has tired her... I don't know about you but I don't want a lot to eat in this warm weather, it's very tempting to just flake out in the coolest place! My own little civvie, Sapphire, has been on and off (mostly off) her food all week and just lolls around or sleeps somewhere really cool... I've been quite concerned but she seems to recover her appetite late in the day when it's cooler. So give Josie a bit longer this evening and she may start to feel peckish soon. And I wouldn't worry *too* much about the 21.9 and 19.8 numbers, the difference is negligible really.

    See if she eats something now it's starting to get cooler. You should be ok to dose 0.25u at a BG of around 20 but test again at say 9pm and let us know what her number is then if you're undecided.
     
    Monica Lewis likes this.
  13. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

    Joined:
    Feb 18, 2015
    I notice she dropped almost 50% of her pre-shot last night by +2 which makes me think she may have dropped even further and that would likely have set off a bounce likely contributing to the pre-shot this morning and likely still ongoing. It can take up to 3 days for a bounce to occur. She had a nice drop today by +4 and may have gone lower by +6 as she sometimes seems to nadir around +6. I don't think her BG is of any concern right now.

    I'd keep trying to get her to eat and if need be, give her whatever she will take whether it's on her allowable food list or not. Got any deli meat or baby food on hand to get something into her tummy? A little poached chicken? You could try warming her cat food up a bit to make it smell more enticing to her. Sometimes you just have to jump start them!

    I'd also test for ketones just to be on the safe side. I doubt that's the problem but better to check.
    Breathe! These little monkeys can get fussy for unknown reasons sometimes and then will suddenly eat just fine. It's Ok if she misses a shot. Safety first. That said, if you check for ketones and get any indication of their presence, then we need to rethink skipping the shot.
     
    Monica Lewis likes this.
  14. Monica Lewis

    Monica Lewis Member

    Joined:
    Apr 16, 2017
    Thank you ladies!
    Just got back from supermarket with her favourite food tuna flakes in spring water. As soon as she heard the tin opener she got up slowly came in and sat by me. Then ate two mouthful of tuna drank little water and went back to lay down.
    She growled at us before when we lifted her up to test which she only does when unwell and doesn't want to be bothered.
    As only tested 90 minutes ago and it was high maybe we could give her a tiny dose without testing again?
    No ketone strips I'm sorry. Meant to order but keep forgetting and vet said before no need at this stage..?
    Will get some asap.
     
  15. Monica Lewis

    Monica Lewis Member

    Joined:
    Apr 16, 2017
    This is how she is leaning over her water bowl now, sometimes drinking but staying down there the whole time..
    She was like this just before diagnosed and a once more a couple of weeks ago when she was sick with yellow foam.
    Never got to the bottom it why she does this but apparently she's not the only one..
    Any ideas?
     

    Attached Files:

  16. Diana&Tom

    Diana&Tom Well-Known Member

    Joined:
    Dec 29, 2009
    Well it's a good sign that she responded to the sign of the tin opener... if she was really unwell she wouldn't have reacted to that.

    Hunching over the water bowl clearly shows she is thirsty which is a classic symptom/sign of an unregulated diabetic, so when Josie is highish as she seems to be at the moment, and the weather's warm, it's no surprise that she wants to drink. The yellow foam indiciates an acid tummy and therefore nausea which also means disinterest in food. It's a vicious circle because food would settle her tummy and make her feel better. I'd be inclined to keep trying to tempt her with the tuna - put some on your finger and see if she will take it that way - and give her a tiny dose.

    It does look as if how she is presenting at the moment is a mixture of high BGs, warm weather and nausea combined... not a nice way to feel and that's no doubt why she is growling at you. Spend a bit of time with her to soothe her and she may relax and eat a little for you... all fingers and paws crossed here.
     
    Monica Lewis likes this.
  17. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    I see where you lowered her dose a few days ago when she had a yellow PMPS. I read your note that you did it to be on the safe side because she hadn't eaten much. Then you kept the lower dose in an experiment to see if it would alleviate the bouncing. In my opinion it looks like 0.25 u is too low because she's been in higher numbers since. Urine ketone test strips can be had at any human pharmacy. I recommend you go buy some ASAP and test her for ketones. I'd also increase back up to 0.5 u tonight.
     
    Monica Lewis likes this.
  18. Monica Lewis

    Monica Lewis Member

    Joined:
    Apr 16, 2017
    Yes a nice little combo is just what I needed on top of the sick child and flea infestation Im dealing with at the mo! Once better I will praise Josie for her excellent timing skills!

    She ate a tiny bit more so we gave her a tiny dose just to keep the numbers down a bit for the time being..
     
  19. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    Hi Monica,
    Could you clarify please: what tiny dose did you give and at what time? Please add it to your SS. My sympathy to you - these things always seem to happen together.
     
    Monica Lewis likes this.
  20. Monica Lewis

    Monica Lewis Member

    Joined:
    Apr 16, 2017
    Yes I think you're right and we probably need to increase her dosage eventually as .25 doesn't seem to be keeping her low enough ( unless things change.. ) but I think i'd be nervous increasing the dosage tonight as she's not eating much and not looking too well..

    Gave her a small dose to get her numbers lower for the night and will rethink dosage as soon as she's eating well again. Thank you!
     
    Diana&Tom and Kris & Teasel like this.
  21. Diana&Tom

    Diana&Tom Well-Known Member

    Joined:
    Dec 29, 2009
    So sorry this is adding to your woes, Monica... it never rains but it pours.
    I know you've had different thoughts again here this evening and it does get confusing trying to think it all through, so I was going to suggest the usual "go with your gut" which you have done... let's see how Josie is in the morning and meanwhile give yourself a nice drink or some treat to keep you going with all that's going on.
    Try to get a good night's sleep!
     
    Monica Lewis likes this.
  22. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    Please get urine ketone test strips and start testing. I'm sorry if I'm pressuring you but I went through an episode of diabetic ketoacidosis (DKA) with Teasel. I'm not saying that's what's going on with Rosie but not eating much along with high-ish BGs is part of the recipe for ketone development. Caught early, they're treatable at home. They can increase quickly and kitty can become very ill.
     
    Yong and Monica Lewis like this.
  23. Monica Lewis

    Monica Lewis Member

    Joined:
    Apr 16, 2017
    Yes will try to get them tomorrow. We live in the countryside with no overnight pharmacy and I don't drive so will have to wait til tomorrow.
    Asked my vet on our last visit about ketones and she told us not to be concerned about ketones at this stage so we left it.
    Thank you, no worries I understand now that it could be important. Although not sure how I'm going to test as Josie doesn't have a litter tray and uses the garden through her cat flap as and when needed.
    I'll just have to figure that one out somehow.
     
  24. Monica Lewis

    Monica Lewis Member

    Joined:
    Apr 16, 2017
    I can't drink Diana, I need to stay focused here! :)
     
  25. Monica Lewis

    Monica Lewis Member

    Joined:
    Apr 16, 2017
    Josie only ate late around 10.30 this morning, little tuna and a spoonful of plain greek yogurt so gave her delayed shot of .25u at 10.30. She ate again since steamed white fish and another little spoon of yogurt. She's laying upstairs, she was purring when went to talk to her and rolled on her back exposing her belly waiting for strokes. I suppose it's a good sign..?
    Also not seeing any other visible signs of illness only lacking of energy..

    Just tested her, it was 18.4.

    As numbers are consistently higher since on .25u if she eats ok this eve would it be a good idea to increase her dosage from tonight to 0.5u and keep her on it for a while?

    Also as morning short was delayed by about 3 hours when should we give her the evening dose?

    Many thanks!

    Ps. Would you take her to the vet tomorrow for check up, maybe ask for new blood tests and pancreas test or anything else? She had last work done end of April when diagnosed and it all came back clear..

    Or just leave vet if she recovers fully ( like she usually does within a couple of days...)?
     
  26. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    I agree. Fingers crossed. :)

    Yes, I think she needs to go up. However, with the three hour delay this AM, the dose timing this evening will be tricky. There's about an hour plus or minus in time flexibility with Caninsulin. You could plan to test/feed/dose about two hours later than normal this evening, one hour later tomorrow AM and then you'll be back on track tomorrow PM. The dose you give will depend on the PS BG number quite a bit because it's possible that there'll be a little overlap between doses.

    Why not give it another day or so to see if she rallies? If she'll eat something (break all the rules if you have to) she *should* be OK. I'd get those ketone test strips and start that routine soon, though.
     
    Yong and Monica Lewis like this.
  27. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

    Joined:
    Feb 18, 2015
    Monica....a couple of requests........Can you please put the doses she got last night and this morning into the regular unit columns because you still want to be able to see what she is up to at any given hour post shot. If you are unsure how to do this, have a peak at my girl's sheet at the end of the evening cycle 25Apr17 and beginning of the day cycle 26Apr17 when I had to do something similar. You will have to manually colour code the boxes if there is any extra text added like the hour in any box. Right now with a quick peak, it looks like she missed two shots which she didn't. ;)

    I agree with Kris' suggestions for getting back onto your normal shot schedule and about the vet and ketones if you can manage to test Josie. Any chance you'd be able to sneak a long handled spoon under Josie's butt while she's tending her business in the yard?

    It is looking like Josie may need a bit more insulin but if she is feeling poorly that could also explain the higher numbers. See what her pre-shot is tonight and then decide on dose.
     
    Monica Lewis likes this.
  28. Monica Lewis

    Monica Lewis Member

    Joined:
    Apr 16, 2017
    Yes we'll see how things are. Ketone strips are on top of my list now, not sure about the ladle or going back to setting up a litter tray and try to keep her indoors, she'd probably be confused and drive us mad scratching on the cat flap and door for hours!

    Ill figure something out.. Or maybe the vet will do it for us when she's in for check?

    If her PMPS numbers are high and she's eaten then maybe should be ok to give her 0.5u dose without waiting an extra 2 hours as 0.25u Caninsulin wore off already? As it's only effective for 8-10 hours?

    Of course I will delay if that's how it must be done, I was just thinking maybe no need to delay that much longer as it was a tiny amount in the morning and she'd probably have high readings anyway. Maybe delay only by one hour?

    Will test her around 8pm instead of 7.15 and post the numbers if anyone is around to check?

    Thank you!
     
    Kris & Teasel likes this.
  29. Monica Lewis

    Monica Lewis Member

    Joined:
    Apr 16, 2017
    Yes the spreadsheet blip bugs me too, will try to correct it thank you!

    I was thinking about what you said Linda that she still might be bouncing but she's been on .25 for 5 days now so Im inclined to think that it was long enough time to clear the bounce if that was the case?
     
  30. Monica Lewis

    Monica Lewis Member

    Joined:
    Apr 16, 2017
    Oh bugger!!! Good news and bad news.

    I've just discovered as was about to test Josie that I have only ONE test strip left and the spare box been used up!:banghead:

    Pharmacy will open tomorrow morning..

    The good news is that Josie just came downstairs and asked for food then just finished a small plate of steamed white fish! :)

    Oh dear, dear what is one to do now.....
     
    Kris & Teasel likes this.
  31. Diana&Tom

    Diana&Tom Well-Known Member

    Joined:
    Dec 29, 2009
    Save strip for tonight's pre-shot test and do a dash to the pharmacy early tomorrow before you test and give insulin then?
     
    Yong, Monica Lewis and Kris & Teasel like this.
  32. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    Glad about the food. Darn it all about the strips! I like Diana's plan. :)
     
    Monica Lewis likes this.
  33. Monica Lewis

    Monica Lewis Member

    Joined:
    Apr 16, 2017
    Well it has to be. I cannot tell you how annoyed I am with myself. Just like the emoji above I could bang my head against the wall for being so dumb!:(

    Well fingers crossed we won't mess up tonight's read...
     
  34. Diana&Tom

    Diana&Tom Well-Known Member

    Joined:
    Dec 29, 2009
    Take a chill pill, Monica :) it will be fine. Josie is unlikely to be too low to shoot, so as long as she eats something that's fine, maybe stick to the current 0.25u if you do mess up the test and are worried.

    BTW if you have any human friends/relatives/neighbours with diabetes, you could always ask to borrow a meter and strips from them - may not be exactly the same as your meter but would give you a ballpark figure.
     
  35. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

    Joined:
    Feb 18, 2015
    Life happens! All will be fine. Another vote here for Diana's plan! :)
     
    Monica Lewis likes this.
  36. Diana&Tom

    Diana&Tom Well-Known Member

    Joined:
    Dec 29, 2009
    I think it's the only plan, Linda! :)
     
  37. Monica Lewis

    Monica Lewis Member

    Joined:
    Apr 16, 2017
    haha yes I was thinking exactly the same about the chill pill:D
     
  38. Monica Lewis

    Monica Lewis Member

    Joined:
    Apr 16, 2017
    Not helping that we are dealing with yet another flea infestation at the moment and just caught a flea on my little boy's face... To say that I am not a happy bunny would be an understatement...!:mad:
     
  39. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

    Joined:
    Feb 18, 2015
    :bighug::bighug::bighug:. Sounds like you need these!
     
    Monica Lewis likes this.
  40. Monica Lewis

    Monica Lewis Member

    Joined:
    Apr 16, 2017
    Well yes it's either these or a straitjacket! lol Thanks Linda, they were well received.. :)
     
    MrWorfMen's Mom likes this.
  41. Monica Lewis

    Monica Lewis Member

    Joined:
    Apr 16, 2017
    Evening PS number is 18.4 so going ahead with 0.5unit if she eats reasonably well..?
     
    MrWorfMen's Mom likes this.
  42. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

    Joined:
    Feb 18, 2015
    Not that I think Josie is going to pull any punches but conservative me would probably not make a dose increase, even if I thought it was needed, unless I had strips to test should the need arise. Just a thought! One more night at 0.25u isn't going to hurt Josie.
     
  43. Monica Lewis

    Monica Lewis Member

    Joined:
    Apr 16, 2017
    Good thinking, although she's been eating her usual food with great vigour at the moment..:)
     
    Diana&Tom and Kris & Teasel like this.
  44. Monica Lewis

    Monica Lewis Member

    Joined:
    Apr 16, 2017
    I'm always up for keeping her on the safe side..
     
    Diana&Tom and MrWorfMen's Mom like this.
  45. Diana&Tom

    Diana&Tom Well-Known Member

    Joined:
    Dec 29, 2009
    Yes good thinking!
     
    Monica Lewis likes this.
  46. Diana&Tom

    Diana&Tom Well-Known Member

    Joined:
    Dec 29, 2009
    Great - so try not to worry too much if she has the odd quiet day, food-wise. I really don't blame her for not having much appetite in the recent weather but eating with great vigour sounds like she's making up for it!
     
    Monica Lewis and MrWorfMen's Mom like this.
  47. Monica Lewis

    Monica Lewis Member

    Joined:
    Apr 16, 2017
    Thanks very much everyone!
     
    Yong likes this.
  48. Monica Lewis

    Monica Lewis Member

    Joined:
    Apr 16, 2017
    Good morning,
    Got the strips,
    AMPS is much lower at 17.4. Shall we start on the 0.5 unit then or keep the same 0.25 as it might've gone down by itself and bounce is clearing???
    Hopefully one of you will see this soon, just prepping kitty's breakfast in the meantime thank you!
     
  49. Monica Lewis

    Monica Lewis Member

    Joined:
    Apr 16, 2017
    Couldn't keep her waiting anymore for food so went for .25u for once more.
    If PS numbers keep staying low then I guess I made the right decision, if goes up will increase to 0.5. Fingers crossed once again...
     
  50. Diana&Tom

    Diana&Tom Well-Known Member

    Joined:
    Dec 29, 2009
    I think you have a good understanding now Monica and yes probably the right decision to stick with the lower dose for a couple more days if necessary... last week's extreme weather could have contributed to the higher BGs so now that factor is out of the equation (phew!) we can see a more realistic picture with the 0.25u, hopefully.

    When in doubt, it may help to look back at your spreadsheet and see what dose you gave on a given number and how Josie responded then... I like the curve on 19 June when you got some nice blues mid-cycle, and not too steep a drop or rise. But other days have seen a different pattern. The more I see of this the more I think a sliding scale might be appropriate - adjusting the dose depending on the number. It muddies the waters in some ways and clarifies it in others... vets don't usually approve but if you get better results from it that's what counts. So if the 0.25u doesn't cut it after a couple more days, I personally would try a sliding scale. But you have other options too - raise the dose in tiny increments - and others here may have other opinions. As we keep saying, we can chip in with our thoughts but that's all they are - suggestions for you to consider taking into account everything else that's going on with Josie.

    Paws crossed for some nice numbers this week!
     
    Yong, Kris & Teasel and Monica Lewis like this.
  51. Monica Lewis

    Monica Lewis Member

    Joined:
    Apr 16, 2017
    Thank you Diana!
    I'm on the edge of my seat and eagerly awaiting to find out which way is Josie going to swing us this week..!
     
  52. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

    Joined:
    Feb 18, 2015
    There is no doubt that the weather could be playing a role in Josie's recent numbers but I'm wondering if some of those high numbers you saw in the last week are a result of bouncing too because on 23Jun evening cycle, Josie dropped 180 points within 2 hours of her shot....that's almost 50% within 2 hours. We don't know if she went even lower that cycle but that significant drop that early in the cycle could have been enough to set off a bounce.

    I think I'd be inclined to see how today's cycle goes and continue 0.25u for tonight's shot. If the numbers aren't improving, I'd raise Josie to 0.5u tomorrow morning. I personally prefer to do dose increases on day cycles so I am able to monitor as needed.

    Some cats do great on a sliding scale but as Diana says, it can muddy the waters somewhat. Ideally kitty is stable enough that a particular dose is giving you similar results consistently so you can determine what that sliding scale should look like.
     
  53. Diana&Tom

    Diana&Tom Well-Known Member

    Joined:
    Dec 29, 2009
    Nice gentle curve today, Monica - bet you're pleased to see that yellow pre-shot number! Stick to the dose tonight if you haven't already - will be interesting to see her number tomorrow morning.
     
    Monica Lewis likes this.
  54. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

    Joined:
    Feb 18, 2015
    Josie is looking good today. Fingers crossed we see more of those yellow pre-shots in days to come! :D
     
    Monica Lewis likes this.
  55. Monica Lewis

    Monica Lewis Member

    Joined:
    Apr 16, 2017
    Oh I can't tell you guys how excited I got when saw the PMPS numbers! Almost turned on the waterworks once again...haha

    Glad we decided to stick with the 0.25u for a little longer, may she keep up the good work and numbers..:cat:
     
    Yong, Diana&Tom and MrWorfMen's Mom like this.
  56. Monica Lewis

    Monica Lewis Member

    Joined:
    Apr 16, 2017
    Just so you know Linda I can always hear your voice in the back of my head when deciding on dose saying 'try to hold that .25u just a little bit longer if you can...' :)

    You also gave me a good idea of what to take on next, I'm going to compare spreadsheets and trying to work out patterns to have a better understanding of the cycles and how is it all going to work towards achieving possible remission?

    Im still not clear on what is it that we are going to aim for? Keep a cat within more less normal range and wait how they respond naturally and they will gradually go lower and lower eventually or we are increasing dosage slowly to push them into even closer to lower numbers to 'make ' them recover...

    Thank you anyway for your insights and theories, Im constantly learning so much from all of you!
     
  57. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

    Joined:
    Feb 18, 2015
    OH Dear! I hope I'm not too loud or annoying! :woot:

    Insulin is a hormone....not a medication. While 2 aspirins might relieve a headache better than 1 aspirin, the same does not hold true with insulin. Sometimes less is more especially when starting out with an insulin like Caninsulin because of the faster and steeper BG drops and the potential bouncing this can cause.

    We all have that ultimate goal of remission but there is no guarantee that if you do x,y & z you are going to win that jackpot. So your goal is to keep Josie in the most optimal BG range for as long per day as possible. Doing this gives the pancreas a chance to rejuvenate and in some cases, the pancreas heals enough to take over doing it's job completely and the dream of remission is realized.

    Keeping kitty in the best numbers possible sometimes means patience rather than rushing will be more effective. Too much insulin can look just like too little number wise so while you don't want Josie sitting in high numbers and seeing no improvement for too long, you also don't want to rush the process & try to avoid bouncing as much as possible. This is a marathon, not a sprint so a slow steady methodical approach helps get kitty regulated faster. For safety sake I'd aim to get Josie into the 5 mmol to 8mmol range at nadir and keep her in the blues for as long per day as possible. That would be great regulation and who knows, maybe lead to remission! :)
     
    Monica Lewis likes this.
  58. Monica Lewis

    Monica Lewis Member

    Joined:
    Apr 16, 2017
    Ok I see what you mean and it sounds sensible.
    My question then would be HOW to keep kitty in safe blue numbers longer?
    Is that something that she is going to achieve by herself eventually or do I need to take it to the next level, such as tight regulation or dosage change?

    If we continue with .25u here and suppose things were going well, will those preshot numbers get lower by themselves eventually as Josie's pancreas starts kicking in producing more insulin or do we have to assist it by altering the dosage to get her to stay longer in the blues..?
    I hope this makes sense.. sorry!
     
  59. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

    Joined:
    Feb 18, 2015
    You make perfect sense! This sugar dance is anything but intuitive. Sometimes it's downright confounding!

    First step is to find a dose that keeps pre-shots at a reasonable level, gets nadirs to more optimal numbers but is also not causing excessive bouncing anymore. That gives the body a chance to re-acquaint itself with somewhat lower numbers. Once the bouncing stops, you can raise the dose by 0.25u and again allow a few days to see how that dose is working. This is a "wash, repeat" process until you find that sweet dose that gives kitty the best cycles possible. Josie doesn't seem to be bouncing much if at all now and her cycles are a lot flatter so it's time to raise her dose to 0.5u and see how she does with that.

    Josie has become used to high numbers so her defence system that keeps her BG from going too low, revs into action prematurely. So when she got down to those blue and green numbers, her body panicked and pushed out hormones to raise her BG. Unfortunately it often pushes the BG up way beyond where it needs to be and that effect, although waning can last up to 6 cycles. If you raise the dose while she is bouncing, you set off more bouncing and poor kitty ends up on a roller coaster of highs and lows. Bringing the BG down gradually allows the body more time to get used to being in lower BG ranges so more optimal numbers can be maintained for longer periods.

    When you start getting the cycles you want, then it's a matter of fine tuning and making sure she doesn't go too low and that is where, IMHO, sliding scale dosing can be a good option.

    I hope that helps but if not, ask away! :D
     
  60. Monica Lewis

    Monica Lewis Member

    Joined:
    Apr 16, 2017
    It's brilliant thanks very much!
     
    MrWorfMen's Mom likes this.
  61. Diana&Tom

    Diana&Tom Well-Known Member

    Joined:
    Dec 29, 2009
    Yes brilliant summation of the whole thing from Linda, this should really help to clarify things for you, Monica.

    All newbies here learn certain "catchphrases" here very quickly - FD is a marathon not a sprint; start low, go slow; ECID (every cat is different) to name but a few! Treating FD is a labour of love, that's for sure, and not an easy thing by any means to get one's head round. It can feel like learning a new subject back st school! What makes it all worthwhile is the confidence you gain in treating your kitty... we feel so helpless at the start but bit by bit when it starts to come together we feel more empowered and that enables us to keep on learning and helping our kitty. And in doing so we form even tighter bonds with these dear little creatures whose health and wellbeing means so much to us...and in due course we can put our knowledge and experience to wider use by helping other people on this board. It really is the most amazing place.

    There is a certain point at which you feel you have turned a corner in your understanding and I think you're now turning that corner. As I've said, you have a great positive attitude and that is your great advantage.

    Sorry for the ramble, it just came out! Hope today is another good day! :)
     
  62. Monica Lewis

    Monica Lewis Member

    Joined:
    Apr 16, 2017
    Aaahhh... thanks very much Diana, all those sleepless nights of internet browsing, FDMB conversations and wanting to learn endless finally paying off. I am a lot calmer and do feel more confident about things. I even started advising overwhelmed newbies who just started going through this whole madness. I can help them from my own experience how to 'breathe, calm down and prioritise':)

    I think now I'm beginning to understand why you guys are helping us so much.

    And yes thank you, numbers are looking very promising today as well....:D
     
    Kris & Teasel and Diana&Tom like this.
  63. JanetNJ

    JanetNJ Well-Known Member

    Joined:
    Jun 8, 2016
    Now that the bouncing has settled it may be time to up it to .5 to try to get that nadir down a bit... we can't be satisfied with her staying in the 200's all the time. what do you guys think.
     
  64. Monica Lewis

    Monica Lewis Member

    Joined:
    Apr 16, 2017
    Yes I was also wondering what will be the next step.

    Was going to give it a couple more days at least though on 0,25u to see which way is Josie going to go?
    Plus we have a problem that can complicate things.. Now she started scratching and getting jumpy shaking her legs so looks like she has fleas. Whenever we treat her for flea almost around that time she seem to be getting these 'off food sick days' but we can't say it for sure that that's what causes it.

    Have to pop in to vet for another vial of flea treatment today and no choice but to treat her as fleas are taking over our house as well.
    Could we wait with any changes until we see how she is going to respond to the flea treatment?
     
  65. Diana&Tom

    Diana&Tom Well-Known Member

    Joined:
    Dec 29, 2009
    Yes I'd stay with 0.25u for another couple of days to get a better picture and then look at increasing to hopefully get pre shot numbers down. Fleas might raise BGs too - stress - so see what the treatment does...
    Marathon not a sprint!!!
     
    Monica Lewis likes this.
  66. Monica Lewis

    Monica Lewis Member

    Joined:
    Apr 16, 2017
    Hello everyone!
    Numbers were not going down past few days but creeping up with an AMPS of 21 / 385 this morning so on everyone's advice we increased dosage to 0.5u. Let's see what happens..

    I do have another question though. Josie gets bored with just one food so now we have two different makes that we alternate, Sheba Flakes and Butcher's Classic.
    The Sheba Flakes carb content is 2.5% , Butcher's Classic Really Meaty 3.5% and Butcher's Classic Original 8.8%. ( very high meat content in all Butcher's Classics and no added nasties)

    Does it make a big difference in the BG readings and in general whether I feed the 2.5% or the 8.8% carb food or as long as they're both under 10% it doesn't make much difference?

    What carb content do you usually go for?
    Many thanks everyone!

    Ps. Finally managed to get our vet to access Josie's spreadsheet, her words were ' wow it's brilliant, it's amazing and I'm very impressed!' She's also totally on board with everything I'm doing so that makes life a lot easier!:)
     
  67. JanetNJ

    JanetNJ Well-Known Member

    Joined:
    Jun 8, 2016
    Anything under 10 is ok. Give it a try.
     
    Monica Lewis likes this.
  68. Diana&Tom

    Diana&Tom Well-Known Member

    Joined:
    Dec 29, 2009
    Glad to hear your vet approves, Monica, so she should!!
    Yes 0.5u seems to be indicated now so good move to up the dose. Will be interesting to see the response.
    Janet has answered your question about carb content - - good rule of thumb.

    Good luck!
    Diana
     
    Monica Lewis likes this.
  69. Yong

    Yong Well-Known Member

    Joined:
    Jan 11, 2017
    0.5U sounds good here too :cat:. Like Janet said, try it out. Her numbers will probably let you know if there's a significant impact between 2.5% carb and 8.8% carb ;)
     
    Monica Lewis likes this.
  70. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    Hurray about your vet!! Re carbs: some kitties are more sensitive than others and Josie's BGs will tell the story. It's also true that you can drive yourself nuts worrying about slight differences in carb content even if the various foods are under 10%. Unless you have SS evidence that your kitty is one of the very few extremely sensitive kitties, you can mix up the food offerings to keep Josie interested.
     
    Monica Lewis and MrWorfMen's Mom like this.
  71. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

    Joined:
    Feb 18, 2015
    Ditto to what's already been said. Looking forward to seeing what the dose increase does for Josie! :)
     
    Monica Lewis likes this.
  72. Monica Lewis

    Monica Lewis Member

    Joined:
    Apr 16, 2017
    Wow thanks very much everyone, it feels really nice that actually ALL of you got back to me with your little comments! I can really feel the love:)
    It's probably just what I needed today as I must admit I got very disappointed, disheartened and frustrated seeing the unusually high AMPS number this morning and that her BG hardly gone lower throughout the day which makes no sense...?
    I feel like it's all getting to me at the moment. I'm having a selfish day today when feel sorry for myself that I haven't had an early night or a lie in in the morning for months, just the constant worry and hovering over Josie like a helicopter all the time and unable to relax. And just when I thought we were getting somewhere we are back to square one..
    It's probably time for me to take another chill pill!:banghead:
    How have you guys been able to cope with this for so long? What's your secret for keeping sane?? Hats off to all of you btw!
    I hope I'm not the only one who has ups and downs..
     
  73. Diana&Tom

    Diana&Tom Well-Known Member

    Joined:
    Dec 29, 2009
    Awwwww (((Monica))))... you're due an off day, everyone feels like this from time to time and you've been doing sooooo well. Treating/managing FD is a labour of love and it does seem as if there is no time off from it... it's one of those things that does require a lot of monitoring in the early stages especially. Give yourself a big pat on the back and some kind of treat - your favourite takeaway for dinner, or a bowl of ice-cream (not sure why all our suggested treats are foodie ones but they do help!!)

    Josie's system is still unsure what's going on as far as her insulin dosing is concerned so maybe give it a couple more days on the 0.5u before you start fretting too much. All the dosing is still trial and error until we start to see a consistent pattern and a dose that gives the sort of curve we're looking for. More experienced Caninsulin users might be able to add some substance to this comment!

    Remember, if Caninsulin doesn't seem to be achieving the desired effect, you can try another insulin that works in a different way, basically a longer-lasting insulin that would hopefully keep Josie in better numbers for more hours of the day. I think that's a little way into the future but you can discuss it with your vet if you really feel you're not getting where you want to be... you do have to look after your own physical and mental health as well!

    I'm sure you'll bounce back, Monica... and know that how you're feeling is far from unusual. You just have to plod on a bit longer and meanwhile put some nice events, treats, whatever into your routine to get you back smiling again!
     
    Monica Lewis likes this.
  74. Monica Lewis

    Monica Lewis Member

    Joined:
    Apr 16, 2017
    Thank you Diana!
     
  75. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    I can tell you from my own experience with a very tricky kitty that what keeps me sane is relinquishing any notion that I'm in control of Teasel's FD. He responds the way he responds and I just follow by testing and giving my best (educated) guess about what dose he needs. And when I'm wrong, I do what I can to fix it. I'm in it for the long haul, have no expectation that I will get to a specific goal and just keep putting one foot in front of the other. I don't intend for this to sound defeatist because it's NOT where I'm coming from. FD - and a lot of other challenges in life - have taught me that wishing for something won't make it happen. You have to confront what's in front of you and do the best you can. Sermon over ... ;)
     
  76. Monica Lewis

    Monica Lewis Member

    Joined:
    Apr 16, 2017
    That's a healthy way to look at it. I suppose I have to accept that's it's not going to be the case when I have a plan and kitty will follow it and fall in line but the other way around where kitty tells me which way to go and I change my plans accordingly..
    I suppose I'm lucky as our case is not even that complicated and many dealing with a lot worse so seems petty getting frustrated, I guess I'm just an impatient person wanting to see some results or just settle somewhere..
    Thanks for helping me to put things into perspective
    I will also try to worry less and sleep more!
     
    Kris & Teasel and Diana&Tom like this.
  77. Diana&Tom

    Diana&Tom Well-Known Member

    Joined:
    Dec 29, 2009
    That's about it, Monica... I think a lot if not most people start out thinking that this is going to sort quite easily/quickly but FD isn't usually like that so the realisation is something of a shock to the system... but you'll be fine, it's actually quite liberating when you accept that it's not a race to the finishing line... you know you're among friends here, people who understand, so post any time you need a little moral support... you're only human!
     
    Kris & Teasel likes this.
  78. Monica Lewis

    Monica Lewis Member

    Joined:
    Apr 16, 2017
    Yes I think you're right about that Diana, it takes a little time to settle and realise what's the actual deal here.
    And thanks so much for your kind words, I probably should've just stuck to asking dosing advice but I thought I'd share how I felt cos if anyone would understand it's you lot!
    Thanks again for your support
     
    Kris & Teasel and Diana&Tom like this.
  79. Diana&Tom

    Diana&Tom Well-Known Member

    Joined:
    Dec 29, 2009
    Sharing how you feel is important actually... we all need propping up sometimes!
     
    Yong, Monica Lewis and Kris & Teasel like this.
  80. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

    Joined:
    Feb 18, 2015
    I have a kitty with a high dose condition and had more than a few meltdowns in the early days before I knew what was causing all my careful methodical care to fail miserably. I learned to take each BG reading as a snapshot of one moment in time but to focus on the movie that was being created as I got more and more data. My goal was and is, simply to keep my girl as happy and healthy as possible. Finally realizing you can't force mother nature and just taking each day as it comes and acting accordingly is the best way I've found to deal with this. And don't be afraid to let your needs supersede Josie's when you need to. We, as caregiver's need to look after ourselves well so we are able to keep up with our furry little kids when they really need our attention.
     
    Monica Lewis and Kris & Teasel like this.
  81. Monica Lewis

    Monica Lewis Member

    Joined:
    Apr 16, 2017
    Thanks ladies, you definitely turned around my way of looking at things. Now feel a bit silly whining about my trivial 'problems'... I'm sorry and thank you!
    I have to to learn to go with the flow and I shall stop trying to fit kitty in the box when kitty clearly wants to roam around outside of it!:cat:

    As for update Josie's BG was higher this morning but no insulin given as she wasn't eating again at all. She's down at the vet at the mo for a full check up, bloodwork and ultrasound, hopefully we'll get a little wiser by the end of the day...
     
    Kris & Teasel likes this.
  82. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

    Joined:
    Feb 18, 2015
    No apologies needed Monica. We've all been there and know venting is needed sometimes. IMHO, venting is just part of looking after yourself because there is no one size fits all treatment plan for all cats and it can be frustrating especially in the early days. Josie is a unique individual who is doing her version of the sugar dance and all you can do is follow her lead.
     
    Monica Lewis and Kris & Teasel like this.
  83. Diana&Tom

    Diana&Tom Well-Known Member

    Joined:
    Dec 29, 2009
    Gosh no don't apologise, Monica. We understand! And in a way, it's another corner turned because you'll stop striving for a perfect situation because one may not exist (not to be defeatist, but FD does, shall we say, keep us on our toes).
    The thing is, when you realise that this is how it is, for now at least, you relax more... and appreciate Josie and this situation for how things are right now... and don't worry too much about the future.
    Let us know what the vet says.
     
    Monica Lewis and Kris & Teasel like this.
  84. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    Wise words from these ladies. You'll feel much more calm if you go with the flow. :smuggrin:
     
    Monica Lewis likes this.
  85. Monica Lewis

    Monica Lewis Member

    Joined:
    Apr 16, 2017
    Josie had a blood test, X-ray and ultrasound -
    Blood work came back good, she's well hydrated, negative for ketones, pancreas and kidneys looking good, overall in good health apart from she has slightly dilated liver at bile ducts and bridging spondylosis at the end of her spine. Vet said if she's in no pain and not showing other symptoms there's no need to medicate her just yet. Will read up more about it to help her condition though.
    Was only given stomach upset medicine which we struggled to give her but she's recovering well anyway. Still none the wiser about the frequent 'off food days'...?
    She's back to eating ok.

    As for dosing the increased dose of .5u from .25u seem to be making no difference in the past few days?! Thought BG would go down noticeably lower as doubled the dose.. or get some in the blues at least?
    Could be down to her being unwell so probably will wait a few more days to collect more data and until she's fully back to normal. Then again I know I gotta stop having expectations or trying to make sense of things...:banghead: :D
    Any suggestions or thoughts about her SS or dosage would be much appreciated, thanks!

    Happy Sunday everyone! :)
     
  86. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    Sounds like a good vet report, Monica. :) You could try bumping up her dose to 0.75 u next AM dose. A lot of this is "try something, see what happens". You haven't seen any dark green numbers for quite a long time.
     
    Diana&Tom and Monica Lewis like this.
  87. Yong

    Yong Well-Known Member

    Joined:
    Jan 11, 2017
    Wonder if you should have gotten some pain meds to try with her, just in case. Kitties are VERY good at hiding pain. Could just see how one dose effects her: Does nothing or helps her :). If anything I would imagine the spondylosis could be a little uncomfortable to her. Pain can also contribute to higher BG. Maybe just something to think about?

    Sorry for all the elusive-ness; would'a could'a :p:smuggrin:
     
  88. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

    Joined:
    Feb 18, 2015
    Josie has been pretty flat the last few days. I agree it would be worth trying a bit more insulin to see what Josie does.
     
  89. Monica Lewis

    Monica Lewis Member

    Joined:
    Apr 16, 2017
    Good point, although I didn't notice any signs of pain of discomfort. When in the mood Josie runs around like a nutter doing double flips..
    Vet is on holiday for a week, will discuss properly upon next visit.
     
  90. Diana&Tom

    Diana&Tom Well-Known Member

    Joined:
    Dec 29, 2009
    Yes I'd be inclined to give a smidge more tomorrow morning if Josie gives you a pink... any bouncing should be long cleared now and it does seem as if she needs a higher dose now. It's worth a try anyway.
     
    Monica Lewis likes this.
  91. Monica Lewis

    Monica Lewis Member

    Joined:
    Apr 16, 2017
    Yes thanks I'll probably do that. Although she did surprise me with this eve's unexpected yellow PMPS..?
    Ps. Good thing I stopped with all the expectations and learning to go with the flow otherwise I'd probably go bonkers trying to make sense of this all.. lol:D
     
    Kris & Teasel, Yong and Diana&Tom like this.
  92. Diana&Tom

    Diana&Tom Well-Known Member

    Joined:
    Dec 29, 2009
    Welcome to the bonkers club, Monica!!!
     
  93. Yong

    Yong Well-Known Member

    Joined:
    Jan 11, 2017
    This may just have been a U.S. cartoon, he is Disney, but this is Bonker's D. Bobcat ;)
    [​IMG]
     
  94. Monica Lewis

    Monica Lewis Member

    Joined:
    Apr 16, 2017
    Haha brilliant!
     
  95. Monica Lewis

    Monica Lewis Member

    Joined:
    Apr 16, 2017
    Holding off on the dosage increase as Josie gave us a nice yellow amps this morning at 15/270 :cat:
     
  96. Elizabeth and Bertie

    Elizabeth and Bertie Well-Known Member

    Joined:
    Sep 6, 2010
    Nice. :cat:
    .
     
    Monica Lewis likes this.
  97. Monica Lewis

    Monica Lewis Member

    Joined:
    Apr 16, 2017
    Hello everyone, I need guidance once again please if you don't mind.
    As Josie doesn't seem to go low enough for long enough between shots plus she started giving us the odd lower pmps numbers these days I think a dosage adjustment might be needed here?
    Im thinking the sliding scale might be the way forward but if so I'm not quite sure what the guidelines would be for dosage adjustment.
    Would you be able to give me some guidelines for dosing Josie please, what amount of insulin for what ps numbers?
    To complicate things a bit further I am going away for 10 days in 2 weeks time leaving Josie under my husband's care which I am actually getting more and more anxious about:nailbiting: and as he is working full time and usually goes to bed with the chickens he won't be able to test nadir times..
    Is there a point changing things now or shall wait til i get back or maybe is there a way to a more cautious sliding scale to follow?
    Thanks so much, your input as always greatly appreciated!:cat:

    Have a nice day:)
     
  98. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    @JanetNJ is the go-to designer of sliding scales for Caninsulin. She'll be able to help. I have no experience with sliding scales myself.
     
    Monica Lewis likes this.
  99. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

    Joined:
    Feb 18, 2015
    I'm a bit flummoxed by Josie's numbers. It looks like 0.75u is bringing numbers down a bit more mid cycle but pre-shots are mostly about the same although there have been a couple nicely lower. I'm no good at sliding scales either and would also recommend having Janet take a look and offer her opinion. I'm wondering if we are missing something in the +3 to +5 period in the cycle and would suggest getting a few more tests in that time frame to fill in a bit more data.

    When you go on vacation, if you are concerned that DH won't be able to test mid cycle, you can reduce the dose slightly during your absence to keep numbers down but not necessarily optimal just for safety sake.
     
    Yong and Monica Lewis like this.
  100. Monica Lewis

    Monica Lewis Member

    Joined:
    Apr 16, 2017
    It doesn't have to be sliding scales it was just a thought, I'm open to all options..
     

Share This Page